UK PubMed Central (United Kingdom)

BackgroundLung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently,...Full Text Available

British Library Electronic Table of Contents (United Kingdom)

SummaryBackground The choice of sampling techniques in bronchoscopy with sampling from a visible lesion will depend on the expected diagnostic yields and the costs of the sampling techniques. Aims The aim of this study was to determine the most economical combination of sampling techniques when approaching endobronchial visible lesions. Methods A cost minimization analysis was performed. All bronchoscopies from 2003 and 2004 at Haukeland university hospital, Bergen, Norway, were reviewed retrospectively for diagnostic yields. 162 patients with endobronchial disease were included. Potential sampling techniques used were biopsy, brushing, endobronchial needle aspiration (EBNA) and washings. Costs were estimated based on registration of equipment costs and personnel costs. Sensitivity analyse...

UK PubMed Central (United Kingdom)

This article is a story of networking of palliative care at the corporate level. This gives an insight that if you have will and dedication then you can imagine and make it true that networking can...Full Text Available

UK PubMed Central (United Kingdom)

Hemoptysis in patients with lung cancer is not uncommon and sometimes have dangerous consequences. Hemoptysis has been managed with various treatment options other than surgery and medicine, such as...Full Text Available

UK PubMed Central (United Kingdom)

Goals of workThe goal of this study was to evaluate, at a population level, the association between specialized palliative care services (SPCS) and short- and long-term caregiver...Full Text Available

International Nuclear Information System (INIS)

... pathological changes patients radiation protection radiotherapy diseases

International Nuclear Information System (INIS)

Radiotherapy has been reported to be of benefit in prolonging the survival of patients with cholangiocarcinoma. This study examined whether radiotherapy in addition to endoscopic stenting improved survival. The survival advantage of radiotherapy in those with a type II/III stricture is seen only in the first 10 months after diagnosis. The costs of radiotherapy and significantly increased time spent in hospital, however, raise doubts over its routine use in the management of non-resectable cholangiocarcinoma. (Author).

Energy Technology Data Exchange (ETDEWEB)

In this article, the author presents the principles, applications and advantages of proton and heavy ion beams used for radiotherapy.

CERN Document Server

Determination of absorbed dose in a patient irradiated by beams of x or gamma rays in radiotherapy procedures

UK PubMed Central (United Kingdom)

A ten week old girl who had previously undergone a palliative procedure for the hypoplastic left heart syndrome had unrelieved aortic coarctation that did not respond to standard balloon dilatation....Full Text Available

UK PubMed Central (United Kingdom)

AIM: To evaluate the efficacy of self expandable metallic stents (SEMS) in patients with malignant esophageal obstruction and fistulas.METHODS: SEMS were implanted in the presence of fluoroscopic...Full Text Available

International Nuclear Information System (INIS)

The document reports the main issues discussed during the first course-debate on quality controls in radiotherapy, held in Rome in December 3-4, 1998 and May 3-5 1999 in collaboration between the Istituto Superiore di Sanita' and the Istituto Regina Elena. The points considered critical to the quality assurance in radiotherapy by the participants are presented in relation to the total radiotherapy procedure.

Energy Technology Data Exchange (ETDEWEB)

No abstract prepared.

UK PubMed Central (United Kingdom)

The aim of this study is to compare the dosimetry results that are obtained by using Convolution, Superposition and Fast Superposition algorithms in Conventional Radiotherapy, Three-Dimensional Conformal...Full Text Available

Science.gov (United States)

PMID:21533865

Science.gov (United States)

Caring for a child with a potentially fatal medical condition is a challenge for parents or caregivers. The ability to measure parental self-efficacy in pediatric palliative care may be an important component of targeting supportive services that address individual needs of families. Therefore, the goal was to develop a Pediatric Palliative Care Parental Self-Efficacy Measure (PCPEM). First, a list of questions were generated that asked parents their level of confidence in carrying out tasks involved in caring for a child with a potentially fatal medical condition in 6 palliative care domains: 1) medical discussion/decisions; 2) symptom management/medication; 3) daily activities; 4) feelings/concerns; 5) spirituality; and 6) end-of-life care. The PCPEM was narrowed to 58 questions after expert reviews. Then, 16 caregivers of children receiving palliative care services and 9 bereaved caregivers ...

UK PubMed Central (United Kingdom)

SummaryRadiotherapy is used commonly in the treatment of gynecologic malignancies. Many patients experience emotional distress prior to the initiation of radiotherapy, during...Full Text Available

UK PubMed Central (United Kingdom)

Intensity modulated radiotherapy (IMRT) is widely used in clinical applications in developed countries, for the treatment of malignant and non-malignant diseases. This technique uses multiple radiation...Full Text Available

UK PubMed Central (United Kingdom)

In many radiotherapy clinics, geometric uncertainties in the delivery of 3D conformal radiation therapy and intensity modulated radiation therapy of the prostate are reduced by aligning the...Full Text Available

International Nuclear Information System (INIS)

Objective: To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods: 7 biliary metallic stents were placed in 7 patients with recurrent jaundice after T-tube drainage in cholangiocarcinoma cases. Results: Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment. Conclusions: Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma-induced obstructive jaundice

International Nuclear Information System (INIS)

Treatment of Ewing's sarcoma by radiotherapy, chemotherapy and surgery singly and in combination is reviewed.(M.G.B.).

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the safety and efficacy of TACE with microspheres preloaded with doxorubicin in unresectable intrahepatic cholangiocarcinoma (UCH). Twenty patients with UCH were observed; 9 refused, preferring other palliative care or chemotherapy, and 11 agreed to be treated with one or more cycles of DC beads loaded with doxorubicin (100-150 mg) in a TACE procedure between February 2006 and September 2007. A total of 29 individual TACE procedures were performed. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to evaluate the response and need for further treatment. Each patient received i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival rate was calculated using Kaplan-Meier survival curve. A response rate of 100% followed RECIST criteria was observed. Eight of eleven patients are alive, with a median survival of 13 months. TACE was ...

Energy Technology Data Exchange (ETDEWEB)

Contributions to the population dose due to medical applications of ionising radiation are presented. It appears that contributions due to radiotherapy and X ray diagnosis are of comparable magnitude. To account for the age dependency of the radiation risks, contributions in terms of somatically significant dose equivalent are calculated as 0.3 mSv per caput per annum for X ray diagnosis and as 0.2 mSv per caput per annum for radiotherapy, the latter referring to only doses to organs outside the target volume. (author).

International Nuclear Information System (INIS)

Purpose: To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer. Patients and Methods: Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data. Results: There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in distant recurrence-free ...

British Library Electronic Table of Contents (United Kingdom)

The initial management of nonfunctioning pituitary macroadenomas (NFAs) is usually surgery; however, a significant proportion of NFAs may require further treatment. Radiotherapy is currently used in patients with residual tumour and achieves excellent long-term control, but there are concerns about potential late toxicity. Stereotactic radiotherapy, both in the form of radiosurgery or fractionated stereotactic radiotherapy, has been developed as a more accurate technique of irradiation with more precise tumour localization and consequently a reduction in the volume of normal tissue, particularly the brain, irradiated to high radiation doses. A review of the literature suggests that new radiation techniques offer safe and effective treatment for recurrent or residual pituitary adenomas; how...

International Nuclear Information System (INIS)

Objective: To evaluate the effect of metallic stent combined with stereotactic conformal radiotherapy (SCRT) for hilar cholangiocarcinoma. Methods: Fifty-four patients with hilar cholangiocarcinoma were analyzed, including 31 treated with stent plus stereotactic conformal radiotherapy (combined group) and 23 with metallic stent alone (control group). Results: The mean survival time of combined group was 11.1 #+-# 4.6 months, compared with 5.1 #+-# 2.8 months of the control group, giving a significant difference between the two groups (P<0.01). Conclusion: The combination of metallic stent and stereotactic conformal radiotherapy is more effective than metallic stent alone for unresectable hilar cholangiocarcinoma. (authors)

Energy Technology Data Exchange (ETDEWEB)

The objective of this project was to implement a centralised data base of internal quality control in radiotherapy according to the criteria of the decree of A.f.s.s.a.p.s. (French agency of sanitary safety of health products on 27 july 2007, about the internal quality control of external radiotherapy facilities. The software on one year meets the objectives: compliance by comparison with A.f.s.s.a.p.s. criteria but particularly optimization of the centralisation and analysis of the internal quality controls. (N.C.)

UK PubMed Central (United Kingdom)

Adaptive radiation therapy for liver cancer has the potential to reduce normal tissue complications and enable dose escalation, allowing the potential for tumor control in this challenging site....Full Text Available

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to evaluate the safety and the retrievability of a new covered retrievable nitinol tracheobronchial stent. Stents were knitted from 0.2mm nitinol wire, covered with polyurethane, and were 20-22mm in diameter and 2cm in length. Under fluoroscopic guidance, a stent was placed in the normal right bronchus intermedius of ten dogs. Using a retrieval hook, stent retrieval was attempted after 1 month(N=5) or 2 months(N=5). After removal, the dogs were sacrificed and their their tracheobronchial trees were examined grossly and histologically. Eleven stents were successfully placed in ten dogs. Migration and expectoration occurred in four of ten stents in nine dogs(40%). Five stents were successfully removed from six dogs(83%). Without significant difference between the two groups, mild to moderate mucosal hyperplasia was noted at the sites of stents as well as above and below them. On microscopy, three of five dogs showed pneumonia in the right middle lobes, but ...

Science.gov (United States)

A 67-year-old man presented with gastrointestinal bleeding resulting from a fistula between the aortic stump and the fourth part of the duodenum 14 months after an axillobifemoral bypass, graft excision, and aortic stump closure for aortic graft infection. The patient initially refused any attempt at definitive surgical treatment so coil embolization of the aortic stump was performed via a brachial approach. Coil embolization may be a useful adjunct in the management of such difficult problems. This approach may buy time and allow careful planning of a definitive treatment or may serve as a palliative procedure in inoperable patients. PMID:15947052

Energy Technology Data Exchange (ETDEWEB)

Carcinoma en cuirasse of the breast, which invades the skin via lymphatics and may encase the entire thorax and abdomen, is poorly controlled by surgery, chemotherapy, or conventional irradiation. Palliation of patients with breast carcinoma en cuirasse is a difficult clinical problem which must be effectively managed over extended periods due to the indolent nature of this disease. The management of three cases is reported, and the new technique of rotational subtotal skin electron-beam therapy (SSEBT) is presented. (author).

International Nuclear Information System (INIS)

The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was ...

Energy Technology Data Exchange (ETDEWEB)

To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading technique was used. Stent placement was technically successful in ...

International Nuclear Information System (INIS)

In the present study an estimate is made of the malignancy significant dose from external beam radiotherapy in New Zealand utilizing data obtained in a survey conducted in 1975. This survey had been designed to assess genetically significant dose. A weighted effective dose equivalent is derived from the malignancy significant dose for direct comparison with mean per capita effective dose equivalents arising from other sources of radiation. 14 refs., 1 fig., 8 tabs.

Energy Technology Data Exchange (ETDEWEB)

This report summarizes the activities and major accomplishments for the Idaho National Laboratory Advanced Radiotherapy Research Program for calendar year 2004. Topics covered include boron analysis in biological samples, computational dosimetry and treatment planning software development, medical neutron source development and characterization, and collaborative dosimetry studies at the RA-1 facility in Buenos Aires, Argentina.

Energy Technology Data Exchange (ETDEWEB)

This report summarizes the activities and major accomplishments for the Idaho National Engineering and Environmental Laboratory (INEEL) Advanced Radiotherapy Research Program for calendar year 2002. Topics covered include computational dosimetry and treatment planning software development, medical neutron source development and characterization, and boron analytical chemistry.

