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Sample records for accelerated partial-breast irradiation

  1. Conformal accelerated partial breast irradiation: State of the art

    Breast conserving treatment (breast conserving surgery followed by whole breast irradiation) has commonly been used in early breast cancer since many years. New radiation modalities have been recently developed in early breast cancers, particularly accelerated partial breast irradiation. Three-dimensional conformal accelerated partial breast irradiation is the most commonly used modality of radiotherapy. Other techniques are currently being developed, such as intensity-modulated radiotherapy, arc-therapy, and tomo-therapy. The present article reviews the indications, treatment modalities and side effects of accelerated partial breast irradiation. (authors)

  2. Accelerated partial breast irradiation: the case for current use

    The treatment of early stage breast cancer is evolving from traditional breast conservation techniques, employing conventionally fractionated whole breast irradiation, to techniques in which partial breast irradiation is used in an accelerated fractionation scheme. A growing body of evidence exists, including favorable findings. Additional studies are under way that may ultimately prove equivalence. The logic behind this approach is reviewed, and the currently available data are presented to support the current use of carefully applied partial breast irradiation techniques in appropriately selected and informed patients

  3. Accelerated partial breast irradiation trials: Diversity in rationale and design

    Seven randomised trials are currently testing accelerated partial breast irradiation against whole breast radiotherapy after breast conservation surgery. The trials are varied in the techniques used to deliver partial breast radiotherapy, reflecting the range of opportunities offered by advanced brachytherapy and teletherapy modalities. Dose schedules also vary between trials, but the most important point of difference between them reflects alternative concepts of clinical and planning target volumes. These are based mainly on the spatial pattern of relapse in retrospective and prospective studies, which report the majority of first local relapses close to the primary tumour site, and on the assumption that radiotherapy does not prevent the development of new primary tumours developing elsewhere in the breast. However, the pattern of ipsilateral breast tumour relapse is not accurately defined in the clinical literature and does not correspond closely to pathological findings. In addition, published data are consistent with a significant reduction in the rate of other quadrant relapse after whole breast radiotherapy. Regardless of the biological model of local tumour relapse and responsiveness to radiation, the ongoing trials will generate level I evidence for or against accelerated partial breast irradiation, provided patients are followed up long enough before the first reporting of results.

  4. Accelerated partial breast irradiation:advances and controversies

    Mani Akhtari; Bin S Teh

    2016-01-01

    The management of localized breast cancer has changed dramatically over the past three to four decades. Breast-conserving therapy, which involved lumpectomy followed by adjuvant irradiation, is now widely considered the standard of care in women with early-stage breast cancer. Accelerated partial breast irradiation (APBI), which involves focal irradiation of the lumpectomy cavity over a short period of time, has developed over the past two decades as an alternative to whole breast irradiation (WBI). Multiple APBI modalities have been developed including brachytherapy, external beam irradiation, and intraoperative irradiation. These new techniques have provided early-stage breast can-cer patients with shorter treatment duration and more focused irradiation, delivering very high biological doses to the region at a high risk of failures over a much shorter treatment course as compared with conventional radiotherapy. However, the advantages of APBI over conventional radiotherapy are controversial, including a higher risk of compli-cations reported in retrospective literature and shorter follow-up duration in the intraoperative APBI trials. Neverthe-less, APBI presents a valuable alternative to WBI for a selected population of women with early-stage breast cancer.

  5. Accelerated Partial Breast Irradiation with Intensity-Modulated Radiotherapy Is Feasible for Chinese Breast Cancer Patients

    He, Zhenyu; Wu, Sangang; Zhou, Juan; Li, Fengyan; Sun, Jiayan; Lin, Qin; Lin, Huanxin; Guan, Xunxing

    2014-01-01

    Purpose Several accelerated partial breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. The present study evaluated the feasibility, early toxicity, initial efficacy, and cosmetic outcomes of accelerated partial breast intensity-modulated radiotherapy (IMRT) for Chinese female patients with early-stage breast cancer after breast-conserving surgery. Methods A total of 38 patients met the inclusion criteria and an accelerated partial breast in...

  6. Accelerated Partial Breast Irradiation (APBI): A review of available techniques

    Breast conservation therapy (BCT) is the procedure of choice for the management of the early stage breast cancer. However, its utilization has not been maximized because of logistics issues associated with the protracted treatment involved with the radiation treatment. Accelerated Partial Breast Irradiation (APBI) is an approach that treats only the lumpectomy bed plus a 1-2 cm margin, rather than the whole breast. Hence because of the small volume of irradiation a higher dose can be delivered in a shorter period of time. There has been growing interest for APBI and various approaches have been developed under phase I-III clinical studies; these include multicatheter interstitial brachytherapy, balloon catheter brachytherapy, conformal external beam radiation therapy and intra-operative radiation therapy (IORT). Balloon-based brachytherapy approaches include Mammosite, Axxent electronic brachytherapy and Contura, Hybrid brachytherapy devices include SAVI and ClearPath. This paper reviews the different techniques, identifying the weaknesses and strength of each approach and proposes a direction for future research and development. It is evident that APBI will play a role in the management of a selected group of early breast cancer. However, the relative role of the different techniques is yet to be clearly identified

  7. Accelerated partial breast irradiation utilizing brachytherapy: patient selection and workflow

    Wobb, Jessica; Manyam, Bindu; Khan, Atif; Vicini, Frank

    2016-01-01

    Accelerated partial breast irradiation (APBI) represents an evolving technique that is a standard of care option in appropriately selected woman following breast conserving surgery. While multiple techniques now exist to deliver APBI, interstitial brachytherapy represents the technique used in several randomized trials (National Institute of Oncology, GEC-ESTRO). More recently, many centers have adopted applicator-based brachytherapy to deliver APBI due to the technical complexities of interstitial brachytherapy. The purpose of this article is to review methods to evaluate and select patients for APBI, as well as to define potential workflow mechanisms that allow for the safe and effective delivery of APBI. Multiple consensus statements have been developed to guide clinicians on determining appropriate candidates for APBI. However, recent studies have demonstrated that these guidelines fail to stratify patients according to the risk of local recurrence, and updated guidelines are expected in the years to come. Critical elements of workflow to ensure safe and effective delivery of APBI include a multidisciplinary approach and evaluation, optimization of target coverage and adherence to normal tissue guideline constraints, and proper quality assurance methods. PMID:26985202

  8. Accelerated Partial Breast Irradiation for Pure Ductal Carcinoma in Situ

    Purpose: To report outcomes for ductal carcinoma in situ (DCIS) treated with breast-conserving therapy using accelerated partial breast irradiation (APBI). Methods and Materials: From March 2001 to February 2009, 53 patients with Stage 0 breast cancer were treated with breast conserving surgery and adjuvant APBI. Median age was 62 years. All patients underwent excision with margins negative by ≥1 mm before adjuvant radiotherapy (RT). A total of 39 MammoSite brachytherapy (MS) patients and 14 three-dimensional conformal external beam RT (3DCRT) patients were treated to the lumpectomy bed alone with 34 Gy and 38.5 Gy, respectively. Of the DCIS cases, 94% were mammographically detected. All patients with calcifications had either specimen radiography or postsurgical mammography confirmation of clearance. Median tumor size was 6 mm, and median margin distance was 5 mm. There were no statistically significant differences according to APBI method for race/ethnicity, tumor detection method, tumor grade, estrogen receptor (ER) status, or use of tamoxifen (p = NS). Recurrence and survival were calculated using the Kaplan-Meier method. Cosmesis was scored by the Harvard criteria. Results: With a median follow-up of 3.6 years (range, 0.4-6.3 years), the overall and cause-specific survival rates were 98% and 100%, respectively. Three-year actuarial ipsilateral breast tumor recurrence was 2%. One failure was observed at the resection bed 11 months post-RT. No other elsewhere breast failures, regional recurrences, or distant metastases were noted. Cosmesis was excellent or good in 92.4% of cases, with no statistically significant differences according to the APBI method (92.3% with MammoSite and 92.8% with 3DCRT; p = 0.649). Conclusions: APBI as part of breast-conserving therapy for pure DCIS was associated with excellent local control and survival rates, with the vast majority of patients having good to excellent cosmesis. This finding supports the recent analysis by the

  9. External Beam Accelerated Partial Breast Irradiation Yields Favorable Outcomes in Patients with Prior Breast Augmentation

    RachelYi-FengLei; CharlesELeonard; JaneMKercher; TereseKaske

    2014-01-01

    Purpose: To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI) utilizing intensity modulated radiotherapy (IMRT) or 3-dimensional conformal radiotherapy (3D-CRT), both with image-guided radiotherapy (IGRT).Methods and Materials: 16 stage 0/I breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on c...

  10. Accelerated partial breast irradiation using 3D conformal radiotherapy: initial clinical experience

    Gatti, M.; Madeddu, A.; Malinverni, G.; Delmastro, E.; Bona, C.; Gabriele, P. [IRCC-Radiotherapy, Candiolo, TO (Italy); Baiotto, B.; Stasi, M. [IRCC-Medical Physics, Candiolo, TO (Italy); Ponzone, R.; Siatis, D. [IRCC-Surgery, Candiolo, TO (Italy)

    2006-11-15

    Accelerated partial breast irradiation using 3D-C.R.T. is technically sophisticate but feasible and acute toxicity to date has been minimal. A C.T.V.-to-P.T.V. margin of 10 mm seems to provide coverage for analyzed patients. However, more patients and additional studies will be needed to validate the accuracy of this margin, and longer follow-up will be needed to assess acute and chronic toxicity, tumor control, and cosmetic results. (author)

  11. Determination of exit skin dose for 192Ir intracavitary accelerated partial breast irradiation with thermoluminescent dosimeters

    Raffi, Julie A.; Stephen D. Davis; Hammer, Cliff G.; Micka, John A.; Kunugi, Keith A.; Musgrove, Jana E.; Winston, John W.; Ricci-Ott, Terresa J.; DeWerd, Larry A.

    2010-01-01

    Purpose: Intracavitary accelerated partial breast irradiation (APBI) has become a popular treatment for early stage breast cancer in recent years due to its shortened course of treatment and simplified treatment planning compared to traditional external beam breast conservation therapy. However, the exit dose to the skin is a major concern and can be a limiting factor for these treatments. Most treatment planning systems (TPSs) currently used for high dose-rate (HDR) 192Ir brachytherapy overe...

  12. Radiation recall secondary to adjuvant docetaxel after balloon-catheter based accelerated partial breast irradiation

    Wong, Nathan W. [Summer Intern, Mayo Clinic Arizona, Scottsdale, AZ (United States); Wong, William W., E-mail: wong.william@mayo.ed [Department of Radiation Oncology, Mayo Clinic Arizona, 13400 E. Shea Boulevard, Scottsdale, AZ 85259 (United States); Karlin, Nina J. [Division of Oncology, Mayo Clinic Arizona, Scottsdale, AZ (United States); Gray, Richard J. [Department of Surgery, Mayo Clinic Arizona, Scottsdale, AZ (United States)

    2010-08-15

    For early stage breast cancer, wide local excision and post-operative whole breast irradiation is a standard treatment. If adjuvant chemotherapy is recommended, radiation is usually given after completion of chemotherapy. In recent years, accelerated partial breast irradiation (APBI) with balloon-cathetered based brachytherapy has become an option for selected patients. For these patients, adjuvant chemotherapy would have to be administered after radiation. The sequence of treatment with radiation followed by chemotherapy results in increased risk of radiation recall reaction (RRD) in these patients. Docetaxel is becoming a more commonly used drug as adjuvant treatment for breast cancer. Here we report a case of docetaxel induced RRD after APBI with balloon-cathetered based brachytherapy. Such reaction would have an adverse impact on the cosmetic outcome and quality of life of the patient. For patients who develop an intense skin reaction after the administration of docetaxel following APBI, RRD should be considered in the differential diagnosis.

  13. Toxicity and cosmetic outcome of three-dimensional conformal radiotherapy for accelerated partial breast irradiation

    Gatti, M.; Bresciani, S.; Ponzone, R.; Panaia, R.; Salatino, A.; Stasi, M.; Gabriele, P. [IRCC, Candiolo (Italy)

    2011-10-15

    Full text of publication follows: Purpose.- To analyse the incidence and severity of acute and late normal tissue toxicity and cosmetic outcome using three - dimensional conformal radiotherapy to deliver accelerated partial breast irradiation. Patients and Methods.- 70 patients with stage I disease were treated with three-dimensional conformal radiotherapy for accelerated partial breast irradiation, in an approved protocol. The prescribed dose was 34 Gy in all patients delivered in 10 fractions over 5 consecutive days. On all CT scans gross tumor volume (GTV ) was defined around surgical clips. A 1.5 cm margin was added in order to account for clinical target volume (CTV) . A margin of 1 cm was added to CTI to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the specifications as dictated in the NSABP/RTOG protocol. After treatment, patients underwent a clinical and cosmetic evaluation every 3 months. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed by the physicians using the controlateral untreated breast as the reference (Harvard scale). Results.- Median patient age was 66 years (range 51-80). Median follow-up was 15 months (range 6-46). Tumor size was < 10 mm in 33 patients (53%) and > 2 cm in 4(6%). The mean value of the ratio between the PTV and the whole ipsilateral breast volume was 38 % and the median percentage whole breast volume that received 95 % of prescribed dose was 34% (range 16%-55%). The rate of G1 and G2 acute skin toxicity was 28% and 2% respectively and the late toxicity was 17% (G1). G2 or greater toxicities were not observed. The most pronounced G1 late toxicity was subcutaneous fibrosis, developed in 3 patients. The cosmetic outcome was excellent in 83% and good in 17%. Conclusion.- Accelerated partial breast irradiation using three-dimensional conformal radiotherapy is technically feasible with very low acute and late toxicity. Long

  14. Toxicity and cosmetic outcome of three-dimensional conformal radiotherapy for accelerated partial breast irradiation

    Full text of publication follows: Purpose.- To analyse the incidence and severity of acute and late normal tissue toxicity and cosmetic outcome using three - dimensional conformal radiotherapy to deliver accelerated partial breast irradiation. Patients and Methods.- 70 patients with stage I disease were treated with three-dimensional conformal radiotherapy for accelerated partial breast irradiation, in an approved protocol. The prescribed dose was 34 Gy in all patients delivered in 10 fractions over 5 consecutive days. On all CT scans gross tumor volume (GTV ) was defined around surgical clips. A 1.5 cm margin was added in order to account for clinical target volume (CTV) . A margin of 1 cm was added to CTI to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the specifications as dictated in the NSABP/RTOG protocol. After treatment, patients underwent a clinical and cosmetic evaluation every 3 months. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed by the physicians using the controlateral untreated breast as the reference (Harvard scale). Results.- Median patient age was 66 years (range 51-80). Median follow-up was 15 months (range 6-46). Tumor size was 2 cm in 4(6%). The mean value of the ratio between the PTV and the whole ipsilateral breast volume was 38 % and the median percentage whole breast volume that received 95 % of prescribed dose was 34% (range 16%-55%). The rate of G1 and G2 acute skin toxicity was 28% and 2% respectively and the late toxicity was 17% (G1). G2 or greater toxicities were not observed. The most pronounced G1 late toxicity was subcutaneous fibrosis, developed in 3 patients. The cosmetic outcome was excellent in 83% and good in 17%. Conclusion.- Accelerated partial breast irradiation using three-dimensional conformal radiotherapy is technically feasible with very low acute and late toxicity. Long-term results are needed to assess

  15. Accelerated Partial Breast Irradiation Consensus Statement From the American Society for Radiation Oncology (ASTRO)

    Purpose: To present guidance for patients and physicians regarding the use of accelerated partial-breast irradiation (APBI), based on current published evidence complemented by expert opinion. Methods and Materials: A systematic search of the National Library of Medicine's PubMed database yielded 645 candidate original research articles potentially applicable to APBI. Of these, 4 randomized trials and 38 prospective single-arm studies were identified. A Task Force composed of all authors synthesized the published evidence and, through a series of meetings, reached consensus regarding the recommendations contained herein. Results: The Task Force proposed three patient groups: (1) a 'suitable' group, for whom APBI outside of a clinical trial is acceptable, (2) a 'cautionary' group, for whom caution and concern should be applied when considering APBI outside of a clinical trial, and (3) an 'unsuitable' group, for whom APBI outside of a clinical trial is not generally considered warranted. Patients who choose treatment with APBI should be informed that whole-breast irradiation (WBI) is an established treatment with a much longer track record that has documented long-term effectiveness and safety. Conclusion: Accelerated partial-breast irradiation is a new technology that may ultimately demonstrate long-term effectiveness and safety comparable to that of WBI for selected patients with early breast cancer. This consensus statement is intended to provide guidance regarding the use of APBI outside of a clinical trial and to serve as a framework to promote additional clinical investigations into the optimal role of APBI in the treatment of breast cancer.

  16. Accelerated partial breast irradiation using 3D conformal radiation therapy (3D-CRT)

    Purpose: We present a novel three-dimensional conformal radiation therapy (3D-CRT) technique to treat the lumpectomy cavity, plus a 1.5-cm margin, in patients with early-stage breast cancer and study its clinical feasibility. Methods and Materials: A 3D-CRT technique for partial-breast irradiation was developed using archived CT scans from 7 patients who underwent an active breathing control study. The clinical feasibility of this technique was then assessed in 9 patients who were prospectively enrolled on an Investigational Review Board-approved protocol of partial-breast irradiation. The prescribed dose was 34 Gy in 5 patients and 38.5 Gy in 4 patients, delivered in 10 fractions twice daily over 5 consecutive days. The impact of both breathing motion and patient setup uncertainty on clinical target volume (CTV) coverage was studied, and an appropriate CTV-to-PTV (planning target volume) margin was calculated. Results: By adding a CTV-to-PTV 'breathing-only' margin of 5 mm, 98%-100% of the CTV remained covered by the 95% isodose surface at the extremes of normal inhalation and normal exhalation. The 'total' CTV-to-PTV margin employed to accommodate organ motion and setup error (10 mm) was found to be sufficient to accommodate the observed uncertainty in the delivery precision. Patient tolerance was excellent, and acute toxicity was minimal. No skin changes were noted during treatment, and at the initial 4-8-week follow-up visit, only mild localized hyperpigmentation and/or erythema was observed. No instances of symptomatic radiation pneumonitis have occurred. Conclusions: Accelerated partial-breast irradiation using 3D-CRT is technically feasible, and acute toxicity to date has been minimal. A CTV-to-PTV margin of 10 mm seems to provide coverage for most patients. However, more patients and additional studies will be needed to validate the accuracy of this margin, and longer follow-up will be needed to assess acute and chronic toxicity, tumor control, and cosmetic

  17. Accelerated partial breast irradiation with brachytherapy: patient selection and technique considerations

    Trifiletti DM

    2015-07-01

    Full Text Available Daniel M Trifiletti,1 Kara D Romano,1 Shayna L Showalter,2 Kelli A Reardon,1 Bruce Libby,1 Timothy N Showalter11Department of Radiation Oncology, 2Division of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USAAbstract: Accelerated partial breast irradiation (APBI through breast brachytherapy is a relatively recent development in breast radiotherapy that has gained international favor because of its reduction in treatment duration and normal tissue irradiation while maintaining favorable cancer-specific and cosmetic outcomes. Despite the fact that several large national trials have not reported final results yet, many providers are currently offering APBI to select patients and APBI is listed as a treatment option for selecting patients in the National Comprehensive Cancer Network guidelines. Multiple consensus guidelines exist in selecting patients for APBI, some with conflicting recommendations. In this review, the existing patient selection guidelines are reported, compared, and critiqued, grouping them in helpful subcategories. Unique patient and technical selection factors for APBI with brachytherapy are explored.Keywords: breast cancer, APBI, breast brachytherapy

  18. Accelerated partial breast irradiation using robotic radiotherapy: a dosimetric comparison with tomotherapy and three-dimensional conformal radiotherapy

    Rault, Erwann; Lacornerie, Thomas; Dang, Hong-Phuong; Crop, Frederik; Lartigau, Eric; Reynaert, Nick; Pasquier, David

    2016-01-01

    Background Accelerated partial breast irradiation (APBI) is a new breast treatment modality aiming to reduce treatment time using hypo fractionation. Compared to conventional whole breast irradiation that takes 5 to 6 weeks, APBI is reported to induce worse cosmetic outcomes both when using three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). These late normal tissue effects may be attributed to the dose volume effect because a large portion of the no...

  19. Predictors of Local Recurrence Following Accelerated Partial Breast Irradiation: A Pooled Analysis

    Shah, Chirag; Wilkinson, John Ben [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Lyden, Maureen [Biostat Inc., Tampa, Florida (United States); Beitsch, Peter [Dallas Breast Center, Dallas, Texas (United States); Vicini, Frank A., E-mail: fvicini@pol.net [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2012-04-01

    Purpose: To analyze a pooled set of nearly 2,000 patients treated on the American Society of Breast Surgeons (ASBS) Mammosite Registry Trial and at William Beaumont Hospital (WBH) to identify factors associated with local recurrence following accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,961 women underwent partial breast irradiation between April 1993 and November 2010 as part of the ASBS Registry Trial or at WBH. Rates of ipsilateral breast tumor recurrence (IBTR), regional recurrence (RR), distant metastases (DM), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed for each group and for the pooled cohort. Clinical, pathologic, and treatment-related variables were analyzed including age, tumor stage/size, estrogen receptor status, surgical margins, and lymph node status to determine their association with IBTR. Results: The two groups weres similar, but WBH patients were more frequently node positive, had positive margins, and were less likely to be within the American Society for Radiation Oncology-unsuitable group. At 5 years, the rates of IBTR, RR, DM, DFS, CSS, and OS for the pooled group of patients were 2.9%, 0.5%, 2.4%, 89.1%, 98.5%, and 91.8%, respectively. The 5-year rate of true recurrence/marginal miss was 0.8%. Univariate analysis of IBTR found that negative estrogen receptor status (odds ratio [OR], 2.83, 95% confidence interval 1.55-5.13, p = 0.0007) was the only factor significantly associated with IBTR, while a trend was seen for age less than 50 (OR 1.80, 95% confidence interval 0.90-3.58, p = 0.10). Conclusions: Excellent 5-year outcomes were seen following APBI in over 1,900 patients. Estrogen receptor negativity was the only factor associated with IBTR, while a trend for age less than 50 was noted. Significant differences in factors associated with IBTR were noted between cohorts, suggesting that factors driving IBTR may be predicated based on the risk

  20. Predictors of Local Recurrence Following Accelerated Partial Breast Irradiation: A Pooled Analysis

    Purpose: To analyze a pooled set of nearly 2,000 patients treated on the American Society of Breast Surgeons (ASBS) Mammosite Registry Trial and at William Beaumont Hospital (WBH) to identify factors associated with local recurrence following accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,961 women underwent partial breast irradiation between April 1993 and November 2010 as part of the ASBS Registry Trial or at WBH. Rates of ipsilateral breast tumor recurrence (IBTR), regional recurrence (RR), distant metastases (DM), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed for each group and for the pooled cohort. Clinical, pathologic, and treatment-related variables were analyzed including age, tumor stage/size, estrogen receptor status, surgical margins, and lymph node status to determine their association with IBTR. Results: The two groups weres similar, but WBH patients were more frequently node positive, had positive margins, and were less likely to be within the American Society for Radiation Oncology-unsuitable group. At 5 years, the rates of IBTR, RR, DM, DFS, CSS, and OS for the pooled group of patients were 2.9%, 0.5%, 2.4%, 89.1%, 98.5%, and 91.8%, respectively. The 5-year rate of true recurrence/marginal miss was 0.8%. Univariate analysis of IBTR found that negative estrogen receptor status (odds ratio [OR], 2.83, 95% confidence interval 1.55–5.13, p = 0.0007) was the only factor significantly associated with IBTR, while a trend was seen for age less than 50 (OR 1.80, 95% confidence interval 0.90–3.58, p = 0.10). Conclusions: Excellent 5-year outcomes were seen following APBI in over 1,900 patients. Estrogen receptor negativity was the only factor associated with IBTR, while a trend for age less than 50 was noted. Significant differences in factors associated with IBTR were noted between cohorts, suggesting that factors driving IBTR may be predicated based on the risk

  1. First results of the preoperative accelerated partial breast irradiation (PAPBI) trial

    Background and purpose: The aim of this study is to assess the toxicity and cosmetic outcome of preoperative accelerated partial breast irradiation (PAPBI) for breast cancer patients with low risk on local recurrence. Material and methods: Women aged ⩾60 years with an invasive, unifocal ⩽3 cm on MRI, (non-lobular) adenocarcinoma of the breast and a negative sentinel node received PAPBI (40 Gray in 10 fractions over 2 weeks). Six weeks after radiotherapy a wide local excision was performed. Results: 70 patients with a median follow-up of 23 months (3–44 months) were evaluated. The overall postoperative infection rate was 11%. At 1, 2 and 3 years of follow-up respectively 89%, 98% and 100% of patients had no or mild induration-fibrosis. Fibrosis was only found in a small volume of the breast. The global cosmetic outcome was good to excellent in 77% at 6 months to 100% at 3 years. Two patients developed a local recurrence. Conclusion: Our first results show limited fibrosis in a small volume and good to excellent cosmetic outcome. In selected patients, preoperative radiotherapy appears to be a good option for breast conserving therapy

  2. Comparison of accelerated partial breast irradiation via multicatheter interstitial brachytherapy versus whole breast radiation

    Brachytherapy as adjuvant treatment for early-stage breast cancer has become widely available and offers patients an expedited treatment schedule. Given this, many women are electing to undergo brachytherapy in lieu of standard fractionation radiotherapy. We compare outcomes between patients treated with accelerated partial breast irradiation (APBI) via multicatheter interstitial brachytherapy versus patients who were also eligible for and offered APBI but who chose whole breast radiation (WBI). Patients treated from December 2002 through May 2007 were reviewed. Selection criteria included patients with pTis-T2N0 disease, ≤ 3 cm unifocal tumors, and negative margins who underwent breast conservation surgery. Local control (LC), cause-specific (CSS) and overall survival (OS) were analyzed. 202 patients were identified in the APBI cohort and 94 patients in the WBI cohort. Median follow-up for both groups exceeded 60 months. LC was 97.0% for the APBI cohort and 96.2% for the WBI cohort at 5 years (ns). Classification by 2010 ASTRO APBI consensus statement categories did not predict worse outcomes. APBI via multicatheter interstitial brachytherapy provides similar local failure rates compared to WBI at 5 years for properly selected patients. Excellent results were seen despite the high fraction of younger patients (< 60 years old) and patients with DCIS

  3. Comparison of accelerated partial breast irradiation via multicatheter interstitial brachytherapy versus whole breast radiation

    Ferraro Daniel J

    2012-03-01

    Full Text Available Abstract Background Brachytherapy as adjuvant treatment for early-stage breast cancer has become widely available and offers patients an expedited treatment schedule. Given this, many women are electing to undergo brachytherapy in lieu of standard fractionation radiotherapy. We compare outcomes between patients treated with accelerated partial breast irradiation (APBI via multicatheter interstitial brachytherapy versus patients who were also eligible for and offered APBI but who chose whole breast radiation (WBI. Methods Patients treated from December 2002 through May 2007 were reviewed. Selection criteria included patients with pTis-T2N0 disease, ≤ 3 cm unifocal tumors, and negative margins who underwent breast conservation surgery. Local control (LC, cause-specific (CSS and overall survival (OS were analyzed. Results 202 patients were identified in the APBI cohort and 94 patients in the WBI cohort. Median follow-up for both groups exceeded 60 months. LC was 97.0% for the APBI cohort and 96.2% for the WBI cohort at 5 years (ns. Classification by 2010 ASTRO APBI consensus statement categories did not predict worse outcomes. Conclusion APBI via multicatheter interstitial brachytherapy provides similar local failure rates compared to WBI at 5 years for properly selected patients. Excellent results were seen despite the high fraction of younger patients (

  4. Impact of residual and intrafractional errors on strategy of correction for image-guided accelerated partial breast irradiation

    Guo Xiao-Mao; Yang Zhao-Zhi; Pan Zi-Qiang; Yu Xiao-Li; Chen Jia-Yi; Hu Wei-Gang; Cai Gang; Shao Zhi-Min; Jiang Guo-Liang

    2010-01-01

    Abstract Background The cone beam CT (CBCT) guided radiation can reduce the systematic and random setup errors as compared to the skin-mark setup. However, the residual and intrafractional (RAIF) errors are still unknown. The purpose of this paper is to investigate the magnitude of RAIF errors and correction action levels needed in cone beam computed tomography (CBCT) guided accelerated partial breast irradiation (APBI). Methods Ten patients were enrolled in the prospective study of CBCT guid...

  5. Accelerated partial breast irradiation: Bi-fractionated 40 Gy in one week. A French pilot phase II study

    Purpose: Since 2009, accelerated partial breast irradiation (APBI) in North America has been allowed to be used for selected group of patients outside a clinical trial according to the ASTRO consensus statement. In France, accelerated partial breast irradiation is still considered investigational, several clinical trials have been conducted using either intraoperative (Montpellier) or MammositeR (Lille) or brachytherapy modality (PAC GERICO/FNCLCC). Here, we report the original dosimetric results of this technique. Patients and methods: Since October 2007, Institut Gustave-Roussy has initiated a phase II trial using 3D-conformal accelerated partial breast irradiation (40 Gy in 10 fractions BID in 1 week). Twenty-five patients with pT1N0 breast cancer were enrolled and were treated by two mini-tangent photons beams (6 MV) and an 'en face' electron beam (6-22 MeV). Results: The mean clinical target volume and planning target volume were respectively 15.1 cm3 (range: 5.2-28.7 cm3) and 117 cm3 (range: 52-185 cm3). The planning target volume coverage was adequate with at least a mean of 99% of the volume encompassed by the isodose 40 Gy. The mean dose to the planning target volume was 41.8 Gy (range: 41-42.4 Gy). Dose inhomogeneity did not exceed 5%. Mean doses to the ipsilateral lung and heart were 1.6 Gy (range: 1.0-2.3 Gy) and 1.2 Gy (range: 1.0-1.6 Gy), respectively. Conclusion: The 3D conformal accelerated partial breast irradiation using two mini-tangent and 'en face' electron beams using a total dose of 40 Gy in 10 fractions BID over 5 days achieves appropriate planning target volume coverage and offers significant normal-tissue sparing (heart, lung). Longer follow-up is needed to evaluate the tissue tolerance to this radiation dose. (authors)

  6. Dosimetric comparison of three dimensional conformal radiation therapy versus intensity modulated radiation therapy in accelerated partial breast irradiation

    Moorthy, S; H S Elhateer; SKD Majumdar; Mohammed, S; Patnaik, R; Narayanamurty

    2016-01-01

    Aim of Study: Breast conserving surgery (BCS) is the standard treatment for stage I and II breast cancer. Multiple studies have shown that recurrences after lumpectomy occur mainly in or near the tumor bed. Use of accelerated partial breast irradiation (APBI) allows for significant reduction in the overall treatment time that results in increasing patient compliance and decreasing healthcare costs. We conducted a treatment planning study to evaluate the role of intensity modulated radiation t...

  7. Mixed modality treatment planning of accelerated partial breast irradiation: to improve complex dosimetry cases

    Although 3D-conformal accelerated partial breast irradiation (APBI) is widely used, several questions still remain such as what are the optimal treatment planning modalities. Indeed, some patients may have an unfavorable anatomy and/or inadequate dosimetric constraints could be fulfilled ('complex cases'). In such cases, we wondered which treatment planning modality could be applied to achieve 3D-conformal APBI (2 mini-tangents and an 'en face' electron field or non-coplanar photon multiple fields; or a mixed technique combining non-coplanar photon multiple fields with an 'en face' electron beam). From October 2007 to March 2010, 55 patients with pT1N0 breast cancer were enrolled in a phase II APBI trial. Among them, 7 patients were excluded as they were considered as 'complex cases'. A dosimetric comparison was performed according to the 3 APBI modalities mentioned above and assessed: planning treatment volume (PTV) coverage, PTV/whole breast ratio, lung and heart distance within irradiated field and exposure of organs at risk (OAR). Adequate PTV coverage was obtained with the 3 different treatment planning. Regarding OAR exposure, the 'mixed technique' seemed to reduce the volume of non-target breast tissue in 4 cases compared to the other techniques (in only 1 case), with the mean V50% at 44.9% (range, 13.4 - 56.9%) for the mixed modality compared to 51.1% (range, 22.4 - 63.4%) and 51.8% (range, 23.1 - 59.5%) for the reference and non-coplanar techniques, respectively. The same trend was observed for heart exposure. The mixed technique showed a promising trend of reducing the volume of non-target breast tissue and heart exposure doses in APBI 'complex cases'

  8. Potential of using cerium oxide nanoparticles for protecting healthy tissue during accelerated partial breast irradiation (APBI).

    Ouyang, Zi; Mainali, Madan Kumar; Sinha, Neeharika; Strack, Guinevere; Altundal, Yucel; Hao, Yao; Winningham, Thomas Andrew; Sajo, Erno; Celli, Jonathan; Ngwa, Wilfred

    2016-04-01

    The purpose of this study is to investigate the feasibility of using cerium oxide nanoparticles (CONPs) as radical scavengers during accelerated partial breast irradiation (APBI) to protect normal tissue. We hypothesize that CONPs can be slowly released from the routinely used APBI balloon applicators-via a degradable coating-and protect the normal tissue on the border of the lumpectomy cavity over the duration of APBI. To assess the feasibility of this approach, we analytically calculated the initial concentration of CONPs required to protect normal breast tissue from reactive oxygen species (ROS) and the time required for the particles to diffuse to various distances from the lumpectomy wall. Given that cerium has a high atomic number, we took into account the possible inadvertent dose enhancement that could occur due to the photoelectric interactions with radiotherapy photons. To protect against a typical MammoSite treatment fraction of 3.4Gy, 5ng·g(-1) of CONPs is required to scavenge hydroxyl radicals and hydrogen peroxide. Using 2nm sized NPs, with an initial concentration of 1mg·g(-1), we found that 2-10days of diffusion is required to obtain desired concentrations of CONPs in regions 1-2cm away from the lumpectomy wall. The resultant dose enhancement factor (DEF) is less than 1.01 under such conditions. Our results predict that CONPs can be employed for radioprotection during APBI using a new design in which balloon applicators are coated with the NPs for sustained/controlled in-situ release from within the lumpectomy cavity. PMID:27053452

  9. Outcomes After Accelerated Partial Breast Irradiation in Patients With ASTRO Consensus Statement Cautionary Features

    Purpose: To evaluate outcomes among women with American Society for Radiation Oncology (ASTRO) consensus statement cautionary features treated with brachytherapy-based accelerated partial breast irradiation (APBI). Methods and Materials: Between March 2001 and June 2006, 322 consecutive patients were treated with high-dose-rate (HDR) APBI at the University of Wisconsin. A total of 136 patients were identified who met the ASTRO cautionary criteria. Thirty-eight (27.9%) patients possessed multiple cautionary factors. All patients received 32 to 34 Gy in 8 to 10 twice-daily fractions using multicatheter (93.4%) or Mammosite balloon (6.6%) brachytherapy. Results: With a median follow-up of 60 months, there were 5 ipsilateral breast tumor recurrences (IBTR), three local, and two loco-regional. The 5-year actuarial rate of IBTR was 4.8% ± 4.1%. The 5-year disease-free survival was 89.6%, with a cause-specific survival and overall survival of 97.6% and 95.3%, respectively. There were no IBTRs among 32 patients with ductal carcinoma in situ (DCIS) vs. 6.1% for patients with invasive carcinoma (p = 0.24). Among 104 patients with Stage I or II invasive carcinoma, the IBTR rate for patients considered cautionary because of age alone was 0% vs. 12.7% in those deemed cautionary due to histopathologic factors (p = 0.018). Conclusions: Overall, we observed few local recurrences among patients with cautionary features. Women with DCIS and patients 50 to 59 years of age with Stage I/II disease who otherwise meet the criteria for suitability appear to be at a low risk of IBTR. Patients with tumor-related cautionary features will benefit from careful patient selection.

  10. Intrafractional Target Motions and Uncertainties of Treatment Setup Reference Systems in Accelerated Partial Breast Irradiation

    Purpose: This study investigated the magnitude of intrafractional motion and level of accuracy of various setup strategies in accelerated partial breast irradiation (APBI) using three-dimensional conformal external beam radiotherapy. Methods and Materials: At lumpectomy, gold fiducial markers were strategically sutured to the surrounding walls of the cavity. Weekly fluoroscopy imaging was conducted at treatment to investigate the respiration-induced target motions. Daily pre- and post-RT kV imaging was performed, and images were matched to digitally reconstructed radiographs based on bony anatomy and fiducial markers, respectively, to determine the intrafractional motion magnitudes over the course of treatment. The positioning differences of the laser tattoo- and the bony anatomy-based setups compared with those of the marker-based setup (benchmark) were also determined. The study included 21 patients. Results: Although lung exhibited significant motion, the average marker motion amplitude on the fluoroscopic image was about 1 mm. Over a typical treatment time period, average intrafractional motion magnitude was 4.2 mm and 2.6 mm based on the marker and bony anatomy matching, respectively. The bony anatomy- and laser tattoo-based interfractional setup errors, with respect to the fiducial marker-based setup, were 7.1 and 9.0 mm, respectively. Conclusions: Respiration has limited effects on the target motion during APBI. Bony anatomy-based treatment setup improves the accuracy relative to that of the laser tattoo-based setup approach. Since fiducial markers are sutured directly to the surgical cavity, the marker-based approach can further improve the interfractional setup accuracy. On average, a seroma cavity exhibits intrafractional motion of more than 4 mm, a magnitude that is larger than that which is otherwise derived based on bony anatomy matching. A seroma-specific marker-based approach has the potential to improve treatment accuracy by taking the true inter

  11. Phase II trial of proton beam accelerated partial breast irradiation in breast cancer

    Background and purpose: Here, we report the results of our phase II, prospective study of proton beam accelerated partial breast irradiation (PB-APBI) in patients with breast cancer after breast conserving surgery (BCS). Materials and methods: Thirty patients diagnosed with breast cancer were treated with PB-APBI using a single-field proton beam or two fields after BCS. The treatment dose was 30 cobalt gray equivalent (CGE) in six CGE fractions delivered once daily over five consecutive working days. Results: All patients completed PB-APBI. The median follow-up time was 59 months (range: 43–70 months). Of the 30 patients, none had ipsilateral breast recurrence or regional or distant metastasis, and all were alive at the last follow-up. Physician-evaluated toxicities were mild to moderate, except in one patient who had severe wet desquamation at 2 months that was not observed beyond 6 months. Qualitative physician cosmetic assessments of good or excellent were noted in 83% and 80% of the patients at the end of PB-APBI and at 2 months, respectively, and decreased to 69% at 3 years. A good or excellent cosmetic outcome was noted in all patients treated with a two-field proton beam at any follow-up time point except for one. For all patients, the mean percentage breast retraction assessment (pBRA) value increased significantly during the follow-up period (p = 0.02); however, it did not increase in patients treated with two-field PB-APBI (p = 0.3). Conclusions: PB-APBI consisting of 30 CGE in six CGE fractions once daily for five consecutive days can be delivered with excellent disease control and tolerable skin toxicity to properly selected patients with early-stage breast cancer. Multiple-field PB-APBI may achieve a high rate of good-to-excellent cosmetic outcomes. Additional clinical trials with larger patient groups are needed

  12. Accelerated Partial Breast Irradiation With Interstitial Implants: Risk Factors Associated With Increased Local Recurrence

    Purpose: To analyze patient, disease, and treatment-related factors regarding their impact on local control after interstitial multicatheter accelerated partial breast irradiation (APBI). Methods and Materials: Between November 2000 and April 2005, 274 patients with early breast cancer were recruited for the German-Austrian APBI Phase II trial ( (ClinicalTrials.gov) identifier: NCT00392184). In all, 64% (175/274) of the patients received pulsed-dose-rate (PDR) brachytherapy and 36% (99/274) received high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3 to 4 days. Results: The median follow-up time was 64 months (range, 9-110). The actuarial 5-year local recurrence free survival rate (5-year LRFS) was 97.7%. Comparing patients with an age <50 years (49/274) vs. ≥50 years (225/274), the 5-year LRFS resulted in 92.5% and 98.9% (exact p = 0.030; 99% confidence interval, 0.029-0.032), respectively. Antihormonal treatment (AHT) was not applied in 9% (24/274) of the study population. The 5-year LRFS was 99% and 84.9% (exact p = 0.0087; 99% confidence interval, 0.0079-0.0094) in favor of the patients who received AHT. Lobular histology (45/274) was not associated with worse local control compared with all other histologies (229/274). The 5-year LRFS rates were 97.6% and 97.8%, respectively. Conclusions: Local control at 5 years is excellent and comparable to therapeutic successes reported from corresponding whole-breast irradiation trials. Our data indicate that patients <50 years of age ought to be excluded from APBI protocols, and that patients with hormone-sensitive breast cancer should definitely receive adjuvant AHT when interstitial multicatheter APBI is performed. Lobular histology need not be an exclusion criterion for future APBI trials.

  13. Comparative dosimetric findings using accelerated partial breast irradiation across five catheter subtypes

    Accelerated partial breast irradiation (APBI) with balloon and strut adjusted volume implants (SAVI) show promising results with excellent tumor control and minimal toxicity. Knowing the factors that contribute to a high skin dose, rib dose, and D95 coverage may reduce toxicity, improve tumor control, and help properly predict patient outcomes following APBI. A retrospective analysis of 594 patients treated with brachytherapy based APBI at a single institution from May 2008 to September 2014 was grouped by applicator subtype. Patients were treated to a total of 34 Gy (3.4 Gy x 10 fractions over 5 days delivered BID) targeting a planning target volume (PTV) 1.0 cm beyond the lumpectomy cavity using a high dose rate source. SAVI devices had the lowest statistically significant values of DmaxSkin (81.00 ± 29.83), highest values of D90 (101.50 ± 3.66), and D95 (96.09 ± 4.55). SAVI-mini devices had the lowest statistically significant values of DmaxRib (77.66 ± 32.92) and smallest V150 (18.01 ± 3.39). Multi-lumen balloons were able to obtain the smallest V200 (5.89 ± 2.21). Strut-based applicators were more likely to achieve a DmaxSkin and a DmaxRib less than or equal to 100 %. The effect of PTV on V150 showed a strong positive relationship (p < .001). PTV and DmaxSkin showed a weak negative relationship in multi-lumen applicators (p = .016) and SAVI-mini devices (p < .001). PTV and DmaxRib showed a weak negative relationship in multi-lumen applicators (p = .009), SAVI devices (p < .001), and SAVI-mini devices (p < .001). PTV volume is strongly correlated with V150 in all devices and V200 in strut based devices. Larger PTV volumes result in greater V150 and V200, which could help predict potential risks for hotspots and resulting toxicities in these devices. PTV volume is also weakly negatively correlated with max skin dose and max rib dose, meaning that as the PTV volumes increase one can expect slightly smaller max skin and rib doses. Strut based applicators are

  14. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

    Ott, Oliver J.; Lotter, Michael; Fietkau, Rainer; Strnad, Vratislav [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2009-03-15

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p = 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven

  15. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven that

  16. Surgical Clips Assist in the Visualization of the Lumpectomy Cavity in Three-Dimensional Conformal Accelerated Partial-Breast Irradiation

    Purpose: To determine to what extent the placement of surgical clips helps delineate the cavity in three-dimensional conformal accelerated partial-breast irradiation. Patients and Methods: Planning CT images of 100 lumpectomy cavities were reviewed in a cohort of 100 consecutive patients. The cavities were determined and categorized by two radiation oncologists according to cavity visualization score criteria and the breast density score. The two physicians first attempted to delineate the lumpectomy cavity without clips and then with clips. Results: In the case of high-density mammary tissue, the breast remodeling done during surgery does not enable the lumpectomy cavity to be sufficiently visualized. The use of surgical clips significantly improved the ability to visualize the lumpectomy cavity, with a 69% rate of concordance between physicians regardless of the breast tissue density. Conclusion: The placement of surgical clips at lumpectomy enables visualization of the lumpectomy cavity and allows upgrading of the cavity visualization score on CT scans obtained for accelerated partial-breast irradiation treatment planning.

  17. Persistent seroma after intraoperative placement of MammoSite for accelerated partial breast irradiation: Incidence, pathologic anatomy, and contributing factors

    Purpose: To investigate the incidence of, and possible factors associated with, seroma formation after intraoperative placement of the MammoSite catheter for accelerated partial breast irradiation. Methods and Materials: This study evaluated 38 patients who had undergone intraoperative MammoSite catheter placement at lumpectomy or reexcision followed by accelerated partial breast irradiation with 34 Gy in 10 fractions. Data were collected regarding dosimetric parameters, including the volume of tissue enclosed by the 100%, 150%, and 200% isodose shells, dose homogeneity index, and maximal dose at the surface of the applicator. Clinical and treatment-related factors were analyzed, including patient age, patient weight, history of diabetes and smoking, use of reexcision, interval between surgery and radiotherapy, total duration of catheter placement, total excised specimen volume, and presence or absence of postprocedural infection. Seroma was verified by clinical examination, mammography, and/or ultrasonography. Persistent seroma was defined as seroma that was clinically detectable >6 months after radiotherapy completion. Results: After a median follow-up of 17 months, the overall rate of any detectable seroma was 76.3%. Persistent seroma (>6 months) occurred in 26 (68.4%) of 38 patients, of whom 46% experienced at least modest discomfort at some point during follow-up. Of these symptomatic patients, 3 required biopsy or complete cavity excision, revealing squamous metaplasia, foreign body giant cell reaction, fibroblasts, and active collagen deposition. Of the analyzed dosimetric, clinical, and treatment-related variables, only body weight correlated positively with the risk of seroma formation (p = 0.04). Postprocedural infection correlated significantly (p = 0.05) with a reduced risk of seroma formation. Seroma was associated with a suboptimal cosmetic outcome, because excellent scores were achieved in 61.5% of women with seroma compared with 83% without seroma

  18. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Five-year Results of 100 Patients

    Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Hsu, Howard; Fenton-Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Roses, Daniel; Guth, Amber [Department of Surgery, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Jozsef, Gabor [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Goldberg, Judith D. [Division of Biostastistics, Department of Environmental Medicine, New York University School of Medicine and Langone Medical Center, New York, New York (United States); DeWyngaert, J. Keith [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States)

    2012-11-01

    Purpose: To report the 5-year results of a prospective trial of three-dimensional conformal external beam radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation in the prone position. Methods and Materials: Postmenopausal patients with Stage I breast cancer with nonpalpable tumors <2 cm, negative margins and negative nodes, positive hormone receptors, and no extensive intraductal component were eligible. The trial was offered only after eligible patients had refused to undergo standard whole-breast radiotherapy. Patients were simulated and treated on a dedicated table for prone setup. 3D-CRT was delivered at a dose of 30 Gy in five 6-Gy/day fractions over 10 days with port film verification at each treatment. Rates of ipsilateral breast failure, ipsilateral nodal failure, contralateral breast failure, and distant failure were estimated using the cumulative incidence method. Rates of disease-free, overall, and cancer-specific survival were recorded. Results: One hundred patients were enrolled in this institutional review board-approved prospective trial, one with bilateral breast cancer. One patient withdrew consent after simulation, and another patient elected to interrupt radiotherapy after receiving two treatments. Ninety-eight patients were evaluable for toxicity, and, in 1 case, both breasts were treated with partial breast irradiation. Median patient age was 68 years (range, 53-88 years); in 55% of patients the tumor size was <1 cm. All patients had hormone receptor-positive cancers: 87% of patients underwent adjuvant antihormone therapy. At a median follow-up of 64 months (range, 2-125 months), there was one local recurrence (1% ipsilateral breast failure) and one contralateral breast cancer (1% contralateral breast failure). There were no deaths due to breast cancer by 5 years. Grade 3 late toxicities occurred in 2 patients (one breast edema, one transient breast pain). Cosmesis was rated good/excellent in 89% of patients with at least 36

  19. Stereotactic Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Rationale, Feasibility, and Early Experience Using the CyberKnife Radiosurgery Delivery Platform

    Obayomi-Davies, Olusola; Kole, Thomas P.; Oppong, Bridget; Rudra, Sonali; Makariou, Erini V.; Lloyd D Campbell; Hozaifa M Anjum; Sean P Collins; Unger, Keith; WILLEY, SHAWNA; Tousimis, Eleni; Collins, Brian T.

    2016-01-01

    Purpose The efficacy of accelerated partial breast irradiation (APBI) utilizing brachytherapy or conventional external beam radiation has been studied in early-stage breast cancer treated with breast-conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rati...

  20. Stereotactic Accelerated Partial Breast Irradiation (SAPBI) for Early Stage Breast Cancer: Rationale, Feasibility and Early Experience using the CyberKnife Radiosurgery Delivery Platform

    Olusola eOBAYOMI-DAVIES; Kole, Thomas P.; Bridget eOppong; Sonali eRudra; Erini eMakariou; Lloyd D Campbell; Hozaifa M Anjum; Sean P Collins; Keith eUnger; Willey, Shawna C.; Eleni A Tousimis; Brian Timothy Collins

    2016-01-01

    Purpose: The efficacy of accelerated partial breast irradiation (APBI) utilizing brachytherapy or conventional external beam radiation has been studied in early stage breast cancer treated with breast conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rat...

  1. Phase II trial of 3D-conformal accelerated partial breast irradiation: Lessons learned from patients and physicians’ evaluation

    Introduction: The present study prospectively reported both physicians’ and patients’ assessment for toxicities, cosmetic assessment and patients’ satisfaction after 3D-conformal accelerated partial breast irradiation (APBI). Materials and Methods: From October 2007 to September 2009, 30 early breast cancer patients were enrolled in a 3D-conformal APBI Phase II trial (40 Gy/10 fractions/5 days). Treatment related toxicities and cosmetic results were assessed by both patients and physicians at each visit (at 1, 2, 6 months, and then every 6 months). Patient satisfaction was also scored. Results: After a median follow-up of 27.7 months, all patients were satisfied with APBI treatment, regardless of cosmetic results or late adverse events. Good/excellent cosmetic results were noticed by 80% of patients versus 92% of cases by radiation oncologists. Breast pain was systematically underestimated by physicians (8–20% vs. 16.6–26.2%; Kappa coefficient KC = 0.16–0.44). Grade 1 and 2 fibrosis and/or breast retraction occurred in 7–12% of patients and were overestimated by patients (KC = 0.14–0.27). Conclusions: Present results have shown discrepancies between patient and physician assessments. In addition to the assessment of efficacy and toxicity after 3D-conformal APBI, patients’ cosmetic results consideration and satisfaction should be also evaluated.

  2. Fat necrosis in women with early-stage breast cancer treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy

    Purpose: To report the incidence of clinical, pathological and radiological fat necrosis (FN) in women treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy (BRT) for early-stage breast cancer and to study certain variables associated with it. Methods and materials: Between May 2000 and August 2008, 171 women were treated with APBI using high dose rate (HDR) BRT. Patients were treated to a dose of 34 Gy/10 fractions/1 week with two fractions/day after intraoperative/postoperative placement of catheters. Results: At a median follow up of 48 months (SD: 28) 20 women developed FN with median time to detection being 24 months (range: 4–62 months, SD: 20). Actuarial 5 and 7 year FN rate was 18% and 23%, respectively. Grade 1 FN was seen in 4, grade 2 in 8 and grade 4 in 8 women. Additional investigations such as aspiration/biopsy were done in 9 patients. Volume of excision was the only significant factor affecting FN (p = 0.04). Conclusions: Actuarial FN rate of 18% at 5 years in our study was comparable to other reported series of FN. Median time of detection of FN was 24 months. Higher volume of excision resulted in an increased incidence of fat necrosis.

  3. Factors Associated With Chest Wall Toxicity After Accelerated Partial Breast Irradiation Using High-Dose-Rate Brachytherapy

    Purpose: The purpose of this analysis was to evaluate dose-volume relationships associated with a higher probability for developing chest wall toxicity (pain) after accelerated partial breast irradiation (APBI) by using both single-lumen and multilumen brachytherapy. Methods and Materials: Rib dose data were available for 89 patients treated with APBI and were correlated with the development of chest wall/rib pain at any point after treatment. Ribs were contoured on computed tomography planning scans, and rib dose-volume histograms (DVH) along with histograms for other structures were constructed. Rib DVH data for all patients were sampled at all volumes ≥0.008 cubic centimeter (cc) (for maximum dose related to pain) and at volumes of 0.5, 1, 2, and 3 cc for analysis. Rib pain was evaluated at each follow-up visit. Patient responses were marked as yes or no. No attempt was made to grade responses. Eighty-nine responses were available for this analysis. Results: Nineteen patients (21.3%) complained of transient chest wall/rib pain at any point in follow-up. Analysis showed a direct correlation between total dose received and volume of rib irradiated with the probability of developing rib/chest wall pain at any point after follow-up. The median maximum dose at volumes ≥0.008 cc of rib in patients who experienced chest wall pain was 132% of the prescribed dose versus 95% of the prescribed dose in those patients who did not experience pain (p = 0.0035). Conclusions: Although the incidence of chest wall/rib pain is quite low with APBI brachytherapy, attempts should be made to keep the volume of rib irradiated at a minimum and the maximum dose received by the chest wall as low as reasonably achievable.

  4. Dosimetric comparison of 3D conformal, IMRT, and V-MAT techniques for accelerated partial-breast irradiation (APBI)

    Qiu, Jian-Jian [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai (China); Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (China); Chang, Zheng; Horton, Janet K.; Wu, Qing-Rong Jackie; Yoo, Sua [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Yin, Fang-Fang, E-mail: fangfang.yin@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    2014-07-01

    The purpose is to dosimetrically compare the following 3 delivery techniques: 3-dimensional conformal radiation therapy (3D-CRT), intensity-modulated arc therapy (IMRT), and volumetric-modulated arc therapy (V-MAT) in the treatment of accelerated partial-breast irradiation (APBI). Overall, 16 patients with T1/2N0 breast cancer were treated with 3D-CRT (multiple, noncoplanar photon fields) on the RTOG 0413 partial-breast trial. These cases were subsequently replanned using static gantry IMRT and V-MAT technology to understand dosimetric differences among these 3 techniques. Several dosimetric parameters were used in plan quality evaluation, including dose conformity index (CI) and dose-volume histogram analysis of normal tissue coverage. Quality assurance studies including gamma analysis were performed to compare the measured and calculated dose distributions. The IMRT and V-MAT plans gave more conformal target dose distributions than the 3D-CRT plans (p < 0.05 in CI). The volume of ipsilateral breast receiving 5 and 10 Gy was significantly less using the V-MAT technique than with either 3D-CRT or IMRT (p < 0.05). The maximum lung dose and the ipsilateral lung volume receiving 10 (V{sub 10}) or 20 Gy (V{sub 20}) were significantly less with both V-MAT and IMRT (p < 0.05). The IMRT technique was superior to 3D-CRT and V-MAT of low dose distributions in ipsilateral lung (p < 0.05 in V{sub 5} and D{sub 5}). The total mean monitor units (MUs) for V-MAT (621.0 ± 111.9) were 12.2% less than those for 3D-CRT (707.3 ± 130.9) and 46.5% less than those for IMRT (1161.4 ± 315.6) (p < 0.05). The average machine delivery time was 1.5 ± 0.2 minutes for the V-MAT plans, 7.0 ± 1.6 minutes for the 3D-CRT plans, and 11.5 ± 1.9 minutes for the IMRT plans, demonstrating much less delivery time for V-MAT. Based on this preliminary study, V-MAT and IMRT techniques offer improved dose conformity as compared with 3D-CRT techniques without increasing dose to the ipsilateral lung. In

  5. Accelerated partial breast irradiation using multicatheter brachytherapy for select early-stage breast cancer: local control and toxicity

    To investigate the efficacy and safety of accelerated partial breast irradiation (APBI) via high-dose-rate (HDR) multicatheter interstitial brachytherapy for early-stage breast cancer. Between 2002 and 2006, 48 prospectively selected patients with early-stage breast cancer received APBI using multicatheter brachytherapy following breast-conserving surgery. Their median age was 52 years (range 36-78). A median of 34 Gy (range 30-34) in 10 fractions given twice daily within 5 days was delivered to the tumor bed plus a 1-2 cm margin. Most (92%) patients received adjuvant systemic treatments. The median follow-up was 53 months (range 36-95). Actuarial local control rate was estimated from surgery using Kaplan-Meier method. Local recurrence occurred in two patients. Both were true recurrence/marginal miss and developed in patients with close (< 0.2 cm) surgical margin after 33 and 40 months. The 5-year actuarial local recurrence rate was 4.6%. No regional or distant relapse and death has occurred to date. Late Grade 1 or 2 late skin and subcutaneous toxicity was seen in 11 (22.9%) and 26 (54.2%) patients, respectively. The volumes receiving 100% and 150% of the prescribed dose were significantly higher in the patients with late subcutaneous toxicity (p = 0.018 and 0.034, respectively). Cosmesis was excellent to good in 89.6%. APBI using HDR multicatheter brachytherapy yielded local control, toxicity, and cosmesis comparable to those of conventional whole breast irradiation for select early-stage breast cancer. Patients with close resection margins may be ineligible for APBI

  6. Identifying Patients Who Are Unsuitable for Accelerated Partial Breast Irradiation Using Three-dimensional External Beam Conformal Techniques

    Purpose: Several recent studies reported that severe late toxicities including soft-tissue fibrosis and fat necrosis are present in patients treated with accelerated partial breast irradiation (APBI) and that these toxicities are associated with the large volume of tissue targeted by high-dose irradiation. The present study was performed to clarify which patients are unsuitable for APBI to avoid late severe toxicities. Methods and Materials: Study subjects comprised 50 consecutive patients with Stage 0−II unilateral breast cancer who underwent breast-conserving surgery, and in whom five or six surgical clips were placed during surgery. All patients were subsequently replanned using three-dimensional conformal radiotherapy (3D-CRT) APBI techniques according to the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39 and Radiation Therapy Oncology Group (RTOG) 0413 protocol. The beam arrangements included mainly noncoplanar four- or five-field beams using 6-MV photons alone. Results: Dose–volume histogram (DVH) constraints for normal tissues according to the NSABP/RTOG protocol were satisfied in 39 patients (78%). Multivariate analysis revealed that only long craniocaudal clip distance (CCD) was correlated with nonoptimal DVH constraints (p = 0.02), but that pathological T stage, anteroposterior clip distance (APD), site of ipsilateral breast (IB) (right/left), location of the tumor (medial/lateral), and IB reference volume were not. DVH constraints were satisfied in 20% of patients with a long CCD (≥5.5 cm) and 92% of those with a short CCD (p 50) of all patients was 49.0% (range, 31.4–68.6). Multivariate analysis revealed that only a long CCD was correlated with large IB-V50 (p 50.

  7. 早期乳腺癌部分乳腺加速放疗%Accelerated partial breast irradiation for early breast cancer

    张秋宁; 王小虎

    2011-01-01

    随着乳腺癌术后复发模式的研究进展,部分乳腺照射方法 成为乳腺癌放疗的热点.组织间插植、球囊近距离治疗、术中放疗及三维适形放疗和调强放疗等部分乳腺加速放疗已进入临床研究.其局部控制率和安全性与全乳腺照射比较相当,同时具有治疗周期短、方便患者等优势.部分乳腺加速放疗在部分患者有望代替全乳腺放疗,成为早期乳腺癌保乳术后放疗的标准治疗之一.%With a view to patterns of local recurrence after breast conserving surgery, whole breast irradiation(WBI) after surgery is controversial and partial-breast irradiation(PBI) came up. Many clinical trials related with accelerated partial-breast irradiation using a variety of radiotherapeutic techniques such as interstitial brachytherapy (IBT), MammoSite Radiation Therapy System, intraoperative radiotherapy(IORT), threedimensional conformal radiotherapy(3-DCRT)and intensity modulated radiation therapy(IMRT) in selected patients have been carried out. Accelerated partial-breast irradiation that provides faster, more convenient treat-ment demonstrates local control rate and safety comparable to that of whole breast irradiation. Partial breast irradiation may be an alternative way to whole breast radiotherapy and will be one of the standard treatments in women with early breast cancer seeking breast conservation.

  8. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    Kuehr, Marietta, E-mail: marietta.kuehr@ukb.uni-bonn.de [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Wolfgarten, Matthias; Stoelzle, Marco [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Leutner, Claudia [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Hoeller, Tobias [Department of Medical Statistics and Epidemiology, University of Bonn, Bonn (Germany); Schrading, Simone; Kuhl, Christiane; Schild, Hans [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Kuhn, Walther; Braun, Michael [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany)

    2011-11-15

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size {<=}3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget's disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  9. Validating Fiducial Markers for Image-Guided Radiation Therapy for Accelerated Partial Breast Irradiation in Early-Stage Breast Cancer

    Purpose: Image-guided radiation therapy (IGRT) may be beneficial for accelerated partial breast irradiation (APBI). The goal was to validate the use of intraparenchymal textured gold fiducials in patients receiving APBI. Methods and Materials: Twenty-six patients were enrolled on this prospective study that had three or four textured gold intraparenchymal fiducials placed at the periphery of the lumpectomy cavity and were treated with three-dimensional (3D) conformal APBI. Free-breathing four-dimensional computed tomography image sets were obtained pre- and posttreatment, as were daily online megavoltage (MV) orthogonal images. Intrafraction motion, variations in respiratory motion, and fiducial marker migration were calculated using the 3D coordinates of individual fiducials and a calculated center of mass (COM) of the fiducials. We also compared the relative position of the fiducial COM with the geometric center of the seroma. Results: There was less than 1 mm of intrafraction respiratory motion, variation in respiratory motion, or fiducial marker migration. The change in seroma position relative to the fiducial COM was 1 mm ± 1 mm. The average position of the geometric seroma relative to the fiducial COM pretreatment compared with posttreatment was 1 mm ± 1 mm. The largest daily variation in displacement when using bony landmark was in the anteroposterior direction and two standard deviations (SD) of this variation was 10 mm. The average variation in daily separation between the fiducial pairs from daily MV images was 3 mm ± 3 mm therefore 2 SD is 6 mm. Conclusion: Fiducial markers are stable throughout the course of APBI. Planning target volume margins when using bony landmarks should be 10 mm and can be reduced to 6 mm if using fiducials.

  10. External beam accelerated partial breast irradiation (EB-APBI yields favorable outcomes in patients with prior breast augmentation

    Rachel Yi-Feng Lei

    2014-06-01

    Full Text Available Purpose: To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI utilizing intensity modulated radiotherapy (IMRT or 3-dimensional conformal radiotherapy (3D-CRT, both with image-guided radiotherapy (IGRT.Methods and Materials: 16 stage 0/I breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on clinicaltrials.gov. Patients received 38.5 Gy in 10 fractions over 5 consecutive days. Breast/chest wall pain and cosmesis were rated by patient; cosmesis was additionally evaluated by physician per RTOG criteria.Results: The median follow-up from APBI completion was 18.0 months (range, 1.2-58.6. Little to no change in cosmesis or pain from baseline was reported. Cosmetic outcomes at last follow-up were judged by patients as excellent/good in 93.8% (15/16, and by physicians as excellent/good in 100% (16/16. Eight patients (50.0% reported no breast/chest wall pain, and the remaining 8 patients (50.0% reported mild pain. All patients remain disease free at last follow-up. The median ipsilateral breast, planning target volume (PTV, and implant volumes were 614 cc, 57 cc, and 333 cc. The median ratios of PTV/ipsilateral breast volume (implant excluded and PTV/total volume (implant included were 9% and 6%. Conclusions: These 16 breast cancer cases with prior bilateral breast augmentation treated with external beam APBI demonstrate favorable clinical outcomes. Further exploration of external beam APBI as a treatment option for this patient po

  11. Results With Accelerated Partial Breast Irradiation in Terms of Estrogen Receptor, Progesterone Receptor, and Human Growth Factor Receptor 2 Status

    Purpose: To report our results with accelerated partial breast irradiation (APBI) in terms of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2/neu) status. Methods and Materials: Between February 2003 and June 2009, 209 women with early-stage breast carcinomas were treated with APBI using multicatheter, MammoSite, or Contura brachytherapy to 34 Gy in 10 fractions twice daily over 5-7 days. Three patient groups were defined by receptor status: Group 1: ER or PR (+) and HER-2/neu (-) (n = 180), Group 2: ER and PR (-) and HER-2/neu (+) (n = 10), and Group 3: ER, PR, and HER-2/neu (-) (triple negative breast cancer, n = 19). Median follow-up was 22 months. Results: Group 3 patients had significantly higher Scarff-Bloom-Richardson scores (p < 0.001). The 3-year ipsilateral breast tumor control rates for Groups 1, 2, and 3 were 99%, 100%, and 100%, respectively (p = 0.15). Group 3 patients tended to experience relapse in distant sites earlier than did non-Group 3 patients. The 3-year relapse-free survival rates for Groups 1, 2, and 3 were 100%, 100%, and 81%, respectively (p = 0.046). The 3-year cause-specific and overall survival rates for Groups 1, 2, and 3 were 100%, 100%, and 89%, respectively (p = 0.002). Conclusions: Triple negative breast cancer patients typically have high-grade tumors with significantly worse relapse-free, cause-specific, and overall survival. Longer follow-up will help to determine whether these patients also have a higher risk of ipsilateral breast tumor relapse.

  12. Nomogram for Predicting the Risk of Locoregional Recurrence in Patients Treated With Accelerated Partial-Breast Irradiation

    Wobb, Jessica L. [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Chen, Peter Y., E-mail: PChen@beaumont.edu [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Shah, Chirag [Department of Radiation Oncology, Summa Health System, Akron, Ohio (United States); Moran, Meena S. [Department of Therapeutic Radiology, Yale School of Medicine, Norwich, Connecticut (United States); Shaitelman, Simona F. [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Vicini, Frank A. [Department of Radiation Oncology, Michigan Healthcare Professionals/21st Century Oncology, Farmington, Michigan (United States); Mbah, Alfred K.; Lyden, Maureen [Biostat International Inc, Tampa, Florida (United States); Beitsch, Peter [Department of Surgery, Dallas Breast Center, Dallas, Texas (United States)

    2015-02-01

    Purpose: To develop a nomogram taking into account clinicopathologic features to predict locoregional recurrence (LRR) in patients treated with accelerated partial-breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: A total of 2000 breasts (1990 women) were treated with APBI at William Beaumont Hospital (n=551) or on the American Society of Breast Surgeons MammoSite Registry Trial (n=1449). Techniques included multiplanar interstitial catheters (n=98), balloon-based brachytherapy (n=1689), and 3-dimensional conformal radiation therapy (n=213). Clinicopathologic variables were gathered prospectively. A nomogram was formulated utilizing the Cox proportional hazards regression model to predict for LRR. This was validated by generating a bias-corrected index and cross-validated with a concordance index. Results: Median follow-up was 5.5 years (range, 0.9-18.3 years). Of the 2000 cases, 435 were excluded because of missing data. Univariate analysis found that age <50 years, pre-/perimenopausal status, close/positive margins, estrogen receptor negativity, and high grade were associated with a higher frequency of LRR. These 5 independent covariates were used to create adjusted estimates, weighting each on a scale of 0-100. The total score is identified on a points scale to obtain the probability of an LRR over the study period. The model demonstrated good concordance for predicting LRR, with a concordance index of 0.641. Conclusions: The formulation of a practical, easy-to-use nomogram for calculating the risk of LRR in patients undergoing APBI will help guide the appropriate selection of patients for off-protocol utilization of APBI.

  13. Impact of the Number of Cautionary and/or Unsuitable Risk Factors on Outcomes After Accelerated Partial Breast Irradiation

    Wobb, Jessica; Wilkinson, J. Ben [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Shah, Chirag [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Mitchell, Christina; Wallace, Michelle; Ye, Hong; Stromberg, Jannifer; Grills, Inga [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Chen, Peter Y., E-mail: PChen@beaumont.edu [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2013-09-01

    Purpose: To examine clinical outcomes of accelerated partial-breast irradiation (APBI) stratified by the number of American Society for Radiation Oncology consensus statement cautionary/unsuitable risk factors (RFs) present. Methods and Materials: A total of 692 patients were treated with APBI at a single institution between April 1993 and January 2012 using interstitial (n=195), balloon (n=292), and 3-dimensional conformal radiation therapy (n=205) techniques. Clinical outcomes were evaluated by risk group and number of RFs. Results: Median follow-up was 5.2 years (range, 0-18.3 years). Most patients were classified as suitable (n=240, 34%) or cautionary (n=343, 50%) risk, whereas 16% (n=109) were unsuitable. In patients with increasing total RFs (1 RF, 2 RF, 3+ RF), higher rates of grade 3 histology (10% vs 18% vs 32%, P<.001), estrogen receptor negativity (0 vs 12% vs 29%, P<.001), close/positive margins (0 vs 6% vs 17%, P<.001), and use of adjuvant chemotherapy (3% vs 12% vs 33%, P<.001) were noted. When pooling cautionary and unsuitable patients, increased ipsilateral breast tumor recurrence/regional recurrence was most notable for patients with 3 or more combined RFs versus 2 or fewer combined RFs (P<.001). Conclusions: Patients with 3 or more cautionary or unsuitable RFs may be at risk for higher local, regional, and distant recurrence after breast-conserving therapy using APBI. Patients with 2 or fewer total RFs have 98% locoregional control at 5 years. Inclusion of total number of RFs in future risk stratification schemes for APBI may be warranted.

  14. Impact of the Number of Cautionary and/or Unsuitable Risk Factors on Outcomes After Accelerated Partial Breast Irradiation

    Purpose: To examine clinical outcomes of accelerated partial-breast irradiation (APBI) stratified by the number of American Society for Radiation Oncology consensus statement cautionary/unsuitable risk factors (RFs) present. Methods and Materials: A total of 692 patients were treated with APBI at a single institution between April 1993 and January 2012 using interstitial (n=195), balloon (n=292), and 3-dimensional conformal radiation therapy (n=205) techniques. Clinical outcomes were evaluated by risk group and number of RFs. Results: Median follow-up was 5.2 years (range, 0-18.3 years). Most patients were classified as suitable (n=240, 34%) or cautionary (n=343, 50%) risk, whereas 16% (n=109) were unsuitable. In patients with increasing total RFs (1 RF, 2 RF, 3+ RF), higher rates of grade 3 histology (10% vs 18% vs 32%, P<.001), estrogen receptor negativity (0 vs 12% vs 29%, P<.001), close/positive margins (0 vs 6% vs 17%, P<.001), and use of adjuvant chemotherapy (3% vs 12% vs 33%, P<.001) were noted. When pooling cautionary and unsuitable patients, increased ipsilateral breast tumor recurrence/regional recurrence was most notable for patients with 3 or more combined RFs versus 2 or fewer combined RFs (P<.001). Conclusions: Patients with 3 or more cautionary or unsuitable RFs may be at risk for higher local, regional, and distant recurrence after breast-conserving therapy using APBI. Patients with 2 or fewer total RFs have 98% locoregional control at 5 years. Inclusion of total number of RFs in future risk stratification schemes for APBI may be warranted

  15. Long-Term Efficacy and Patterns of Failure After Accelerated Partial Breast Irradiation: A Molecular Assay-Based Clonality Evaluation

    Purpose: To determine the long-term efficacy and cosmetic results of accelerated partial breast irradiation (APBI) by reviewing our institution's experience. Methods and Materials: A total of 199 patients with early-stage breast cancer were treated prospectively with adjuvant APBI after lumpectomy using interstitial brachytherapy. All patients had negative margins, 82% had Stage I disease, median tumor size was 1.1 cm, and 12% had positive lymph nodes. The median follow-up for surviving patients was 8.6 years. Fifty-three patients (27%) have been followed for ≥10 years. Results: Six ipsilateral breast tumor recurrences (IBTRs) were observed, for a 5-year and 10-year actuarial rate of 1.6% and 3.8%, respectively. A total of three regional nodal failures were observed, for a 10-year actuarial rate of 1.6%. Five contralateral breast cancers developed, for a 5- and 10-year actuarial rate of 2.2% and 5.2%, respectively. The type of IBTR (clonally related vs. clonally distinct) was analyzed using a polymerase chain reaction-based loss of heterozygosity assay. Eighty-three percent of IBTRs (n = 5) were classified as clonally related. Multiple clinical, pathologic, and treatment-related factors were analyzed for an association with the development of an IBTR, regional nodal failure, or contralateral breast cancer. On multivariate analysis, no variable was associated with any of these events. Cosmetic results were rated as excellent/good in 99% of patients. Conclusions: Long-term results with APBI using interstitial brachytherapy continue to demonstrate excellent long-term local and regional control rates and cosmetic results. According to a polymerase chain reaction-based loss of heterozygosity assay, 83% of recurrences were classified as clonally related

  16. Combined modulated electron and photon beams planned by a Monte-Carlo-based optimization procedure for accelerated partial breast irradiation

    Atriana Palma, Bianey; Ureba Sánchez, Ana; Salguero, Francisco Javier; Arráns, Rafael; Míguez Sánchez, Carlos; Walls Zurita, Amadeo; Romero Hermida, María Isabel; Leal, Antonio

    2012-03-01

    The purpose of this study was to present a Monte-Carlo (MC)-based optimization procedure to improve conventional treatment plans for accelerated partial breast irradiation (APBI) using modulated electron beams alone or combined with modulated photon beams, to be delivered by a single collimation device, i.e. a photon multi-leaf collimator (xMLC) already installed in a standard hospital. Five left-sided breast cases were retrospectively planned using modulated photon and/or electron beams with an in-house treatment planning system (TPS), called CARMEN, and based on MC simulations. For comparison, the same cases were also planned by a PINNACLE TPS using conventional inverse intensity modulated radiation therapy (IMRT). Normal tissue complication probability for pericarditis, pneumonitis and breast fibrosis was calculated. CARMEN plans showed similar acceptable planning target volume (PTV) coverage as conventional IMRT plans with 90% of PTV volume covered by the prescribed dose (Dp). Heart and ipsilateral lung receiving 5% Dp and 15% Dp, respectively, was 3.2-3.6 times lower for CARMEN plans. Ipsilateral breast receiving 50% Dp and 100% Dp was an average of 1.4-1.7 times lower for CARMEN plans. Skin and whole body low-dose volume was also reduced. Modulated photon and/or electron beams planned by the CARMEN TPS improve APBI treatments by increasing normal tissue sparing maintaining the same PTV coverage achieved by other techniques. The use of the xMLC, already installed in the linac, to collimate photon and electron beams favors the clinical implementation of APBI with the highest efficiency.