Energy Technology Data Exchange (ETDEWEB)

The authors describe their experience of endocavitary radiotherapy of adenomas and carcinomas of the lower rectum. The method is an alternative for patients who cannot undergo standard surgical procedure or do no want a permanent colostomy. This method is cheap, fast and causes little discomfort to the patients, gives reasonable long-term results and has low morbidity. 11 refs., 4 figs., 2 tabs.

International Nuclear Information System (INIS)

In consistency with the increasing requests from Member States for establishing radiotherapy programmes, an IAEA Technical Co-operation project was initiated in Latin America aimed at improving the physical aspects (as a complement to the clinical issues) of quality assurance in radiotherapy; this ARCAL XXX project (RLA/6/032) was classified as a Model Project of the IAEA. Among the important outcomes of the project were (i) the training of a considerable number of medical physicists in hospitals of the region, (ii) the development of a protocol for quality control procedures, and (iii) the organization of quality audit site visits (to the participant countries) where the implementation in hospitals of the developed quality control procedures is verified. The present publication is the protocol for quality control of the physical aspects of radiotherapy. It contains detailed procedures on what should be measured by a ...

International Nuclear Information System (INIS)

The evaluation of radiotherapy and surgery as exclusive local treatment in comparably selected subgroups of patients with Ewing's sarcoma on the basis of the CESS 86-data. In the German multicenter Ewing's sarcoma study CESS 86, treatment consisted for four 9-week-courses of VACA- or VAIA-chemotherapy plus local therapy. VACA (vincristine, actinomycin D, cyclophosphamide, adriamycin) was given in low-risk extremity tumors with a tumor volume below 100 cm"3. Highrisk patients with central lesions or a tumor volume >100 m"3 received VAIA (ifosfamide instead of cyclophosphamide). Local therapy started after one complete chemotherapy course in week 10. Based on an individual decision in each patient, local therapy was either radical surgery or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy. Because of poor results with radiotherapy in a preceeding study, it was intended to restrict ...

International Nuclear Information System (INIS)

Purpose: We present an update analysis of the multiinstitutional Ewing's sarcoma study CESS 86. Methods and Materials: From January 1986 through June 1991, 177 patients with localized Ewing's sarcoma of bone, aged 25 years or less, were recruited. Chemotherapy consisted of four 9-week courses of vincristine, actinomycin D, cyclophosphamide, and adriamycin (VACA) in low-risk tumors (extremity tumors =# 100 cm"3). Local therapy was an individual decision in each patient and was either radical surgery (amputation, wide resection) or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy (45 Gy plus boost). Irradiated patients were randomized concerning the type of fractionation in either conventional fractionation (once daily 1.8-2.0 Gy, break of chemotherapy) or hyperfractionated split-course irradiation simultaneously with the VACA/VAIA chemotherapy (twice daily 1.6 Gy, break of 12 days after 22.4 Gy and 44.8 Gy, total dose and ...

Science.gov (United States)

PMID:18640506

UK PubMed Central (United Kingdom)

This paper presents a new deformable model using both population and patient-specific statistics to segment the prostate from CT images. There are two novelties in the proposed method. First,...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe precision in carbon ion radiotherapy depends on the calibration of Hounsfield units (HU) as measured with computed tomography (CT) to water equivalence. This calibration...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

The document reports the main issues discussed during the first course-debate on quality controls in radiotherapy, held in Rome in December 3-4, 1998 and May 3-5 1999 in collaboration between the Istituto Superiore di Sanita' and the Istituto Regina Elena. The points considered critical to the quality assurance in radiotherapy by the participants are presented in relation to the total radiotherapy procedure. [Italian] Questo documento e' dedicato al primo corso-dibattito sui controlli di qualita' in radioterapia svoltosi a Roma il 3-4 dicembre 1998 e il 3-5 maggio 1999 in collaborazione tra l'Istituto Superiore di Sanita' e l'Istituto Regina Elena. Esso presenta gli argomenti ritenuti critici per l'assicurazione di qualita' in radioterapia in relazione all'intera procedura radioterapica, in base alle esperienze dei partecipanti.

UK PubMed Central (United Kingdom)

PurposeAuto-propagation of anatomical region-of-interests (ROIs) from the planning CT to daily CT is an essential step in image-guided adaptive radiotherapy. The...Full Text Available

UK PubMed Central (United Kingdom)

Adaptive radiation therapy (ART) is the incorporation of daily images in the radiotherapy treatment process so that the treatment plan can be evaluated and modified to maximize the amount of radiation...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

Background: The effective-dose method which was proposed by the ICRP (International Commission of Radiation Protection) for the estimation of risk to the general population from occupational or environmental, low-dose radiation exposure is not adequate for estimating the risk of cancer induction by radiotherapy of malignant or nonmalignant diseases. Methods:The risk of cancer induction by radiotherapy of benign diseases should be based on epidemiologic data directly derived from follow-up studies of patients who had been given radiotherapy for nonmalignant diseases in the past. Results: Risk factors were derived from epidemiologic studies of patients treated with irradiation for nonmalignant diseases to be used for selecting treatment options and optimizing treatment procedures. Conclusion: In most cases, cancer risks estimated by the effective-dose method may overestimate the true risks by one order of magnitude, yet in ...

UK PubMed Central (United Kingdom)

The aim of this study is to develop an Automatic Post-processing Tool for four-dimensional (4D) treatment planning (APT4D) that enables the user to perform some necessary procedures related...Full Text Available

International Nuclear Information System (INIS)

Between 1973 and 1978 combined radiotherapy and chemotherapy were given to 22 patients with histologically proven Ewing's sarcoma. The combined chemotherapy consisted of cyclophosphamide, vincristin, adriamycin, as well as dacarbazine in some cases. The neoplasm was a localized one at the beginning of treatment in 14 of the 22. These patients received high-voltage rediotherapy to the primary focus at a focal dose between 42 and 55 Gray (4200-5500 rad), followed by chemotherapy. After 6-8 treatment cycles, adriamycin was replaced by methotrexate. Nine of the 14 patients survived without recurrence for 12 to over 59 months. Eight patients had extensive metastases at the beginning of treatment: they at first received only chemotherapy, followed by radiotherapy or operation, as indicated. Full clinical remission was achieved in five of them: in three this remission has now lasted for more than 18, 40 and 44 months, respectively. These results ...

International Nuclear Information System (INIS)

Rectum reference dose points have a direct impact on the morbidity seen in gynecological intracavitaty radiotherapy. The aim of this study is to obtain less morbidity by marking rectum with radio opaque solution. Fourteen patients with gynecological cancer who underwent external radiotherapy received 15 Gray (Gy) intracavitary radiotherapy. During the internal radiotherapy planning, radio opaque solution has been administered into the rectum to observe it on lateral radiogram. Thus rectum reference dose point and five points were marked at sites nearest to the sources. Nucletron Planning system was used for obtaining three-dimensional planning. After therapy patients were followed at every three months. Median follow-up was 18 months. Most frequently observed morbidities were grade 1-2 rectitis and cystitis in six patients. As a result, more accurate rectum dose values and less factors causing dose ...

UK PubMed Central (United Kingdom)

Based on the assumption that an accelerated proliferation process prevails in tumour cell residues after surgery, the possibility that treatment acceleration would offer a therapeutic advantage in postoperative...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

Aim: To systematically review the currently available high quality evidence evaluating treatments for moist desquamation in radiotherapy patients. Design: Systematic literature review. Methods: Electronic databases, websites, reference lists, key journals and conference proceedings were searched. Attempts were also made to uncover unpublished material. Relevant studies proceeded to data extraction and quality assessment. Results: Twenty studies were found; 10 were eligible for inclusion. Although many studies were small, none had unacceptably poor quality. No meta-analysis was undertaken as the studies were not homogenous in their interventions or methods. No convincing evidence for any intervention was found. Conclusion: Despite being recommended by many guidelines (College of Radiographers Summary of Intervention for Acute Radiotherapy Induced Skin Reactions in Cancer Patients (London, 2001); NHS Quality Improvement Scotland Best Practice ...

International Nuclear Information System (INIS)

The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in the role of combined modality therapy especially for hilar cholangiocarcinoma. (authors)

Energy Technology Data Exchange (ETDEWEB)

The paper discusses a number of recent studies investigating into the energy conservation and environmental impacts of electric heating systems (off-peak storage systems). In future, i.e. in and after 1993, off-peak storage systems will be evaluated through comparative analyses of oil-fired heating systems, pollutant emission analyses, the eventual success of pollution abatement measures designed for power plant emissions to keep within the legal limiting values, and the possible abandonment of pollution abatement measures abroad. Opposing the electric heating studies submitted by the electric power industry the author refutes their favourable results referring to the palliative selection of inadequate or vague parameters. Assuming average power plant pollutant emissions of 180 mg/standard/sup 3/ the nitrogen oxide emissions of oil-fired heating systems (134.1 kg/Tj) are found to be below those of off-peak storage systems (242.5 kg/Tj).

International Nuclear Information System (INIS)

Combined treatment of 131 patients aged 3-16 with local form of Ewing's sarcoma is carried out. Survival rate per year was studied in patients without diagnosed metastases depending on chemiotherapy method. It is stated that improved results of treatment of children with Ewing's sarcoma may be achieved by combining radiotherapy with long-term systemic polychemotherapy. The most efficient and expedient method of radiotherapy of long bone sarcoma in children is dialy three-field irradiation with 2 Gy at SFD to the tumor 60 Gy, and adjacent tissues - 40 Gy.

Energy Technology Data Exchange (ETDEWEB)

This report summarizes the major activities and accomplishments of the Idaho National Engineering and Environmental Laboratory (INEEL) Advanced Radiotherapy Research Program for calendar year 2001. Applications of supportive research and development, as well as technology deployment in the fields of chemistry, radiation physics and dosimetry, and neutron source design and demonstration are described. Contributions in the fields of physics and biophysics include development of advanced patient treatment planning software, feasibility studies of accelerator neutron source technology for Neutron Capture Therapy (NCT), and completion of major modifications to the research reactor at Washington State University to produce an epithermal-neutron beam for NCT research applications.

International Nuclear Information System (INIS)

Radiotherapy recent development in cancer treatment needs strong procedures and quality assessment to improve safety both for patients and professionals. In Ile de France territory, a coordinated action between ASN inspectors and medical doctors specialized in public health (MISP), working as civil servants in health administration, was initiated at the end of 2007. An inspection guideline was implemented in a workshop between ASN and Regional Hospital Agency (ARH). The MISP as health administrator has to verify if care organisation responds to treatment cancer regulatory framework: as a doctor he is authorized to access to patient records to know which treatment was chosen. He has to assure if the therapeutic guidelines are respected. His comprehensive approach is essentially patient-oriented. The MISP inspection coordinated with ASN inspectors is a very pertinent pluri-disciplinary approach, undeniably necessary in such a medical technic. The effectiveness of the ...

Energy Technology Data Exchange (ETDEWEB)

We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for the remainder of ...

Energy Technology Data Exchange (ETDEWEB)

Inferior vena cava (IVC) obstruction is a well-described clinical entity. Most IVC obstructions from malignant neoplasms are a direct result of tumor compression [Oviedo J, Cerda S. Vascular invasion by hepatocellular carcinoma. Arch Pathol Lab Med 2001;125: 454-5; Furui S, Sawada S, et al. Gianturco stent placement in malignant caval obstruction: analysis of factors for predicting the outcome. Radiology 1995;195:147-52; Fletcher WS, Lakin PC, et al. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg 1998;133:935-8]. The symptoms of IVC obstruction include progressive ascites, scrotal edema and lower body edema. These constellations of symptoms are described as IVC syndrome and are devastating to a patient with end-stage cancer. We describe a palliative therapy utilizing Luminexx nitinol self-expanding stents to treat intracaval hepatoma thrombus obstructing the IVC. The procedure is rapidly performed, technically ...

Energy Technology Data Exchange (ETDEWEB)

Radio-biologists have pointed out a novel radiobiological phenomenon observed in many tumor and normal cell lines: hyper-radiosensitivity to very low-dose (H.R.S.) followed by induced radioresistance (I.R.R.) after a threshold dose of 0.1-0.3 Gy that depends on the cell line. Radioresistance at high dose (i.e. higher than 0.5 Gy) and metastatic potential of tumor cells are likely major factors of failure in radiotherapy. A careful review of literature suggests that: 1) radiotherapy does not increase the metastatic potential of tumor cells; 2) radioresistance at high dose and metastatic potential are not related. However, inside a given tumor cell line, highly metastatic clones may elicit more cells showing H.R.S; or are more radiosensitive at high dose than poorly metastatic ones. Recent data obtained from molecular techniques (comet and immunofluorescence assays) applied to single cells irradiated at very low radiation doses (1-100 mGy) ...

International Nuclear Information System (INIS)

The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent chemotherapy was administered in 30 patients. The median follow-up period was 14 months ...

International Nuclear Information System (INIS)

Purpose: Treatment results and the pattern of relapse were evaluated in the multimodal treatment of Ewing's sarcomas of the chest wall. Methods and Materials: In a retrospective analysis, 114 patients with non-metastatic Ewing's sarcoma of the chest wall were evaluated. They were treated in the CESS 81, CESS 86, or EICESS 92 studies between January 1981 and December 1993. The treatment consisted of polychemotherapy (VACA, VAIA, or EVAIA) and local therapy, either surgery alone (14 patients), radiotherapy alone (28 patients) or a combination of both (71 patients). The median follow-up was 46.6 months (range 5-170). A relapse analysis for all patients with local or combined relapses was performed. Results: Overall survival was 60% after 5 years, event-free survival was 50%. Thirty-seven patients had a systemic relapse (32.4%), 11 patients had a local relapse alone (9.6%), and 3 patients had a combined local and systemic relapse (2.6%). The risk to relapse locally ...

Energy Technology Data Exchange (ETDEWEB)

The lymphographic agent Lipiodol (iodized oil) has been found to localize and remain in tumor vessels. Based on this finding, we attempted transcatheter internal radiotherapy by radioactive iodized oil (I-131 tagged Lipiodol) prepared by isotopic exchange reaction. Transcatheter internal radiotherapy (TCIR) was attempted in twelve patients with inoperable hepatoma by infusing a therapeutic dose of I-131 Lipiodol (7.6 approx. 28.3 mCi/2.0 approx. 5.0 ml) via the hepatic artery. Serial changes of serum alpha-fetoprotein (AFP) levels and in the size of tumor on computed tomography (CT) were estimated to evaluate the therapeutic effect. Serum AFP levels decreased in 9 patients with initial elevated levels of serum AFP, although they were again elevated in three of them within four weeks. More than 50 % decrease in tumor size was observed in 6 patients (50 %). There were no serious complications. This preliminary results suggest that TCIR with I-131 ...

International Nuclear Information System (INIS)

We present our initial experience with a new biodegradable (BD) esophageal stent in two patients, one for a therapy-resistant benign esophageal stricture, and the other as a temporary measure during curative radiotherapy for oesophageal carcinoma. The BD stents need to be loaded into a conventional pull-back delivery system but are then placed in a standard fashion. Pre-dilatation should be avoided to reduce the risk of migration, however if migration occurs the stents can be left to dissolve in the stomach. The stents are radiolucent but easily identified on CT with minimal artefact and thus might even aid with radiotherapy planning. BD stents offer an exciting new strategy for therapy-resistant benign strictures as well as a supportive measure for oesophageal cancer undergoing non-surgical treatment. (orig.)

International Nuclear Information System (INIS)

Despite high local control rate in Ewing's sarcoma the exact indication of radiation therapy is still controversial as well as the choice of the target volume and the optimal dose of radiation. The importance of the quality of radiotherapy has been stressed in recently published data and has shown a significant impact on long term local control with adequate radiation therapy. The dramatic improvement of precision allowed by the conformal therapy and three dimensional dosimetry allow to expect a decrease of late effects expected for second malignancies. However, late sequelae and radio-induced osteosarcoma still remain the major side effects after radiotherapy. The authors discuss the results of the main trials on Ewing's sarcoma on the choice of dose and target volume. Surgery is still the preferred choice for small tumors if the foreseen outcome is identical. (authors). 28 refs.

International Nuclear Information System (INIS)

Local control of Ewing's sarcoma was analysed in a series of 67 patients treated by surgery and/or radiotherapy as well as combination chemotherapy. Radiotherapy was employed with or without surgery in 60 patients and produced an overall local control rate of 55%; complete excision of the primary lesion seemed to be beneficial. There was a marked variation in control rates depending on the site of the primary lesion: limb 85%, rib 53%, pelvis 31% and other sites 33%.Primary tumours greater than 10 cm in diameter were significantly less likely to be controlled. Using daily fractions of approximately 180 cGy, total doses in excess of 6000 cGy seem more likely to produce serious late morbidity amd may not increase the local control rate. No cases of second malignancy arising in irradiated tissue have been observed to date, but one patient developed acute lymphoblastic leukaemia. (author).

International Nuclear Information System (INIS)

The behaviors of peripheral eosinophils during radiotherapy were examined in 200 cases of non-resected cervical cancer. Before irradiation, the mean absolute eosinophil count had been 170 +- 168/mm_3, and eosinophilia (more than 500/mm_3) had been observed in 11 cases (5.5%). Postirradiation eosinophilia occurred in 126 cases (63%). The mean period between institution of irradiation and the peak of the eosinophil count was 27.8 days. The mean highest eosinophil count was 691 +- 437/mm_3, and the mean bone marrow dose in this period was 906 rad. Comparisons of the eosinophil count according to the stage showed no significant differences. (Chiba, N.).

Energy Technology Data Exchange (ETDEWEB)

The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that ...

International Nuclear Information System (INIS)

MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic ...

Energy Technology Data Exchange (ETDEWEB)

To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression. Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier method was used. Thirty of 31 attempted ...

UK PubMed Central (United Kingdom)

Multiple myeloma is a highly radiosensitive skeletal malignancy, but bone-seeking radionuclides have not yet found their place in disease management. We previously reported that the proteasome inhibitor...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

The document, based on European guidelines, was jointly developed by radiation oncologists, radiation physicists and radiation technologists. It contains the aims of the guidelines, professional profiles, roles and responsibilities, personnel and equipment requirements, procedures.

UK PubMed Central (United Kingdom)

33 patients with advanced malignant melanoma were studied after intravenous administration of 131I-labeled Fab fragments specific for p97, an oncofetal glycoprotein of human melanoma. In all, 47 gamma...Full Text Available

International Nuclear Information System (INIS)

The implementation of a three-dimensional conformal radiotherapy facility in the radiotherapy department of the Heinrich Heine University is described. Complex radiotherapy techniques with commercially available networked systems are introduced to improve clinical work. Over 18 month we have gained clinical experience with a PHILIPS Multileaf Collimator (MLC) mounted on a SL 25 linear accelerator. For a limited period the MLC was used as a conventional blocking device. The standard MLC-shapes are controlled with a stand-alone computer system. In addition, a three-dimensional treatment planning system (3-D-TPS / TMS-Radix, Helax AB) based on convolution/superposition algorithms was recently installed. Treatment optimization is achieved using static field arrangements with complete volumetric computerized tomographic patient data for 3-D-TPS. Conformal adaptation of the 95%-isodose to the Planning Target Volume (PTV, ICRU 50) ...

UK PubMed Central (United Kingdom)

The purpose of this study was to investigate if interfraction and intrafraction motion in free-breathing and gated lung IMRT can lead to systematic dose differences between 3DCT and 4DCT. Dosimetric...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

Electron beam therapy applied to a lymph node metastasis from a squamous cell carcinoma was followed by the development of histologically and immunologically typical bullous pemphigoid, the lesions being initially strictly confined to the irradiation area. This observation suggests that the bullous pemphigoid antigen may be altered or unmasked by electron beam radiotherapy, leading subsequently to the production of autoantibodies. The disease in this case effectively responded to the administration of tetracycline and niacinamide, a therapeutic regimen described recently.

Energy Technology Data Exchange (ETDEWEB)

In order to consider some procedures to prevent errors in radiotherapy based in learned lessons of accidental expositions and in accordance with information contained in international reports elaborated by International Atomic Energy Agency (IAEA) and of the data base availability by the European group Radiation Oncology Safety Information System (ROSIS) on the events, a research of the occurred errors was performed. For the evaluation of the incidents a data base based in the ROSIS and added plus a parameter was created 'type of error'. All the stored data make possible the evaluation of the 839 incidents in terms of frequency of the type of error, the process of detention, the number of reached patients and the degree of severity. Of the 50 types of found errors, the type of error more frequently was 'incorrect treatment coordinate', confirmed with the data of literature and representing 28,96 por cent of the total of the ...

International Nuclear Information System (INIS)

The medical applications of radiation comprise three main fields namely: Diagnostic Radiology, Radiotherapy and Nuclear Medicine. With the new weighting factors of ICRP (IC91a) the effective dose due to medical applications can be established. I is common to separate the effective dose into the genetic part and the somatic part, SED. In dealing with gonad doses it is important to account for the age of the person at the time of exposure as this will influence the number of children still to be expected from that person. The resulting dose will then be called the genetically significant dose, GSD. In a similar fashion this age factor will be important in considering the chance of tumor induction. The age of patients differs considerably from the average age of the general population. This age difference has to be accounted for if a comparison is to be made with other sources of radiation. This justifies establishing a somatically significant dose, SSD. The reduction ...

Energy Technology Data Exchange (ETDEWEB)

Radiotherapy can be very significant as the treatment for ocular lesions, eyes need to be preserved as properly as possible on their functions and cosmetics. The application of conventional X ray therapy has been gradually abandoned as conventional X ray therapy ceased to be accepted as the general treatment for malignant tumors. Consequently the necessity of electron beam therapy has been rising even as the substituted method for conventional X ray therapy. The department of radiology of Gunma University was obliged to establish a new therapy for ocular lesions, and has been trying electron beam therapy since 1973. It is concluded that electron beam therapy is not at all inferior to conventional X ray therapy as reported above. Basic therapeutic methods for ocular lesions are the following: 1) For epidermoid carcinoma, 600 rads at a time, 3600 - 4200 rads in total is applied by 8 MeV electron twice a week method. 2) For malignant melanoma, 1000 rads at a time, ...

International Nuclear Information System (INIS)

Dose measurements were performed in several body regions of patients suffering from inflammatory degenerative diseases (humeral epicondylitis, humeroscapular periarthritis, gonarthrosis, axillary hidradenitis, rheumatoid arthritis, coxarthrosis, parotitis). The problem of the radiation induction of neoplasms is predominant concerning somatic as well as genetic risk, discussed by example of the most frequently occurring organ cancer. Compared to the rate of breast cancer in the highly developed industrial states (5,000 to 6,000 cancers/100,000 women) the 'radiation induction' calculated according to a mathematical model of ICRP 26 (1.25 cases of death for breast cancers/100,000 women following for example irradiation of epicondylitis) is behind several powers of ten and not demonstrable. The genetic radiation exposure is also low. Derived from the measurements it is wrong to give up reliable and approved indications of radiotherapy of non-malignant diseases because ...