  17. Dosimetric comparison of three dimensional conformal radiation therapy versus intensity modulated radiation therapy in accelerated partial breast irradiation

    S Moorthy

    2016-01-01

    Full Text Available Aim of Study: Breast conserving surgery (BCS is the standard treatment for stage I and II breast cancer. Multiple studies have shown that recurrences after lumpectomy occur mainly in or near the tumor bed. Use of accelerated partial breast irradiation (APBI allows for significant reduction in the overall treatment time that results in increasing patient compliance and decreasing healthcare costs. We conducted a treatment planning study to evaluate the role of intensity modulated radiation therapy (IMRT with regards to three-dimensional conformal radiation therapy (3DCRT in APBI. Materials and Methods: Computed tomography planning data sets of 33 patients (20 right sided and 13 left sided with tumor size less than 3 cm and negative axillary lymph nodes were used for our study. Tumor location was upper outer, upper inner, central, lower inner, and lower outer quadrants in 10, 10, 5, 4 and 4 patients, respectively. Multiple 3DCRT and IMRT plans were created for each patient. Total dose of 38.5 Gy in 10 fractions were planned. Dosimetric analysis was done for the best 3DCRT and IMRT plans. Results: The target coverage has been achieved by both the methods but IMRT provided better coverage (P = 0.04 with improved conformity index (P = 0.01. Maximum doses were well controlled in IMRT to below 108% (P < 0.01. Heart V2 Gy (P < 0.01, lung V5 Gy (P = 0.01, lung V10 Gy (P = 0.02, contralateral breast V1 Gy (P < 0.01, contralateral lung V2 Gy (P < 0.01, and ipsilateral uninvolved breast (P < 0.01 doses were higher with 3DCRT compared to IMRT. Conclusion: Dosimetrically, IMRT–APBI provided best target coverage with less dose to normal tissues compared with 3DCRT-APBI.

  18. Accelerated partial-breast irradiation using high-dose-rate interstitial brachytherapy: 12-year update of a prospective clinical study

    Background and purpose: To report the 12-year updated results of accelerated partial-breast irradiation (APBI) using multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT). Patients and methods: Forty-five prospectively selected patients with T1N0-N1mi, nonlobular breast cancer without the presence of an extensive intraductal component and with negative surgical margins were treated with APBI after breast-conserving surgery (BCS) using interstitial HDR BT. A total dose of 30.3 Gy (n = 8) and 36.4 Gy (n = 37) in seven fractions within 4 days was delivered to the tumour bed plus a 1-2 cm margin. The median follow-up time was 133 months for surviving patients. Local and regional control, disease-free (DFS), cancer-specific (CSS), and overall survival (OS), as well as late side effects, and cosmetic results were assessed. Results: Four (8.9%) ipsilateral breast tumour recurrences were observed, for a 5-, 10-, and 12-year actuarial rate of 4.4%, 9.3%, and 9.3%, respectively. A total of two regional nodal failures were observed for a 12-year actuarial rate of 4.4%. The 12-year DFS, CSS, and OS was 75.3%, 91.1%, and 88.9%, respectively. Grade 3 fibrosis was observed in one patient (2.2%). No patient developed grade 3 teleangiectasia. Fat necrosis requiring surgical intervention occurred in one woman (2.2%). Cosmetic results were rated excellent or good in 35 patients (77.8%). Conclusions: Twelve-year results with APBI using HDR multicatheter interstitial implants continue to demonstrate excellent long-term local tumour control, survival, and cosmetic results with a low-rate of late side effects.

  19. Feasibility of accelerated partial breast irradiation with volumetric-modulated arc therapy in elderly and frail patients

    Accelerated partial breast irradiation (APBI) is an option for adjuvant radiotherapy according to ASTRO and ESTRO recommendations. Among the available techniques, volumetric-modulated arc therapy (VMAT) is attractive but has not been extensively studied for APBI. This study assessed its feasibility, tolerance and early oncological outcomes. We analysed the data of nine patients (median age 74 years) with ten lesions (one bilateral cancer) treated from May 2011 to July 2012 with APBI using VMAT. The radiation oncologist delineated the surgical tumour bed, and added an 18 mm isotropic margin to obtain the planning target volume (PTV). The dose was 40 Gy prescribed in 4 Gy fractions given twice a day over five days. Patients were regularly followed for toxicities and oncological outcomes. Mean PTV was 100.0 cm3 and 95 % of the PTV received a mean dose of 99.7 % of the prescribed dose. Hot spots represented 0.3 % of the PTV. 6.2 %, 1.6 % and 0.3 % of the ipsilateral lung volume received 5 Gy (V5Gy), 10 Gy (V10Gy) and 20 Gy (V20Gy), respectively. Regarding the contralateral lung, V5Gy was 0.3 %, and V10Gy and V20Gy were nil. V5Gy accounted for 3.1 % of the heart. An average 580 monitor units were delivered. No acute or late grade ≥ 2 toxicities were observed. With a median follow-up of 26 months, no relapses occurred. In our study, VMAT allowed optimal dosimetry with consequential high therapeutic ratio in elderly and frail patients

  20. Three-Year Outcomes of a Canadian Multicenter Study of Accelerated Partial Breast Irradiation Using Conformal Radiation Therapy

    Berrang, Tanya S., E-mail: tberrang@bccancer.bc.ca [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Olivotto, Ivo [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Kim, Do-Hoon [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Nichol, Alan [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Cho, B.C. John [Princess Margaret Hospital, Ontario (Canada); University of Toronto, Ontario (Canada); Mohamed, Islam G. [British Columbia Cancer Agency-Southern Interior, BC (Canada); University of British Columbia, BC (Canada); Parhar, Tarnjit [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Wright, J.R. [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Truong, Pauline [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Tyldesley, Scott [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Sussman, Jonathan [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Wai, Elaine [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Whelan, Tim [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada)

    2011-12-01

    Purpose: To report 3-year toxicity, cosmesis, and efficacy of a multicenter study of external beam, accelerated partial breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: Between March 2005 and August 2006, 127 women aged {>=}40 years with ductal carcinoma in situ or node-negative invasive breast cancer {<=}3 cm in diameter, treated with breast-conserving surgery achieving negative margins, were accrued to a prospective study involving five Canadian cancer centers. Women meeting predefined dose constraints were treated with APBI using 3 to 5 photon beams, delivering 35 to 38.5 Gy in 10 fractions, twice a day, over 1 week. Patients were assessed for treatment-related toxicities, cosmesis, and efficacy before APBI and at specified time points for as long as 3 years after APBI. Results: 104 women had planning computed tomography scans showing visible seromas, met dosimetric constraints, and were treated with APBI to doses of 35 Gy (n = 9), 36 Gy (n = 33), or 38.5 Gy (n = 62). Eighty-seven patients were evaluated with minimum 3-year follow-up after APBI. Radiation dermatitis, breast edema, breast induration, and fatigue decreased from baseline levels or stabilized by the 3-year follow-up. Hypopigmentation, hyperpigmentation, breast pain, and telangiectasia slightly increased from baseline levels. Most toxicities at 3 years were Grade 1. Only 1 patient had a Grade 3 toxicity with telangiectasia in a skin fold inside the 95% isodose. Cosmesis was good to excellent in 86% (89/104) of women at baseline and 82% (70/85) at 3 years. The 3-year disease-free survival was 97%, with only one local recurrence that occurred in a different quadrant away from the treated site and two distant recurrences. Conclusions: At 3 years, toxicity and cosmesis were acceptable, and local control and disease-free survival were excellent, supporting continued accrual to randomized APBI trials.

  1. Nomogram for Predicting the Risk of Locoregional Recurrence in Patients Treated With Accelerated Partial-Breast Irradiation

    Purpose: To develop a nomogram taking into account clinicopathologic features to predict locoregional recurrence (LRR) in patients treated with accelerated partial-breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: A total of 2000 breasts (1990 women) were treated with APBI at William Beaumont Hospital (n=551) or on the American Society of Breast Surgeons MammoSite Registry Trial (n=1449). Techniques included multiplanar interstitial catheters (n=98), balloon-based brachytherapy (n=1689), and 3-dimensional conformal radiation therapy (n=213). Clinicopathologic variables were gathered prospectively. A nomogram was formulated utilizing the Cox proportional hazards regression model to predict for LRR. This was validated by generating a bias-corrected index and cross-validated with a concordance index. Results: Median follow-up was 5.5 years (range, 0.9-18.3 years). Of the 2000 cases, 435 were excluded because of missing data. Univariate analysis found that age <50 years, pre-/perimenopausal status, close/positive margins, estrogen receptor negativity, and high grade were associated with a higher frequency of LRR. These 5 independent covariates were used to create adjusted estimates, weighting each on a scale of 0-100. The total score is identified on a points scale to obtain the probability of an LRR over the study period. The model demonstrated good concordance for predicting LRR, with a concordance index of 0.641. Conclusions: The formulation of a practical, easy-to-use nomogram for calculating the risk of LRR in patients undergoing APBI will help guide the appropriate selection of patients for off-protocol utilization of APBI

  2. Accelerated partial breast irradiation

    2002-01-01

    @@ Whole breast radiotherapy afier tumor lumpectomy is based on the premise that that the breast cancer recurrence rate is reduced through the elimination of residual cancer foci in the remaining tissue immediately adjacent to the lumpectomy site and occult multicentric areas of in situ or infiltrating cancer in remote areas of the breast. The relevance of remote foci to ipsilateral breast failure rates after breast conserving treatment is debatable, because 65%~100% of recurrences develop in the same quadrant as the initial tumor. This has led several investigators to question whether radiotherapy must be administered to the entire breast.

  3. Accelerated partial breast irradiation using once-daily fractionation: analysis of 312 cases with four years median follow-up

    Shaikh Arif Y

    2012-02-01

    Full Text Available Abstract Background There are limited data on accelerated partial breast irradiation (APBI using external beam techniques. Moreover, there are recent reports of increased fibrosis and unacceptable cosmesis with APBI using external beam with BID fractionation. We adopted a once daily regimen of APBI with fractionation similar to that shown to be effective in a Canadian randomized trial of whole breast irradiation. It is unclear whether patients with DCIS or invasive lobular carcinoma (ILC are suitable for APBI. Methods The retrospective cohort included 310 patients with 312 tumors of T1-T2N0-N1micM0 invasive ductal carcinoma (IDC, ILC, or Tis (DCIS treated with APBI via external beam. Most patients were treated using IMRT with 16 daily fractions of 270 cGy to a dose of 4320 cGy. The target volume included the lumpectomy cavity plus 1.0 cm to account for microscopic disease and an additional 0.5 to 1.0 cm for setup uncertainty and breathing motion. Ipsilateral breast failure (IBF was pathologically confirmed as a local failure (LF or an elsewhere failure (EF. Results Median follow-up was 49 months. Among the 312 cases, 213 were IDC, 31 ILC, and 68 DCIS. Median tumor size was 1.0 cm. There were 9 IBFs (2.9% including 5 LFs and 4 EFs. The IBF rates among patients with IDC, ILC, and DCIS were 2.4%, 3.2%, and 4.4%, respectively, with no significant difference between histologies. When patients were analyzed by the ASTRO APBI consensus statement risk groups, 32% of treated cases were considered suitable, 50% cautionary, and 18% unsuitable. The IBF rates among suitable, cautionary, and unsuitable patients were 4.0%, 2.6%, and 1.8%, respectively, with no significant difference between risk groups. Acute skin reactions were rare and long-term cosmetic outcome was very good to excellent. Conclusions External beam APBI with once daily fractionation has a low rate of IBF consistent with other published APBI studies. The ASTRO risk stratification did not

  4. Accelerated partial breast irradiation using once-daily fractionation: analysis of 312 cases with four years median follow-up

    There are limited data on accelerated partial breast irradiation (APBI) using external beam techniques. Moreover, there are recent reports of increased fibrosis and unacceptable cosmesis with APBI using external beam with BID fractionation. We adopted a once daily regimen of APBI with fractionation similar to that shown to be effective in a Canadian randomized trial of whole breast irradiation. It is unclear whether patients with DCIS or invasive lobular carcinoma (ILC) are suitable for APBI. The retrospective cohort included 310 patients with 312 tumors of T1-T2N0-N1micM0 invasive ductal carcinoma (IDC), ILC, or Tis (DCIS) treated with APBI via external beam. Most patients were treated using IMRT with 16 daily fractions of 270 cGy to a dose of 4320 cGy. The target volume included the lumpectomy cavity plus 1.0 cm to account for microscopic disease and an additional 0.5 to 1.0 cm for setup uncertainty and breathing motion. Ipsilateral breast failure (IBF) was pathologically confirmed as a local failure (LF) or an elsewhere failure (EF). Median follow-up was 49 months. Among the 312 cases, 213 were IDC, 31 ILC, and 68 DCIS. Median tumor size was 1.0 cm. There were 9 IBFs (2.9%) including 5 LFs and 4 EFs. The IBF rates among patients with IDC, ILC, and DCIS were 2.4%, 3.2%, and 4.4%, respectively, with no significant difference between histologies. When patients were analyzed by the ASTRO APBI consensus statement risk groups, 32% of treated cases were considered suitable, 50% cautionary, and 18% unsuitable. The IBF rates among suitable, cautionary, and unsuitable patients were 4.0%, 2.6%, and 1.8%, respectively, with no significant difference between risk groups. Acute skin reactions were rare and long-term cosmetic outcome was very good to excellent. External beam APBI with once daily fractionation has a low rate of IBF consistent with other published APBI studies. The ASTRO risk stratification did not differentiate a subset of patients with a higher rate of IBF

  5. Identifying Patients Who Are Unsuitable for Accelerated Partial Breast Irradiation Using Three-dimensional External Beam Conformal Techniques

    Shikama, Naoto, E-mail: nshikama0525@gmail.com [Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama (Japan); Nakamura, Naoki; Kunishima, Naoaki; Hatanaka, Shogo; Sekiguchi, Kenji [Department of Radiation Oncology, St. Luke' s International Hospital, Tokyo (Japan)

    2012-07-01

    Purpose: Several recent studies reported that severe late toxicities including soft-tissue fibrosis and fat necrosis are present in patients treated with accelerated partial breast irradiation (APBI) and that these toxicities are associated with the large volume of tissue targeted by high-dose irradiation. The present study was performed to clarify which patients are unsuitable for APBI to avoid late severe toxicities. Methods and Materials: Study subjects comprised 50 consecutive patients with Stage 0-II unilateral breast cancer who underwent breast-conserving surgery, and in whom five or six surgical clips were placed during surgery. All patients were subsequently replanned using three-dimensional conformal radiotherapy (3D-CRT) APBI techniques according to the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39 and Radiation Therapy Oncology Group (RTOG) 0413 protocol. The beam arrangements included mainly noncoplanar four- or five-field beams using 6-MV photons alone. Results: Dose-volume histogram (DVH) constraints for normal tissues according to the NSABP/RTOG protocol were satisfied in 39 patients (78%). Multivariate analysis revealed that only long craniocaudal clip distance (CCD) was correlated with nonoptimal DVH constraints (p = 0.02), but that pathological T stage, anteroposterior clip distance (APD), site of ipsilateral breast (IB) (right/left), location of the tumor (medial/lateral), and IB reference volume were not. DVH constraints were satisfied in 20% of patients with a long CCD ({>=}5.5 cm) and 92% of those with a short CCD (p < 0.0001). Median IB reference volume receiving {>=}50% of the prescribed dose (IB-V{sub 50}) of all patients was 49.0% (range, 31.4-68.6). Multivariate analysis revealed that only a long CCD was correlated with large IB-V{sub 50} (p < 0.0001), but other factors were not. Conclusion: Patients with long CCDs ({>=}5.5 cm) might be unsuitable for 3D-CRT APBI because of nonoptimal DVH constraints and large IB

  6. Accelerated partial-breast irradiation with interstitial implants. The clinical relevance of the calculation of skin doses

    Purpose: To describe relative skin dose estimations and their impact on cosmetic outcome in interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 105 consecutive patients with early breast cancer were recruited in Erlangen, Germany, for this substudy of the German-Austrian APBI phase II trial. 51% (54/105) received pulsed-dose-rate (PDR), and 49% (51/105) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy every hour. Total treatment time was 3-4 days. With a wire cross on the skin surface during the brachytherapy-planning procedure the minimal, mean and maximal relative skin doses (SDmin%, SDmax%, SDmean%) were recorded. Endpoint of this evaluation was the cosmetic outcome in relation to the relative skin doses. Results: Median follow-up time was 38 months (range, 19-65 months). Cosmetic results for all patients were excellent in 57% (60/105), good in 36% (38/105), and fair in 7% (7/105). The SDmin% (27.0% vs. 31.7%; p = 0.032), SDmean% (34.2% vs. 38.1%; p 0.008), and SDmax% (38.2% vs. 46.4%; p 0.003) were significantly lower for patients with excellent cosmetic outcome compared to patients with a suboptimal outcome. SDmean% (37.6% vs. 34.2%; p = 0.026) and SDmax% (45.4% vs. 38.2%; p = 0.008) were significantly higher for patients with good cosmetic outcome compared with the patients with excellent results. Conclusion: The appraisal of skin doses has been shown to be relevant to the achievement of excellent cosmetic outcome. Further investigations are necessary, especially on the basis of CT-based brachytherapy planning, to further improve the treatment results of multicatheter APBI. (orig.)

  7. Dosimetric experience with 2 commercially available multilumen balloon-based brachytherapy to deliver accelerated partial-breast irradiation

    Fu, Weihua, E-mail: fuw@upmc.edu; Kim, Jong Oh; Chen, Alex S.J.; Mehta, Kiran; Pucci, Pietro; Huq, M. Saiful

    2015-10-01

    The purpose of this work was to report dosimetric experience with 2 kinds of multilumen balloon (MLB), 5-lumen Contura MLB (C-MLB) and 4-lumen MammoSite MLB (MS-MLB), to deliver accelerated partial-breast irradiation, and compare the ability to achieve target coverage and control skin and rib doses between 2 groups of patients treated with C-MLB and MS-MLB brachytherapy. C-MLB has 5 lumens, the 4 equal-spaced peripheral lumens are 5 mm away from the central lumen. MS-MLB has 4 lumens, the 3 equal-spaced peripheral lumens are 3 mm away from the central lumen. In total, 43 patients were treated, 23 with C-MLB, and 20 with MS-MLB. For C-MLB group, 8 patients were treated with a skin spacing < 7 mm and 12 patients with rib spacing < 7 mm. For MS-MLB group, 2 patients were treated with a skin spacing < 7 mm and 5 patients with rib spacing < 7 mm. The dosimetric goals were (1) ≥ 95% of the prescription dose (PD) covering ≥ 95% of the target volume (V{sub 95%} ≥ 95%), (2) maximum skin dose ≤ 125% of the PD, (3) maximum rib dose ≤ 145% of the PD (if possible), and (4) the V{sub 150%} ≤ 50 cm{sup 3} and V{sub 200%} ≤ 10 cm{sup 3}. All dosimetric criteria were met concurrently in 82.6% of C-MLB patients, in 80.0% of MS-MLB patients, and in 81.4% of all 43 patients. For each dosimetric parameter, t-test of these 2 groups showed p > 0.05. Although the geometric design of C-MLB is different from that of MS-MLB, both applicators have the ability to shape the dose distribution and to provide good target coverage, while limiting the dose to skin and rib. No significant difference was observed between the 2 patient groups in terms of target dose coverage and dose to organs at risk.

  8. Using corrected Cone-Beam CT image for accelerated partial breast irradiation treatment dose verification: the preliminary experience

    Accurate target localization is mandatory in the accelerated partial breast irradiation (APBI) delivery. Dosimetric verification for positional error will further guarantee the accuracy of treatment delivery. The purpose of this study is to evaluate the clinical feasibility of a cone beam computer tomographic (CBCT) image correction method in APBI. A CBCT image correction method was developed. First, rigid image registration was proceeded for CTs and CBCTs; second, these images were separated into four parts; then, ratio images for each of the four parts of planning CTs/CBCTs were calculated and filtered to reduce the high spatial frequency; finally, the enhanced CBCT images were generated combing the four parts. An anthropomorphic thorax rando phantom was used to evaluate the feasibility and accuracy of the CBCT correction method. The CBCT images of consecutive 10 patients receiving APBI were corrected using the above method and dosimetric variations were evaluated. Each set of CBCT is composed of three images: one acquired after skin-marker setup, one after online setup correction and one after treatment delivery. The phantom study showed the improved accuracy of dose calculation with corrected CBCT. The Dose Volume Histogram (DVH) difference between the planning CT and corrected CBCT is less than the difference between the planning CT and original CBCT. The maximum dose difference between the corrected CBCT and planning CT is 0.8% in PTV-EVAL V100, which is 3.8% between original CBCT and planning. In the patient study, 67.4% of fractions benefit from CBCT setup corrections in PTV-EVAL D95, while in 47.4% of the fractions, reduced dose coverage was found on the post-treatment CBCT. Overall, the CBCT based initial setup correction guaranteed target dose coverage in 9 patients. A generic CBCT image correction algorithm was created and proved to be easily implemented in clinic. Compared to the original CBCT, the corrected CBCT has more accuracy in dose calculation

  9. Impact of residual and intrafractional errors on strategy of correction for image-guided accelerated partial breast irradiation

    The cone beam CT (CBCT) guided radiation can reduce the systematic and random setup errors as compared to the skin-mark setup. However, the residual and intrafractional (RAIF) errors are still unknown. The purpose of this paper is to investigate the magnitude of RAIF errors and correction action levels needed in cone beam computed tomography (CBCT) guided accelerated partial breast irradiation (APBI). Ten patients were enrolled in the prospective study of CBCT guided APBI. The postoperative tumor bed was irradiated with 38.5 Gy in 10 fractions over 5 days. Two cone-beam CT data sets were obtained with one before and one after the treatment delivery. The CBCT images were registered online to the planning CT images using the automatic algorithm followed by a fine manual adjustment. An action level of 3 mm, meaning that corrections were performed for translations exceeding 3 mm, was implemented in clinical treatments. Based on the acquired data, different correction action levels were simulated, and random RAIF errors, systematic RAIF errors and related margins before and after the treatments were determined for varying correction action levels. A total of 75 pairs of CBCT data sets were analyzed. The systematic and random setup errors based on skin-mark setup prior to treatment delivery were 2.1 mm and 1.8 mm in the lateral (LR), 3.1 mm and 2.3 mm in the superior-inferior (SI), and 2.3 mm and 2.0 mm in the anterior-posterior (AP) directions. With the 3 mm correction action level, the systematic and random RAIF errors were 2.5 mm and 2.3 mm in the LR direction, 2.3 mm and 2.3 mm in the SI direction, and 2.3 mm and 2.2 mm in the AP direction after treatments delivery. Accordingly, the margins for correction action levels of 3 mm, 4 mm, 5 mm, 6 mm and no correction were 7.9 mm, 8.0 mm, 8.0 mm, 7.9 mm and 8.0 mm in the LR direction; 6.4 mm, 7.1 mm, 7.9 mm, 9.2 mm and 10.5 mm in the SI direction; 7.6 mm, 7.9 mm, 9.4 mm, 10.1 mm and 12.7 mm in the AP direction

  10. Three-year outcomes of a once daily fractionation scheme for accelerated partial breast irradiation (APBI) using 3-D conformal radiotherapy (3D-CRT)

    The aim of this study was to report 3-year outcomes of toxicity, cosmesis, and local control using a once daily fractionation scheme (49.95 Gy in 3.33 Gy once daily fractions) for accelerated partial breast irradiation (APBI) using three-dimensional conformal radiotherapy (3D-CRT). Between July 2008 and August 2010, women aged ≥40 years with ductal carcinoma in situ or node-negative invasive breast cancer ≤3 cm in diameter, treated with breast-conserving surgery achieving negative margins, were accrued to a prospective study. Women were treated with APBI using 3–5 photon beams, delivering 49.95 Gy over 15 once daily fractions over 3 weeks. Patients were assessed for toxicities, cosmesis, and local control rates before APBI and at specified time points. Thirty-four patients (mean age 60 years) with Tis 0 (n = 9) and T1N0 (n = 25) breast cancer were treated and followed up for an average of 39 months. Only 3% (1/34) patients experienced a grade 3 subcutaneous fibrosis and breast edema and 97% of the patients had good/excellent cosmetic outcome at 3 years. The 3-year rate of ipsilateral breast tumor recurrence (IBTR) was 0% while the rate of contralateral breast events was 6%. The 3-year disease-free survival (DFS), overall survival (OS), and breast cancer-specific survival (BCSS) was 94%, 100%, and 100%, respectively. Our novel accelerated partial breast fractionation scheme of 15 once daily fractions of 3.33 Gy (49.95 Gy total) is a remarkably well-tolerated regimen of 3D-CRT-based APBI. A larger cohort of patients is needed to further ascertain the toxicity of this accelerated partial breast regimen

  11. Accelerated partial breast irradiation with intraoperative electrons: Using GEC–ESTRO recommendations as guidance for patient selection

    Purpose: To evaluate outcomes among early-stage breast cancer patients after conservative surgery and full-dose intraoperative radiotherapy electrons (ELIOT) by applying the Groupe Européen de Curiethérapie–European Society for Therapeutic Radiology and Oncology (GEC–ESTRO) recommendations for partial breast irradiation (APBI). Materials and Methods: One-thousand eight-hundred and twenty-two patients were stratified into the three GEC–ESTRO categories of “good candidates”, “possible candidates” and “contraindication” in order to assess outcomes. Results: All the 1822 cases except 7 could be classified according to GEC–ESTRO groups: 573 patients met the criteria to be included in the “good candidates” group, 468 patients in the “possible candidates” group and 767 patients in the “contraindication” group. Median and mean follow-up length was 3.5 years (range 0–10.5 years) and 3.8 years (SD 2.2), respectively. The 5-year rate of in-breast tumor reappearances for “good candidates”, “possible candidates” and “contraindication” groups were 1.9%, 7.4% and 7.7%, respectively (p 0.001). While the regional node relapse showed no difference, the rate of distant metastases was significantly different in the “contraindication” group compared to the other two categories, having a significant impact on survival. Conclusions: Among the ELIOT population, the GEC–ESTRO recommendations enabled the selection of the good candidates with a low rate of local recurrence, but failed to differentiate the “possible candidates” and the “contraindication” groups

  12. Stereotactic Accelerated Partial Breast Irradiation (SAPBI for Early Stage Breast Cancer: Rationale, Feasibility and Early Experience using the CyberKnife Radiosurgery Delivery Platform

    Olusola eOBAYOMI-DAVIES

    2016-05-01

    Full Text Available Purpose: The efficacy of accelerated partial breast irradiation (APBI utilizing brachytherapy or conventional external beam radiation has been studied in early stage breast cancer treated with breast conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rationale for SAPBI delivery using the CyberKnife radiosurgery system.Methods: Ten patients completed CyberKnife SAPBI in 2013 at Georgetown University Hospital. Four gold fiducials were implanted around the lumpectomy cavity prior to treatment under ultrasound guidance. The synchrony system tracked intrafraction motion of the fiducials. The clinical target volume (CTV was defined on contrast enhanced CT scans using surgical clips and post-operative changes. A 5 mm expansion was added to create the planning treatment volume (PTV. A total dose of 30 Gy was delivered to the PTV in 5 consecutive fractions. Target and critical structure doses were assessed as per the National Surgical Adjuvant Breast and Bowel Project B-39 study.Results: At least 3 fiducials were tracked in 100% of cases. The Mean treated PTV was 70 cm3 and the mean prescription isodose line was 80%. Mean dose to target volumes and constraints are as follows: 100% of the PTV received the prescription dose (PTV30. The volume of the ipsilateral breast receiving 30 Gy (V30 and above 15 Gy (V>15 was 14% and 31% respectively. The ipsilateral lung volume receiving 9 Gy (V9 was 3% and the contralateral lung volume receiving 1.5 Gy (V1.5 was 8%. For left sided breast cancers, the volume of heart receiving 1.5 Gy (V1.5 was 31%. Maximum skin dose was 36 Gy. At a median follow up of 1.3 years, all patients have experienced excellent/good breast cosmesis outcomes, and no breast events have been recorded

  13. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall’s tau (τβ) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4–14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome (τβ 0.6, p β 0.5, p β 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias ≥1 cm2. Grade 3–4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose (τβ 0.3–0.5, p ≤ .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence-free survival, and overall survival rate was 85% (95% confidence interval, 70–97%), 72% (95% confidence interval, 54–86%), and 87% (95% confidence

  14. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    Hattangadi, Jona A. [Harvard Radiation Oncology Program, Boston, MA (United States); Powell, Simon N. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); MacDonald, Shannon M.; Mauceri, Thomas; Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Freer, Phoebe [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Lawenda, Brian [21st Century Oncology, Las Vegas, NV (United States); Alm El-Din, Mohamed A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Department of Clinical Oncology, Tanta University Hospital, Tanta (Egypt); Gadd, Michele A.; Smith, Barbara L. [Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

    2012-07-01

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall's tau ({tau}{sub {beta}}) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4-14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome ({tau}{sub {beta}} 0.6, p < .0001), lower patient satisfaction ({tau}{sub {beta}} 0.5, p < .001), and worse fibrosis ({tau}{sub {beta}} 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias {>=}1 cm{sup 2}. Grade 3-4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose ({tau}{sub {beta}} 0.3-0.5, p {<=} .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence

  15. Accelerated Partial Breast Irradiation: 5-Year Results of the German-Austrian Multicenter Phase II Trial Using Interstitial Multicatheter Brachytherapy Alone After Breast-Conserving Surgery

    Purpose: To evaluate the impact of accelerated partial breast irradiation on local control, side effects, and cosmesis using multicatheter interstitial brachytherapy as the sole method for the adjuvant local treatment of patients with low-risk breast cancer. Methods and Materials: 274 patients with low-risk breast cancer were treated on protocol. Patients were eligible for the study if the tumor size was 35 years, hormone receptors were positive, and histologic grades were 1 or 2. Of the 274 patients, 175 (64%) received pulse-dose-rate brachytherapy (Dref = 50 Gy). and 99 (36%) received high-dose-rate brachytherapy (Dref = 32.0 Gy). Results: Median follow-up was 63 months (range, 9-103). Only 8 of 274 (2.9%) patients developed an ipsilateral in-breast tumor recurrence at the time of analysis. The 5-year actuarial local recurrence-free survival probability was 98%. The 5- year overall and disease-free survival probabilities of all patients were 97% and 96%, respectively. Contralateral in-breast malignancies were detected in 2 of 274 (0.7%) patients, and distant metastases occurred in 6 of 274 (2.2%). Late side effects ≥Grade 3 (i.e., breast tissue fibrosis and telangiectasia) occurred in 1 patient (0.4%, 95%CI:0.0-2.0%) and 6 patients (2.2%, 95%CI:0.8-4.7%), respectively. Cosmetic results were good to excellent in 245 of 274 patients (90%). Conclusions: The long-term results of this prospective Phase II trial confirm that the efficacy of accelerated partial breast irradiation using multicatheter brachytherapy is comparable with that of whole breast irradiation and that late side effects are negligible.

  16. Outcomes in Women Treated With MammoSite Brachytherapy or Whole Breast Irradiation Stratified by ASTRO Accelerated Partial Breast Irradiation Consensus Statement Groups

    Zauls, A. Jason, E-mail: zauls@musc.edu [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States); Watkins, John M. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States); Wahlquist, Amy E. [Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC (United States); Brackett, N. Craig [Coastal Carolina Breast Center, Georgetown, SC (United States); Aguero, Eric G. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States); Baker, Megan K. [Department of Surgery, Medical University of South Carolina, Charleston, SC (United States); Jenrette, Joseph M. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States); Garrett-Mayer, Elizabeth [Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC (United States); Harper, Jennifer L. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States)

    2012-01-01

    Purpose: The American Society for Radiation Oncology published a Consensus Statement for accelerated partial breast irradiation identifying three groups: Suitable, Cautionary, and Unsuitable. The objective of this study was to compare oncologic outcomes in women treated with MammoSite brachytherapy (MB) vs. whole breast irradiation (WBI) after stratification into Statement groups. Methods: Eligible women had invasive carcinoma or ductal carcinoma in situ (DCIS) {<=}3 cm, and {<=}3 lymph nodes positive. Women were stratified by radiation modality and Statement groups. Survival analysis methods including Kaplan-Meier estimation, Cox regression, and competing risks analysis were used to assess overall survival (OS), disease-free survival (DFS), time to local failure (TTLF), and tumor bed failure (TBF). Results: A total of 459 (183 MB and 276 WBI) patients were treated from 2002 to 2009. After a median follow-up of 45 months, we found no statistical differences by stratification group or radiation modality with regard to OS and DFS. At 4 years TTLF or TBF were not statistically different between the cohorts. Univariate analysis in the MB cohort revealed that nodal positivity (pN1 vs. pN0) was related to TTLF (hazard ratio 6.39, p = 0.02). There was a suggestion that DCIS histology had an increased risk of failure when compared with invasive ductal carcinoma (hazard ratio 3.57, p = 0.06). Conclusions: MB and WBI patients stratified by Statement groups seem to combine women who will have similar outcomes regardless of radiation modality. Although outcomes were similar, we remain guarded in overinterpretation of these preliminary results until further analysis and long-term follow-up data become available. Caution should be used in treating women with DCIS or pN1 disease with MB.

  17. Outcomes in Women Treated With MammoSite Brachytherapy or Whole Breast Irradiation Stratified by ASTRO Accelerated Partial Breast Irradiation Consensus Statement Groups

    Purpose: The American Society for Radiation Oncology published a Consensus Statement for accelerated partial breast irradiation identifying three groups: Suitable, Cautionary, and Unsuitable. The objective of this study was to compare oncologic outcomes in women treated with MammoSite brachytherapy (MB) vs. whole breast irradiation (WBI) after stratification into Statement groups. Methods: Eligible women had invasive carcinoma or ductal carcinoma in situ (DCIS) ≤3 cm, and ≤3 lymph nodes positive. Women were stratified by radiation modality and Statement groups. Survival analysis methods including Kaplan-Meier estimation, Cox regression, and competing risks analysis were used to assess overall survival (OS), disease-free survival (DFS), time to local failure (TTLF), and tumor bed failure (TBF). Results: A total of 459 (183 MB and 276 WBI) patients were treated from 2002 to 2009. After a median follow-up of 45 months, we found no statistical differences by stratification group or radiation modality with regard to OS and DFS. At 4 years TTLF or TBF were not statistically different between the cohorts. Univariate analysis in the MB cohort revealed that nodal positivity (pN1 vs. pN0) was related to TTLF (hazard ratio 6.39, p = 0.02). There was a suggestion that DCIS histology had an increased risk of failure when compared with invasive ductal carcinoma (hazard ratio 3.57, p = 0.06). Conclusions: MB and WBI patients stratified by Statement groups seem to combine women who will have similar outcomes regardless of radiation modality. Although outcomes were similar, we remain guarded in overinterpretation of these preliminary results until further analysis and long-term follow-up data become available. Caution should be used in treating women with DCIS or pN1 disease with MB.

  18. Interfractional Target Variations for Partial Breast Irradiation

    Purpose: In this work, we quantify the interfractional variations in the shape of the clinical target volume (CTV) by analyzing the daily CT data acquired during CT-guided partial breast irradiation (PBI) and compare the effectiveness of various repositioning alignment strategies considered to account for the variations. Methods and Materials: The daily CT data for 13 breast cancer patients treated with PBI in either prone (10 patients) or supine (3 patients) with daily kV CT guidance using CT on Rails (CTVision, Siemens, Malvern, PA) were analyzed. For approximately 25 points on the surface of the CTV, deformation vectors were calculated by means of deformable image registration and verified by visual inspection. These were used to calculate the distances along surface normals (DSN), which directly related to the required margin expansions for each point. The DSN values were determined for seven alignment methods based on volumetric imaging and also two-dimensional projections (portal imaging). Results: The margin expansion necessary to cover 99% of all points for all days was 2.7 mm when utilizing the alignment method based on deformation field data (the best alignment method). The center-of-mass based alignment yielded slightly worse results (a margin of 4.0 mm), and shifts obtained by operator placement (7.9 mm), two-dimensional-based methods (7.0–10.1 mm), and skin marks (13.9 mm) required even larger margin expansions. Target shrinkage was evident for most days by the negative values of DSN. Even with the best alignment, the range of DSN values could be as high as 7 mm, resulting in a large amount of normal tissue irradiation, unless adaptive replanning is employed. Conclusion: The appropriate alignment method is important to minimize the margin requirement to cover the significant interfractional target deformations observed during PBI. The amount of normal tissue unnecessarily irradiated is still not insignificant, and can be minimized if adaptive

  19. Monte Carlo-derived TLD cross-calibration factors for treatment verification and measurement of skin dose in accelerated partial breast irradiation

    Garnica-Garza, H M [Centro de Investigacion y de Estudios Avanzados del Instituto Politecnico Nacional Unidad Monterrey, VIa del Conocimiento 201 Parque de Investigacion e Innovacion Tecnologica, Apodaca NL C.P. 66600 (Mexico)], E-mail: hgarnica@cinvestav.mx

    2009-03-21

    Monte Carlo simulation was employed to calculate the response of TLD-100 chips under irradiation conditions such as those found during accelerated partial breast irradiation with the MammoSite radiation therapy system. The absorbed dose versus radius in the last 0.5 cm of the treated volume was also calculated, employing a resolution of 20 {mu}m, and a function that fits the observed data was determined. Several clinically relevant irradiation conditions were simulated for different combinations of balloon size, balloon-to-surface distance and contents of the contrast solution used to fill the balloon. The thermoluminescent dosemeter (TLD) cross-calibration factors were derived assuming that the calibration of the dosemeters was carried out using a Cobalt 60 beam, and in such a way that they provide a set of parameters that reproduce the function that describes the behavior of the absorbed dose versus radius curve. Such factors may also prove to be useful for those standardized laboratories that provide postal dosimetry services.

  20. Monte Carlo-derived TLD cross-calibration factors for treatment verification and measurement of skin dose in accelerated partial breast irradiation

    Monte Carlo simulation was employed to calculate the response of TLD-100 chips under irradiation conditions such as those found during accelerated partial breast irradiation with the MammoSite radiation therapy system. The absorbed dose versus radius in the last 0.5 cm of the treated volume was also calculated, employing a resolution of 20 μm, and a function that fits the observed data was determined. Several clinically relevant irradiation conditions were simulated for different combinations of balloon size, balloon-to-surface distance and contents of the contrast solution used to fill the balloon. The thermoluminescent dosemeter (TLD) cross-calibration factors were derived assuming that the calibration of the dosemeters was carried out using a Cobalt 60 beam, and in such a way that they provide a set of parameters that reproduce the function that describes the behavior of the absorbed dose versus radius curve. Such factors may also prove to be useful for those standardized laboratories that provide postal dosimetry services.

  1. Accelerated partial breast irradiation using intensity-modulated radiotherapy technique compared to whole breast irradiation for patients aged 70 years or older: subgroup analysis from a randomized phase 3 trial

    Meattini, Icro; Saieva, Calogero; Marrazzo, Livia; Di Brina, Lucia; Pallotta, Stefania; Mangoni, Monica; Meacci, Fiammetta; Bendinelli, Benedetta; Francolini, Giulio; Desideri, Isacco; De Luca Cardillo, Carla; Scotti, Vieri; Furfaro, Ilaria Francesca; Rossi, Francesca; Greto, Daniela

    2015-01-01

    The purpose of this study was to report the efficacy and the safety profile on the subset of selected early breast cancer (BC) patients aged 70 years or older from a single-center phase 3 trial comparing whole breast irradiation (WBI) to accelerated partial breast irradiation (APBI) using intensity-modulated radiation therapy technique. Between 2005 and 2013, 520 patients aged more than 40 years old were enrolled and randomly assigned to receive either WBI or APBI in a 1:1 ratio. Eligible pat...

  2. Breast conserving therapy with accelerated partial breast versus external beam whole breast irradiation: comparison of imaging sequela and complications in a matched population.

    Monticciolo, Debra L; Biggs, Kelly; Gist, Ashley K; Sincleair, Spencer T; Hajdik, Rodney L; Nipper, Michael L; Schnitker, James B

    2011-01-01

    Our purpose was to evaluate and compare the imaging sequela and complications of accelerated partial breast irradiation (APBI) with those occurring in patients treated with standard external beam therapy. Patient selection included those who met the criteria for possible ABPI: age 45 or older; cancer stage T1N0M0 or ductal carcinoma in situ 3 cm or less, and negative surgical margins. One hundred and ninety seven had complete records and films available for review. Ninety-seven (49%) were treated with APBI (MammoSite) and 100(51%) were treated with external beam. Image findings for APBI versus external beam were: distortion 90(93%) versus 83(83%), seroma 67(69%) versus 7(7%), skin edema 52(54%) versus 47(47%), increased stroma 75(77%) versus 66(66%), calcifications 10(10%) versus 6(6%), and fat necrosis 12(12%) versus 6(6%). For APBI, skin and stromal edema was more commonly focal. At imaging, the seroma rate was statistically and significantly different between the two treatment modes (p < 0.0001). For patients treated with APBI, seroma formation was not related to balloon size and only weakly related to lumpectomy cavity size. The complication rate was significantly higher for those treated with APBI (36 versus 20%) and the types and treatment of complications differed. There were three recurrences among the APBI group and none among those treated with external beam radiation. PMID:21306469

  3. Five-Year Outcomes, Cosmesis, and Toxicity With 3-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation

    Purpose: To report the interim results from a study comparing the efficacy, toxicity, and cosmesis of breast-conserving treatment with accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) using 3-dimensional conformal external beam radiation therapy (3D-CRT). Methods and Materials: 102 patients with early-stage breast cancer who underwent breast-conserving surgery were randomized to receive either WBI (n=51) or APBI (n=51). In the WBI arm, 48 Gy was delivered to the whole breast in daily fractions of 2 Gy, with or without additional 10 Gy to the tumor bed. In the APBI arm, patients received 37.5 Gy in 3.75 Gy per fraction delivered twice daily. Toxicity results were scored according to the Radiation Therapy Oncology Group Common Toxicity Criteria. Skin elasticity was measured using a dedicated device (Multi-Skin-Test-Center MC-750-B2, CKelectronic-GmbH). Cosmetic results were assessed by the physician and the patients as good/excellent, regular, or poor. Results: The median follow-up time was 5 years. No local recurrences were observed. No significant differences in survival rates were found. APBI reduced acute side effects and radiation doses to healthy tissues compared with WBI (P75% of patients in the APBI arm had excellent or good cosmesis, and these outcomes appear to be stable over time. The percentage of patients with excellent/good cosmetic results was similar in both groups. Conclusions: APBI delivered by 3D-CRT to the tumor bed for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with conventional WBI

  4. A Japanese prospective multi-institutional feasibility study on accelerated partial breast irradiation using interstitial brachytherapy: treatment planning and quality assurance

    In Japan, breast-conserving surgery with closed cavity has generally been performed for breast cancer patients, and accelerated partial breast irradiation (APBI) is considered difficult because Asian females generally have smaller breast sizes than Western females. Therefore, common identification of target and treatment plan method in APBI is required. A prospective multicenter study was conducted in Japan to determine institutional compliance with APBI using high-dose-rate interstitial brachytherapy (ISBT) designed for Japanese female patients. For this study, 46 patients were recruited at eight institutions from January 2009 to December 2011. The reproducibility of the ISBT–APBI plan was evaluated using three criteria: (1) minimum clinical target volume dose with a clip dose ≥ 6 Gy/fraction, (2) irradiated volume constraint of 40-150 cm3, and (3) uniformity of dose distribution, expressed as the dose non-uniformity ratio (DNR, V150/V100) < 0.35. The ISBT–APBI plan for each patient was considered reproducible when all three criteria were met. When the number of non-reproducible patients was ≤ 4 at study completion, APBI at this institution was considered statistically reproducible. Half of the patients (52 %) had a small bra size (A/B cup). The mean values of the dose-constrained parameters were as follows: Vref, 117 cm3 (range, 40-282), DNR, 0.30 (range, 0.22-0.51), and clip dose, 784 cGy (range, 469-3146). A total of 43/46 treatment plans were judged to be compliant and ISBT–APBI was concluded to be reproducible. This study showed that multi-institutional ISBT–APBI treatment plan was reproducible for small breast patient with closed cavity

  5. Early Side Effects of Three-Dimensional Conformal External Beam Accelerated Partial Breast Irradiation to a Total Dose of 40 Gy in One Week (A Phase II Trial)

    Bourgier, Celine, E-mail: bourgier@igr.fr [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Pichenot, Charlotte; Verstraet, Rodolfe [Department of Physics, Institut Gustave Roussy, Villejuif (France); El Nemr, Mohamed; Heymann, Steve [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Biron, Bruno [Department of Physics, Institut Gustave Roussy, Villejuif (France); Delaloge, Suzette [Department of Breast Oncology, Institut Gustave Roussy, Villejuif (France); Mathieu, Marie-Christine [Department of Pathology, Institut Gustave Roussy, Villejuif (France); Garbay, Jean-Remy [Department of Breast Surgery, Institut Gustave Roussy, Villejuif (France); Bourhis, Jean [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Taghian, Alphonse G. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Marsiglia, Hugo [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Radiotherapy Unit, University of Florence, Florence (Italy)

    2011-12-01

    Purpose: Several accelerated partial breast irradiation (APBI) techniques are described in the literature, and apparently, the three-dimensional (3D)-conformal technique is being used increasingly. Nonetheless, the optimal radiation dose is not yet known. Here, we report feasibility and early toxicities of APBI delivering 40 Gy over 5 days, in a phase II trial. Methods and Materials: From October 2007 to September 2008, 25 patients with pT1N0 cancer received 3D-conformal APBI. The prescribed radiation dose was 40 Gy in 4-Gy fractions given twice daily. This technique used two minitangents and an 'en face' electron field. Toxicities were systematically assessed at 1, 2, and 6 months and then once every 6 months. Results: The planning tumor volume for evaluation (PTV{sub E}VAL) coverage was adequate: the mean dose to the PTV{sub E}VAL was 41.8 Gy (range, 41-42.4 Gy). Mean doses to the ipsilateral lung and heart were 1.6 Gy (range, 1.0-2.3 Gy) and 1.2 Gy (range, 1.0-1.6 Gy), respectively. One and two months after completion of APBI, most patients had no or mild erythema (n = 16 patients at 1 month; n = 25 patients at 2 months); none of these patients developed moist desquamation. After a median follow-up of 12 months, only 1 patient had a significant moderate field contracture (grade 2). Other reported late toxicities were grade 1. Conclusions: 3D-conformal APBI (with two minitangents and an 'en face' electron field) using a total dose of 40 Gy in 10 fractions twice daily over 5 days achieved appropriate PTV{sub E}VAL coverage and offered significant sparing of normal tissue. Early tolerance was excellent.

  6. Dose volume histogram analysis of normal structures associated with accelerated partial breast irradiation delivered by high dose rate brachytherapy and comparison with whole breast external beam radiotherapy fields

    Mutyala Subhakar

    2008-11-01

    Full Text Available Abstract Purpose To assess the radiation dose delivered to the heart and ipsilateral lung during accelerated partial breast brachytherapy using a MammoSite™ applicator and compare to those produced by whole breast external beam radiotherapy (WBRT. Materials and methods Dosimetric analysis was conducted on patients receiving MammoSite breast brachytherapy following conservative surgery for invasive ductal carcinoma. Cardiac dose was evaluated for patients with left breast tumors with a CT scan encompassing the entire heart. Lung dose was evaluated for patients in whom the entire lung was scanned. The prescription dose of 3400 cGy was 1 cm from the balloon surface. MammoSite dosimetry was compared to simulated WBRT fields with and without radiobiological correction for the effects of dose and fractionation. Dose parameters such as the volume of the structure receiving 10 Gy or more (V10 and the dose received by 20 cc of the structure (D20, were calculated as well as the maximum and mean doses received. Results Fifteen patients were studied, five had complete lung data and six had left-sided tumors with complete cardiac data. Ipsilateral lung volumes ranged from 925–1380 cc. Cardiac volumes ranged from 337–551 cc. MammoSite resulted in a significantly lower percentage lung V30 and lung and cardiac V20 than the WBRT fields, with and without radiobiological correction. Conclusion This study gives low values for incidental radiation received by the heart and ipsilateral lung using the MammoSite applicator. The volume of heart and lung irradiated to clinically significant levels was significantly lower with the MammoSite applicator than using simulated WBRT fields of the same CT data sets. Trial registration Dana Farber Trial Registry number 03-179

  7. Accelerated partial breast irradiation with external beam three-dimensional conformal radiotherapy. Five-year results of a prospective phase II clinical study

    The aim of this study was to report the 5-year results of accelerated partial breast irradiation (APBI) using external beam three-dimensional conformal radiotherapy (3D-CRT). Between 2006 and 2011, 44 patients with low-risk, stage I-II breast cancer underwent breast-conserving surgery. Postoperative APBI was given by means of 3D-CRT using three to five non-coplanar fields. The total dose of APBI was 36.9 Gy (nine fractions of 4.1 Gy b.i.d.). The mean follow-up time was 58.2 months for surviving patients. Survival results, side effects, and cosmetic results were assessed. One (2.3 %) local recurrence was observed, for a 5-year actuarial rate of 3.7 %. Neither regional nor distant failure was observed. Two patients died of internal disease. The 5-year disease-free, cancer-specific, and overall survival rates were 96.3, 100, and 95.1 %, respectively. Acute side effects included grade 1 (G1) erythema in 75 %, G1 parenchymal induration in 46 %, and G1 pain in 46 % of patients. No G2 or higher acute side effect occurred. Late side effects included G1, G2, and G3 fibrosis in 44, 7, and 2 % of patients, respectively, G1 skin pigmentation in 12 %, and G1 pain in 2 %. Asymptomatic fat necrosis occurred in 14 %. Cosmetic results were rated excellent or good in 86 % of cases by the patients themselves and 84 % by the physicians. The 5-year local tumor control, toxicity profile, and cosmetic results of APBI delivered with external beam 3D-CRT are encouraging and comparable to other APBI series. (orig.)

  8. Analysis of Treatment Efficacy, Cosmesis, and Toxicity Using the MAMMOSITE Breast Brachytherapy Catheter to Deliver Accelerated Partial-Breast Irradiation: The William Beaumont Hospital Experience

    Purpose: To review our institution's experience of treating patients with the MammoSite (Cytyc Corp., Marlborough, MA) breast brachytherapy catheter to deliver accelerated partial-breast irradiation (APBI), for determining short-term treatment efficacy, cosmesis, and toxicity. Methods and Materials: From January 2000 to April 2006, 80 patients treated with breast-conserving therapy (BCT) received adjuvant radiation using the MammoSite (34 Gy in 3.4-Gy fractions prescribed to 1.0 cm from the balloon surface). Twenty-three patients (29%) had Stage 0 breast cancer, 46 (57%) had Stage I breast cancer, and 11 (14%) had Stage II breast cancer. The median follow-up was 22.1 months. Results: Two ipsilateral breast-tumor recurrences (IBTRs) (2.5%) developed for a 3-year actuarial rate of 2.9% (no regional failures were observed). On molecular-based clonality assay evaluation, both recurrences were clonally related. Younger age at diagnosis was the only variable associated with IBTR (continuous variable, p = 0.044; categorical variable [<55 years vs. ≥55 years], p = 0.012). The percentages of patients with good/excellent cosmetic results at 12 and 36 months were 96.9% and 88.2%, respectively (p = NS). Patients with applicator-to-skin spacing <7 mm and those who received adjuvant systemic chemotherapy exhibited lower rates of good/excellent cosmetic results, though the association was not statistically significant. The overall incidence of symptomatic seromas and any seromas was 10% and 45%, respectively. The overall incidence of fat necrosis and infections was 8.8% and 11.3%, respectively. Conclusions: Early-stage breast-cancer patients treated with adjuvant APBI using the MammoSite catheter exhibited a 3-year treatment efficacy, cosmesis, and toxicity similar to those observed with other forms of interstitial APBI at this length of follow-up

  9. Improvement of registration accuracy in accelerated partial breast irradiation using the point-based rigid-body registration algorithm for patients with implanted fiducial markers

    Inoue, Minoru; Yoshimura, Michio, E-mail: myossy@kuhp.kyoto-u.ac.jp; Sato, Sayaka; Nakamura, Mitsuhiro; Yamada, Masahiro; Hirata, Kimiko; Ogura, Masakazu; Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto 606-8507 (Japan); Sasaki, Makoto; Fujimoto, Takahiro [Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507 (Japan)

    2015-04-15

    Purpose: To investigate image-registration errors when using fiducial markers with a manual method and the point-based rigid-body registration (PRBR) algorithm in accelerated partial breast irradiation (APBI) patients, with accompanying fiducial deviations. Methods: Twenty-two consecutive patients were enrolled in a prospective trial examining 10-fraction APBI. Titanium clips were implanted intraoperatively around the seroma in all patients. For image-registration, the positions of the clips in daily kV x-ray images were matched to those in the planning digitally reconstructed radiographs. Fiducial and gravity registration errors (FREs and GREs, respectively), representing resulting misalignments of the edge and center of the target, respectively, were compared between the manual and algorithm-based methods. Results: In total, 218 fractions were evaluated. Although the mean FRE/GRE values for the manual and algorithm-based methods were within 3 mm (2.3/1.7 and 1.3/0.4 mm, respectively), the percentages of fractions where FRE/GRE exceeded 3 mm using the manual and algorithm-based methods were 18.8%/7.3% and 0%/0%, respectively. Manual registration resulted in 18.6% of patients with fractions of FRE/GRE exceeding 5 mm. The patients with larger clip deviation had significantly more fractions showing large FRE/GRE using manual registration. Conclusions: For image-registration using fiducial markers in APBI, the manual registration results in more fractions with considerable registration error due to loss of fiducial objectivity resulting from their deviation. The authors recommend the PRBR algorithm as a safe and effective strategy for accurate, image-guided registration and PTV margin reduction.

  10. Early Side Effects of Three-Dimensional Conformal External Beam Accelerated Partial Breast Irradiation to a Total Dose of 40 Gy in One Week (A Phase II Trial)

    Purpose: Several accelerated partial breast irradiation (APBI) techniques are described in the literature, and apparently, the three-dimensional (3D)-conformal technique is being used increasingly. Nonetheless, the optimal radiation dose is not yet known. Here, we report feasibility and early toxicities of APBI delivering 40 Gy over 5 days, in a phase II trial. Methods and Materials: From October 2007 to September 2008, 25 patients with pT1N0 cancer received 3D-conformal APBI. The prescribed radiation dose was 40 Gy in 4-Gy fractions given twice daily. This technique used two minitangents and an “en face” electron field. Toxicities were systematically assessed at 1, 2, and 6 months and then once every 6 months. Results: The planning tumor volume for evaluation (PTVEVAL) coverage was adequate: the mean dose to the PTVEVAL was 41.8 Gy (range, 41–42.4 Gy). Mean doses to the ipsilateral lung and heart were 1.6 Gy (range, 1.0–2.3 Gy) and 1.2 Gy (range, 1.0–1.6 Gy), respectively. One and two months after completion of APBI, most patients had no or mild erythema (n = 16 patients at 1 month; n = 25 patients at 2 months); none of these patients developed moist desquamation. After a median follow-up of 12 months, only 1 patient had a significant moderate field contracture (grade 2). Other reported late toxicities were grade 1. Conclusions: 3D-conformal APBI (with two minitangents and an “en face” electron field) using a total dose of 40 Gy in 10 fractions twice daily over 5 days achieved appropriate PTVEVAL coverage and offered significant sparing of normal tissue. Early tolerance was excellent.

  11. A phase I/II study piloting accelerated partial breast irradiation using CT-guided intensity modulated radiation therapy in the prone position

    Background and purpose: External beam accelerated partial breast irradiation (EB-aPBI) is noninvasive with broader potential applicability than aPBI using brachytherapy. However, it has inherent challenges in daily reproducibility. Image-guide radiotherapy (IGRT) can improve daily reproducibility, allowing smaller treatment margins. Our institution proposed IG-IMRT in the prone position to evaluate dose homogeneity, conformality, normal tissue avoidance, and reliable targeting for EB-aPBI. We report preliminary results and toxicity from a phase I/II study evaluating the feasibility of EB-aPBI in the prone position using IG-IMRT. Materials and methods: Twenty post-menopausal women with node-negative breast cancer, excised tumors 99% of the PTV. Dose constraints for the whole breast, lungs and heart were met. Results: The median patient age was 61.5. Mean tumor size was 1.0 cm. 35% of patients had DCIS. Median PTV was 243 cc (108–530) and median breast reference volume was 1698 cc (647–3627). Average daily shifts for IGRT were (0.6, −4.6, 1.7 mm) with standard deviations of (6.3, 6.5, 6.4 mm). Acute toxicity was G1 erythema in 80%, and G2 erythema, G2 fatigue, and G2 breast pain each occurred in 1 patient. With a median follow-up of 18.9 months (12–35), 40% of patients have G1 fibrosis and 30% have G1 hyperpigmentation. 95% of patients have good to excellent cosmesis. There have been no recurrences. Conclusions: These data demonstrate that EB-aPBI in the prone position using IG-IMRT is well tolerated, yields good dosimetric conformality, and results in promising early toxicity profiles

  12. External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study

    Pashtan, Itai M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Recht, Abram [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Brachtel, Elena [Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts (United States); Abi-Raad, Rita F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); D' Alessandro, Helen A. [Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts (United States); Levy, Antonin; Wo, Jennifer Y. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Hirsch, Ariel E. [Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts (United States); Kachnic, Lisa A. [Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Goldberg, Saveli [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle; Gadd, Michelle; Smith, Barbara L. [Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Powell, Simon N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2012-11-01

    Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.

  13. Long-term Cosmetic Outcomes and Toxicities of Proton Beam Therapy Compared With Photon-Based 3-Dimensional Conformal Accelerated Partial-Breast Irradiation: A Phase 1 Trial

    Galland-Girodet, Sigolène; Pashtan, Itai; MacDonald, Shannon M.; Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Hirsch, Ariel E.; Kachnic, Lisa A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts (United States); Specht, Michelle; Gadd, Michele; Smith, Barbara L. [Department of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Powell, Simon N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Recht, Abram [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-11-01

    Purpose: To present long-term outcomes of a prospective feasibility trial using either protons or 3-dimensional conformal photon-based (accelerated partial-breast irradiation [APBI]) techniques. Methods and Materials: From October 2003 to April 2006, 98 evaluable patients with stage I breast cancer were treated with APBI (32 Gy in 8 fractions given twice daily) on a prospective clinical trial: 19 with proton beam therapy (PBT) and 79 with photons or mixed photons/electrons. Median follow-up was 82.5 months (range, 2-104 months). Toxicity and patient satisfaction evaluations were performed at each visit. Results: At 7 years, the physician rating of overall cosmesis was good or excellent for 62% of PBT patients, compared with 94% for photon patients (P=.03). Skin toxicities were more common for the PBT group: telangiectasia, 69% and 16% (P=.0013); pigmentation changes, 54% and 22% (P=.02); and other late skin toxicities, 62% and 18% (P=.029) for PBT and photons, respectively. There were no significant differences between the groups in the incidences of breast pain, edema, fibrosis, fat necrosis, skin desquamation, and rib pain or fracture. Patient-reported cosmetic outcomes at 7 years were good or excellent for 92% and 96% of PBT and photon patients, respectively (P=.95). Overall patient satisfaction was 93% for the entire cohort. The 7-year local failure rate for all patients was 6%, with 3 local recurrences in the PBT group (7-year rate, 11%) and 2 in photon-treated patients (4%) (P=.22). Conclusions: Local failure rates of 3-dimensional APBI and PBT were similar in this study. However, PBT, as delivered in this study, led to higher rates of long-term telangiectasia, skin color changes, and skin toxicities. We recommend the use of multiple fields and treatment of all fields per treatment session or the use of scanning techniques to minimize skin toxicity.

  14. Factors Associated With Optimal Long-Term Cosmetic Results in Patients Treated With Accelerated Partial Breast Irradiation Using Balloon-Based Brachytherapy

    Purpose: To evaluate factors associated with optimal cosmetic results at 72 months for early-stage breast cancer patients treated with Mammosite balloon-based accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,440 patients (1,449 cases) with early-stage breast cancer undergoing breast-conserving therapy were treated with balloon-based brachytherapy to deliver APBI (34 Gy in 3.4-Gy fractions). Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good (E/G) or fair/poor (F/P). Follow-up was evaluated at 36 and 72 months to establish long-term cosmesis, stability of cosmesis, and factors associated with optimal results. Results: The percentage of evaluable patients with excellent/good (E/G) cosmetic results at 36 months and more than 72 months were 93.3% (n = 708/759) and 90.4% (n = 235/260). Factors associated with optimal cosmetic results at 72 months included: larger skin spacing (p = 0.04) and T1 tumors (p = 0.02). Using multiple regression analysis, the only factors predictive of worse cosmetic outcome at 72 months were smaller skin spacing (odds ratio [OR], 0.89; confidence interval [CI], 0.80–0.99) and tumors greater than 2 cm (OR, 4.96, CI, 1.53–16.07). In all, 227 patients had both a 36-month and a 72-month cosmetic evaluation. The number of patients with E/G cosmetic results decreased only slightly from 93.4% at 3 years to 90.8% (p = 0.13) at 6 years, respectively. Conclusions: APBI delivered with balloon-based brachytherapy produced E/G cosmetic results in 90.4% of cases at 6 years. Larger tumors (T2) and smaller skin spacing were found to be the two most important independent predictors of cosmesis.

  15. Long-term Cosmetic Outcomes and Toxicities of Proton Beam Therapy Compared With Photon-Based 3-Dimensional Conformal Accelerated Partial-Breast Irradiation: A Phase 1 Trial

    Purpose: To present long-term outcomes of a prospective feasibility trial using either protons or 3-dimensional conformal photon-based (accelerated partial-breast irradiation [APBI]) techniques. Methods and Materials: From October 2003 to April 2006, 98 evaluable patients with stage I breast cancer were treated with APBI (32 Gy in 8 fractions given twice daily) on a prospective clinical trial: 19 with proton beam therapy (PBT) and 79 with photons or mixed photons/electrons. Median follow-up was 82.5 months (range, 2-104 months). Toxicity and patient satisfaction evaluations were performed at each visit. Results: At 7 years, the physician rating of overall cosmesis was good or excellent for 62% of PBT patients, compared with 94% for photon patients (P=.03). Skin toxicities were more common for the PBT group: telangiectasia, 69% and 16% (P=.0013); pigmentation changes, 54% and 22% (P=.02); and other late skin toxicities, 62% and 18% (P=.029) for PBT and photons, respectively. There were no significant differences between the groups in the incidences of breast pain, edema, fibrosis, fat necrosis, skin desquamation, and rib pain or fracture. Patient-reported cosmetic outcomes at 7 years were good or excellent for 92% and 96% of PBT and photon patients, respectively (P=.95). Overall patient satisfaction was 93% for the entire cohort. The 7-year local failure rate for all patients was 6%, with 3 local recurrences in the PBT group (7-year rate, 11%) and 2 in photon-treated patients (4%) (P=.22). Conclusions: Local failure rates of 3-dimensional APBI and PBT were similar in this study. However, PBT, as delivered in this study, led to higher rates of long-term telangiectasia, skin color changes, and skin toxicities. We recommend the use of multiple fields and treatment of all fields per treatment session or the use of scanning techniques to minimize skin toxicity

  16. Clinical outcomes of prospectively treated 140 women with early stage breast cancer using accelerated partial breast irradiation with 3 dimensional computerized tomography based brachytherapy

    Purpose: To study the clinical outcomes of women with early breast cancer (EBC) treated with accelerated partial breast irradiation (APBI) with multicatheter interstitial brachytherapy (MIB) using 3 dimensional computerized tomography (3DCT) based planning. Materials and methods: During August 2005 to January 2013, 140 women with EBC were treated prospectively with APBI using high dose rate (HDR) MIB. After 3DCT based planning patients were treated to a dose of 34 Gy/10 #/1 week with bid regimen. Results: Median age was 57 years and tumor size 2 cm (range: 0.6–3.2 cm). Infiltrating duct carcinoma (IDC) was the most common histology; grade III tumors were seen in 82%. Median dose homogeneity index (DHI) was 0.76 (range: 0.49–0.85). The median coverage index (CI) of the cavity was 90% (61.4–100) and 80.5% (53.6–97.4) for planning target volume (PTV). Median follow up was 60 months (1–102 months). The 5 and 7 year local control rates (LC) were 97% and 92% respectively. Her2 positivity was the only prognostic factor which had an adverse impact on LC (p = 0.01). Five and 7 year disease free survival (DFS) and overall survival (OAS) were 93%, 84%, 97.5% and 89% respectively. Good to excellent cosmetic outcomes at last follow up were seen in 87 (77%) women. Conclusions: 3DCT based MIB results in excellent long term outcomes and good to excellent cosmesis. Her2 positivity has an adverse impact on LC rates

  17. External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study

    Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.

  18. Accelerated partial breast irradiation with iridium-192 multicatheter PDR/HDR brachytherapy. Preliminary results of the German-Austrian multicenter trial

    that accelerated partial breast irradiation with iridium-192 interstitial multicatheter PDR/HDR implants is feasible with low perioperative morbidity, low acute and mild late toxicity, and does not significantly affect cosmetic results at a median follow-up of 24 months. (orig.)

  19. Accelerated partial breast irradiation with iridium-192 multicatheter PDR/HDR brachytherapy. Preliminary results of the German-Austrian multicenter trial

    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [Dept. of Radiation Oncology, Univ. Hospital Erlangen, Erlangen (Germany); Poetter, R.; Resch, A. [Dept. of Radiotherapy and Radiobiology, Univ. Hospital AKH Wien, Vienna (Austria); Hammer, J. [Dept. of Radiation Oncology, Barmherzige Schwestern Hospital Linz, Linz (Austria); Hildebrandt, G. [Dept. of Radiation Oncology, Univ. Hospital Leipzig, Leipzig (Germany); Poehls, U.; Beckmann, M.W. [Dept. of Gynecology, Univ. Hospital Erlangen, Erlangen (Germany)

    2004-10-01

    : this analysis indicates that accelerated partial breast irradiation with iridium-192 interstitial multicatheter PDR/HDR implants is feasible with low perioperative morbidity, low acute and mild late toxicity, and does not significantly affect cosmetic results at a median follow-up of 24 months. (orig.)