Energy Technology Data Exchange (ETDEWEB)

This study examines some radiation accidents occurred in the past. This information has been systematically assessed to get global lessons. The experience feedback shows that the most of accidents happened in certain conditions. These conditions can be distributed in four categories: 1- perception and vigilance in occupation: accidental exposure happened by lack of vigilance in details and lack of vigilance and perception; 2- procedures: accidental exposure happened following a lack of procedures or control that were not enough complete, not enough documented or not completely implemented; 3- training and understanding: accidental exposures happened because the personnel was not enough qualified and educated, did not get the general training nor the the necessary specialized training; 4- liabilities: accidental exposures happened following lacks and ambiguity in the definition of functions of the personnel and in the hierarchy liabilities. In these precise cases the safety tasks have ...

Energy Technology Data Exchange (ETDEWEB)

From December 1981 to September 1986, 149 patients were treated at the Radiotherapy Department of the Hospital Clinico y Provincial of Barcelona by means of intracavity irradiation with 137 cesium high 1 sources and 2. To 112 of the total number of patients external radiotherapy to the whole of the pelvis using photons of 6 MeV was also administered. A total of 46 (30.7%) patients presented rectal complications. The rectitis observed was mild in 16 cases (10.7%), moderate in 15(10%) and severe in 15(10%). The 15 patients with severe rectitis had to be treated by unloading colostomy. In patients with severe complications, the maximum total rectal dose administered was between 5,855 and 9,490 cGy, and the maximum rectal dose administered via curietherapy was 1,055 to 7,320 cGy. Maximum total rectal dose administration greater than 4,000 cGy and maximum rectal dose administered via curietherapy greater than 5,800 cGy were statistically significant ...

International Nuclear Information System (INIS)

From 1964 to 1973 at the Institute of Oncology and Radiobiology, Havana City, 18 clinical histories were studied, all of them from patients with Erwing's sarcoma, histologically diagnosticated by biopsy. Age, sex, race, traumatism background, hemogram disturbances, radiographic signs, primary tumor localization, and early treatment, were exposed. Early treatment in 14(83%) patients as radiotherapy. Local recurrence or metastasis was presented in 10(55,5%) patients during the two first years following attack treatment. Five (35,7%) patients was the survival rate within five years starting early treatemt. After five years, three (21,4%) patients were alive: for 18 and 14 year, and 64 month period; two patients died at 62 and 64 months. It is concluded that this survival may be increased by initial behaviour enclosed at the technologic therapeutic patterns of the the Institute of Oncology and Radiobiology, of Havana City. (author).

International Nuclear Information System (INIS)

Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was ...

Energy Technology Data Exchange (ETDEWEB)

The radiotherapy is the prime treatment for the cavum cancer. It is also useful to treat the tumor recurrences, in this case the reirradiation stays the only efficient therapy option to give a correct local control. The reirradiation, exclusive or in association with other therapies can contribute to the local control of cavum cancer recurrences with a survival rate at five years of 36 to 58%. (N.C.)

Energy Technology Data Exchange (ETDEWEB)

A simple and cheap method is described for the manufacturing of individual positioning aids made of foamed polyurethane. Some examples are given to demonstrate the applicability of these positioning aids for the irradiation of different body regions. The reproducibility of the radiation field in the head and neck area was investigated with and without positioning aid. It was proved that the field is adjusted more exactly when positioning aids are applied. The dosimetric investigations performed showed a negligible influence of foamed polyurethane on the radiation quality. So the positioning aids could be left within the radiation field when drawing the field borders.

Energy Technology Data Exchange (ETDEWEB)

It is possible to produce energetic beams of radioactive nuclei, as secondary beams, from the heavy-particle compound accelerator called BEVALAC. These beams can be focused into experimental areas without significant contamination using suitable magnetic filters and proper beam-optics. Properly selected high-energy beams of radioactive nuclei (those which defay by positron emission) can provide a truly unique opportunity to evaluate the effectiveness of these beams in localizing the Bragg peak on a tumor volume - necessary in heavy-particle therapy. Preliminary data are presented here to demonstrate the possible use of these beams in radiotherapy treatment-planning verification.

International Nuclear Information System (INIS)

Purpose: The occurrence of extraosseous Ewing's sarcoma (ES) in deep soft tissues has been well described, but cases in which this tumor occurs in a primary cutaneous or subcutaneous site have rarely been reported. The superficial variant may be less aggressive than are the more common bony and deep soft tissue counterparts with an apparently favorable outcome. A retrospective review of patients with cutaneous or subcutaneous ES was conducted to analyze outcome and patterns of failure. Methods and Materials: Between July 1985 and March 1997, 14 patients with cutaneous or subcutaneous ES were treated at St. Jude Children's Research Hospital. The median age at presentation was 16 years (range 7-21 years). Anatomic locations included trunk and pelvis (7), upper or lower extremity (4), and head and neck (3). The median size of the lesion was 3 cm (range, 1-12 cm). Thirteen had definitive surgical resections, and one had biopsy of the mass at the time of referral. They were enrolled on ...

International Nuclear Information System (INIS)

A computer-assisted rotation and stationary conformation radiotherapy system with overrunning multileaf collimators has been developed. This system can produce any shape of target volume, including a number of target areas outside the axis of the rotation, regardless of the location of the axis at 360"0 rotation irradiation. In addition, by changing the dose rate and deleting a partial region within a field, multiple stationary irradiation can produce more homogeneous target volumes - thus avoiding excessive irradiation to critical organs - than the rotation technique. (orig.).

International Nuclear Information System (INIS)

We encountered a case of Ewing's sarcoma. The patient was a 19 year-old girl, who visited a local physician because of pain in the left scapular region, and was referred to us. Roentgenograms of her left scapula revealed an irregular moth-eaten shadow which was suspected to be a malignant bone tumor. The histological diagnosis of Ewing's sarcoma was comfirmed by needle biopsy. The initial stage of treatment consisted of radiation therapy (6000 rads) and chemotherapy (VAC and ADR). At the end of the initial stage, the symptoms were improved, the size of the local lesion was reduced on the roentgenogram and there was no evidence of distant metastases. (author).

International Nuclear Information System (INIS)

Purpose: To evaluate the role of stereotactic radiosurgery (SRS) and whole-brain radiotherapy (WBRT) for the treatment of brain metastases in patients with renal cell cancer (RCC). Patients and methods: 88 patients were treated with either SRS (n = 51) or SRS + WBRT (n = 17) for one to three lesions, or with WBRT (n = 20) for more than three brain metastases. Overall survival (OS), intracerebral control (IC) and local control (LC) were retrospectively analyzed. Six potential prognostic factors were assessed: age, gender, number of brain metastases, extracerebral metastases, recursive partitioning analysis (RPA) class, and interval from tumor diagnosis to irradiation. Results: The median times for OS, IC, and LC from the time of diagnosis were 11, 9, and 10 months. The median OS times for SRS, SRS + WBRT, and WBRT were 12, 16, and 2 months. Addition of WBRT to the SRS improved IC (p = 0.032) but not OS (p = 0.703). On multivariate analyses, improved OS was ...

Science.gov (United States)

PURPOSE: To determine the recommended dose of radiotherapy when combined with full-dose gemcitabine and erlotinib for unresected pancreas cancer. METHODS AND MATERIALS: Patients with unresected pancreatic cancer (Zubrod performance status 0-2) were eligible for the present study. Gemcitabine was given weekly for 7 weeks (1,000 mg/m(2)) with erlotinib daily for 8 weeks (100 mg). A final toxicity assessment was performed in Week 9. Radiotherapy (starting at 30 Gy in 2-Gy fractions, 5 d/wk) was given to the gross tumor plus a 1-cm margin starting with the first dose of gemcitabine. A standard 3 plus 3 dose escalation (an additional 4 Gy within 2 days for each dose level) was used, except for the starting dose level, which was scheduled to contain 6 patients. In general, Grade 3 or greater gastrointestinal toxicity was considered a dose-limiting toxicity, except for Grade 3 anorexia or Grade 3 fatigue alone. RESULTS: A total of 20 patients were ...

International Nuclear Information System (INIS)

A human cholangiocarcinoma, Ch-1, serially transplanted to nude mice was used for experimental chemotherapy, radiotherapy, and conbination chemoradiotherapy. In the group of chemotherapy with single drug, Mitomycin C (MMC) revealed greater effectiveness than Adriamycin in terms of tumor regression, histological findings, and minor side effects. MMC and radiotherapy by Linac X-ray showed exponential linear dose response curve against tumor weight. Their effects were equivalent at doses of MMC 1 mg/kg and radiation 1,000 rads/mouse in the changes of tumor weight and of histological findings which were similar to each other. Combination chemoradiotherapy showed the synergistic action when the radiation (500 rads/mouse) was performed before MMC (0.5 mg/kg) administration, whereas only the additive effect was observed when the sequence was reversed. The cell kinetic analysis was performed by the impulse cytophotometry, "3H-thymidine uptake labeling ...

Energy Technology Data Exchange (ETDEWEB)

Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD (follicle-stimulating hormone (FSH), 10 +/- 5 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml) and 17 beta-estradiol (E2) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developed persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 108 +/- 29 mlU/ml; LH, 72 +/- 19 mlU/ml) and E2 (19 +/- 8 ...

Energy Technology Data Exchange (ETDEWEB)

The construction of Heavy Ion Medical Accelerator in Chiba (HIMAC) at the National Institute of Radiological Sciences was completed in December 1993. HIMAC consists of an injector linac, two synchrotron rings, a high energy beam transport system and a beam irradiation system. Its accelerator parameters are based on the medical requirement, and helium, carbon, neon, silicon and argon were selected as the accelerated ion species. It has 3 therapy rooms (A{approx}C). Room A has a vertical irradiation system, Room C horizontal and Room B both vertical and horizontal. Two rings can supply beams independently to the vertical and horizontal irradiation systems. Clinical trial started on June 21 1994, after several basic biological and physics experiments lasting about 2 months. Cancer is the top cause of death in Japan since 1981, and people expect good treatment results at HIMAC. Proton and heavy ion radiotherapy has the advantage of dose distribution and biological ...

Energy Technology Data Exchange (ETDEWEB)

We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by comparing the food intake capacity before and after the procedure. The complications were ...

Energy Technology Data Exchange (ETDEWEB)

To investigate the problems of the Hanaro stent (Solco Intermed, Seoul, Korea) when used in the palliative treatment of patients with inoperable malignant biliary obstruction. Between January 2000 and May 2001, the treatment of 46 patients with malignant biliary obstruction involved percutaneous placement of the Hanaro stent. Five patients encountered problems during removal of the stent's introduction system. The causes of obstruction were pancreatic carcinoma (n=2), cholangiocarcinoma (n=2), and gastric carcinoma with biliary invasion (n=1). In one patient, percutaneous transhepatic cholangiography and stent insertion were performed as a one-step procedure, while the others underwent conventional percutaneous transhepatic biliary drainage for at least two days prior to stent insertion. A self-expandable Hanaro stent, 8-10 mm in deameter and 50-100 mm in lengh, and made from a strand of nitinol wire, was used in all cases. Among the five patients who ...

Energy Technology Data Exchange (ETDEWEB)

The patient positioning and repositioning control in radiation therapy all along the treatment can be conducted using a variety of X-ray sources and imaging detector devices. The development of image guided radiation therapy techniques leads to more frequent use of this imaging control. In this article we summarize the current methods for measuring the dose delivered by X-ray imaging devices used in radiation therapy, as well as basic proposals to take account of these imaging doses for prescribing, recording and reporting radiation therapy treatment. (authors)

Energy Technology Data Exchange (ETDEWEB)

The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.