  20. TH-C-12A-09: Planning and Delivery of the Fully Dynamic Trajectory Modulated Arc Therapy: Application to Accelerated Partial Breast Irradiation

    Liang, J; Atwood, T; Fahimian, B; Chin, E; Hristov, D [Department of Radiation Oncology, Stanford University, CA (United States); Otto, K [Department of Physics, University of British Columbia, BC (Canada)

    2014-06-15

    Purpose: A novel trajectory modulated arc therapy (TMAT) system was developed that uses source motion trajectory involving synchronized gantry rotation with translational and rotational couch movement. MLC motion and dose rate were fully optimized for dynamic beam delivery. This work presents a platform for planning deliverable TMAT on a collision free coronal trajectory and evaluates its benefit for accelerated partial breast irradiation (APBI) in a prone position. Methods: The TMAT algorithm was built on VMAT with modifications (physical properties on couch movement were defined) and enhancements (pencil beam dose calculation engine to support extended SSDs) to make it feasible for TMAT delivery. A Matlab software environment for TMAT optimization and dose calculation was created to allow any user specified motion axis. TMAT delivery was implemented on Varian TrueBeamTM STx via XML scripts. 10 prone breast irradiation cases were evaluated in VMAT and compared with a 6- field non-coplanar IMRT plan. Patient selection/exclusion criteria and structure contouring followed the guidelines of NSABP B-39/RTOG 0413 protocol. Results: TMAT delivery time was ∼4.5 minutes. 251.5°±7.88° of non-isocentric couch arc was achieved by the optimized trajectory with 180– 210 control points at 1°–2° couch increments. The improved dose distribution by TMAT was most clearly observed by the marked reduction in the volume of irradiated normal breast tissue in the high dose region. The ratios of the normal breast tissue volume receiving more than 50%, 80% and 100% of the prescription dose for TMAT versus IMRT were: V50%(TMAT/IMRT) = 78.38%±13.03%, V80%(TMAT/IMRT) = 44.19%±9.04% and V100% (TMAT/IMRT) = 9.96%±7.55%, all p≤0.01. Conclusion: The study is the first demonstration of planning and delivery implementation of a fully dynamic APBI TMAT system with continuous couch motion. TMAT achieved significantly improved dosimetry over noncoplanar IMRT on dose volume parameters

  1. Five-Year Outcomes, Cosmesis, and Toxicity With 3-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation

    Rodríguez, Núria, E-mail: nrodriguez@parcdesalutmar.cat [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain); Sanz, Xavier [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain); Dengra, Josefa [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Foro, Palmira [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain); Membrive, Ismael; Reig, Anna [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Quera, Jaume [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain); Fernández-Velilla, Enric; Pera, Óscar; Lio, Jackson; Lozano, Joan [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Algara, Manuel [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain)

    2013-12-01

    Purpose: To report the interim results from a study comparing the efficacy, toxicity, and cosmesis of breast-conserving treatment with accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) using 3-dimensional conformal external beam radiation therapy (3D-CRT). Methods and Materials: 102 patients with early-stage breast cancer who underwent breast-conserving surgery were randomized to receive either WBI (n=51) or APBI (n=51). In the WBI arm, 48 Gy was delivered to the whole breast in daily fractions of 2 Gy, with or without additional 10 Gy to the tumor bed. In the APBI arm, patients received 37.5 Gy in 3.75 Gy per fraction delivered twice daily. Toxicity results were scored according to the Radiation Therapy Oncology Group Common Toxicity Criteria. Skin elasticity was measured using a dedicated device (Multi-Skin-Test-Center MC-750-B2, CKelectronic-GmbH). Cosmetic results were assessed by the physician and the patients as good/excellent, regular, or poor. Results: The median follow-up time was 5 years. No local recurrences were observed. No significant differences in survival rates were found. APBI reduced acute side effects and radiation doses to healthy tissues compared with WBI (P<.01). Late skin toxicity was no worse than grade 2 in either group, without significant differences between the 2 groups. In the ipsilateral breast, the areas that received the highest doses (ie, the boost or quadrant) showed the greatest loss of elasticity. WBI resulted in a greater loss of elasticity in the high-dose area compared with APBI (P<.05). Physician assessment showed that >75% of patients in the APBI arm had excellent or good cosmesis, and these outcomes appear to be stable over time. The percentage of patients with excellent/good cosmetic results was similar in both groups. Conclusions: APBI delivered by 3D-CRT to the tumor bed for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with

  2. Tracking the dynamic seroma cavity using fiducial markers in patients treated with accelerated partial breast irradiation using 3D conformal radiotherapy

    Yue, Ning J.; Haffty, Bruce G.; Goyal, Sharad [Department of Radiation Oncology, Cancer Institute of New Jersey, UMDNJ/Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903 (United States); Kearney, Thomas; Kirstein, Laurie [Division of Surgical Oncology, Cancer Institute of New Jersey, UMDNJ/Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903 (United States); Chen Sining [Department of Biostatistics, Cancer Institute of New Jersey, UMDNJ/School of Public Health, New Brunswick, NJ 08901 (United States)

    2013-02-15

    Purpose: The purpose of the present study was to perform an analysis of the changes in the dynamic seroma cavity based on fiducial markers in early stage breast cancer patients treated with accelerated partial breast irradiation (APBI) using three-dimensional conformal external beam radiotherapy (3D-CRT). Methods: A prospective, single arm trial was designed to investigate the utility of gold fiducial markers in image guided APBI using 3D-CRT. At the time of lumpectomy, four to six suture-type gold fiducial markers were sutured to the walls of the cavity. Patients were treated with a fractionation scheme consisting of 15 fractions with a fractional dose of 333 cGy. Treatment design and planning followed NSABP/RTOG B-39 guidelines. During radiation treatment, daily kV imaging was performed and the markers were localized and tracked. The change in distance between fiducial markers was analyzed based on the planning CT and daily kV images. Results: Thirty-four patients were simulated at an average of 28 days after surgery, and started the treatment on an average of 39 days after surgery. The average intermarker distance (AiMD) between fiducial markers was strongly correlated to seroma volume. The average reduction in AiMD was 19.1% (range 0.0%-41.4%) and 10.8% (range 0.0%-35.6%) for all the patients between simulation and completion of radiotherapy, and between simulation and beginning of radiotherapy, respectively. The change of AiMD fits an exponential function with a half-life of seroma shrinkage. The average half-life for seroma shrinkage was 15 days. After accounting for the reduction which started to occur after surgery through CT simulation and treatment, radiation was found to have minimal impact on the distance change over the treatment course. Conclusions: Using the marker distance change as a surrogate for seroma volume, it appears that the seroma cavity experiences an exponential reduction in size. The change in seroma size has implications in the size of

  3. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate 192Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicator to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy applicators and

  4. The Effect of Dose-Volume Parameters and Interfraction Interval on Cosmetic Outcome and Toxicity After 3-Dimensional Conformal Accelerated Partial Breast Irradiation

    Leonard, Kara Lynne, E-mail: karalynne.kerr@gmail.com [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts (United States); Hepel, Jaroslaw T. [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts (United States); Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island (United States); Hiatt, Jessica R. [Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island (United States); Dipetrillo, Thomas A. [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts (United States); Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island (United States); Price, Lori Lyn [Department of Biostatistics Research Center, Institute of Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts (United States); Wazer, David E. [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts (United States); Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island (United States)

    2013-03-01

    Purpose: To evaluate dose-volume parameters and the interfraction interval (IFI) as they relate to cosmetic outcome and normal tissue effects of 3-dimensional conformal radiation therapy (3D-CRT) for accelerated partial breast irradiation (APBI). Methods and Materials: Eighty patients were treated by the use of 3D-CRT to deliver APBI at our institutions from 2003-2010 in strict accordance with the specified dose-volume constraints outlined in the National Surgical Adjuvant Breast and Bowel Project B39/Radiation Therapy Oncology Group 0413 (NSABP-B39/RTOG 0413) protocol. The prescribed dose was 38.5 Gy in 10 fractions delivered twice daily. Patients underwent follow-up with assessment for recurrence, late toxicity, and overall cosmetic outcome. Tests for association between toxicity endpoints and dosimetric parameters were performed with the chi-square test. Univariate logistic regression was used to evaluate the association of interfraction interval (IFI) with these outcomes. Results: At a median follow-up time of 32 months, grade 2-4 and grade 3-4 subcutaneous fibrosis occurred in 31% and 7.5% of patients, respectively. Subcutaneous fibrosis improved in 5 patients (6%) with extended follow-up. Fat necrosis developed in 11% of women, and cosmetic outcome was fair/poor in 19%. The relative volume of breast tissue receiving 5%, 20%, 50%, 80%, and 100% (V5-V100) of the prescribed dose was associated with risk of subcutaneous fibrosis, and the volume receiving 50%, 80%, and 100% (V50-V100) was associated with fair/poor cosmesis. The mean IFI was 6.9 hours, and the minimum IFI was 6.2 hours. The mean and minimum IFI values were not significantly associated with late toxicity. Conclusions: The incidence of moderate to severe late toxicity, particularly subcutaneous fibrosis and fat necrosis and resulting fair/poor cosmesis, remains high with continued follow-up. These toxicity endpoints are associated with several dose-volume parameters. Minimum and mean IFI values were

  5. WE-G-BRE-09: Targeted Radiotherapy Enhancement During Accelerated Partial Breast Irradiation (ABPI) Using Controlled Release of Gold Nanoparticles (GNPs)

    Cifter, G; Ngwa, W [University of Massachusetts (United States); Harvard Medical School, Dana Farber Cancer Institute (United States); Chin, J; Cifter, F; Sajo, E [University of Massachusetts (United States); Sinha, N [Wentworth Institute of Technology, Boston, MA (United States); Bellon, J [Harvard Medical School, Dana Farber Cancer Institute (United States)

    2014-06-15

    Purpose: Several studies have demonstrated low rates of local recurrence with brachytherapy-based accelerated partial breast irradiation (APBI). However, long-term outcomes on toxicity (e.g. telangiectasia), and cosmesis remain a major concern. The purpose of this study is to investigate the dosimetric feasibility of using targeted non-toxic radiosensitizing gold nanoparticles (GNPs) for localized dose enhancement to the planning target volume (PTV) during APBI while reducing dose to normal tissue. Methods: Two approaches for administering the GNPs were considered. In one approach, GNPs are assumed to be incorporated in a micrometer-thick polymer film on the surface of routinely used mammosite balloon applicators, for sustained controlled in-situ release, and subsequent treatment using 50-kVp Xoft devices. In case two, GNPs are administered directly into the lumpectomy cavity e.g. via injection or using fiducials coated with the GNP-loaded polymer film. Recent studies have validated the use of fiducials for reducing the PTV margin during APBI with 6 MV beams. An experimentally determined diffusion coefficient was used to determine space-time customizable distribution of GNPs for feasible in-vivo concentrations of 43 mg/g. An analytic calculational approach from previously published work was employed to estimate the dose enhancement due to GNPs (2 and 10 nm) as a function of distance up to 1 cm from lumpectomy cavity. Results: Dose enhancement due to GNP was found to be about 130% for 50-kVp x-rays, and 110% for 6-MV external beam radiotherapy, 1 cm away from the lumpectomy cavity wall. Higher customizable dose enhancement could be achieved at other distances as a function of nanoparticle size. Conclusion: Our preliminary results suggest that significant dose enhancement can be achieved to residual tumor cells targeted with GNPs during APBI with electronic brachytherapy or external beam therapy. The findings provide a useful basis for developing nanoparticle

  6. WE-G-BRE-09: Targeted Radiotherapy Enhancement During Accelerated Partial Breast Irradiation (ABPI) Using Controlled Release of Gold Nanoparticles (GNPs)

    Purpose: Several studies have demonstrated low rates of local recurrence with brachytherapy-based accelerated partial breast irradiation (APBI). However, long-term outcomes on toxicity (e.g. telangiectasia), and cosmesis remain a major concern. The purpose of this study is to investigate the dosimetric feasibility of using targeted non-toxic radiosensitizing gold nanoparticles (GNPs) for localized dose enhancement to the planning target volume (PTV) during APBI while reducing dose to normal tissue. Methods: Two approaches for administering the GNPs were considered. In one approach, GNPs are assumed to be incorporated in a micrometer-thick polymer film on the surface of routinely used mammosite balloon applicators, for sustained controlled in-situ release, and subsequent treatment using 50-kVp Xoft devices. In case two, GNPs are administered directly into the lumpectomy cavity e.g. via injection or using fiducials coated with the GNP-loaded polymer film. Recent studies have validated the use of fiducials for reducing the PTV margin during APBI with 6 MV beams. An experimentally determined diffusion coefficient was used to determine space-time customizable distribution of GNPs for feasible in-vivo concentrations of 43 mg/g. An analytic calculational approach from previously published work was employed to estimate the dose enhancement due to GNPs (2 and 10 nm) as a function of distance up to 1 cm from lumpectomy cavity. Results: Dose enhancement due to GNP was found to be about 130% for 50-kVp x-rays, and 110% for 6-MV external beam radiotherapy, 1 cm away from the lumpectomy cavity wall. Higher customizable dose enhancement could be achieved at other distances as a function of nanoparticle size. Conclusion: Our preliminary results suggest that significant dose enhancement can be achieved to residual tumor cells targeted with GNPs during APBI with electronic brachytherapy or external beam therapy. The findings provide a useful basis for developing nanoparticle

  7. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher’s exact test was performed to correlate age (≤70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors ≤2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  8. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    Khan, Atif J., E-mail: atif_khan@rwjuh.edu [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Vicini, Frank A.; Beitsch, Peter [American Society of Breast Surgeons, Columbia, MD (United States); Goyal, Sharad [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Kuerer, Henry M.; Keisch, Martin; Quiet, Coral; Zannis, Victor; Keleher, Angela; Snyder, Howard; Gittleman, Mark; Whitworth, Pat; Fine, Richard [American Society of Breast Surgeons, Columbia, MD (United States); Lyden, Maureen [BioStat International, Inc., Tampa, FL (United States); Haffty, Bruce G. [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); American Society of Breast Surgeons, Columbia, MD (United States)

    2012-10-01

    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher's exact test was performed to correlate age ({<=}70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors {<=}2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  9. Decline of Cosmetic Outcomes Following Accelerated Partial Breast Irradiation Using Intensity Modulated Radiation Therapy: Results of a Single-Institution Prospective Clinical Trial

    Liss, Adam L. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Ben-David, Merav A. [Department of Radiation Oncology, The Sheba Medical Center, Ramat Gan (Israel); Jagsi, Reshma; Hayman, James A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Biostatistics Unit, University of Michigan, Ann Arbor, Michigan (United States); Moran, Jean M.; Marsh, Robin B. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Pierce, Lori J., E-mail: ljpierce@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2014-05-01

    Purpose: To report the final cosmetic results from a single-arm prospective clinical trial evaluating accelerated partial breast irradiation (APBI) using intensity modulated radiation therapy (IMRT) with active-breathing control (ABC). Methods and Materials: Women older than 40 with breast cancer stages 0-I who received breast-conserving surgery were enrolled in an institutional review board-approved prospective study evaluating APBI using IMRT administered with deep inspiration breath-hold. Patients received 38.5 Gy in 3.85-Gy fractions given twice daily over 5 consecutive days. The planning target volume was defined as the lumpectomy cavity with a 1.5-cm margin. Cosmesis was scored on a 4-category scale by the treating physician. Toxicity was scored according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 3.0). We report the cosmetic and toxicity results at a median follow-up of 5 years. Results: A total of 34 patients were enrolled. Two patients were excluded because of fair baseline cosmesis. The trial was terminated early because fair/poor cosmesis developed in 7 of 32 women at a median follow-up of 2.5 years. At a median follow-up of 5 years, further decline in the cosmetic outcome was observed in 5 women. Cosmesis at the time of last assessment was 43.3% excellent, 30% good, 20% fair, and 6.7% poor. Fibrosis according to CTCAE at last assessment was 3.3% grade 2 toxicity and 0% grade 3 toxicity. There was no correlation of CTCAE grade 2 or greater fibrosis with cosmesis. The 5-year rate of local control was 97% for all 34 patients initially enrolled. Conclusions: In this prospective trial with 5-year median follow-up, we observed an excellent rate of tumor control using IMRT-planned APBI. Cosmetic outcomes, however, continued to decline, with 26.7% of women having a fair to poor cosmetic result. These results underscore the need for continued cosmetic assessment for patients treated with APBI by technique.

  10. Accelerated Partial Breast Irradiation Is Safe and Effective Using Intensity-Modulated Radiation Therapy in Selected Early-Stage Breast Cancer

    Lewin, Alan A., E-mail: alanl@baptisthealth.net [Department of Radiation Oncology, Baptist Hospital of Miami, Miami, FL (United States); Derhagopian, Robert [Department of Surgery, Baptist Hospital of Miami, Miami, FL (United States); Saigal, Kunal; Panoff, Joseph E. [Department of Radiation Oncology, University of Miami, Miami, FL (United States); Abitbol, Andre; Wieczorek, D. Jay; Mishra, Vivek [Department of Radiation Oncology, Baptist Hospital of Miami, Miami, FL (United States); Reis, Isildinha; Ferrell, Annapoorna [Division of Biostatistics, University of Miami, Miami, FL (United States); Moreno, Lourdes [Department of Radiation Oncology, Baptist Hospital of Miami, Miami, FL (United States); Takita, Cristiane [Department of Radiation Oncology, University of Miami, Miami, FL (United States)

    2012-04-01

    Purpose: To report the feasibility, toxicity, cosmesis, and efficacy of using intensity-modulated radiation therapy (IMRT) with respiratory gating to deliver accelerated partial breast irradiation (APBI) in selected Stage I/II breast cancer after breast-conserving surgery. Methods and Materials: Eligible patients with node-negative Stage I/II breast cancer were prospectively enrolled in an institutional review board approved protocol to receive APBI using IMRT after breast-conserving surgery. The target volume was treated at 3.8 Gy/fraction twice daily for 5 days, to a total dose of 38 Gy. Results: Thirty-six patients were enrolled for a median follow-up time of 44.8 months. The median tumor size was 0.98 cm (range, 0.08-3 cm). The median clinical target volume (CTV) treated was 71.4 cc (range, 19-231 cc), with the mean dose to the CTV being 38.96 Gy. Acute toxicities included Grade 1 erythema in 44% of patients and Grade 2 in 6%, Grade 1 hyperpigmentation in 31% of patients and Grade 2 in 3%, and Grade 1 breast/chest wall tenderness in 14% of patients. No Grade 3/4 acute toxicities were observed. Grade 1 and 2 late toxicities as edema, fibrosis, and residual hyperpigmentation occurred in 14% and 11% of patients, respectively; Grade 3 telangiectasis was observed in 3% of patients. The overall cosmetic outcome was considered 'excellent' or 'good' by 94% of patients and 97% when rated by the physician, respectively. The local control rate was 97%; 1 patient died of a non-cancer-related cause. Conclusions: APBI can be safely and effectively administered using IMRT. In retrospective analysis, IMRT enabled the achievement of normal tissue dose constraints as outlined by Radiation Therapy Oncology Group 04-13/NSABP B-13 while providing excellent conformality for the CTV. Local control and cosmesis have remained excellent at current follow-up, with acceptable rates of acute/late toxicities. Our data suggest that cosmesis is dependent on target volume

  11. The Effect of Dose-Volume Parameters and Interfraction Interval on Cosmetic Outcome and Toxicity After 3-Dimensional Conformal Accelerated Partial Breast Irradiation

    Purpose: To evaluate dose-volume parameters and the interfraction interval (IFI) as they relate to cosmetic outcome and normal tissue effects of 3-dimensional conformal radiation therapy (3D-CRT) for accelerated partial breast irradiation (APBI). Methods and Materials: Eighty patients were treated by the use of 3D-CRT to deliver APBI at our institutions from 2003-2010 in strict accordance with the specified dose-volume constraints outlined in the National Surgical Adjuvant Breast and Bowel Project B39/Radiation Therapy Oncology Group 0413 (NSABP-B39/RTOG 0413) protocol. The prescribed dose was 38.5 Gy in 10 fractions delivered twice daily. Patients underwent follow-up with assessment for recurrence, late toxicity, and overall cosmetic outcome. Tests for association between toxicity endpoints and dosimetric parameters were performed with the chi-square test. Univariate logistic regression was used to evaluate the association of interfraction interval (IFI) with these outcomes. Results: At a median follow-up time of 32 months, grade 2-4 and grade 3-4 subcutaneous fibrosis occurred in 31% and 7.5% of patients, respectively. Subcutaneous fibrosis improved in 5 patients (6%) with extended follow-up. Fat necrosis developed in 11% of women, and cosmetic outcome was fair/poor in 19%. The relative volume of breast tissue receiving 5%, 20%, 50%, 80%, and 100% (V5-V100) of the prescribed dose was associated with risk of subcutaneous fibrosis, and the volume receiving 50%, 80%, and 100% (V50-V100) was associated with fair/poor cosmesis. The mean IFI was 6.9 hours, and the minimum IFI was 6.2 hours. The mean and minimum IFI values were not significantly associated with late toxicity. Conclusions: The incidence of moderate to severe late toxicity, particularly subcutaneous fibrosis and fat necrosis and resulting fair/poor cosmesis, remains high with continued follow-up. These toxicity endpoints are associated with several dose-volume parameters. Minimum and mean IFI values were

  12. Decline of Cosmetic Outcomes Following Accelerated Partial Breast Irradiation Using Intensity Modulated Radiation Therapy: Results of a Single-Institution Prospective Clinical Trial

    Purpose: To report the final cosmetic results from a single-arm prospective clinical trial evaluating accelerated partial breast irradiation (APBI) using intensity modulated radiation therapy (IMRT) with active-breathing control (ABC). Methods and Materials: Women older than 40 with breast cancer stages 0-I who received breast-conserving surgery were enrolled in an institutional review board-approved prospective study evaluating APBI using IMRT administered with deep inspiration breath-hold. Patients received 38.5 Gy in 3.85-Gy fractions given twice daily over 5 consecutive days. The planning target volume was defined as the lumpectomy cavity with a 1.5-cm margin. Cosmesis was scored on a 4-category scale by the treating physician. Toxicity was scored according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 3.0). We report the cosmetic and toxicity results at a median follow-up of 5 years. Results: A total of 34 patients were enrolled. Two patients were excluded because of fair baseline cosmesis. The trial was terminated early because fair/poor cosmesis developed in 7 of 32 women at a median follow-up of 2.5 years. At a median follow-up of 5 years, further decline in the cosmetic outcome was observed in 5 women. Cosmesis at the time of last assessment was 43.3% excellent, 30% good, 20% fair, and 6.7% poor. Fibrosis according to CTCAE at last assessment was 3.3% grade 2 toxicity and 0% grade 3 toxicity. There was no correlation of CTCAE grade 2 or greater fibrosis with cosmesis. The 5-year rate of local control was 97% for all 34 patients initially enrolled. Conclusions: In this prospective trial with 5-year median follow-up, we observed an excellent rate of tumor control using IMRT-planned APBI. Cosmetic outcomes, however, continued to decline, with 26.7% of women having a fair to poor cosmetic result. These results underscore the need for continued cosmetic assessment for patients treated with APBI by technique

  13. Accelerated Partial Breast Irradiation Is Safe and Effective Using Intensity-Modulated Radiation Therapy in Selected Early-Stage Breast Cancer

    Purpose: To report the feasibility, toxicity, cosmesis, and efficacy of using intensity-modulated radiation therapy (IMRT) with respiratory gating to deliver accelerated partial breast irradiation (APBI) in selected Stage I/II breast cancer after breast-conserving surgery. Methods and Materials: Eligible patients with node-negative Stage I/II breast cancer were prospectively enrolled in an institutional review board approved protocol to receive APBI using IMRT after breast-conserving surgery. The target volume was treated at 3.8 Gy/fraction twice daily for 5 days, to a total dose of 38 Gy. Results: Thirty-six patients were enrolled for a median follow-up time of 44.8 months. The median tumor size was 0.98 cm (range, 0.08–3 cm). The median clinical target volume (CTV) treated was 71.4 cc (range, 19–231 cc), with the mean dose to the CTV being 38.96 Gy. Acute toxicities included Grade 1 erythema in 44% of patients and Grade 2 in 6%, Grade 1 hyperpigmentation in 31% of patients and Grade 2 in 3%, and Grade 1 breast/chest wall tenderness in 14% of patients. No Grade 3/4 acute toxicities were observed. Grade 1 and 2 late toxicities as edema, fibrosis, and residual hyperpigmentation occurred in 14% and 11% of patients, respectively; Grade 3 telangiectasis was observed in 3% of patients. The overall cosmetic outcome was considered “excellent” or “good” by 94% of patients and 97% when rated by the physician, respectively. The local control rate was 97%; 1 patient died of a non–cancer-related cause. Conclusions: APBI can be safely and effectively administered using IMRT. In retrospective analysis, IMRT enabled the achievement of normal tissue dose constraints as outlined by Radiation Therapy Oncology Group 04-13/NSABP B-13 while providing excellent conformality for the CTV. Local control and cosmesis have remained excellent at current follow-up, with acceptable rates of acute/late toxicities. Our data suggest that cosmesis is dependent on target volume size

  14. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    Vargo, John A.; Verma, Vivek; Kim, Hayeon; Kalash, Ronny; Heron, Dwight E.; Johnson, Ronald; Beriwal, Sushil, E-mail: beriwals@upmc.edu

    2014-02-01

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate {sup 192}Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicator to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy

  15. Partial breast irradiation with interstitial high dose-rate brachytherapy: acute and late toxicities and cosmetic results

    Accelerated partial breast irradiation aims at decreasing the overall treatment time and reducing toxicity. The study we report is for early stage breast cancer and is a multicentre clinical investigation of partial breast irradiation achieved by interstitial high dose-rate (HDR) brachytherapy with intraoperative placement of catheters. We have been able to conclude from the initial data that an interstitial perioperative brachytherapy implant is a feasible method of treatment with good tolerance and good cosmetic results. (author)

  16. Accelerated partial breast irradiation: An analysis of variables associated with late toxicity and long-term cosmetic outcome after high-dose-rate interstitial brachytherapy

    Purpose: To perform a detailed analysis of variables associated with late tissue effects of high-dose-rate (HDR) interstitial brachytherapy accelerated partial breast irradiation (APBI) in a large cohort of patients with prolonged follow-up. Methods and Materials: Beginning in 1995, 75 women with Stage I/II breast cancer were enrolled in identical institutional trials evaluating APBI as monotherapy after lumpectomy. Patients eligible included those with T1-2, N0-1 (≤3 nodes positive), M0 tumors of nonlobular histology with negative surgical margins, no extracapsular nodal extension, and negative results on postexcision mammogram. All patients underwent surgical excision and postoperative irradiation with HDR interstitial brachytherapy. The planning target volume was defined as the excision cavity plus a 2-cm margin. Treatment was delivered with a high-activity Ir-192 source at 3.4 Gy per fraction twice daily for 5 days to a total dose of 34 Gy. Dosimetric analyses were performed with three-dimensional postimplant dose and volume reconstructions. All patients were evaluated at 3-6-month intervals and assessed with a standardized cosmetic rating scale and according to Radiation Therapy Oncology Group late normal tissue toxicity scoring criteria. Clinical and therapy-related features were analyzed for their relationship to cosmetic outcome and toxicity rating. Clinical features analyzed included age, volume of resection, history of diabetes or hypertension, extent of axillary surgery, and systemic therapies. Therapy-related features analyzed included volume of tissue encompassed by the 100%, 150%, and 200% isodose lines (V100, V150, and V200, respectively), the dose homogeneity index (DHI), number of source dwell positions, and planar separation. Results: The median follow-up of all patients was 73 months (range, 43-118 months). The cosmetic outcome at last follow-up was rated as excellent, good, and fair/poor in 67%, 24%, and 9% of patients, respectively

  17. Accelerated partial breast irradiation with external beam three-dimensional conformal radiotherapy. Five-year results of a prospective phase II clinical study

    Mozsa, Emoeke [National Institute of Oncology, Centre of Radiotherapy, Budapest (Hungary); Landesklinikum Wiener Neustadt, Department of Radiooncology and Radiotherapy, Wiener Neustadt (Austria); Meszaros, Norbert; Major, Tibor; Froehlich, Georgina; Stelczer, Gabor; Fodor, Janos; Polgar, Csaba [National Institute of Oncology, Centre of Radiotherapy, Budapest (Hungary); Sulyok, Zoltan [National Institute of Oncology, Centre of Surgery, Budapest (Hungary)

    2014-05-15

    The aim of this study was to report the 5-year results of accelerated partial breast irradiation (APBI) using external beam three-dimensional conformal radiotherapy (3D-CRT). Between 2006 and 2011, 44 patients with low-risk, stage I-II breast cancer underwent breast-conserving surgery. Postoperative APBI was given by means of 3D-CRT using three to five non-coplanar fields. The total dose of APBI was 36.9 Gy (nine fractions of 4.1 Gy b.i.d.). The mean follow-up time was 58.2 months for surviving patients. Survival results, side effects, and cosmetic results were assessed. One (2.3 %) local recurrence was observed, for a 5-year actuarial rate of 3.7 %. Neither regional nor distant failure was observed. Two patients died of internal disease. The 5-year disease-free, cancer-specific, and overall survival rates were 96.3, 100, and 95.1 %, respectively. Acute side effects included grade 1 (G1) erythema in 75 %, G1 parenchymal induration in 46 %, and G1 pain in 46 % of patients. No G2 or higher acute side effect occurred. Late side effects included G1, G2, and G3 fibrosis in 44, 7, and 2 % of patients, respectively, G1 skin pigmentation in 12 %, and G1 pain in 2 %. Asymptomatic fat necrosis occurred in 14 %. Cosmetic results were rated excellent or good in 86 % of cases by the patients themselves and 84 % by the physicians. The 5-year local tumor control, toxicity profile, and cosmetic results of APBI delivered with external beam 3D-CRT are encouraging and comparable to other APBI series. (orig.) [German] Evaluation der 5-Jahres-Ergebnisse bezueglich Ueberleben, Tumorkontrolle, Nebenwirkungen und Kosmetik nach Teilbrustbestrahlung (APBI) mittels 3-D-konformaler, akzelerierter Radiotherapie (3D-CRT). Zwischen 2006 und 2011 wurden 44 Patienten mit Brustkrebs im Stadium I-II und niedrigem Risikoprofil brusterhaltend operiert. Die adjuvante, 3-D-konformale APBI wurde mittels 3-5 nonkoplanarer Feldern durchgefuehrt. Die Gesamtdosis betrug 36,9 Gy bei 9 -mal 4,1 Gy b.i.d.. Nach

  18. 3D-conformal Accelerated Partial Breast Irradiation treatment planning: the value of surgical clips in the delineation of the lumpectomy cavity

    Accurate localisation of the lumpectomy cavity (LC) volume is one of the most critical points in 3D-conformal Partial breast irradiation (3D-APBI) treatment planning because the irradiated volume is restricted to a small breast volume. Here, we studied the role of the placement of surgical clips at the 4 cardinal points of the lumpectomy cavity in target delineation. Forty CT-based 3D-APBI plans were retrieved on which a total of 4 radiation oncologists, two trainee and two experienced physicians, outlined the lumpectomy cavity. The inter-observer variability of LC contouring was assessed when the CTV was defined as the delineation that encompassed both surgical clips and remodelled breast tissue. The conformity index of tumour bed delineation was significantly improved by the placement of surgical clips within the LC (median at 0.65). Furthermore, a better conformity index of LC was observed according to the experience of the physicians (median CI = 0.55 for trainee physicians vs 0.65 for experienced physicians). The placement of surgical clips improved the accuracy of lumpectomy cavity delineation in 3D-APBI. However, a learning curve is needed to improve the conformity index of the lumpectomy cavity

  19. Prospective Trial of Accelerated Partial Breast Intensity-Modulated Radiotherapy

    Purpose: To examine the feasibility and acute toxicities of an accelerated, partial breast, intensity-modulated radiotherapy (IMRT) protocol. Methods and Materials: Between February 2004 and August 2005, 55 patients with Stage I breast cancer and initial follow-up were enrolled at four facilities on a HealthONE and Western institutional review board-approved accelerated partial breast IMRT protocol. All patients were treated in 10 equal fractions delivered twice daily within 5 consecutive days. The first 7 patients were treated to 34 Gy, and the remaining 48 patients were treated to 38.5 Gy. Results: The median follow-up after IMRT was 10 months (range, <1-19) and after diagnosis was 11.5 months (range, 2-21). No local or distant recurrences developed. The T stage distribution was as follows: T1a in 11 patients, T1b in 24, and T1c in 20. The median tumor size was 9 mm (range, 1-20 mm). Breast cosmesis was judged by the patient as poor by 2, good by 12, and excellent by 40 (1 patient was legally blind) and by the physician as poor for 1, good for 10, and excellent for 44 patients. Breast pain, as judged by patient, was none in 34, mild in 19, moderate in 2, and severe in 0 patients. There was a single report of telangiectasia but no incidents of significant edema. Compared with historic controls for whom three-dimensional treatment planning techniques were used, IMRT provided similar dose delivery to the target while reducing the volume of normal breast included in the 100%, 75%, and 50% isodose lines. Conclusion: This initial report prospectively explored the feasibility of accelerated partial breast IMRT. After short-term follow-up, the dose delivery and clinical outcomes were very acceptable. We believe this regimen deserves additional investigation under institutional review board guidance

  20. Accelerated partial breast irradiation using intensity-modulated radiotherapy technique compared to whole breast irradiation for patients aged 70 years or older: subgroup analysis from a randomized phase 3 trial.

    Meattini, Icro; Saieva, Calogero; Marrazzo, Livia; Di Brina, Lucia; Pallotta, Stefania; Mangoni, Monica; Meacci, Fiammetta; Bendinelli, Benedetta; Francolini, Giulio; Desideri, Isacco; De Luca Cardillo, Carla; Scotti, Vieri; Furfaro, Ilaria Francesca; Rossi, Francesca; Greto, Daniela; Bonomo, Pierluigi; Casella, Donato; Bernini, Marco; Sanchez, Luis; Orzalesi, Lorenzo; Simoncini, Roberta; Nori, Jacopo; Bianchi, Simonetta; Livi, Lorenzo

    2015-10-01

    The purpose of this study was to report the efficacy and the safety profile on the subset of selected early breast cancer (BC) patients aged 70 years or older from a single-center phase 3 trial comparing whole breast irradiation (WBI) to accelerated partial breast irradiation (APBI) using intensity-modulated radiation therapy technique. Between 2005 and 2013, 520 patients aged more than 40 years old were enrolled and randomly assigned to receive either WBI or APBI in a 1:1 ratio. Eligible patients were women with early BC (maximum diameter 2.5 cm) suitable for breast conserving surgery. This study is registered with ClinicalTrials.gov, NCT02104895. A total of 117 patients aged 70 years or more were analyzed (58 in the WBI arm, 59 in the APBI arm). At a median follow-up of 5-years (range 3.4-7.0), the ipsilateral breast tumor recurrence (IBTR) rate was 1.9 % in both groups. No significant difference between the two groups was identified (log-rank test p = 0.96). The 5-year disease-free survival (DFS) rates in the WBI group and APBI group were 6.1 and 1.9 %, respectively (p = 0.33). The APBI group presented significantly better results in terms of acute skin toxicity, considering both any grade (p = 0.0001) and grade 2 or higher (p = 0.0001). Our subgroup analyses showed a very low rate and no significant difference in terms of IBTR, using both WBI and APBI. A significant impact on patients compliance in terms of acute and early late toxicity was shown, which could translate in a consistent improvement of overall quality of life. PMID:26350524

  1. Recommendations from GEC ESTRO Breast Cancer Working Group (I): Target definition and target delineation for accelerated or boost Partial Breast Irradiation using multicatheter interstitial brachytherapy after breast conserving closed cavity surgery

    Objective: The aim was to develop a delineation guideline for target definition for APBI or boost by consensus of the Breast Working Group of GEC-ESTRO. Proposed recommendations: Appropriate delineation of CTV (PTV) with low inter- and intra-observer variability in clinical practice is complex and needs various steps as: (1) Detailed knowledge of primary surgical procedure, of all details of pathology, as well as of preoperative imaging. (2) Definition of tumour localization before breast conserving surgery inside the breast and translation of this information in the postoperative CT imaging data set. (3) Calculation of the size of total safety margins. The size should be at least 2 cm. (4) Definition of the target. (5) Delineation of the target according to defined rules. Conclusion: Providing guidelines based on the consensus of a group of experts should make it possible to achieve a reproducible and consistent definition of CTV (PTV) for Accelerated Partial Breast Irradiation (APBI) or boost irradiation after breast conserving closed cavity surgery, and helps to define it after selected cases of oncoplastic surgery

  2. Accelerated partial breast irradiation with multi-catheter brachytherapy: Local control, side effects and cosmetic outcome for 274 patients. Results of the German-Austrian multi-centre trial

    Background and purpose: To evaluate the safety and effectiveness of accelerated partial breast irradiation (APBI) with multi-catheter brachytherapy. Patients and methods: Between 11/2000 and 04/2005, 274 patients participated. Patients were eligible for APBI if they had histologically confirmed breast cancer, a tumour diameter ≤3 cm, complete resection with clear margins ≥2 mm, negative axillary lymph nodes or singular nodal micro-metastasis, no distant metastases, hormone receptor-positive tumours, and were ≥35 years. Patients were excluded if mammographically they showed a multicentric invasive growth pattern, poorly differentiated tumours, residual diffuse micro-calcifications, extensive intraductal component, or vessel invasion. Median follow-up was 32 months (range; 8-68). Results: The local control rate was 99.3% (272/274), the 3 year-local-recurrence-free survival probability, 99.6%. Peri-operative complications occurred in 5.5% (15/274): 9 (3.3%) experienced implant infection and 6 (2.2%) hematoma. Acute toxicity (Grade 1/2 radio-dermatitis) was seen in 6.6% (18/274). Late side effects ≥ Grade 3 (fibrosis, telangiectasia) occurred in 1.8% (4/274). Cosmetic results were excellent/good in 94% (253/274). Conclusions: This analysis underlined the safety and effectiveness of APBI in a carefully selected subgroup with favourable disease characteristics. Of course, longer follow-up and randomised trials are necessary to conclusively assess the potential of APBI

  3. Predictors for Clinical Outcomes After Accelerated Partial Breast Intensity-Modulated Radiotherapy

    Purpose: To correlate the treatment planning parameters with the clinical outcomes in patients treated with accelerated partial breast intensity-modulated radiotherapy. Methods and Materials: A total of 105 patients with Stage I breast cancer were treated between February 2004 and March 2007 in a Phase II prospective trial and had detailed information available on the planning target volume (PTV), ipsilateral breast volume (IBV), PTV/IBV ratio, lung volume, chest wall volume, surgery to radiotherapy interval, follow-up interval, breast pain, and cosmesis. The first 7 of these patients were treated to 34 Gy, and the remaining 98 were treated to 38.5 Gy. All patients were treated twice daily for 5 consecutive days. Univariate and multivariate analyses were performed. Results: The median follow-up was 13 months. No recurrences or deaths were observed. Of the 105 patients, 30 reported mild or moderate breast pain in their most recently recorded follow-up visit. The irradiated lung volume (p 35 Gy (p 35 Gy) and to lung correlated with reports of mild pain after accelerated partial breast intensity-modulated radiotherapy. Also, the PTV, but not the PTV/IBV ratio, was predictive of post-treatment reports of pain.

  4. Trajectory Modulated Arc Therapy: A Fully Dynamic Delivery With Synchronized Couch and Gantry Motion Significantly Improves Dosimetric Indices Correlated With Poor Cosmesis in Accelerated Partial Breast Irradiation

    Liang, Jieming; Atwood, Todd; Eyben, Rie von; Fahimian, Benjamin; Chin, Erika; Horst, Kathleen [Department of Radiation Oncology, Stanford University, California (United States); Otto, Karl [Department of Physics, University of British Columbia, British Columbia (Canada); Hristov, Dimitre, E-mail: dimitre.hristov@stanford.edu [Department of Radiation Oncology, Stanford University, California (United States)

    2015-08-01

    Purpose: To develop planning and delivery capabilities for linear accelerator–based nonisocentric trajectory modulated arc therapy (TMAT) and to evaluate the benefit of TMAT for accelerated partial breast irradiation (APBI) with the patient in prone position. Methods and Materials: An optimization algorithm for volumetrically modulated arc therapy (VMAT) was generalized to allow for user-defined nonisocentric TMAT trajectories combining couch rotations and translations. After optimization, XML scripts were automatically generated to program and subsequently deliver the TMAT plans. For 10 breast patients in the prone position, TMAT and 6-field noncoplanar intensity modulated radiation therapy (IMRT) plans were generated under equivalent objectives and constraints. These plans were compared with regard to whole breast tissue volume receiving more than 100%, 80%, 50%, and 20% of the prescription dose. Results: For TMAT APBI, nonisocentric collision-free horizontal arcs with large angular span (251.5 ± 7.9°) were optimized and delivered with delivery time of ∼4.5 minutes. Percentage changes of whole breast tissue volume receiving more than 100%, 80%, 50%, and 20% of the prescription dose for TMAT relative to IMRT were −10.81% ± 6.91%, −27.81% ± 7.39%, −14.82% ± 9.67%, and 39.40% ± 10.53% (P≤.01). Conclusions: This is a first demonstration of end-to-end planning and delivery implementation of a fully dynamic APBI TMAT. Compared with IMRT, TMAT resulted in marked reduction of the breast tissue volume irradiated at high doses.

  5. Accelerated partial breast irradiation: Bi-fractionated 40 Gy in one week. A French pilot phase II study; Etude pilote francaise de phase 2 d'irradiation partielle acceleree du sein conformationnelle tridimensionnelle bi-fractionnee hebdomadaire de 40 Gy

    Bourgier, C.; Heymann, S.; Bourhis, J.; Marsiglia, H. [Departement d' oncologie-radiotherapie, institut Gustave-Roussy, 94 - Villejuif (France); Pichenot, C.; Verstraet, R.; Biron, B. [Departement de physique, institut Gustave-Roussy, 94 - Villejuif (France); Balleyguier, C. [Departement de radiologie, institut Gustave-Roussy, 94 - Villejuif (France); Delalogen, S. [Departement d' oncologie medicale, institut Gustave-Roussy, 94 - Villejuif (France); Mathieu, M.C. [Departement d' anatomie-pathologie, institut Gustave-Roussy, 94 - Villejuif (France); Uzan, C.; Garbay, J.R.; Marsiglia, H. [Departement de chirurgie-senologie, institut Gustave-Roussy, 94 - Villejuif (France); Taghian, A. [Departement d' oncologie-radiotherapie, Massachusetts General Hospital, Harvard Medical School, Massachusetts (United States); Bourgier, C.; Pichenot, C.; Verstraet, R.; Heymann, S.; Biron, B.; Balleyguier, C.; Delalogen, S.; Mathieu, M.C.; Uzan, C.; Garbay, J.R.; Bourhis, J.; Taghian, A.; Marsiglia, H. [Universite de Florence, Firenze (Italy)

    2010-12-15

    Purpose: Since 2009, accelerated partial breast irradiation (APBI) in North America has been allowed to be used for selected group of patients outside a clinical trial according to the ASTRO consensus statement. In France, accelerated partial breast irradiation is still considered investigational, several clinical trials have been conducted using either intraoperative (Montpellier) or Mammosite{sup R} (Lille) or brachytherapy modality (PAC GERICO/FNCLCC). Here, we report the original dosimetric results of this technique. Patients and methods: Since October 2007, Institut Gustave-Roussy has initiated a phase II trial using 3D-conformal accelerated partial breast irradiation (40 Gy in 10 fractions BID in 1 week). Twenty-five patients with pT1N0 breast cancer were enrolled and were treated by two mini-tangent photons beams (6 MV) and an 'en face' electron beam (6-22 MeV). Results: The mean clinical target volume and planning target volume were respectively 15.1 cm{sup 3} (range: 5.2-28.7 cm{sup 3}) and 117 cm{sup 3} (range: 52-185 cm{sup 3}). The planning target volume coverage was adequate with at least a mean of 99% of the volume encompassed by the isodose 40 Gy. The mean dose to the planning target volume was 41.8 Gy (range: 41-42.4 Gy). Dose inhomogeneity did not exceed 5%. Mean doses to the ipsilateral lung and heart were 1.6 Gy (range: 1.0-2.3 Gy) and 1.2 Gy (range: 1.0-1.6 Gy), respectively. Conclusion: The 3D conformal accelerated partial breast irradiation using two mini-tangent and 'en face' electron beams using a total dose of 40 Gy in 10 fractions BID over 5 days achieves appropriate planning target volume coverage and offers significant normal-tissue sparing (heart, lung). Longer follow-up is needed to evaluate the tissue tolerance to this radiation dose. (authors)

  6. Objective and Longitudinal Assessment of Dermatitis After Postoperative Accelerated Partial Breast Irradiation Using High-Dose-Rate Interstitial Brachytherapy in Patients With Breast Cancer Treated With Breast Conserving Therapy: Reduction of Moisture Deterioration by APBI

    Tanaka, Eiichi [Department of Radiation Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Yamazaki, Hideya, E-mail: hideya10@hotmail.com [Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto (Japan); Yoshida, Ken; Takenaka, Tadashi [Department of Radiation Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Masuda, Norikazu [Department of Surgery and Breast Oncology, National Hospital Organization, Osaka National Hospital, Osaka (Japan); Kotsuma, Tadayuki; Yoshioka, Yasuo; Inoue, Takehiro [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita (Japan)

    2011-11-15

    Purpose: To objectively evaluate the radiation dermatitis caused by accelerated partial breast irradiation (APBI) using high-dose-rate interstitial brachytherapy. Patients and Methods: The skin color and moisture changes were examined using a newly installed spectrophotometer and corneometer in 22 patients who had undergone APBI using open cavity implant high-dose-rate interstitial brachytherapy (36 Gy in six fractions) and compared with the corresponding values for 44 patients in an external beam radiotherapy (EBRT) control group (50-60 Gy in 25-30 fractions within 5-6 weeks) after breast conserving surgery. Results: All values changed significantly as a result of APBI. The extent of elevation in a Asterisk-Operator (reddish) and reduction in L Asterisk-Operator (black) values caused by APBI were similar to those for EBRT, with slightly delayed recovery for 6-12 months after treatment owing to the surgical procedure. In contrast, only APBI caused a change in the b Asterisk-Operator values, and EBRT did not, demonstrating that the reduction in b Asterisk-Operator values (yellowish) depends largely on the surgical procedure. The changes in moisture were less severe after APBI than after EBRT, and the recovery was more rapid. The toxicity assessment using the Common Toxicity Criteria, version 3, showed that all dermatitis caused by APBI was Grade 2 or less. Conclusion: An objective analysis can quantify the effects of APBI procedures on color and moisture cosmesis. The radiation dermatitis caused by APBI using the present schedule showed an equivalent effect on skin color and a less severe effect on moisture than the effects caused by standard EBRT.

  7. Late Toxicity and Patient Self-Assessment of Breast Appearance/Satisfaction on RTOG 0319: A Phase 2 Trial of 3-Dimensional Conformal Radiation Therapy-Accelerated Partial Breast Irradiation Following Lumpectomy for Stages I and II Breast Cancer

    Purpose: Late toxicities and cosmetic analyses of patients treated with accelerated partial breast irradiation (APBI) on RTOG 0319 are presented. Methods and Materials: Patients with stages I to II breast cancer ≤3 cm, negative margins, and ≤3 positive nodes were eligible. Patients received three-dimensional conformal external beam radiation therapy (3D-CRT; 38.5 Gy in 10 fractions twice daily over 5 days). Toxicity and cosmesis were assessed by the patient (P), the radiation oncologist (RO), and the surgical oncologist (SO) at 3, 6, and 12 months from the completion of treatment and then annually. National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0, was used to grade toxicity. Results: Fifty-two patients were evaluable. Median follow-up was 5.3 years (range, 1.7-6.4 years). Eighty-two percent of patients rated their cosmesis as good/excellent at 1 year, with rates of 64% at 3 years. At 3 years, 31 patients were satisfied with the treatment, 5 were not satisfied but would choose 3D-CRT again, and none would choose standard radiation therapy. The worst adverse event (AE) per patient reported as definitely, probably, or possibly related to radiation therapy was 36.5% grade 1, 50% grade 2, and 5.8% grade 3 events. Grade 3 AEs were all skin or musculoskeletal-related. Treatment-related factors were evaluated to potentially establish an association with observed toxicity. Surgical bed volume, target volume, the number of beams used, and the use of bolus were not associated with late cosmesis. Conclusions: Most patients enrolled in RTOG 0319 were satisfied with their treatment, and all would choose to have the 3D-CRT APBI again

  8. Late Toxicity and Patient Self-Assessment of Breast Appearance/Satisfaction on RTOG 0319: A Phase 2 Trial of 3-Dimensional Conformal Radiation Therapy-Accelerated Partial Breast Irradiation Following Lumpectomy for Stages I and II Breast Cancer

    Chafe, Susan, E-mail: susan.chafe@albertahealthservices.ca [Department of Radiation Oncology, Cross Cancer Institute-University of Alberta, Edmonton, Alberta (Canada); Moughan, Jennifer [Department of Radiation Oncology, RTOG Statistical Center, Philadelphia, Pennsylvania (United States); McCormick, Beryl [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Wong, John [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland (United States); Pass, Helen [Womens' Breast Center, Stamford Hospital, Stamford, Connecticut (United States); Rabinovitch, Rachel [Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Petersen, Ivy [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); White, Julia [Department of Radiation Oncology, Ohio State University, Columbus, Ohio (United States); Vicini, Frank A. [Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States)

    2013-08-01

    Purpose: Late toxicities and cosmetic analyses of patients treated with accelerated partial breast irradiation (APBI) on RTOG 0319 are presented. Methods and Materials: Patients with stages I to II breast cancer ≤3 cm, negative margins, and ≤3 positive nodes were eligible. Patients received three-dimensional conformal external beam radiation therapy (3D-CRT; 38.5 Gy in 10 fractions twice daily over 5 days). Toxicity and cosmesis were assessed by the patient (P), the radiation oncologist (RO), and the surgical oncologist (SO) at 3, 6, and 12 months from the completion of treatment and then annually. National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0, was used to grade toxicity. Results: Fifty-two patients were evaluable. Median follow-up was 5.3 years (range, 1.7-6.4 years). Eighty-two percent of patients rated their cosmesis as good/excellent at 1 year, with rates of 64% at 3 years. At 3 years, 31 patients were satisfied with the treatment, 5 were not satisfied but would choose 3D-CRT again, and none would choose standard radiation therapy. The worst adverse event (AE) per patient reported as definitely, probably, or possibly related to radiation therapy was 36.5% grade 1, 50% grade 2, and 5.8% grade 3 events. Grade 3 AEs were all skin or musculoskeletal-related. Treatment-related factors were evaluated to potentially establish an association with observed toxicity. Surgical bed volume, target volume, the number of beams used, and the use of bolus were not associated with late cosmesis. Conclusions: Most patients enrolled in RTOG 0319 were satisfied with their treatment, and all would choose to have the 3D-CRT APBI again.

  9. Objective and Longitudinal Assessment of Dermatitis After Postoperative Accelerated Partial Breast Irradiation Using High-Dose-Rate Interstitial Brachytherapy in Patients With Breast Cancer Treated With Breast Conserving Therapy: Reduction of Moisture Deterioration by APBI

    Purpose: To objectively evaluate the radiation dermatitis caused by accelerated partial breast irradiation (APBI) using high-dose-rate interstitial brachytherapy. Patients and Methods: The skin color and moisture changes were examined using a newly installed spectrophotometer and corneometer in 22 patients who had undergone APBI using open cavity implant high-dose-rate interstitial brachytherapy (36 Gy in six fractions) and compared with the corresponding values for 44 patients in an external beam radiotherapy (EBRT) control group (50–60 Gy in 25–30 fractions within 5–6 weeks) after breast conserving surgery. Results: All values changed significantly as a result of APBI. The extent of elevation in a∗ (reddish) and reduction in L∗ (black) values caused by APBI were similar to those for EBRT, with slightly delayed recovery for 6–12 months after treatment owing to the surgical procedure. In contrast, only APBI caused a change in the b∗ values, and EBRT did not, demonstrating that the reduction in b∗ values (yellowish) depends largely on the surgical procedure. The changes in moisture were less severe after APBI than after EBRT, and the recovery was more rapid. The toxicity assessment using the Common Toxicity Criteria, version 3, showed that all dermatitis caused by APBI was Grade 2 or less. Conclusion: An objective analysis can quantify the effects of APBI procedures on color and moisture cosmesis. The radiation dermatitis caused by APBI using the present schedule showed an equivalent effect on skin color and a less severe effect on moisture than the effects caused by standard EBRT.

  10. Five-Year Analysis of Treatment Efficacy and Cosmesis by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in Patients Treated With Accelerated Partial Breast Irradiation

    Purpose: To present 5-year data on treatment efficacy, cosmetic results, and toxicities for patients enrolled on the American Society of Breast Surgeons MammoSite breast brachytherapy registry trial. Methods and Materials: A total of 1440 patients (1449 cases) with early-stage breast cancer receiving breast-conserving therapy were treated with the MammoSite device to deliver accelerated partial-breast irradiation (APBI) (34 Gy in 3.4-Gy fractions). Of 1449 cases, 1255 (87%) had invasive breast cancer (IBC) (median size, 10 mm) and 194 (13%) had ductal carcinoma in situ (DCIS) (median size, 8 mm). Median follow-up was 54 months. Results: Thirty-seven cases (2.6%) developed an ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial rate of 3.80% (3.86% for IBC and 3.39% for DCIS). Negative estrogen receptor status (p = 0.0011) was the only clinical, pathologic, or treatment-related variable associated with IBTR for patients with IBC and young age (<50 years; p = 0.0096) and positive margin status (p = 0.0126) in those with DCIS. The percentage of breasts with good/excellent cosmetic results at 60 months (n = 371) was 90.6%. Symptomatic breast seromas were reported in 13.0% of cases, and 2.3% developed fat necrosis. A subset analysis of the first 400 consecutive cases enrolled was performed (352 with IBC, 48 DCIS). With a median follow-up of 60.5 months, the 5-year actuarial rate of IBTR was 3.04%. Conclusion: Treatment efficacy, cosmesis, and toxicity 5 years after treatment with APBI using the MammoSite device are good and similar to those reported with other forms of APBI with similar follow-up.

  11. Transforming Growth Factor β-1 (TGF-β1) Is a Serum Biomarker of Radiation Induced Fibrosis in Patients Treated With Intracavitary Accelerated Partial Breast Irradiation: Preliminary Results of a Prospective Study

    Purpose: To examine a relationship between serum transforming growth factor β -1 (TGF-β1) values and radiation-induced fibrosis (RIF). Methods and Materials: We conducted a prospective analysis of the development of RIF in 39 women with American Joint Committee on Cancer stage 0-I breast cancer treated with lumpectomy and accelerated partial breast irradiation via intracavitary brachytherapy (IBAPBI). An enzyme-linked immunoassay (Quantikine, R and D, Minneapolis, MN) was used to measure serum TGF-β1 before surgery, before IBAPBI, and during IBAPBI. Blood samples for TGF-β1 were also collected from 15 healthy, nontreated women (controls). The previously validated tissue compliance meter (TCM) was used to objectively assess RIF. Results: The median time to follow-up for 39 patients was 44 months (range, 5-59 months). RIF was graded by the TCM scale as 0, 1, 2, and 3 in 5 of 20 patients (25%), 6 of 20 patients (30%), 5 of 20 patients (25%), and 4 of 20 patients (20%), respectively. The mean serum TGF-β1 values were significantly higher in patients before surgery than in disease-free controls, as follows: all cancer patients (30,201 ± 5889 pg/mL, P=.02); patients with any type of RIF (32,273 ± 5016 pg/mL, PROC of 0.867 (95% confidence interval 0.700-1.000). The TGF-β1 threshold cutoff was determined to be 31,000 pg/mL, with associated sensitivity and specificity of 77.8% and 90.0%, respectively. Conclusions: TGF-β1 levels correlate with the development of moderate to severe RIF. The pre-IBAPBI mean TGF-β1 levels can serve as an early biomarker for the development of moderate to severe RIF after IBAPBI

  12. Higher toxicity with 42 Gy in 10 fractions as a total dose for 3D-conformal accelerated partial breast irradiation: results from a dose escalation phase II trial

    Recent recommendations regarding indications of accelerated partial breast irradiation (APBI) have been put forward for selected breast cancer (BC) patients. However, some treatment planning parameters, such as total dose, are not yet well defined. The Institut Gustave Roussy has initiated a dose escalation trial at the 40 Gy/10 fractions/5 days and at a further step of total dose (TD) of 42 Gy/10 fractions/ 5 days. Here, we report early results of the latest step compared with the 40 Gy dose level. From October 2007 to March 2010, a total of 48 pT1N0 BC patients were enrolled within this clinical trial: 17 patients at a TD of 42 Gy/10f/5d and 31 at a TD of 40 Gy/10f/5d. Median follow-up was 19 months (min-max, 12–26). All the patients were treated by APBI using a technique with 2 minitangents and an “enface” electrons delivering 20% of the total dose. Toxicities were systematically assessed at 1; 2; 6 months and then every 6 months. Patients’ recruitment of 42 Gy step was ended owing to persistent grade 3 toxicity 6 months after APBI completion (n = 1). Early toxicities were statistically higher after a total dose of 42 Gy regarding grade ≥2 dry (p = 0.01) and moist (p = 0.05) skin desquamation. Breast pain was also statistically higher in the 42 Gy step compared to 40 Gy step (p = 0.02). Other late toxicities (grade ≥2 fibrosis and telangectasia) were not statistically different between 42 Gy and 40 Gy. Early toxicities were more severe and higher rates of late toxicities were observed after 42 Gy/10 fractions/5 days when compared to 40 Gy/10 fractions/5 days. This data suggest that 40 Gy/10 fractions/ 5 days could potentially be the maximum tolerance for PBI although longer follow-up is warranted to better assess late toxicities

  13. Interim Cosmetic Results and Toxicity Using 3D Conformal External Beam Radiotherapy to Deliver Accelerated Partial Breast Irradiation in Patients With Early-Stage Breast Cancer Treated With Breast-Conserving Therapy

    Purpose: We present our ongoing clinical experience utilizing three-dimensional (3D)-conformal radiation therapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer treated with breast-conserving therapy. Methods and Materials: Ninety-one consecutive patients were treated with APBI using our previously reported 3D-CRT technique. The clinical target volume consisted of the lumpectomy cavity plus a 10- to 15 -mm margin. The prescribed dose was 34 or 38.5 Gy in 10 fractions given over 5 consecutive days. The median follow-up was 24 months. Twelve patients have been followed for ≥4 years, 20 for ≥3.5 years, 29 for >3.0 years, 33 for ≥2.5 years, and 46 for ≥2.0 years. Results: No local recurrences developed. Cosmetic results were rated as good/excellent in 100% of evaluable patients at ≥ 6 months (n = 47), 93% at 1 year (n = 43), 91% at 2 years (n = 21), and in 90% at ≥3 years (n = 10). Erythema, hyperpigmentation, breast edema, breast pain, telangiectasias, fibrosis, and fat necrosis were evaluated at 6, 24, and 36 months after treatment. All factors stabilized by 3 years posttreatment with grade I or II rates of 0%, 0%, 0%, 0%, 9%, 18%, and 9%, respectively. Only 2 patients (3%) developed grade III toxicity (breast pain), which resolved with time. Conclusions: Delivery of APBI with 3D-CRT resulted in minimal chronic (≥6 months) toxicity to date with good/excellent cosmetic results. Additional follow-up is needed to assess the long-term efficacy of this form of APBI

  14. How Do the ASTRO Consensus Statement Guidelines for the Application of Accelerated Partial Breast Irradiation Fit Intraoperative Radiotherapy? A Retrospective Analysis of Patients Treated at the European Institute of Oncology

    Purpose: To verify how the classification according to the American Society for Therapeutic Radiation Oncology (ASTRO) consensus statement (CS) for the application of accelerated partial breast irradiation (APBI) fits patients treated with intraoperative radiotherapy with electrons (ELIOT) at a single institution. Methods and Materials: The study included 1,822 patients treated with ELIOT as the sole radiation modality outside of a clinical trial at the European Institute of Oncology after breast-conserving surgery for invasive breast cancer, who were classified into CS groups of suitable, cautionary, and unsuitable. The outcome in terms of ipsilateral breast recurrence, regional node relapse, distant metastases, progression free-survival, cause-specific survival, and overall survival were assessed. Results: All the 1,822 cases except for 25 could be classified according to ASTRO CS: 294 patients met the criteria for inclusion into the suitable group, 691 patients into the cautionary group, and 812 patients into the unsuitable group. The 5-year rate of ipsilateral breast recurrence for suitable, cautionary, and unsuitable groups were 1.5%, 4.4%, and 8.8%, respectively (p = 0.0003). Whereas the regional node relapse showed no difference, the rate of distant metastases was significantly different in the unsuitable group compared with the suitable and cautionary groups, having a significant impact on survival. Conclusion: In the context of patients treated with ELIOT, the ASTRO guidelines identify well the groups for whom APBI might be considered as an effective alternative to whole breast radiotherapy and also identify groups for whom APBI is not indicated.

  15. Cosmetic Outcomes for Accelerated Partial Breast Irradiation Before Surgical Excision of Early-Stage Breast Cancer Using Single-Dose Intraoperative Radiotherapy

    Purpose: Determine cosmetic outcome and toxicity profile of intraoperative radiation delivered before tumor excision for patients with early-stage breast cancer. Methods and Materials: Patients age 48 or older with ultrasound-visible invasive ductal cancers <3 cm and clinically negative lymph nodes were eligible for treatment on this institutional review board-approved Phase II clinical trial. Treatment planning ultrasound was used to select an electron energy and cone size sufficient to cover the tumor plus a 1.5- to 2.0-cm circumferential margin laterally and a 1-cm-deep margin with the 90% isodose line. The dose was prescribed to a nominal 15 Gy and delivered using a Mobetron electron irradiator before tumor excision by segmental mastectomy. Physician- and patient-assessed cosmetic outcome and patient satisfaction were determined by questionnaire. Results: From March 2003 to July 2007, 71 patients were treated with intraoperative radiation therapy. Of those, 56 patients were evaluable, with a median follow-up of 3.1 years (minimum 1 year). Physician and patient assessment of cosmesis was 'good or excellent' (Radiation Therapy Oncology Group cosmesis scale) in 45/56 (80%) and 32/42 (76%) of all patients, respectively. Eleven patients who received additional whole breast radiation had similar rates of good or excellent cosmesis: 40/48 (83%) and 29/36 (81%), respectively). Grade 1 or 2 acute toxicities were seen in 4/71 (6%) patients. No Grade 3 or 4 toxicities or serious adverse events have been seen. Conclusion: Intraoperative radiotherapy delivered to an in situ tumor is feasible with acceptable acute tolerance. Patient and physician assessment of the cosmetic outcome is good to excellent.

  16. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended

  17. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    Abbott, Andrea M.; Portschy, Pamela R. [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Lee, Chung [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Le, Chap T. [Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota (United States); Han, Linda K. [Department of Surgery, Indiana University, Indianapolis, Indiana (United States); Washington, Tara [Vantage Oncology, Redhawk and Wildomar Centers California, Wildomar, California (United States); Kinney, Michael [Center for Advanced Breast Care, Arlington Heights, Illinois (United States); Bretzke, Margit [Surgical Specialists of Minnesota, Minneapolis, Minnesota (United States); Tuttle, Todd M., E-mail: tuttl006@umn.edu [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States)

    2013-11-01

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended.

  18. Partial breast irradiation for early breast cancer: 3-year results of the German-Austrian phase II-trial

    Purpose: to evaluate perioperative morbidity, toxicity and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole radiation modality after breast conserving surgery. Materials and methods: from 11/2000 to 11/2004, 240 women with early stage breast cancer participated in a protocol of tumor bed irradiation alone using pulsed dose rate (PDR) or high dose rate (HDR) interstitial multi-catheter implants (partial breast irradiation). Perioperative morbidity, acute and late toxicity as well as cosmetic outcome were assessed. Of the first 51 patients treated in this multicenter trial, we present interim findings after a median follow-up of 36 months. Results: perioperative Morbidity: Bacterial infection of the implant: 2% (1/51). Acute toxicity: radiodermatitis grade 1: 4% (2/51). Late toxicity: breast pain grade 1: 8% (4/51), grade 2: 2% (1/51); dyspigmentation grade 1: 8% (4/51); fibrosis grade 1: 4% (2/51), grade 2: 8% (4/51); telangiectasia grade 1: 10% (5/51), grade 2: 4% (2/51). Cosmetic results: Excellent and good in 94% (48/51) of the patients. Conclusion: this analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter PDR-/HDR-implants (partial breast irradiation) is feasible with low perioperative morbidity, low acute and mild late toxicity at a median follow-up of 36 months. The cosmetic result is not significantly affected. (orig.)

  19. Evaluation of Current Consensus Statement Recommendations for Accelerated Partial Breast Irradiation: A Pooled Analysis of William Beaumont Hospital and American Society of Breast Surgeon MammoSite Registry Trial Data

    Wilkinson, J. Ben [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Beitsch, Peter D. [Dallas Surgical Group, Dallas, Texas (United States); Shah, Chirag [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Arthur, Doug [Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia (United States); Haffty, Bruce G. [Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Camden, New Jersey (United States); Wazer, David E. [Department of Radiation Oncology, Tufts Medical Center, Boston, Massachusetts and Rhode Island Hospital/Brown University, Providence, Rhode Island (United States); Keisch, Martin [Department of Radiation Oncology, Cancer Healthcare Associates, Miami, Florida (United States); Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lyden, Maureen [Biostat International, Inc, Tampa, Florida (United States); Chen, Peter Y. [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Vicini, Frank A., E-mail: fvicini@pol.net [Department of Radiation Oncology, Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States)

    2013-04-01

    Purpose: To determine whether the American Society for Radiation Oncology (ASTRO) Consensus Statement (CS) recommendations for accelerated partial breast irradiation (APBI) are associated with significantly different outcomes in a pooled analysis from William Beaumont Hospital (WBH) and the American Society of Breast Surgeons (ASBrS) MammoSite® Registry Trial. Methods and Materials: APBI was used to treat 2127 cases of early-stage breast cancer (WBH, n=678; ASBrS, n=1449). Three forms of APBI were used at WBH (interstitial, n=221; balloon-based, n=255; or 3-dimensional conformal radiation therapy, n=206), whereas all Registry Trial patients received balloon-based brachytherapy. Patients were divided according to the ASTRO CS into suitable (n=661, 36.5%), cautionary (n=850, 46.9%), and unsuitable (n=302, 16.7%) categories. Tumor characteristics and clinical outcomes were analyzed according to CS group. Results: The median age was 65 years (range, 32-94 years), and the median tumor size was 10.0 mm (range, 0-45 mm). The median follow-up time was 60.6 months. The WBH cohort had more node-positive disease (6.9% vs 2.6%, P<.01) and cautionary patients (49.5% vs 41.8%, P=.06). The 5-year actuarial ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), and distant metastasis (DM) for the whole cohort were 2.8%, 0.6%, 1.6%. The rate of IBTR was not statistically higher between suitable (2.5%), cautionary (3.3%), or unsuitable (4.6%) patients (P=.20). The nonsignificant increase in IBTR for the cautionary and unsuitable categories was due to increased elsewhere failures and new primaries (P=.04), not tumor bed recurrence (P=.93). Conclusions: Excellent outcomes after breast-conserving surgery and APBI were seen in our pooled analysis. The current ASTRO CS guidelines did not adequately differentiate patients at an increased risk of IBTR or tumor bed failure in this large patient cohort.

  20. Transforming Growth Factor β-1 (TGF-β1) Is a Serum Biomarker of Radiation Induced Fibrosis in Patients Treated With Intracavitary Accelerated Partial Breast Irradiation: Preliminary Results of a Prospective Study

    Boothe, Dustin L. [Weill Cornell Medical College of Cornell University, New York, New York (United States); Coplowitz, Shana [Department of Radiation Oncology, Stich Radiation Center, Weill Cornell Medical College of Cornell University, New York, New York (United States); Greenwood, Eleni [Weill Cornell Medical College of Cornell University, New York, New York (United States); Barney, Christian L. [Department of Radiation Oncology, Ohio State University, Columbus, Ohio (United States); Christos, Paul J. [Division of Biostatistics and Epidemiology, Department of Public Health, Weill Cornell Medical College of Cornell University, New York, New York (United States); Parashar, Bhupesh; Nori, Dattatreyudu; Chao, K. S. Clifford [Department of Radiation Oncology, Stich Radiation Center, Weill Cornell Medical College of Cornell University, New York, New York (United States); Wernicke, A. Gabriella, E-mail: gaw9008@med.cornell.edu [Department of Radiation Oncology, Stich Radiation Center, Weill Cornell Medical College of Cornell University, New York, New York (United States)

    2013-12-01

    Purpose: To examine a relationship between serum transforming growth factor β -1 (TGF-β1) values and radiation-induced fibrosis (RIF). Methods and Materials: We conducted a prospective analysis of the development of RIF in 39 women with American Joint Committee on Cancer stage 0-I breast cancer treated with lumpectomy and accelerated partial breast irradiation via intracavitary brachytherapy (IBAPBI). An enzyme-linked immunoassay (Quantikine, R and D, Minneapolis, MN) was used to measure serum TGF-β1 before surgery, before IBAPBI, and during IBAPBI. Blood samples for TGF-β1 were also collected from 15 healthy, nontreated women (controls). The previously validated tissue compliance meter (TCM) was used to objectively assess RIF. Results: The median time to follow-up for 39 patients was 44 months (range, 5-59 months). RIF was graded by the TCM scale as 0, 1, 2, and 3 in 5 of 20 patients (25%), 6 of 20 patients (30%), 5 of 20 patients (25%), and 4 of 20 patients (20%), respectively. The mean serum TGF-β1 values were significantly higher in patients before surgery than in disease-free controls, as follows: all cancer patients (30,201 ± 5889 pg/mL, P=.02); patients with any type of RIF (32,273 ± 5016 pg/mL, P<.0001); and women with moderate to severe RIF (34,462 ± 4713 pg/mL, P<0.0001). Patients with moderate to severe RIF had significantly elevated TGF-β1 levels when compared with those with none to mild RIF before surgery (P=.0014) during IBAPBI (P≤0001), and the elevation persisted at 6 months (P≤.001), 12 months (P≤.001), 18 months (P≤.001), and 24 months (P=.12). A receiver operating characteristic (ROC) curve of TGF-β1 values predicting moderate to severe RIF was generated with an area under the curve (AUC){sub ROC} of 0.867 (95% confidence interval 0.700-1.000). The TGF-β1 threshold cutoff was determined to be 31,000 pg/mL, with associated sensitivity and specificity of 77.8% and 90.0%, respectively. Conclusions: TGF-β1 levels correlate with

  1. Evaluation of Current Consensus Statement Recommendations for Accelerated Partial Breast Irradiation: A Pooled Analysis of William Beaumont Hospital and American Society of Breast Surgeon MammoSite Registry Trial Data

    Purpose: To determine whether the American Society for Radiation Oncology (ASTRO) Consensus Statement (CS) recommendations for accelerated partial breast irradiation (APBI) are associated with significantly different outcomes in a pooled analysis from William Beaumont Hospital (WBH) and the American Society of Breast Surgeons (ASBrS) MammoSite® Registry Trial. Methods and Materials: APBI was used to treat 2127 cases of early-stage breast cancer (WBH, n=678; ASBrS, n=1449). Three forms of APBI were used at WBH (interstitial, n=221; balloon-based, n=255; or 3-dimensional conformal radiation therapy, n=206), whereas all Registry Trial patients received balloon-based brachytherapy. Patients were divided according to the ASTRO CS into suitable (n=661, 36.5%), cautionary (n=850, 46.9%), and unsuitable (n=302, 16.7%) categories. Tumor characteristics and clinical outcomes were analyzed according to CS group. Results: The median age was 65 years (range, 32-94 years), and the median tumor size was 10.0 mm (range, 0-45 mm). The median follow-up time was 60.6 months. The WBH cohort had more node-positive disease (6.9% vs 2.6%, P<.01) and cautionary patients (49.5% vs 41.8%, P=.06). The 5-year actuarial ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), and distant metastasis (DM) for the whole cohort were 2.8%, 0.6%, 1.6%. The rate of IBTR was not statistically higher between suitable (2.5%), cautionary (3.3%), or unsuitable (4.6%) patients (P=.20). The nonsignificant increase in IBTR for the cautionary and unsuitable categories was due to increased elsewhere failures and new primaries (P=.04), not tumor bed recurrence (P=.93). Conclusions: Excellent outcomes after breast-conserving surgery and APBI were seen in our pooled analysis. The current ASTRO CS guidelines did not adequately differentiate patients at an increased risk of IBTR or tumor bed failure in this large patient cohort

  2. Feasibility and acute toxicity of 3-dimensional conformal external-beam accelerated partial-breast irradiation for early-stage breast cancer after breast-conserving surgery in Chinese female patients

    LI Feng-yan; HE Zhen-yu; XUE Ming; CHEN Li-xin; WU San-gang; GUAN Xun-xing

    2011-01-01

    Background A growing number of studies worldwide have advocated the replacement of whole-breast irradiation with accelerated partial breast irradiation using three-dimensional conformal external-beam radiation (APBI-3DCRr) for early-stage breast cancer. But APBI can be only used in selected population of patients with early-staged breast cancer. It is not replacing the whole breast radiotherapy. This study aimed to examine the feasibility and acute normal tissue toxicity of the APBI-3DCRT technique in Chinese female patients who generally have smaller breasts compared to their Western counterparts.Methods From May 2006 to December 2009, a total of 48 Chinese female patients (with early-stage breast cancer who met the inclusion criteria) received APBI-3DCRT after breast-conserving surgery at Sun Yat-sen University Cancer Center. The total dosage from APBI-3DCRT was 34 Gy, delivered in 3.4 Gy per fractions, twice per day at intervals of at least six hours. The radiation dose, volume of the target area and volume of irradiated normal tissues were calculated.Acute toxicity was evaluated according to the Common Toxicity Criteria (CTC) 3.0.Results Among the 48 patients, the planning target volume for evaluation (PTVE) was (90.42±9.26) cm3, the ipsilateral breast volume (IBV) was (421.74±28.53) cm3, and the ratio between the two was (20.74±5.86)%. Evaluation of the dosimetric characteristics of the PTVE revealed excellent dosimetric results in 14 patients and acceptable results in 34 patients. The dose delivered to the PTVE ranged from 93% to 110% of the prescribed dose. The average ratio of the volume of PTVE receiving 95% of the prescription dose (V95) was (99.26±0.37)%. The habituation index (HI) and the conformity index (CI) were 1.08±0.01 and 0.72±0.02, respectively, suggesting good homogeneity and conformity of the dose delivered to the target field. The radiation dose to normal tissues and organs was within the dose limitation.Subjects experienced mild acute

  3. Dosimetric validation of planning system Eclipse 10 in partial breast irradiation treatments with IMRT

    Partial breast irradiation is a new type of external radiation therapy to treat breast cancer in early clinical stages. Consist of administering to the channel surgical high doses of radiation in few treatment sessions. In this paper the dose calculations of the planning system Eclipse version 10 for a treatment of partial breast irradiation with X-rays beams (6 MV) intensity modulated were compared against the measurements made with OSL dosimeters and radio-chromic dye film. An anthropomorphic mannequin was used in which OSL dosimeters were collocated near the surface, an inside the radio-chromic dye film one plate; with this latest one dimensional dose distribution was measured. Previously dosimeters were calibrated irradiating them with a beam of X-rays 6 MV under the conditions specified in the IAEA-398 protocol. The OSL dosimeters were read in the Micro star Landauer equipment, the radio-chromic dye films were read with a scanner Epson 10000-Xl and analyzed with FilmCal and PTW Verisoft programs. The differences between measured and calculated dose were as follows: 3.6±1% for the OSL dosimeter and 96.3±1% of the analyzed points approved the gamma index criterion (3%, 3m m) when comparing the matrices of calculated dose and measured with the radio-chromic dye film. These results confirm the good dosimetric performance of planning system used under specific conditions used in the partial breast irradiation technique. (Author)

  4. Dosimetric comparison of three techniques in treatment of accelerated partial breast irradiation%乳腺癌保乳术后部分乳腺三种放疗计划的剂量学比较

    姚晖; 邱健健; 王芸; 徐志勇

    2014-01-01

    Objective To dosimetrically compare three delivery techniques of VMAT,IMRT and 3D-CRT in the treatment of accelerated partial breast irradiation (APBI).Methods Twenty patients with T1/2N0M0breast cancer were treated with VMAT.These cases were subsequently re-planned using static gantry IMRT and 3D-CRT technology to evaluate dosimetric differences.Dosimetric parameters including dose conformity index (CI),dose volume histogram (DVH) analysis of normal tissue coverage,dose parameters of PTV and normal tissues were evaluated,the delivery parameters including MU and delivery time were also analyzed.Results The IMRT and VMAT plans provided lower maximum dose,better mean dose and more conformal target dose distributions than the 3D-CRT plans (F =14.86,8.57,18.23,P <0.05).The volume of ipsilateral breast receiving 5 Gy for VMAT technique was significantly less than that of3D-CRTor IMRT(F=5.83,P<0.05).The ipsilateral lung volume receiving 20 Gy (V20),5 Gy(V5) and the 5% volume dose (D5) of IMRT were superior to those of 3D-CRT and VMAT(F =16.39,3.62,4.81,P < 0.05).The low volume dose distributions of D5 in contralateral lung for IMRT was better than that of VMAT and 3D-CRT(F =3.99,3.43,P < 0.05).The total mean MUs for VMAT,3D-CRT and IMRT were 621.0 ± 111.9,707.3 ± 130.9 and 1161.4 ± 315.6,respectively (F =31.30,P < 0.05).The average machine delivery time was(1.5 ± 0.2)min for the VMAT plans,(7.0 ± 1.6)min for the 3D-CRT plans and (11.5 ± 1.9)min for the IMRT plans.Conclusions VMAT and IMRT techniques offer improved dose conformity as compared with 3D-CRT techniques without increasing dose to the ipsilateral lung.In terms of MU and delivery time,VMAT is more efficient for APBI than conventional 3D-CRT and static beam IMRT.%目的 比较容积弧形调强(VMAT)、固定野动态调强(IMRT)及三维适形放疗(3D-CRT)技术对乳腺癌保乳术后采用部分乳腺放疗的剂量学差异.方法 选取20例临床分期为T1-2N0M0的早期乳腺癌保乳

  5. Partial-Breast Irradiation Versus Whole-Breast Irradiation for Early-Stage Breast Cancer: A Cost-Effectiveness Analysis

    Purpose: Accelerated partial-breast irradiation (PBI) is a new treatment paradigm for patients with early-stage breast cancer. Although PBI may lead to greater local recurrence rates, it may be cost-effective because of better tolerability and lower cost. We aim to determine the incremental cost-effectiveness of PBI compared with whole-breast radiation therapy (WBRT) for estrogen receptor-positive postmenopausal women treated for early-stage breast cancer. Methods and Materials: We developed a Markov model to describe health states in the 15 years after radiotherapy for early-stage breast cancer. External beam (EB) and MammoSite (MS) PBI were considered and assumed to be equally effective, but carried different costs. Patients received tamoxifen, but not chemotherapy. Utilities, recurrence risks, and costs were adapted from the literature; the baseline utility for no disease after radiotherapy was set at 0.92. Probabilistic sensitivity analyses were performed to model uncertainty in the PBI hazard ratio, recurrence pattern, and patient utilities. Costs (in 2004 US dollars) and quality-adjusted life-years were discounted at 3%/y. Results: The incremental cost-effectiveness ratio for WBRT compared with EB-PBI was $630,000/quality-adjusted life-year; WBRT strongly dominated MS-PBI. One-way sensitivity analysis found that results were sensitive to PBI hazard ratio, recurrence pattern, baseline recurrence risk, and no evidence of disease PBI utility values. Probabilistic sensitivity showed that EB-PBI was the most cost-effective technique over a wide range of assumptions and societal willingness-to-pay values. Conclusions: EB-PBI was the most cost-effective strategy for postmenopausal women with early-stage breast cancer. Unless the quality of life after MS-PBI proves to be superior, it is unlikely to be cost-effective.