International Nuclear Information System (INIS)

Purpose: During recent years, more intensified systemic and local treatment regimens have increased the 5-year survival figures in localized Ewing's sarcoma to more than 60%. There is, however, concern about the risk of second malignancies (SM) in long-term survivors. We have analyzed the second malignancies in patients treated in the German Ewing's Sarcoma Studies CESS 81 and CESS 86. Materials and Methods: From January 1981 through June 1991, 674 patients were registered in the two sequential multicentric Ewing's sarcoma trials CESS 81 (recruitment period 1981-1985) and CESS 86 (1986-1991). The systemic treatment in both studies consisted of a four-drug-regimen (VACA = vincristine, actinomycin D, cyclophosphamide, and adriamycin; or VAIA = vincristine, actinomycin D, ifosfamide, and adriamycin) and a total number of four courses, each lasting nine weeks, was recommended by the protocol. Local therapy in curative patients was either complete surgery (n = 162), surgery plus ...

International Nuclear Information System (INIS)

New values of the factors required to convert the reading of a radiation dosemeter calibrated in terms of air kerma (or exposure) into absorbed dose to water for medium-energy x-radiation were given in a code of practice published by the International Atomic Energy Agency in 1987. These are not considered to possess sufficient support from other sources. It is therefore recommended that the F-factors given or codes of practice should continue to be used. Values of backscatter factors for low-energy x-radiation (below 140 kV) in Supplement 17 of the British Journal of Radiology appear to be inaccurate. New values based on Monte Carlo calculations, and supported by new experimental data, are given for use in radiotherapy. (author).

Energy Technology Data Exchange (ETDEWEB)

Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The clinical, angiographic, and histologic features ...

International Nuclear Information System (INIS)

Full text: Verification of the dose delivered to a patient during radiotherapy is an important quality assurance procedure, however this is rarely performed due to the extra time involved. Electronic portal images (EPIs) are currently acquired at many centres during radiotherapy treatment for positioning verification. These could be utilised for dose verification provided 1) an accurate prediction of the dose transmitted through the patient to the EPID can be produced for the patients' radiotherapy beams, and, 2) the EPID image can be converted to an accurate measured dose. Ideally, the radiotherapy planning system (RTPS) would be used to produce the predicted dose as part of the planning procedure. The aim of this project is to investigate whether the convolution-superposition model of the Pinnacle RTPS can accurately calculate dose transmitted through a patient and deposited in a phantom at a large ...

British Library Electronic Table of Contents (United Kingdom)

Allogeneic stem-cell transplantation (SCT) is potentially curative therapy in AML by providing both dose-intensive chemo-radiotherapy and induction of graft-versus-leukemia (GvL) effect. Historically, more emphasis was given to the intensity of conditioning. Over the last decade the pendulum turned more towards induction of GvL as the primary goal. A plethora of non-myeloablative (NMA) and reduced-intensity conditioning regimens (RIC) were introduced trying to reduce transplant-related toxicities and allow SCT in elderly and medically infirm patients. In addition, reduced-toxicity myeloablative regimens (RTC) based on fludarabine and myeloablative alkylating-agent doses were designed to allow safer administration of dose-intensive therapy. Conditioning dose-intensity is highly correlated w...

International Nuclear Information System (INIS)

Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.)

Energy Technology Data Exchange (ETDEWEB)

The technical complexity of intraoperative radiotherapy (IORT) requires modification of the standard physical and dosimetric methods used in external electron beam therapy. At the National Cancer Institute, a number of technical innovations have been integrated into ongoing clinical studies of IORT. These include: (1) an electron beam applicator system that is significantly different from other IORT systems and includes customized squircle applicators; (2) peripheral dose shields; (3) a modified surgical table replacing the standard radiation treatment couch; and (4) routine use of multiple IORT fields that necessitates field matching. The IORT applicator system and related devices and techniques are dosimetrically characterized in detail both for use in the IORT program and in order to illustrate many useful facets of electron dosimetry.

International Nuclear Information System (INIS)

A retrospective study of Ewing's Sarcoma at The Armed Forces Malignant Diseases Treatment Centre, Command Hospital, Pune, is presented. A total of 38 cases over a period of thirteen years have been studied. Males predominate slightly, and the common age group on presentation has been in the second and third decade. Humerus, pelvis and femur are the bones commonly affected. The initial line of management has been primarily radiotherapy, which has been over the years supplemented by combination chemotherapy. All the cases achieved remission, though only 32 cases (84 per cent) had complete remission, and the remaining only partial remission. The overall survival in those offered aggressive therapy has been over 50 per cent in two years. The present policy in the management of these cases is discussed. (author). 4 tabs.

International Nuclear Information System (INIS)

In everyday radiotherapy we must carry out the determination of absorbed dose measurement according to JARP's protocol. We explained an outline of JARP's 1974 and 1986 protocol in electron beam therapy, and mentioned it about the matter that should examined. To use it easily in clinic, a simplified procedure based on precisely to JARP's 1986 protocol is practical, the character of this procedure settles briefly the determination of mean incident energy of electron beams and get ready to table of ionization to absorbed dose conversion factor for various ionization chamber. Also, this procedure almost not influence on the accuracy of determination. We described systematically practical procedure for requisite absorbed dose calculation in a patient in electron beam therapy. (author).

International Nuclear Information System (INIS)

Invading melanoma spreads to local and unpredictable distant location at the early stages of its development. It is justifiable, therefore, to classify the disease as a systemic disorder. This requires a systemic treatment that reaches all melanoma cells irrespective of whether they are singly dispersed and in circulation or already forming solid tumours of various sizes. Targeted radiotherapy affects directly and selectively cancer cells provided an appropriate radionuclide and its carrier are chosen. Melanoma is a pigmented tumour. Methylene blue (MTB)) accumulates selectively in melanoma cells due to its exceptionally high affinity to melanin. MTB serves, therefore, as a carrier for radionuclides. "2"1"1At-MTB has proved to be particularly effective in treating disseminated melanoma when administered systemically and, at the same time, non-toxic to normal non-pigmented and pigmented organs. (authors)

Energy Technology Data Exchange (ETDEWEB)

In the treatment of prostatic cancer using a newly proposed intermittent multiportal therapy (DIMT), acute reactions, change in tumor marker levels, and complications more than 6 months after treatment were evaluated. From June 1989 to September 1990, 26 patients with prostatic cancer (stage A2, 3 patients; B, 9; C, 2; D, 10; recurrence, 2) were treated. Fifteen patients were followed up for more than one year, with a mean period of 11.6 months. The treatment schedule is 52.5 Gy in 16 fractions in 4 weeks for radical treatment, and 30.0 Gy in 8 fractions in 2 weeks for palliative treatment. The 360 degree rotation about the patient was divided into 16 fractions, and 2 opposing fractions were used in one day as parallel opposed portals to treat the target volume. The fractions were serially treated one per day, so that 8 treatment days produced a total dose of distribution similar to that for conventional conformational therapy. The size of the irradiation field ...

International Nuclear Information System (INIS)

Objective: To evaluate the effect of PTBD in treating malignant biliary obstruction caused by hilar cholangiocarcinoma. Methods: We retrospectively analyzed the data of 103 patients(M:62,F:41)with malignant obstructive jaundice caused by hilar cholangiocarcinoma. After taking percutaneous transhepatic cholangiography, metallic stent or plastic external catheter or external-internal catheter for drainage was deployed and then followed up was undertaken with clinical and radiographic evaluation and laboratory. examination. Results: All patients went though PTBD successfully (100%). According to Bismuth classification, all 103 cases consisted of I type(N=30), II type (N=30), III type (N=26) and IV type (N=17). Thirty-nine cases were placed with 47 stents and 64 eases with drainage tubes. 4 cases installed two stems for bilateral drainage, 2 cases installed two stents because of long segmental strictures with stent in stent, 1 case was placed with three stents, and 3 cases installed stent ...

Energy Technology Data Exchange (ETDEWEB)

Hyaluronic acid (HA) is a significant component of the extracellular matrix (ECM), particular interest being shown herein in synovial fluid. The present study aims to investigate the degrading effects of X-ray radiation on HA at radiotherapy doses. Measurements of viscosity and shear stresses on HA solutions have been made at different shear rates using various types of viscometer for different concentrations in the range 0.01-1% w/v of HA. The HA has been subjected to doses of 6 MV photon radiation ranging from 0 to 20 Gy, the major emphasis being on doses below 5 Gy. It is found that there is a dose-dependent relationship between viscosity and shear rate, viscosity reducing with radiation dose, this being related to polymer scissions via the action of radiation-induced free radicals. The dependency appears to become weaker at higher concentrations, possibly due to the contribution to viscosity from polymer entanglement becoming dominant over that from mean ...

International Nuclear Information System (INIS)

The role of radiation therapy in local tumor control and decreased incidence of pulmonary metastasis is reported in 271 patients who were entered into the Intergroup Ewing's Sarcoma Study with more than one year follow-up and on whom all radiotherapy records were reviewed. The majority of the patients were irradiated to the primary tumor with doses of 4500 to 6500 rad in five to six weeks in combination with systemic administration of three drugs (vincristine, actinomycin-D and cyclophosphamide) or four drugs (vincristine, actinomycin-D, cyclophosphamide and adriamycin). One of the groups of patients was treated with three drugs and bilateral pulmonary irradiation (1500 rad, uncorrected dose, in two weeks). Preliminary analysis shows an overall local primary tumor control of 89%. Patients with lesions in the pelvis had a local failure rate of 17% (9 of 52) and in the humerus 23% (7 of 31). Factors affecting local recurrences are analyzed in detail. Distant ...

International Nuclear Information System (INIS)

For the study of radiation biology and its application to radiotherapy, the double differential cross section of electron emission from water vapor induced by 6.0 MeV alpha particle beam is measured. The energy spectra of electrons ranging 7- 10000 eV are detected by the electrostatic analyzer and micro channel plate. The measurements are made at angles between 20 and 160 degrees. With use of this data set, the radial dose distribution in water is calculated by using KURBUC code. It is the Monte Carlo type code of the electron transport process, where the track of the electron is simulated through each individual interactions including elastic scattering, ionization cross section and total excitation cross section in case that electrons with certain energy are put in the liquid-density water. In order to understand the effect of radiation when the particle flux is injected in the human body like radiotherapy using accelerator beam, the dose ...

International Nuclear Information System (INIS)

Ewing's sarcoma is the most common malignant bone tumour occurring in children and adolescents and exists in two different clinico pathological entities: osseous Ewing's sarcoma (OES) and extraosseous Ewing's sarcoma (EES). Five cases of primary epidural EES are described, which presented with non-specific symptoms leading to a long diagnostic delay. The median age at diagnosis was 22 years (range 13-36 years). The median diagnostic delay was 3 months. All patients had one or more neurological deficits. All underwent surgical exploration with a laminectomy and partial resection followed by adjuvant radiotherapy to a dose of 46-50 Gy and chemotherapy with VAC (vincristine, adriamycin and cyclophosphamide) alternating with ICE (ifosphamide, cisplatin and etoposide) for at least six cycles. The mean follow-up period is 21.2 months (range 11-32 months). Four of the five patients achieved a complete remission and are disease free at the time of writing this report. Two ...