  6. Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009)

    Purpose: To give recommendations on patient selection criteria for the use of accelerated partial-breast irradiation (APBI) based on available clinical evidence complemented by expert opinion. Methods and materials: Overall, 340 articles were identified by a systematic search of the PubMed database using the keywords 'partial-breast irradiation' and 'APBI'. This search was complemented by searches of reference lists of articles and handsearching of relevant conference abstracts and book chapters. Of these, 3 randomized and 19 prospective non-randomized studies with a minimum median follow-up time of 4 years were identified. The authors reviewed the published clinical evidence on APBI, complemented by relevant clinical and pathological studies of standard breast-conserving therapy and, through a series of personal communications, formulated the recommendations presented in this article. Results: The GEC-ESTRO Breast Cancer Working Group recommends three categories guiding patient selection for APBI: (1) a low-risk group for whom APBI outside the context of a clinical trial is an acceptable treatment option; including patients ageing at least 50 years with unicentric, unifocal, pT1-2 (≤30 mm) pN0, non-lobular invasive breast cancer without the presence of an extensive intraductal component (EIC) and lympho-vascular invasion (LVI) and with negative surgical margins of at least 2 mm, (2) a high-risk group, for whom APBI is considered contraindicated; including patients ageing ≤40 years; having positive margins, and/or multicentric or large (>30 mm) tumours, and/or EIC positive or LVI positive tumours, and/or 4 or more positive lymph nodes or unknown axillary status (pNx), and (3) an intermediate-risk group, for whom APBI is considered acceptable only in the context of prospective clinical trials. Conclusions: These recommendations will provide a clinical guidance regarding the use of APBI outside the context of a clinical trial before large-scale randomized

  7. Clinical Experience With Image-Guided Radiotherapy in an Accelerated Partial Breast Intensity-Modulated Radiotherapy Protocol

    Purpose: To explore the feasibility of fiducial markers for the use of image-guided radiotherapy (IGRT) in an accelerated partial breast intensity modulated radiotherapy protocol. Methods and Materials: Nineteen patients consented to an institutional review board approved protocol of accelerated partial breast intensity-modulated radiotherapy with fiducial marker placement and treatment with IGRT. Patients (1 patient with bilateral breast cancer; 20 total breasts) underwent ultrasound guided implantation of three 1.2- x 3-mm gold markers placed around the surgical cavity. For each patient, table shifts (inferior/superior, right/left lateral, and anterior/posterior) and minimum, maximum, mean error with standard deviation were recorded for each of the 10 BID treatments. The dose contribution of daily orthogonal films was also examined. Results: All IGRT patients underwent successful marker placement. In all, 200 IGRT treatment sessions were performed. The average vector displacement was 4 mm (range, 2-7 mm). The average superior/inferior shift was 2 mm (range, 0-5 mm), the average lateral shift was 2 mm (range, 1-4 mm), and the average anterior/posterior shift was 3 mm (range, 1 5 mm). Conclusions: This study shows that the use of IGRT can be successfully used in an accelerated partial breast intensity-modulated radiotherapy protocol. The authors believe that this technique has increased daily treatment accuracy and permitted reduction in the margin added to the clinical target volume to form the planning target volume.

  8. SU-E-T-528: Robustness Evaluation for Fiducial-Based Accelerated Partial Breast Proton Therapy

    Zhao, L; Rana, S; Zheng, Y [Procure Proton Therapy Center, Oklahoma City, OK (United States)

    2014-06-01

    Purpose: To investigate the robustness of the proton treatment plans in the presence of rotational setup error when patient is aligned with implanted fiducials. Methods: Five Stage I invasive breast cancer patients treated with the APBP protocol (PCG BRE007-12) were studied. The rotational setup errors were simulated by rotating the original CT images around the body center clockwise and counterclockwise 5 degrees (5CW and 5CCW). Manual translational registration was then performed to match the implanted fiducials on the rotated images to the original dataset. Patient contours were copied to the newly created CT set. The original treatment plan was applied to the new CT dataset with the beam isocenter placed at the geometrical center of PTV. The dose distribution was recalculated for dosimetric parameters comparison. Results: CTV and PTV (D95 and V95) coverages were not significantly different between the two simulated plans (5CW and 5CCW) and the original plan. PTV D95 and CTV D95 absolute difference among the three plans were relatively small, with maximum changes of 0.28 CGE and 0.15 CGE, respectively. PTV V95 and CTV V95 absolute differences were 0.79% and 0.48%. The dosage to the thyroid, heart, contralateral breast and lung remained zero for all three plans. The Dmax and Dmean to the volume of ipsilateral breast excluding CTV were compared, with maximum difference values of 1.02 CGE for Dmax and 3.56 CGE for Dmean. Ipsilateral lung Dmean maintained no significant changes through the three plan comparison, with the largest value 0.32 CGE. Ipsilateral lung Dmax was the most sensitive parameter to this simulation study, with a maximum difference at 20.2 CGE. Conclusion: Our study suggests that fiducial-based Accelerated Partial Breast Proton Therapy is robust with respect to +/− 5 degree patient setup rotational errors, as long as the internal fiducial markers are used for patient alignment.

  9. Partial Breast Irradiation Versus Whole Breast Radiotherapy for Early-Stage Breast Cancer: A Decision Analysis

    Purpose: To compare the quality-adjusted life expectancy between women treated with partial breast irradiation (PBI) vs. whole breast radiotherapy (WBRT) for estrogen receptor-positive early-stage breast cancer. Methods and Materials: We developed a Markov model to describe health states in the 15 years after radiotherapy for estrogen receptor-positive early-stage breast cancer. Breast cancer recurrences were separated into local recurrences and elsewhere failures. Ipsilateral breast tumor recurrence (IBTR) risk was extracted from the Oxford overview, and rates and utilities were adapted from the literature. We studied two cohorts of women (aged 40 and 55 years), both of whom received adjuvant tamoxifen. Results: Assuming a no evidence of disease (NED)-PBI utility of 0.93, quality-adusted life expectancy after PBI (and WBRT) was 12.61 (12.57) and 12.10 (12.06) years for 40-year-old and 55-year-old women, respectively. The NED-PBI utility thresholds for preferring PBI over WBRT were 0.923 and 0.921 for 40-year-old and 55-year-old women, respectively, both slightly greater than the NED-WBRT utility. Outcomes were sensitive to the utility of NED-PBI, the PBI hazard ratio for local recurrence, the baseline IBTR risk, and the percentage of IBTRs that were local. Overall the degree of superiority of PBI over WBRT was greater for 55-year-old women than for 40-year-old women. Conclusions: For most utility values of the NED-PBI health state, PBI was the preferred treatment modality. This result was highly sensitive to patient preferences and was also dependent on patient age, PBI efficacy, IBTR risk, and the fraction of IBTRs that were local

  10. Three-dimensional conformal partial breast external-beam irradiation after conservative surgery of the breast

    Objective: To explore the methods, dosimetric features and short-term effects of partial breast irradiation carried out by three-dimensional external-beam irradiation (3DCPBI) assisted by active breathing control (ABC). Methods: Computed tomography (CT) simulation assisted by active breathing control (ABC) was carried out for each patient and intended to get CT images in condition of 75% deepest inspiration named moderate deep inspiration breath hold (mDIBH). The extent labeled by the silver slips located in the cavity was delineated as gross target volume (GTV), GTV plus the margin of 15 mm was defined as planning target volume (PTV). 6 MV X-ray was selected as the radiation source and noncoplanar radiation with four three-dimensional conformal fields was used, the described dose was 34 Gy/10f/5d. The volume of GTV, PTV, the affected whole breast, and the percentage of PTV accounted for the affected whole breast, the percentages of PTV included by 100%, 95% and 90% isodose curve, the percentage of volume of the affected breast irradiated by 34.0, 27.2, 20.4, 13.6 and 6.8 Gy , and Dmean, D5, V20 of the lungs and heart were calculated respectively. Acute radiation skin response was recorded and the cosmetic effect of the breast after radiotherapy were appraised, with the local tumor control and survival rate followed. Results: The mean of volume ratio of PTV and affected whole breast was 14.88%; the mean of the volume covered by 90% isodose curve accounted for 92.54% of the PTV; the volume irradiated by 34 Gy (100% of described dose) accounted for 17.23% (mean) of the whole breast and 6.8 Gy (20% of described dose) for 46.11%, in other words, the volume covered by 20% of described dose was less than 50% of the whole breast. The Dmean, D5, V20 for the affected lateral lung were 1.97, 9.25 Gy and 1.58%, it was 0.20, 0.87 Gy, and 0% for the unaffected lateral lung. The Dmean, D5, V20 for the heart was 0.65 Gy, 2.82 Gy, and 0.85%. Zero grade of acute radiation skin

  11. Partial breast irradiation for early breast cancer: 3-year results of the German-Austrian phase II-trial; Teilbrustbestrahlung beim Mammakarzinom mit guenstigen prognostischen Faktoren: 3-Jahres-Ergebnisse der deutschoesterreichischen Phase II-Studie

    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [Strahlenklinik, Universitaetsklinikum Erlangen (Germany); Poetter, R. [Universitaetsklinik fuer Strahlentherapie und Strahlenbiologie, AKH Wien (Austria); Hildebrandt, G. [Strahlenklinik, Universitaetsklinikum Leipzig (Germany); Hammer, J. [Abt. fuer Strahlentherapie, KH Barmherzige Schwestern Linz (Austria); Beckmann, M.W. [Frauenklinik, Universitaetsklinikum Erlangen (Germany)

    2005-07-01

    Purpose: to evaluate perioperative morbidity, toxicity and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole radiation modality after breast conserving surgery. Materials and methods: from 11/2000 to 11/2004, 240 women with early stage breast cancer participated in a protocol of tumor bed irradiation alone using pulsed dose rate (PDR) or high dose rate (HDR) interstitial multi-catheter implants (partial breast irradiation). Perioperative morbidity, acute and late toxicity as well as cosmetic outcome were assessed. Of the first 51 patients treated in this multicenter trial, we present interim findings after a median follow-up of 36 months. Results: perioperative Morbidity: Bacterial infection of the implant: 2% (1/51). Acute toxicity: radiodermatitis grade 1: 4% (2/51). Late toxicity: breast pain grade 1: 8% (4/51), grade 2: 2% (1/51); dyspigmentation grade 1: 8% (4/51); fibrosis grade 1: 4% (2/51), grade 2: 8% (4/51); telangiectasia grade 1: 10% (5/51), grade 2: 4% (2/51). Cosmetic results: Excellent and good in 94% (48/51) of the patients. Conclusion: this analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter PDR-/HDR-implants (partial breast irradiation) is feasible with low perioperative morbidity, low acute and mild late toxicity at a median follow-up of 36 months. The cosmetic result is not significantly affected. (orig.)

  12. Phase II investigation: partial breast irradiation with high-dose brachytherapy using intratissue multicatheter implant

    Local control, side-effects, and cosmetic results were analyzed in patients with early-stage breast cancer after organpreserving surgery and adjuvant partial accelerated irradiation of the breast using high dose rate brachytherapy and intratissue multicatheter implant. The patients over 50 with solitary tumors < 3 cm invasive ductal carcinoma, differentiation grade I-III, resection R0, N0 (axillary dissection or investigation of signal lymph node) were included in the study. The irradiation was performed twice a day with a 6-hour interval at a single dose of 4 Gy. Total focal dose of 32 Gy was delivered with 8 fractions. With a mean observation period of 31 months (13-46), a local relapse was diagnosed in one patient (1.7 %). Cosmetic results were assessed as good and excellent. Immediate complications of the treatment were minimal. The method can be indicated in a selected group of patients and cannot be a standard of treatment at present.

  13. Can We Predict Plan Quality for External Beam Partial Breast Irradiation: Results of a Multicenter Feasibility Study (Trans Tasman Radiation Oncology Group Study 06.02)

    Kron, Tomas, E-mail: Tomas.Kron@petermac.org [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia); School of Science, Engineering and Technology, Royal Melbourne Institute of Technology University, Melbourne, Victoria (Australia); Willis, David; Link, Emma [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Lehman, Margot [Princess Alexandra Hospital, Department of Radiation Oncology, Brisbane, Queensland (Australia); Campbell, Gillian [Auckland City Hospital, Department of Radiation Oncology, Auckland (New Zealand); O' Brien, Peter [Newcastle Calvary Mater Hospital, Department of Radiation Oncology, Newcastle, NSW (Australia); Chua, Boon [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia)

    2013-11-15

    Purpose: Partial breast irradiation (PBI) after lumpectomy may be an option for selected patients with early breast cancer. A feasibility study of accelerated PBI delivered using external beam 3-dimensional conformal radiation therapy (RT) was undertaken at 8 Australasian centers. The present study evaluated the impact of patient, tumor, and RT technique-related factors on the quality of RT plans as determined by the dose–volume parameters of organs at risk. Methods and Materials: Forty-eight patients were enrolled in the study. All RT plans were centrally reviewed using predefined dosimetric criteria before commencement and after completion of protocol therapy. The RT plans of 47 patients met the dose–volume constraints, and all 47 patients received PBI to a prescribed dose of 38.5 Gy in 10 fractions. The RT plan quality was determined by volumes of the ipsilateral whole breast, lung, and heart that received 50% and 95%; 30%; and 5% of the prescribed dose, respectively. Patient, tumor, and RT technique-related factors were investigated for association with the parameters of RT plan quality. Results: The ratio of the planning target volume to the ipsilateral whole-breast volume was significantly associated with the ipsilateral breast doses on multiple variable analyses. The distance of the postlumpectomy surgical cavity from the heart and lung were predictive for heart and lung doses, respectively. A distance between surgical cavity and heart of >4 cm typically resulted in <1% of the heart volume receiving 5 Gy or less. It was more difficult to meet the heart dose constraint for left-sided and medially located tumors. Conclusions: Partial breast irradiation using 3-dimensional conformal RT was feasible within the study constraints. The ratio of planning target volume to ipsilateral whole-breast volume and the distance of surgical cavity from the heart were significant predictors of the quality of treatment plan for external beam PBI.

  14. Sci—Thur PM: Planning and Delivery — 04: Respiratory margin derivation and verification in partial breast irradiation

    Quirk, S [Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta (Canada); Conroy, L [Department of Physics and Astronomy, University of Calgary, Calgary, Alberta (Canada); Smith, WL [Department of Oncology, University of Calgary, Calgary, Alberta (Canada)

    2014-08-15

    Partial breast irradiation (PBI) following breast-conserving surgery is emerging as an effective means to achieve local control and reduce irradiated breast volume. Patients are planned on a static CT image; however, treatment is delivered while the patient is free-breathing. Respiratory motion can degrade plan quality by reducing target coverage and/or dose homogeneity. A variety of methods can be used to determine the required margin for respiratory motion in PBI. We derive geometric and dosimetric respiratory 1D margin. We also verify the adequacy of the typical 5 mm respiratory margin in 3D by evaluating plan quality for increasing respiratory amplitudes (2–20 mm). Ten PBI plans were used for dosimetric evaluation. A database of volunteer respiratory data, with similar characteristics to breast cancer patients, was used for this study. We derived a geometric 95%-margin of 3 mm from the population respiratory data. We derived a dosimetric 95%-margin of 2 mm by convolving 1D dose profiles with respiratory probability density functions. The 5 mm respiratory margin is possibly too large when 1D coverage is assessed and could lead to unnecessary normal tissue irradiation. Assessing margins only for coverage may be insufficient; 3D dosimetric assessment revealed degradation in dose homogeneity is the limiting factor, not target coverage. Hotspots increased even for the smallest respiratory amplitudes, while target coverage only degraded at amplitudes greater than 10 mm. The 5 mm respiratory margin is adequate for coverage, but due to plan quality degradation, respiratory management is recommended for patients with respiratory amplitudes greater than 10 mm.

  15. Implementation of the technique of partial irradiation accelerated the breast with high doses (HDR) brachytherapy; Puesta en marcha de la tecnica de irradiacion parcial acelerada de la mama con braquterapia de alta tasa de dosis (HDR)

    Molina Lopez, M. Y.; Pardo Perez, E.; Castro Novais, J.; Martinez Ortega, J.; Ruiz Maqueda, S.; Cerro Penalver, E. del

    2013-07-01

    The objective of this work is presents procedure carried out in our Centre for the implementation of the accelerated partial breast irradiation (APBI, accelerated partial-breast irradiation) with high-rate brachytherapy (HDR), using plastic tubes as applicators. Carried out measures, the evaluation of the dosimetric parameters analyzing and presenting the results. (Author)

  16. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    Kowalchik, Kristin V. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); Vallow, Laura A., E-mail: vallow.laura@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); McDonough, Michelle [Department of Radiology, Mayo Clinic, Jacksonville, Florida (United States); Thomas, Colleen S.; Heckman, Michael G. [Section of Biostatistics, Mayo Clinic, Jacksonville, Florida (United States); Peterson, Jennifer L. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); Adkisson, Cameron D. [Department of General Surgery, Mayo Clinic, Jacksonville, Florida (United States); Serago, Christopher [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); McLaughlin, Sarah A. [Department of General Surgery, Mayo Clinic, Jacksonville, Florida (United States)

    2013-09-01

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  17. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  18. Investigation of variability in image acquisition and contouring during 3D ultrasound guidance for partial breast irradiation

    Three-dimensional ultrasound (3DUS) at simulation compared to 3DUS at treatment is an image guidance option for partial breast irradiation (PBI). This study assessed if user dependence in acquiring and contouring 3DUS (operator variability) contributed to variation in seroma shifts calculated for breast IGRT. Eligible patients met breast criteria for current randomized PBI studies. 5 Operators participated in this study. For each patient, 3 operators were involved in scan acquisitions and 5 were involved in contouring. At CT simulation (CT1), a 3DUS (US1) was performed by a single radiation therapist (RT). 7 to 14 days after CT1 a second CT (CT2) and 3 sequential 3DUS scans (US2a,b,c) were acquired by each of 3 RTs. Seroma shifts, between US1 and US2 scans were calculated by comparing geometric centers of the seromas (centroids). Operator contouring variability was determined by comparing 5 RT’s contours for a single image set. Scanning variability was assessed by comparing shifts between multiple scans acquired at the same time point (US1-US2a,b,c). Shifts in seromas contoured on CT (CT1-CT2) were compared to US data. From an initial 28 patients, 15 had CT visible seromas, met PBI dosimetric constraints, had complete US data, and were analyzed. Operator variability contributed more to the overall variability in seroma localization than the variability associated with multiple scan acquisitions (95% confidence mean uncertainty of 6.2 mm vs. 1.1 mm). The mean standard deviation in seroma shift was user dependent and ranged from 1.7 to 2.9 mm. Mean seroma shifts from simulation to treatment were comparable to CT. Variability in shifts due to different users acquiring and contouring 3DUS for PBI guidance were comparable to CT shifts. Substantial inter-observer effect needs to be considered during clinical implementation of 3DUS IGRT

  19. Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

    Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

  20. Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

    Couto, Henrique Lima, E-mail: enriquecouto@hotmail.com [Santa Fe Women' s and Maternity Hospital, Belo Horizonte, MG (Brazil); Amorim, Washington Cancado; Guimaraes, Rodrigo [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital Geral; Ramires, Leandro Cruz; Castilho, Marcus Simoes [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Fac. de Medicina; Dominguez, Lorena Lima Coto [Universidade Estacio de Sa (UNESA), Rio de Janeiro, EJ (Brazil)

    2014-07-15

    Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

  1. A Prospective Study of the Utility of Magnetic Resonance Imaging in Determining Candidacy for Partial Breast Irradiation

    Dorn, Paige L.; Al-Hallaq, Hania A.; Haq, Farah; Goldberg, Mira [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States); Abe, Hiroyuki [Department of Radiology, University of Chicago Medical Center, Chicago, Illinois (United States); Hasan, Yasmin [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States); Chmura, Steven J., E-mail: schmura@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States)

    2013-03-01

    Purpose: Retrospective data have demonstrated that breast magnetic resonance imaging (MRI) may change a patient's eligibility for partial breast irradiation (PBI) by identifying multicentric, multifocal, or contralateral disease. The objective of the current study was to prospectively determine the frequency with which MRI identifies occult disease and to establish clinical factors associated with a higher likelihood of MRI prompting changes in PBI eligibility. Methods and Materials: At The University of Chicago, women with breast cancer uniformly undergo MRI in addition to mammography and ultrasonography. From June 2009 through May 2011, all patients were screened prospectively in a multidisciplinary conference for PBI eligibility based on standard imaging, and the impact of MRI on PBI eligibility according to National Surgical Adjuvant Breast and Bowel Project protocol B-39/Radiation Therapy Oncology Group protocol 0413 entry criteria was recorded. Univariable analysis was performed using clinical characteristics in both the prospective cohort and in a separate cohort of retrospectively identified patients. Pooled analysis was used to derive a scoring index predictive of the risk that MRI would identify additional disease. Results: A total of 521 patients were screened for PBI eligibility, and 124 (23.8%) patients were deemed eligible for PBI based on standard imaging. MRI findings changed PBI eligibility in 12.9% of patients. In the pooled univariable analysis, tumor size ≥2 cm on mammography or ultrasonography (P=.02), age <50 years (P=.01), invasive lobular histology (P=.01), and HER-2/neu amplification (P=.01) were associated with a higher likelihood of MRI changing PBI eligibility. A predictive score was generated by summing the number of significant risk factors. Patients with a score of 0, 1, 2, and 3 had changes to eligibility based on MRI findings in 2.8%, 13.2%, 38.1%, and 100%, respectively (P<.0001). Conclusions: MRI identified additional

  2. Outcome of a phase II prospective study on partial breast irradiation with interstitial multi-catheter high-dose-rate brachytherapy

    Background and purpose: Partial breast irradiation (PBI) is an alternative to whole-breast irradiation after breast-conserving surgery in selected patients. Until the results of randomized phase III studies are available, phase II studies inform about PBI. We report the 5 year results of a phase II prospective study with PBI using interstitial multi-catheter high-dose-rate brachytherapy (ClinicalTrials.gov Identifier: (NCT00499057)). Methods: Hundred patients received PBI (4 Gy, twice a day for 4 days, until 32 Gy). Inclusion criteria were: age ⩾40 years, infiltrating carcinoma without lobular histology, ductal in situ carcinoma, tumor size ⩽2.5 cm, negative surgical margins and axillary lymph nodes. Results: At a median follow-up of 60 months late toxicity occurred in 25 patients; the 5-year probability of freedom from late toxicity was 72.6% (95% CI: 63.7–81.7). Tamoxifen was the only significant risk factor for late toxicity. Cosmetic results, judged by physicians and patients, were good/excellent in 98 patients. Three local relapses (1 true, 2 elsewhere) and 1 regional relapse occurred. The 5-year probability of local or regional relapse-free survival was 97.7% (95% CI: 91.1–99.4) and 99.0% (95% CI: 92.9–99.8), respectively. Conclusion: PBI with interstitial multi-catheter brachytherapy is associated with low relapse and late toxicity rates

  3. Dosimetric validation of planning system Eclipse 10 in partial breast irradiation treatments with IMRT; Validacion dosimetrica del sistema de planeacion Eclipse 10 en tratamientos de irradiacion parcial de mama con IMRT

    Velazquez T, J. J.; Gutierrez M, J. G.; Ortiz A, C. S.; Chagoya G, A.; Gutierrez C, J. G., E-mail: jvelaesfm@gmail.com [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamentos de Fisica Medica y Radioterapia, Av. Cuauhtemoc 330, 03020 Mexico D. F. (Mexico)

    2015-10-15

    Partial breast irradiation is a new type of external radiation therapy to treat breast cancer in early clinical stages. Consist of administering to the channel surgical high doses of radiation in few treatment sessions. In this paper the dose calculations of the planning system Eclipse version 10 for a treatment of partial breast irradiation with X-rays beams (6 MV) intensity modulated were compared against the measurements made with OSL dosimeters and radio-chromic dye film. An anthropomorphic mannequin was used in which OSL dosimeters were collocated near the surface, an inside the radio-chromic dye film one plate; with this latest one dimensional dose distribution was measured. Previously dosimeters were calibrated irradiating them with a beam of X-rays 6 MV under the conditions specified in the IAEA-398 protocol. The OSL dosimeters were read in the Micro star Landauer equipment, the radio-chromic dye films were read with a scanner Epson 10000-Xl and analyzed with FilmCal and PTW Verisoft programs. The differences between measured and calculated dose were as follows: 3.6±1% for the OSL dosimeter and 96.3±1% of the analyzed points approved the gamma index criterion (3%, 3m m) when comparing the matrices of calculated dose and measured with the radio-chromic dye film. These results confirm the good dosimetric performance of planning system used under specific conditions used in the partial breast irradiation technique. (Author)

  4. Equivalent uniform dose for accelerated partial breast irradiation using the MammoSite applicator

    Introduction: This study aims to quantify the radiobiology of the MammoSite applicator and examine whether there is a relationship between equivalent uniform dose (EUD) and radiotherapy-associated toxicity. Methods and materials: A previously-published version of the linear quadratic (LQ) model, designed to address the impact of dose-gradients in brachytherapy applications, was used to determine the biological effective dose (BED), equivalent dose in 2 Gray per fraction (EQD2) and EUD for the most common fractionation scheme for the MammoSite catheter (34 Gy in 10 fractions prescribed to 1 cm from the balloon surface), using a range of balloon sizes in a series of patients treated with single or multiple dwell positions. Toxicity from the MammoSite catheter was assessed and statistical associations with the calculated EUDs were investigated. Results: The acute- and late-toxicity EUDs respectively range from 34.8–39.4 Gy and 33.4–37.6 Gy, with EUD decreasing as balloon diameter increases and/or the number of dwell positions increases. There was a positive association between EUD and hyperpigmentation and telangiectasia. Conclusions: For APBI using the Mammosite applicator, EUD is higher than the marginal prescription dose and, for the dose-fractionation patterns considered here, was associated with acute and late skin toxicity. EUD is a potentially useful parameter to characterize non-uniform dose distributions related to brachytherapy treatments. Further evaluation in future studies is warranted

  5. Feasibility, efficacy and cosmetic effect of three-dimensional conformal external bean partial breast irradiation for the selected early stage breast cancer patients after breast-conserving surgery

    Objective: To explore the feasibility, efficacy and cosmetic effect of three-dimensional conformal external beam partial breast irradiation (EB-PBI) after breast-conserving surgery for the selected Chinese early stage breast cancer patients. Methods: From June 2003 to December 2010, Forty-four early stage breast cancer patients underwent underwent EB-PBI after breast-conserving surgery. Twenty patients had CT simulation scan in moderate deep inspiration breathing hold, and twenty-four patients in free breathing. EB-PBI was planned and delivered by three-dimensional conformal radiotherapy (3DCRT) with four non-coplanar beams. The prescribed dose was 3.40 Gy per fraction in thirty-nine patients and 3.85 Gy per fraction in five patients, twice per day at an interval of at least six hours, in five consecutive days. Results: The number of patients with follow up time of 2, 3 and 5 years were 39, 31 and 16, Grade 1 acute radiation-induced dermatitis was observed in 17 patients (39%) at three months. Cosmesis was good or excellent in all cases at six months after radiotherapy and in 95% cases at two years after radiotherapy. The 2-, 3- and 5- year local control rates were 100%, 99% and 94%, respectively. The 2-, 3-, and 5-year survival rates were all 100% and no metastases occurred. Conclusions: EB-PBI delivered by 3DCRT is feasible for selected Chinese early stage breast cancer patients after breast-conserving surgery. The cosmetic effect, local control rate and long-term survival rate are satisfactory, and acute radiation toxicity is very low. (authors)

  6. SU-E-J-37: Feasibility of Utilizing Carbon Fiducials to Increase Localization Accuracy of Lumpectomy Cavity for Partial Breast Irradiation

    Zhang, Y; Hieken, T; Mutter, R; Park, S; Yan, E; Brinkmann, D; Pafundi, D [Mayo Clinic, Rochester, MN (United States)

    2015-06-15

    Purpose To investigate the feasibility of utilizing carbon fiducials to increase localization accuracy of lumpectomy cavity for partial breast irradiation (PBI). Methods Carbon fiducials were placed intraoperatively in the lumpectomy cavity following resection of breast cancer in 11 patients. The patients were scheduled to receive whole breast irradiation (WBI) with a boost or 3D-conformal PBI. WBI patients were initially setup to skin tattoos using lasers, followed by orthogonal kV on-board-imaging (OBI) matching to bone per clinical practice. Cone beam CT (CBCT) was acquired weekly for offline review. For the boost component of WBI and PBI, patients were setup with lasers, followed by OBI matching to fiducials, with final alignment by CBCT matching to fiducials. Using carbon fiducials as a surrogate for the lumpectomy cavity and CBCT matching to fiducials as the gold standard, setup uncertainties to lasers, OBI bone, OBI fiducials, and CBCT breast were compared. Results Minimal imaging artifacts were introduced by fiducials on the planning CT and CBCT. The fiducials were sufficiently visible on OBI for online localization. The mean magnitude and standard deviation of setup errors were 8.4mm ± 5.3 mm (n=84), 7.3mm ± 3.7mm (n=87), 2.2mm ± 1.6mm (n=40) and 4.8mm ± 2.6mm (n=87), for lasers, OBI bone, OBI fiducials and CBCT breast tissue, respectively. Significant migration occurred in one of 39 implanted fiducials in a patient with a large postoperative seroma. Conclusion OBI carbon fiducial-based setup can improve localization accuracy with minimal imaging artifacts. With increased localization accuracy, setup uncertainties can be reduced from 8mm using OBI bone matching to 3mm using OBI fiducial matching for PBI treatment. This work demonstrates the feasibility of utilizing carbon fiducials to increase localization accuracy to the lumpectomy cavity for PBI. This may be particularly attractive for localization in the setting of proton therapy and other scenarios

  7. SU-E-J-37: Feasibility of Utilizing Carbon Fiducials to Increase Localization Accuracy of Lumpectomy Cavity for Partial Breast Irradiation

    Purpose To investigate the feasibility of utilizing carbon fiducials to increase localization accuracy of lumpectomy cavity for partial breast irradiation (PBI). Methods Carbon fiducials were placed intraoperatively in the lumpectomy cavity following resection of breast cancer in 11 patients. The patients were scheduled to receive whole breast irradiation (WBI) with a boost or 3D-conformal PBI. WBI patients were initially setup to skin tattoos using lasers, followed by orthogonal kV on-board-imaging (OBI) matching to bone per clinical practice. Cone beam CT (CBCT) was acquired weekly for offline review. For the boost component of WBI and PBI, patients were setup with lasers, followed by OBI matching to fiducials, with final alignment by CBCT matching to fiducials. Using carbon fiducials as a surrogate for the lumpectomy cavity and CBCT matching to fiducials as the gold standard, setup uncertainties to lasers, OBI bone, OBI fiducials, and CBCT breast were compared. Results Minimal imaging artifacts were introduced by fiducials on the planning CT and CBCT. The fiducials were sufficiently visible on OBI for online localization. The mean magnitude and standard deviation of setup errors were 8.4mm ± 5.3 mm (n=84), 7.3mm ± 3.7mm (n=87), 2.2mm ± 1.6mm (n=40) and 4.8mm ± 2.6mm (n=87), for lasers, OBI bone, OBI fiducials and CBCT breast tissue, respectively. Significant migration occurred in one of 39 implanted fiducials in a patient with a large postoperative seroma. Conclusion OBI carbon fiducial-based setup can improve localization accuracy with minimal imaging artifacts. With increased localization accuracy, setup uncertainties can be reduced from 8mm using OBI bone matching to 3mm using OBI fiducial matching for PBI treatment. This work demonstrates the feasibility of utilizing carbon fiducials to increase localization accuracy to the lumpectomy cavity for PBI. This may be particularly attractive for localization in the setting of proton therapy and other scenarios

  8. Cone-beam computed tomography guided study on silver clips displacement in breast cancer patients treated by three-dimensional conformal partial breast irradiation assisted by active breathing control after breast-conserving surgery

    Objective: To study the displacement of silver clips guided by cone-beam computed tomography (CBCT) to explore the margin of clinical target volume (CTV) to planning target volume (PTV) for breast cancer patients treated by three-dimensional conformal external-beam partial breast irradiation (EB-PBI) assisted by active breathing control (ABC) after breast-conserving surgery. Methods: All patients received CT simulated positioning assisted by ABC to get CT images based on the respiratory condition of moderate deep inspiration breath hold (mDIBH), and the images were transferred to Varian Eclipse treatment planning system. Four silver clips located at the cephal, pedal, lateral border and bottom of the cavity were delineated respectively and the cavity based on all of the clips were delineated as gross tumor volume (GTV). The treatment planning for EB-PBI was performed in Varian 23 EX linear accelerator equipped with kilovoltage(kV) CBCT image-guided system named On-Board Imager (OBI) system. Before each irradiation, kV-CBCT were carried out twice for patients on the respiratory condition of mDIBH assisted by ABC device with the same threshold as CT simulated positioning to get the CBCT images. 3D-3D automatic registration based on pixel between the CBCT image and the planning CT image was finished and the displacement on LAT, LNG and VRT directions were recorded, and then the marked clips were registered by hand movement based on the automatic registration and the shifts and directions were also recorded. A total of eight groups data of displacement of each marked clip for each patient were got from four fractions with two groups data during each fraction. Based on the registration data of the marked clips, the intrafraction and interfraction group systematic errors (Σintra vs Σinter) and group random errors (σintra vs σinter) were analysed. General group systematic error Σgeneral and general random error σgeneral were calculated based on combination of

  9. Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: Alternative to mastectomy? Results from a prospective trial

    Purpose: To assess the outcome of multi-catheter pulse dose rate (PDR) brachytherapy of re-irradiation for local ipsilateral breast tumour recurrence (IBTR) in regard to local control, survival, morbidity and quality of life (QoL). Patients and methods: Between 1999 and 2006, 39 patients were included with histologically confirmed IBTR, Karnofsky index ⩾80% and refusal of mastectomy. Exclusion criteria were multicentric invasive growth pattern, unclear surgical margins, distant metastasis and a postoperative breast not suitable for interstitial brachytherapy. Primary endpoint was local tumour control. Morbidity, cosmetic outcome and QoL were assessed in 24/39 patients. Results: The five year actuarial local control rate was 93% after a mean follow up of 57 (±30) months with two second local relapses. Overall survival and disease free survival, both at 5 years, were 87% and 77%, respectively. Late side effects Grade 1–2 were observed in 20/24 patients after a mean follow-up of 30 (±18) months. Late side effects ⩾Grade 3 occurred in 4/24 patients. Cosmetic outcome was excellent to fair in 76% of women. Overall QoL was comparable to a healthy control group. Mean scores of scales and items of QLQ-BR23 were comparable to primary breast conserving therapy. Conclusions: Accelerated PDR-brachytherapy following breast conserving surgery (BCS) for local IBTR results in local tumour control comparable to mastectomy. Morbidity is moderate; the cosmetic outcome is good and hardly any impairment on QoL is observed.

  10. Intensity Modulated Accelerated Partial Breast Irradiation Before Surgery in Treating Older Patients With Hormone Responsive Stage 0-I Breast Cancer

    2016-05-04

    Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Ductal Breast Carcinoma With Predominant Intraductal Component; Lobular Breast Carcinoma in Situ; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-positive Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Tubular Ductal Breast Carcinoma

  11. Dose and polymorphic genes xrcc1, xrcc3, gst play a role in the risk of articledeveloping erythema in breast cancer patients following single shot partial breast irradiation after conservative surgery

    To evaluate the association between polymorphisms involved in DNA repair and oxidative stress genes and mean dose to whole breast on acute skin reactions (erythema) in breast cancer (BC) patients following single shot partial breast irradiation (SSPBI) after breast conservative surgery. Acute toxicity was assessed using vers.3 criteria. single nucleotides polymorphisms(SNPs) in genes: XRCC1(Arg399Gln/Arg194Trp), XRCC3 (A4541G-5'UTR/Thr241Met), GSTP1(Ile105Val), GSTA1 and RAD51(untranslated region). SNPs were determined in 57 BC patients by the Pyrosequencing analysis. Univariate(ORs and 95% CI) and logistic multivariate analyses (MVA) were performed to correlate polymorphic genes with the risk of developing acute skin reactions to radiotherapy. After SSPBI on the tumour bed following conservative surgery, grade 1 or 2 acute erythema was observed in 19 pts(33%). Univariate analysis indicated a higher significant risk of developing erythema in patients with polymorphic variant wt XRCC1Arg194Trp, mut/het XRCC3Thr241Met, wt/het XRCC3A4541G-5'UTR. Similarly a higher erythema rate was also found in the presence of mut/het of XRCC1Arg194Trp or wt of GSTA1. Whereas, a lower erythema rate was observed in patients with mut/het of XRCC1Arg194Trp or wt of XRCC1Arg399Gln. The mean dose to whole breast(p = 0.002), the presence of either mut/het XRCC1Arg194Trp or wt XRCC3Thr241Met (p = 0.006) and the presence of either mut/het XRCC1Arg194Trp or wt GSTA1(p = 0.031) were confirmed as predictors of radiotherapy-induced erythema by MVA. The Whole breast mean dose together with the presence of some polymorphic genes involved in DNA repair or oxidative stress could explain the erythema observed after SSPBI, but further studies are needed to confirm these results in a larger cohort. ClinicalTrials.gov Identifier: http://www.clinicaltrials.gov/ct2/show/NCT01316328

  12. Comparison of displacement of the geometry constituted by silver clips in cavity in the different state of respiration assisted by active breathing control system in external-beam partial breast irradiation

    Objective: To investigate the effect of the displacement of the selected silver clip in the different respiratory state achieved by active breathing control (ABC) system on the displacement of the geometry constituted by all of the silver clips at the border of the cavity in external-beam partial breast irradiation (EB-PBI). Methods: Two sets of CT images in state of moderate deep inspiratory breathing hold (mDIBH), deep expiratory breathing hold (DEBH), and free breath (FB) were acquired in the same CT simulation assisted by ABC system for each of the 27 patients after breast conservative surgery. All silver clips in the cavity were delineated based on each set of CT images. Thereafter, the irregular geometry based on the silver clips as the vertices was automatically formed. Four selected clips located at the top, bottom, lateral border and medial border of the cavity were correspondingly manually registered based on automatic registration of the CT images acquired in the same or different state of respiration including mDIBH, FB, and DEBH. The displacement of center of the geometry in the direction of right-left (RL), anterior-posterior (AP), and superior-inferior (SI) separately based on automatic registration and manual registration was evaluated. The difference of the displacement was analyzed by Kruskal-Wallis H-test and Kolmogorov-Smirnov Z-test. Results: When registered between mDIBH and mDIBH, FB and FB, DEBH and DEBH, the differences of the displacement of the center of geometry were not statistically significant (H =0.00 - 1.76, P=0.184-0.954). When registered between mDIBH and DEBH,the differences were statistically significant (Z =11.31 - 23.00, P =0.000 - 0.001). There were statistically significant differences in the displacement of geometry center based on the selected silver clip between different registration forms in AP and SI directions (Z=4.76-25.54, P=0.000-0.029). Conclusions: The difference of intrafraction displacement of the geometry

  13. A Phase I Trial of Preoperative Partial Breast Radiotherapy: Patient Selection, Target Delineation, and Dose Delivery

    Blitzblau, Rachel C.; Arya, Ritu; Yoo, Sua; Baker, Jay A.; Chang, Zheng; Palta, Manisha; Duffy, Eileen; Horton, Janet K.

    2015-01-01

    Purpose Diffusion of accelerated partial breast irradiation (APBI) into clinical practice is limited by the need for specialized equipment and training. The accessible external beam technique yields unacceptable complication rates, likely due to large post-operative target volumes. We designed a phase I trial evaluating preoperative radiotherapy to the intact tumor utilizing widely available technology. Methods Patients received 15, 18, or 21Gy in a single fraction to the breast tumor plus margin. Magnetic resonance imaging (MRI) was used in conjunction with standard computed tomography (CT)-based planning to identify contrast enhancing tumor. Skin markers and an intra-tumor biopsy marker were utilized for verification during treatment. Results MRI imaging was critical for target delineation as not all breast tumors were reliably identified on CT scan. Breast shape differences were consistently seen between CT and MRI but did not impede image registration or tumor identification. Target volumes were markedly smaller than historical post-operative volumes and normal tissue constraints were easily met. A biopsy marker within the breast proved sufficient for set up localization. Conclusions This single fraction linear-accelerator based ABPI approach can be easily incorporated at most treatment centers. In vivo targeting may improve accuracy and can reduce the dose to normal tissues. PMID:25834942

  14. Image guided Brachytherapy: The paradigm of Gynecologic and Partial Breast HDR Brachytherapy

    Diamantopoulos, S.; Kantemiris, I.; Konidari, A.; Zaverdinos, P.

    2015-09-01

    High dose rate (HDR) brachytherapy uses high strength radioactive sources and temporary interstitial implants to conform the dose to target and minimize the treatment time. The advances of imaging technology enable accurate reconstruction of the implant and exact delineation of high-risk CTV and the surrounding critical structures. Furthermore, with sophisticated treatment planning systems, applicator devices and stepping source afterloaders, brachytherapy evolved to a more precise, safe and individualized treatment. At the Radiation Oncology Department of Metropolitan Hospital Athens, MRI guided HDR gynecologic (GYN) brachytherapy and accelerated partial breast irradiation (APBI) with brachytherapy are performed routinely. Contouring and treatment planning are based on the recommendations of the GEC - ESTRO Working group. The task of this presentation is to reveal the advantages of 3D image guided brachytherapy over 2D brachytherapy. Thus, two patients treated at our department (one GYN and one APBI) will be presented. The advantage of having adequate dose coverage of the high risk CTV and simultaneous low doses to the OARs when using 3D image- based brachytherapy will be presented. The treatment techniques, equipment issues, as well as implantation, imaging and treatment planning procedures will be described. Quality assurance checks will be treated separately.

  15. Blood irradiation with accelerator produced electron beams

    Blood and blood products are irradiated with gamma rays to reduce the risk of graft versus host disease (GVHD). A simple technique using electron beams produced by a medical linear accelerator has been studied to evaluate irradiation of blood and blood products. Variations in applied doses for a single field 20 MeV electron beam are measured in a phantom study. Doses have been verified with ionization chambers and commercial diode detectors. Results show that the blood product volume can be given a relatively homogeneous dose to within 6% using 20 MeV electrons without the need to rotate the blood bags or the beam entry point. The irradiation process takes approximately 6.5 minutes for 30 Gy applied dose to complete as opposed to 12 minutes for a dual field x-ray field irradiation at our centre. Electron beams can be used to satisfactorily irradiate blood and blood products in a minimal amount of time. (author)

  16. Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence: Multicentric study of the GEC-ESTRO Breast Cancer Working Group

    Purpose: To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR). Material and methods: Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS. Results: Median follow-up after the IBTR was 3.9 years [range: 1.1–10.3]. Five and 10-year actuarial 2nd LR rates were 5.6% [range: 1.5–9.5] and 7.2% [range: 2.1–12.1], respectively. Five and 10-year actuarial DM rates were 9.6% [range: 5.7–15.2] and 19.1% [range: 7.8–28.3], respectively. Five and 10-year actuarial OS rates were 88.7% [range: 83.1–94.8] and 76.4% [range: 66.9–87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p = 0.008) and OS (p = 0.02); while tumour size was prognostic factor for DM (p = 0.03). G3-4 complication rate was 11%. Excellent/good cosmetic result was achieved in 85%. Conclusion: This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy

  17. Use of electron accelerators in food irradiation

    Preservation of food by ionizing radiations involves controlled application of energy of radiation to agricultural commodities, foods and food ingredients, for improving storage life, hygiene and safety. Insects and microbes cause major economic losses to stored crops. Many of our food products are contaminated with diseases causing germs and toxin producing molds. Without improvement in microbial quality and getting properly treated to overcome quarantine barriers our agricultural products cannot get international markets. In this respect electron accelerators have immense potential in commercial radiation processing of foods. Both low and high dose applications with increased process rates can be achieved using accelerators to cover a wide spectrum of food commodities approved for commercial radiation processing as per the recent gazette notification under Atomic Energy (Radiation Processing of Food and Allied Products) Rule, 2012. The effectiveness of processing of food by ionizing radiation depends on proper delivery of absorbed dose and its reliable measurement. For food destined for international trade, it is important that the dosimetry used for dose determination is carried out accurately and that the process is monitored in accordance with the internationally accepted procedures. Experiments using alanine-EPR system were carried out to optimize the process parameters of 10 MeV electron beam for commercial irradiation of food. Different food commodities namely, mango, potato and rawa (semolina) were irradiated to measure the absorbed dose distribution. The actual depth dose profile in food products and useful scan width of the electron beam were determined for commercial radiation processing of food using electron beam. (author)

  18. Accelerated partial irradiation for breast cancer: Systematic review and meta-analysis of 8653 women in eight randomized trials

    Background and purpose: Accelerated partial breast irradiation (APBI) is the strategy that allows adjuvant treatment delivery in a shorter period of time in smaller volumes. This study was undertaken to assess the effectiveness and outcomes of APBI in breast cancer compared with whole-breast irradiation (WBI). Material and methods: Systematic review and meta-analysis of randomized controlled trials of WBI versus APBI. Two authors independently selected and assessed the studies regarding eligibility criteria. Results: Eight studies were selected. A total of 8653 patients were randomly assigned for WBI versus APBI. Six studies reported local recurrence outcomes. Two studies were matched in 5 years and only one study for different time of follow-up. Meta-analysis of two trials assessing 1407 participants showed significant difference in the WBI versus APBI group regarding the 5-year local recurrence rate (HR = 4.54, 95% CI: 1.78–11.61, p = 0.002). Significant difference in favor of WBI for different follow-up times was also found. No differences in nodal recurrence, systemic recurrence, overall survival and mortality rates were observed. Conclusions: APBI is associated with higher local recurrence compared to WBI without compromising other clinical outcomes

  19. Preoperative Single Fraction Partial Breast Radiotherapy for Early-Stage Breast Cancer

    Palta, Manisha; Yoo, Sua; Adamson, Justus D.; Prosnitz, Leonard R. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Horton, Janet K., E-mail: janet.horton@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    2012-01-01

    Purpose: Several recent series evaluating external beam accelerated partial breast irradiation (PBI) have reported adverse cosmetic outcomes, possibly related to large volumes of normal tissue receiving near-prescription doses. We hypothesized that delivery of external beam PBI in a single fraction to the preoperative tumor volume would be feasible and result in a decreased dose to the uninvolved breast compared with institutional postoperative PBI historical controls. Methods and Materials: A total of 17 patients with unifocal Stage T1 breast cancer were identified. Contrast-enhanced subtraction magnetic resonance images were loaded into an Eclipse treatment planning system and used to define the target volumes. A 'virtual plan' was created using four photon beams in a noncoplanar beam arrangement and optimized to deliver 15 Gy to the planning target volume. Results: The median breast volume was 1,713 cm{sup 3} (range: 1,014-2,140), and the median clinical target volume was 44 cm{sup 3} (range: 26-73). In all cases, 100% of the prescription dose covered 95% of the clinical target volume. The median conformity index was 0.86 (range: 0.70-1.12). The median percentage of the ipsilateral breast volume receiving 100% and 50% of the prescribed dose was 3.8% (range: 2.2-6.9) and 13.3% (range: 7.5-20.8) compared with 18% (range: 3-42) and 53% (range: 24-65) in the institutional historical controls treated with postoperative external beam PBI (p = .002). The median maximum skin dose was 9 Gy. The median dose to 1 and 10 cm{sup 3} of skin was 6.7 and 4.9 Gy. The doses to the heart and ipsilateral lung were negligible. Conclusion: Preoperative PBI resulted in a substantial reduction in ipsilateral breast tissue dose compared with postoperative PBI. The skin dose appeared reasonable, given the small volumes. A prospective Phase I trial evaluating this technique is ongoing.

  20. Cost evaluation of irradiation system with electron accelerator

    The features of electron beam irradiation system using electron accelerator are direct energy pour into the irradiated material, no third material mixture such as catalyst, suitable for mass production and easy operation and maintenance work available. These features can bring the various applications such as cross-linking action, graft polymerization, radical polymerization and others. The selection of electron accelerator ratings is made under consideration of quality, width and thickness of irradiated material, production amount, dose required for reaction and irradiation atmosphere. Especially in a case of irradiation of wire with high insulation material such as polyethylene, the consideration of maximum thickness toward irradiation direction is necessary to avoid the discharge (Lichtenberg discharge) by charged-up electrons inside insulation material. Therefore, the acceleration voltage should be selected to make the maximum penetration larger than maximum irradiation thickness. The actual model case of estimate the irradiation cost was selected that the irradiation object was polyethylene insulated wire up to AWG no.14, irradiation amount was 5,000 km/month, necessary dose was 200 kGy, operation time was 22 d/month and 8 h/day and actual operation efficiency was considered loss time such as bobbin changing as 80%. The selected ratings of electron accelerator were acceleration voltage of 800 kV, beam current of 100 mA and irradiation width of 180 cm with irradiation pulleys stand of 60 turns x 3 lanes. The initial total cost was estimated as 3 M$(US) and operation cost was evaluated as 215 k$(US). Therefore, the irradiation cost of wire was evaluated as 0.0036 $/m. (author)

  1. Toxicity and cosmetic result of partial breast high-dose-rate interstitial brachytherapy for conservatively operated early breast cancer

    Objective: Objective To study the method, side effects and cosmetic outcome of high- dose-rate (HDR) accelerated partial breast interstitial irradiation (APBI) alone in early stage breast cancer' after conservative surgery. Methods: From February 2002 to June 2003,47 breast cancer lesions from 46 patients suffering from stage I/II breast cancer were treated with HDR 192Ir APBI after conservative surgery. All patients were over 40 year-old, with T1-2N0-1 (≤3 lymph nodes positive), surgical margin > 1-2 mm, but those having lobular or inflammatory breast cancer were excluded. HDR brachytherapy with 34 Gy, 10 fractions/5 days was used after surgery, toxic reaction and cosmetic outcome were observed in one month, 6 and 12 months respectively. Results: Follow up of 1846 months, 34 months was carried out for the whole group. During the treatment, acute reactions including: erythema, edema, tenderness and infection, all under I-II grade, none of III-IV grade were observed in 21 patients(46%); late toxicity reactions: skin fibrosis, breast tenderness, fat necrosis, and telangiectasia, totally 20 patients (43%) were observed: 2 patients in III grade but one patient received 6 cycle chemotherapy. The result of cosmetic outcome evaluation was excellent or good, at 6 months 95% and 12 months 98%, respectively, but there was no recurfence. Conclusions: Excellent and favorable cosmetic results are noted after APBI by interstitial alone. Acute and late reactions are few. Long term observation is necessary for the rate of' local control. (authors)

  2. Irradiation application of electronic beam accelerator NBL-1010

    The application of electronic beam accelerator NBL-1010 in semiconductor denature, gem coloring, waster treatment, chemical synthesize of radiation, degrading of agricultural waster, sterilization of one-off medical treatment, sterilization of herbs, food preservation, crystal coloring and preservation of commodities was studied for its effects equaled with cobalt gamma irradiation

  3. Irradiation-Accelerated Corrosion of Reactor Core Materials. Final Report

    Jiao, Zhujie [Univ. of Michigan, Ann Arbor, MI (United States); Was, Gary [Univ. of Michigan, Ann Arbor, MI (United States); Bartels, David [Univ. of Notre Dame, IN (United States)

    2015-04-02

    This project aims to understand how radiation accelerates corrosion of reactor core materials. The combination of high temperature, chemically aggressive coolants, a high radiation flux and mechanical stress poses a major challenge for the life extension of current light water reactors, as well as the success of most all GenIV concepts. Of these four drivers, the combination of radiation and corrosion places the most severe demands on materials, for which an understanding of the fundamental science is simply absent. Only a few experiments have been conducted to understand how corrosion occurs under irradiation, yet the limited data indicates that the effect is large; irradiation causes order of magnitude increases in corrosion rates. Without a firm understanding of the mechanisms by which radiation and corrosion interact in film formation, growth, breakdown and repair, the extension of the current LWR fleet beyond 60 years and the success of advanced nuclear energy systems are questionable. The proposed work will address the process of irradiation-accelerated corrosion that is important to all current and advanced reactor designs, but remains very poorly understood. An improved understanding of the role of irradiation in the corrosion process will provide the community with the tools to develop predictive models for in-reactor corrosion, and to address specific, important forms of corrosion such as irradiation assisted stress corrosion cracking.

  4. Irradiation-Accelerated Corrosion of Reactor Core Materials. Final Report

    This project aims to understand how radiation accelerates corrosion of reactor core materials. The combination of high temperature, chemically aggressive coolants, a high radiation flux and mechanical stress poses a major challenge for the life extension of current light water reactors, as well as the success of most all GenIV concepts. Of these four drivers, the combination of radiation and corrosion places the most severe demands on materials, for which an understanding of the fundamental science is simply absent. Only a few experiments have been conducted to understand how corrosion occurs under irradiation, yet the limited data indicates that the effect is large; irradiation causes order of magnitude increases in corrosion rates. Without a firm understanding of the mechanisms by which radiation and corrosion interact in film formation, growth, breakdown and repair, the extension of the current LWR fleet beyond 60 years and the success of advanced nuclear energy systems are questionable. The proposed work will address the process of irradiation-accelerated corrosion that is important to all current and advanced reactor designs, but remains very poorly understood. An improved understanding of the role of irradiation in the corrosion process will provide the community with the tools to develop predictive models for in-reactor corrosion, and to address specific, important forms of corrosion such as irradiation assisted stress corrosion cracking.

  5. Induction linear accelerators for commercial photon irradiation processing

    A number of proposed irradiation processes requires bulk rather than surface exposure with intense applications of ionizing radiation. Typical examples are irradiation of food packaged into pallet size containers, processing of sewer sludge for recycling as landfill and fertilizer, sterilization of prepackaged medical disposals, treatment of municipal water supplies for pathogen reduction, etc. Volumetric processing of dense, bulky products with ionizing radiation requires high energy photon sources because electrons are not penetrating enough to provide uniform bulk dose deposition in thick, dense samples. Induction Linear Accelerator (ILA) technology developed at the Lawrence Livermore National Laboratory promises to play a key role in providing solutions to this problem. This is discussed in this paper

  6. Strain acceleration of the low temperature irradiated zirconium

    The strain of a Zr-0,06 at.% 235U specimen irradiated during 4800 h in the RA-3 at a temperature near 40 C degrees is presented. An equivalent neutron fluence of 3.1 x 1026 n m-2 was achieved by means of the generation of fission fragment within the material. The experimental conditions are described and a sudden strain acceleration independent of the neutron flux variations occurred during irradiation is shown. This behavior is compared with previous data obtained at different temperatures. (author)

  7. Accelerated oxygen precipitation in fast neutron irradiated Czochralski silicon

    Ma Qiao-Yun; Li Yang-Xian; Chen Gui-Feng; Yang Shuai; Liu Li-Li; Niu Ping-Juan; Chen Dong-Feng; Li Hong-Tao

    2005-01-01

    Annealing effect of the oxygen precipitation and the induced defects have been investigated on the fast neutron irradiated Czochralski silicon (CZ-Si) by infrared absorption spectrum and the optical microscopy. It is found that the fast neutron irradiation greatly accelerates the oxygen precipitation that leads to a sharp decrease of the interstitial oxygen with the annealing time. At room temperature (RT), the 1107cm-1 infrared absorption band of interstitial oxygen becomes weak and broadens to low energy side. At low temperature, the infrared absorption peaks appear at 1078cm-1, 1096cm-1, and 1182cm-1, related to different shapes of the oxygen precipitates. The bulk microdefects,including stacking faults, dislocations and dislocation loops, were observed by the optical microscopy. New or large stacking faults grow up when the silicon self-interstitial atoms are created and aggregate with oxygen precipitation.

  8. Target volume definition for external beam partial breast radiotherapy: Clinical, pathological and technical studies informing current approaches

    Partial breast irradiation (PBI) is currently under investigation in several phase III trials and, following a recent consensus statement, its use off-study may increase despite ongoing uncertainty regarding optimal target volume definition. We review the clinical, pathological and technical evidence for target volume definition in external beam partial breast irradiation (EB-PBI). The optimal method of tumour bed (TB) delineation requires X-ray CT imaging of implanted excision cavity wall markers. The definition of clinical target volume (CTV) as TB plus concentric 15 mm margins is based on the anatomical distribution of multifocal and multicentric disease around the primary tumour in mastectomy specimens, and the clinical locations of local tumour relapse (LR) after breast conservation surgery. If the majority of LR originate from foci of residual invasive and/or intraduct disease in the vicinity of the TB after complete microscopic resection, CTV margin logically takes account of the position of primary tumour within the surgical resection specimen. The uncertain significance of independent primary tumours as sources of preventable LR, and of wound healing responses in stimulating LR, increases the difficulties in defining optimal CTV. These uncertainties may resolve after long-term follow-up of current PBI trials. By contrast, a commonly used 10 mm clinical to planning target volume (PTV) margin has a stronger evidence base, although departmental set-up errors need to be confirmed locally. A CTV-PTV margin >10 mm may be required in women with larger breasts and/or large seromas, whilst the role of image-guided radiotherapy with or without TB markers in reducing CTV-PTV margins needs to be explored.

  9. Radiation doses inside industrial irradiation installation with linear electron accelerator

    Lima, Alexandre R., E-mail: alexandre.lima@cnen.gov.br [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Pelegrineli, Samuel Q.; Alo, Gabriel F., E-mail: samuelfisica@yahoo.com.br, E-mail: gabriel.alo@aceletron.com.br [Aceletron Irradiacao Industrial, Aceletrica Comercio e Representacoes Ltda, Rio de Janeiro, RJ (Brazil); Silva, Francisco C.A. Da, E-mail: dasilva@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2015-07-01

    Aceletron Industrial Irradiation Company is the unique installation in South America to provide industrial irradiation service using two linear electron accelerators of 18 kW and 10 MeV energy. The electron beam technology allows using electrons to irradiate many goods and materials, such as hospital and medical equipment, cosmetics, herbal products, polymers, peat, gemstones and food. Aceletron Company uses a concrete bunker with 3.66 m of thickness to provide the necessary occupational and environmental radiation protection of X-rays produced. The bunker is divided in main four areas: irradiation room, maze, tower and pit. Inside the irradiation room the x-rays radiation rates are measured in two ways: direct beam and 90 deg C. The rates produced in the conveyor system using 10 MeV energy are 500 Gy/min/mA and 15 Gy/min/mA, respectively. For a 1.8 mA current, the rates produced are 900 Gy/min and 27 Gy/min, respectively. Outside the bunker the radiation rate is at background level, but in the tower door and modulation room the radiation rate is 10 μSv/h. In 2014, during a routine operation, an effective dose of 30.90 mSv was recorded in a monthly individual dosimeter. After the investigation, it was concluded that the dose was only in the dosimeter because it felt inside the irradiation room. As Aceletron Company follows the principles of safety culture, it was decided to perform the radiation isodose curves, inside the four areas of the installation, to know exactly the hotspots positions, exposure times and radiation doses. Five hotspots were chosen taking into account worker's routes and possible operational places. The first experiment was done using a package with three TLD and OSLD dosimeters to obtain better statistical results. The first results for the five hotspots near the accelerator machine showed that the radiation dose rates were between 26 Gy/h and 31 Gy/h. The final measurements were performed using a package with one TLD and one OSLD

  10. The application analysis of high energy electron accelerator in food irradiation processing

    Irradiation technology of high energy electron accelerator has been highly concerned in food processing industry with its fast development, especially in the field of food irradiation processing. In this paper, equipment and research situation of high energy electron accelerator were collected, meanwhile, the similarities and differences between high energy electron beam and 60Co γ-rays were discussed. In order to provide more references of high energy electron beam irradiation, the usages of high energy electron in food irradiation processing was prospected. These information would promote the development of domestic food irradiation industry and give a useful message to irradiation enterprises and researchers. (authors)

  11. 2 MeV, 60 kW dual-beam type electron accelerator irradiation facility

    The specification of new irradiation facility which has been constructed from 1978 through 1981 as the replacement of 1st Accelerator of JAERI, TRCRE are described. The accelerator is the Cockcroft-Walton type and both vertical and horizontal accelerating tubes are arranged on a single high voltage generator. Transferring of the high voltage to the horizontal accelerating tube is performed with the high voltage changing system in the pressure vessel. The output ratings of the accelerator are 2 MV of acceleration voltage and 30 mA of beam current. By providing the dual beam system, two irradiation rooms, one for vertical and the other for horizontal beam, are independently operationable. Persons can enter the horizontal irradiation room for experimental setting even when the vertical irradiation room is in operation. The specification of the buildings, the exhaust air treatment system, the irradiation conveyor and the safety observation system are also described. (author)

  12. Effects of X-Ray Irradiation Produced by Linear Accelerator on Biochemical Parameters of Irradiated Blood Units

    Irradiation of blood and cellular blood components is currently practiced in developed and in a few developing countries. The purpose of this procedure is the prevention of transfusion associated graft versus host disease in immunodeficient patients. Dedicated blood irradiators are only available at limited number of facilities in developing countries. Therefore, irradiation remains a limitedly available service due to excessive cost. This study aims to assess the biochemical changes in samples of packed red blood cell units irradiated using X-rays produced by linear accelerator (LINAC), used for radiotherapy, as an efficient and cost-effective solution for hospitals in developing countries instead of a dedicated device. X-rays generated by linear accelerator were used to irradiate red blood cell units. Each unit was divided to two equal portions, one portion was subjected to irradiation and the other portion used as control, irradiation process was performed in 3 minutes.Ph, potassium levels and percentage of hemolysis were analyzed on different storage periods. Progressive increase in potassium and hemolysis percentage and decrease in Ph was noted in the irradiated units. All parameters were within acceptable ranges indicating that the component is suitable for transfusion. From the above results we conclude that packed RBCs (pRBCs) irradiation using radiotherapy linear accelerator is an efficacious and cost-effective solution for most of the hospitals in developing countries

  13. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    Bush, David A., E-mail: dbush@llu.edu [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Do, Sharon [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Lum, Sharon; Garberoglio, Carlos [Department of Surgical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Mirshahidi, Hamid [Department of Medical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Patyal, Baldev; Grove, Roger; Slater, Jerry D. [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States)

    2014-11-01

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  14. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  15. Linear-accelerator-based stereotactic irradiation for metastatic brain tumors

    To assess the safety and availability of stereotactic radiotherapy (SRT) for metastatic brain tumors, we reviewed 54 consecutive cases with a total of 118 brain metastases treated with linear-accelerator-based stereotactic irradiation (STI). Nineteen patients with a total of 27 brain tumors that were larger than 3 cm or close to critical normal tissues were treated with SRT. The marginal dose of SRT was 15-21 Gy (median 21 Gy) in 3 fractions for 3 days. The median marginal dose of stereotactic radiosurgery (SRS) was 20 Gy. Effective rates of imaging studies were 72.7% and 94.4%, and those of clinical symptoms were 46.7% and 55.6% for SRT and SRS, respectively. One-year and two-year survival rates of SRT were 40.9% and 17.6%, respectively, and the median follow-up period was 6.4 months. The one-year survival rate of SRS was 32.7%, with a median follow-up of 4.6 months. Fourteen cases (7 cases each) had recurrent tumors at STI sites. Early complications were observed in one case of SRT and 8 cases of SRS, and late complications occurred in 3 cases of SRS. There were no significant differences among effective rates, survival rates, median follow-up times, recurrence rates, and complications between SRT and SRS. We concluded that SRT is a safe, effective therapy for large or eloquent area metastases. (author)

  16. Linear-accelerator-based stereotactic irradiation for metastatic brain tumors

    Takemoto, Mitsuhiro; Katsui, Kuniaki; Yoshida, Atsushi [Okayama Univ. (Japan). School of Medicine] [and others

    2003-05-01

    To assess the safety and availability of stereotactic radiotherapy (SRT) for metastatic brain tumors, we reviewed 54 consecutive cases with a total of 118 brain metastases treated with linear-accelerator-based stereotactic irradiation (STI). Nineteen patients with a total of 27 brain tumors that were larger than 3 cm or close to critical normal tissues were treated with SRT. The marginal dose of SRT was 15-21 Gy (median 21 Gy) in 3 fractions for 3 days. The median marginal dose of stereotactic radiosurgery (SRS) was 20 Gy. Effective rates of imaging studies were 72.7% and 94.4%, and those of clinical symptoms were 46.7% and 55.6% for SRT and SRS, respectively. One-year and two-year survival rates of SRT were 40.9% and 17.6%, respectively, and the median follow-up period was 6.4 months. The one-year survival rate of SRS was 32.7%, with a median follow-up of 4.6 months. Fourteen cases (7 cases each) had recurrent tumors at STI sites. Early complications were observed in one case of SRT and 8 cases of SRS, and late complications occurred in 3 cases of SRS. There were no significant differences among effective rates, survival rates, median follow-up times, recurrence rates, and complications between SRT and SRS. We concluded that SRT is a safe, effective therapy for large or eloquent area metastases. (author)

  17. The 10-Year Local Recurrence and Partial Breast Radiotherapy for Early Breast Cancer Treated by Conservative Surgery

    Zhizhen Wang; Ruiying Li

    2006-01-01

    OBJECTIVE To study the local recurrence and the role of whole breast radiotherapy for early breast cancer treated by conservative surgery.METHODS From April 1990 to December 2000, 49 patients with early primary breast cancer were treated by conservative surgery in our hospital. The cases were comprised of Stage 0, 1; Stage Ⅰ, 31; and Stage Ⅱa,17. Forty cases underwent quadrantectomy plus axillary lymph node dissection, and the other 9 cases had lumpectomy alone. Irradiation, which was received by 39 patients, was administered by using low tangential half fields with 6 MV X-ray to decrease the pulmonary irradiative volume.The dose to the whole breast was 45 Gy/22~23f/4.5W, then a 15 Gy boost dose was delivered to the tumor bed by an electron beam. The other patients underwent an irradiated regional field according to postoperative pathology.RESULTS All patients were followed-up for 10 years or more. The 10year local recurrence rates, distant metastasis rates and survival rates were 6.1%, 4.1% and 98.0% respectively. All of the 3 patients who had a local recurrence had infiltrative carcinomas and negative lymph nodes.The 10-year local recurrence rate was higher (2.6% vs. 20.0%) with nonpostoperative whole breast radiotherapy, but the statistical difference was not marked because of the low number of cases. All of the recurrent lesions localized within 3 cm of the primary lesion.CONCLUSION Original recurrence of the tumor was the main type of local recurrence. Radiotherapy after conservative surgery is very essential.After conservative surgery it is feasible that irradiation can be delivered alone to the neighboring region of the tumor bed. Partial breast radiotherapy can substitute for whole breast radiotherapy.

  18. Innovative combination of therapeutic mammoplasty and expandable-implant breast augmentation for immediate partial breast reconstruction

    A.M.H. Choo

    2016-01-01

    Conclusion: A “novel” oncoplastic technique herein termed “augmentation-therapeutic mastopexy” is described for partial breast reconstruction during the treatment of a patient with bilateral breast cancer. It enabled adequate treatment of her cancer while reshaping the breast and achieving the desired larger breast size. It should be considered in selected breast-conservation patients who wish to maintain or increase their breast size.