International Nuclear Information System (INIS)

Purpose: This study presents a dosimetric optimization effort aiming to compare intensity-modulated (IM) X-rays and IM protons in 4 different orbital and paraorbital tumors. These are most challenging targets for standard radiotherapy due to their close relationship with the eyes and related structures. Methods and Materials: A primary orbital lymphoma, an optic nerve meningioma, a sphenoidal ridge meningioma protruding into the orbit, and a pediatric parameningeal paraorbital rhabdomyosarcoma were selected for the purpose of this study. Planning target volumes (PTVs) and organs at risk (OAR) were defined in each patient CT data set for each tumor site. IM X-ray and IM proton three-dimensional treatment plans were implemented. The following total tumor doses were prescribed: 30 Gy for the orbital lymphoma, 54 Gy for both meningiomas, and 50.4 Gy for the rhabdomyosarcoma case. Dose-volume histograms (DVHs) were obtained for all targets and OAR with both treatment ...

Energy Technology Data Exchange (ETDEWEB)

Accurate lung tumor tracking in real time is a keystone to image-guided radiotherapy of lung cancers. Existing lung tumor tracking approaches can be roughly grouped into three categories: (1) deriving tumor position from external surrogates; (2) tracking implanted fiducial markers fluoroscopically or electromagnetically; (3) fluoroscopically tracking lung tumor without implanted fiducial markers. The first approach suffers from insufficient accuracy, while the second may not be widely accepted due to the risk of pneumothorax. Previous studies in fluoroscopic markerless tracking are mainly based on template matching methods, which may fail when the tumor boundary is unclear in fluoroscopic images. In this paper we propose a novel markerless tumor tracking algorithm, which employs the correlation between the tumor position and surrogate anatomic features in the image. The positions of the surrogate features are not directly tracked; instead, we use principal ...

International Nuclear Information System (INIS)

A report on the long-term follow up of the first cooperative Scandinavian Sarcoma Group study in Ewing's sarcoma of bone is presented. Fifty-two previously untreated patients entered the study between 1984 and 1990. Half of the tumors were located in the extremities and one quarter in the pelvis. The combined modality treatment consisted of 5 cycles of chemotherapy - including vincristine, methotrexate, doxorubicin, cyclophosphamide, bleomycin and dactinomycin. The first two cycles were followed by local resection or amputation in 35 patients and by radiotherapy alone in 17 patients. When surgery was not performed, was incomplete or yielded poor margins radiotherapy was given at a dose of 40-60 Gy. Local tumor relapses developed in 10 patients and in all but one patient were accompanied by metastatic disease. Five patients had metastasis at diagnosis and distant metastases developed after primary treatment in 27 patients after a median of 14 ...

International Nuclear Information System (INIS)

The convolution/superposition calculations for radiotherapy dose distributions are traditionally performed by convolving polyenergetic energy deposition kernels with TERMA (total energy released per unit mass) precomputed in each voxel of the irradiated phantom. We propose an alternative method in which the TERMA calculation is replaced by random sampling of photon energy, direction and interaction point. Then, a direction is randomly sampled from the angular distribution of the monoenergetic kernel corresponding to the photon energy. The kernel ray is propagated across the phantom, and energy is deposited in each voxel traversed. An important advantage of the explicit sampling of energy is that spectral changes with depth are automatically accounted for. No spectral or kernel hardening corrections are needed. Furthermore, the continuous sampling of photon direction allows us to model sharp changes in fluence, such as those due to collimator tongue-and-groove. The ...

International Nuclear Information System (INIS)

This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain. Materials and Methods: Between January 2004 and December 2006, 68 patients with ?4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patients received SRS and 39 patients received whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10?20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy fractions, for a total of 30 Gy. After completion of treatment, a follow-up brain MRI or a contrast-enhanced brain CT was reviewed. ...

Energy Technology Data Exchange (ETDEWEB)

The serum levels of ferritin in 394 patients, including 339 patients with various malignant tumors and 23 with various non-malignant diseases, and 32 healthy subjects were determined. The normal levels of ferritin were 82.7 +- 42.3 ng/ml for males and 42.0 +- 36.9 ng/ml for females. The positive ratio of serum ferritin level was 28% in patients with malignant tumors and 22% in patients with non-malignant diseases. The usefulness of serum ferritin assay in screening for malignant tumors appeared to be limited. High serum levels of ferritin were found in patients with malignant lymphoma (positive ratio: 42%), pulmonary cancer (38%) and esophageal cancer (37%). According to the histological types, epidermoid cancer appeared to produce a higher serum level of ferritin than adenocarcinoma in patients with pulmonary cancer. It was interesting that malignant lymphoma had a high serum level of ferritin in spite of its low serum level of CEA. Carcinoma of the digestive tracts except for ...

International Nuclear Information System (INIS)

Background and purpose: the recent RTOG guidelines for future clinical developments in gynecologic malignancies included the investigation of dose escalation in the paraaortic (PO) region which is, however, very difficult to target due to the presence of critical organs such as kidneys, liver, spinal cord, and digestive structures. The aim of this study was to investigate intensity-modulated radiotherapy's (IMRT) possibilities of either increasing, in a safe way, the dose to 50-60 Gy in case of macroscopic disease or decreasing the dose to organs at risk (OR) when treatment is given in an adjuvant setting. Material and methods: the dosimetric charts of 14 patients irradiated to the PO region at the department of radiation oncology, university hospital of Liege, Belgium, in 2000 were analyzed in order to compare six-field conformal external-beam radio-therapy (CEBR) and five-beam IMRT approaches. Both CEBR and IMRT investigations were planned to ...

Energy Technology Data Exchange (ETDEWEB)

Purpose. We have tested a procedure of focal injection of the contrast medium Lipiodol as a fiducial marker for image-guided boost of the tumor in bladder cancer radiotherapy (RT). In this study, we have evaluated the feasibility and the safety of the method as well as the inter- and intra-fraction shift of the bladder tumor. Materials and methods. Five patients with muscle invasive urinary bladder cancer were included in the study. Lipiodol was injected during flexible cystoscopy into the submucosa of the bladder wall at the periphery of the tumor or the post resection tumor-bed. Cone-beam CT (CBCT) scans were acquired daily throughout the course of RT. Results. Lipiodol demarcation of the bladder tumor was feasible and safe with only a minimum of side effects related to the procedure. The Lipiodol spots were visible on CT and CBCT scans for the duration of the RT course. More than half of all the treatment fractions required a geometric shift of 5 mm or more to ...

International Nuclear Information System (INIS)

Full text: Radiotherapy treatment planning (RTP) relies heavily on medical imaging. Until recently, the most important planning tool was the treatment simulator. The kilovoltage radiographic capabilities in a treatment simulator enabled the boundaries of treatment fields to be visualized with respect to bony anatomic landmarks. Perhaps the most important advance in treatment planning in recent years is the ability to visualize the passage of the beams with respect to a more accurate geometrical representation of the tumor and other soft tissue structures. This 'virtual simulation' uses a computer-based representation of a patient to determine the extent of the disease and the location of radiation sensitive normal tissue. Computer tomographic (CT) imaging produces a high-resolution three-dimensional representation of anatomy that can be correlated with other image sets such as magnetic resonance images (MRI) of function. Positron emission tomographic (PET) imaging ...

Energy Technology Data Exchange (ETDEWEB)

Sixteen patients with advanced cutaneous T-cell lymphoma (CTCL) with or without lymph node involvement, but without evidence of extranodal manifestations, were treated with a combination of total skin electron beam therapy (TSEB) and total nodal irradiation (TNI). Fourteen (87%) patients achieved a complete response (CR) lasting from 1 to 84+ months (median, 8+ months) from the completion of treatment. The best results occurred in 6 patients with pretumorous intracutaneous CTCL (Stages IB and IIA) where the CR has lasted in all patients from 8 to 84+ months (median about 27+ months). Radiotherapy was well tolerated with the major toxicity being bone marrow suppression. The authors conclude that combined TSEB and TNI is a relatively safe and effective treatment for patients with CTCL prior to the development of lymph node involvement. Long-term follow-up is needed to assess the curative potential of this treatment.

International Nuclear Information System (INIS)

We developed a new TLD array for precise dose measurement and verification of the spatial dose distribution in small radiation targets. It consists of a hemicylindrical, tissue-equivalent rod made of polystyrene with 17 parallel moulds for an exact positioning of each TLD. The spatial resolution of the TLD array was evaluated using the Leskell spherical phantom. Dose planning was performed with KULA 4.4 under stereotactic conditions on axial CT images. In the Leksell gamma unit the TLD array was irradiated with a maximal dose of 10 Gy with an unplugged 14 mm collimator. The doses delivered to the TLDs were rechecked by diode detector and film dosimetry and compared to the computer-generated dose profile. We found excellent agreement of our measured values, even at the critical penumbra decline. For the 14 mm and 18 mm collimator and for the 11 mm collimator combination we compared the measured and calculated data at full width at half maximum. This TLD array may be useful for phantom ...

British Library Electronic Table of Contents (United Kingdom)

Purpose Radiation-induced heart disease (RIHD) is a severe side effect of thoracic radiotherapy. This study examined the effects of pentoxifylline (PTX) and a-tocopherol on cardiac injury in a rat model of RIHD. Methods and Materials Male Sprague-Dawley rats received fractionated local heart irradiation with a daily dose of 9 Gy for 5 days and were observed for 6 months after irradiation. Rats were treated with a combination of PTX, 100 mg/kg/day, and a-tocopherol (20 IU/kg/day) and received these compounds either from 1 week before until 6 months after irradiation or starting 3 months after irradiation, a time point at which histopathologic changes become apparent in our model of RIHD. Results Radiation-induced increases in left ventricular diastolic pressure (in mm Hg: 35 +- 6 after sham...

Energy Technology Data Exchange (ETDEWEB)

Experiments were carried out on mice and the subjects irradiated for cancer therapy to evaluate the protective efficacy of a Chinese medicinal herb-compound (CMHC). The lethality and the degree of leucopenia caused by radiation in mice medicated with CMHC were significantly less in comparison with control mice (p less than 0.01 and p less than 0.001, respectively). CMHC significantly improved the WBC and the thrombocytes in irradiated workers (p less than 0.01 and p less than 0.001, respectively). The WBC count of 40 patients under radiotherapy while treated with CMHC recovered from 3450 +/- 77/c.mm to 5425 +/- 264/c.mm (p less than 0.001); whereas, in the control group, without any medication, the WBC count dropped significantly (p less than 0.001). Our results revealed the applicabilities of CMHC in protection against radiation damage in spaceflight and in other fields.

International Nuclear Information System (INIS)

135 patients with histologically proven Ewing's sarcoma, treated at the Institute Gustave Roussy between 1960-1974 were reviewed in order to establish the effectiveness and the complications associated with radiotherapy. In 133 patients, a dose of at least 60 Gy for long bones, 55 Gy for flat bones and 45 Gy for vertebrae was given. 26 major complications (of which more than one occured in certain patients) were observed: 12 cases of growth retardation, loss of joint function in 7 cases, 3 fractures, 2 osteonecroses, 2 cases of delayed healing, one massive soft tissue fibrosis, 1 abdominocutaneous fistula, 2 cases of symptomatic pulmonary fibrosis with associated infection, 2 cases of radiation enteropathy, 2 of mammary hypoplasia and 1 osteosarcoma developing in an irradiated zone. These complications necessitated 12 surgical interventions, including 4 disarticulations or amputations. The incidence of complications can be related to the age of the patient and to ...

International Nuclear Information System (INIS)

We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiation therapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left carotid angiography showed complete occlusion of the terminal portion of the ...

International Nuclear Information System (INIS)

When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal ...