  19. L-positioned Perforator Propeller Flap for Partial Breast Reconstruction with Axillary Dead Space

    Yamamoto, Mao; Shimizu, Daisuke; Yokoyama, Akiko; Ito, Osamu

    2016-01-01

    Summary: Partial breast reconstruction using perforator flaps harvested from the lateral chest wall has become a well-established surgical technique recently. In the case of a partial mastectomy with an axillary lymph node dissection, there are 2 main defects; one is a partial breast defect and the other is an axillary dead space. To reconstruct the 2 separate defects with local flaps, basically 2 different flaps are needed, and usually, it is rather difficult to harvest 2 different local flaps in the adjacent area. To resolve this problem, we introduce the L-positioned perforator propeller flap (PPF). We used an L-positioned PPF on 2 female patients, aged 46 and 47 years old, who were suffering from breast cancer in the upper outer quadrant. The concept of this flap design is as follows: the partial breast defect is reconstructed with the longer lobe of the L-positioned PPF and the axillary defect is filled with the smaller lobe of the L-positioned PPF at the same time. The reconstruction time was 2 hours and 0 minutes and 1 hour and 46 minutes in each case. The patients were successfully provided with aesthetically acceptable breast reconstruction without postoperative complications. Moreover, both patients had consecutive postoperative radiotherapy on the reconstructed area without complications. With this flap design, it is possible for patients to have safe and aesthetic reconstruction with only 1 local flap and fewer invasive procedures.

  20. L-positioned Perforator Propeller Flap for Partial Breast Reconstruction with Axillary Dead Space.

    Yamamoto, Mao; Yano, Tomoyuki; Shimizu, Daisuke; Yokoyama, Akiko; Ito, Osamu

    2016-06-01

    Partial breast reconstruction using perforator flaps harvested from the lateral chest wall has become a well-established surgical technique recently. In the case of a partial mastectomy with an axillary lymph node dissection, there are 2 main defects; one is a partial breast defect and the other is an axillary dead space. To reconstruct the 2 separate defects with local flaps, basically 2 different flaps are needed, and usually, it is rather difficult to harvest 2 different local flaps in the adjacent area. To resolve this problem, we introduce the L-positioned perforator propeller flap (PPF). We used an L-positioned PPF on 2 female patients, aged 46 and 47 years old, who were suffering from breast cancer in the upper outer quadrant. The concept of this flap design is as follows: the partial breast defect is reconstructed with the longer lobe of the L-positioned PPF and the axillary defect is filled with the smaller lobe of the L-positioned PPF at the same time. The reconstruction time was 2 hours and 0 minutes and 1 hour and 46 minutes in each case. The patients were successfully provided with aesthetically acceptable breast reconstruction without postoperative complications. Moreover, both patients had consecutive postoperative radiotherapy on the reconstructed area without complications. With this flap design, it is possible for patients to have safe and aesthetic reconstruction with only 1 local flap and fewer invasive procedures. PMID:27482501

  1. Preoperative Single-Fraction Partial Breast Radiation Therapy: A Novel Phase 1, Dose-Escalation Protocol With Radiation Response Biomarkers

    Purpose: Women with biologically favorable early-stage breast cancer are increasingly treated with accelerated partial breast radiation (PBI). However, treatment-related morbidities have been linked to the large postoperative treatment volumes required for external beam PBI. Relative to external beam delivery, alternative PBI techniques require equipment that is not universally available. To address these issues, we designed a phase 1 trial utilizing widely available technology to 1) evaluate the safety of a single radiation treatment delivered preoperatively to the small-volume, intact breast tumor and 2) identify imaging and genomic markers of radiation response. Methods and Materials: Women aged ≥55 years with clinically node-negative, estrogen receptor–positive, and/or progesterone receptor–positive HER2−, T1 invasive carcinomas, or low- to intermediate-grade in situ disease ≤2 cm were enrolled (n=32). Intensity modulated radiation therapy was used to deliver 15 Gy (n=8), 18 Gy (n=8), or 21 Gy (n=16) to the tumor with a 1.5-cm margin. Lumpectomy was performed within 10 days. Paired pre- and postradiation magnetic resonance images and patient tumor samples were analyzed. Results: No dose-limiting toxicity was observed. At a median follow-up of 23 months, there have been no recurrences. Physician-rated cosmetic outcomes were good/excellent, and chronic toxicities were grade 1 to 2 (fibrosis, hyperpigmentation) in patients receiving preoperative radiation only. Evidence of dose-dependent changes in vascular permeability, cell density, and expression of genes regulating immunity and cell death were seen in response to radiation. Conclusions: Preoperative single-dose radiation therapy to intact breast tumors is well tolerated. Radiation response is marked by early indicators of cell death in this biologically favorable patient cohort. This study represents a first step toward a novel partial breast radiation approach. Preoperative radiation should

  2. Preoperative Single-Fraction Partial Breast Radiation Therapy: A Novel Phase 1, Dose-Escalation Protocol With Radiation Response Biomarkers

    Horton, Janet K., E-mail: janet.horton@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Blitzblau, Rachel C.; Yoo, Sua [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Geradts, Joseph [Department of Pathology, Duke University Medical Center, Durham, North Carolina (United States); Chang, Zheng [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Baker, Jay A. [Department of Radiology, Duke University Medical Center, Durham, North Carolina (United States); Georgiade, Gregory S. [Department of Surgery, Duke University Medical Center, Durham, North Carolina (United States); Chen, Wei [Department of Bioinformatics: Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina (United States); Siamakpour-Reihani, Sharareh; Wang, Chunhao [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Broadwater, Gloria [Department of Biostatistics: Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina (United States); Groth, Jeff [Department of Pathology, Duke University Medical Center, Durham, North Carolina (United States); Palta, Manisha; Dewhirst, Mark [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Barry, William T. [Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina (United States); Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Duffy, Eileen A. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); and others

    2015-07-15

    Purpose: Women with biologically favorable early-stage breast cancer are increasingly treated with accelerated partial breast radiation (PBI). However, treatment-related morbidities have been linked to the large postoperative treatment volumes required for external beam PBI. Relative to external beam delivery, alternative PBI techniques require equipment that is not universally available. To address these issues, we designed a phase 1 trial utilizing widely available technology to 1) evaluate the safety of a single radiation treatment delivered preoperatively to the small-volume, intact breast tumor and 2) identify imaging and genomic markers of radiation response. Methods and Materials: Women aged ≥55 years with clinically node-negative, estrogen receptor–positive, and/or progesterone receptor–positive HER2−, T1 invasive carcinomas, or low- to intermediate-grade in situ disease ≤2 cm were enrolled (n=32). Intensity modulated radiation therapy was used to deliver 15 Gy (n=8), 18 Gy (n=8), or 21 Gy (n=16) to the tumor with a 1.5-cm margin. Lumpectomy was performed within 10 days. Paired pre- and postradiation magnetic resonance images and patient tumor samples were analyzed. Results: No dose-limiting toxicity was observed. At a median follow-up of 23 months, there have been no recurrences. Physician-rated cosmetic outcomes were good/excellent, and chronic toxicities were grade 1 to 2 (fibrosis, hyperpigmentation) in patients receiving preoperative radiation only. Evidence of dose-dependent changes in vascular permeability, cell density, and expression of genes regulating immunity and cell death were seen in response to radiation. Conclusions: Preoperative single-dose radiation therapy to intact breast tumors is well tolerated. Radiation response is marked by early indicators of cell death in this biologically favorable patient cohort. This study represents a first step toward a novel partial breast radiation approach. Preoperative radiation should

  3. Near monochromatic 20 Me V proton acceleration using fs laser irradiating Au foils in target normal sheath acceleration regime

    Torrisi, L.; Cutroneo, M.; Ceccio, G.; Cannavò, A.; Batani, D.; Boutoux, G.; Jakubowska, K.; Ducret, J. E.

    2016-04-01

    A 200 mJ laser pulse energy, 39 fs-pulse duration, 10 μm focal spot, p-polarized radiation has been employed to irradiate thin Au foils to produce proton acceleration in the forward direction. Gold foils were employed to produce high density relativistic electrons emission in the forward direction to generate a high electric field driving the ion acceleration. Measurements were performed by changing the focal position in respect of the target surface. Proton acceleration was monitored using fast SiC detectors in time-of-flight configuration. A high proton energy, up to about 20 Me V, with a narrow energy distribution, was obtained in particular conditions depending on the laser parameters, the irradiation conditions, and a target optimization.

  4. Development of Grid Control Electron Gun for Multi-energy Irradiation Accelerator

    HAN; Guang-wen; ZHU; Zhi-bin; WANG; Shu-xian

    2012-01-01

    <正>In the project of multi-energy electron irradiation accelerator, It is necessary to adjust the electron beam pulse inject to the accelerating tube. Under the same conditions of the injection energy, the grid controlled electron gun was used in the accelerator. Using cathode-grid assembly, after the simulation of electron optics program design, we manufactured focus electrode, the anode, and built an experiment

  5. Evaluation of some commercial grade polymers as possible dosimeters for technological irradiations in electron accelerators

    Bryl-Sandelewska, T

    2002-01-01

    Dosimetric properties of two kinds of clear polymethylmethacrylate (PMMA)and one kind of polystyrene (PS) sheets in technological accelerator irradiations, are presented. Absorbance of the sheets and its dependence on the dose have been measured at a suitable wavelength using a UV/VIS spectrophotometer. Both kind PMMA can be used for technological dose measurements but each of them in the different range of the doses (approx 3 to approx 30 kGy and approx 30 to above 200 kGy). Heating the samples after irradiation accelerates the stabilization of the absorbance, which change slowly during the storage of the samples if not heated.Absorbance of clear PS sheets decreases very much during the storage after irradiation, and heating of the samples does not accelerate the stabilization of the value. It can be said that the Ps investigated is not suitable for technological dose measurements in accelerator i radiations.

  6. Particle Accelerator Applications: Ion and Electron Irradiation in Materials Science, Biology and Medicine

    Rodríguez-Fernández, Luis

    2010-09-01

    Although the developments of particle accelerators are devoted to basic study of matter constituents, since the beginning these machines have been applied with different purposes in many areas also. Today particle accelerators are essential instruments for science and technology. This work presents an overview of the main application for direct particle irradiation with accelerator in material science, biology and medicine. They are used for material synthesis by ion implantation and charged particle irradiation; to make coatings and micromachining; to characterize broad kind of samples by ion beam analysis techniques; as mass spectrometers for atomic isotopes determination. In biomedicine the accelerators are applied for the study of effects by charged particles on cells. In medicine the radiotherapy by electron irradiation is widely used, while hadrontherapy is still under development. Also, they are necessary for short life radioisotopes production required in radiodiagnostic.

  7. Particle Accelerator Applications: Ion and Electron Irradiation in Materials Science, Biology and Medicine

    Although the developments of particle accelerators are devoted to basic study of matter constituents, since the beginning these machines have been applied with different purposes in many areas also. Today particle accelerators are essential instruments for science and technology. This work presents an overview of the main application for direct particle irradiation with accelerator in material science, biology and medicine. They are used for material synthesis by ion implantation and charged particle irradiation; to make coatings and micromachining; to characterize broad kind of samples by ion beam analysis techniques; as mass spectrometers for atomic isotopes determination. In biomedicine the accelerators are applied for the study of effects by charged particles on cells. In medicine the radiotherapy by electron irradiation is widely used, while hadrontherapy is still under development. Also, they are necessary for short life radioisotopes production required in radiodiagnostic.

  8. Radiation stability of iron nanoparticles irradiated with accelerated iron ions

    Uglov, V.V., E-mail: uglov@bsu.by [Belarusian State University, Nezavisimosty ave., 4, Minsk 220030 (Belarus); Tomsk Polytechnic University, Lenina ave., 2a, Tomsk 634028 (Russian Federation); Remnev, G.E., E-mail: remnev06@mail.ru [Tomsk Polytechnic University, Lenina ave., 2a, Tomsk 634028 (Russian Federation); Kvasov, N.T.; Safronov, I.V.; Shymanski, V.I. [Belarusian State University, Nezavisimosty ave., 4, Minsk 220030 (Belarus)

    2015-07-01

    Highlights: • Dynamic processes in nanoparticles after ion irradiation were studied. • The mechanism of the enhanced radiation stability of nanoparticles was showed. • The criteria of the enhanced radiation stability of nanoparticles was proposed. - Abstract: In the present work the dynamic processes occurring in a nanoscale iron particle exposed to irradiation with iron ions of different energies are studied in detailed. It is shown that the elastic and thermoelastic crystal lattice responses to irradiation form force factors affecting the evolution of defect-impurity system, which, in turn, leads to a decrease in the number of structural defects. Quantitative estimations of the spatial distribution of defects resulting in their migration to the surface were obtained. Such self-organization of nanoparticles exposed to ionizing radiation can be used as a basis for the production of radiation-resistant nanostructured materials capable of sustaining a long-term radiation influence.

  9. Radiosensitivity of chlorella after medium energy accelerated electron irradiation

    The survival curves (capability of multiplication) of chlorella pyrenoidosa after irradiations can be used for soft electrons (0.65 and 1 MeV), hence penetrating into only 2 to 4 millimeters of water: the algae are laying on porous membranes and the doses are calculated from the power of the electron beam measured by the electric current on a metallic target or by Fricke's dosimetry. With these techniques, it is showed and discussed the part of anoxia in the radioprotection (magnitude or reduction of the dose calculated from the slope of survival curves: 2.5 ) that is more important than the restoration studied by the fractionation of the dose. The 0.65 and 1 MeV electrons have a biologic effect lesser than 180 keV X-rays (RBE - relative biological efficiency - calculated on the slope of survival curves is 0.92 in aerated irradiation, 0.56 in the deoxygenated irradiation). (author)

  10. Toxicity and cosmesis outcomes after single fraction partial breast irradiation in early stage breast cancer

    To report the clinical outcome after a Single Shot 3D-CRT PBI (SSPBI) in breast cancer patients after conservative surgery (ClinicalTrials.gov Identifier: NCT01316328). A dose of 18Gy (in the first 4 patients) and 21Gy (in the remaining 60 patients) was prescribed in a single session and delivered to the index area (i.e. the area of breast including the primary tumor bed and the surrounding tissue) using 3D-CRT with patients in prone position. Acute and late toxicity was assessed using the National Cancer Institute's CTC for Adverse Events. Cosmesis was defined based on modified Harvard criteria. Differences between dosimetric or clinical parameters of patients with/without G2 or more late toxicity or unsatisfactory (poor or fair) cosmetic outcome were evaluated with the Mann-Whitney test. Odds ratios and 95% confidence interval were calculated for cosmesis and fibrosis. Univariate and multivariate analyses(UVA/MVA) were used to determine covariates associated with an increase in fibrosis or fat necrosis rate. Sixty four patients were enrolled. With a median follow-up of 3 years, G2 and G3 subcutaneous fibrosis was detected in 20(31%) and in 8(13%) patients, and ≥G2 fat necrosis was observed in 2(3%) patients. Good to excellent, fair and poor cosmesis was observed in 38(59%), 23(36%) and 3(5%) patients, respectively. Based on UVA, the breast volume receiving more than 21Gy (V21Gy) was found to be a predictor of the ≥G1 or ≥G2 fibrosis/fat necrosis. Based on MVA, V21Gy was confirmed as a predictor for ≥G1 fibrosis/fat necrosis, the results correlated as a trend for ≥G2. Cosmesis was correlated with whole breast (WB) mean dose (p = 0.030). Our choice of a single dose of 21Gy significantly increased the treatment related toxicity. However, this should not discourage novel SSPBI approaches with lower equivalent doses

  11. Evaluation of the effectiveness of packed red blood cell irradiation by a linear accelerator

    Olivo, Ricardo Aparecido; da Silva, Marcus Vinícius; Garcia, Fernanda Bernadelli; Soares, Sheila; Rodrigues Junior, Virmondes; Moraes-Souza, Helio

    2015-01-01

    Irradiation of blood components with ionizing radiation generated by a specific device is recommended to prevent transfusion-associated graft-versus-host disease. However, a linear accelerator can also be used in the absence of such a device, which is the case of the blood bank facility studied herein. In order to evaluate the quality of the irradiated packed red blood cells, this study aimed to determine whether the procedure currently employed in the facility is effective in inhibiting the ...

  12. Evaluation of a dispersion medium for the irradiation of blood products in a electron linear accelerator

    The use of bags of rice as dispersion medium in irradiation of blood products for medical use is less effective than the immersion from the point of view dosimetric water. However, given the wide range of dose values for a valid result and once subjected to quality control procedure, the method provides the necessary work for the irradiation of blood products in a linear electron accelerator. (Author)

  13. Tolerance of rats to +Gz acceleration under immobilization and X-rays irradiation

    Tolerance of rats to + 20 Gz acceleration under long-term hypokinesis, acute irradiation with 5,0 Gy of X-rays and after combined action of both factors was examined. A slight decrease of tolerance in irradiated rats in some stages of radiation sickness was found. Tolerance to + 20 Gz acceleration fell by prolonging the duration of immobilization. When exposing the rats to combined action of both factors, radiation diminishes to some extent unfavourable influences of immobilization, increasing tolerance to gravitational stress. (author)

  14. Proton acceleration by high-intensity UV laser irradiation with thin foil targets

    Proton acceleration experiments by irradiation of intense ultra-violet lasers with thin foil targets were conducted. Energies and efficiencies of the accelerated protons were investigated over the target thickness from several μm to 50 nm using various materials. In order to irradiate the very thin foil targets, the discharge pre-amplifier in the previous system was removed to reduce amplified spontaneous emission which disturbed the main pulse interactions. A Thomson parabola ion spectrometer with CR39 plastic nuclear track detectors were used to observe spectra of the accelerated protons. The maximum energies and efficiencies of accelerated protons increased with decreasing the target thickness rather than the product of the density and thickness of the targets. These results were explained by a geometrical effect on hot electron recycling. (author)

  15. Shielding aspects of accelerators, targets and irradiation facilities

    Particle accelerators have evolved over the last half-century from simple devices to powerful machines, and will continue to have an important impact on research, technology and lifestyle. Today they cover a wide range of applications, from television and computer displays in households to the investigation of the origin and structure of matter. It has become common practice to use them for material science and medical applications. In recent years, requirements from new technological and research applications have emerged: increased particle beams intensities, higher flexibility, etc., giving rise to new radiation shielding aspects and problems. These Proceedings review newer accelerator facilities, identify problematic aspects concerning radiation shielding that need to be solved, and indicate areas where international co-operation and co-ordination are highly desirable. (authors). 480 refs., 200 figs., 48 tabs

  16. Induction of the Tn10 Precise Excision in E. coli Cells after Accelerated Heavy Ions Irradiation

    Zhuravel, D V

    2003-01-01

    The influence of the irradiation of different kinds on the indication of the structural mutations in the bacteria Escherichia coli is considered. The regularities of the Tn10 precise excision after accelerated ^{4}He and ^{12}C ions irradiations with different linear energy transfer (LET) were investigated. Dose dependences of the survival and relative frequency of the Tn10 precise excision were obtained. It was shown, that the relative frequency of the Tn10 precise excision is the exponential function from the irradiation dose. Relative biological efficiency (RBE), and relative genetic efficiency (RGE) were calculated, and were treated as the function of the LET.

  17. Change in surface of polymer materials upon irradiation of accelerated micro-particles

    Kudo, Hisaaki [Nuclear Engineering Research Laboratory, School of Engineering, University of Tokyo, 2-22 Shirakata-Shirane, Tokai, Ibaraki 319-1188 (Japan)]. E-mail: hkudo@utnl.jp; Tadokoro, Masashi [Nuclear Engineering Research Laboratory, School of Engineering, University of Tokyo, 2-22 Shirakata-Shirane, Tokai, Ibaraki 319-1188 (Japan); Narita, Shintaro [Nuclear Engineering Research Laboratory, School of Engineering, University of Tokyo, 2-22 Shirakata-Shirane, Tokai, Ibaraki 319-1188 (Japan); Matsuoka, Leo [Nuclear Engineering Research Laboratory, School of Engineering, University of Tokyo, 2-22 Shirakata-Shirane, Tokai, Ibaraki 319-1188 (Japan); Muroya, Yusa [Nuclear Engineering Research Laboratory, School of Engineering, University of Tokyo, 2-22 Shirakata-Shirane, Tokai, Ibaraki 319-1188 (Japan); Katsumura, Yosuke [Nuclear Engineering Research Laboratory, School of Engineering, University of Tokyo, 2-22 Shirakata-Shirane, Tokai, Ibaraki 319-1188 (Japan)

    2005-07-01

    As a new method of use of a particle accelerator (ionizing radiation generator), we irradiated accelerated micro-particles of silver (Ag) onto polymer materials such as polyimides, glass, ceramics and semi-conductors. The particles can be generated at a Van de Graaff electrostatic accelerator operating at 1-3 MV. The velocity was around 1-10 km/s, size of diameter was about 1-10 {mu}m and charge was about 1-2 {mu}C. We investigated the change in surface of materials upon irradiation, by using laser microscope, atomic force microscope and scanning electron microscope. Crater-shaped irradiation spots having limb structure were found, and their diameter and depth were evaluated, ranging in a few micrometers. The planar distribution of the projectile around the irradiation spot was examined with energy dispersive X-ray spectroscopy. Correlation between size of the irradiation spots and kinetic energy of the accelerated micro-particles was investigated, and compared with an empirical formula and molecular dynamics study. Numerical simulation dealing with dynamic behaviour of elastic structure was carried out based on SPH (Smoothed Particle Hydrodynamics) method, a kind of (virtual) particle method. The simulation also found that a crater-shaped spot having limb structure is formed upon collision of the accelerated projectile with the target-materials. The results of simulation were compared with the experimental observations. These experiment and simulation are important for the evaluation of damages and resistance of polymer materials used in the space, such as the thermal control material, and cover glass of solar cells etc., towards space debris and dusts. It would be complement the on-ground radiation resistant tests on the materials conducted by using electron and ion beam accelerators.

  18. Total body irradiation with a 10 MV linear accelerator in conjunction with bone marrow transplantation

    Total body irradiation (1000 rad, single dose) in conjunction with chemotherapy and bone marrow transplantation is a therapy for acute leukemia. We show that a 10 MV linear accelerator is a suitable source of radiation for these procedures. Dosimetric and clinical results are presented for 25 patients who were treated between 5/76 and 12/78

  19. Study of dose distribution for stereotactic irradiation. Evolution of using gamma unit and linear accelerator

    Currently used stereotactic irradiation techniques that employ high-energy photon beams are based either on a gamma unit that uses stationary 201-cobalt beams or on isocentric linear accelerators. The techniques that rely on linear accelerators are divided into multiple non-coplanar converging arcs, precessional convergent irradiation, and others. These techniques have respective physical characteristics, for example, the precision of dose convergence and isodose distributions. We discuss the physical characteristics of the gamma unit, multiple non-coplanar converging arcs, and precessional convergent irradiation. In terms of the precision of dose convergence, the best was the gamma unit, followed by precessional convergent irradiation, with multiple non-coplanar converging arcs third. The precision of dose convergence deteriorated with diminishing field size in all techniques, and the precision of dose convergence was improved using a circular field with supplementary collimator among the techniques using linear accelerators. In addition, stereotactic irradiation techniques should be examined for disease treatment and running cost, because the techniques that have the greatest precision in dose convergence are incompatible with all-purpose usage. (author)

  20. A compact biological cell irradiation system with a Van de Graaff accelerator

    This report describes the development of a compact microcell irradiation system in the 3 MV KN Van de Graaff accelerator in the Accelerator Laboratory of National Tsing Hua University (NTHU). The main feature of this system is backscattering, a technique whereby a 100 nm gold scattering foil is placed in the center of a scattering chamber, instead of a 90° bending magnet. The incident particles produced by the accelerator bombard the scattering foil and scatter isotropically. A set of micro pinholes was installed above the scattering foil and directed the 90° scattering particles to irradiate the cell target. This innovation simplifies the system design and massively reduces the cost and space requirements for system construction

  1. Status and prospect on accelerator use for food irradiation

    Radiation processing by machine sources is industry standard, worldwide. In 1996, the total number of installations reached 1000 with a total power of about 50 MW (compared to a total power of about 3 MW for 180 gamma-facilities). Of these most facilities are in the lower energy range and utilized for product improvement like cable insulation, cross-linking enhancement or for medical product sterilization. Radiation processing of food requires higher penetration, ie the 10 MeV provided by Codex Alimentarius Standard. Of the about 30 facilities in the energy range from 5 to 15 MeV only a very limited number is dedicated to food processing. A facility in Brittany, France is solely exploited for elimination of pathogen microorganisms from mechanically deboned poultry meat in deep-frozen blocks. There is an increasing demand for radiation processing of food worldwide and the often presupposed lack of consumer acceptance is not validated when the irradiated product appears on the marked or is fading away once consumers make up their minds testing the real product. Such an increasing demand creates commercial chances for more radiation processing facilities, both gamma and electrons, including bremsstrahlung. The potential and the technical constraints of such machine sources contrasted to gamma facilities will be discussed. Especial consideration is given to changing the Codex Alimentarius Standard limit for bremsstrahlung nominal energy from now 5 MeV to at least 7.5 MeV. (author)

  2. 7.5 MeV High Average Power Linear Accelerator System for Food Irradiation Applications

    In December 2004 the US Food and Drug Administration (FDA) approved the use of 7.5 MeV X-rays for irradiation of food products. The increased efficiency for treatment at 7.5 MeV (versus the previous maximum allowable X-ray energy of 5 MeV) will have a significant impact on processing rates and, therefore, reduce the per-package cost of irradiation using X-rays. Titan Pulse Sciences Division is developing a new food irradiation system based on this ruling. The irradiation system incorporates a 7.5 MeV electron linear accelerator (linac) that is capable of 100 kW average power. A tantalum converter is positioned close to the exit window of the scan horn. The linac is an RF standing waveguide structure based on a 5 MeV accelerator that is used for X-ray processing of food products. The linac is powered by a 1300 MHz (L-Band) klystron tube. The electrical drive for the klystron is a solid state modulator that uses inductive energy store and solid-state opening switches. The system is designed to operate 7000 hours per year. Keywords: Rf Accelerator, Solid state modulator, X-ray processing

  3. Monte Carlo Simulation of the Irradiation of Alanine Coated Film Dosimeters with Accelerated Electrons

    Uribe, R. M.; Salvat, F.; Cleland, M. R.; Berejka, A.

    2009-03-01

    The Monte Carlo code PENELOPE was used to simulate the irradiation of alanine coated film dosimeters with electron beams of energies from 1 to 5 MeV being produced by a high-current industrial electron accelerator. This code includes a geometry package that defines complex quadratic geometries, such as those of the irradiation of products in an irradiation processing facility. In the present case the energy deposited on a water film at the surface of a wood parallelepiped was calculated using the program PENMAIN, which is a generic main program included in the PENELOPE distribution package. The results from the simulation were then compared with measurements performed by irradiating alanine film dosimeters with electrons using a 150 kW Dynamitron™ electron accelerator. The alanine films were placed on top of a set of wooden planks using the same geometrical arrangement as the one used for the simulation. The way the results from the simulation can be correlated with the actual measurements, taking into account the irradiation parameters, is described. An estimation of the percentage difference between measurements and calculations is also presented.

  4. Monte Carlo Simulation of the Irradiation of Alanine Coated Film Dosimeters with Accelerated Electrons

    The Monte Carlo code PENELOPE was used to simulate the irradiation of alanine coated film dosimeters with electron beams of energies from 1 to 5 MeV being produced by a high-current industrial electron accelerator. This code includes a geometry package that defines complex quadratic geometries, such as those of the irradiation of products in an irradiation processing facility. In the present case the energy deposited on a water film at the surface of a wood parallelepiped was calculated using the program PENMAIN, which is a generic main program included in the PENELOPE distribution package. The results from the simulation were then compared with measurements performed by irradiating alanine film dosimeters with electrons using a 150 kW Dynamitron electron accelerator. The alanine films were placed on top of a set of wooden planks using the same geometrical arrangement as the one used for the simulation. The way the results from the simulation can be correlated with the actual measurements, taking into account the irradiation parameters, is described. An estimation of the percentage difference between measurements and calculations is also presented.

  5. Defocusing beam line design for an irradiation facility at the TAEA SANAEM Proton Accelerator Facility

    Gencer, A.; Demirköz, B.; Efthymiopoulos, I.; Yiğitoğlu, M.

    2016-07-01

    Electronic components must be tested to ensure reliable performance in high radiation environments such as Hi-Limu LHC and space. We propose a defocusing beam line to perform proton irradiation tests in Turkey. The Turkish Atomic Energy Authority SANAEM Proton Accelerator Facility was inaugurated in May 2012 for radioisotope production. The facility has also an R&D room for research purposes. The accelerator produces protons with 30 MeV kinetic energy and the beam current is variable between 10 μA and 1.2 mA. The beam kinetic energy is suitable for irradiation tests, however the beam current is high and therefore the flux must be lowered. We plan to build a defocusing beam line (DBL) in order to enlarge the beam size, reduce the flux to match the required specifications for the irradiation tests. Current design includes the beam transport and the final focusing magnets to blow up the beam. Scattering foils and a collimator is placed for the reduction of the beam flux. The DBL is designed to provide fluxes between 107 p /cm2 / s and 109 p /cm2 / s for performing irradiation tests in an area of 15.4 cm × 21.5 cm. The facility will be the first irradiation facility of its kind in Turkey.

  6. The practice of mantel irradiation for the treatment of lymphogranulomatosis by the linear accelerator Neptun 10-p

    The Neptun 10-p type linear accelerator of the National Oncological Institute, Hungary, has been used for large-field electron irradiation for therapeutical purposes. The mantel irradiation practice of patients suffering from lymphogranulomatosis is described through the presentation of the sequence of processes from the positioning of the patients to the starting of the actual irradiation. The results of mantel irradiation of 19 patients are reported. (R.P.) 10 refs.; 4 figs

  7. Evaluation of the effectiveness of packed red blood cell irradiation by a linear accelerator

    Ricardo Aparecido Olivo; Marcus Vinícius da Silva; Fernanda Bernadelli Garcia; Sheila Soares; Virmondes Rodrigues Junior; Helio Moraes-Souza

    2015-01-01

    Irradiation of blood components with ionizing radiation generated by a specific device is recommended to prevent transfusion-associated graft-versus-host disease. However, a lin- ear accelerator can also be used in the absence of such a device, which is the case of the blood bank facility studied herein. In order to evaluate the quality of the irradiated packed red blood cells, this study aimed to determine whether the procedure currently employed in the facility is effective in inhibiting the...

  8. Laboratory installation for cleaning of exhausted gases by irradiation with accelerated electrons

    A laboratory installation for the cleaning of exhaust gas containing NOx and SO2, using electron beams generated by the linear accelerator ALIN-10 (6.23 MeV) was developed in the Electron Accelerator Laboratory, Institute of Laser Plasma and Radiation Physics. The aim of this method is to obtain simultaneous removal by precipitation with ammonia of NOx and SO2 exhaust gases from fossil-fuel power plants and iron steel industry. The main successive stages of this process are: obtaining of gaseous mixture, heating of dry gaseous mixture, evaporation of ammonia, irradiation with electron beams and filtration. (author) 2 Figs.; 2 Tabs.; 5 Refs

  9. Charged-particle acceleration through laser irradiation of thin foils at Prague Asterix Laser System

    Thin foils, 0.5–50 μm in thickness, have been irradiated in vacuum at Prague Asterix Laser System in Prague using 1015–16 W cm−2 laser intensity, 1315 nm wavelength, 300 ps pulse duration and different focal positions. Produced plasmas from metals and polymers films have been monitored in the forward and backward directions. Ion and electron accelerations have been investigated by using Thomson parabola spectrometer, x-ray streak camera, ion collectors and SiC semiconductor detectors, the latter employed in time-of-flight configuration. Ion acceleration up to about 3 MeV per charge state was measured in the forward direction. Ion and electron emissions were detected at different angles as a function of the irradiation conditions. (paper)

  10. Water and sludge treatment device provided with a system for irradiating by accelerated charged particles

    Treatment system for a fluid made up of water and sludge, provided with a system for irradiating the fluid by a beam of accelerated charged particles comprising means for obtaining a constant flow of the fluid to be treated, facilities for monitoring this flow, an irradiation channel located on the path of the beam, in which the fluid to be treated can flow, a portion of this channel having at least one window transparent to the beam of accelerated particles. A safety system associated with the system for monitoring the characteristics of the beam and with the system for monitoring the flow of the fluid to be treated, stops the flow of the fluid and the recycling of the fluid defectively treated

  11. Disinfection of sludge and waste-water by irradiation with electrons of low accelerating voltage

    From the point of view of hygiene, sewage sludge and water accumulating in ever increasing quantities, some of which is used in agriculture, represent a potential threat to the health of man and beast, as well as to the environment. It is known that these chains of infection can be broken up by ionizing radiation. The use of natural ionizing radiation or electron radiation with high accelerating voltage has not been accepted in practice because the radiation cannot be cut off and the investment cost for electron accelerators with an accelerating voltage of more than 1 MV is very high. These disadvantages may be overcome by using an electron accelerator with low accelerating voltage. Complex experiments have shown that it is not necessary to adapt the thickness of sewage sludge or water layer to the range of electrons. The layer to be irradiated may be much thicker if the substrate is revolved during irradiation. The advantages of this method are low accelerating voltage for the electrons and hence less costly radiation shielding, complete absorption of the radiated energy by the substrate, and low investment and operating cost. The sterilizing effect of the process can be explained by the secondary reactions that take place in the water, in addition to the primary reactions, when irradiating with high specific ionizing density. It is known from experiments carried out by Muenzner that water irradiated with electrons of high specific ionization density, when added to bacterial cultures, will destroy them. This is explained by the Weiss radical theory of water, with reaction products such as H2, O2 and H2O2. The success of this process is shown by experiments with Escherichia coli, tap water to which Salmonella senftenberg were added, and by the content of Enterobacteriaceae in various sludges as a function of the irradiation period, as well as by the rate at which various invariable species of strongilide larvae, eggs of Ascaris suum, Fasciola hepatica and oocysts

  12. Radiograaff, a proton irradiation facility for radiobiological studies at a 4 MV Van de Graaff accelerator

    Constanzo, J. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); CNRS/IN2P3, Institut de Physique Nucléaire de Lyon, F-69622 Villeurbanne (France); Fallavier, M., E-mail: m.fallavier@ipnl.in2p3.fr [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); CNRS/IN2P3, Institut de Physique Nucléaire de Lyon, F-69622 Villeurbanne (France); Alphonse, G. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); Faculté de Médecine Lyon-Sud, LRCM, F-69921 Oullins (France); Hospices-Civils-de-Lyon, CHLS, F-69495 Pierre-Bénite (France); Bernard, C. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); CNRS/IN2P3, Institut de Physique Nucléaire de Lyon, F-69622 Villeurbanne (France); Battiston-Montagne, P. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); Faculté de Médecine Lyon-Sud, LRCM, F-69921 Oullins (France); Rodriguez-Lafrasse, C. [Université de Lyon, F-69622, Lyon (France); Université Lyon 1, Villeurbanne (France); Faculté de Médecine Lyon-Sud, LRCM, F-69921 Oullins (France); Hospices-Civils-de-Lyon, CHLS, F-69495 Pierre-Bénite (France); and others

    2014-09-01

    A horizontal beam facility for radiobiological experiments with low-energy protons has been set up at the 4 MV Van de Graaff accelerator of the Institut de Physique Nucléaire de Lyon. A homogeneous irradiation field with a suitable proton flux is obtained by means of two collimators and two Au-scattering foils. A monitoring chamber contains a movable Faraday cup, a movable quartz beam viewer for controlling the intensity and the position of the initial incident beam and four scintillating fibers for beam monitoring during the irradiation of the cell samples. The beam line is ended by a thin aluminized Mylar window (12 μm thick) for the beam extraction in air. The set-up was simulated by the GATE v6.1 Monte-Carlo platform. The measurement of the proton energy distribution, the evaluation of the fluence-homogeneity over the sample and the calibration of the monitoring system were performed using a silicon PIPS detector, placed in air in the same position as the biological samples to be irradiated. The irradiation proton fluence was found to be homogeneous to within ±2% over a circular field of 20 mm diameter. As preliminary biological experiment, two Human Head and Neck Squamous Carcinoma Cell lines (with different radiosensitivities) were irradiated with 2.9 MeV protons. The measured survival curves are compared to those obtained after X-ray irradiation, giving a Relative Biological Efficiency between 1.3 and 1.4.

  13. Flt3 ligand accelerates the recovery of the immune system in irradiated mice

    Objective: To study the immuno-protective potential of Flt3 ligand (FL) alone or in combination with other cytokines in irradiated mice. Methods: The number of peripheral blood cells was counted by using F-800 apparatus and the phenotype of lymphocytes was analyzed by flow cytometry. the pathological manifestations of spleen, thymus and lymph nodes were also evaluated. Results: FL used alone before irradiation or in combination with other cytokines after irradiation could stimulate the recovery of peripheral white blood cells, especially CD8+ T lymphocytes, and accelerate the recovery of ratio of CD4+/CD8+ T lymphocytes. FL reduced immune tissue damage and stimulated recovery of spleen, thymus and lymph nodes. The administration of FL to mice prior to irradiation and, to a lesser extent, after irradiation, significantly enhanced survival rate of animals. Conclusion: FL can stimulate not only the recovery of hematopoiesis, but also the improvement of immune function in irradiated mice. FL alone or in combination with other cytokines exerts a distinct radio-protection effect

  14. Radiograaff, a proton irradiation facility for radiobiological studies at a 4 MV Van de Graaff accelerator

    A horizontal beam facility for radiobiological experiments with low-energy protons has been set up at the 4 MV Van de Graaff accelerator of the Institut de Physique Nucléaire de Lyon. A homogeneous irradiation field with a suitable proton flux is obtained by means of two collimators and two Au-scattering foils. A monitoring chamber contains a movable Faraday cup, a movable quartz beam viewer for controlling the intensity and the position of the initial incident beam and four scintillating fibers for beam monitoring during the irradiation of the cell samples. The beam line is ended by a thin aluminized Mylar window (12 μm thick) for the beam extraction in air. The set-up was simulated by the GATE v6.1 Monte-Carlo platform. The measurement of the proton energy distribution, the evaluation of the fluence-homogeneity over the sample and the calibration of the monitoring system were performed using a silicon PIPS detector, placed in air in the same position as the biological samples to be irradiated. The irradiation proton fluence was found to be homogeneous to within ±2% over a circular field of 20 mm diameter. As preliminary biological experiment, two Human Head and Neck Squamous Carcinoma Cell lines (with different radiosensitivities) were irradiated with 2.9 MeV protons. The measured survival curves are compared to those obtained after X-ray irradiation, giving a Relative Biological Efficiency between 1.3 and 1.4

  15. Accelerated ageing of the insect Drosophila melanogaster by γ irradiations of pupae

    The purpose of the study was to induce accelerated aging in the fly Drosophila melanogaster (Diptera) using free radicals, and to distinguish aging from radiation syndrome. After irradiation of 12 to 24-hour-old pupae with doses of 500-2500 rad, very similar fly emergence rates were observed in control and treated populations. The life span was shortened and dose-related in mixed populations and in both virgin and mated male and female populations. Males were more radiosensitive than females. In the 500-2500 rad dose range, all the populations tested were fertile after irradiation. Young treated as pupae and control adults both displayed similar mating ability and negative geotactic responses. Their response levels decreased with time, but the decline was faster and dose-related in the treated animals. The study demonstrates that irradiation of 12 to 24-hour-old pupae with doses of 500-2500 rad induces accelerated aging, without causing serious biological damage. For example, after an irradiation with 1750 rad, the ''lethal time'' (LT) 50 dropped by about 30%. (author)

  16. Development of an accelerated aging method for evaluation of long-term irradiation effects on UHMWPE implants

    A general scheme for developing an accelerated aging method for irradiated biomaterials is proposed. Using UHMWPE implants as an example, an accelerated thermal diffusion oxidative aging (ATDOA) method has been developed. The method requires an optimum initial heating rate and an optimum aging temperature to accelerate oxidation reactions. Based upon oxidation-induced material property changes (crystallinity by DSC, tensile properties by ASTM D638 tensile test, and oxidation index by FTIR), correlations between accelerated aging time, shelf aging time, and implantation time can be obtained. The new ATDOA method allows a rapid evaluation of long-term irradiation effects on the material properties of UHMWPE implants

  17. Measurement of volatile evolution from polyurethane induced by accelerated ion beam irradiation

    Irradiation of polymer samples using an accelerated beam of He2+ ions passed through a 10μm thick window of havar foil has been performed. Such irradiation simulates the effects of large α radiation doses, on a vastly reduced time-scale. Analysis of volatiles evolved during irradiation is performed by a residual gas analyser (RGA), which is located close to the sample chamber. Presented in this paper are the results obtained during a radiation study on polyester/MDI based polyurethane materials. During high dose rate irradiation a number of high mass species were observed. A comparison between two similar polyurethanes formulated with slightly different polyesters indicated some differences. They were, however, too minor to link to specific degradation mechanisms. The dominant degradation products evident to the RGA at low dose rates were H2 , CO and CO2 . A series of polyurethane samples previously conditioned by γ irradiation at doses between 0 and 5MGy were irradiated in the ion beam. Identification of differences in trends in the rates of volatile evolution between these samples indicated the precise vacuum conditions at the time of irradiation had a major influence. There was also an indication that the surface of the sample had a small effect on rates of volatile evolution. Comparative plots of CO and CO2 evolution for a series of 1MGy irradiations indicated variations in behaviour between samples with different γ doses. Evolution during the first 1MGy was inhibited for the unirradiated sample, the extent of inhibition diminished with increasing γ dose and was no longer evident in a sample with 1.5MGy γ dose. H2 does not show an equivalent inhibition. Evidence for a low dose crosslinking reaction is put forward as a reason for the inhibition. Chemical reaction mechanisms are postulated and used to explain differences in the behaviour observed

  18. A dosimetric system for quantitative cell irradiation experiments with laser-accelerated protons

    An integrated dosimetry and cell irradiation system (IDOCIS) with laser-accelerated proton beams was developed, characterized, calibrated and successfully used for systematic in vitro experiments. Due to the broad exponentially shaped energy spectrum, the low-energy range of the protons (<20 MeV) and the high pulse dose, the absolute dosimetry for this beam quality is challenging. Therefore, a dedicated Faraday cup is used as an energy and dose rate independent absolute dosimeter that has been calibrated consistently with three independent methods. A transmission ionization chamber providing online relative dose information is cross-calibrated against the Faraday cup. Providing both online and absolute dose information, the IDOCIS allows for quantitative dosimetric and radiobiological studies at current low-energy laser-accelerated proton beams. Finally, first dosimetric characterizations of a laser-accelerated proton beam with the IDOCIS are presented.

  19. Shielding Aspects of Accelerators, Targets and Irradiation Facilities - SATIF-11 Workshop Proceedings Report

    Particle accelerators have evolved over the last decades from simple devices to powerful machines. In recent years, new technological and research applications have helped to define requirements while the number of accelerator facilities in operation, being commissioned, designed or planned has grown significantly. Their parameters, which include the beam energy, currents and intensities, and target composition, can vary widely, giving rise to new radiation shielding issues and challenges. Particle accelerators must be operated in safe ways to protect operators, the public and the environment. As the design and use of these facilities evolve, so must the analytical methods used in the safety analyses. These workshop proceedings review the state of the art in radiation shielding of accelerator facilities and irradiation targets. They also evaluate progress in the development of modelling methods used to assess the effectiveness of such shielding as part of safety analyses. The transport of radiation through shielding materials is a major consideration in the safety design studies of nuclear power plants, and the modelling techniques used may be applied to many other types of scientific and technological facilities. Accelerator and irradiation facilities represent a key capability in R and D, medical and industrial infrastructures, and they can be used in a wide range of scientific, medical and industrial applications. High-energy ion accelerators, for example, are now used not only in fundamental research, such as the search for new super-heavy nuclei, but also for therapy as part of cancer treatment. While the energy of the incident particles on the shielding of these facilities may be much higher than those found in nuclear power plants, much of the physics associated with the behaviour of the secondary particles produced is similar, as are the computer modelling techniques used to quantify key safety design parameters, such as radiation dose and activation levels

  20. An Economic Study for Establishment GAMMA Irradiation and Electron Beam Accelerator Facilities for Sterilization of Arabic Sudan Gum Export

    This study was carried out to discuss the economic analysis for using gamma irradiation and electron beam accelerators facilities to develop the marketing abilities of exported Arabic Sudan gum by radiation sterilization. This study included the technical marketing aspects and financial analysis for the projects of irradiated Arabic gum.

  1. How does knowledge of three-dimensional excision margins following breast conservation surgery impact upon clinical target volume definition for partial-breast radiotherapy?

    Background and purpose: To compare partial-breast clinical target volumes generated using a standard 15 mm margin (CTVstandard) with those generated using three-dimensional surgical excision margins (CTVtailored30) in women who have undergone wide local excision (WLE) for breast cancer. Material and methods: Thirty-five women underwent WLE with placement of clips in the anterior, deep and coronal excision cavity walls. Distances from tumour to each of six margins were measured microscopically. Tumour bed was defined on kV-CT images using clips. CTVstandard was generated by adding a uniform three-dimensional 15 mm margin, and CTVtailored30 was generated by adding 30 mm minus the excision margin in three-dimensions. Concordance between CTVstandard and CTVtailored30 was quantified using conformity (CoI), geographical-miss (GMI) and normal-tissue (NTI) indices. An external-beam partial-breast irradiation (PBI) plan was generated to cover 95% of CTVstandard with the 95% isodose. Percentage-volume coverage of CTVtailored30 by the 95% isodose was measured. Results: Median (range) coronal, superficial and deep excision margins were 15.0 (0.5-76.0) mm, 4.0 (0.0-60.0) mm and 4.0 (0.5-35.0) mm, respectively. Median CoI, GMI and NTI were 0.62, 0.16 and 0.20, respectively. Median coverage of CTVtailored30 by the PBI-plan was 97.7% (range 84.9-100.0%). CTVtailored30 was inadequately covered by the 95% isodose in 4/29 cases. In three cases, the excision margin in the direction of inadequate coverage was ≤2 mm. Conclusions: CTVs based on 3D excision margin data are discordant with those defined using a standard uniform 15 mm TB-CTV margin. In women with narrow excision margins, the standard TB-CTV margin could result in a geographical miss. Therefore, wider TB-CTV margins should be considered where re-excision does not occur.

  2. The destruction of parasitic resistant stages in sewage sludge by irradiation with low accelerating voltage electrons

    The destroying effect of ionizing radiation on parasitic resistant stages in sludge has been tested. Suitable for that process is an electron beam accelerator which will be provided with energy from the electric power supply network which can be switched on and off according to the requirements. Such modern utilities have an enormous beam capacity and a high operating safety. The process is working according to the continuous flow principle and at room temperature. In a series of 13 experiments the effect of different doses has been tested. A dose of 480 kRad (accelerating voltage: 400 kV, beam current: 10 mA , irradiation time: 24 sec.) can easily obtained in practical work and is economically acceptable. By these means approximately 97% of the following parasitic stages have been destroyed: undeveloped eggs of Ascaris suum, Trichuris suis, Fasciola hepatica and gastrointestinal strongylids of pigs, embryonated eggs of Capillaria obsignata and probably of Taenia spec. A few third-stage larvae of Oesophagostomum (Strongylidae) of pigs survived even 108 sec of irradiation; however, they did not develop to maturity in the definitive host. Approximately 25% of the sporulated oocysts of Eimeria tenella were still infective after 108 sec of irradiation. (orig.)

  3. Ageing evaluation of low voltage cables and insulators with gamma ray irradiation and thermal accelerated ageing tests

    To optimize lifetime prediction method of cables and to understand cable ageing mechanism, ageing evaluation of low voltage cables and insulators with gamma ray irradiation and thermal accelerated ageing tests were conducted. Insulators had no indication of the ageing after 1000 hours of the accelerated ageing tests. (author)

  4. Accelerated radiation aging of polymer materials by γ-irradiation in oxygen under pressure

    As an accelerated test of radiation aging of polymer materials at low level radiation environment, the degradation of various polymer materials for electric cable insulation was studied by Co-60 γ-ray irradiation in oxygen under pressure at high dose rate. By this method, the oxidation induced by radiation proceeded throughout the specimens in the same way as at irradiation at low dose rate. The degradation was found to be nearly the same as obtained by the long-term radiation aging at 5 krad/h in air for specially formulated materials. In the combination of radiation-thermal aging, the synergistic effect was remarkable when the sequential aging of radiation oxidation followed by thermal aging was carried out. The tested polymers were polyethylene, ethylene-propylene-diene rubber, chloroprene rubber (Neoprene) and chlorosulfonated polyethylene (Hypalon)

  5. Induction of micronuclei in plant cells after exposure to accelerated ion irradiation

    Vasilenko, A. [Inst. of Botany, Ukrainian National Academy of Sciences, Kiev (Ukraine); Sidorenko, P.G. [Inst. of Botany, Ukrainian National Academy of Sciences, Kiev (Ukraine)

    1995-06-01

    The root apex cells of Pisum sativum were irradiated in an U-240 isochronous cyclotron at the Institute for Nuclear Research of the Ukrainian National Academy of Sciences, Kyiv. Several types of micronuclei, differing in structural peculiarities, were observed in the 84 h following exposure to beams of accelerated {sup 1}H, {sup 4}He, and {sup 14}N ions with linear energy transfer (LET) of 0.95, 9.34, and 221 keV/{mu}m, respectively. The maximum micronucleus induction was observed after irradiation with helium ions. Results obtained show that the micronucleus assay is a responsive test for investigations of cytogenetic damage produced by high LET beams in dividing cell systems in vivo. (orig.)

  6. Effects of Prenatal Irradiation with an Accelerated Heavy-Ion Beam on Postnatal Development in Rats

    Wang, B.; Murakami, M.; Eguchi-Kasai, K.; Nojima, K.; Shang, Y.; Tanaka, K.; Fujita, K.; Coffigny, H.; Hayata, I.

    Effects on postnatal neurophysiological development in offspring were studied following exposure of pregnant Wistar rats to accelerated neon-ion beams with a LET value of about 30 keV mu m at a dose range from 0 1 Gy to 2 0Gy on the 15th day of gestation The age at which four physiologic markers appeared and five reflexes were acquired was examined prior to weaning Gain in body weight was monitored until the offspring were 3 months old Male offspring were evaluated as young adults using two behavioral tests The effects of X-rays at 200 kVp measured for the same biological end points were studied for comparison Our previous study on carbon-ion beams with a LET value of about 13 keV mu m was also cited to elucidate a possible LET-related effect For most of the endpoints at early age significant alteration was even observed in offspring prenatally received 0 1 Gy of accelerated neon ions while neither X rays nor carbon-ions under the same dose resulted in such a significant alteration compared to that from the sham-irradiated dams All offspring whose mothers received 2 0 Gy died prior to weaning Offspring from dams irradiated with accelerated neon ions generally showed higher incidences of prenatal death and preweaning mortality markedly delayed accomplishment in their physiological markers and reflexes and gain in body weight compared to those exposed to X-rays or carbon ions at doses of 0 1 to 1 5 Gy Significantly reduced ratios of main organ weight to body weight at postnatal ages of 30 60 and 90 days were also observed

  7. Optimizing design for the maze exit of a 10-MeV electron irradiation accelerator

    Background: Irradiation accelerator is being used more and more widely, but the optimizing of radiation shielding is always a problem to be solved. Purpose: To make the dose rates of the maze exit lower and the cost to achieve it less, it is of great significance to design a shielding which is cheap and effective. Methods: The radiation dose rates at different maze exits of a 10-MeV industrial electron linear accelerator were compared by formula and Monte Carlo (Fluka) method. A real-time measurement system composed of Mini Digital Data Logging (Mini-DDL) and Gamma detectors was also used. Results: With one comer added to the exit, another scattering would be generated. The dose rate of exit before changing was 3-4 μGy·h-1 while it was 200 nGy·h-1 after that. Conclusion: The radiation dose rate at the exit will be reduced by one order of magnitude because of another scattering generated by the added turn to the maze exit. All of these do not increase any additional cost and conform to the ALARA (as low as reasonably achievable) principle. It provides a good reference for the future design of shielding for industrial electron linear accelerator. (authors)

  8. Late course accelerated hyperfractionated irradiation combined with intraluminal hyperthermia for esophageal carcinoma

    Objective: To evaluate the effect of late course accelerated hyperfractionated irradiation combined with intraluminal hyperthermia for esophageal carcinoma. Methods: From March 2000 to October 2002, totally 91 such eligible patients were entered into the prospective randomized control trial of late course accelerated hyperfractionated irradiation (LCAH-, 44 patients) versus LCAH combined with intraluminal hyperthermia (LC- AH-HT-, 47 patients). Radiotherapy regimen consisted of conventional fractionation radiotherapy (1.8 Gy/f, 5f/w, totally 41.4 Gy/23fx) during the first two-thirds of the radiotherapy course, followed by accelerated hyperfrac-tionation radiotherapy (1.5 Gy/f, 2f/d, with 6h interval), using the cone-down fields, to a total dose of 68.4 Gy/41fx. Hyperthermia was given weekly during conventional fractionation irradiation, totally 4 times. Results: The CR and PR rates were 47.7% and 72.3%, 52.3% and 27.8% in the LCAH arm and LCAH-HT group, respectively (P=0.016). The median survivals were 30.3 and 30.6 months, the 1-, 2-, 3-year survival rates were 77.3%, 57.4%, 37.3% and 80.5%, 68.6%, 46.3% (P=0.526), the 1-, 2-, 3- year local control rates were 86.3%, 70.5%, 56.5% and 92.4%, 72.5%, 65.5% (P=0.686) in the LCAH group and LCAH-HT group, respectively. Grade III and severer of esophagitis were 18.2% and 27.6% in LCAH and LCAH-HT (P=0.498), Grade III and severer tracheitis were 11.4% and 19.2% respectively (P=0.191). Conclusions: The immediate effect of LCAH combined with hyperthermia is better than that of LCAH alone. Additional hyper-thermia to LCAH does not increase the likelihood of radiation injury. (authors)

  9. Resonant absorption effects induced by polarized laser light irradiating thin foils in the TNSA regime of ion acceleration

    Torrisi, L.; Badziak, J.; Rosinski, M.; Zaras-Szydlowska, A.; Pfeifer, M.; Torrisi, A.

    2016-04-01

    Thin foils were irradiated by short pulsed lasers at intensities of 1016‑19W/cm2 in order to produce non-equilibrium plasmas and ion acceleration from the target-normal-sheath-acceleration (TNSA) regime. Ion acceleration in forward direction was measured by SiC detectors and ion collectors used in the time-of-flight configuration. Laser irradiations were employed using p-polarized light at different incidence angles with respect to the target surface and at different focal distances from the target surface. Measurements demonstrate that resonant absorption effects, due to the plasma wave excitations, enhance the plasma temperature and the ion acceleration with respect to those performed without to use of p-polarized light. Dependences of the ion flux characteristics on the laser energy, wavelength, focal distance and incidence angle will be reported and discussed.

  10. Evaluation of onion root tip cell surviving fraction by measuring growing speed irradiated by accelerated heavy ions

    Average growth of germinating onion seed roots irradiated with accelerated heavy ions decreased with increase of absorbed dose, and the ratio to the non-irradiated seeds approached asymptotically to about 40% with increasing of the dose and almost converged at 10 Gy. The converged ratio was about 20% for green sorgo seeds and about 80% for alphalfa seeds. Irradiation of the heavy ions and γ-ray larger than 2 Gy delayed appearance of micronuclei in the onion root tip cells. The delay increased with the increase of linear energy transfer (LET) and absorbed dose. (author)

  11. Aspects of licensing and control use of accelerators and other irradiators: MBE for crosslinking chitosan, seaweed gel, latex, sterilization irradiators, and cyclotron for F18 PET

    Aspects of licensing and control the use of other accelerators and irradiators: EBM for crosslinking chitosan, Seaweed Gel, Latex, Sterilization Irradiators, and cyclotron for F18 PET has been discussed. From the regulatory point of view, one of the purposes of BAPETEN (Nuclear Energy Regulatory Agency) is to ensure the safety and health of workers, public, and environmental protection in the use of nuclear energy. Requirements and licensing procedures established in accordance with the risks associated with radiation safety and security of Radioactive Sources and Nuclear Materials, so the higher the risk of a use, then the licensing requirements imposed increasingly stringent. Licensing requirements consist of administrative, technical and special requirements. Licensing the use of irradiators category I do not need the special requirements for the lowest risk and 1 (one) stage licensing. While irradiators category II through IV, and F18 PET cyclotron require special requirements and more than one stages licensing. (author)

  12. Irradiated Volume as a Predictor of Brain Radionecrosis After Linear Accelerator Stereotactic Radiosurgery

    Purpose: To investigate the correlation between volume of brain irradiated by stereotactic radiosurgery (SRS) and the incidence of symptomatic and asymptomatic brain radionecrosis (RN). Methods and Materials: A retrospective analysis was performed of patients treated with single-fraction SRS for brain metastases at our institution. Patients with at least 6-month imaging follow-up were included and diagnosed with RN according to a combination of criteria, including appearance on serial imaging and histology. Univariate and multivariate analyses were performed to determine the predictive value of multiple variables, including volume of brain receiving a specific dose (V8 Gy-V18 Gy). Results: Sixty-three patients were reviewed, with a total of 173 lesions. Most patients (63%) had received previous whole-brain irradiation. Mean prescribed SRS dose was 18 Gy. Symptomatic RN was observed in 10% and asymptomatic RN in 4% of lesions treated. Multivariate regression analysis showed V8 Gy-V16 Gy to be most predictive of symptomatic RN (p 3 for V10 Gy and 7.85 cm3 for V12 Gy. Conclusions: Analysis of patient and treatment variables revealed V8 Gy-V16 Gy to be the best predictors for RN using linear accelerator-based single-fraction SRS for brain metastases. We propose that patients with V10 Gy >10.5 cm3 or V12 Gy >7.9 cm3 be considered for hypofractionated rather than single-fraction treatment, to minimize the risk of symptomatic RN.

  13. Radiation field calculation of ventilation duct for 3-MeV electron irradiation accelerator

    Background: Ozone will be produced when the accelerator runs. Because ozone can cause corrosive damage to metal, ventilation duct has to be set in the irradiation room to discharge ozone. Purpose: Photons go into the ventilation duct, and then produce additional radiation. To do the quantitative assessment of radiation field at the outlet of duct, the simulate calculation of radiation doses at the outlet has been done. Methods: The Monte Carlo code of MCNP can analog the electronic and photon transport, so that using MCNP can solve the problem. Results: The result shows that the location and the number of backscattered interface of duct significantly affect the dosage rate while the size of duct doesn't. Increasing a backscatter interface can lower dosage rate attenuation about three orders of magnitude. The dosage rate under the target is two orders of magnitude than that in the comer. The setting project of duct is drawn and the ratio of length and depth has been optimized. The duct should be about 3 m long and 80 cm deep when the multi-tortuous duct is placed under the target, and U-shaped duct should be about 6 m long and l m deep when it is set at the comer of irradiation room. Conclusions: In order to reduce dosage rates and economic costs, the shape of duct and the location of duct are designed critically. And according to the actual situation, the project is flexible. (authors)

  14. Accelerator-Based Biological Irradiation Facility Simulating Neutron Exposure from an Improvised Nuclear Device.

    Xu, Yanping; Randers-Pehrson, Gerhard; Turner, Helen C; Marino, Stephen A; Geard, Charles R; Brenner, David J; Garty, Guy

    2015-10-01

    We describe here an accelerator-based neutron irradiation facility, intended to expose blood or small animals to neutron fields mimicking those from an improvised nuclear device at relevant distances from the epicenter. Neutrons are generated by a mixed proton/deuteron beam on a thick beryllium target, generating a broad spectrum of neutron energies that match those estimated for the Hiroshima bomb at 1.5 km from ground zero. This spectrum, dominated by neutron energies between 0.2 and 9 MeV, is significantly different from the standard reactor fission spectrum, as the initial bomb spectrum changes when the neutrons are transported through air. The neutron and gamma dose rates were measured using a custom tissue-equivalent gas ionization chamber and a compensated Geiger-Mueller dosimeter, respectively. Neutron spectra were evaluated by unfolding measurements using a proton-recoil proportional counter and a liquid scintillator detector. As an illustration of the potential use of this facility we present micronucleus yields in single divided, cytokinesis-blocked human peripheral lymphocytes up to 1.5 Gy demonstrating 3- to 5-fold enhancement over equivalent X-ray doses. This facility is currently in routine use, irradiating both mice and human blood samples for evaluation of neutron-specific biodosimetry assays. Future studies will focus on dose reconstruction in realistic mixed neutron/photon fields. PMID:26414507

  15. The radiation field measurement and analysis outside the shielding of A 10 MeV electron irradiation accelerator

    Shang, Jing; Li, Juexin; Xu, Bing; Li, Yuxiong

    2011-10-01

    Electron accelerators are employed widely for diverse purposes in the irradiation-processing industry, from sterilizing medical products to treating gemstones. Because accelerators offer high efficiency, high power, and require little preventative maintenance, they are becoming more and more popular than using the 60Co isotope approach. However, the electron accelerator exposes potential radiation hazards. To protect workers and the public from exposure to radiation, the radiation field around the electronic accelerator must be assessed, especially that outside the shielding. Thus, we measured the radiation dose at different positions outside the shielding of a 10-MeV electron accelerator using a new data-acquisition unit named Mini-DDL (Mini-Digital Data Logging). The measurements accurately reflect the accelerator's radiation status. In this paper, we present our findings, results and compare them with our theoretical calculations. We conclude that the measurements taken outside the irradiation hall are consistent with the findings from our calculations, except in the maze outside the door of the accelerator room. We discuss the reason for this discrepancy.

  16. The radiation field measurement and analysis outside the shielding of A 10 MeV electron irradiation accelerator

    Shang Jing [National Synchrotron Radiation Lab, University of Science and Technology of China (China); Li Juexin, E-mail: juexin@ustc.edu.cn [National Synchrotron Radiation Lab, University of Science and Technology of China (China); Xu Bing; Li Yuxiong [National Synchrotron Radiation Lab, University of Science and Technology of China (China)

    2011-10-01

    Electron accelerators are employed widely for diverse purposes in the irradiation-processing industry, from sterilizing medical products to treating gemstones. Because accelerators offer high efficiency, high power, and require little preventative maintenance, they are becoming more and more popular than using the {sup 60}Co isotope approach. However, the electron accelerator exposes potential radiation hazards. To protect workers and the public from exposure to radiation, the radiation field around the electronic accelerator must be assessed, especially that outside the shielding. Thus, we measured the radiation dose at different positions outside the shielding of a 10-MeV electron accelerator using a new data-acquisition unit named Mini-DDL (Mini-Digital Data Logging). The measurements accurately reflect the accelerator's radiation status. In this paper, we present our findings, results and compare them with our theoretical calculations. We conclude that the measurements taken outside the irradiation hall are consistent with the findings from our calculations, except in the maze outside the door of the accelerator room. We discuss the reason for this discrepancy.

  17. The radiation field measurement and analysis outside the shielding of A 10 MeV electron irradiation accelerator

    Electron accelerators are employed widely for diverse purposes in the irradiation-processing industry, from sterilizing medical products to treating gemstones. Because accelerators offer high efficiency, high power, and require little preventative maintenance, they are becoming more and more popular than using the 60Co isotope approach. However, the electron accelerator exposes potential radiation hazards. To protect workers and the public from exposure to radiation, the radiation field around the electronic accelerator must be assessed, especially that outside the shielding. Thus, we measured the radiation dose at different positions outside the shielding of a 10-MeV electron accelerator using a new data-acquisition unit named Mini-DDL (Mini-Digital Data Logging). The measurements accurately reflect the accelerator's radiation status. In this paper, we present our findings, results and compare them with our theoretical calculations. We conclude that the measurements taken outside the irradiation hall are consistent with the findings from our calculations, except in the maze outside the door of the accelerator room. We discuss the reason for this discrepancy.

  18. How does imaging frequency and soft tissue motion affect the PTV margin size in partial breast and boost radiotherapy?

    Purpose: This study investigates (i) the effect of verification protocols on treatment accuracy and PTV margins for partial breast and boost breast radiotherapy with short fractionation schema (15 fractions), (ii) the effect of deformation of the excision cavity (EC) on PTV margin size, (iii) the imaging dose required to achieve specific PTV margins. Methods and materials: Verification images using implanted EC markers were studied in 36 patients. Target motion was estimated for a 15 fraction partial breast regimen using imaging protocols based on on-line and off-line motion correction strategies (No Action Level (NAL) and the extended NAL (eNAL) protocols). Target motion was used to estimate a PTV margin for each protocol. To evaluate treatment errors due to deformation of the excision cavity, individual marker positions were obtained from 11 patients. The mean clip displacement and daily variation in clip position during radiotherapy were determined and the contribution of these errors to PTV margin calculated. Published imaging dose data were used to estimate total dose for each protocol. Finally the number of images required to obtain a specific PTV margin was evaluated and hence, the relationship between PTV margins and imaging dose was investigated. Results: The PTV margin required to account for excision cavity motion, varied between 10.2 and 2.4 mm depending on the correction strategy used. Average clip movement was 0.8 mm and average variation in clip position during treatment was 0.4 mm. The contribution to PTV margin from deformation was estimated to be small, less than 0.2 mm for both off-line and on-line correction protocols. Conclusion: A boost or partial breast PTV margin of ∼10 mm, is possible with zero imaging dose and workload, however, patients receiving boost radiotherapy may benefit from a margin reduction of ∼4 mm with imaging doses from 0.4 cGy to 25 cGy using an eNAL protocol. PTV margin contributions from deformation errors are likely

  19. Characterization of solvents containing CyMe4-BTPhen in selected cyclohexanone-based diluents after irradiation by accelerated electrons

    Distler, P.; Kondé, J.; John, J.; Hájková, Zuzana; Švehla, Jaroslav; Grüner, Bohumír

    2015-01-01

    Roč. 60, č. 4 (2015), s. 885-891. ISSN 0029-5922 EU Projects: European Commission(XE) 323282 - SACSESS Institutional support: RVO:61388980 Keywords : accelerated electrons * CyMe4-BTPhen * irradiation * radiation stability * solvent extraction Subject RIV: CA - Inorganic Chemistry Impact factor: 0.477, year: 2014

  20. SNPs in DNA repair or oxidative stress genes and late subcutaneous fibrosis in patients following single shot partial breast irradiation

    Falvo Elisabetta; Strigari Lidia; Citro Gennaro; Giordano Carolina; Boboc Genoveva; Fabretti Fabiana; Bruzzaniti Vicente; Bellesi Luca; Muti Paola; Blandino Giovanni; Pinnarò Paola

    2012-01-01

    Abstract Background The aim of this study was to evaluate the potential association between single nucleotide polymorphisms related response to radiotherapy injury, such as genes related to DNA repair or enzymes involved in anti-oxidative activities. The paper aims to identify marker genes able to predict an increased risk of late toxicity studying our group of patients who underwent a Single Shot 3D-CRT PBI (SSPBI) after BCS (breast conserving surgery). Methods A total of 57 breast cancer pa...

  1. SNPs in DNA repair or oxidative stress genes and late subcutaneous fibrosis in patients following single shot partial breast irradiation

    Falvo Elisabetta

    2012-01-01

    Full Text Available Abstract Background The aim of this study was to evaluate the potential association between single nucleotide polymorphisms related response to radiotherapy injury, such as genes related to DNA repair or enzymes involved in anti-oxidative activities. The paper aims to identify marker genes able to predict an increased risk of late toxicity studying our group of patients who underwent a Single Shot 3D-CRT PBI (SSPBI after BCS (breast conserving surgery. Methods A total of 57 breast cancer patients who underwent SSPBI were genotyped for SNPs (single nucleotide polymorphisms in XRCC1, XRCC3, GST and RAD51 by Pyrosequencing technology. Univariate analysis (ORs and 95% CI was performed to correlate SNPs with the risk of developing ≥ G2 fibrosis or fat necrosis. Results A higher significant risk of developing ≥ G2 fibrosis or fat necrosis in patients with: polymorphic variant GSTP1 (Ile105Val (OR = 2.9; 95%CI, 0.88-10.14, p = 0.047. Conclusions The presence of some SNPs involved in DNA repair or response to oxidative stress seem to be able to predict late toxicity. Trial Registration ClinicalTrials.gov: NCT01316328

  2. ASPIRE: An automated sample positioning and irradiation system for radiation biology experiments at Inter University Accelerator Centre, New Delhi

    An automated irradiation setup for biology samples has been built at Inter University Accelerator Centre (IUAC), New Delhi, India. It can automatically load and unload 20 biology samples in a run of experiment. It takes about 20 min [2% of the cell doubling time] to irradiate all the 20 samples. Cell doubling time is the time taken by the cells (kept in the medium) to grow double in numbers. The cells in the samples keep growing during entire of the experiment. The fluence irradiated to the samples is measured with two silicon surface barrier detectors. Tests show that the uniformity of fluence and dose of heavy ions reaches to 2% at the sample area in diameter of 40 mm. The accuracy of mean fluence at the center of the target area is within 1%. The irradiation setup can be used to the studies of radiation therapy, radiation dosimetry and molecular biology at the heavy ion accelerator. - Highlights: • Automated positioning and irradiation setup for biology samples at IUAC is built. • Loading and unloading of 20 biology samples can be automatically carried out. • Biologicals cells keep growing during entire experiment. • Fluence and dose of heavy ions are measured by two silicon barrier detectors. • Uniformity of fluence and dose of heavy ions at sample position reaches to 2%

  3. Accelerator

    The invention claims equipment for stabilizing the position of the front covers of the accelerator chamber in cyclic accelerators which significantly increases accelerator reliability. For stabilizing, it uses hydraulic cushions placed between the electromagnet pole pieces and the front chamber covers. The top and the bottom cushions are hydraulically connected. The cushions are disconnected and removed from the hydraulic line using valves. (J.P.)

  4. Characterization of solvents containing CyMe4-BTPhen in selected cyclohexanone-based diluents after irradiation by accelerated electrons

    Distler Petr

    2015-12-01

    Full Text Available Radiation stability of CyMe4-BTPhen was examined in systems with three selected cyclohexanone-based diluents. Accelerated electrons were used as a source of ionizing radiation. The CyMe4-BTPhen radiation degradation identification and characterization of the degradation products were performed by high performance liquid chromatography (HPLC and mass spectrometry (MS analyses. Residual concentrations of tested ligand were determined. Moreover, extraction properties of the solvents irradiated at two different doses were compared with the extraction properties of non-irradiated solvents to estimate the influence of the presence of degradation products in the organic phase.

  5. A Program To Calculate Operator - Parameters For Irradiation On UELR-10-15S2 Accelerator Basing On Experimental Results

    All elements effect to absorption dose inside object irradiated on UELR-10-15S2 electron beam accelerator at VINAGAMMA were researched. These were: depth-dose profile, beam-size, surface-dose vs distance scanning-horn to object, limitation of conveyor speed. Base on the received results, a computer program for operator to calculate the DUR and determine the set-up values of power, the speed of conveyor, and the scanning frequency of UELR-10-15S2 (operator-parameter) in a specific irradiation case were built. Outputs of the program are good appropriate with perform case. (author)

  6. Debate about breast cancer: 'Cons: Intraoperative radiotherapy'; Debats autour du cancer du sein: 'contre' la radiotherapie peroperatoire

    Bourgier, C.; Heymann, S.; Verstraet, R.; Biron, B.; Marsiglia, H. [Departement de radiotherapie, institut Gustave-Roussy, 114, rue edouard-Vaillant, 94800 Villejuif (France)

    2011-10-15

    Early breast cancer incidence increases owing to mammography screening. Hypo-fractionated radiotherapy is more and more proposed in women with low local relapse risk breast cancer, especially accelerated partial breast irradiation. Various irradiation modalities have been reported: brachytherapy, intraoperative irradiation, 3D-conformal accelerated partial breast irradiation. We describe limitations of intraoperative irradiation and the advantages of alternative techniques. (authors)

  7. A new experimental system for irradiating tumors in mice using a linear accelerator under specific pathogen-free conditions

    We developed a reliable system for the irradiation of xenografted tumors in mice which allows for accurate local irradiation under specific pathogen-free conditions. The system presented here consists of acrylic supports for mice and an acrylic box connected to a pump through 0.22 μm pore-sized filters. Mice with xenotransplanted tumors growing on their right hind legs were set on the supports and put into the box in a laminar flow hood. The tumors of 7 mice were irradiated simultaneously with X-rays of 6 and 10 MV generated by a linear accelerator at a dose rate of 3.1-4.7 Gy/min. The air was ventilated through filters during irradiation in the closed box. Microorganism tests confirmed that no bacteria entered or left the box. One of the significant characteristics of this setup is that it allows for irradiation under conditions of acute hypoxia, which is obtained using an integrated tourniquet. The dose variation among 7 tumors was less than 1%. The rest of the mouse's body was shielded effectively by a half-field technique and a lead block. As a result, the whole body dose for the mice was 0-4% of the total dose absorbed by the tumor. Due to the high dose rate and the ability to irradiate 7 mice simultaneously under specific pathogen-free conditions, this new system can be considered a time-saving and valuable tool for radiation oncology research. (author)

  8. A new experimental system for irradiating tumors in mice using a linear accelerator under specific pathogen-free conditions.