Energy Technology Data Exchange (ETDEWEB)

There is an increasing interest in using radioisotopes of rare earth elements for internal radiotherapy and for imaging in nuclear medicine. {sup 177}Lu is one of the promising radionuclides. This article reports on the first measurements of the excitation function for the production of {sup 177}Lu with proton-beam energies up to 17 MeV on natural hafnium targets. The experimental cross sections for the reaction {sup nat}Hf(p,x){sup 177}Lu were obtained by the activation of a stacked-foil target and subsequent gamma spectrometry. Theoretical cross sections were calculated up to 35 MeV with the EMPIRE nuclear reaction model code. The measured and calculated cross sections were used for deriving the thick-target yields and for estimating the production of other nuclides than {sup 177}Lu. Measured production cross sections of {sup 175,176,177,178}Ta on the same target are also presented.

Energy Technology Data Exchange (ETDEWEB)

Perforated thermoplastic masks are used to provide patients immobilization. This procedure inserts a material in the path of the radiation beam, that attenuates and modifies the beam fluence and flatness. The present study evaluates the increase in skin dose as a result of using thermoplastic masks. Relative doses were measured on the surface of a solid water phantom, in the presence and absence of masks. These masks were stretched according to deformation patterns observed in clinical routine. The measurements were obtained with a plane-parallel chamber (Markus type 23343) and radiochromic film (EBT Gafchromic) for 6MV X-rays from a linear accelerator, and for a radiation beam from a cobalt therapy unit. The results showed that thermoplastic masks, whose thickness varied between 2 and 3 mm, increased the dose on the surface by a factor of 3. Due to the variations in the skin dose distribution, clinical procedures were suggested to minimize radiobiological damages in subcutaneous ...

International Nuclear Information System (INIS)

Based on the replies to a questionnaire distributed throughout Japan in 1983, genetically significant dose (GSD), per Caput mean bone marrow dose (CMD), leukemogenically significant dose (LSD), malignantly significant dose (MSD), and per Caput effective dose equivalent (EDE) from using small sealed radiation sources for radiotherapy were estimated. Annual frequencies of brachytherapy were estimated to be 2.6 x 10"3 for men and 36.3 x 10"3 for women, with a total of 38.9 x 10"3. The annual frequencies of using afterloading technique were 0.3 x 10"3 for men and 18.8 x 10"3 for women, with a total of 19.1 x 10"3. The annual population doses per person were 7.9 nGy for GSD, 118 #mu#Gy for CMD, 19.3 #mu#Gy for LSD, 172 #mu#Gy for MSD, and 428 #mu#Gy for EDE. The annual collective effective dose equivalent was estimated to be 5.13 x 10"4 man Sv. (Namekawa, K.).

Energy Technology Data Exchange (ETDEWEB)

Background: the authors report on the conception and first clinical application of a donut-shaped high-dose configuration for proton therapy (PT). This approach allows one to intensify target volume dose coverage for targets encompassing a critical, dose-limiting structure - like here, the cauda equina -, whilst delivering minimal dose to other healthy structures surrounding the target, thereby reducing the integral dose. Methods and results: intensity-modulated PT methods (IMPT) for spot scanning were applied to create and deliver a donut-shaped high-dose configuration with protons, allowing treating > 75% of the target with at least 95% of the prescribed dose of 72.8 CGE, whilst restricting dose to the cauda equina to 60-65 CGE. Integral dose was lower by a factor of 3.3 as compared to intensity-modulated radiotherapy with photons (IMXT). Conclusion: IMPT and spot scanning technology allow a potentially clinically useful approach which is also applicable ...

Energy Technology Data Exchange (ETDEWEB)

Introduction: The goal of this study was to compare contrast-enhanced T1-weighted Flash and Turbo-Flash sequences with conventional spin-echo sequences as a basis for planning high-precision radiotherapy. Methods: A total of 25 consecutive patients with different intracranial tumors and a disrupted blood-brain barrier were studied. T1-weighted Flash, Turbo-Flash and conventional spin-echo images were evaluated after controlled 30-s infusion of 0.1 mmol/kg body weight of Gd-DTPA. The evaluation of the three sequences included the measurement of the signal- and contrast-to-noise ratios, the visual inspection of the tumors and artifacts, and the measurement of tumor size. Results: The signal- and contrast-to-noise ratios were significantly (P<0.05-0.01) lower for Flash and Turbo-Flash than for conventional spin-echo sequences. However, visual inspection of the contrast-enhancing tumors revealed in 23 and 24 of 25 lesions of Flash and Turbo-Flash images, ...

International Nuclear Information System (INIS)

Radiation necrosis of normal CNS tissue represents one of the main risk factors of brain irradiation, occurring more frequently and earlier at higher total doses and higher doses per fraction. At present, it is believed that the necrosis results due to increasing capillary permeability caused by cytokine release leading to extracellular edema. This process is sustained by endothelial dysfunction, tissue hypoxia, and subsequent necrosis. Consequently, blocking the vascular endothelial growth factor (VEGF) at an early stage could be an option to reduce the development of radiation necrosis by decreasing the vascular permeability. This might help to reverse the pathological mechanisms, improve the symptoms and prevent further progression. A patient with radiation-induced necrosis was treated with an anti-VEGF antibody (bevacizumab), in whom neurologic signs and symptoms improved in accordance with a decrease in T1-weighted fluid-attenuated inversion recovery signals. Our case report ...

British Library Electronic Table of Contents (United Kingdom)

Objective The aim of this study was to analyze the clinical results of our adaptive radiation therapy scheme of a two-step intensity-modulated radiotherapy (IMRT) method for nasopharyngeal cancer (NPC) at Kinki University Hospital. Methods Between 2000 and 2007, 35 patients with Stage I-IVB NPC treated by IMRT were included. For all patients, treatment-planning computed tomography was done twice before and during IMRT to a total dose of 60-70 Gy/28-35 fractions (median 68 Gy). Chemotherapy (cisplatin 80 mg/m2/3 weeks x 1-3 courses) was given concurrently with IMRT for 31 patients. Results The 3- and 5-year overall survival rates for the 31 patients treated with concurrent chemotherapy were 88% and 83%, respectively. The 3- and 5-year loco-regional control rates for the 31 patients were 93%...

Energy Technology Data Exchange (ETDEWEB)

MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic ...

Energy Technology Data Exchange (ETDEWEB)

Objective: Pretargeting is the concept that combines optimal delivery of the antibody and rapid capture and elimination of the radioactivity. In this study, we evaluated the potential of antibody pretargeting to enable the tumor-targeting {sup 212}Pb for in vivo generation of {sup 212}Bi for {alpha} particle radiotherapy. Methods: The {sup 212}Pb/{sup 212}Bi chelate of DOTA-biotin, as well as their {gamma}-emitting analogues, {sup 203}Pb and {sup 205}Bi, was prepared and characterized. The radiolabeled compounds were injected in animals for evaluation of tumor targeting and normal tissue uptake and retention. In the pretargeting protocol, injection of 400 {mu}g of NR-LU-10 antibody-streptavidin conjugate was given at t=0 h, then 100 {mu}g of N-acetyl-galatosamine-biotin clearing agent was injected at t=20-24 h; finally, 1 {mu}g of {sup 212}Pb/{sup 212}Bi-DOTA-biotin was injected 6 h later. Results: Both {sup 203}Pb and {sup 205}Bi-DOTA-biotin were stable for at ...

International Nuclear Information System (INIS)

Purpose: To assess the prognostic value of biologic (p53, Ki-67) and clinical factors in squamous cell carcinoma of the oropharynx after radical surgery and postoperative radiotherapy (RT). Methods and Materials: Between 1985 and 1995, a total of 102 patients with 104 tumor sites were entered onto the study. Fifty-five primary tumors (53%) involved the tonsils, 26 (25%) the soft palate, and 23 (22%) the base of the tongue. Median age was 53 years (range 36-80 years). The clinical T- and N-categories (UICC 1997) were: T1 (30), T2 (47), T3 (22), T4 (5), N0 (33), N1 (28), N2 (42), and N3 (1). Histologically-clear margins were achieved in all patients by initial surgery. Postoperative RT to the primary and regional lymphatics was given, to a total of 60 Gy in 6 weeks, and single daily fractions of 2 Gy. The expression of the nuclear p53- and Ki-67-labeling index (LI) was investigated by immunostaining using the monoclonal antibodies DO-7 and MIB 1. The nuclear ...

International Nuclear Information System (INIS)

Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event free (EFS) and overall survival rates from multi-disciplinary therapy in Ewing's Sarcoma (ES). Materials and Methods: Between 1983 and 1988, 184 children with ES were enrolled onto POG 8346. 178 (97%) met eligibility criteria; 6 had non-ES pathology. Induction treatment of Cyclophosphamide/Adriamycin (C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy (XRT) and C/A, Dactinomycin and Vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. 40 patients were randomized to receive SF, whole bone XRT to 39.6 Gy plus a 16.2 Gy boost (total 55.8 Gy) or IF to 55.8 Gy while 84 were assigned to IF XRT. Results: Of 179 eligible patients, 141 (79%) had localized disease and 37 ...

International Nuclear Information System (INIS)

Purpose: The results of therapy in 288 men with pathologic Stage C prostate cancer who underwent radical retropubic prostatectomy (RRP) were analyzed to determine the effects of adjuvant therapy. Methods and Materials: Twenty-seven of the 288 patients received preoperative neoadjuvant hormonal therapy (leuprolide acetate). Postoperatively, 60 patients received adjuvant radiotherapy (RT) to the prostate bed. Follow-up ranged from 3 to 83 months (median = 32 months). Freedom from failure (FFF) was defined as maintaining a serum PSA level of #<=# 0.3 ng/ml. Results: The FFF was 61% at 3 years and 45% at 5 years for the entire group. The FFF following RRP plus RT was 75% at 3 years and 57% at 5 years as compared to 56% at 3 years and 40% at 5 years for RRP without RT (p = 0.049). The FFF following RRP plus neoadjuvant hormonal therapy was 58% at 3 years and 40% at 5 years as compared to 60% at 3 years and 45% at 5 years following RRP without hormonal therapy (p = ...

Energy Technology Data Exchange (ETDEWEB)

To evaluate the predictive factors for treatment response and prognostic factors affecting survival outcomes after concurrent chemoradiotherapy (CCRT) for patients with anal squamous cell carcinoma. Medical records of forty two patients with histologically confirmed analsquamous cell carcinoma, who had complete CCRT between 1993 and 2008, were reviewed retrospectively. Median age was 61.5 years (39-89 years), and median radiotherapy (RT) dose was 50.4 Gy (30.0-64.0 Gy). A total of 36 patients had equal to or less than T2 stage (85.7%). Fourteen patients (33.3%) showed regional nodal metastasis, 36 patients (85.7%) were treated with 5-fluorouracil (5-FU) plus mitomycin, and the remaining patients were treated by 5-FU plus cisplatinum. The median follow--up time was 62 months (2-202 months).The 5-year overall survival, locoregional relapse-free survival, disease-free survival, and colostomy-free survival rates were 86.0%, 71.7%, 71.7%, 78.2%, respectively. Regarding ...

International Nuclear Information System (INIS)

Purpose: Efficacy and safety of the own single-center experience with moderately dosed radiosurgery (SRS) for limited (one to four) brain metastases were analyzed and correlated with patient- and treatment-related variables. Patients and Methods: Between 05/1998 and 10/2006, 93 patients received SRS for a total of 142 brain metastases. The median number of brain metastases treated per patient was one (range, one to four). 46 patients (49%) received initial SRS alone, 13 patients (14%) SRS with up-front whole-brain radiotherapy (WBRT), and 34 patients (37%) SRS for recurrent metastases after WBRT. Median dose was 16 Gy (range, 10-20 Gy). Results: Median overall survival (OS) was 7.5 months. The actuarial 6- and 12-month data for OS were 60% and 35%, for local brain control (LBC) 87% and 79%, and for distant brain control (DBC) 48% and 37%, respectively. Only ten of 46 patients (22%) with initial SRS alone ultimately received WBRT. Ten patients suffered from seizures ...

International Nuclear Information System (INIS)

With accurate calculation algorithms in inverse planning for beamlet-based intensity modulated radiotherapy (IMRT), it takes time to calculate the dose matrix, which represents the dose distribution of each beamlet element to each voxel for unit fluence. To reduce the calculation time, coarse or approximate algorithms are often a choice, but this results in a final dose distribution that cannot reflect the real value. In addition, it is necessary to test if a coarse algorithm is capable of calculating the dose matrix of beamlets. In this work, simulated dynamics optimization algorithm was applied to optimize the segment weight to minish the dose error from the dose matrix calculation. After calculating the dose matrix by ray-tracing algorithm which takes into account just the primary component of absorbed dose, the original beam profile intensity distribution was optimized by using the simulated dynamics algorithm. Before segmentation, the even-spaced algorithm and ...

International Nuclear Information System (INIS)

Background: In the German CESS-studies, Ewing's sarcoma patients with pulmonary metastases at diagnosis were considered as candidates for additional bilateral lung irradiation. We have retrospectively analyzed the impact of radiotherapy on survival. Material and methods: Out of 42 patients presenting with pulmonary metastases of Ewing's sarcoma between 1981 and June 1992, 30 were evaluable. One patient died of progressive disease prior to lung irradiation. The other patients had a complete radiographic remission either after chemotherapy (n=25) or chemotherapy plus resection of lung metastases (n=4). 22 patients received bilateral lung irradiation with doses of 12 to 21 Gy (once daily 1.5 Gy or twice daily 1.25 Gy), six had no further treatment and one had bone marrow transplantation for consolidation. Results: Ten patients are in complete remission, nine of them had received lung irradiation and one had a complete resection of three lung metastases. Two patients ...

International Nuclear Information System (INIS)

Purpose: To identify results and prognostic factors on long-term survival and local control following treatment of localized Ewing's sarcoma. Patients and Methods: Between 1979 and 2004, a total of 60 children and young adults with Ewing's sarcoma were treated. Patients with distant metastases at presentation (n = 6) and recurrent cases (n = 2) were excluded from this analysis. Patients were exclusively treated within ongoing national and international protocols CESS-81, CESS-86, EICESS-92, EURO-EWING-99. All patients received local irradiation with a total dose of 45-60 Gy; in addition, 41 (79%) of the patients had local surgical procedures, 27 (52%) of them with clear margins. Results: Overall survival rates at 5 and 10 years were 56% and 45%, respectively. Patients #<=# 14 years at diagnosis had overall survival rates of 66% and 61% at 5 and 10 years compared to older patients with corresponding survival rates of 47% and 31%, respectively (p = 0.05). Patients with tumors of lower ...

International Nuclear Information System (INIS)

In radiotherapy treatment planning, convolution/superposition algorithms currently represent the best practical approach for accurate photon dose calculation in heterogeneous tissues. In this work, the implementation, accuracy and performance of the FFT convolution (FFTC) and multigrid superposition (MGS) algorithms are presented. The FFTC and MGS models use the same 'TERMA' calculation and are commissioned using the same parameters. Both models use the same spectra, incorporate the same off-axis softening and base incident lateral fluence on the same measurements. In addition, corrections are explicitly applied to the polyenergetic and parallel kernel approximations, and electron contamination is modelled. Spectra generated by Monte Carlo (MC) modelling of treatment heads are used. Calculations using the MC spectra were in excellent agreement with measurements for many linear accelerator types. To speed up the calculations, a number of calculation techniques were ...

International Nuclear Information System (INIS)

Optimal design of the hyperfractionated radiotherapy requires basic radiobiological data such as the critical dose per fraction, number of fractions per day and total equivalent dose, to name a few. As a prelude to in vivo hyperfractionated irradiation, the authors carried out experiments to determine quantitative changes in the proliferation and cell kinetic parameters of multicellular spheroids after hyperfractionated irradiation. Experiments were carried out with HeLa S-3 spheroid growing in MEM culture media. Hyperfractionated irradiation schedules were 1.5 Gy/f, 2f/day and 1.0 Gy/f, 3 f/day. At intervals after irradiation, cell numbers, growth delays and cell cycle distribution of spheroids were determined. The kinetic data were obtained by the use of flow cytometry. The most pronounced changes in cell kinetic parameters were early G/sub 2/M block, proportional to single radiation dose up to 4.0 Gy. There was a corresponding depletion of G1 population as a ...

International Nuclear Information System (INIS)

Little clinical evidence has been provided to show the minimization of radiation resistance of tumors using high linear energy transfer radiation. We therefore investigated the radiobiological and molecular pathological aspects of carbon beam therapy. A total of 27 patients with squamous cell carcinoma (SCC) of the cervix were treated using a carbon beam and 50 control patients with SCC of the cervix using a photon beam. The expression of Ki-67, p53, and p27 proteins before radiotherapy and 5 and 15 days after therapy initiation were investigated using immunohistochemistry. Similar changes were observed in Ki-67 labeling index (LI) and p53 LI during carbon and photon beam therapies. However, for carbon beam therapy, the mean p27 LI significantly decreased from 25.2% before treatment to 18.6% on the 5th day after treatment initiation, followed by a significant increase to 36.1% on the 15th day. In contrast, for photon beam therapy, the p27 LI consistently decreased ...

International Nuclear Information System (INIS)

From 1979 to 1986, 182 patients with biopsy proven diagnosis of Ewing's sarcoma of bone were observed. One hundred of the 182 patients (72 males, 28 females, median age 15.8 years) with localized disease and no previous treatment were treated with chemotherapy (VCR, ADM, CTX, D-ACT) for 15-18 months. Local treatment was radiotherapy (42 patients), surgery (31 patients), or a combination of both (27 pts). Radiation doses ranged from 45 to 64 Gy given with conventional fractionation. Median follow-up was 51.2 months (24-106). Overall and disease-free survival were, respectively, 58.7 and 42.6%. Resected patients tended to have a better local control (Surgery 93.6%, Surgery + Radiation therapy 92.6%, Radiation therapy 69.1%). Disease-free survival was significantly related to the volume of the primary tumor (bulky: 33.2%, not-bulky: 57.7%), to site (extremities 54.6%, central sites 16.6%, other sites 40.9%), and to local treatment (Radiation therapy 30.3%, Surgery + ...

International Nuclear Information System (INIS)

The purpose of this study is to evaluate the accuracy of dose calculations by three algorithms. Depth dose, OPF (Output Factor) and dose profiles were measured in a heterogeneous phantom. These values were also calculated by three algorithms of the Batho power law (BPL), Equivalent-Tissue Air Ratio (ETAR) and Convolution superposition (CS). The data were obtained for 4, 6 and 10 MV photon beams with a linear accelerator (Varian 21EX). Field size ranged from 3 x 3 cm"2 to 10 x 10 cm"2. Dose profiles of beam penumbra were also measured by a 0.125 ml ionization chamber at the point of 8, 13 and 18 cm from the surface of the phantom at intervals of 1 mm. Differences between measured and calculated depth doses were within 2% in BPL and CS, but depth doses were overestimated in ETAR. OPFs were also overestimated with the error of more than 4% in ETAR. Absorbed dose calculated by CS were in agreement with the values measured by the ionization chamber. The absorbed dose by BPL and ETAR, ...

Energy Technology Data Exchange (ETDEWEB)

Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.) [German] Das ...

Energy Technology Data Exchange (ETDEWEB)

Parallel imaging and echo sharing techniques have markedly reduced the acquisition times for MRI of large volumes. Dynamic 2 and 3-dimensional data sets of the chest with high temporal resolution (up to 10 images/s with single slice and 2 volume/s) allow an analysis of respiratory motion of the lungs and tumors. Time-resolved 2D series in preselected planes can be used to observe respiratory motion during free breathing or after respiratory commands, e.g. to exclude chest wall invasion by a tumor or for diagnosing impairment of respiratory mechanics. Time-resolved 3D-series (4D-MRI) allow monitoring of the spatial displacement of the lungs and tumors as a whole volume. Present limitations such as an overestimation of tumor size and an underestimation of displacement due to a limited temporal resolution are expected to be overcome with further technical developments. However, 4D-MRI already appears to be the appropriate tool to select patients for motion-adapted ...

International Nuclear Information System (INIS)

Background and purpose: The low density of lung tissue causes a reduced attenuation of photons and an increased range of secondary electrons, which is inaccurately predicted by the algorithms incorporated in some commonly available treatment planning systems (TPSs). This study evaluates the differences in dose in normal lung tissue computed using a simple and a more correct algorithm. We also studied the consequences of these differences on the dose-effect relations for radiation-induced lung injury. Materials and methods: The treatment plans of 68 lung cancer patients initially produced in a TPS using a calculation model that incorporates the equivalent-pathlength (EPL) inhomogeneity-correction algorithm, were recalculated in a TPS with the convolution-superposition (CS) algorithm. The higher accuracy of the CS algorithm is well-established. Dose distributions in lung were compared using isodoses, dose-volume histograms (DVHs), the mean lung dose (MLD) and the percentage of lung ...

International Nuclear Information System (INIS)

Purpose/Objective: With the advent of computed tomography and magnetic resonance imaging, the three dimensional representation of the patient anatomy has become an invaluable resource for better diagnosis and delineation of the target volume and sensitive structures in radiation therapy. Although the therapeutic linear accelerator industry has made available highly sophisticated equipment, the aggressiveness in dose prescription and delivery has to be complimented by accurate dose computation methods. We have adopted a convolution/superposition algorithm for the calculation of absolute dose that fully accounts for the external shape and internal structure of the patient for photon treatment radiotherapy. In this paper, we will discuss the principles of the convolution algorithm and we will show how the computed dose compares to clinically relevant treatment techniques. Materials and Methods: A computer controlled data acquisition system and a water tank where used ...

International Nuclear Information System (INIS)

High-energy ionizing radiation is a prominent modality for the treatment of many cancers. The approaches to electron dose calculation can be categorized into semi-empirical models (e.g. Fermi-Eyges, convolution-superposition) and probabilistic methods (e.g. Monte Carlo). A third approach to dose calculation has only recently attracted attention in the medical physics community. This approach is based on the deterministic kinetic equations of radiative transfer. We derive a macroscopic partial differential equation model for electron transport in tissue. This model involves an angular closure in the phase space. It is exact for the free streaming and the isotropic regime. We solve it numerically by a newly developed HLLC scheme based on Berthon et al (2007 J. Sci. Comput. 31 347-89) that exactly preserves the key properties of the analytical solution on the discrete level. We discuss several test cases taken from the medical physics literature. A test case with an academic ...

International Nuclear Information System (INIS)

Full text: A semiempirical algorithm for absorbed dose calculation at off-axis points in irregular beams was implemented. It is well known that semiempirical methods are very useful because of their easy implementation and its helpfulness in dose calculation in the clinic. These methods can be used as independent tools for dosimetric calculation in many applications of quality assurance. However, the applicability of such methods has some limitations, even in homogeneous media, specially at off axis points, near beam fringes or outside the beam. Only methods derived from tissue-air-ratio (TAR) or scatter-maximum-ratio (SMR) have been devised for those situations, many years ago. Despite there have been improvements for these manual methods, like the Sc-Sp ones, no attempt has been made to extend their usage at off axis points. In this work, a semiempirical formalism was introduced, based on the works of Venselaar et al. (1999) and Sanz et al. (2004), aimed to the Sc-Sp separation. This ...