    Kuroda M

    1999-06-01

    Full Text Available We developed a reliable system for the irradiation of xenografted tumors in mice which allows for accurate local irradiation under specific pathogen-free conditions. The system presented here consists of acrylic supports for mice and an acrylic box connected to a pump through 0.22 microns pore-sized filters. Mice with xenotransplanted tumors growing on their right hind legs were set on the supports and put into the box in a laminar flow hood. The tumors of 7 mice were irradiated simultaneously with X-rays of 6 and 10 MV generated by a linear accelerator at a dose rate of 3.1-4.7 Gy/min. The air was ventilated through filters during irradiation in the closed box. Microorganism tests confirmed that no bacteria entered or left the box. One of the significant characteristics of this setup is that it allows for irradiation under conditions of acute hypoxia, which is obtained using an integrated tourniquet. The dose variation among 7 tumors was less than 1%. The rest of the mouse's body was shielded effectively by a half-field technique and a lead block. As a result, the whole body dose for the mice was 0-4% of the total dose absorbed by the tumor. Due to the high dose rate and the ability to irradiate 7 mice simultaneously under specific pathogen-free conditions, this new system can be considered a time-saving and valuable tool for radiation oncology research.

  9. Enhanced collimated GeV monoenergetic ion acceleration from a shaped foil target irradiated by a circularly polarized laser pulse

    Chen, M; Yu, T P; Sheng, Z M

    2009-01-01

    Using multi-dimensional particle-in-cell (PIC) simulations we study ion acceleration from a foil irradiated by a circularly polarized laser pulse at 1022W/cm^2 intensity. When the foil is shaped initially in the transverse direction to match the laser intensity profile, the center part of the target can be uniformly accelerated for a longer time compared to a usual flat target. Target deformation and undesirable plasma heating are effectively suppressed. The final energy spectrum of the accelerated ion beam is improved dramatically. Collimated GeV quasi-mono-energetic ion beams carrying as much as 18% of the laser energy are observed in multi-dimensional simulations. Radiation damping effects are also checked in the simulations.

  10. The present situation and prospect of industrial irradiation accelerator industry in China

    Accelerator technology and the machines are an important part of the nuclear technology and also are the system integration of modern science technology. The application of accelerator technology has made the important breakthrough in many science research fields, in the development course of particle physics, several milestone developments are closely related to accelerator developments. In 1960s, accelerators gradually transferred from the science research to the national economy and society application fields. In 1970s, accelerators applied in many fields involved the industry, medical hygiene, agriculture, environmental protection, and proceed the development of new technique, new craft, new product, and developed lots of newly arisen edge industries, such as the medical equipments, no damage examination, ion injecting, radiation processing. Now accelerators have become a firmly established industry. This paper primarily reviewed the application of industrial radiation accelerators by the 20 years developments of accelerators in China. (author)

  11. Charged-particle acceleration through laser irradiation of thin foils at Prague Asterix Laser System

    Torrisi, L.; Cutroneo, M.; Cavallaro, S.; Musumeci, P.; Calcagno, L.; Wolowski, J.; Rosinski, M.; Zaras-Szydlowska, A.; Ullschmied, Jiří; Krouský, Eduard; Pfeifer, Miroslav; Skála, Jiří; Velyhan, Andriy

    T161, May (2014), 1-4. ISSN 0031-8949 Institutional support: RVO:68378271 Keywords : target normal sheath acceleration * ion acceleration * plasma diagnostics Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 1.126, year: 2014

  12. Accelerated recovery of hematopoiesis following sub-lethal whole body irradiation with recombinant murine interleukin-1 (IL-1)

    This communication reports the results of studies designed to investigate the ability of recombinant murine interleukin-1 (rIL-1) to enhance the recovery of hematopoiesis following administration of sub-lethal whole body irradiation (2 Gy). Mice were administered rIL-1 (100 and 500 units) i.p. Twenty-four hours later these mice were administered 2 Gy radiation. Irradiated control mice were given only phosphate buffered saline (PBS). Animals were then serially sacrificed (on days 1, 2, 4, 7, 9, and 12 following irradiation) and their peripheral blood was analyzed for indices (packed red cell volume, WBC, platelets, and differential). Femoral bone marrow was harvested and assayed for their stem cell content--erythroid (CFU-E, BFU-E), granulocyte-macrophage (CFU-GM), and megakaryocyte (CFU-MEG). Irradiated mice pretreated with rIL-1 demonstrated accelerated hematopoietic recovery as measured by higher WBC, platelets and femoral stem cell content than PBS-treated irradiated controls. These results indicate IL-1 may be an effective radioprotective agent against the hematotoxicity induced by ionizing radiation

  13. Double sided irradiation on homogenous products of different densities at an industrial EB accelerator of 2 MeV energy

    An industrial type 2 MeV/20 kW electron beam accelerator is operational in India for development of applications and technology demonstration to the Indian industry in the field of polymer modifications and for processing of various other products. For routine monitoring of beam current during radiation processing of products at the facility, a current density measurement system was fabricated using high quality graphite material. Depth–dose distribution was experimentally measured in materials of different densities for optimizing suitable thickness for double sided irradiation under 2 MeV beam. The present paper describes the features of the current density measurement system and experiments for optimizing thickness suitable for double sided irradiation for materials of different densities. - Highlights: • A current density measurement system was fabricated using high quality graphite material for routine monitoring of electron beam current for 2 MeV ILU-6 accelerator. • Effect of double sided irradiation on products under 2 MeV electron beam has been studied. • Dose distribution in homogenous products of different densities in the range of 0.3–1.4 g/cm3 has been studied

  14. Authors reply

    Meattini, Icro; Saieva, Calogero; Livi, Lorenzo

    2015-01-01

    Comment on In regard to Livi et al. "Accelerated partial breast irradiation using intensity-modulated radiotherapy versus whole breast irradiation: 5 year survival analysis of a phase 3 randomised controlled trial". [Eur J Cancer. 2015] Accelerated partial breast irradiation using intensity-modulated radiotherapy versus whole breast irradiation: 5-year survival analysis of a phase 3 randomised controlled trial. [Eur J Cancer. 2015

  15. Study of irradiation induced restructuring of high burnup fuel - Use of computer and accelerator for fuel science and engineering -

    In order to develop advanced fuel for future LWR reactors, trials were made to simulate the high burnup restructuring of the ceramics fuel, using accelerator irradiation out of pile and with computer simulation. The target is to reproduce the principal complex process as a whole. The reproduction of the grain subdivision (sub grain formation) was successful at experiments with sequential combined irradiation. It was made by recovery process of the accumulated dislocations, making cells and sub-boundaries at grain boundaries and pore surfaces. Details of the grain sub division mechanism is now in front of us outside of the reactor. Extensive computer science studies, first principle and molecular dynamics gave behavior of fission gas atoms and interstitial oxygen, assisting the high burnup restructuring

  16. Evaluation of onion root tip cell surviving fraction by measuring growing speed irradiated by accelerated heavy ions

    Irradiation of accelerated heavy ions to germinated onion seeds reduced the root growth. The extent of the root shortening increased with the increase of the absorbed dose and with the increase of linear energy transfer (LET). The growing curve looks like converging to a limited curve with increase of the dose and the growing did not stop even at highest dose of 100 Gy. Germinated seeds of green sorgo and alphalfa were investigated for comparison and they showed different dose responses from onion. Growth of green sorgo germs almost stopped at high doses. Growth of alphalfa germs was unaffected by radiations. (author)

  17. Application of an ultraminiature thermal neutron monitor for irradiation field study of accelerator-based neutron capture therapy

    Phantom experiments to evaluate thermal neutron flux distribution were performed using the Scintillator with Optical Fiber (SOF) detector, which was developed as a thermal neutron monitor during boron neutron capture therapy (BNCT) irradiation. Compared with the gold wire activation method and Monte Carlo N-particle (MCNP) calculations, it was confirmed that the SOF detector is capable of measuring thermal neutron flux as low as 105 n/cm2/s with sufficient accuracy. The SOF detector will be useful for phantom experiments with BNCT neutron fields from low-current accelerator-based neutron sources. (author)

  18. Fast electron generation and transport in solid matter irradiated at relativistic intensities. Evidence of vxB acceleration

    Baton, S. D.; Santos, J. J.; Amiranoff, F.; Popescu, H.; Gremillet, L.; Koenig, M.; Martinolli, E.; Rousseaux, C.; Rabec-Le-Gloahec, M.; Hall, T. A.; Batani, D.; Perelli, E.; Scianitti, F.; Cowan, T. E.

    2002-11-01

    In the context of the fast electron transport in solid matter and the fast ignitor scheme,we report on measurements of second harmonic of the laser light observed on the rear side of solid targets irradiated by the 100 TW laser at LULI. This emission can be explained by the acceleration of short bunches of electrons in the front of the target by the vxB force. The observations indicate that, in our conditions, the minimum fraction of the laser energy transferred to these electron bunches is of the order of 1 °.

  19. Curcumin Mitigates Accelerated Aging after Irradiation in Drosophila by Reducing Oxidative Stress

    Ki Moon Seong; Mira Yu; Kyu-Sun Lee; Sunhoo Park; Young Woo Jin; Kyung-Jin Min

    2015-01-01

    Curcumin, belonging to a class of natural phenol compounds, has been extensively studied due to its antioxidative, anticancer, anti-inflammatory, and antineurodegenerative effects. Recently, it has been shown to exert dual activities after irradiation, radioprotection, and radiosensitization. Here, we investigated the protective effect of curcumin against radiation damage using D. melanogaster. Pretreatment with curcumin (100 μM) recovered the shortened lifespan caused by irradiation and incr...

  20. Investigation of longitudinal proton acceleration in exploded targets irradiated by intense short-pulse laser

    Gauthier, M. [LULI, École Polytechnique, CNRS, CEA, UPMC, route de Saclay, 91128 Palaiseau (France); CEA, DAM, DIF, 91297 Arpajon (France); Lévy, A. [LULI, École Polytechnique, CNRS, CEA, UPMC, route de Saclay, 91128 Palaiseau (France); Sorbonne Universités, UPMC, Paris 06, CNRS, INSP, UMR 7588, F-75005, Paris (France); D' Humières, E.; Beaucourt, C.; Breil, J.; Feugeas, J. L.; Nicolaï, P.; Tikhonchuk, V. [Univ. Bordeaux, CNRS, CEA, UMR 5107, F-33400 Talence (France); Glesser, M. [LULI, École Polytechnique, CNRS, CEA, UPMC, route de Saclay, 91128 Palaiseau (France); INRS-EMT, Varennes, PQ J3X 1S2 (Canada); Albertazzi, B. [LULI, École Polytechnique, CNRS, CEA, UPMC, route de Saclay, 91128 Palaiseau (France); Univ. Bordeaux, CNRS, CEA, UMR 5107, F-33400 Talence (France); Chen, S. N.; Dervieux, V.; Fuchs, J. [LULI, École Polytechnique, CNRS, CEA, UPMC, route de Saclay, 91128 Palaiseau (France); Pépin, H. [INRS-EMT, Varennes, PQ J3X 1S2 (Canada); Antici, P. [LULI, École Polytechnique, CNRS, CEA, UPMC, route de Saclay, 91128 Palaiseau (France); INRS-EMT, Varennes, PQ J3X 1S2 (Canada); Dipartimento SBAI, Universita di Roma “Sapienza,” Via A. Scarpa 16, 00161 Rome (Italy)

    2014-01-15

    It was recently shown that a promising way to accelerate protons in the forward direction to high energies is to use under-dense or near-critical density targets instead of solids. Simulations have revealed that the acceleration process depends on the density gradients of the plasma target. Indeed, under certain conditions, the most energetic protons are predicted to be accelerated by a collisionless shock mechanism that significantly increases their energy. We report here the results of a recent experiment dedicated to the study of longitudinal ion acceleration in partially exploded foils using a high intensity (∼5 × 10{sup 18} W/cm{sup 2}) picosecond laser pulse. We show that protons accelerated using targets having moderate front and rear plasma gradients (up to ∼8 μm gradient length) exhibit similar maximum proton energy and number compared to proton beams that are produced, in similar laser conditions, from solid targets, in the well-known target normal sheath acceleration regime. Particle-In-Cell simulations, performed in the same conditions as the experiment and consistent with the measurements, allow laying a path for further improvement of this acceleration scheme.

  1. Local heart irradiation of ApoE−/− mice induces microvascular and endocardial damage and accelerates coronary atherosclerosis

    Background and purpose: Radiotherapy of thoracic and chest-wall tumors increases the long-term risk of radiation-induced heart disease, like a myocardial infarct. Cancer patients commonly have additional risk factors for cardiovascular disease, such as hypercholesterolemia. The goal of this study is to define the interaction of irradiation with such cardiovascular risk factors in radiation-induced damage to the heart and coronary arteries. Material and methods: Hypercholesterolemic and atherosclerosis-prone ApoE−/− mice received local heart irradiation with a single dose of 0, 2, 8 or 16 Gy. Histopathological changes, microvascular damage and functional alterations were assessed after 20 and 40 weeks. Results: Inflammatory cells were significantly increased in the left ventricular myocardium at 20 and 40 weeks after 8 and 16 Gy. Microvascular density decreased at both follow-up time-points after 8 and 16 Gy. Remaining vessels had decreased alkaline phosphatase activity (2–16 Gy) and increased von Willebrand Factor expression (16 Gy), indicative of endothelial cell damage. The endocardium was extensively damaged after 16 Gy, with foam cell accumulations at 20 weeks, and fibrosis and protein leakage at 40 weeks. Despite an accelerated coronary atherosclerotic lesion development at 20 weeks after 16 Gy, gated SPECT and ultrasound measurements showed only minor changes in functional cardiac parameters at 20 weeks. Conclusions: The combination of hypercholesterolemia and local cardiac irradiation induced an inflammatory response, microvascular and endocardial damage, and accelerated the development of coronary atherosclerosis. Despite these pronounced effects, cardiac function of ApoE−/− mice was maintained.

  2. Effects of Gamma Irradiation on Shelf-Life and Sensory Scores of Squid Sundae under Accelerated Storage Conditions

    This study was conducted to examine the effects of gamma irradiation on the shelf-life and sensory scores of squid Sundae under accelerated storage conditions. Squid Sundae was stored at 37°C for 35 days following gamma irradiation at doses of 0, 10, and 20 kGy. For total viable cell counts, control and gamma-irradiated (GI) (10 kGy) squid Sundae were already spoiled in 4 days, whereas GI (20 kGy) squid Sundae showed complete suppression of bacterial growth during storage. There were no significant changes in pH values compared to the control. The VBN and TBARS (thiobarbituric acid reactive substance) values of GI (20 kGy) squid Sundae were significantly lower than those of the control. In addition, the induction period of GI (20 kGy) squid Sundae as measured by a Rancimat showed a higher level compared to that of the control. In the sensory evaluation, there were no significant changes between the control and GI samples. These results suggest that a dose of 20 kGy is the optimum and effective dose for preservation of squid Sundae. (author)

  3. Tree-code simulations of proton acceleration from laser-irradiated wire targets

    Recent experiments using Terawatt lasers to accelerate protons deposited on thin wire targets are modeled with a new type of gridless plasma simulation code. In contrast to conventional mesh-based methods, this technique offers a unique capability in emulating the complex geometry and open-ended boundary conditions characteristic of contemporary experimental conditions. Comparisons of ion acceleration are made between the tree code and standard particle-in-cell simulations for a typical collisionless 'hole boring' scenario in slab geometry. The utility of the gridless approach is emphasized by a series of simulations in 'wire' geometry, in which electrons are permitted to circulate around the target at arbitrary distances from the focal region. The simulations reveal a number of features in common with recent experimental observations, including a disclike emission pattern of the MeV protons accelerated away from the wire

  4. Curcumin Mitigates Accelerated Aging after Irradiation in Drosophila by Reducing Oxidative Stress

    Ki Moon Seong

    2015-01-01

    Full Text Available Curcumin, belonging to a class of natural phenol compounds, has been extensively studied due to its antioxidative, anticancer, anti-inflammatory, and antineurodegenerative effects. Recently, it has been shown to exert dual activities after irradiation, radioprotection, and radiosensitization. Here, we investigated the protective effect of curcumin against radiation damage using D. melanogaster. Pretreatment with curcumin (100 μM recovered the shortened lifespan caused by irradiation and increased eclosion rate. Flies subjected to high-dose irradiation showed a mutant phenotype of outstretched wings, whereas curcumin pretreatment reduced incidence of the mutant phenotype. Protein carbonylation and formation of γH2Ax foci both increased following high-dose irradiation most likely due to generation of reactive oxygen species. Curcumin pretreatment reduced the amount of protein carbonylation as well as formation of γH2Ax foci. Therefore, we suggest that curcumin acts as an oxidative stress reducer as well as an effective protective agent against radiation damage.

  5. Subtotal body irradiation with linear accelerator as preparation for marrow engraftment in aplastic anemia

    Two cases of multitransfused severe aplastic anemia were retransplanted with bone marrow from the same HLA compatible sibling donors after subtotal body irradiation (800 r). Only minor non hematologic toxicity was observed. No permanent take was seen in relation to this procedure. During the survival time of the patients (78-120 days) no signs of interstitial pneumonia were observed

  6. Study of accelerated diffusion in gold and aluminium under neutron irradiation

    The speed-up of diffusion under neutron irradiation was studied. The experiments concern the self-diffusion of gold as a function of temperature and the heterodiffusion of copper and gold in aluminium against flux and temperature. In each of these systems the coefficients measured were 106 times higher than the expected extra-irradiation values for a flux of 6.1012n/cm2/s and at a temperature 0.33 Tsub(f), Tsub(f) being the matting point of the matrix expressed in Kelvins. The results obtained can be explained satisfactorily by assuming that, under irradiation: the activation energy of the diffusion coefficient is equal to half the hole migration energy (corrected for the hole-impurity interaction terms in the case of heterodiffusion); the diffusion coefficient under irradiation varies with the square root of the flux; defect wells eliminate interstitials much more efficient by than holes. The first two points agree well with theoretical predictions if the holes and interstitials are assumed to disappear essentially by mutual recombination, whereas the third can be interpreted in terms of a low efficiency of wells for holes and by supposing that the interstitial elimination reaction is limited only by the diffusion rate of these interstitials

  7. Accelerating complex for intraoperation irradiations and traditional electron and gamma therapy

    A project of the microtron based complex for intraoperation irradiations and traditional electron and gamma therapy, is described. Two surgical rooms are foreseen for these aims. Project of a microtron with the beam, energy of which changes from 2 to 22 MeV, is developed. Prototype of the microtron during two years is successfully used in a free electron laser

  8. Void swelling and defect processes in ti-modified steels using accelerator irradiation

    The void swelling behaviour of (15Ni-14Cr)-O.25Ti and (15Ni-14Cr)-O.15Ti steels are studied using heavy ion irradiation for understanding the influence of titanium in the void swelling resistance of these D9 alloys. The cold worked samples have been pre-implanted with a uniform helium concentration of 30 appm spanning a width of about 640 nm. This was followed by a 5-MeV nickel ion irradiation to create a peak damage of ∼ 100 dpa at a damage rate of 7 x 10-3 dpa/s at various irradiation temperatures between 700 and 970 K. The gross swelling in the implanted range is measured by step height measurements. It is found that the peak swelling temperatures and the magnitude of swelling for the alloys are different. The difference in void swelling behaviour with variation in titanium concentration in these two alloys is discussed on the basis of the role of titanium on the vacancy migration and TiC precipitate formation. Isochronal annealing study of the positron lifetime in the un-irradiated alloys reveals different TiC precipitates formation behaviour in the two alloys. Ab initio calculations of positron lifetime, using large super-cells, show that C vacancies at the TiC/austenite interface are the predominant positron trapping centres in these alloys. (authors)

  9. Accelerated large volume irradiation with dynamic Jaw/Dynamic Couch Helical Tomotherapy

    Helical Tomotherapy (HT) has unique capacities for the radiotherapy of large and complicated target volumes. Next generation Dynamic Jaw/Dynamic Couch HT delivery promises faster treatments and reduced exposure of organs at risk due to a reduced dose penumbra. Three challenging clinical situations were chosen for comparison between Regular HT delivery with a field width of 2.5 cm (Reg 2.5) and 5.0 cm (Reg 5.0) and DJDC delivery with a maximum field width of 5.0 cm (DJDC 5.0): Hemithoracic Irradiation, Whole Abdominal Irradiation (WAI) and Total Marrow Irradiation (TMI). For each setting, five CT data sets were chosen, and target coverage, conformity, integral dose, dose exposure of organs at risk (OAR) and treatment time were calculated. Both Reg 5.0 and DJDC 5.0 achieved a substantial reduction in treatment time while maintaining similar dose coverage. Treatment time could be reduced from 10:57 min to 3:42 min / 5:10 min (Reg 5.0 / DJDC 5.0) for Hemithoracic Irradiation, from 18:03 min to 8:02 min / 8:03 min for WAI and to 18:25 min / 18:03 min for TMI. In Hemithoracic Irradiation, OAR exposure was identical in all modalities. For WAI, Reg 2.5 resulted in lower exposure of liver and bone. DJDC plans showed a small but significant increase of ∼ 1 Gy to the kidneys, the parotid glans and the thyroid gland. While Reg 5.0 and DJDC were identical in terms of OAR exposure, integral dose was substantially lower with DJDC, caused by a smaller dose penumbra. Although not clinically available yet, next generation DJDC HT technique is efficient in improving the treatment time while maintaining comparable plan quality

  10. Accelerated large volume irradiation with dynamic Jaw/Dynamic Couch Helical Tomotherapy

    Krause Sonja

    2012-11-01

    Full Text Available Abstract Background Helical Tomotherapy (HT has unique capacities for the radiotherapy of large and complicated target volumes. Next generation Dynamic Jaw/Dynamic Couch HT delivery promises faster treatments and reduced exposure of organs at risk due to a reduced dose penumbra. Methods Three challenging clinical situations were chosen for comparison between Regular HT delivery with a field width of 2.5 cm (Reg 2.5 and 5.0 cm (Reg 5.0 and DJDC delivery with a maximum field width of 5.0 cm (DJDC 5.0: Hemithoracic Irradiation, Whole Abdominal Irradiation (WAI and Total Marrow Irradiation (TMI. For each setting, five CT data sets were chosen, and target coverage, conformity, integral dose, dose exposure of organs at risk (OAR and treatment time were calculated. Results Both Reg 5.0 and DJDC 5.0 achieved a substantial reduction in treatment time while maintaining similar dose coverage. Treatment time could be reduced from 10:57 min to 3:42 min / 5:10 min (Reg 5.0 / DJDC 5.0 for Hemithoracic Irradiation, from 18:03 min to 8:02 min / 8:03 min for WAI and to 18:25 min / 18:03 min for TMI. In Hemithoracic Irradiation, OAR exposure was identical in all modalities. For WAI, Reg 2.5 resulted in lower exposure of liver and bone. DJDC plans showed a small but significant increase of ∼ 1 Gy to the kidneys, the parotid glans and the thyroid gland. While Reg 5.0 and DJDC were identical in terms of OAR exposure, integral dose was substantially lower with DJDC, caused by a smaller dose penumbra. Conclusions Although not clinically available yet, next generation DJDC HT technique is efficient in improving the treatment time while maintaining comparable plan quality.

  11. CLINICAL STUDY IN ACCELERATED HYPERFRACTIONATED IRRADIATION IN THE TREATMENT OF LOCAL ADVANCED NON-SMALL CELL LUNG CANCER

    姚原; 吴国华; 陆冬青; 蒋马伟; 邬国琴; 翁霞

    2001-01-01

    Objective To evaluate the effect of accelerated hyperfractionated irradiation ( AHFI ) and conventional fractionated irradiation (CFI) for local advanced non-small cell lung cancer (NSCLC). Methods The patients of AHFI group were irradiated to large-field target volume by a daily fraction of 2Gy , and small-field target volume by a daily fraction of 1Gy with more than 6h interval. The total dose of largefield target volume was 50Gy /25Fx/5W and of small-field target volume was 75Gy /50Fx/5W. The patients in CFI group were irradiated by a daily fraction of 2Gy to the total dose of 66Gy /33Fx/6. 6W. After 3 months of radiotherapy, the tumor response rates of complete recovery ( CR ), partial recovery ( PR ), and no change ( NC ) and 1- and 2- year survival rate in the two groups were observed. Results The tumor response rates of CR, PR, NC in AHFI group and CFI group were 22.9% (8/35), 60.0% (21/35), 17.1% (6/35) and 11.4% (4/35), 51.4% (18/35), 37.2% (13/35) respectively (P>0.05). All patients were followed up 2 years or more. The 1- and 2- year survival rates in AHFI group and CFI group were 62.9% (22/35 ), 31.4 % ( 11/35) and 42.9% (15/35) , 17.1% (6/35) respectively (P0.05). Conclusion In comparison with CFI, AHFI may increase 1- and 2- year survival rate after treatment of local advanced non-small cell lung cancer, while the radio-reactions, either early or late, did not increase significantly.

  12. Polyurethanes irradiation by accelerated electrons: molecular and supramolecular evolution, incidence on the extractable and biomedical implications

    Face to the development of radiosterilization and polymers medical devices it was wished to study the behavior of polyurethanes under accelerated electrons in oxidizing atmosphere. This study has been made to reveal the physico chemical and organisational modifications of polyurethanes for a medical use. (N.C.)

  13. Ion irradiation studies of construction materials for high-power accelerators

    Mustafin, E.; Seidl, T.; Plotnikov, A.; Strašík, I.; Pavlovič, M.; Miglierini, M.; Stanček, S.; Fertman, A.; Lančok, Adriana

    2009-01-01

    Roč. 164, 7-8 (2009), s. 460-469. ISSN 1042-0150 R&D Projects: GA AV ČR KAN400100653 Institutional research plan: CEZ:AV0Z40320502 Keywords : particle accelerator * activation * metallic glasses Subject RIV: CA - Inorganic Chemistry Impact factor: 0.550, year: 2009

  14. Laser irradiations of advanced targets promoting absorption resonance for ion acceleration in TNSA regime

    Torrisi, L.; Calcagno, L.; Giulietti, D.; Cutroneo, Mariapompea; Zimbone, M.; Skála, Jiří

    2015-01-01

    Roč. 355, JUL (2015), s. 221-226. ISSN 0168-583X Institutional support: RVO:68378271 ; RVO:61389005 Keywords : "p"-polarization * laser -generated plasma * TNSA regtime * ion acceleration in plasma Subject RIV: BG - Nuclear, Atomic and Molecular Physics , Colliders; BH - Optics, Masers, Laser s (FZU-D) Impact factor: 1.124, year: 2014

  15. Experimental destruction of Ascarid ova in sewage sludge by accelerated electron irradiation

    Horak, Petr (Charles Univ., Prague (Czech Republic). Dept. of Parasitology)

    1994-04-01

    Aerobically-treated sewage sludge containing eggs of the nematode Ascaris suum was processed using accelerated electrons. After 8 weeks of incubation the morphological and developmental status of eggs was determined. Inhibition of development and the destruction of nematode embryos within eggs were observed at doses over 1.1 kGy. (author).

  16. Experimental destruction of Ascarid ova in sewage sludge by accelerated electron irradiation

    Aerobically-treated sewage sludge containing eggs of the nematode Ascaris suum was processed using accelerated electrons. After 8 weeks of incubation the morphological and developmental status of eggs was determined. Inhibition of development and the destruction of nematode embryos within eggs were observed at doses over 1.1 kGy. (author)

  17. Total body irradiation with a four-field technique using a 10 MV linear accelerator

    Recently, total body irradiation (TBI) is being used as a method of preparation for bone marrow transplantation (BMT). However, many variations exist in the TBI procedure, such as the irradiation technique, total dose, dose rate and dose fractionation. In TBI treatment, it is important to apply a homogeneous dose to the total body, and avoid interstitial pneumonitis and cataracta. Therefore, we applied a four-field technique using 10 MV X-rays with a shield for lungs and eyeballs, and employed tissue compensators and bolus to obtain a homogeneous dose distribution. The midpoint doses in 12 positions of the total body have been achieved within ±10% of that of the pelvis with the use of this technique. Also, this TBI technique is capable of accurately controlling absorbed doses to the lungs and eyes. (author)

  18. Cytosteatonecrosis after breast accelerated conformational partial irradiation at 40 Gy in 10 fractions a week: multicentre prospective study; Cytosteatonecrose apres irradiation partielle acceleree conformationnelle du sein a 40 Gy en 10 fractions par semaine: etude prospective multicentrique

    Levy, A.; Bourgier, C. [Institut Gustave-Roussy, Villejuif (France); Taghian, A.; Ancukiewicz, M.; MacDonald, S.; Smith, B. [Massachusetts General Hospital, Boston MA (United States); Hirsch, A.; Kachnic, L. [Boston Medical Center, Boston MA (United States); Recht, A. [Beth Israel Deaconess Medical Center, Boston MA (United States)

    2011-10-15

    Conformational accelerated partial irradiation is always more often used but the optimal dose is not yet known. Therefore, the authors report an assessment of the cytosteatonecrosis rate within a multicentre prospective study which delivered 40 Gy over 5 days. They analyse and comment the results obtained on a range of more than 150 women treated for breast cancer. Results are discussed in terms of age, tumour size. The method resulted in an acceptable cytosteatonecrosis rate in comparison with other accelerated partial irradiation. But a more precise assessment of the toxicity rate requires further investigations. Short communication

  19. Structural changes in ultra-high molecular weight polyethylene after irradiation with accelerated electrons

    Synková, Hana; Šlouf, Miroslav; Baldrian, Josef; Sikora, Antonín; Kovářová, Jana; Stephan, M.

    Paris: International Union of Pure and Applied Chemistry, 2004, 5.3.5. [IUPAC International Symposium on Macromolecules, World Polymer Congress MACRO /40./. Paris (FR), 04.07.2004-09.07.2004] R&D Projects: GA ČR GA106/04/1118 Institutional research plan: CEZ:AV0Z4050913 Keywords : ultrahigh molecular weight polyethylene * irradiation * supramolecular structure Subject RIV: CD - Macromolecular Chemistry http://www.e-polymers.org/paris/data/L2387.pdf

  20. Irradiation studies at Los Alamos Neutron Science Center supporting the Accelerator Production of Tritium project

    Recognizing the need for definitive mechanical and physical property data supporting design work, the APT project sponsored an aggressive irradiation program at the beam stop area at the Los Alamos Neutron Science Center (LANSCE). The LANSCE beam energy is 800 MeV with a current of 2 mA. By focusing the beam, a proton flux prototype to that expected at APT was achieved. The initial irradiations focused on radiation damage effects on the mechanical and physical properties of materials selected for structural components and neutron-producing target elements. The irradiations also included models of the Pb-Al blanket module and capsules that served as models of the He gas containment system. The program was extended to include measurement of in situ corrosion0related phenomena, decay heat induced by proton bombardment of a W target, and performance of He-gas-handling equipment. These later measurements also were effective in developing instrumentation applicable to the surveillance of an operating plant. Results from these studies are becoming available and are summarized here

  1. Economics of electron accelerators in the preservation of food by irradiation

    Since the last IAEA Symposium on Food Preservation in 1972 work on both the reliability and power level of electron beam accelerators has continued. As a result of this continued development effort, electron beam equipment is now available that can process large quantities of foodstuffs at relatively low unit costs. The combination of higher power and therefore lower-cost radiation devices in conjunction with the increasing cost of energy consumed in one manner or another in the production, distribution and storage of foodstuffs has brought about a significant improvement in the economic feasibility of radiation processing foods. The paper outlines five case studies using electron beam accelerators. Two of the five cases employ X-rays, while the other three use the electron output directly. In all instances it is evident that the economics of electron preservation of food is well within the realm of practical utility. (author)

  2. Economics of Electron Accelerators in the Preservation of Food by Irradiation

    Since the last IAEA Symposium on Food Preservation in 1972 work on both the reliability and power level of electron beam accelerators has continued. As a result of this continued development effort, electron beam equipment is now available that can process large quantities of foodstuffs at relatively low unit costs. The combination of higher power and therefore lower-cost radiation devices in conjunction with the increasing cost of energy consumed in one manner or another in the production, distribution and storage of foodstuffs has brought about a significant improvement in the economic feasibility of radiation processing foods. The paper outlines five case studies using electron beam accelerators. Two of the five cases employ X-rays, while the other three use the electron output directly. In all instances it is evident that the economics of electron preservation of food is well within the realm of practical utility. (author)

  3. Irradiated shocks in the W28 A2 massive star-forming region: a site for cosmic rays acceleration?

    Gusdorf, A; Gerin, M; Guesten, R

    2015-01-01

    The formation of massive stars play a crucial role in galaxies from numerous points of view. The protostar generates a strong ultraviolet radiation field that ionizes its surroundings, and it drives powerful shock waves in the neighbouring medium in the form of jets and bipolar outflows, whose structure can be partially organized by local, strong magnetic field. Such an ejection activity locally modifies the interstellar chemistry, contributing to the cycle of matter. It also significantly participates to the energetic balance of galaxies. In the latter stages of massive star formation, the protostar is surrounded by an ultra-compact HII region, and irradiates its bipolar outflows, where an intrinsically strong magnetic field structure is associated to the generally high densities. In the HII region, or in the bipolar outflows, the question of in situ cosmic rays acceleration can then be raised by the simultaneous presence of strong magnetic fields, significant ionization of the matter, and mechanical energy ...

  4. Novel Ways of Heat Removal from Highly Irradiated Superconducting Windings in Accelerator Magnets

    Bielert, Erwin R.; Verweij, Arjan P.; Kate, ten, Herman H.J.

    2012-01-01

    Novel ideas of heat removal from superconducting windings in accelerator type magnets are investigated with the help of a recently developed and validated thermal model of a magnet cold mass implemented in COMSOL Multiphysics. Here the focus is on how to improve heat removal from the midplane of a superconducting quadrupole magnet, the area exposed to the highest radiation heat load. In addition, this part of the coil windings has the longest thermal path towards the heat sink and several the...

  5. Combined modality treatment of the rhabdomyosarcoma R1H of the rat: tumor and normal tissue response after cisplatin and conventional or accelerated irradiation treatment

    Purpose: To test the importance of the sequence of cisplatin and irradiation, either conventional or accelerated fractionated. Methods and Materials: 30 fractions of 2 Gy were given in 6 or 3 weeks preceded or followed by (time interval between cisplatin and radiotherapy: 3 days) a single IP dose of 5 mg/kg cisplatin in the rhabdomyosarcoma R1H of the rat. Survival curves were generated, and comparisons were made by the log-rank test. Results: After 60 Gy in 6 weeks, no local tumor controls were observed. If cisplatin was injected 3 days before start of 60 Gy/6 weeks, 11 ± 10% (mean ± SE) of the tumors were controlled. Cisplatin after radiotherapy resulted in 50 ± 14% local controls. The difference was significant (p 0.01) for cisplatin after radiotherapy in comparison to radiotherapy alone where no local controls were observed. After accelerated fractionation, 57 ± 19% of the animals were cured with or without cisplatin before radiotherapy. If the drug was injected after end of 60 Gy/3 weeks, 86 ± 13% survived recurrence free. The difference to accelerated radiotherapy alone was not significant. Accelerated radiotherapy produced significantly higher control rates than conventional radiotherapy (p < 0.001). Conclusions: Accelerated radiotherapy resulted in higher local tumor control rates as compared to conventional fractionated irradiation. Cisplatin combined with radiotherapy showed significantly better results if given after but not before irradiation, either conventional or accelerated fractionated

  6. Relative biological effectiveness in canine osteosarcoma cells irradiated with accelerated charged particles

    Maeda, Junko; Cartwright, Ian M.; Haskins, Jeremy S.; Fujii, Yoshihiro; Fujisawa, Hiroshi; Hirakawa, Hirokazu; Uesaka, Mitsuru; Kitamura, Hisashi; Fujimori, Akira; Thamm, Douglas H.; Kato, Takamitsu A.

    2016-01-01

    Heavy ions, characterized by high linear energy transfer (LET) radiation, have advantages compared with low LET protons and photons in their biological effects. The application of heavy ions within veterinary clinics requires additional background information to determine heavy ion efficacy. In the present study, comparison of the cell-killing effects of photons, protons and heavy ions was investigated in canine osteosarcoma (OSA) cells in vitro. A total of four canine OSA cell lines with various radiosensitivities were irradiated with 137Cs gamma-rays, monoenergetic proton beams, 50 keV/µm carbon ion spread out Bragg peak beams and 200 keV/µm iron ion monoenergetic beams. Clonogenic survival was examined using colony-forming as says, and relative biological effectiveness (RBE) values were calculated relative to gamma-rays using the D10 value, which is determined as the dose (Gy) resulting in 10% survival. For proton irradiation, the RBE values for all four cell lines were 1.0–1.1. For all four cell lines, exposure to carbon ions yielded a decreased cell survival compared with gamma-rays, with the RBE values ranging from 1.56–2.10. Iron ions yielded the lowest cell survival among tested radiation types, with RBE values ranging from 3.51–3.69 observed in the three radioresistant cell lines. The radiosensitive cell line investigated demonstrated similar cell survival for carbon and iron ion irradiation. The results of the present study suggest that heavy ions are more effective for killing radioresistant canine OSA cells when compared with gamma-rays and protons. This markedly increased efficiency of cell killing is an attractive reason for utilizing heavy ions for radioresistant canine OSA. PMID:27446477

  7. Double use of focused microwave irradiation for accelerated matrix hydrolysis and lipid extraction in milk samples

    Irradiation with microwave energy has allowed to carry out the extraction of lipids from milk samples (namely, cow, goat and sheep) with quantitative results similar to the Weibull–Berntrop extraction procedure but milk fat obtained by microwave assisted extraction undergoes lesser chemical transformation of triglycerides during the whole process. A considerable reduction of the procedure time (50 min versus 10 h) is achieved with similar reproducibility to that provided by the conventional method. An in situ’ solvent recycling step makes the method environmentally clean

  8. Accelerated repopulation of mouse tongue epithelium during fractionated irradiations or following single doses

    Mouse tongue mucosa was established as an animal model to study repopulation after large single doses or during continuous irradiation. A top-up irradiation technique was used employing priming doses or fractionated treatment to the whole snout (300 kV X-rays) followed by local test doses (25 kV X-rays) to elicit denudation in a confined field of the inferior tongue surface. Clearcut quantal dose-response curves of ulcer incidence were obtained to all protocols; animal morbidity, i.e. body weight loss was minimal. Repopulation following priming doses of 10 and 13 Gy started with a delay of at least 3 days and then progressed rapidly to nearly restore original tissue tolerance by day 11. During continuous fractionation over 1 to 3 weeks with 5 fractions/week and doses per fraction of 2.5, 3 and 3.5 Gy, repopulation was small in week one but subsequently increased to fully compensate the weekly dose at all dose levels. Additional measurements of cell density during a 4 weeks course of 5 x 3 Gy or 5 x 4 Gy per week showed only moderate depletion to 67% of the control figures. The fact that rapid repopulation is achieved at relatively moderate damage levels should be taken into account when the timing of a treatment split is considered. (author). 18 refs.; 7 figs.; 1 tab

  9. FAFNIR: Strategy and risk reduction in accelerator driven neutron sources for fusion materials irradiation data

    Surrey, E; Caballero, A; Davenne, T; Findlay, D; Letchford, A; Thomason, J; Marrow, J; Roberts, S; Seryi, A; Connolly, B; Mummery, P; Owen, H

    2014-01-01

    The need to populate the fusion materials engineering data base has long been recognized, the IFMIF facility being the present proposed neutron source for this purpose. Re-evaluation of the regulatory approach for the EU proposed DEMO device shows that the specification of the neutron source can be reduced with respect to IFMIF, allowing lower risk technology solutions to be considered. The justification for this approach is presented and a description of a proposed facility, FAFNIR, is presented with more detailed discussion of the accelerator and target designs.

  10. Ion acceleration with a narrow energy spectrum by nanosecond laser-irradiation of solid target

    Altana, C., E-mail: altana@lns.infn.it [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Via S. Sofia 62, 95123 Catania (Italy); Dipartimento di Fisica e Astronomia, Università degli Studi di Catania, Via S. Sofia 64, 95123 Catania (Italy); Lanzalone, G. [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Via S. Sofia 62, 95123 Catania (Italy); Università degli Studi di Enna “Kore,” Via delle Olimpiadi, 94100 Enna (Italy); Mascali, D.; Cirrone, G. A. P.; Schillaci, F.; Tudisco, S. [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Via S. Sofia 62, 95123 Catania (Italy); Muoio, A. [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Via S. Sofia 62, 95123 Catania (Italy); Dipartimento di Fisica e Scienze della Terra, Università degli Studi di Messina, Viale F. D’Alcontres 31, 98166 Messina (Italy)

    2016-02-15

    In laser-driven plasma, ion acceleration of aluminum with the production of a quasi-monoenergetic beam has occurred. A useful device to analyze the ions is the Thomson parabolas spectrometer, a well-known diagnostic that is able to obtain information on charge-to-mass ratio and energy distribution of the charged particles. At the LENS (Laser Energy for Nuclear Science) laboratory of INFN-LNS in Catania, experimental measures were carried out; the features of LENS are: Q-switched Nd:YAG laser with 2 J laser energy, 1064 nm fundamental wavelengths, and 6 ns pulse duration.

  11. Hybrid ion acceleration with ultrathin composite foils irradiated by high intensity circularly-polarized laser light

    A complete analytical description of ion acceleration in the laser radiation-pressure regime is presented. The combined effects of hot electron and light-pressure phenomena are used to qualitatively and quantitatively describe most recent experimental results in this regime. An essential part of the developed model is exhibited in the calculation of nonlinear laser light reflection and transmission properties, as well as in the spectral characterization of the laser light after interaction. The validity of the analytical model is supported by recent experimental results and by particle-in-cell simulations.

  12. A simple and accurate measurement method of current density of an electron accelerator for irradiation

    For simple and accurate measurement of the current distribution in a broad beam from electron accelerators, a method for detecting the charge absorbed in a graphite target exposed to the air has been examined. The present report means to solve several fundamental problems. The effective incidence area of the absorber is strictly defined by the design of the geometrical arrangement of the absorber assembly. Electron backscattering from the absorber is corrected with backscattering coefficients in consideration of oblique incidence on the absorber. The influence of ionic charge produced in air is ascribed to the contact potential between the absorber and the guard, and correction methods are proposed. (orig.)

  13. Ion acceleration with a narrow energy spectrum by nanosecond laser-irradiation of solid target

    In laser-driven plasma, ion acceleration of aluminum with the production of a quasi-monoenergetic beam has occurred. A useful device to analyze the ions is the Thomson parabolas spectrometer, a well-known diagnostic that is able to obtain information on charge-to-mass ratio and energy distribution of the charged particles. At the LENS (Laser Energy for Nuclear Science) laboratory of INFN-LNS in Catania, experimental measures were carried out; the features of LENS are: Q-switched Nd:YAG laser with 2 J laser energy, 1064 nm fundamental wavelengths, and 6 ns pulse duration

  14. Ion acceleration in shell cylinders irradiated by a short intense laser pulse

    The interaction of a short high intensity laser pulse with homo and heterogeneous shell cylinders has been analyzed using particle-in-cell simulations and analytical modeling. We show that the shell cylinder is proficient of accelerating and focusing ions in a narrow region. In the case of shell cylinder, the ion energy exceeds the ion energy for a flat target of the same thickness. The constructed model enables the evaluation of the ion energy and the number of ions in the focusing region

  15. Monte Carlo model of the female RANDO phantom irradiation with an Elekta Precise linear accelerator

    Anthropomorphic laboratory phantoms are a very useful aid in radiotherapy treatment planning. Such phantoms allow estimating detailed mapping of dose distribution. The phantom utilized in this work is the female RANDO Phantom, which represents a 163 cm tall and 54 kg figure that does not have arms or legs. It is constructed with a natural human skeleton which is cast inside soft tissue-simulating material and lung-simulating material. A set of computer tomography images of the RANDO Phantom was obtained and segmented. Once the slices were segmented and the pixel intensities related with the phantom materials, they were input to a Matlab algorithm developed by the authors and validated in previous works, which uses the CT slices to build up a three-dimensional numerical voxelized phantom by pixel and material identification, and writes it in the MCNP5 input deck format utilizing the lattice card, together with an MCNP5 model for the Elekta Precise Linear Accelerator. The Linear Accelerator model has also been also validated in previous works. The simulation results in mapping of dose distribution inside the phantom, utilizing the MCNP5 tool FMESH, superimposed mesh tally, which allows registering the results over the problem geometry.

  16. Strategy Selection of Film Irradiation by Accelerated ^{40}Ar^{8+} Ions for Manufacturing of Track Membranes

    Denisov, Yu N; Kalinichenko, V V; Karamysheva, G A; Fedorenko, S B

    2004-01-01

    The industrial cyclotron CYTRACK is dedicated to the production of the track membranes. It is the basic instrument for the industry of membrane products to be consumed in medicine, biotechnology, pharmacology, microelectronics and many other industries. The cyclotron CYTRACK started working in the August of 2002. Argon ions were accelerated to a project energy of 2.4 MeV/nucleon, the extracted beam intensity was about 200 nA, the extraction efficiency totaled \\sim 50 %. In starting up operation the film was exposed in various controlled ways to charged particles with a view to achieving the values of parameters required for production of "Rosa" membranous plasmafilters. The pore uniformity in transverse direction was provided by beam scanning with a scanning magnet voltage of 73 V, the one in the longitudinal direction was provided by constancy of the film motion rate and stability of beam intensity during all the time of exposition.

  17. Proton driven acceleration by intense laser pulses irradiating thin hydrogenated targets

    Torrisi, L.; Cutroneo, M.; Cavallaro, S.; Giuffrida, L.; Andò, L.; Cirrone, P.; Bertuccio, G.; Puglisi, D.; Calcagno, L.; Verona, C.; Picciotto, A.; Krása, Josef; Margarone, Daniele; Velyhan, Andriy; Láska, Leoš; Krouský, Eduard; Pfeifer, Miroslav; Skála, Jiří; Ullschmied, Jiří; Wolowski, J.; Badziak, J.; Rosinski, M.; Ryc, L.; Szydlowski, A.

    2013-01-01

    Roč. 272, May (2013), s. 2-5. ISSN 0169-4332 R&D Projects: GA MŠk ED1.1.00/02.0061; GA MŠk EE2.3.20.0279; GA MŠk EE.2.3.20.0087; GA MŠk(CZ) 7E09092; GA MŠk(CZ) LC528 Grant ostatní: ELI Beamlines(XE) CZ.1.05/1.1.00/02.0061; OPVK 3 Laser Zdroj(XE) CZ.1.07/2.3.00/20.0279; OP VK 2 LaserGen(XE) CZ.1.07/2.3.00/20.0087; 7FP LASERLAB-EUROPE(XE) 228334 Institutional support: RVO:68378271 Keywords : laser-matter-interaction * plasma * proton-acceleration * hydrogenated-target Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 2.538, year: 2013

  18. Field ionization effects on ion acceleration in laser-irradiated clusters

    Field ionization is included in our two-dimensional particle-in-cell simulations of femtosecond laser pulse interactions with submicron water clusters. Though laser field does not penetrate into the interior of submicron clusters, field ionization is shown to be efficient there due to the electric fields induced by quasineutrality violation due to expelled electrons by laser wave together with hot electron bunches which cross the cluster in the next half-period of the laser. Thus, oxygen atoms are ionized up to Z≥6 in the whole submicron cluster by 40 fs laser pulses of amplitude a0≥0.5. The impact of oxygen ion charge state on the spectrum of accelerated protons is shown and comparison of the spectrum with simulations with fixed ion charge states is presented.

  19. Development of dual-beam system using an electrostatic accelerator for in-situ observation of swift heavy ion irradiation effects on materials

    Matsuda, M.; Asozu, T.; Sataka, M.; Iwase, A.

    2013-11-01

    We have developed the dual beam system which accelerates two kinds of ion beams simultaneously especially for real-time ion beam analysis. We have also developed the alternating beam system which can efficiently change beam species in a short time in order to realize efficient ion beam analysis in a limited beam time. The acceleration of the dual beam is performed by the 20 UR Pelletron™ tandem accelerator in which an ECR ion source is mounted at the high voltage terminal [1,2]. The multi-charged ions of two or more elements can be simultaneously generated from the ECR ion source, so dual-beam irradiation is achieved by accelerating ions with the same charge to mass ratio (for example, 132Xe11+ and 12C+). It enables us to make a real-time beam analysis such as Rutherford Back Scattering (RBS) method, while a target is irradiated with swift heavy ions. For the quick change of the accelerating ion beam, the program of automatic setting of the optical parameter of the accelerator has been developed. The switchover time for changing the ion beam is about 5 min. These developments have been applied to the study on the ion beam mixing caused by high-density electronic excitation induced by swift heavy ions.

  20. Technique and dosimetry for total body irradiation with an 8-MV linear accelerator

    The aim of the study was to develop a method for calculation of the absorbed dose at an arbitrary point in the patient (adults and children). The method should be accurate but simple to use in clinical routine and it should as far as possible follow the recommendations by ICRU for conventional radiotherapy. An 8-MV linear accelerator is used with a diamond-shaped field and an isocentric technique at a focus-axis distance of 430 cm. The dose rate in an arbitrary point in the patient is calculated from the absorbed dose rate in dose maximum for a phantom size of 30 x 30 x 30 cm3 in the TBI field, an inverse square law factor, the tissue-maximum ratio, an equivalent field size correction factor determined from the patient contour using the Clarkson method, a factor correcting for lack of backscattering material, an off-axis output correction factor, and a factor that corrects for off-axis variations in effective photon beam energy and for oblique beam penetration of the patient. A personal computer is used for the dose calculations. The formula was tested with TLD measurements in a RT Humanoid (adult) phantom and in a Pedo-RT Humanoid (child) phantom. In vivo dose measurements are also presented

  1. Co-targeting Deoxyribonucleic Acid–Dependent Protein Kinase and Poly(Adenosine Diphosphate-Ribose) Polymerase-1 Promotes Accelerated Senescence of Irradiated Cancer Cells

    Azad, Arun, E-mail: arun.azad@bccancer.bc.ca [Division of Cancer Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Department of Pathology, St. Vincent' s Hospital, University of Melbourne, Parkville, Victoria (Australia); Bukczynska, Patricia; Jackson, Susan [Division of Cancer Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Haput, Ygal; Cullinane, Carleen [Division of Cancer Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria (Australia); McArthur, Grant A.; Solomon, Benjamin [Division of Cancer Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Division of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Department of Medicine, St. Vincent' s Hospital, University of Melbourne, Parkville, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria (Australia)

    2014-02-01

    Purpose: To examine the effects of combined blockade of DNA-dependent protein kinase (DNA-PK) and poly(adenosine diphosphate-ribose) polymerase-1 (PARP-1) on accelerated senescence in irradiated H460 and A549 non-small cell lung cancer cells. Methods and Materials: The effects of KU5788 and AG014699 (inhibitors of DNA-PK and PARP-1, respectively) on clonogenic survival, DNA double-strand breaks (DSBs), apoptosis, mitotic catastrophe, and accelerated senescence in irradiated cells were examined in vitro. For in vivo experiments, H460 xenografts established in athymic nude mice were treated with BEZ235 (a DNA-PK, ATM, and phosphatidylinositol 3-kinase/mammalian target of rapamycin inhibitor) and AG014699 to determine effects on proliferation, DNA DSBs, and accelerated senescence after radiation. Results: Compared with either inhibitor alone, combination treatment with KU57788 and AG014699 reduced postradiation clonogenic survival and significantly increased persistence of Gamma-H2AX (γH2AX) foci in irradiated H460 and A549 cells. Notably, these effects coincided with the induction of accelerated senescence in irradiated cells as reflected by positive β-galactosidase staining, G2-M cell-cycle arrest, enlarged and flattened cellular morphology, increased p21 expression, and senescence-associated cytokine secretion. In irradiated H460 xenografts, concurrent therapy with BEZ235 and AG014699 resulted in sustained Gamma-H2AX (γH2AX) staining and prominent β-galactosidase activity. Conclusion: Combined DNA-PK and PARP-1 blockade increased tumor cell radiosensitivity and enhanced the prosenescent properties of ionizing radiation in vitro and in vivo. These data provide a rationale for further preclinical and clinical testing of this therapeutic combination.

  2. Shielding design of a treatment room for an accelerator-based epithermal neutron irradiation facility for BNCT

    Protecting the facility personnel and the general public from radiation exposure is a primary safety concern of an accelerator-based epithermal neutron irradiation facility. This work makes an attempt at answering the questions open-quotes How much?close quotes and open-quotes What kind?close quotes of shielding will meet the occupational limits of such a facility. Shielding effectiveness is compared for ordinary and barytes concretes in combination with and without borated polyethylene. A calculational model was developed of a treatment room, patient open-quotes scatterer,close quotes and the epithermal neutron beam. The Monte Carlo code, MCNP, was used to compute the total effective dose equivalent rates at specific points of interest outside of the treatment room. A conservative occupational effective dose rate limit of 0.01 mSv h-1 was the guideline for this study. Conservative Monte Carlo calculations show that constructing the treatment room walls with 1.5 m of ordinary concrete, 1.2 m of barytes concrete, 1.0 m of ordinary concrete preceded by 10 cm of 5% boron-polyethylene, or 0.8 m of barytes concrete preceded by 10 cm of 5% boron-polyethylene will adequately protect facility personnel. 20 refs., 8 figs., 2 tabs

  3. Application of accelerated evaluation method of alteration temperature and constant dose rate irradiation on bipolar linear regulator LM317

    With different irradiation methods including high dose rate irradiation, low dose rate irradiation, alteration temperature and constant dose rate irradiation, and US military standard constant high temperature and constant dose rate irradiation, the ionizing radiation responses of bipolar linear regulator LM317 from three different companies were investigated under the operating and zero biases. The results show that compared with constant high temperature and constant dose rate irradiation method, the alteration temperature and constant dose rate irradiation method can not only very rapidly and accurately evaluate the dose rate effect of three bipolar linear regulators, but also well simulate the damage of low dose rate irradiation. Experiment results make the alteration temperature and constant dose rate irradiation method successfully apply to bipolar linear regulator. (authors)

  4. Intraoperative radiation therapy using a mobile electron linear accelerator: field matching for large-field electron irradiation

    Intraoperative radiation therapy (IORT) consists of delivering a large, single-fraction dose of radiation to a surgically exposed tumour or tumour bed at the time of surgery. With the availability of a mobile linear accelerator in the OR, IORT procedures have become more feasible for medical centres and more accessible to cancer patients. Often the area requiring irradiation is larger than what the treatment applicators will allow, and therefore, two or more adjoining fields are used. Unfortunately, the divergence and scattering of the electron beams may cause significant dose variations in the region of the field junction. Furthermore, because IORT treatments are delivered in a large single fraction, the effects of underdosing or overdosing could be more critical when compared to fractionated external beam therapy. Proper matching of the fields is therefore an important technical aspect of treatment delivery. We have studied the matching region using the largest flat applicator available for three different possibilities: abutting the fields, leaving a small gap or creating an overlap. Measurements were done using film dosimetry for the available energies of 4, 6, 9 and 12 MeV. Our results show the presence of clinically significant cold spots for the low-energy beams when the fields are either gapped or abutted, suggesting that the fields should be overlapped. No fields should be gapped. The results suggest that an optimal dose distribution may be obtained by overlapping the fields at 4 and 6 MeV and simply abutting the fields at 9 and 12 MeV. However, due to uncertainties in the placement of lead shields during treatment delivery, one may wish to consider overlapping the higher energy fields as well. (note)

  5. Partial breast irradiation as sole therapy for low risk breast carcinoma: Early toxicity, cosmesis and quality of life results of a MammoSite brachytherapy phase II study

    Purpose: The MammoSite is a device that was developed with the goal of making breast-conserving surgery (BCT) more widely available. Our objective was to evaluate the MammoSite device performances after an open cavity placement procedure and quality of life in highly selected patients with early-stage breast cancer. Methods and materials: From March 2003 to March 2005, 43 patients with T1 breast cancer were enrolled in a phase II study. The median age was 72 years. Twenty-five (58%) patients were treated with high-dose rate brachytherapy using the MammoSite applicator to deliver 34 Gy in 10 fractions. The main disqualifying factor was pathologic sentinel node involvement (10/43; 23%). There were no device malfunctions, migration or rupture of the balloon. Results: After a median follow-up of 13 months, there were no local recurrences and one contralateral lobular carcinoma. Seventeen (68%), 13 (52%), 8 (32%), 5 (20%) and 2 (8%) patients had erythema, seroma, inflammation, hematoma and sever infection, respectively. Only 2 patients developed telangiectasia. At 1 year the rate of 'good to excellent' cosmetic results was 84%. Significant changes in QoL were observed for emotional and social well-being between 3 and 12 months. At 24 months, only emotional well-being subscore changes were statistically significant (p = 0.015). Conclusions: Our data in patients older than 60 years support the previously published data. Histologic features were the main disqualifying criteria. With higher skin spacing levels we observed very low incidence of telangiectasia. QoL evaluation indicates that baseline scores were satisfactory. Changes concerned emotional and social well-being

  6. The affect of erbium hydride on the conversion efficience to accelerated protons from ultra-shsort pulse laser irradiated foils

    Offermann, Dustin Theodore [The Ohio State Univ., Columbus, OH (United States)

    2008-01-01

    This thesis work explores, experimentally, the potential gains in the conversion efficiency from ultra-intense laser light to proton beams using erbium hydride coatings. For years, it has been known that contaminants at the rear surface of an ultra-intense laser irradiated thin foil will be accelerated to multi-MeV. Inertial Confinement Fusion fast ignition using proton beams as the igniter source requires of about 1016 protons with an average energy of about 3MeV. This is far more than the 1012 protons available in the contaminant layer. Target designs must include some form of a hydrogen rich coating that can be made thick enough to support the beam requirements of fast ignition. Work with computer simulations of thin foils suggest the atomic mass of the non-hydrogen atoms in the surface layer has a strong affect on the conversion efficiency to protons. For example, the 167amu erbium atoms will take less energy away from the proton beam than a coating using carbon with a mass of 12amu. A pure hydrogen coating would be ideal, but technologically is not feasible at this time. In the experiments performed for my thesis, ErH3 coatings on 5 μm gold foils are compared with typical contaminants which are approximately equivalent to CH1.7. It will be shown that there was a factor of 1.25 ± 0.19 improvement in the conversion efficiency for protons above 3MeV using erbium hydride using the Callisto laser. Callisto is a 10J per pulse, 800nm wavelength laser with a pulse duration of 200fs and can be focused to a peak intensity of about 5 x 1019W/cm2. The total number of protons from either target type was on the order of 1010. Furthermore, the same experiment was performed on the Titan laser, which has a 500fs pulse duration, 150J of energy and can be focused to about 3 x 1020 W/cm2. In this experiment 1012 protons were seen from both erbium hydride and

  7. High power pulsed/microwave technologies for electron accelerators vis a vis 10MeV, 10kW electron LINAC for food irradiation at CAT

    Use of electron accelerators for irradiation of food items is gathering momentum in India. The various technologies for powering the electron LINAC were needed to be developed in the country due to embargo situations as well as reservations of the developers worldwide to share the information related to this development. Centre for Advanced Technology, CAT, Indore, is engaged in the development of particle accelerators for medical industrial and scientific applications. Amongst other electron accelerators developed in CAT, a 10MeV, 10kW LINAC for irradiation of food items has been commissioned and tested for full rated 10kW beam power. The high power pulsed microwave driver for the LINAC was designed, developed and commissioned with full indigenous efforts, and is right now operational at CAT. It consists of a 6MW, 25kW S-band pulsed klystron, 15MW peak power pulse modulator system for the klystron, microwave driver amplifier chain, stabilized generator, protection and control electronics, waveguide system to handle the high peak and average power, gun modulator electronics, grid electronics etc. The present paper highlights various technologies like the pulsed power systems and components, microwave circuits and systems etc. Also the performance results of the high power microwave driver for the 10MeV LINAC at CAT are discussed. Future strategies for developing the state of art technologies are highlighted. (author)

  8. Development of picture and voice gated intermittent irradiation system connected without linear accelerator for voluntary breath-hold synchronized with respiration

    In patients with lung cancer of the lower lobes and liver cancer, treatment volume including respiratory motion is an important therapeutic problem. We developed a voluntary breath-hold system using pictures and voice messages so as to reduce the excessive safety margin that covers respiratory motion. The system consists of two sets of monitor and speaker, and a computer and software for control without direct connection to a linear accelerator. When the patient repeatedly holds his or her breath in response to a picture and voice message, irradiation is manually performed and then proceeds intermittently. Although safety problems remain to be solved because of off-line, synchronized irradiation with our system is simple, inexpensive, and could be widely used. It also would be expected to reduce the tumor target volume around the diaphragm. (author)

  9. Application of a 500 keV electron accelerator to the continuous irradiation of liquids, especially waste waters

    Construction of and practical experience with laboratory set-up for low energy electron beam irradiation are described. The liquid can be irradiated usefully in a layer which is at least 5 times thicker than expected according to the penetration of the 500-keV electrons used. This can be explained by the mixing of the fluid caused by turbulent flow during the irradiation. Application of this method has been tested with pure and commercial dyes, a cyanide solution and coloured industrial waste waters. Costs were estimated for an irradiation plant with a capacity of 40 m3 sewage water per hour. From the technical and economical point of view installation of such a plant seems to be feasible. (orig./HP)

  10. A Prospective Pathologic Study to Define the Clinical Target Volume for Partial Breast Radiation Therapy in Women With Early Breast Cancer

    Purpose: To determine an appropriate clinical target volume for partial breast radiation therapy (PBRT) based on the spatial distribution of residual invasive and in situ carcinoma after wide local excision (WLE) for early breast cancer or ductal carcinoma in situ (DCIS). Methods and Materials: We performed a prospective pathologic study of women potentially eligible for PBRT who had re-excision and/or completion mastectomy after WLE for early breast cancer or DCIS. A pathologic assessment protocol was used to determine the maximum radial extension (MRE) of residual carcinoma from the margin of the initial surgical cavity. Women were stratified by the closest initial radial margin width: negative (>1 mm), close (>0 mm and ≤1 mm), or involved. Results: The study population was composed of 133 women with a median age of 59 years (range, 27-82 years) and the following stage groups: 0 (13.5%), I (40.6%), II (38.3%), and III (7.5%). The histologic subtypes of the primary tumor were invasive ductal carcinoma (74.4%), invasive lobular carcinoma (12.0%), and DCIS alone (13.5%). Residual carcinoma was present in the re-excision and completion mastectomy specimens in 55.4%, 14.3%, and 7.2% of women with an involved, close, and negative margin, respectively. In the 77 women with a noninvolved radial margin, the MRE of residual disease, if present, was ≤10 mm in 97.4% (95% confidence interval 91.6-99.5) of cases. Larger MRE measurements were significantly associated with an involved margin (P30 mm (P=.03), premenopausal status (P=.03), and negative progesterone receptor status (P=.05). Conclusions: A clinical target volume margin of 10 mm would encompass microscopic residual disease in >90% of women potentially eligible for PBRT after WLE with noninvolved resection margins.

  11. A Prospective Pathologic Study to Define the Clinical Target Volume for Partial Breast Radiation Therapy in Women With Early Breast Cancer

    Nguyen, Brandon T., E-mail: Brandon.Nguyen@act.gov.au [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Canberra Hospital, Radiation Oncology Department, Garran, ACT (Australia); Deb, Siddhartha [Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Victorian Cancer Biobank, Cancer Council of Victoria, Carlton, Victoria (Australia); Fox, Stephen [Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Hill, Prudence [Department of Anatomical Pathology, St. Vincent' s Hospital Melbourne, Fitzroy, Victoria (Australia); Collins, Marnie [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Chua, Boon H. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia)

    2012-12-01

    Purpose: To determine an appropriate clinical target volume for partial breast radiation therapy (PBRT) based on the spatial distribution of residual invasive and in situ carcinoma after wide local excision (WLE) for early breast cancer or ductal carcinoma in situ (DCIS). Methods and Materials: We performed a prospective pathologic study of women potentially eligible for PBRT who had re-excision and/or completion mastectomy after WLE for early breast cancer or DCIS. A pathologic assessment protocol was used to determine the maximum radial extension (MRE) of residual carcinoma from the margin of the initial surgical cavity. Women were stratified by the closest initial radial margin width: negative (>1 mm), close (>0 mm and {<=}1 mm), or involved. Results: The study population was composed of 133 women with a median age of 59 years (range, 27-82 years) and the following stage groups: 0 (13.5%), I (40.6%), II (38.3%), and III (7.5%). The histologic subtypes of the primary tumor were invasive ductal carcinoma (74.4%), invasive lobular carcinoma (12.0%), and DCIS alone (13.5%). Residual carcinoma was present in the re-excision and completion mastectomy specimens in 55.4%, 14.3%, and 7.2% of women with an involved, close, and negative margin, respectively. In the 77 women with a noninvolved radial margin, the MRE of residual disease, if present, was {<=}10 mm in 97.4% (95% confidence interval 91.6-99.5) of cases. Larger MRE measurements were significantly associated with an involved margin (P<.001), tumor size >30 mm (P=.03), premenopausal status (P=.03), and negative progesterone receptor status (P=.05). Conclusions: A clinical target volume margin of 10 mm would encompass microscopic residual disease in >90% of women potentially eligible for PBRT after WLE with noninvolved resection margins.

  12. Effects of prenatal irradiation with an accelerated heavy-ion beam on postnatal development in rats: II. Further study on neurophysiologic alterations

    Wang, B.; Murakami, M.; Eguchi-Kasai, K.; Nojima, K.; Shang, Y.; Tanaka, K.; Watanabe, K.; Fujita, K.; Moreno, S. G.; Coffigny, H.; Hayata, I.

    Organogenesis is a highly radiosensitive period, study of prenatal exposure to high LET heavy ion beams on postnatal development is important for clarifying the radiation risk in space and promoting the evidence-based mechanism research. The effects from heavy ion irradiations are not well studied as those for low LET radiations such as X-rays in this field, even the ground-based investigations remain to be addressed. Using the Heavy Ion Medical Accelerator in Chiba (HIMAC) and Wistar rats, postnatal neurophysiological development in offspring was investigated following exposure of pregnant rats to accelerated neon-ion beams with a LET value of about 30 keV/μm at a dose range from 0.1 to 2.0 Gy on the 15th day of gestation. The age for appearance of four physiologic markers and attainment of five neonatal reflexes, and gain in body weight were monitored. Male offspring were evaluated as young adults using two behavioral tests including open field and hole-board dipping tests. The effects of X-rays at 200 kVp measured for the same biological end points were studied for comparison. For most of the endpoints at early age, significant neurophysiological alteration was observed even in offspring receiving 0.1 Gy of accelerated neon ions but not X-rays. All offspring receiving 2.0 Gy of accelerated neon ions died prior to weaning. Offspring prenatally irradiated with neon ions generally showed higher incidences of prenatal death, increased preweaning mortality, markedly delayed accomplishment in physiological markers and reflexes, significantly lower body weight and reduced ratios of main organ weight to body weight, and altered behavior compared to those exposed to X-rays at doses of 0.1 1.5 Gy. These findings indicate that irradiations with neon ions at 0.1 1.5 Gy on day 15 of gestation caused varied developmental alterations in offspring, and efficient dose leading to the detrimental effects seemed to be lower than that of X-rays.

  13. The regularities of the induction and reparation of DNA double strand breaks in human lymphocytes after irradiation with accelerated heavy ions of different energy

    The regularities of the induction of DNA double strand breaks (DSB) in human lymphocytes after irradiation with different doses of accelerated lithium and carbon ions (33 and 480 MeV/nucleon, LET = 20 and 10.2 keV/μm, respectively) and γ-rays 60Co by using comet assay were investigated. It was shown that dependence of DSB formation increases linearly with growing of the dose of lithium and carbon ions and γ-rays. The biological effectiveness of carbon ions with high energy was similar to γ-rays, lithium ions possess greater biological effectiveness in comparison with γ-rays and value of RBE of lithium ions amount to 1.6±0.1. The kinetics of DSB reparation in human lymphocytes after irradiation with lithium and carbon ions and γ-rays was studied. It is revealed that the reparation proceeds effectively with heavy-ion and γ-ray irradiation by exponential kinetics

  14. Polyurethanes irradiation by accelerated electrons: molecular and supramolecular evolution, incidence on the extractable and biomedical implications; Irradiation de polyurethannes par electrons acceleres: evolution moleculaire et supramoleculaire, incidence sur les extractibles et implications biomedicales

    Guignot, C

    2002-11-15

    Face to the development of radiosterilization and polymers medical devices it was wished to study the behavior of polyurethanes under accelerated electrons in oxidizing atmosphere. This study has been made to reveal the physico chemical and organisational modifications of polyurethanes for a medical use. (N.C.)

  15. Ionization and acceleration of heavy ions in high-Z solid target irradiated by high intensity laser

    Kawahito, D.; Kishimoto, Y.

    2016-05-01

    In the interaction between high intensity laser and solid film, an ionization dynamics inside the solid is dominated by fast time scale convective propagation of the internal sheath field and the slow one by impact ionization due to heated high energy electrons coupled with nonlocal heat transport. Furthermore, ionization and acceleration due to the localized external sheath field which co- propagates with Al ions constituting the high energy front in the vacuum region. Through this process, the maximum charge state and then q/A increase in the rear side, so that ions near the front are further accelerated to high energy.

  16. Randomized clinical trial on seven-day-per-week continuous accelerated irradiation for patients with esophageal carcinoma:Preliminary report on tumor response and acute toxicity

    Su-Ping Sun; Ya-Zhou Liu; Tao Ye; Wen Zhang; Wen-Bin Shen; Jing-Lei Shi; Hai-Ting Xu; Wei-Dong Wang

    2006-01-01

    AIM: Tumor response and normal tissue toxicity of seven-day-per-week continuous accelerated irradiation (CAIR) for patients with esophageal carcinoma were evaluated and compared to conventional irradiation (CR).METHODS: Sixty patients with squamous cell carcinoma of the esophagus were randomized into two groups:the CAIR group (30 patients) and the CR group (30 pa(RT) with 2 Gy/fraction per day at 7 d/wk with a total dose of 50-70 Gy (average dose 64.2 Gy). The overall time of irradiation was 3.6-5.0 wk (average 4.6 wk). RT in the CR group was 2 Gy/fraction per day at 5 d/wk with a total dose of 40-70 Gy (average dose 61.7 Gy).The overall time of irradiation was 4.0-7.0 wk (average 6.4wk).RESULTS: The data showed that the immediate tumor response to RT was better in the CAIR group than in the CR group. Efficiency rates (CR plus PR) were 82.8%(24/29) and 58.6% (17/29), respectively (P = 0.047). In both groups the incidences of esophagitis and tracheitis were insignificant (P = 0.376, 0.959), and no patient received toxicity that could not be tolerated.CONCLUSION: CAIR shortens overall treatment time and is well tolerated by patients. It may be superior to CR in enhancing the local response of tumor, but its remote effect for esophageal carcinoma awaits further follow-up.

  17. SU-E-T-226: Junction Free Craniospinal Irradiation in Linear Accelerator Using Volumetric Modulated Arc Therapy : A Novel Technique Using Dose Tapering

    Purpose: Spatially separated fields are required for craniospinal irradiation due to field size limitation in linear accelerator. Field junction shits are conventionally done to avoid hot or cold spots. Our study was aimed to demonstrate the feasibility of junction free irradiation plan of craniospinal irradiation (CSI) for Meduloblastoma cases treated in linear accelerator using Volumetric modulated arc therapy (VMAT) technique. Methods: VMAT was planned using multiple isocenters in Monaco V 3.3.0 and delivered in Elekta Synergy linear accelerator. A full arc brain and 40° posterior arc spine fields were planned using two isocentre for short (<1.3 meter height ) and 3 isocentres for taller patients. Unrestricted jaw movement was used in superior-inferior direction. Prescribed dose to PTV was achieved by partial contribution from adjacent beams. A very low dose gradient was generated to taper the isodoses over a long length (>10 cm) at the conventional field junction. Results: In this primary study five patients were planned and three patients were delivered using this novel technique. As the dose contribution from the adjacent beams were varied (gradient) to create a complete dose distribution, therefore there is no specific junction exists in the plan. The junction were extended from 10–14 cm depending on treatment plan. Dose gradient were 9.6±2.3% per cm for brain and 7.9±1.7 % per cm for spine field respectively. Dose delivery error due to positional inaccuracy was calculated for brain and spine field for ±1mm, ±2mm, ±3mm and ±5 mm were 1%–0.8%, 2%–1.6%, 2.8%–2.4% and 4.3%–4% respectively. Conclusion: Dose tapering in junction free CSI do not require a junction shift. Therefore daily imaging for all the field is also not essential. Due to inverse planning dose to organ at risk like thyroid kidney, heart and testis can be reduced significantly. VMAT gives a quicker delivery than Step and shoot or dynamic IMRT

  18. Evaluation of a dispersion medium for the irradiation of blood products in a electron linear accelerator; Evaluacion de un medio dispersor para la irradiacion de hemoderivados en un acelerador lineal de electrones

    Ordiales, J. M.; Falero, B.; Vazquez, M.; Alvarez, F. J.

    2013-07-01

    The use of bags of rice as dispersion medium in irradiation of blood products for medical use is less effective than the immersion from the point of view dosimetric water. However, given the wide range of dose values for a valid result and once subjected to quality control procedure, the method provides the necessary work for the irradiation of blood products in a linear electron accelerator. (Author)

  19. Accelerated hyperfractionated intensity-modulated radiotherapy for recurrent/unresectable rectal cancer in patients with previous pelvic irradiation: results of a phase II study

    This study was conducted to investigate the local effects and toxicity of accelerated hyperfractionated intensity-modulated radiotherapy for recurrent/unresectable rectal cancer in patients with previous pelvic irradiation. Twenty-two patients with recurrent/unresectable rectal cancer who previously received pelvic irradiation were enrolled in our single-center trial between January 2007 and August 2012. Reirradiation was scheduled for up to 39 Gy in 30 fractions using intensity-modulated radiotherapy plans. The dose was delivered via a hyperfractionation schedule of 1.3 Gy twice daily. Patient follow-up was performed by clinical examination, CT/MRI, or PET/CT every 3 months for the first 2 years and every 6 months thereafter. Tumor response was evaluated 1 month after reirradiation by CT/MRI based on the RECIST criteria. Adverse events were assessed using the National Cancer Institute (NCI) common toxicity criteria (version 3.0). The median time from the end of the initial radiation therapy to reirradiation was 30 months (range, 18-93 months). Overall local responses were observed in 9 patients (40.9%). None of the patients achieved a complete response (CR), and 9 patients (40.9%) had a partial response (PR). Thirteen patients failed to achieve a clinical response: 12 (54.5%) presented with stable disease (SD) and 1 (4.5%) with progressive disease (PD). Among all the patients who underwent reirradiation, partial or complete symptomatic relief was achieved in 6 patients (27.3%) and 13 patients (59.1%), respectively. Grade 4 acute toxicity and treatment-related deaths were not observed. The following grade 3 acute toxicities were observed: diarrhea (2 patients, 9.1%), cystitis (1 patient, 4.5%), dermatitis (1 patient, 4.5%), and intestinal obstruction (1 patient, 4.5%). Late toxicity was infrequent. Chronic severe diarrhea, small bowel obstruction, and dysuria were observed in 2 (9.1%), 1 (4.5%) and 2 (9.1%) of the patients, respectively. This study showed that

  20. Effects of prenatal irradiation with accelerated heavy-ion beams on postnatal development in rats: III. Testicular development and breeding activity

    Wang, B.; Murakami, M.; Eguchi-Kasai, K.; Nojima, K.; Shang, Y.; Tanaka, K.; Watanabe, K.; Fujita, K.; Moreno, S. G.; Coffigny, H.; Hayata, I.

    With a significant increase in human activities dealing with space missions, potential teratogenic effects on the mammalian reproductive system from prenatal exposure to space radiation have become a hot topic that needs to be addressed. However, even for the ground experiments, such effects from exposure to high LET ionizing radiation are not as well studied as those for low LET ionizing radiations such as X-rays. Using the Heavy-Ion Medical Accelerator in Chiba (HIMAC) and Wistar rats, effects on gonads in prenatal male fetuses, on postnatal testicular development and on breeding activity of male offspring were studied following exposure of the pregnant animals to either accelerated carbon-ion beams with a LET value of about 13 keV/μm or neon-ion beams with a LET value of about 30 keV/μm at a dose range from 0.1 to 2.0 Gy on gestation day 15. The effects of X-rays at 200 kVp estimated for the same biological end points were studied for comparison. A significantly dose-dependent increase of apoptosis in gonocytes appeared 6 h after irradiations with a dose of 0.5 Gy or more. Measured delayed testis descent and malformed testicular seminiferous tubules were observed to be significantly different from the control animals at a dose of 0.5 Gy. These effects are observed to be dose- and LET-dependent. Markedly reduced testicular weight and testicular weight to body weight ratio were scored at postnatal day 30 even in the offspring that were prenatally irradiated with neon-ions at a dose of 0.1 Gy. A dose of 0.5 Gy from neon-ion beams induced a marked decrease in breeding activity in the prenatally irradiated male rats, while for the carbon-ion beams or X-rays, the significantly reduced breeding activity was observed only when the prenatal dose was at 1.0 Gy or more. These findings indicated that prenatal irradiations with heavy-ion beams on gestation day 15 generally induced markedly detrimental effects on prenatal gonads, postnatal testicular development and male

  1. Application of an ultraminiature thermal neutron monitor for irradiation field study of accelerator-based neutron capture therapy

    Ishikawa, Masayori; Tanaka, Kenichi; Endo, Satrou; Hoshi, Masaharu

    2015-01-01

    Phantom experiments to evaluate thermal neutron flux distribution were performed using the Scintillator with Optical Fiber (SOF) detector, which was developed as a thermal neutron monitor during boron neutron capture therapy (BNCT) irradiation. Compared with the gold wire activation method and Monte Carlo N-particle (MCNP) calculations, it was confirmed that the SOF detector is capable of measuring thermal neutron flux as low as 105 n/cm2/s with sufficient accuracy. The SOF detector will be u...

  2. Application of an ultraminiature thermal neutron monitor for irradiation field study of accelerator-based neutron capture therapy

    Ishikawa, Masayori; Tanaka, Kenichi; Endo, Satrou; Hoshi, Masaharu

    2015-01-01

    Phantom experiments to evaluate thermal neutron flux distribution were performed using the Scintillator with Optical Fiber (SOF) detector, which was developed as a thermal neutron monitor during boron neutron capture therapy (BNCT) irradiation. Compared with the gold wire activation method and Monte Carlo N-particle (MCNP) calculations, it was confirmed that the SOF detector is capable of measuring thermal neutron flux as low as 105 n/cm2/s with sufficient accuracy. The SOF detector ...

  3. Mitigation of solid waste and reuse of effluent from paint and varnish automotive and industrial treated by irradiation at electron beam accelerator

    One of the most representative industrial segments is the polymeric coatings for house paint, automotive, industrial, marine, maintenance, and repainting markets. The general consumption of paint market in 2010 was 438,364 103 gallons of paint, in Brazil. However, when produce paints and varnishes, various kinds of solid wastes and liquid effluent are generated. The present research focus on the effluent from resins, water base paint and paint for electrophoresis, automotive industry, and general industrial coatings. The goal of this study is to use ionizing radiation to destroy the pollutants allowing the use of part of effluent as reuse water, and the rest discarded within the specified requirements. Actual industrial effluent samples were irradiated at Electron beam Accelerator applying absorbed doses of 10 kGy, 30 kGy and 50 kGy. The results, in this preliminary stage, showed a reduction of organic compounds and suspended solids. (author)

  4. Decursin was Accelerated Human Lung Cancer Cell Death Caused by Proton Beam Irradiation via Blocking the p42/44 MAPK pathway

    Decursin, which is one of the extract of Angelica gigas Nakai root, has been traditionally used in Korean folk medicine as a tonic and for treatment of anemia and other common diseases. There are some reports about the pharmacological properties of decursin showing anti-bacterial and anti-amnestic effect, depression of cardiac contraction, antitumor and anti-angiogenic activity. Cell death induced by proton beam is identified as apoptosis. The study investigated that genes involved in apoptosis are checked by RT-PCR and used LET instead of SPBP of proton beam. Apoptosis is the tight regulated by multi-protein action in physiological cell death program. Proton therapy is an attractive approach for the treatment of deep-seated tumor. Recently, many researchers tried to new therapeutic strategy, combination of proton therapy and chemotherapy, in order to increase therapeutic effect. In this study, we investigate whether decursin can accelerate effect of human lung cell apoptosis in proton irradiated cancer cells

  5. Decursin was Accelerated Human Lung Cancer Cell Death Caused by Proton Beam Irradiation via Blocking the p42/44 MAPK pathway

    Jung, Myung Hwan; Ra, Se Jin; Kim, Kye Ryung [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-10-15

    Decursin, which is one of the extract of Angelica gigas Nakai root, has been traditionally used in Korean folk medicine as a tonic and for treatment of anemia and other common diseases. There are some reports about the pharmacological properties of decursin showing anti-bacterial and anti-amnestic effect, depression of cardiac contraction, antitumor and anti-angiogenic activity. Cell death induced by proton beam is identified as apoptosis. The study investigated that genes involved in apoptosis are checked by RT-PCR and used LET instead of SPBP of proton beam. Apoptosis is the tight regulated by multi-protein action in physiological cell death program. Proton therapy is an attractive approach for the treatment of deep-seated tumor. Recently, many researchers tried to new therapeutic strategy, combination of proton therapy and chemotherapy, in order to increase therapeutic effect. In this study, we investigate whether decursin can accelerate effect of human lung cell apoptosis in proton irradiated cancer cells

  6. Research on the dose of the tissues located outside the treatment field when breast cancer was irradiated by linear accelerator

    The purpose of study was to determine the dose of the tissues which located outside the treatment field, when breast cancer was irradiated by 9 MeV electron-beam and 6 MV-X ray after operation. A search for decreasing the dose of the tissues outside the treatment field was made. Clinically relevant treatment fields were simulated on a tissue-equivalent material phantom and subsequently irradiated with 9 MeV electron-beam and 6 MV-X ray. TLD were used to measure absorbed doses. The prescribed dose of breast cancer region was 50.0 Gy, region-lymph-nodes were 60.0 Gy, each exposure dose was 2.0 Gy. In breast cancer region, if only with 9 MeV electron-beam, the dose of the tissues located outside the treatment field were from 29.0 cGy to 295.5 cGy, when shielded with Pb lump, the doses of the tissues outside the treatment field may descended 9.4%-53.6%; if only with 6 MV-X ray, the doses of aforementioned tissues were from 32.0 cGy to 206.7 cGy, when shielded with Pb lump, the doses of the tissues outside the treatment field descended 19.7%-56.6%. In region-lymph-nodes, with 6 MV-X ray, the doses of aforementioned tissues were from 22.5 cGy to 1650.9 cGy, when shielded with Pb lump, the doses of the tissues outside the treatment field descended 19.7-65.6%. If mix-irradiation (9 MeV electron-beam vs. 6 MV-X ray 2:3) was used, the doses outside field would be lower than only used 9 MeV electron-beam or 6 MV-X ray were used

  7. Exposure to 56Fe irradiation accelerates normal brain aging and produces deficits in spatial learning and memory

    Shukitt-Hale, Barbara; Casadesus, Gemma; Carey, Amanda N.; Rabin, Bernard M.; Joseph, James A.

    Previous studies have shown that radiation exposure, particularly to particles of high energy and charge (HZE particles) such as 56Fe, produces deficits in spatial learning and memory. These adverse behavioral effects are similar to those seen in aged animals. It is possible that these shared effects may be produced by the same mechanism. For example, an increased release of reactive oxygen species, and the subsequent oxidative stress and inflammatory damage caused to the central nervous system, is likely responsible for the deficits seen in aging and following irradiation. Therefore, dietary antioxidants, such as those found in fruits and vegetables, could be used as countermeasures to prevent the behavioral changes seen in these conditions. Both aged and irradiated rats display cognitive impairment in tests of spatial learning and memory such as the Morris water maze and the radial arm maze. These rats have decrements in the ability to build spatial representations of the environment, and they utilize non-spatial strategies to solve tasks. Furthermore, they show a lack of spatial preference, due to a decline in the ability to process or retain place (position of a goal with reference to a “map” provided by the configuration of numerous cues in the environment) information. These declines in spatial memory occur in measures dependent on both reference and working memory, and in the flexibility to reset mental images. These results show that irradiation with 56Fe high-energy particles produces age-like decrements in cognitive behavior that may impair the ability of astronauts, particularly middle-aged ones, to perform critical tasks during long-term space travel beyond the magnetosphere.

  8. Fat necrosis after conserving surgery and interstitial brachytherapy and/or external-beam irradiation in women with breast cancer

    Purpose: to investigate the incidence of fat necrosis, breast tissue fibrosis and breast pain after conserving surgery and accelerated partial-breast irradiation (APBI, group A), whole-breast external-beam irradiation (EBRT, group B), or EBRT combined with an interstitial boost (EBIB, group C) in women with breast cancer. Patients and methods: 85 patients who received breast-conserving therapy from 02/2000 to 03/2002 were analyzed. 30 patients received EBRT, 33 patients APBI, and 22 patients EBIB. Median follow-up was 35.5, 35.0, and 37.5 months, respectively. Fat necrosis was detected and rated by mammograms, fibrosis and pain were clinically rated with the LENT-SOMA scores. Results: the incidence of fat necrosis was 15.3% for all patients; and 15.2%, 20.0%, and 9.0% for groups A, B, and C, respectively. The 3-year fat necrosis-free survival probability was 83%, 76%, and 95% (difference not significant). The mean time to first diagnosis of fat necrosis was 25.6, 26.2, and 26.0 months. No patient needed surgical intervention because of fat necrosis-related pain. Fibrosis was present in 27.3%, 63.3%, and 77.3% (p<0.001), breast pain in 9.0%, 33.4%, and 18.1% (p<0.05). Conclusion: asymptomatic fat necrosis is a common finding after both percutaneous and interstitial irradiation after breast-conserving surgery. This analysis did not support the hypothesis that APBI with multicatheter implants leads to higher rates of fat necrosis, fibrosis, or pain. (orig.)

  9. Research of irradiation effects on chicken feet with pickled peppers by 10 MeV linear accelerator

    The electronic accelerator has small investment and low production cost, it has no requirement of additional radioactive source, moreover there is no radiation after shutdown and its high dose rate and production speediness, so it has obvious advantages on price and economic in the market of radiation sterilization nowadays. Using high-energy electronic 10 MeV accelerator, we researched the radiation processing of chicken feet with pickled peppers. According to the dose test, we found that the absorption radiation dose of chicken feet packages (thickness is 149-millimeters), is almost uniform (the unevenness <2) after full power and two-side radiation with 10 MeV electron beam. After microbial detection, we found that the 10 kGy dose treatment can primly meet the sterilized requirement. However the one-side radiation process cannot meet the requirement, because we found that the dose of chicken feet in the 4th layer (the pack age has 6 layers) already had decreased for 10% and the downtrend of dose is more sharp in the 5th and the 6th layers after the dose test. (authors)

  10. Inherent change in MammoSite applicator three-dimensional geometry over time

    Accelerated partial breast irradiation is commonly done with the MammoSite applicator, which requires symmetry to treat the patient. This paper describes three cases that were asymmetric when initially placed and became symmetric over time, without manipulation

  11. Chitosan Dermal Substitute and Chitosan Skin Substitute Contribute to Accelerated Full-Thickness Wound Healing in Irradiated Rats

    Abu Bakar Mohd Hilmi

    2013-01-01

    Full Text Available Wounds with full-thickness skin loss are commonly managed by skin grafting. In the absence of a graft, reepithelialization is imperfect and leads to increased scar formation. Biomaterials can alter wound healing so that it produces more regenerative tissue and fewer scars. This current study use the new chitosan based biomaterial in full-thickness wound with impaired healing on rat model. Wounds were evaluated after being treated with a chitosan dermal substitute, a chitosan skin substitute, or duoderm CGF. Wounds treated with the chitosan skin substitute showed the most re-epithelialization (33.2 ± 2.8%, longest epithelial tongue (1.62 ± 0.13 mm, and shortest migratory tongue distance (7.11 ± 0.25 mm. The scar size of wounds treated with the chitosan dermal substitute (0.13 ± 0.02 cm and chitosan skin substitute (0.16 ± 0.05 cm were significantly decreased (P<0.05 compared with duoderm (0.45 ± 0.11 cm. Human leukocyte antigen (HLA expression on days 7, 14, and 21 revealed the presence of human hair follicle stem cells and fibroblasts that were incorporated into and surviving in the irradiated wound. We have proven that a chitosan dermal substitute and chitosan skin substitute are suitable for wound healing in full-thickness wounds that are impaired due to radiation.

  12. Accelerating total body irradiation with large field modulated arc therapy in standard treatment rooms without additional equipment

    Polednik, Martin; Lohr, Frank; Ehmann, Michael; Wenz, Frederik [Universitaetsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Department of Radiation Oncology, Mannheim (Germany)

    2015-11-15

    The aim of this study was to develop a generic and ultra-efficient modulated arc technique for treatment with total body irradiation (TBI) without additional equipment in standard treatment rooms. A continuous gantry arc between 300 and 70 composed of 26 subarcs (5 per subarc) using a field size of 40 x 40 cm{sup 2} was used to perform the initial beam data measurements. The profile was measured parallel to the direction of gantry rotation at a constant depth of 9 cm (phantom thickness 18 cm). Beam data were measured for single 5 subarcs, dissecting the individual contribution of each subarc to a certain measurement point. The phantom was moved to 20 measurement positions along the profile. Then profile optimization was performed manually by varying the weighting factors of all segments until calculated doses at all points were within ± 1 %. Finally, the dose distribution of the modulated arc was verified in phantom thicknesses of 18 and 28 cm. The measured profile showed a relative mean dose of 99.7 % [standard deviation (SD) 0.7 %] over the length of 200 cm at a depth of 9 cm. The measured mean effective surface dose (at a depth of 2 cm) was 102.7 % (SD 2.1 %). The measurements in the 28 cm slab phantom revealed a mean dose of 95.9 % (SD 2.9 %) at a depth of 14 cm. The mean dose at a depth of 2 cm was 111.9 % (SD 4.1 %). Net beam-on-time for a 2 Gy fraction is approximately 8 min. This highly efficient modulated arc technique for TBI can replace conventional treatment techniques, providing a homogeneous dose distribution, dosimetric robustness, extremely fast delivery, and applicability in small treatment rooms, with no need for additional equipment. (orig.) [German] Das Ziel dieses Projekts war die Entwicklung einer generischen, hocheffizienten und modulierten Rotationsbestrahlungstechnik fuer Ganzkoerperbestrahlung (TBI, ''total body irradiation''), die ohne zusaetzliches Equipment in Standartbehandlungsraeumen angewendet werden kann. Ein

  13. Dithiothreitol inhibits the acceleration of DNA strand breaks by human serum albumin in a metal-catalyzed oxidation and γ-irradiation system

    Intact or Cys-34 modified human serum albumin (HSA) was significantly damaged and degraded in the metal-catalyzed oxidation (MCO) system containing dithiothreitol (DTT) as an electron donor and, while it lasted, this protein might have prohibited the hydroxy radical OH or H2O2 from attacking DNA. However, in the glutathione (GSH) and ascorbate (non-thiol) MCO system, HSA was not sacrificially degraded and accelerated rather than prevented DNA strand breaks. In contrast, human ceruloplasmin was not sacrificially degraded but significantly prevented DNA strand breaks in both GSH and DTT MCO system. In γ-irradiation system, only DTT attenuated the acceleration of DNA strand breaks by HSA. This protein did not remove more H2O2 in the presence of reduced GSH (thiol-linked peroxidase) than in the absence of GSH. Therefore it seems that in an MCO system, the antioxidant activity of HSA is dependent on the effectiveness of reducing equivalents to induce the exposure of a functional group scavenging hydroxy radical OH or H2O2 by reduction of disulfide bonds in HSA. In the presence of DTT, disulfide bonds in HSA were completely reduced to cysteinyl residues but not significantly converted into cysteines by ascorbate or GSH. On the other hand, human ceruloplasmin has a resistance to reduction. In conclusion, the antioxidant activity of HSA in the DTT MCO system is thought not to be due to peroxidase function by thiol specificity, but due to sacrificial antioxidant activity by the functional groups, such as hydrophobic compounds exposed to the protein surface by DTT. (author)

  14. Food irradiation

    The colloquium has been held on the occasion of the commissioning of a new linear electron accelerator. The 17 papers presented by the experts give a survey of the present status of food irradiation and related aspects. Every paper has been analysed and prepared for retrieval from the database. (orig.)

  15. Preliminary simulation of implants breast through the accelerated partial irradiation technique: coverage rates and homogeneity; Simulacion previa de implates de mama mediante la tecnica de irradiacion parcial acelerada: indices de cubrimiento y homegeneidad

    Moral Sanchez, S. C.; Paula Carranza, B. de; Erzibengoa, M.; Bragado Alvarez, L.; Guisasola Berasetegui, A.

    2013-07-01

    In this work we present and evaluate the process of pre-simulation we have drawn up when it comes to treatments of accelerated partial irradiation of breast. Previous simulation that we will allow you to have greater control over the location of catheters with respect to the area to radiate. The goodness of this procedure is evaluated through representative quality indexes of the implant. (Author)

  16. Pre-irradiation carboplatin and etoposide and accelerated hyperfractionated radiation therapy in patients with high-grade astrocytomas: a phase II study

    Purpose: To investigate feasibility, activity and toxicity of pre-irradiation chemotherapy (CHT) in patients with newly diagnosed high-grade astrocytoma. Material and Methods: Thirty-five patients with glioblastoma multiform (GBM) and ten patients with anaplastic astrocytoma (AA) entered into this study. Three weeks after surgery patients started their CHT consisting of two cycles of carboplatin (CBDCA) (C) 400 mg/m2, day 1 and etoposide (VP 16) (E) 120 mg/m2, days 1-3, given in a 3-week interval. One week after the second cycle of CE, accelerated hyperfractionated radiation therapy (ACC HFX RT) was introduced with tumor dose of 60 Gy in 40 fractions in 20 treatment days in 4 weeks, 1.5 Gy b.i.d. fractionation.Results: Responses to two cycles of CE could be evaluated in 29 (67%) of 43 patients who received it. Fourteen patients were found impossible to determine radiographic response due to an absence of post-operative contrast enhancement because they were all grossly totally resected. There were 7, 24% (95% confidence intervals - CI, 9-40%), PR (2 AA and 5 GBM), 19 SD, and 3 PD. After RT, of those 29 patients, there were 3 CR and 11 PR (overall objective response rate was 48% (95% CI, 30-67%)), 12 SD, and 3 PD. Median survival time (MST) for all 45 patients is 14 months (95% CI, 11-20 months, while median time to progression (MTP) for all patients is 12 months (95% CI, 8-16 months). Toxicities of this combined modality approach were mild to moderate, with the incidences of CHT-induced grade 3 leukopenia, being 5% (95% CI, 0-11%), and grade 3 thrombocytopenia being 7% (95% CI, 0-15%). Of RT-induced toxicity, grade 1 external otitis was observed in 26% (95% CI, 13-39%), while nausea, vomiting and somnolence were each observed in 5% (95% CI, 0-11%) patients.Conclusion: Pre-irradiation CE and ACC HFX RT was a feasible treatment regimen with mild to moderate toxicity, but failed to improve results over what usually would be obtained with 'standard' approach in this

  17. Elective lymph node irradiation late course accelerated hyper-fractionated radiotherapy plus concurrent cisplatin-based chemotherapy for esophageal squamous cell carcinoma: a phase II study

    In this phase II study, we evaluated the efficacy, toxicity, and patterns of failure of elective lymph node irradiation (ENI) late course accelerated hyper-fractionated radiotherapy (LCAHRT) concurrently with cisplatin-based chemotherapy (CHT) for esophageal squamous cell carcinoma (ESCC). Patients with clinical stage II-IVa (T1-4N0-1M0 or M1a) ESCC were enrolled between 2004 and 2011. Radiation therapy (RT) comprised two courses: The first course of radiation covered the primary and metastatic regional tumors and high risk lymph nodal regions, given at 2 Gy per fraction for a dose of 40 Gy. In the second course, LCAHRT was delivered to the boost volume twice a day for an additional 19.6 Gy in 7 treatment days, using 1.4 Gy per fraction. Two cycles of CHT were given at the beginning of RT. The median age and Karnofsky performance status were 63 years and 80, respectively. The American Joint Committee on Cancer stage was II in 14 (20.6%) patients, III in 32 (47.1%), and IVa in 22 (32.3%). With a median follow-up of 18.5 months, the overall survival at 1-, 3-, 5-year were 75.5%, 46.5%, 22.7% for whole group patients, versus 78.6%, 49.4%, 39.9% for patients with stage II–III. The patterns of first failure from local recurrence, regional failure, and distant metastasis were seen in 20.6%, 17.6%, and 19.1%, respectively. The most frequent acute high-grade (≥ 3) toxicities were esophagitis and leucopenia, occurred in 26.4% and 32.4%. ENI LCAHRT concurrently with CHT was appeared to be an effective regimen for ESCC patient with a favorable and tolerated profile. Further observation with longer time and randomized phase III trial is currently underway.

  18. Irradiation of goods

    The necessary dose and the dosage limits to be observed depend on the kind of product and the purpose of irradiation. Product density and density distribution, product dimensions, but also packaging, transport and storage conditions are specific parameters influencing the conditions of irradiation. The kind of irradiation plant - electron accelerator or gamma plant - , its capacity, transport system and geometric arrangement of the radiation field are factors influencing the irradiation conditions as well. This is exemplified by the irradiation of 3 different products, onions, deep-frozen chicken and high-protein feed. Feasibilities and limits of the irradiation technology are demonstrated. (orig.)

  19. Weekly bi-fractionated 40 Gy three-dimensional conformational accelerated partial irradiation of breast: results of a phase II French pilot study; Irradiation partielle acceleree du sein tridimensionnelle conformationnelle de 40Gy bifractionnee hebdomadaire: resultats d'une etude pilote francaise de phase II

    Bourgier, C.; Pichenot, C.; Verstraet, R.; Heymann, S.; Biron, B.; Delaloge, S.; Garbay, J.R.; Marsiglia, H.; Bourhis, J. [Intitut Gustave-Roussy, 94 - Villejuif (France); Taghian, A. [Massachusetts General Hospital-Harvard, Boston (United States); Marsiglia, H. [Universite Florence (Italy)

    2010-10-15

    The authors report the first French experience of three-dimensional conformational and accelerated partial irradiation of breast. Twenty five patients have been concerned by this phase II trial. The prescribed total dose was 40 Gy, was delivered over 5 days in two daily fractions. Irradiation was performed with two 6 MV tangential mini-beams and a 6-22 MeV front electron beams. The planning target volume coverage was very good. Toxicity has been assessed. Healthy tissues (heart, lungs) are considerably protected. The acute and late toxicity is correct. Short communication

  20. Measurement of mean cardiac dose for various breast irradiation techniques and corresponding risk of major cardiovascular event.

    Tomas Rodrigo Merino Lara

    2014-10-01

    Full Text Available After breast conserving surgery, early stage breast cancer patients are currently treated with a wide range of radiation techniques including whole breast irradiation (WBI, accelerated partial breast irradiation (APBI using high dose rate (HDR brachytherapy, or 3D conformal radiotherapy (3D-CRT. This study compares the mean heart’s doses for a left breast irradiated with different breast techniques.An anthropomorphic Rando phantom was modified with gelatin-based breast of different sizes and tumors located medially or laterally. The breasts were treated with WBI, 3D-CRT or HDR APBI. The heart’s mean doses were measured with Gafchromic films and controlled with optically stimulated luminescent dosimeters (OSLDs. Following the model reported by Darby (16, major cardiac were estimated assuming a linear risk increase with the mean dose to the heart of 7.4% per gray.Whole breast irradiation lead to the highest mean heart dose (2.99 Gy compared to 3D-CRT APBI, (0.51 Gy, multicatheter (1.58 Gy and balloon HDR (2.17 Gy for a medially located tumor. This translated into long-term coronary event increases of 22%, 3.8%, 11.7%, and 16% respectively. The sensitivity analysis showed that the tumor location had almost no effect on the mean heart dose for 3D-CRT APBI and a minimal impact for HDR APBI. For WBI large breast size and set-up errors lead to sharp increases of the mean heart dose. Its value reached 10.79 Gy for women with large breast and a set-up error of 1.5 cm. Such a high value could increase the risk of having long-term coronary events by 80%.Comparison among different irradiation techniques demonstrates that 3D-CRT APBI appears the safest one with less probability of having cardiovascular events in the future. A sensitivity analysis showed that WBI is the most challenging technique for patients with large breasts or when significant set-up errors are anticipated. In those cases additional heart shielding techniques are required.

  1. Radiation-Free Weekend Rescued! Continuous Accelerated Irradiation of 7-Days per Week Is Equal to Accelerated Fractionation With Concomitant Boost of 7 Fractions in 5-Days per Week: Report on Phase 3 Clinical Trial in Head-and-Neck Cancer Patients

    Skladowski, Krzysztof, E-mail: skladowski@io.gliwice.pl [Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology, Branch in Gliwice (Poland); Hutnik, Marcin; Wygoda, Andrzej; Golen, Maria; Pilecki, Boleslaw; Przeorek, Wieslawa; Rutkowski, Tomasz; Lukaszczyk-Widel, Beata; Heyda, Alicja; Suwinski, Rafal; Tarnawski, Rafal; Maciejewski, Boguslaw [Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology, Branch in Gliwice (Poland)

    2013-03-01

    Purpose: To report long-term results of randomized trial comparing 2 accelerated fractionations of definitive radiation therapy assessing the need to irradiate during weekend in patients with head and neck squamous cell carcinoma. Methods and Materials: A total of 345 patients with SCC of the oral cavity, larynx, and oro- or hypo-pharynx, stage T2-4N0-1M0, were randomized to receive continuous accelerated irradiation (CAIR: once per day, 7 days per week) or concomitant accelerated boost (CB: once per day, 3 days per week, and twice per day, 2 days per week). Total dose ranged from 66.6-72 Gy, dose per fraction was 1.8 Gy, number of fractions ranged from 37-40 fractions, and overall treatment time ranged from 37-40 days. Results: No differences for all trial end-points were noted. At 5 and 10 years, the actuarial rates of local-regional control were 63% and 60% for CAIR vs 65% and 60% for CB, and the corresponding overall survival were 40% and 25% vs 44% and 25%, respectively. Confluent mucositis was the main acute toxicity, with an incidence of 89% in CAIR and 86% in CB patients. The 5-year rate of grade 3-4 late radiation morbidity was 6% for both regimens. Conclusions: Results of this trial indicate that the effects of accelerated fractionation can be achieve by delivering twice-per-day irradiation on weekday(s). This trial has also confirmed that an accelerated, 6-weeks schedule is a reasonable option for patients with intermediate-stage head-and-neck squamous cell carcinoma because of the associated high cure rate and minimal severe late toxicity.

  2. Radiation-Free Weekend Rescued! Continuous Accelerated Irradiation of 7-Days per Week Is Equal to Accelerated Fractionation With Concomitant Boost of 7 Fractions in 5-Days per Week: Report on Phase 3 Clinical Trial in Head-and-Neck Cancer Patients

    Purpose: To report long-term results of randomized trial comparing 2 accelerated fractionations of definitive radiation therapy assessing the need to irradiate during weekend in patients with head and neck squamous cell carcinoma. Methods and Materials: A total of 345 patients with SCC of the oral cavity, larynx, and oro- or hypo-pharynx, stage T2-4N0-1M0, were randomized to receive continuous accelerated irradiation (CAIR: once per day, 7 days per week) or concomitant accelerated boost (CB: once per day, 3 days per week, and twice per day, 2 days per week). Total dose ranged from 66.6-72 Gy, dose per fraction was 1.8 Gy, number of fractions ranged from 37-40 fractions, and overall treatment time ranged from 37-40 days. Results: No differences for all trial end-points were noted. At 5 and 10 years, the actuarial rates of local-regional control were 63% and 60% for CAIR vs 65% and 60% for CB, and the corresponding overall survival were 40% and 25% vs 44% and 25%, respectively. Confluent mucositis was the main acute toxicity, with an incidence of 89% in CAIR and 86% in CB patients. The 5-year rate of grade 3-4 late radiation morbidity was 6% for both regimens. Conclusions: Results of this trial indicate that the effects of accelerated fractionation can be achieve by delivering twice-per-day irradiation on weekday(s). This trial has also confirmed that an accelerated, 6-weeks schedule is a reasonable option for patients with intermediate-stage head-and-neck squamous cell carcinoma because of the associated high cure rate and minimal severe late toxicity

  3. Autologous bone marrow transplantation following high-dose chemotherapy with or without accelerated hyperfractionated total lymphoid irradiation for patients with refractory or relapsed Hodgkin's disease

    PURPOSE: To analyze the 10-year experience at Memorial Sloan-Kettering Cancer Center (MSKCC) in the salvage of relapsed or refractory Hodgkin's disease (HD) patients with high-dose chemotherapy with or without accelerated hyperfractionated total lymphoid irradiation (TLI) followed by autologous bone marrow transplantation (AuBMT). MATERIALS AND METHODS: From 1985 through 1992, 127 patients with relapsed (n=79) or refractory (n=48) patients with HD were enrolled in two high-dose salvage therapy protocols at MSKCC. Patients who had not received any prior radiation therapy were assigned to protocol A (n=58) and those with a history of previous radiation therapy were assigned to protocol B (n=69). In both protocols treatment followed reinduction with standard-dose chemotherapy. Protocol A included involved-field irradiation (15 Gy) to areas of relapsed or persistent disease and TLI (20.04 Gy given in 1.67 Gy fractions, all fields treated t.i.d. for 4 days). Subsequently, patients received high-dose etoposide and cyclophosphamide, followed by infusion of autologous bone marrow. In protocol B, high-dose cyclophosphamide, BCNU and etoposide (CBV) were administered prior to AuBMT. The group selected to treatment on protocol A included significantly more patients with advanced-stage, extra-nodal disease, B symptoms at diagnosis and prior to AuBMT and also a higher fraction of patients who remained refractory to their primary therapy compared to the group treated on protocol B. All surviving patients had a minimum follow-up of 2 years. The median follow-up for survivors was 5+ years. RESULTS: Response to standard-dose reinduction chemotherapy for patients enrolled in protocols A and B was 60% and 80% respectively (p=0.03). The complete response rates after the high-dose therapy were 65% in either protocol. Transplant-related mortality occurred in(9(58)) (16%) patients in protocol A and (3(69)) (4%) of patients in protocol B (p=0.07). However since 1990, mortality in protocol

  4. Food irradiation

    A worldwide standard on food irradiation was adopted in 1983 by codex Alimentarius Commission of the Joint Food Standard Programme of the Food and Agriculture Organization (FAO) of the United Nations and The World Health Organization (WHO). As a result, 41 countries have approved the use of irradiation for treating one or more food items and the number is increasing. Generally, irradiation is used to: food loses, food spoilage, disinfestation, safety and hygiene. The number of countries which use irradiation for processing food for commercial purposes has been increasing steadily from 19 in 1987 to 33 today. In the frames of the national programme on the application of irradiation for food preservation and hygienization an experimental plant for electron beam processing has been established in Inst. of Nuclear Chemistry and Technology. The plant is equipped with a small research accelerator Pilot (19 MeV, 1 kW) and industrial unit Electronika (10 MeV, 10 kW). On the basis of the research there were performed at different scientific institutions in Poland, health authorities have issued permissions for irradiation for; spices, garlic, onions, mushrooms, potatoes, dry mushrooms and vegetables. (author)

  5. Stereotactic Irradiation of the Postoperative Resection Cavity for Brain Metastasis: A Frameless Linear Accelerator-Based Case Series and Review of the Technique

    Purpose: Whole-brain radiation therapy (WBRT) is the standard of care after resection of a brain metastasis. However, concern regarding possible neurocognitive effects and the lack of survival benefit with this approach has led to the use of stereotactic radiosurgery (SRS) to the resection cavity in place of WBRT. We report our initial experience using an image-guided linear accelerator-based frameless stereotactic system and review the technical issues in applying this technique. Methods and Materials: We retrospectively reviewed the setup accuracy, treatment outcome, and patterns of failure of the first 18 consecutive cases treated at Brigham and Women’s Hospital. The target volume was the resection cavity without a margin excluding the surgical track. Results: The median number of brain metastases per patient was 1 (range, 1–3). The median planning target volume was 3.49 mL. The median prescribed dose was 18 Gy (range, 15–18 Gy) with normalization ranging from 68% to 85%. In all cases, 99% of the planning target volume was covered by the prescribed dose. The median conformity index was 1.6 (range, 1.41–1.92). The SRS was delivered with submillimeter accuracy. At a median follow-up of 12.7 months, local control was achieved in 16/18 cavities treated. True local recurrence occurred in 2 patients. No marginal failures occurred. Distant recurrence occurred in 6/17 patients. Median time to any failure was 7.4 months. No Grade 3 or higher toxicity was recorded. A long interval between initial cancer diagnosis and the development of brain metastasis was the only factor that trended toward a significant association with the absence of recurrence (local or distant) (log-rank p = 0.097). Conclusions: Frameless stereotactic irradiation of the resection cavity after surgery for a brain metastasis is a safe and accurate technique that offers durable local control and defers the use of WBRT in select patients. This technique should be tested in larger prospective

  6. Stereotactic Irradiation of the Postoperative Resection Cavity for Brain Metastasis: A Frameless Linear Accelerator-Based Case Series and Review of the Technique

    Kelly, Paul J., E-mail: pkelly@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Lin Yijie Brittany; Yu, Alvin Y. [Harvard Medical School, Boston, MA (United States); Alexander, Brian M.; Hacker, Fred; Marcus, Karen J.; Weiss, Stephanie E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States)

    2012-01-01

    Purpose: Whole-brain radiation therapy (WBRT) is the standard of care after resection of a brain metastasis. However, concern regarding possible neurocognitive effects and the lack of survival benefit with this approach has led to the use of stereotactic radiosurgery (SRS) to the resection cavity in place of WBRT. We report our initial experience using an image-guided linear accelerator-based frameless stereotactic system and review the technical issues in applying this technique. Methods and Materials: We retrospectively reviewed the setup accuracy, treatment outcome, and patterns of failure of the first 18 consecutive cases treated at Brigham and Women's Hospital. The target volume was the resection cavity without a margin excluding the surgical track. Results: The median number of brain metastases per patient was 1 (range, 1-3). The median planning target volume was 3.49 mL. The median prescribed dose was 18 Gy (range, 15-18 Gy) with normalization ranging from 68% to 85%. In all cases, 99% of the planning target volume was covered by the prescribed dose. The median conformity index was 1.6 (range, 1.41-1.92). The SRS was delivered with submillimeter accuracy. At a median follow-up of 12.7 months, local control was achieved in 16/18 cavities treated. True local recurrence occurred in 2 patients. No marginal failures occurred. Distant recurrence occurred in 6/17 patients. Median time to any failure was 7.4 months. No Grade 3 or higher toxicity was recorded. A long interval between initial cancer diagnosis and the development of brain metastasis was the only factor that trended toward a significant association with the absence of recurrence (local or distant) (log-rank p = 0.097). Conclusions: Frameless stereotactic irradiation of the resection cavity after surgery for a brain metastasis is a safe and accurate technique that offers durable local control and defers the use of WBRT in select patients. This technique should be tested in larger prospective studies.

  7. [Long-term results and cause of failure analysis in larynx cancer patients irradiated conventionally and with accelerated fractionation schedules in 1995-1998].

    Szutkowski, Zbigniew; Kawecki, Andrzej; Jarząbski, Andrzej

    2014-01-01

    The clinical material consists of 217 patients with squamous cell carcinoma in supraglottic and glottic larynx in clinical stage T1-3N0M0 irradiated radically in Warsaw Oncology Centre in 1995-1998. All patients were treated with Co-60, according to two schedules of fractionation, with maintenance of the consistent therapeutic protocol. The same team of doctors worked on the treatment of patients and on the follow-up as well. The clinical material is a part of a three-phased clinical trial KBN 0295. In the course of observation, the progression of cancer was not observed in 157 patients, among whom, 66% were treated conventionally and 79% with accelerated fractionation method. 60 cases of loco-regional recurrences were noted, among which 55 were regional. The majority of failure cases was observed until the 30(th) of the month after the radiotherapy ended. In conventional fractionation treatment, recurrences in T1 were 8/31 (26%), in T2 22/59 (37%) and in T3 8/20 (40%). In patients treated with AF, recurrences were T1 5/39 (13%), T2 15/55 (27%) and T3 2/13 (15%) respectively. The percentage of primary site tumour recurrences for each localization and kind of treatment was analysed. In CF 28/78 (37%) of glottic tumour recurrences and 10/34 (29%) of supraglottic tumour, recurrences were observed. In AF, 12/71 (17%) and 10/36 (28%) were observed respectively. In 48 cases salvage surgery was used, and 12 patients were not qualified because of tumour massive progression or because they refused to have a surgery. Among 34 cases (16%) of the second primary tumour or distant methastases, 25 were observed with glottic cancer, among which 23 were observed in early stages, and 9 cases with supraglottic cancer, among which, 6 showed early stage of tumour. In only 3 cases out of all the patients, distant methastases were confirmed in histopatology examination. The main cause of failure in larynx cancer patients in stage T1 is that 3N0M0 are local recurrences. Second primary or

  8. Randomized clinical trial on 7-day continuous accelerated irradiation (CAIR) of head and neck cancer - report on 3-year tumour control and normal tissue toxicity

    The purpose of the study was to evaluate tumour and normal tissues 3-year response to 7-day-a-week continuous accelerated irradiation (CAIR) compared to a conventional treatment (5 days per week) in a randomized trial. One hundred patients with squamous cell carcinoma of the head and neck in stage T2-4-N0-1M0 were entered into the trial between December 1, 1993 and June 30, 1996. Dose per fraction of 2.0 Gy (to the end of 1994), and 1.8 Gy (since January 1, 1995) was the same in both arms and delivered once a day at regular 24-h intervals to total dose in the range of 66-72 Gy (depending on tumour stage). The only difference was overall treatment time being 5 weeks in the CAIR and 7 weeks in control arm. Actuarial 3-year local tumour control was 82% in the CAIR and 37% in the control group (P < 0.0001) with reduction in local recurrence rate of 83%. Actuarial 3-year overall survival was 78 and 32% (P < 0.0001), respectively. Confluent mucositis was significantly more severe and lasted longer in the CAIR than in control arm. After 2.0 Gy fractions five of 23 patients (22%) in the CAIR developed early necroses over a period of 2-4 months of follow-up which can be considered as a consequential to severe protracted acute mucosal reactions (CLE). For this reason dose per fraction was lowered to 1.8 Gy and the CLE was not observed again until now. Thus the overall rate of CLE decreased to 10%. The gain in tumour control is likely the effect of shortening of overall treatment time by 14 days and regular continuous dose delivery during the whole course of radiation therapy including weekends. A 7-day schedule produces more severe acute mucosal reactions lasting longer than in conventional fractionation, however tolerable by patients. Relatively high rate (22%) of CLE in the 7-day arm observed during the first year of the study was eliminated by decreasing dose per fraction from 2.0 Gy to 1.8 Gy

  9. High-intensity accelerators

    The design of high-intensity accelerators is described, using examples of machines being built at the Los Alamos National Laboratory. The major design problem with these accelerators is associated with control of beam loss when accelerator intensity is increased. Beam dynamics, beam loss, and the radio-frequency quadrupole structure are discussed in the first part of the chapter followed by an explanation of plans to achieve high-intensity operation in three projects: the Fusion Material Irradiation Tests (a joint effort with the Hanford Development Laboratory in Richland, Washington), the Proton Storage Ring (an addition to the LAMPF accelerator), and the Racetrack Microtron Project

  10. Structural and electrical properties of polycrystalline CdSe thin films, before and after irradiation with 6 MeV accelerated electrons

    Structural and electrical properties of polycrystalline CdSe thin films irradiated with high-energy electrons are analyzed. The samples were prepared by vacuum deposition of CdSe powder onto optical glass substrate. Their structure and the temperature dependence of the electrical resistance were determined, both before and after irradiation with 6 MeV electrons at fluencies up to 1016 electrons/cm2. There were no measurable changes in the crystalline structure of the films after irradiation. Electrical properties are controlled by the defect level of donor type, possibly a selenium vacancy, with two ionizing states having ionization energies of about 0.40 eV and 0.22 eV, respectively. The major effect of the irradiation is to increase significantly the concentration of these defects. (authors)

  11. Brazilian green propolis water extract up-regulates the early expression level of HO-1 and accelerates Nrf2 after UVA irradiation

    SAITO,Yuichi; Tsuruma, Kazuhiro; Ichihara, Kenji; Shimazawa, Masamitsu; Hara, Hideaki

    2015-01-01

    Background Exposure to ultraviolet A (UVA) irradiation is the major cause of human skin aging. Suppression of UVA irradiation-induced skin fibroblast cell damage protects the skin against aging. An oxidative stress response transcription factor nuclear factor-(erythroid-derived 2)-related factor 2 (Nrf2) has an important role as a cytoprotective system against oxidative stress in the human skin and other organs. Propolis has been commonly used as a traditional medicine since ancient times. Th...

  12. Development and utilization of various target assemblies for proton beam irradiation setup at 14 UD BARC-TIFR pelletron accelerator facility

    Drift space above analyzing magnet is modified to accommodate a proton beam setup at 6 meter level of 14UD BARC-TIFR Pelletron Accelerator Facility. This setup is capable of delivering proton beam in the energy range of 2 MeV to 26 MeV and current in μA range. The shielding at this level is such that radiation is within permissible limit when high proton beam current is accelerated. (author)

  13. Acceleration of mitotic cycle in meristem cells of seedlings roots by gamma irradiation of pea and maize seeds at stimulating doses

    The seeds were irradiated with 500 or 1,000 rads of 60Co γ-rays and laid on filter paper for germination. After 2-3 d the seedlings were placed for 30 min. into a nutrient solution containing 3H-thymidine. Afterwards the seedlings were placed in a non-radioactive nutrient solution and every 2 h the root tip was fixed and prepared for autoradiography for determination of cell division. Irradiation of both the pea and maize seeds resulted in a reduction of the duration of the mitotic cycle, the individual phases being shortened to a different extent. Stimulating radiation doses increased the activity of cell division. (MG)

  14. FMIT accelerator vacuum system

    The Fusion Materials Irradiation Test (FMIT) Facility accelerator is being designed to continuously accelerate 100-mA deuterons to 25 MeV. High vacuum pumping of the accelerator structure and beam lines will be done by ion pumps and titanium sublimation pumps. The design of the roughing system includes a Roots blower/mechanical pump package. For economy the size of the system has been designed to operate at 10-6 torr, where beam particle scattering on residual gases is negligible. For minimum maintenance in this neutron factory, the FMIT vacuum system is designed from the point of view of simplicity and reliability

  15. Can Accelerators Accelerate Learning?

    The 'Young Talented' education program developed by the Brazilian State Funding Agency (FAPERJ)[1] makes it possible for high-schools students from public high schools to perform activities in scientific laboratories. In the Atomic and Molecular Physics Laboratory at Federal University of Rio de Janeiro (UFRJ), the students are confronted with modern research tools like the 1.7 MV ion accelerator. Being a user-friendly machine, the accelerator is easily manageable by the students, who can perform simple hands-on activities, stimulating interest in physics, and getting the students close to modern laboratory techniques.

  16. Plasma accelerators

    Recently attention has focused on charged particle acceleration in a plasma by a fast, large amplitude, longitudinal electron plasma wave. The plasma beat wave and plasma wakefield accelerators are two efficient ways of producing ultra-high accelerating gradients. Starting with the plasma beat wave accelerator (PBWA) and laser wakefield accelerator (LWFA) schemes and the plasma wakefield accelerator (PWFA) steady progress has been made in theory, simulations and experiments. Computations are presented for the study of LWFA. (author)

  17. Linear Accelerators

    Vretenar, M

    2014-01-01

    The main features of radio-frequency linear accelerators are introduced, reviewing the different types of accelerating structures and presenting the main characteristics aspects of linac beam dynamics.

  18. Economics of food irradiation.

    Deitch, J

    1982-01-01

    This article examines the cost competitiveness of the food irradiation process. An analysis of the principal factors--the product, physical plant, irradiation source, and financing--that impact on cost is made. Equations are developed and used to calculate the size of the source for planned product throughput, efficiency factors, power requirements, and operating costs of sources, radionuclides, and accelerators. Methods of financing and capital investment are discussed. A series of tables show cost breakdowns of sources, buildings, equipment, and essential support facilities for both a cobalt-60 and a 10-MeV electron accelerator facility. Additional tables present irradiation costs as functions of a number of parameters--power input, source size, dose, and hours of annual operation. The use of the numbers in the tables are explained by examples of calculations of the irradiation costs for disinfestation of grains and radicidation of feed. PMID:6759046

  19. Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue

    Lu, Sharon M., E-mail: sharonlu@ucsd.edu [Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies (CART), University of California, San Diego, La Jolla, CA (United States); Scanderbeg, Daniel J.; Barna, Patrick; Yashar, William; Yashar, Catheryn [Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies (CART), University of California, San Diego, La Jolla, CA (United States)

    2012-04-01

    The SAVI and Contura breast brachytherapy applicators represent 2 recent advancements in brachytherapy technology that have expanded the number of women eligible for accelerated partial breast irradiation in the treatment of early-stage breast cancer. Early clinical experience with these 2 single-entry, multichannel high-dose-rate brachytherapy devices confirms their ease of use and dosimetric versatility. However, current clinical guidelines for SAVI and Contura brachytherapy may result in a smaller or less optimal volume of treated tissue compared with traditional interstitial brachytherapy. This study evaluates the feasibility of using the SAVI and Contura to irradiate larger and irregularly shaped target volumes, approaching what is treatable with the interstitial technique. To investigate whether additional tissue can be treated, 17 patients treated with the SAVI and 3 with the Contura were selected. For each patient, the planning target volume (PTV) was modified to extend 1.1 cm, 1.3 cm, and 1.5 cm beyond the tumor bed cavity. To evaluate dose conformance to an irregularly shaped target volume, 9 patients treated with the SAVI and 3 with the Contura were selected from the original 20 patients. The following asymmetric PTV margin combinations were assessed for each patient: 1.5/0.3, 1.3/0.3, and 1.1/0.3 cm. For all patients, treatment planning was performed, adopting the National Surgical Adjuvant Breast and Bowel Project guidelines, and dosimetric comparisons were made. The 6-1 and 8-1 SAVI devices can theoretically treat a maximal tissue margin of 1.5 cm and an asymmetric PTV with margins ranging from 0.3 to 1.5 cm. The 10-1 SAVI and Contura can treat a maximal margin of 1.3 cm and 1.1 cm, respectively, and asymmetric PTV with margins ranging from 0.3-1.3 cm. Compared with the Contura, the SAVI demonstrated greater dosimetric flexibility. Risk of developing excessive hot spots increased with the size of the SAVI device. Both the SAVI and Contura appear

  20. Accelerator programme at CAT

    The Accelerator Programme at the Centre for Advanced Technology (CAT), Indore, has very broad based concept under which all types of accelerators are to be taken up for design and fabrication. This centre will be housing a wide variety of accelerators to serve as a common facility for the universities, national laboratories in addition to laboratories under the Department of Atomic Energy. In the first phase of the programme, a series of electron accelerators are designed and fabricated. They are synchrotron radiation sources of 450 MeV (INDUS-I) and of 2 GeV (INDUS-II), microtron upto energy of 20 MeV, linear accelerator upto 20 MeV, and DC Accelerator for industrial irradiation upto 750 KeV and 20 KW. A proton accelerator of 300 MeV with 20 MeV linac injector is also designed. CAT is also developing a strong base for support technologies like ultra high vacuum, radio frequency and microwaves, DC pulsed and superconducting magnets, power supplies and controls etc. These technologies are very useful for other industrial applications also. To develop user groups to utilise INDUS-II synchrotron radiation source, a batch production of rotating Anode X-ray generators with power supplies has been initiated. So also, the sputter ion pumps, electron guns, turbo molecular pumps are brought into batch production. (author)

  1. Craniospinal irradiation using Rapid Arc

    Fandino, J. M.; Silva, M. C.; Marino, A.; Candal, A.; Diaz, I.; Fernandez, C.; Gesto, C.; Izquierdo, P.; Losada, C.; Poncet, M.; Soto, M.; Triana, G.

    2013-07-01

    Cranio-Spinal Irradiation is technically very challenging, historically field edge matching is needed because of the mechanical limitations of standard linear accelerators. The purpose of this study is to assess the Volumetric Arc Therapy as a competitive technique for Cranio-Spinal Irradiation compared to the conventional 3D Conformal Radiotherapy technique. (Author)

  2. Application of electron accelerator worldwide

    Electron accelerator is an important radiation source for radiation technology, which covers broad fields such as industry, health care, food and environmental protection. There are about 1,000 electron accelerators for radiation processing worldwide. Electron accelerator has advantage over Co-60 irradiator in term of high dose rate and power, assurance of safety, and higher economic performance at larger volume of irradiation. Accelerator generating higher energy in the range of 10 MeV and high power electron beam is now commercially available. There is a trend to use high-energy electron accelerator replacing Co-60 in case of large through-put of medical products. Irradiated foods, in particular species, are on the commercial market in 35 countries. Electron accelerator is used efficiently and economically for production of new or modified polymeric materials through radiation-induced cross-linking, grafting and polymerization reaction. Another important application of electron beam is the curing of surface coatings in the manufacture of products. Electron accelerators of large capacity are used for cleaning exhaust gases in industrial scale. Economic feasibility studies of this electron beam process have shown that this technology is more cost effective than the conventional process. It should be noted that the conventional limestone process produce gypsum as a by-product, which cannot be used in some countries. By contrast, the by-product of the electron beam process is a valuable fertilizer. (Y. Tanaka)

  3. A Phase I study of daily carboplatin and simultaneous accelerated, hyperfractionated chest irradiation in patients with regionally inoperable non-small cell lung cancer

    Purpose: This Phase I study was designed to determine the maximally tolerated dose (MTD) of daily low dose carboplatin with concurrent accelerated hyperfractionated radiotherapy (AHFX) in patients with locally advanced non-small-cell lung cancer. Patients also received consolidation chemotherapy with carboplatin. Secondary objectives were to determine the response rate, response duration, sites of first relapse, and survival. Methods and Materials: Thirty patients received daily carboplatin at doses of 25 or 30 mg/m2. Concurrent radiotherapy was given in 1.5 Gy fractions twice daily for a total dose of 60 Gy. Following chemoradiotherapy, patients received four cycles of carboplatin at 350 mg/m2. Results: Grade 4 esophagitis developed in 2 of 6 (33%) patients receiving 30 mg/m2 of daily carboplatin and was dose limiting. The remaining 24 patients received carboplatin at 25 mg/m2, with 3 patients developing Grade 4 esophagitis (13%). One of 22 patients who received consolidation carboplatin developed Grade 4 thrombocytopenia. An objective response was observed in 70% of patients (2 complete and 17 partial). Sites of failure were local (7 patients), distant (7 patients), and both (3 patients). The median time to progression was 8.3 months, with a median survival time of 18.3 months. The 1- and 2-year survival rates were 63 and 49%, respectively. Conclusions: Esophagitis was dose limiting when 30 mg/m2 of daily carboplatin was administered with AHFX. At the MTD of 25 mg/m2 of daily carboplatin plus AHFX followed by four cycles of carboplatin, the regimen was shown to be safe and as active or more active than other regimens. Thus, further studies with this regimen are warranted

  4. Future accelerators (?)

    I describe the future accelerator facilities that are currently foreseen for electroweak scale physics, neutrino physics, and nuclear structure. I will explore the physics justification for these machines, and suggest how the case for future accelerators can be made

  5. Future accelerators (?)

    John Womersley

    2003-08-21

    I describe the future accelerator facilities that are currently foreseen for electroweak scale physics, neutrino physics, and nuclear structure. I will explore the physics justification for these machines, and suggest how the case for future accelerators can be made.

  6. Ripening characteristics of light irradiated tomatoes

    Red color development in breaker stage tomatoes was accelerated by 3 min red (R) irradiation and delayed by 3 min far-red (FR) irradiation during the first 4 days of ripening. The effects were reversible and color development effective whether the interval between R and FR treatments was 1 day or 2 days. Firmness values of tomatoes irradiated with R were lower than those irradiated with FR, treated with ethylene, or stored in darkness. Light irradiation had the greatest effect on color development in tomatoes irradiated at the breaker and turning stages of maturity compared to those irradiated at the pink and light red stages

  7. Electron accelerators for environmental protection

    The primary objective of this publication is to provide information suitable for electron accelerators implementation in facilities applying radiation technology for environmental protection. It should be noticed that radiation processing has been successfully used in the fields of crosslinking polymer curing and medical products sterilization for more than 40 years. Practical application of radiation technology today extends on SO2 and NOx removal from the flue gas (one of major power intensive radiation processing), destruction and removal of organic chemicals from water, decreasing bacteria content in the irradiated sludge and waste water. On the other hand the increased awareness of environmental pollution hazards and more stringent waste regulations in many countries may open stronger support for environmentally oriented technologies. This publication provides an evaluation of electron accelerators capabilities in respect of environmental applications where technological and economical criteria are now well defined. In order to determine the potential of electron accelerators, the literature data were examined as well visits and meetings with various accelerator manufacturers were performed by the author. Experience of the author in accelerator facilities construction and exploitation including those which were used for environmental protection are significant part of this publication. The principle of accelerator action was described in Chapter 1. Early development, accelerator classification and fields of accelerators application were included to this chapter as well. Details of accelerator construction was described in Chapter 2 to illustrate physical capability of accelerators to perform the function of ionizing radiation source. Electron beam extraction devices, under beam equipment, electron beam parameters and measuring methods were characterized in this chapter as well. Present studies of accelerator technology was described in Chapter 3, where direct

  8. Accelerating Value Creation with Accelerators

    Jonsson, Eythor Ivar

    2015-01-01

    accelerator programs. Microsoft runs accelerators in seven different countries. Accelerators have grown out of the infancy stage and are now an accepted approach to develop new ventures based on cutting-edge technology like the internet of things, mobile technology, big data and virtual reality. It is also......Accelerators can help to accelerate value creation. Accelerators are short-term programs that have the objective of creating innovative and fast growing ventures. They have gained attraction as larger corporations like Microsoft, Barclays bank and Nordea bank have initiated and sponsored...

  9. Concurrent chemo-irradiation using accelerated concomitant boost radiation therapy in loco-regionally advanced head and neck squamous cell carcinomas

    Vivek R

    2006-01-01

    Full Text Available Purpose: To investigate the feasibility of combining concomitant boost-accelerated radiation regimen (ACB with full-dose mono-chemotherapy using cisplatin and to assess its local response and acute toxicity patterns in patients with advanced loco-regional head and neck squamous cell carcinoma (HNSCC. Materials and Methods: Between July 2004 and August 2005, a pilot study involving 27 patients with stage III to IVB (AJCC-6th HNSCC of the oropharynx, hypopharynx and larynx who met the eligibility criteria was undertaken. Twenty-four of these patients (median age - 53 years were analyzable. The radiation dose was 72 Gy in 42 fractions over 6 weeks, delivered in one daily fraction of 1.8 Gy during the first 3.5 weeks and two fractions per day, 1.8 Gy and 1.5 Gy boost-separated by> 6 h interval, during the last 2.5 weeks. cisplatin, 100 mg/m2, was given in intravenous (i.v. infusion on day 1 and day 22. Tumor and clinical status were assessed and acute toxicities were graded. Results: Out of 27 patients, 24 patients received both radiation and chemotherapy as per protocol and were available for analysis. The loco-regional response rates were as follows: an overall response of 95.8% (23 patients, a complete response of 79.1% (19 patients, a partial response of 16.7% (4 patients and progressive disease in 4.2% (1 patient. Dysphagia, nausea, vomiting and bone marrow suppression were the most common side effects and were associated with cisplatin administration. One patient (3.7% died of complications (pneumonia and sepsis, 3 patients (12.5% had acute grade 4 toxicity and 21 patients (87.5% had acute grade 3 (17 patients or grade 2 (4 patients toxicity. Conclusion: This data shows that it is feasible to combine ACB and full-dose mono-chemotherapy using cisplatin with manageable, although substantial, toxicity. The compliance to therapy was high and the loco-regional response achieved compared favorably with ACB alone or other concurrent chemoradiation

  10. Prototype of industrial electrons accelerator

    The interest and the necessity of Mexico's industry in the use of irradiation process has been increased in the last years. As examples are the irradiation of combustion gases (elimination of NOx and SO2) and the polymer cross-linking between others. At present time at least twelve enterprises require immediately of them which have been contacted by electron accelerators suppliers of foreign countries. The first project step consisted in to identify the electrons accelerator type that in can be constructed in Mexico with the major number of possible equipment, instruments, components and acquisition materials local and useful for the major number of users. the characteristics of the accelerator prototype are: accelerator type transformer with multiple secondary insulated and rectifier circuits with a potential of 0.8 MV of voltage, the second step it consisted in an economic study that permitted to demonstrate the economic feasibility of its construction. (Author)

  11. Breast-conserving therapy with partial or whole breast irradiation: Ten-year results of the Budapest randomized trial

    Background and purpose: To report the long-term results of a single-institution randomized study comparing the results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Patients and methods: Between 1998 and 2004, 258 selected women with pT1 pN0-1mi M0, grade 1–2, non-lobular breast cancer without the presence of extensive intraductal component and resected with negative margins were randomized after BCS to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 × 5.2 Gy high-dose-rate (HDR) multi-catheter brachytherapy (BT; n = 88) or 50 Gy electron beam (EB) irradiation (n = 40). Primary endpoint was local recurrence (LR) as a first event. Secondary endpoints were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and cosmetic results. Results: After a median follow up of 10.2 years, the ten-year actuarial rate of LR was 5.9% and 5.1% in PBI and WBI arms, respectively (p = 0.77). There was no significant difference in the ten-year probability of OS (80% vs 82%), CSS (94% vs 92%), and DFS (85% vs 84%), either. The rate of excellent-good cosmetic result was 81% in the PBI, and 63% in the control group (p < 0.01). Conclusions: Partial breast irradiation delivered by interstitial HDR BT or EB for a selected group of early-stage breast cancer patients produces similar ten-year results to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with HDR BT implants compared with the outcome after WBI

  12. Laser accelerator

    Vigil, Ricardo

    2014-01-01

    Approved for public release; distribution is unlimited In 1979,W. B. Colson and S. K. Ride proposed a new kind of electron accelerator using a uniform magnetic field in combination with a circularly-polarized laser field. A key concept is to couple the oscillating electric field to the electron’s motion so that acceleration is sustained. This dissertation investigates the performance of the proposed laser accelerator using modern high powered lasers and mag-netic fields that are significan...

  13. Review of Research on Post Irradiation Fruit Quality of Blueberries and Peaches

    The commercial use of irradiation is accelerating with the approval of low dose generic treatments for insect disinfestations and the availability of irradiation facilities. Commercial adoption of irradiation treatment requires an understanding of the radiotolerance limits for individual commodities...

  14. LIBO accelerates

    2002-01-01

    The prototype module of LIBO, a linear accelerator project designed for cancer therapy, has passed its first proton-beam acceleration test. In parallel a new version - LIBO-30 - is being developed, which promises to open up even more interesting avenues.

  15. A single pass electron accelerator

    Higher volumes, increasing competition and the need to improve quality have led us to re-examine the process for irradiation of tubing and wire. Traditionally in Raychem, product irradiation has involved the use of large multi-purpose facilities that were designed to handle relatively small volumes of a large variety of products as a separate process. Today, with larger volumes of certain products, there is an interest in combining processes to improve quality and reduce cost. We have recently designed and constructed a small, low voltage accelerator system that can be placed in-line with another manufacturing process and can uniformly irradiate a tube or wire product in a single pass. The system is comprised to two conventional accelerator systems having elongated filaments and placed on opposite sides of a linear product path. The ribbon shaped electron beams from these two accelerators are scanned, after acceleration toward the product path, in a conventional manner and 180 degrees out of phase from each other. The two accelerated electron beams then enter a third magnetic field that is synchronous with the scanning magnets and whose oscillating polarity is such that the ribbon beams are converged onto a tubular shaped window close to and around a segment of the product path. Trials with a prototype system have produced tubing having a dose concentricity of better than ± 10 percent on a single pass through the system. (author)

  16. A single pass electron accelerator

    Schuetz, M.N.; Vroom, D.A. [Raychem Corp., Menlo Park, CA (United States)

    1995-10-01

    Higher volumes, increasing competition and the need to improve quality have led us to re-examine the process for irradiation of tubing and wire. Traditionally in Raychem, product irradiation has involved the use of large multi-purpose facilities that were designed to handle relatively small volumes of a large variety of products as a separate process. Today, with larger volumes of certain products, there is an interest in combining processes to improve quality and reduce cost. We have recently designed and constructed a small, low voltage accelerator system that can be placed in-line with another manufacturing process and can uniformly irradiate a tube or wire product in a single pass. The system is comprised to two conventional accelerator systems having elongated filaments and placed on opposite sides of a linear product path. The ribbon shaped electron beams from these two accelerators are scanned, after acceleration toward the product path, in a conventional manner and 180 degrees out of phase from each other. The two accelerated electron beams then enter a third magnetic field that is synchronous with the scanning magnets and whose oscillating polarity is such that the ribbon beams are converged onto a tubular shaped window close to and around a segment of the product path. Trials with a prototype system have produced tubing having a dose concentricity of better than {+-} 10 percent on a single pass through the system. (author).

  17. A single pass electron accelerator

    Schuetz, Marlin N.; Vroom, David A.

    1995-02-01

    Higher volumes, increasing competition and the need to improve quality have led us to re-examine the process for irradiation of tubing and wire. Traditionallyin Raychem, product irradiation has involved the use of large multi-purpose facilities that were designed to handle relatively small volumes of a large variety of products as a separate process. Today, with larger volumes of certain products, there is an interest in combining processes to improve quality and reduce cost. We have recently designed and constructed a small, low voltage accelerator system that can be placed in-line with another manufacturing process and can uniformly irradiate a tube or wire product in a single pass. The system is comprised of two conventional accelerator systems having elongated filaments and placed on opposite sides of a linear product path. The ribbon shaped electron beams from these two accelerators are scanned, after acceleration toward the product path, in a conventional manner and 180 degrees out of phase from each other. The two accelerated electron beams then enter a third magnetic field that is synchronous with the scanning magnets and whose oscillating polarity is such that the ribbon beams are converged onto a tubular shaped window close to and around a segment of the product path. Trials with a prototype system have produced tubing having a dose concentricity of better than ± 10 percent on a single pass through the system.

  18. Induction accelerators

    Takayama, Ken

    2011-01-01

    A broad class of accelerators rests on the induction principle whereby the accelerating electrical fields are generated by time-varying magnetic fluxes. Particularly suitable for the transport of bright and high-intensity beams of electrons, protons or heavy ions in any geometry (linear or circular) the research and development of induction accelerators is a thriving subfield of accelerator physics. This text is the first comprehensive account of both the fundamentals and the state of the art about the modern conceptual design and implementation of such devices. Accordingly, the first part of the book is devoted to the essential features of and key technologies used for induction accelerators at a level suitable for postgraduate students and newcomers to the field. Subsequent chapters deal with more specialized and advanced topics.

  19. Electron accelerators for radiosterilization; Akceleratory elektronow dla potrzeb sterylizacji radiacyjnej

    Zimek, Z. [Institute of Nuclear Chemistry and Technology, Warsaw (Poland)

    1997-10-01

    The applications of electron accelerators in commercial plants for radiosterilization have been shown. Advantages of such irradiation source have been presented. The types and parameters of accelerators being installed in worldwide irradiation plants for radiosterilization have been listed as well. 2 tabs.

  20. Materials irradiation research in neutron science

    Noda, Kenji; Oyama, Yukio [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1997-11-01

    Materials irradiation researches are planned in Neutron Science Research Program. A materials irradiation facility has been conceived as one of facilities in the concept of Neutron Science Research Center at JAERI. The neutron irradiation field of the facility is characterized by high flux of spallation neutrons with very wide energy range up to several hundred MeV, good accessibility to the irradiation field, good controllability of irradiation conditions, etc. Extensive use of such a materials irradiation facility is expected for fundamental materials irradiation researches and R and D of nuclear energy systems such as accelerator-driven incineration plant for long-lifetime nuclear waste. In this paper, outline concept of the materials irradiation facility, characteristics of the irradiation field, preliminary technical evaluation of target to generate spallation neutrons, and materials researches expected for Neutron Science Research program are described. (author)

  1. IFMIF accelerator facility RAMI analyses in the engineering design phase

    Bargalló Font, Enric

    2014-01-01

    The planned International Fusion Materials Irradiation Facility (IFMIF) has the mission to test and qualify materials for future fusion reactors. IFMIF will employ the deuteron-lithium stripping reaction to irradiate the test samples with a high-energy neutron flux. IFMIF will consist mainly of two linear deuteron accelerators, a liquid lithium loop and a test cell. Accelerated deuterons will collide with the lithium producing a high-energy neutron flux that will irradiate the material sample...

  2. Breast-Conserving Treatment With Partial or Whole Breast Irradiation for Low-Risk Invasive Breast Carcinoma-5-Year Results of a Randomized Trial

    Purpose: To report the 5-year results of a randomized study comparing the survival and cosmetic results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Methods and Materials: Between 1998 and 2004, 258 selected patients with T1 N0-1mi, Grade 1-2, nonlobular breast cancer without presence of extensive intraductal component and resected with negative margins were randomized after breast-conserving surgery to receive 50 Gy/25 fractions WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy high-dose-rate (HDR) multicatheter brachytherapy (BT; n = 88) or 50 Gy/25 fractions electron beam (EB) irradiation (n = 40). Results: At a median follow-up of 66 months, the 5-year actuarial rate of local recurrence was 4.7% and 3.4% in the PBI and WBI arms, respectively (p = 0.50). There was no significant difference in the 5-year probability of overall survival (94.6% vs. 91.8%), cancer-specific survival (98.3% vs. 96.0%), and disease-free survival (88.3% vs. 90.3%). The rate of excellent to good cosmetic result was 77.6% in the PBI group (81.2% after HDR BT; 70.0% after EB) and 62.9% in the control group (52.2% after telecobalt; 65.6% after 6-9-MV photons; pWBI/PBI = 0.009). Conclusions: Partial breast irradiation using interstitial HDR implants or EB to deliver radiation to the tumor bed alone for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with carefully designed HDR multicatheter implants compared with the outcome after WBI

  3. Breast cancer radiotherapy: controversies and prospectives

    YU Jin-ming; WANG Yong-sheng

    2008-01-01

    @@ Despite consensus on breast cancer radiotherapy, there are still some controversies over post-mastectomy radiotherapy (PMRT) in patients with 1-3 positive lymph nodes, accelerated partial breast irradiation (APBI), appropriate sequence of radiotherapy, chemotherapy and hormonal treatment, and radiotherapy after preoperative systemic therapy.

  4. Phase 2 Trial of Accelerated, Hypofractionated Whole-Breast Irradiation of 39 Gy in 13 Fractions Followed by a Tumor Bed Boost Sequentially Delivering 9 Gy in 3 Fractions in Early-Stage Breast Cancer

    Purpose: To report a phase 2 trial of accelerated, hypofractionated whole-breast irradiation (AH-WBI) delivered as a daily dose of 3 Gy to the whole breast followed by a tumor bed boost. Methods and Materials: Two hundred seventy-six patients diagnosed with breast cancer (pT1-2 and pN0-1a) who had undergone breast-conserving surgery in which the operative margins were negative were treated with AH-WBI delivered as 39 Gy in 13 fractions of 3 Gy to the whole breast once daily over 5 consecutive working days, and 9 Gy in 3 sequential fractions of 3 Gy to a lumpectomy cavity, all within 3.2 weeks. Results: After a median follow-up period of 57 months (range: 27-75 months), the rate of 5-year locoregional recurrence was 1.4% (n=4), whereas that of disease-free survival was 97.4%. No grade 3 skin toxicity was reported during the follow-up period. Qualitative physician cosmetic assessments of good or excellent were noted in 82% of the patients at 2 months after the completion of AH-WBI. The global cosmetic outcome did not worsen over time, and a good or excellent cosmetic outcome was reported in 82% of the patients at 3 years. The mean pretreatment percentage breast retraction assessment was 12.00 (95% confidence interval [CI]: 11.14-12.86). The mean value of percentage breast retraction assessment increased to 13.99 (95% CI: 12.17-15.96) after 1 year and decreased to 13.54 (95% CI: 11.84-15.46) after 3 years but was not significant (P>.05). Conclusions: AH-WBI consisting of 39 Gy in 13 fractions followed by a tumor bed boost sequentially delivering 9 Gy in 3 fractions can be delivered with excellent disease control and tolerable skin toxicity in patients with early-stage breast cancer after breast-conserving surgery

  5. Phase 2 Trial of Accelerated, Hypofractionated Whole-Breast Irradiation of 39 Gy in 13 Fractions Followed by a Tumor Bed Boost Sequentially Delivering 9 Gy in 3 Fractions in Early-Stage Breast Cancer

    Kim, Ja Young [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Jung, So-Youn; Lee, Seeyoun; Kang, Han-Sung; Lee, Eun Sook; Park, In Hae; Lee, Keun Seok; Ro, Jungsil [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Lee, Nam Kwon [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Radiation Oncology, Korea University Medical Center, Collage of Medicine, Seoul (Korea, Republic of); Shin, Kyung Hwan, E-mail: radiat@ncc.re.kr [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Radiation Oncology, Korea University Medical Center, Collage of Medicine, Seoul (Korea, Republic of)

    2013-12-01

    Purpose: To report a phase 2 trial of accelerated, hypofractionated whole-breast irradiation (AH-WBI) delivered as a daily dose of 3 Gy to the whole breast followed by a tumor bed boost. Methods and Materials: Two hundred seventy-six patients diagnosed with breast cancer (pT1-2 and pN0-1a) who had undergone breast-conserving surgery in which the operative margins were negative were treated with AH-WBI delivered as 39 Gy in 13 fractions of 3 Gy to the whole breast once daily over 5 consecutive working days, and 9 Gy in 3 sequential fractions of 3 Gy to a lumpectomy cavity, all within 3.2 weeks. Results: After a median follow-up period of 57 months (range: 27-75 months), the rate of 5-year locoregional recurrence was 1.4% (n=4), whereas that of disease-free survival was 97.4%. No grade 3 skin toxicity was reported during the follow-up period. Qualitative physician cosmetic assessments of good or excellent were noted in 82% of the patients at 2 months after the completion of AH-WBI. The global cosmetic outcome did not worsen over time, and a good or excellent cosmetic outcome was reported in 82% of the patients at 3 years. The mean pretreatment percentage breast retraction assessment was 12.00 (95% confidence interval [CI]: 11.14-12.86). The mean value of percentage breast retraction assessment increased to 13.99 (95% CI: 12.17-15.96) after 1 year and decreased to 13.54 (95% CI: 11.84-15.46) after 3 years but was not significant (P>.05). Conclusions: AH-WBI consisting of 39 Gy in 13 fractions followed by a tumor bed boost sequentially delivering 9 Gy in 3 fractions can be delivered with excellent disease control and tolerable skin toxicity in patients with early-stage breast cancer after breast-conserving surgery.

  6. Accelerator target

    Schlyer, David J. (Bellport, NY); Ferrieri, Richard A. (Patchogue, NY); Koehler, Conrad (Miller Place, NY)

    1999-01-01

    A target includes a body having a depression in a front side for holding a sample for irradiation by a particle beam to produce a radioisotope. Cooling fins are disposed on a backside of the body opposite the depression. A foil is joined to the body front side to cover the depression and sample therein. A perforate grid is joined to the body atop the foil for supporting the foil and for transmitting the particle beam therethrough. A coolant is circulated over the fins to cool the body during the particle beam irradiation of the sample in the depression.

  7. Tandem accelerators

    After the installation of Ti-acceleration tubes and substantial modifications and additions to the EN tandem accelerator the performance of the machine has stabilized. The voltage behaviour of the tubes obviously improves as conditioning times necessary to run up to 6 MV decrease. A gridded lens has been added at the entrance of the first acceleration tube, and a second foil stripper is now installed in the short dead section between the high-energy tubes. The MP tandem also has been running stably during most of the year. However, beam instabilities originating from the last tube section and wear problems at the low-energy set of pelletron-chains caused some loss of beam time. During the fall, one set of pelletron charging chains has to be replaced after 49,000 hours of operation. In the course of the year, the MP and the EN tandem accelerators finished their 100,000th and 150,000th hours of operations, respectively. Preparations for the installation of the 3 MV negative heavy ion injector for the MP are progressing steadily. External beam transport, terminal ion optics, and data acquisition and control systems are to a major extent completed; the integration of the terminal power supplies has started. After the final assembly of the accelerator column structure, first voltage runs can be performed. (orig.)

  8. Accelerators for the advanced radiation technology project

    Ion beam irradiation facilities are now under construction for the advanced radiation technology (ART) project in Takasaki Radiation Chemistry Research Establishment of (Japan Atomic Energy Research Institute) JAERI. The project is intended to make an effective use of ion beams, especially ion beams, in the research field of radiation application technology. The TIARA (Takasaki Ion Accelerators for Advanced Radiation Application) facilities include four ion accelerators to produce almost all kinds of energetic ions in the periodic table. The facilities are also provided with several advanced irradiation means and act as very powerful accelerator complex for material development. Specifically, this report presents an outline of the ART project, features of TIARA as accelerator facilities dedicated to material development, the AVF cyclotron under construction (Sumitomo Heavy Industries, Ltd., Model 930), tandem accelerator, microbeam, and experimental instruments used. (N.K.)

  9. Food irradiation

    Food irradiation is a promising technology in which food products are exposed to a controlled amount of radiant energy to eliminate disease-causing bacteria. The process can also control parasites and insects, reduce spoilage and inhibit ripening and sprouting. Food irradiation is endorsed by the most important health organisations (WHO, CDC, USDA, FDA, EFSA, etc.) and allowed in nearly 40 Countries. It is to remember that irradiation is not a substitute either for comprehensive food safety programs or for good food-handling practices. Irradiated foods must be labelled with either the statement treated with radiation or treated by irradiation and the international symbol for irradiation, the radura. Some consumer associations suppose negative aspects of irradiation, such as increase of the number of free radicals in food and decrease of antioxidant vitamins that neutralize them

  10. Use of accelerators in industry

    Low energy charged particle accelerators are fast replacing the conventional cobalt sources in several industrial applications. The field of applications include: (1) radiography of thick steel plates (upto 500 mm), (2) activation analysis for onspot oxygen determination in many elements of interest to metallurgical and steel industries, (3) radiation chemistry, (4) sterilization and food irradiation, (5) welding special steels and treating of refractory and hard metals, (6) environment and water pollution and (7) agriculture. The requirements and the feasibility of a suitable accelerator for these purposes has been discussed. (auth.)

  11. The operational procedure of an electron beam accelerator

    Lee, Byung Cheol; Choi, Hwa Lim; Yang, Ki Ho; Han, Young Hwan; Kim, Sung Chan

    2008-12-15

    The KAERI(Korea Atomic Energy of Research Institute) high-power electron beam irradiation facility, operating at the energies between 0.3 MeV and 10 MeV, has provided irradiation services to users in industries, universities, and institute in various fields. This manual is for the operation of an electron beam which is established in KAERI, and describes elementary operation procedures of electron beam between 0.3 Mev and 10 MeV. KAERI Electron Accelerator facility(Daejeon, Korea) consists of two irradiators: one is a low-energy electron beam irradiator operated by normal conducting RF accelerator, the other is medium-energy irradiator operated by superconducting RF accelerator. We explain the check points of prior to operation, operation procedure of this facility and the essential parts of electron beam accelerator.

  12. Particle acceleration

    Vlahos, L.; Machado, M. E.; Ramaty, R.; Murphy, R. J.; Alissandrakis, C.; Bai, T.; Batchelor, D.; Benz, A. O.; Chupp, E.; Ellison, D.

    1986-01-01

    Data is compiled from Solar Maximum Mission and Hinothori satellites, particle detectors in several satellites, ground based instruments, and balloon flights in order to answer fundamental questions relating to: (1) the requirements for the coronal magnetic field structure in the vicinity of the energization source; (2) the height (above the photosphere) of the energization source; (3) the time of energization; (4) transistion between coronal heating and flares; (5) evidence for purely thermal, purely nonthermal and hybrid type flares; (6) the time characteristics of the energization source; (7) whether every flare accelerates protons; (8) the location of the interaction site of the ions and relativistic electrons; (9) the energy spectra for ions and relativistic electrons; (10) the relationship between particles at the Sun and interplanetary space; (11) evidence for more than one acceleration mechanism; (12) whether there is single mechanism that will accelerate particles to all energies and also heat the plasma; and (13) how fast the existing mechanisms accelerate electrons up to several MeV and ions to 1 GeV.

  13. Accelerator design

    The feasibility of constructing a TeV region electron-positron linear collider in Japan is discussed. The design target of the collider is given as follows: Energy, 1 TeV + 1 TeV; luminosity, 1032-1033/cm2/s; total length, 25km; electric power, 250MW; energy dispersion, 1%-10%; the start of the first experiment, early 1990s. For realizing the above target, the following research and developmental works are necessary. (a) Development of an acceleration tube with short filling time and high shunt resistance. (b) Short pulse microwave source with high peak power. (c) High current, single bunch linac. (d) Beam dynamics. As for the acceleration tube, some possibility is considered: For example, the use of DAW (Disk and Washer) which is being developed for TRISTAN as a traveling-wave tube; and the Jungle Gym-type acceleration tube. As a promising candidate for the microwave source, the Lasertron has been studied. The total cost of the collider construction is estimated to be about 310 billion yen, of which 120 billion yen is for the tunnel and buildings, and 190 billion yen for the accelerator facilities. The operation cost is estimated to be about 3 billion yen per month. (Aoki, K.)

  14. Accelerator operations

    This section is concerned with the operation of both the tandem-linac system and the Dynamitron, two accelerators that are used for entirely different research. Developmental activities associated with the tandem and the Dynamitron are also treated here, but developmental activities associated with the superconducting linac are covered separately because this work is a program of technology development in its own right

  15. Dose rate effect in food irradiation

    It has been suggested that the minor losses of nutrients associated with radiation processing may be further reduced by irradiating foods at the high dose rates generally associated with electron beams from accelerators, rather than at the low dose rates typical of gamma irradiation (e.g. 60Co). This review briefly examines available comparative data on gamma and electron irradiation of foods to evaluate these suggestions. (137 refs., 27 tabs., 11 figs.)

  16. Advanced accelerators

    This report discusses the suitability of four novel particle acceleration technologies for multi-TeV particle physics machines: laser driven linear accelerators (linac), plasma beat-wave devices, plasma wakefield devices, and switched power and cavity wakefield linacs. The report begins with the derivation of beam parameters practical for multi-TeV devices. Electromagnetic field breakdown of materials is reviewed. The two-beam accelerator scheme for using a free electron laser as the driver is discussed. The options recommended and the conclusions reached reflect the importance of cost. We recommend that more effort be invested in achieving a self-consistent range of TeV accelerator design parameters. Beat-wave devices have promise for 1-100 GeV applications and, while not directly scalable to TeV designs, the current generation of ideas are encouraging for the TeV regime. In particular, surfatrons, finite-angle optical mixing devices, plasma grating accelerator, and the Raman forward cascade schemes all deserve more complete analysis. The exploitation of standard linac geometry operated in an unconventional mode is in a phase of rapid evolution. While conceptual projects abound, there are no complete designs. We recommend that a fraction of sponsored research be devoted to this approach. Wakefield devices offer a great deal of potential; trades among their benefits and constraints are derived and discussed herein. The study of field limitation processes has received inadequate attention; this limits experiment designers. The costs of future experiments are such that investment in understanding these processes is prudent. 34 refs., 12 figs., 3 tabs

  17. Investigation of the effect of some irradiation parameters on the response of various types of dosimeters to electron irradiation

    Farah, K.; Kuntz, F.; Kadri, O.; Ghedira, L.

    2004-09-01

    Several undyed and dyed polymer films are commercially available for dosimetry in intense radiation fields, especially for radiation processing of food and sterilisation of medical devices. The effects of temperature during irradiation and post-irradiation stability, on the response of these dosimeters are of importance to operators of irradiation facilities. The present study investigates the effects of temperature during irradiation by 2.2 MeV electrons beam accelerator and post irradiation storage on the response of several types of dosimeter films. All dosimeters showed a significant effect of temperature during irradiation and post-irradiation storage.

  18. Investigation of the effect of some irradiation parameters on the response of various types of dosimeters to electron irradiation

    Farah, K. E-mail: k.farah@cnstn.rnrt.tn; Kuntz, F.; Kadri, O.; Ghedira, L

    2004-10-01

    Several undyed and dyed polymer films are commercially available for dosimetry in intense radiation fields, especially for radiation processing of food and sterilisation of medical devices. The effects of temperature during irradiation and post-irradiation stability, on the response of these dosimeters are of importance to operators of irradiation facilities. The present study investigates the effects of temperature during irradiation by 2.2 MeV electrons beam accelerator and post irradiation storage on the response of several types of dosimeter films. All dosimeters showed a significant effect of temperature during irradiation and post-irradiation storage.

  19. MUON ACCELERATION

    BERG,S.J.

    2003-11-18

    One of the major motivations driving recent interest in FFAGs is their use for the cost-effective acceleration of muons. This paper summarizes the progress in this area that was achieved leading up to and at the FFAG workshop at KEK from July 7-12, 2003. Much of the relevant background and references are also given here, to give a context to the progress we have made.

  20. KEKB accelerator

    KEKB, the B-Factory at High Energy Accelerator Research Organization (KEK) recently achieved the luminosity of 1 x 1034 cm-2s-1. This luminosity is two orders higher than the world's level at 1990 when the design of KEKB started. This unprecedented result was made possible by KEKB's innovative design and technology in three aspects - beam focusing optics, high current storage, and beam - beam interaction. Now KEKB is leading the luminosity frontier of the colliders in the world. (author)

  1. Accelerating networks

    Evolving out-of-equilibrium networks have been under intense scrutiny recently. In many real-world settings the number of links added per new node is not constant but depends on the time at which the node is introduced in the system. This simple idea gives rise to the concept of accelerating networks, for which we review an existing definition and-after finding it somewhat constrictive-offer a new definition. The new definition provided here views network acceleration as a time dependent property of a given system as opposed to being a property of the specific algorithm applied to grow the network. The definition also covers both unweighted and weighted networks. As time-stamped network data becomes increasingly available, the proposed measures may be easily applied to such empirical datasets. As a simple case study we apply the concepts to study the evolution of three different instances of Wikipedia, namely, those in English, German, and Japanese, and find that the networks undergo different acceleration regimes in their evolution

  2. Quality comparison between gamma-irradiated or electron beam irradiated pork patties

    This study was conducted to evaluate the microbial safety, hardness and sensory properties of pork patties irradiated with gamma ray or electron beam at the absorbed dose from 5 to 20 kGy. Minced pork was prepared in 24 hours after butchery for manufacturing of pork patties. It was produced by methods of our previous study and then packaged to vacuum condition. Gamma (430 kCi, Co-60) and electron beam (2.5 MeV, electron accelerator) were used for food irradiation, and the absorbed doses used were up to 20 kGy under room temperature. The microbiological and sitological characteristics of the samples were observed during accelerated storage at 30 deg. C for 10 d. The results of the total aerobic bacteria in pork patties during the accelerated storage showed that the sterilization effect of gamma irradiation was superior to that of electron beam irradiation. The hardness and sensory properties such as colour, chewiness, taste, and overall acceptability of pork patties were decreased depending upon irradiation dose. Gamma irradiated samples have lower hardness and sensory scores than those of electron beam irradiated samples. In conclusion, gamma irradiation on pork patties was appeared more effective than E-beam irradiation. However, further studies to reduce the quality deterioration of gamma-irradiated pork patties should be continuously conducted

  3. High intensity laser-driven ion acceleration

    Ion acceleration by intense laser-plasma interactions is a very active field of research whose development can be traced in a large number of publications over the last few years. Past studies were mostly performed irradiating thin foils where protons are predominantly accelerated to energies up to 60 MeV in an exponentially decaying spectrum by a mechanism named target normal sheath acceleration (TNSA). We present our latest experimental advances on acceleration schemes away from TNSA, such as shock acceleration, ion beam generation from relativistically transparent targets and radiation-pressure acceleration. These results are a major step towards highly energetic, mono-chromatic ion beams generated at high conversion efficiencies as demanded by many potential applications. Those include fast ignition inertial confinement fusion (ICF) as well as oncology and radiation therapy of tumors.

  4. Irradiated planets

    We present models for the spectra emitted by irradiated planets and discuss the numerical methods used in the modeling. In addition, we show results of simple 3D calculations that are designed as a first step toward detailed multi-dimensional models of irradiated planets

  5. Food irradiation

    The paper discusses the need for effective and efficient technologies in improving the food handling system. It defines the basic premises for the development of food handling. The application of food irradiation technology is briefly discussed. The paper points out key considerations for the adoption of food irradiation technology in the ASEAN region (author)

  6. Food irradiation

    The author reviews in outline the present status of industrial gamma irradiation plants for food and medical sterilization and in particular lists commercial irradiation plants currently operating in the U.K., considering briefly plant design, efficiency, costs and dose control. (UK)

  7. Characterization Study of Accelerator for Application in Biotechnology

    The characterization of accelerator for application in biotechnology was studied. Accelerator is a machine to produce ion beam particles. Accelerator can be used for biotechnology experiments. Ion beam particles irradiation on the biological material will produced variabilities of genetics and induced mutations. In general, new varieties were found by hybridization method or mutation breeding method by gamma rays irradiation. Ion beam particles can be used for biological material irradiation to find variabilities of genetics and induced mutations. The high percentage of mutation rate and LET value by ion beam particles irradiation was found higher than by gamma rays irradiation. Ion beam particle irradiation can also be controlled and foewed to target in biological material. The characterization of accelerator needed for biotechnology experiments are types of accelerator (Tandem Van de Graff, AVF Cyclotron, Synchrotron, Rilac), types of ion particles (C, He, electron, Ar, Ne, Ni, Al, Xe and Au), range of energy (5 - 2.090 MeV), range of dose irradiation (10 - 250 Gy), range of ion current (0.02 - 20 nA), range of ion beam particles diameter (10 - 100 μm), range of LET value (300 - 1.800 keV/μm ) and irradiation time (5 - 30 seconds/samples). (author)

  8. Irradiation damage

    There is considerable interest in irradiation effects in intermetallic compounds from both the applied and fundamental aspects. Initially, this interest was associated mainly with nuclear reactor programs but it now extends to the fields of ion-beam modification of metals, behaviour of amorphous materials, ion-beam processing of electronic materials, and ion-beam simulations of various kinds. The field of irradiation damage in intermetallic compounds is rapidly expanding, and no attempt will be made in this chapter to cover all of the various aspects. Instead, attention will be focused on some specific areas and, hopefully, through these, some insight will be given into the physical processes involved, the present state of our knowledge, and the challenge of obtaining more comprehensive understanding in the future. The specific areas that will be covered are: point defects in intermetallic compounds; irradiation-enhanced ordering and irradiation-induced disordering of ordered alloys; irradiation-induced amorphization

  9. Food irradiation

    Food irradiation can have a number of beneficial effects, including prevention of sprouting; control of insects, parasites, pathogenic and spoilage bacteria, moulds and yeasts; and sterilization, which enables commodities to be stored for long periods. It is most unlikely that all these potential applications will prove commercially acceptable; the extend to which such acceptance is eventually achieved will be determined by practical and economic considerations. A review of the available scientific literature indicates that food irradiation is a thoroughly tested food technology. Safety studies have so far shown no deleterious effects. Irradiation will help to ensure a safer and more plentiful food supply by extending shelf-life and by inactivating pests and pathogens. As long as requirement for good manufacturing practice are implemented, food irradiation is safe and effective. Possible risks of food irradiation are not basically different from those resulting from misuse of other processing methods, such as canning, freezing and pasteurization. (author)

  10. Irradiation damage

    Howe, L.M

    2000-07-01

    There is considerable interest in irradiation effects in intermetallic compounds from both the applied and fundamental aspects. Initially, this interest was associated mainly with nuclear reactor programs but it now extends to the fields of ion-beam modification of metals, behaviour of amorphous materials, ion-beam processing of electronic materials, and ion-beam simulations of various kinds. The field of irradiation damage in intermetallic compounds is rapidly expanding, and no attempt will be made in this chapter to cover all of the various aspects. Instead, attention will be focused on some specific areas and, hopefully, through these, some insight will be given into the physical processes involved, the present state of our knowledge, and the challenge of obtaining more comprehensive understanding in the future. The specific areas that will be covered are: point defects in intermetallic compounds; irradiation-enhanced ordering and irradiation-induced disordering of ordered alloys; irradiation-induced amorphization.

  11. Accelerators and the Accelerator Community

    Malamud, Ernest; Sessler, Andrew

    2008-06-01

    In this paper, standing back--looking from afar--and adopting a historical perspective, the field of accelerator science is examined. How it grew, what are the forces that made it what it is, where it is now, and what it is likely to be in the future are the subjects explored. Clearly, a great deal of personal opinion is invoked in this process.

  12. Development of Theoretical Modeling of Point Radiation Defects, Cascades and Sub-Cascades Formation in Diatomic Materials (AI2O3) Irradiated by Fast Charged Particles on Accelerators and Fast Neutrons in Atomic Reactors

    The main aim of this presentation is a description of modern theoretical models and obtained numerical results for radiation damage production inculing point defects, cascade and sub-cascade formations in different monoatomic materials irradiated by fast ions and fast neutrons taking into account elastic and inelastic processes. The special topic of this presentation is oriented on the theoretical modeling and numerical calculations of radiation damage formation (point defects, cascades and subcascades) in diatomic materials (Al2O3) irradiated by fast charged paricles on accelarators and fast neutrons in atomic reactors using exested nuclear data base

  13. Multi-modality fusion of CT, 3D ultrasound, and tracked strain images for breast irradiation planning

    Foroughi, Pezhman; Csoma, Csaba; Rivaz, Hassan; Fichtinger, Gabor; Zellars, Richard; Hager, Gregory; Boctor, Emad

    2009-02-01

    Breast irradiation significantly reduces the risk of recurrence of cancer. There is growing evidence suggesting that irradiation of only the involved area of the breast, partial breast irradiation (PBI), is as effective as whole breast irradiation. Benefits of PBI include shortened treatment time, and perhaps fewer side effects as less tissue is treated. However, these benefits cannot be realized without precise and accurate localization of the lumpectomy cavity. Several studies have shown that accurate delineation of the cavity in CT scans is very challenging and the delineated volumes differ dramatically over time and among users. In this paper, we propose utilizing 3D ultrasound (3D-US) and tracked strain images as complementary modalities to reduce uncertainties associated with current CT planning workflow. We present the early version of an integrated system that fuses 3D-US and real-time strain images. For the first time, we employ tracking information to reduce the noise in calculation of strain image by choosing the properly compressed frames and to position the strain image within the ultrasound volume. Using this system, we provide the tools to retrieve additional information from 3D-US and strain image alongside the CT scan. We have preliminarily evaluated our proposed system in a step-by-step fashion using a breast phantom and clinical experiments.

  14. accelerating cavity

    On the inside of the cavitytThere is a layer of niobium. Operating at 4.2 degrees above absolute zero, the niobium is superconducting and carries an accelerating field of 6 million volts per metre with negligible losses. Each cavity has a surface of 6 m2. The niobium layer is only 1.2 microns thick, ten times thinner than a hair. Such a large area had never been coated to such a high accuracy. A speck of dust could ruin the performance of the whole cavity so the work had to be done in an extremely clean environment.

  15. Electron Accelerator Facilities

    Lecture presents main aspects of progress in development of industrial accelerators: adaptation of accelerators primary built for scientific experiments, electron energy and beam power increase in certain accelerator constructions, computer control system managing accelerator start-up, routine operation and technological process, maintenance (diagnostics), accelerator technology perfection (electrical efficiency, operation cost), compact and more efficient accelerator constructions, reliability improvement according to industrial standards, accelerators for MW power levels and accelerators tailored for specific use

  16. Triple ion beam irradiation facility

    A unique ion irradiation facility consisting of three accelerators is described. The accelerators can be operated simultaneously to deliver three ion beams on one target sample. The energy ranges of the ions are 50 to 400 keV, 200 keV to 2.5 MeV, and 1.0 to 5.0 MeV. Three different ions in the appropriate mass range can be simultaneously implanted to the same depth in a target specimen as large as 100 mm2 in area. Typical depth ranges are 0.1 to 1.0 μm. The X-Y profiles of all three ion beams are measured by a system of miniature Faraday cups. The low-voltage accelerator can periodically ramp the ion beam energy during the implantation. Three different types of target chambers are in use at this facility. The triple-beam high-vacuum chamber can hold nine transmission electron microscopy specimens at elevated temperature during a irradiation by the three simultaneous beams. A second high-vacuum chamber on the medium-voltage accelerator beamline houses a low- and high-temperature translator and a two-axis goniometer for ion channeling measurements. The third chamber on the high-energy beamline can be gas-filled for special stressed specimen irradiations. Special applications for the surface modification of materials with this facility are described. Appendixes containing operating procedures are also included. 18 refs., 27 figs., 1 tab

  17. Nanoindentation on ion irradiated steels

    Radiation induced mechanical property changes can cause major difficulties in designing systems operating in a radiation environment. Investigating these mechanical property changes in an irradiation environment is a costly and time consuming activity. Ion beam accelerator experiments have the advantage of allowing relatively fast and inexpensive materials irradiations without activating the sample but do in general not allow large beam penetration depth into the sample. In this study, the ferritic/martensitic steel HT-9 was processed and heat treated to produce one specimen with a large grained ferritic microstructure and further heat treated to form a second specimen with a fine tempered martensitic lath structure and exposed to an ion beam and tested after irradiation using nanoindentation to investigate the irradiation induced changes in mechanical properties. It is shown that the HT-9 in the ferritic heat treatment is more susceptible to irradiation hardening than HT-9 after the tempered martensitic heat treatment. Also at an irradiation temperature above 550 deg. C no detectable hardness increase due to irradiation was detected. The results are also compared to data from the literature gained from the fast flux test facility.

  18. Food irradiation

    Food treatment by means of ionizing energy, or irradiation, is an innovative method for its preservation. In order to treat important volumes of food, it is necessary to have industrial irradiation installations. The effect of radiations on food is analyzed in the present special work and a calculus scheme for an Irradiation Plant is proposed, discussing different aspects related to its project and design: ionizing radiation sources, adequate civil work, security and auxiliary systems to the installations, dosimetric methods and financing evaluation methods of the project. Finally, the conceptual design and calculus of an irradiation industrial plant of tubercles is made, based on the actual needs of a specific agricultural zone of our country. (Author)

  19. Fruits irradiation

    The objectives of this project in food irradiation are two-fold, to study the effect of irradiation in prolongation of useful storage life of fruits and to evaluate irradiation as a means of preserving fruits. However radiation is not intended to replace existing preservation processes but may be used in conjunction with current methods such as refrigeration, drying, fermentation etc. In fact radiation should combine with proper storage and packaging techniques in order to ensure maximum benefits. Ripening retardation of fruits by irradiation kinds of fruits: papaya, mango, rambutan, longan and durian. Changes in organoleptic properties of fruit flavor and taste, texture changes by taste panel estimation of significance level of results by statistical mathematical methods, chemical changes determination of climacteric peak in fruits by estimation of carbon dioxide evolution, vitamin C determination by Tillmann's method, carotenoid separation by thin layer chromatography, reducing sugars and acidity determination, volatile components of durian by gas-chromatography

  20. Accelerator system and method of accelerating particles

    Wirz, Richard E. (Inventor)

    2010-01-01

    An accelerator system and method that utilize dust as the primary mass flux for generating thrust are provided. The accelerator system can include an accelerator capable of operating in a self-neutralizing mode and having a discharge chamber and at least one ionizer capable of charging dust particles. The system can also include a dust particle feeder that is capable of introducing the dust particles into the accelerator. By applying a pulsed positive and negative charge voltage to the accelerator, the charged dust particles can be accelerated thereby generating thrust and neutralizing the accelerator system.

  1. Food irradiation

    The preservation of food using irradiation may replace or be used in combination with traditional or conventional food preservation techniques. Studies have shown that the irradiation technique which uses less energy than other preservation methods is a potential way for reducing post harvest losses. However, economic feasibility among other constraints is the core factor to determine the success of the technique at commercial scale. The need and importance for considering this new technique in Malaysia are discussed here. (author)

  2. Medical waste irradiation study. Final report

    The North Star Research Corporation Medical Waste project is described in this report, with details of design, construction, operation, and results to date. The project began with preliminary design of the accelerator. The initial design was for a single accelerator chamber with a vacuum tube cavity driver built into the chamber itself, rather than using a commercial tube separate from the RF accelerator. The authors believed that this would provide more adjustability and permit better coupling to be obtained. They did not have sufficient success with that approach, and finally completed the project using a DC accelerator with a unique new scanning system to irradiate the waste

  3. Irradiation tests report of the 33rd cycle in 'JOYO'

    This report summarizes the operating and irradiation data of the experimental reactor 'JOYO' 33rd cycle, and estimates the 34th cycle irradiation condition. Irradiation tests in the 33rd cycle are as follows: (1) B-type irradiation rig (B9). (a) High burn up performance tests of MONJU' fuel pins, advanced austenitic steel cladding fuel pins, large diameter fuel pins, ferrite steel cladding fuel pins and large diameter annular pellet fuel pins, (b) Mixed carbide and nitride fuel pins irradiation tests (in collaboration with JAERI). (2) C-type irradiation rig (C4F). (a) High burn up performance test of advanced austenitic stainless steel cladding fuel pins (in collaboration with France). (3) C-type irradiation rig (C6D). (a) Large diameter fuel pins irradiation tests. (4) Absorber Materials Irradiation Rig (AMIR-6). (a) Run to absorber pin's cladding breach. (5) Core Materials Irradiation Rig (CMIR-5). (a) Cladding tube materials irradiation tests for 'MONJU'. (6) Core Materials Irradiation Rig (CMIR-5-1). (a) Core materials irradiation tests. (7) Structure Materials Irradiation Rigs (SMIR). (a) Material irradiation tests (in collaboration with universities, (b) Surveillance back up tests for 'MONJU' (8) Upper core structure irradiation Plug Rig (UPR-1-5). (a) Upper core neutron spectrum effect and accelerated irradiation effect. The maximum burnup driver assembly 'PFD516' reached 64,300 MWd/t (pin average). (author)

  4. Nuclear data for designing the IFMIF accelerator

    Sugimoto, Masayoshi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1998-03-01

    The objective of the International Fusion Materials Irradiation Facility (IFMIF) and the design concept of the IFMIF accelerator system are described. The status of the nuclear data, especially for the deuteron-induced reactions, to qualify the system design is reviewed. The requests for the nuclear data compilation and/or evaluation are summarized. (author)

  5. High-frequency charged particle accelerator

    The device is refered to technical physics and may be used as a source of accelerated particles for irradiation of different objects in industry and agriculture. The device is aimed at increase of the power and enhancement of stability of the accelerator operation and decrease of its dimensions. High-frequency accelerator is composed of an accelerating cavity resonator a charged particle source and HF power supply. The aim is attained by the fact, that HF power source anode is made as one of coupling capasitor plates, the second plate of which is the nearest to anode HF power supply grid. The coupling capacitor plalte functional union with the HF power supply electrodes (anode and grid) reduces to spirious inductances of HF power supply circuit to minimum. Besides, the accelerator structure is simplified, as additional cooling system for the charged particle source is not necessary

  6. Radiotherapy using a laser proton accelerator

    Murakami, Masao; Miyajima, Satoshi; Okazaki, Yoshiko; Sutherland, Kenneth L; Abe, Mitsuyuki; Bulanov, Sergei V; Daido, Hiroyuki; Esirkepov, Timur Zh; Koga, James; Yamagiwa, Mitsuru; Tajima, Toshiki

    2008-01-01

    Laser acceleration promises innovation in particle beam therapy of cancer where an ultra-compact accelerator system for cancer beam therapy can become affordable to a broad range of patients. This is not feasible without the introduction of a technology that is radically different from the conventional accelerator-based approach. The laser acceleration method provides many enhanced capabilities for the radiation oncologist. It reduces the overall system size and weight by more than one order of magnitude. The characteristics of the particle beams (protons) make them suitable for a class of therapy that might not be possible with the conventional accelerator, such as the ease for changing pulse intensity, the focus spread, the pinpointedness, and the dose delivery in general. A compact, uncluttered system allows a PET device to be located in the vicinity of the patient in concert with the compact gantry. The radiation oncologist may be able to irradiate a localized tumor by scanning with a pencil-like particle...

  7. HRB-22 irradiation phase test data report

    Irradiation capsule HRB-22 was a test capsule containing advanced Japanese fuel for the High Temperature Test Reactor (HTTR). Its function was to obtain fuel performance data at HTTR operating temperatures in an accelerated irradiation environment. The irradiation was performed in the High Flux Isotope Reactor (HFIR) at the Oak Ridge National Laboratory (ORNL). The capsule was irradiated for 88.8 effective full power days in position RB-3B of the removable beryllium (RB) facility. The maximum fuel compact temperature was maintained at or below the allowable limit of 1300 degrees C for a majority of the irradiation. This report presents the data collected during the irradiation test. Included are test thermocouple and gas flow data, the calculated maximum and volume average temperatures based on the measured graphite temperatures, measured gaseous fission product activity in the purge gas, and associated release rate-to-birth rate (R/B) results. Also included are quality assurance data obtained during the test

  8. Commercial irradiator

    Commercial irradiation, the treatment of products with gamma radiation principally using a Cobalt-60 source, had its beginnings in Europe and Australia 25 years ago. To date the most successful application of the process is the sterilization of medical products and, for a variety of reasons, gamma sterilization is now becoming dominant in this important field. Many other applications have been evaluated over the years and the most exciting is undoubtedly food irradiation for which there is a vast potential. The commercial feasibility of setting up and irradiation facility is a complex subject and the selection of Cobalt-60 gamma plant depends on a number of technical and economic considerations. The parameters which determine the design and capacity of the optimum plant include throughput, product size and dose requirements; a balance has to be struck between plant flexibility and overall economy. The Ansell irradiators are designed primarily for the sterilization of medical products although some experimental food irradiation has been done, particularly in Australia. (author)

  9. Neutron induced activation in the EVEDA accelerator materials: Implications for the accelerator maintenance

    The Engineering Validation and Engineering Design Activities (EVEDA) phase of the International Fusion Materials Irradiation Facility project should result in an accelerator prototype for which the analysis of the dose rates evolution during the beam-off phase is a necessary task for radioprotection and maintenance feasibility purposes. Important aspects of the computational methodology to address this problem are discussed, and dose rates for workers inside the accelerator vault are assessed and found to be not negligible.

  10. Neutron induced activation in the EVEDA accelerator materials: Implications for the accelerator maintenance

    Sanz, J. [Department of Power Engineering, Universidad Nacional de Educacion a Distancia (UNED), C/Juan del Rosal 12, 28040 Madrid (Spain); Institute of Nuclear Fusion, UPM, 28006 Madrid (Spain)], E-mail: jsanz@ind.uned.es; Garcia, M.; Sauvan, P.; Lopez, D. [Department of Power Engineering, Universidad Nacional de Educacion a Distancia (UNED), C/Juan del Rosal 12, 28040 Madrid (Spain); Institute of Nuclear Fusion, UPM, 28006 Madrid (Spain); Moreno, C.; Ibarra, A.; Sedano, L. [CIEMAT, 28040 Madrid (Spain)

    2009-04-30

    The Engineering Validation and Engineering Design Activities (EVEDA) phase of the International Fusion Materials Irradiation Facility project should result in an accelerator prototype for which the analysis of the dose rates evolution during the beam-off phase is a necessary task for radioprotection and maintenance feasibility purposes. Important aspects of the computational methodology to address this problem are discussed, and dose rates for workers inside the accelerator vault are assessed and found to be not negligible.

  11. Microwave-Accelerated Organic Reactions

    LU; TaJung

    2001-01-01

    The use of microwave technology in accelerating organic reactions has received intense attention leading to immense growth recently. Accordingly, we have been interested in improving the efficacy of organic processes by microwave irradiation. Here we report our results on the microwave assisted 1,3-dipolar cycloaddition reaction of nitrile oxides with allylic alcohols, the cleavage reaction of 1,3-diketones under alkaline conditions, and the formation of carbamates from isocyanates with alcohols. The reactions carried out under microwave irradiation, in general, required considerably less reaction time and afforded the desired products in higher yields than those under classical conditions. In all the cases we have studied, the procedures are simplified, the purity of the products are higher, and the cost of reaction is greatly reduced employing microwave.  ……

  12. Microwave-Accelerated Organic Reactions

    LU TaJung

    2001-01-01

    @@ The use of microwave technology in accelerating organic reactions has received intense attention leading to immense growth recently. Accordingly, we have been interested in improving the efficacy of organic processes by microwave irradiation. Here we report our results on the microwave assisted 1,3-dipolar cycloaddition reaction of nitrile oxides with allylic alcohols, the cleavage reaction of 1,3-diketones under alkaline conditions, and the formation of carbamates from isocyanates with alcohols. The reactions carried out under microwave irradiation, in general, required considerably less reaction time and afforded the desired products in higher yields than those under classical conditions. In all the cases we have studied, the procedures are simplified, the purity of the products are higher, and the cost of reaction is greatly reduced employing microwave.

  13. Vinca irradiator

    The development programme of the VINCA radiosterilisation centre involves plans for an irradiator capable of working in several ways. Discontinuous operation. The irradiator is loaded for a certain period then runs automatically until the moment of unloading. This method is suitable as long as the treatment capacity is relatively small. Continuous operation with permanent batch loading and unloading carried out either manually or automatically (by means of equipment to be installed later). Otherwise the design of the apparatus is highly conventional. The source is a vertical panel submersible in a pool. The conveyor is of the 'bucket' type, with 4 tiers to each bucket. The batches pass successively through all possible irradiation positions. Transfert into and out of the cell take place through a maze, which also provides access to the cell when the sources are in storage at the bottom of the pool

  14. Radiation damage by heavy ion irradiation

    Various phenomena caused by heavy ion irradiation are introduced. The experiments concerning this radiation damage are in progress with small size heavy ion accelerators. The accelerated ions are Ar+, Xe+, He+, and Mo+. The samples to be irradiated are Al and Al alloy, Nb and Nb alloy, and W. As the result of heavy ion irradiation, surface sputtering is caused. The rate of sputtering depends on the energy of incident particles, the kinds of particles, and the direction of crystal axis in relation to that of incident particles. Blistering is caused by gaseous atoms in crystals. Usually, the gaseous atoms are injected into the crystals. The phenomenon of blistering proceeds to flaking by further irradiation. Due to these phenomena, the wall of a fusion reactor gets big damage, and the flaked material becomes the impurities in the plasma. Interstitial atom clusters are formed by the atoms ejected from the lattice positions in crystals. (Kato, T.)

  15. Compact RF ion source for industrial electrostatic ion accelerator

    Kwon, Hyeok-Jung, E-mail: hjkwon@kaeri.re.kr; Park, Sae-Hoon; Kim, Dae-Il; Cho, Yong-Sub [Korea Multi-purpose Accelerator Complex, Korea Atomic Energy Research Institute, Gyeongsangbukdo 38180 (Korea, Republic of)

    2016-02-15

    Korea Multi-purpose Accelerator Complex is developing a single-ended electrostatic ion accelerator to irradiate gaseous ions, such as hydrogen and nitrogen, on materials for industrial applications. ELV type high voltage power supply has been selected. Because of the limited space, electrical power, and robust operation, a 200 MHz RF ion source has been developed. In this paper, the accelerator system, test stand of the ion source, and its test results are described.

  16. A new microwave EB accelerator for radiation processing

    Cracknell, P. J.

    1995-02-01

    A new high beam power microwave electron linear accelerator, LINTEC 1020, has been built and installed for the AEA, EBIS (Harwell) Limited medical sterilisation irradiation facility. LINTEC microwave electron beam accelerator designs are based upon travelling wave RF structures working at 1300 MHz, with beam powers from 10 to 45 k Watts at 5 to 12 MeV. The accelerator design, installation and operating details are described together with performance characteristics of alternative equipments.

  17. Electron accelerators for radiation sterilization

    Industrial radiation processes using high power electron accelerators are attractive because the throughput rates are very high and the treatment costs per unit of product are often competitive with more conventional chemical processes. The utilization of energy in e-beam processing is more efficient than typical thermal processing. The use of volatiles or toxic chemicals can be avoided. Strict temperature or moisture controls may not be needed. Irradiated materials are usable immediately after processing. These capabilities are unique in that beneficial changes can be induced rapidly in solid materials and preformed products. In recent years, e-beam accelerators have emerged as the preferred alternative for industrial processing as they offer advantages over isotope radiation sources, such as (a) increased public acceptance since the storage, transport and disposal of radioactive material is not an issue; (b) the ability to hook up with the manufacturing process for in-line processing; (c) higher dose rates resulting in high throughputs. During the 1980s and 1990s, accelerator manufacturers dramatically increased the beam power available for high energy equipment. This effort was directed primarily at meeting the demands of the sterilization industry. During this era, the perception that bigger (higher power, higher energy) was always better prevailed, since the operating and capital costs of accelerators did not increase with power and energy as fast as the throughput. High power was needed to maintain low unit costs for the treatment. During the late 1980s and early 1990s, advances in e-beam technology produced new high energy, high power e-beam accelerators suitable for use in sterilization on an industrial scale. These newer designs achieved high levels of reliability and proved to be competitive with gamma sterilization by 60Co and fumigation with EtO. In parallel, technological advances towards 'miniaturization' of accelerators also made it possible to

  18. Pulsed DC accelerator for laser wakefield accelerator

    For the acceleration of ultra-short, high-brightness electron bunches, a pulsed DC accelerator was constructed. The pulser produced megavolt pulses of 1 ns duration in a vacuum diode. Results are presented from field emission of electrons in the diode. The results indicate that the accelerating gradient in the diode is approximately 1.5 GV/m

  19. Linear Accelerator (LINAC)

    ... News Physician Resources Professions Site Index A-Z Linear Accelerator A linear accelerator (LINAC) customizes high energy x-rays to ... ensured? What is this equipment used for? A linear accelerator (LINAC) is the device most commonly used ...

  20. Transmission electron microscope interfaced with ion accelerators and its application to materials science

    Abe, Hiroaki; Naramoto, Hiroshi [Japan Atomic Energy Research Inst., Takasaki, Gunma (Japan). Takasaki Radiation Chemistry Research Establishment; Hojou, Kiichi; Furuno, Shigemi; Tsukamoto, Tetsuo

    1997-03-01

    We have developed the transmission/analytical electron microscope interfaced with two sets of ion accelerators (TEM-Accelerators Facility) at JAERI-Takasaki. The facility is expected to provide quantitative insights into radiation effects, such as damage evolution, irradiation-induced phase transformation and their stability, through in-situ observation and analysis under ion and/or electron irradiation. The TEM-Accelerators Facility and its application to materials research are reviewed. (author)

  1. Is there a future for industrial food irradiation in Germany?

    Industrial irradiation systems currently in operation in Germany encompass 7 gamma sources with an activity of approx. 10 MCi, and 20 electron accelerators with voltages ranging from 0.5 MeV to 10 MeV. The value of the goods irradiated every year at those installations amounts to approx. DM 5 billion. Irradiation technology plays a significant role in German industry and is expected to become more important in the future. Enhanced non-biased information of the general public about the usefulness of food irradiation, for instance for control of health risks emanating from foodstuffs, is hoped to raise public acceptance of the food irradiation technology. (orig./CB)

  2. Food irradiation: An update

    Recent regulatory and commercial activity regarding food irradiation is highlighted. The effects of irradiation, used to kill insects and microorganisms which cause food spoilage, are discussed. Special attention is given to the current regulatory status of food irradiation in the USA; proposed FDA regulation regarding the use of irradiation; pending irradiation legislation in the US Congress; and industrial applications of irradiation

  3. The studies of irradiation assisted stress corrosion cracking on reactor internals stainless steel under Xe irradiation

    Wang, Rong-shan [Suzhou Nuclear Power Research Institute, Suzhou, Jiangsu Province 215004 (China); Xu, Chao-liang, E-mail: xuchaoliang@cgnpc.com.cn [Suzhou Nuclear Power Research Institute, Suzhou, Jiangsu Province 215004 (China); Liu, Xiang-bing; Huang, Ping [Suzhou Nuclear Power Research Institute, Suzhou, Jiangsu Province 215004 (China); Chen, Yu [Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Beijing 100049 (China)

    2015-02-15

    Specimens of Chinese domestic reactor internals stainless steel were irradiated with 6 MeV Xe ions for three peak displacement damage of 2, 7 and 15 dpa at room temperature. The slow strain rate tests (SSRT), grazing incidence X-ray diffraction (GIXRD) and nano-indentation tests were carried out to study the IASCC properties, phase transition and nano-hardness variations. The SSRT results indicate that the IASCC susceptibility increases with irradiation damage. Ion irradiation accelerates the stress corrosion cracking (SCC). A new ferrite phase diffraction peak of α(1 1 0) after irradiated to 7 dpa and another two α phase of α(2 0 0) and α(2 1 1) after irradiated to 15 dpa were observed by GIXRD, which may be due to localized deformation. A similar trend of irradiation hardening and IASCC susceptibility was observed, which suggests an essential connection between them.

  4. Construction of the virtual accelerator for the IFMIF/EVEDA prototype accelerator commissioning

    The Engineering Validation and Engineering Design Activities (EVEDA) of the International Fusion Materials Irradiation Facility (IFMIF) are on-going and will deliver confirmations and knowledge required to start the construction. At the Rokkasho site in Japan, the prototype accelerator with output energy up to 9MeV and full beam current 125mA CW will be installed and commissioned. In order to prepare and follow the accelerator validation experiment efficiently, a virtual accelerator is planned to construct. The virtual accelerator is based on “TraceWin” code as the software platform bridging to the control system with the EPICS layer. This platform has the functionality of the on-line modeling for optics parameters, feeding back the information to the prototype accelerator commissioning. (author)

  5. Microbiological decontamination of natural honey by irradiation

    Degree of microbiological decontamination, organoleptic and physico-chemical properties of natural honeys were investigated after radiation treatment. Seven kinds of honeys were irradiated with the beams of 10 MeV electrons from a 10 kW linear accelerator ''Elektronika 10-10'' at the dose 10 kGy. It was shown, that after irradiation, the total count of aerobic and anaerobic bacteria and moulds decrease by 99%. The antibiotic value in investigated honeys increased in turn from 1.67 to 2.67 after irradiation. Such factors and parameters of investigated honeys as their consistency, content of water and saccharose, acidity, the diastase and 5-HMF values were not changed significantly after irradiation. Decontamination by irradiation is a process which allows us to obtain high microbiological purity of honeys. It is especially needed, when honeys are used in surgical treatment of injuries and in nutrition of babies with food deficiency

  6. Microbiological decontamination of natural honey by irradiation

    Migdał, W.; Owczarczyk, H. B.; K ȩdzia, B.; Hołderna-K ȩdzia, E.; Madajczyk, D.

    2000-03-01

    Degree of microbiological decontamination, organoleptic and physico-chemical properties of natural honeys were investigated after radiation treatment. Seven kinds of honeys were irradiated with the beams of 10 MeV electrons from a 10 kW linear accelerator "Elektronika 10-10" at the dose 10 kGy. It was shown, that after irradiation, the total count of aerobic and anaerobic bacteria and moulds decrease by 99%. The antibiotic value in investigated honeys increased in turn from 1.67 to 2.67 after irradiation. Such factors and parameters of investigated honeys as their consistency, content of water and saccharose, acidity, the diastase and 5-HMF values were not changed significantly after irradiation. Decontamination by irradiation is a process which allows us to obtain high microbiological purity of honeys. It is especially needed, when honeys are used in surgical treatment of injuries and in nutrition of babies with food deficiency.

  7. Food irradiation

    Various aspects of food treatment by cobalt 60 or caesium 137 gamma radiation are reviewed. One of the main applications of irradiation on foodstuffs lies in its ability to kill micro-organisms, lethal doses being all the lower as the organism concerned is more complex. The effect on parasites is also spectacular. Doses of 200 to 300 krad are recommended to destroy all parasites with no survival period and no resistance phenomenon has ever been observed. The action of gamma radiation on macromolecules was also investigated, the bactericide treatment giving rise to side effects by transformation of food components. Three examples were studied: starch, nucleic acids and a whole food, the egg. The organoleptic aspect of irradiation was examined for different treated foods, then the physical transformations of unpasteurized, heat-pasteurized and radio-pasteurized eggs were compared. The report ends with a brief analysis of the toxicity and conditions of application of the treatment

  8. Food irradiation

    Radiation processing of food is based on irradiation by gamma radiation from a 60Co source or X-ray with energy < 5 MeV or electron beam with energy < 10 MeV. This technique is now completely mastered. About 30 countries use this technique to extend the storage life of food but the total quantity processed is weak, only 30000 tons a year for France. Some countries like Morocco or Tunisia have launched technical programmes about the radiation processing of dates and vegetable oil. These programmes may lead to the creation of a quality label. A joint laboratory between CEA and the Aix-Marseille-3 university is working on the detection of food irradiation in order to fight the fraud. 3 techniques are being investigated: thermoluminescence, electronic paramagnetism resonance and a chemical method. (A.C.)

  9. Endolymphatic irradiation

    The authors analysed the clinical evolution and the result of renal transplantation some years after irradiation in 24 patients (group I) who received endolymphatic 131I as a pre-transplantation immunesuppresive measure. The control group (group II) consisted of 24 non-irradiated patients comparable to group I in age, sex, primary disease, type of donor and immunesuppressive therapy. Significant differences were observed between the two groups regarding such factors a incidence and reversibility of rejection crises in the first 60 post-transplantation days, loss of kidney due to rejection, and dosage of azathioprine. The authors conclude that this method, besides being harmless, has prolonged immunesuppressive action, its administration being advised for receptores of cadaver kidneys, mainly those who show positive cross-match against HLA antigens for painel. (Author)

  10. A particle accelerator probes artifacts

    Dran, J C; Salomon, J

    2002-01-01

    The AGLAE system is made up of a 2 mega volts electrostatic accelerator and of 3 irradiation lines: one leads to a vacuum enclosure in which targets are irradiated and the 2 others lines are designed to irradiate targets under an air or helium atmosphere. The AGLAE system is located in the premises of the Louvre museum in Paris and is devoted to the study of cultural objects through ion beam analysis (IBA). 4 techniques are used: -) proton-induced X-ray emission (PIXE) -) proton-induced gamma ray (PIGE) -) Rutherford backscattering spectrometry (NRS) and -) nuclear reaction analysis (NRA). A decisive progress has permitted the direct analysis of artifacts without sampling. The object itself is set just a few millimeters away from the exit window of the beam in an air or helium atmosphere. The exit window must be resistant enough to bear the atmospheric pressure and the damages caused by the proton beam but must be thin enough to not deteriorate the quality of the beam. By using a 10 sup - sup 7 m thick exit w...

  11. Effect of electron beam irradiation on surgical rubber gloves

    This paper outlines the effects of electron beam irradiation on surgical rubber gloves. The tensile strength, elongation at break and modulus were evaluated as function of dose range 20-100 kGy minimum dose, dose uniformity ratio, 3.1, and both, accelerated and normal aging, were used to study the stability of the irradiated gloves after irradiation. The surgical gloves were found to be useful up to the highest dose tested. (orig.)

  12. Effect of electron beam irradiation on surgical rubber gloves

    Thevy Ratnam, Chantara; Zaman, Khairul

    1998-04-01

    This paper outlines the effects of electron beam irradiation on surgical rubber gloves. The tensile strength, elongation at break and modulus were evaluated as function of dose range 20-100 kGy minimum dose, dose uniformity ratio, 3.1, and both, accelerated and normal aging, were used to study the stability of the irradiated gloves after irradiation. The surgical gloves were found to be useful up to the highest dose tested.

  13. Acceleration without Horizons

    Doria, Alaric; Munoz, Gerardo

    2015-01-01

    We derive the metric of an accelerating observer moving with non-constant proper acceleration in flat spacetime. With the exception of a limiting case representing a Rindler observer, there are no horizons. In our solution, observers can accelerate to any desired terminal speed $v_{\\infty} < c$. The motion of the accelerating observer is completely determined by the distance of closest approach and terminal velocity or, equivalently, by an acceleration parameter and terminal velocity.

  14. How to improve the irradiation conditions for the International Fusion Materials Irradiation Facility

    Daum, E

    2000-01-01

    The accelerator-based intense D-Li neutron source International Fusion Materials Irradiation Facility (IFMIF) provides very suitable irradiation conditions for fusion materials development with the attractive option of accelerated irradiations. Investigations show that a neutron moderator made of tungsten and placed in the IFMIF test cell can further improve the irradiation conditions. The moderator softens the IFMIF neutron spectrum by enhancing the fraction of low energy neutrons. For displacement damage, the ratio of point defects to cascades is more DEMO relevant and for tritium production in Li-based breeding ceramic materials it leads to a preferred production via the sup 6 Li(n,t) sup 4 He channel as it occurs in a DEMO breeding blanket.

  15. Irradiation of food

    Processing of food with ionizing radiation is a method suitable to enhance shelf-life and hygienic quality. Up to a dose of 10 kGy the method is considered wholesome. In many countries the practical use of food irradiation is increasing, however, in the Federal Republic of Germany the process is strictly forbidden. Applications and methods for radiation processing of food are compiled, limits and prospects are explained, and advantages and disadvantages are compared with traditional methods. Identification of irradiated foods and dosimetry and process control for radiation processing of food are areas where further research is needed. Continuous processing of particulate foods in bulk is an application where electron accelerators might be profitable. Beam parameters and velocity distribution of food particles in the treatment area can be matched for an effective result. Thus, dose distribution can be adjusted for homogeneous treatment and at the same time radiation energy is absorbed almost completely. An example of an experimental plant for radiation processing of grain and spices is shown. Decontamination of spices by radiation processing is an alternative to chemical fumigation, which now is widely forbidden. (orig.)

  16. Heavy ion medical accelerator in chiba

    The HIMAC (Heavy Ion Medical Accelerator in Chiba) construction project has been promoted by NIRS (National Institute of Radiological Sciences) as one of the projects of 'Comprehensive 10 year Strategy for Cancer Control' HIMAC is the first heavy-ion accelerator dedicated to medicine in the world, and its design parameters are based on the radiological requirements. It consists of two types of ion sources, an RFQ and an Alvarez linacs, dual synchrotron rings, high energy beam transport lines, and irradiation facilities for treatment and experiments. This report mainly describes the outline of the structure and performance of each HIMAC subsystem. (J.P.N.)

  17. Application and industrialization of irradiation processing technique

    Irradiation processing technique is a new processing technique. At present, there are 40 sets of electron accelerators have been built or are building for industry are, total power comes to 1436 kw. The products provided have been 8 types and several ten kinds. Current status of radiation processing technique at home and abroad are reviewed

  18. Food processing with electrically generated photon irradiation

    A conceptual design for a portable electric food irradiation processing machine is presented and analyzed for cost assuming the required accelerators are available for $1.5 million each. It is shown that food can be processed to 1 kGy for a price of $5.98/ton

  19. Electromagnetic Acceleration Characteristics of Laser-Electric Hybrid Thrusters

    A fundamental study on a laser-electric hybrid thruster was conducted, in which laser-induced plasmas were generated through laser beam irradiation on to a solid target and accelerated by electrical means instead of direct acceleration using only a laser beam. As two typical cases of the hybrid propulsion systems, a feasibility study on electrostatic acceleration mode and electromagnetic acceleration mode of the laser ablation plasma were conducted including thrust performance tests with a torsion-balance, ion current measurements, and ICCD camera observations. It was confirmed that the thrust performances could be improved with electric energy inputs

  20. Accelerator Technology Program. Status report, April-September 1985

    This report presents highlights of major projects in the Accelerator Technology (AT) Division of the Los Alamos National Laboratory. Radio-frequency and microwave technology are dealt with. The p-bar gravity experiment, accelerator theory and simulation activities, the Proton Storage Ring, and the Fusion Materials Irradiation Test accelerator are discussed. Activities on the proposed LAMPF II accelerator, the BEAR (Beam Experiment Aboard Rocket) project, beam dynamics, the National Bureau of Standards racetrack microtron, and the University of Illinois racetrack microtron are covered. Papers published by AT-Division personnel during this reporting period are listed

  1. Accelerator Technology Program. Status report, April-September 1985

    This report presents highlights of major projects in the Accelerator Technology (AT) Division of the Los Alamos National Laboratory. The first section deals with the Fusion Materials Irradiation Test Facility. The second section covers code development and documentation done by the Accelerator Theory and Simulation Group. Following sections relate to the Proton Storage Ring, the racetrack microtron projects, beam dynamics, accelerator structure development, and LAMPF II. The last sections discuss programs involving free-electron laser technology, microwave and magnet technology, the portable accelerator, and klystron code development. The report concludes with a listing of papers published by AT-Division personnel during this reporting period

  2. Food irradiation

    The first part of this data is relative to the study of chemical modifications induced by gamma radiations (60Co, 137Cs) on macromolecules of food and their contaminates with the help of two examples: starch and nucleic acids. Then the second part shows what are the consequences of irradiation on food and their preservation; we make distinction between useful effects (for instance germination inhibition of tubercules, destruction of insects or micro-organisms) and the results which are contingently bad for nutritional, technological and above all toxicologic aspects. The last part is relative to a short restatement of the problems inherent in the industrialization of this treatment

  3. Safety guide of the Tandar accelerator

    The safety standards that the installations of the Tandar accelerator have to comply with are presented here. In order to maintain the safety, the knowledge and the accomplishment of these standards are mandatory for all persons. The risks of external irradiation and of contamination are pointed out. The risks at the Tandar are: the calibration standards used at the premises and the irradiation produced by the activity of the accelerator, which can be primary, secondary, induced or X rays. The identification of the different areas of installation are given with their corresponding classification; the rules concerning the manipulation of radioactive materials and the movement of persons in areas of reglamentary access are established. Finally conventional safety and rules for evacuation and fires are presented. (M.E.L.)

  4. Accelerators for Fusion Materials Testing

    Knaster, Juan; Okumura, Yoshikazu

    Fusion materials research is a worldwide endeavor as old as the parallel one working toward the long term stable confinement of ignited plasma. In a fusion reactor, the preservation of the required minimum thermomechanical properties of the in-vessel components exposed to the severe irradiation and heat flux conditions is an indispensable factor for safe operation; it is also an essential goal for the economic viability of fusion. Energy from fusion power will be extracted from the 14 MeV neutron freed as a product of the deuterium-tritium fusion reactions; thus, this kinetic energy must be absorbed and efficiently evacuated and electricity eventually generated by the conventional methods of a thermal power plant. Worldwide technological efforts to understand the degradation of materials exposed to 14 MeV neutron fluxes >1018 m-2s-1, as expected in future fusion power plants, have been intense over the last four decades. Existing neutron sources can reach suitable dpa (“displacement-per-atom”, the figure of merit to assess materials degradation from being exposed to neutron irradiation), but the differences in the neutron spectrum of fission reactors and spallation sources do not allow one to unravel the physics and to anticipate the degradation of materials exposed to fusion neutrons. Fusion irradiation conditions can be achieved through Li (d, xn) nuclear reactions with suitable deuteron beam current and energy, and an adequate flowing lithium screen. This idea triggered in the late 1970s at Los Alamos National Laboratory (LANL) a campaign working toward the feasibility of continuous wave (CW) high current linacs framed by the Fusion Materials Irradiation Test (FMIT) project. These efforts continued with the Low Energy Demonstrating Accelerator (LEDA) (a validating prototype of the canceled Accelerator Production of Tritium (APT) project), which was proposed in 2002 to the fusion community as a 6.7MeV, 100mA CW beam injector for a Li (d, xn) source to bridge

  5. Solid targetry at the TESLA Accelerator Installation

    According to the concept of the TESLA Accelerator Installation, the channel for production of radioisotopes has to routinely produce 201Tl, 111In, 67Ga, 123I and 18F, and a number of other radionuclides for experimental purposes. The production of 123I and 18F will be performed in dedicated, commercial target stations, while a versatile solid target irradiation system is designed for the routine and experimental production of all other radioisotopes. The solid target station is designed to accept targets for both the 7 deg. and 90 deg. irradiation geometry. The targets used for the routine production will be prepared by electroplating on a silver substrate. They can be irradiated with a 1.5 kW beam using the 7 deg. geometry. The cooling of these targets is enhanced by fins on the back of the silver substrate designed so that the highest temperature on the surface of the target does not exceed 110 deg. C. The irradiation procedures will conform to the GMP requirements for the production of radiopharmaceuticals. The irradiated targets will be transported directly into the appropriate hot cell for radiochemical processing. All cells will be equipped with a target dissolution unit for etching the irradiated, electroplated film. After decontamination and sufficient cooling down, these targets will be reused several times

  6. High intensity hadron accelerators

    In this paper we give an introductory discussion of high intensity hadron accelerators with special emphasis on the high intensity feature. The topics selected for this discussion are: Types of acclerator - The principal actions of an accelerator are to confine and to accelerate a particle beam. Focusing - This is a discussion of the confinement of single particles. Intensity limitations - These are related to confinement of intense beams of particles. Power economics - Considerations related to acceleration of intense beams of particles. Heavy ion kinematics - The adaptation of accelerators to accelerate all types of heavy ions

  7. The direction of acceleration

    Wilhelm, Thomas; Burde, Jan-Philipp; Lück, Stephan

    2015-11-01

    Acceleration is a physical quantity that is difficult to understand and hence its complexity is often erroneously simplified. Many students think of acceleration as equivalent to velocity, a ˜ v. For others, acceleration is a scalar quantity, which describes the change in speed Δ|v| or Δ|v|/Δt (as opposed to the change in velocity). The main difficulty with the concept of acceleration therefore lies in developing a correct understanding of its direction. The free iOS app AccelVisu supports students in acquiring a correct conception of acceleration by showing acceleration arrows directly at moving objects.

  8. Irradiation tests report of the 35th cycle in 'JOYO'

    This report summarizes the operating and irradiation data of the experimental reactor 'JOYO' 35th cycle. Irradiation tests in the 35th cycle are as follows: (1) C-type irradiation rig (C4F). (a) High burn up performance test of advanced austenitic stainless steel cladding fuel pins (in collaboration with France). (2) C-type irradiation rig (C6D). (a) Large diameter fuel pins irradiation tests. (3) Core Materials Irradiation Rig (CMIR-5). (a) Cladding tube materials irradiation tests for 'MONJU'. (4) Structure Materials Irradiation Rigs (SMIR). (a) Decision of material design base standard of structure materials for prototype reactor and large scale reactor. (5) Upper core structure irradiation Plug Rig (UPR-1-5). (a) Upper core neutron spectrum effect and accelerated irradiation effect. (6) SurVeillance un-instrument Irradiation Rig (SVIR). (a) Confirmation of surveillance irradiation condition for 'JOYO'. (a) Material irradiation tests (based on a contract with universities). The maximum burnup driver assembly PFD253' reached 67,600 MWd/t (pin average). (author)

  9. 2014 CERN Accelerator Schools: Plasma Wake Acceleration

    2014-01-01

    A specialised school on Plasma Wake Acceleration will be held at CERN, Switzerland from 23-29 November, 2014.   This course will be of interest to staff and students in accelerator laboratories, university departments and companies working in or having an interest in the field of new acceleration techniques. Following introductory lectures on plasma and laser physics, the course will cover the different components of a plasma wake accelerator and plasma beam systems. An overview of the experimental studies, diagnostic tools and state of the art wake acceleration facilities, both present and planned, will complement the theoretical part. Topical seminars and a visit of CERN will complete the programme. Further information can be found at: http://cas.web.cern.ch/cas/PlasmaWake2014/CERN-advert.html http://indico.cern.ch/event/285444/

  10. Effect of dexamethasone on irradiated rabbit pancreas

    The caudal half of the rabbit pancreas was irradiated with 3,000 rad of 60Co in a single dose. Dexamethasone, 1 mg, was given intravenously 30 minutes before irradiation, and then, 0.5 mg of dexamethasone was given intramuscularly for the following 3 days. Pancreatic tissues were observed 20 hours, 44 hours, 3 days, 4 days, 10 days and 25 days after irradiation. Light microscopic findings in the single irradiated group showed swelling and vacuole formation of acinar cells and dilatation of the ductal system at the early stage after irradiation. Twenty-five days after irradiation, lobules were separated by fibrous tissues, atrophy of acini appeared, and the number of acini decreased. In the dexamethasone, treated group atrophic degeneration of acinar cells was accelerated, focal necrosis appeared at the early stage after irradiation, and fibrosis appeared markedly. Electron microscopic findings in the single irradiated group showed whorle-like configurations of rough endoplasmic reticulum (ER) in acinar cells, an decrease in lysosomes, a decrease in exocrine granules, and large autophagic vacuoles. Changes in nucleus, swelling of basement membranes of acini, and an increase in collagen fibri appeared at the early stage after irradiation. In the dexamethasone treated group, above-mentioned changes were observed more markedly and many necrotic cells were observed at the early stage after irradiation. Twenty-five days after irradiation, a marked increase in collagen fibri and a marked decrease in acini was observed. In acinar cells, a decrease in rough ER, disappearance of exocrine granules, swelling of mitochondria, and appearance of filament-like substances were observed. (Tsunoda, M.)

  11. The role of linear accelerators in industry

    The short-term demand of ionizing energy will increase rapidly due to developing irradiation markets in sludge irradiation, medical product sterilization, biological toxic waste sterilization, exhaust gas treatment, and the much larger area of food disinfestation. Incentives for the increase are due not only to inherent positive characteristics of ionizing radiation, but to the worldwide concern and increased awareness of currently used fumigants, such as methyl bromide, ethylene dibromide, and ethylene oxide. Cobalt-60 is a gamma-emitting isotope, produced primarily by the Atomic Energy of Canada Limited, which can help to satisfy these developing market demands. As an alternative to cobalt-60, the US Department of Energy is promoting cesium-137, a gamma emitter obtained from reprocessed nuclear waste. However, the supply of these two isotopes is limited and unable to meet the projected ionizing energy demands. Utilization of accelerator technology is therefore critical to the development of various product irradiation programs. It will not only meet the demand which is in excess of that covered by the isotopes, but it will also release the limited quantities of isotope for better use in roles for which they are especially suited. The accelerator and isotope roles in the irradiation markets need to be more finely focused in the future to benefit the growth of both systems. (orig.)

  12. San Francisco Accelerator Conference

    'Where are today's challenges in accelerator physics?' was the theme of the open session at the San Francisco meeting, the largest ever gathering of accelerator physicists and engineers

  13. Dielectric Laser Acceleration

    England, R. Joel; Noble, Robert J.; Wu, Ziran; Qi, Minghao

    2013-01-01

    We describe recent advances in the study of particle acceleration using dielectric near-field structures driven by infrared lasers, which we refer to as Dielectric Laser Accelerators. Implications for high energy physics and other applications are discussed.

  14. Standing wave linear accelerator

    Consideration is being given to standing wave linear accelerator containing generator, phase shifter, two accelerating resonator sections, charged particle injector and waveguide bridge. Its first arm is oined up with generator via the phase shifter, the second and the third ones-with accelerating sections and the fourth one - with HF-power absorber. HF-power absorber represents a section of circular diaphragmatic wavequide with transformer with input wave and intrawaveguide output load located between injector and the first accelerating section. The section possesses holes in side walls lying on accelerator axis. The distances between centers of the last cell of the fast accelerating section and the first cell of the second accelerating sectiOn equal (2n+3)lambda/4, where n=1, 2, 3..., lambda - wave length of generator. The suggested system enables to improve by one order spectral characteristics of accelerators as compared to the prototype in which magnetrons are used as generator

  15. Improved plasma accelerator

    Cheng, D. Y.

    1971-01-01

    Converging, coaxial accelerator electrode configuration operates in vacuum as plasma gun. Plasma forms by periodic injections of high pressure gas that is ionized by electrical discharges. Deflagration mode of discharge provides acceleration, and converging contours of plasma gun provide focusing.

  16. High Energy Particle Accelerators

    Audio Productions, Inc, New York

    1960-01-01

    Film about the different particle accelerators in the US. Nuclear research in the US has developed into a broad and well-balanced program.Tour of accelerator installations, accelerator development work now in progress and a number of typical experiments with high energy particles. Brookhaven, Cosmotron. Univ. Calif. Berkeley, Bevatron. Anti-proton experiment. Negative k meson experiment. Bubble chambers. A section on an electron accelerator. Projection of new accelerators. Princeton/Penn. build proton synchrotron. Argonne National Lab. Brookhaven, PS construction. Cambridge Electron Accelerator; Harvard/MIT. SLAC studying a linear accelerator. Other research at Madison, Wisconsin, Fixed Field Alternate Gradient Focusing. (FFAG) Oakridge, Tenn., cyclotron. Two-beam machine. Comments : Interesting overview of high energy particle accelerators installations in the US in these early years. .

  17. Genotoxicity test of irradiated foods

    Safety tests of radiation irradiated foods started as early as from 1967 in Japan and genotoxicity tests in the Hatano Res. Inst., from 1977. The latter is unique in the world and is reviewed in this paper. Tests included those for the initial injury of DNA, mutagenicity, chromosomal aberration and transformation with use of bacteria, cultured mammalian cells and animals (for chromosomal aberration, micronucleus formation and dominant lethality). Foods tested hitherto were onion, rice, wheat and flour, Vienna sausage, fish sausage (kamaboko), mandarian orange, potato, black pepper and red capsicum, of which extract or powder was subjected to the test. Irradiation doses and its purposes were 0.15-6 kGy γ-ray (60Co) or electron beam by the accelerator (only for the orange), and suppression of germination, pesticide action or sterilization, respectively. Genotoxicity of all foods under tested conditions is shown negative. (N.I.)

  18. Maximal Acceleration Is Nonrotating

    Page, Don N.

    1997-01-01

    In a stationary axisymmetric spacetime, the angular velocity of a stationary observer that Fermi-Walker transports its acceleration vector is also the angular velocity that locally extremizes the magnitude of the acceleration of such an observer, and conversely if the spacetime is also symmetric under reversing both t and phi together. Thus a congruence of Nonrotating Acceleration Worldlines (NAW) is equivalent to a Stationary Congruence Accelerating Locally Extremely (SCALE). These congruenc...

  19. Accelerators at school

    Latest subject covered by the CERN Accelerator School was 'Applied Geodesy of Particle Accelerators', which attracted an impressive number of outside participants to CERN for a week in April. Since the forerunners of today's particle accelerators were demonstrated over 50 years ago, the positioning of accelerator components has progressed from the laboratory bench-top to tunnels tens of kilometres long. Despite this phenomenal growth in size, sub-millimetre accuracy is still required

  20. A Solid state accelerator

    We present a solid state accelerator concept utilizing particle acceleration along crystal channels by longitudinal electron plasma waves in a metal. Acceleration gradients of order 100 GV/cm are theoretically possible, but channeling radiation limits the maximum attainable energy to 105 TeV for protons. Beam dechanneling due to multiple scattering is substantially reduced by the high acceleration gradient. Plasma wave dissipation and generation in metals are also discussed