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Sample records for beam therapy tset

  1. Total skin electron therapy treatment verification: Monte Carlo simulation and beam characteristics of large non-standard electron fields

    International Nuclear Information System (INIS)

    Pavon, Ester Carrasco; Sanchez-Doblado, Francisco; Leal, Antonio; Capote, Roberto; Lagares, Juan Ignacio; Perucha, Maria; Arrans, Rafael

    2003-01-01

    Total skin electron therapy (TSET) is a complex technique which requires non-standard measurements and dosimetric procedures. This paper investigates an essential first step towards TSET Monte Carlo (MC) verification. The non-standard 6 MeV 40 x 40 cm 2 electron beam at a source to surface distance (SSD) of 100 cm as well as its horizontal projection behind a polymethylmethacrylate (PMMA) screen to SSD = 380 cm were evaluated. The EGS4 OMEGA-BEAM code package running on a Linux home made 47 PCs cluster was used for the MC simulations. Percentage depth-dose curves and profiles were calculated and measured experimentally for the 40 x 40 cm 2 field at both SSD = 100 cm and patient surface SSD = 380 cm. The output factor (OF) between the reference 40 x 40 cm 2 open field and its horizontal projection as TSET beam at SSD = 380 cm was also measured for comparison with MC results. The accuracy of the simulated beam was validated by the good agreement to within 2% between measured relative dose distributions, including the beam characteristic parameters (R 50 , R 80 , R 100 , R p , E 0 ) and the MC calculated results. The energy spectrum, fluence and angular distribution at different stages of the beam (at SSD = 100 cm, at SSD = 364.2 cm, behind the PMMA beam spoiler screen and at treatment surface SSD = 380 cm) were derived from MC simulations. Results showed a final decrease in mean energy of almost 56% from the exit window to the treatment surface. A broader angular distribution (FWHM of the angular distribution increased from 13deg at SSD 100 cm to more than 30deg at the treatment surface) was fully attributable to the PMMA beam spoiler screen. OF calculations and measurements agreed to less than 1%. The effect of changing the electron energy cut-off from 0.7 MeV to 0.521 MeV and air density fluctuations in the bunker which could affect the MC results were shown to have a negligible impact on the beam fluence distributions. Results proved the applicability of using MC

  2. Proton beam therapy facility

    International Nuclear Information System (INIS)

    1984-01-01

    It is proposed to build a regional outpatient medical clinic at the Fermi National Accelerator Laboratory (Fermilab), Batavia, Illinois, to exploit the unique therapeutic characteristics of high energy proton beams. The Fermilab location for a proton therapy facility (PTF) is being chosen for reasons ranging from lower total construction and operating costs and the availability of sophisticated technical support to a location with good access to patients from the Chicago area and from the entire nation. 9 refs., 4 figs., 26 tabs

  3. Electron beams in radiation therapy

    International Nuclear Information System (INIS)

    Bruinvis, I.A.D.

    1987-01-01

    Clinical electron beams in interaction with beam flattening and collimating devices are studied, in order to obtain the means for adequate electron therapy. A treatment planning method for arbitrary field shapes is developed that takes the properties of the collimated electron beams into account. An electron multiple-scattering model is extended to incorporate a model for the loss of electrons with depth, in order to improve electron beam dose planning. A study of ionisation measurements in two different phantom materials yields correction factors for electron beam dosimetry. (Auth.)

  4. External Beam Therapy (EBT)

    Science.gov (United States)

    ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: ... Cancer Treatment Head and Neck Cancer Treatment Intensity-Modulated Radiation Therapy (IMRT) Brain ...

  5. Neutron beams for therapy

    International Nuclear Information System (INIS)

    Kuplenikov, Eh.L.; Dovbnya, A.N.; Telegin, Yu.N.; Tsymbal, V.A.; Kandybej, S.S.

    2011-01-01

    It was given the analysis and generalization of the study results carried out during some decades in many world countries on application of thermal, epithermal and fast neutrons for neutron, gamma-neutron and neutron-capture therapy. The main attention is focused on the practical application possibility of the accumulated experience for the base creation for medical research and the cancer patients effective treatment.

  6. The clinical case for proton beam therapy

    International Nuclear Information System (INIS)

    Foote, Robert L; Haddock, Michael G; Yan, Elizabeth; Laack, Nadia N; Arndt, Carola A S

    2012-01-01

    Over the past 20 years, several proton beam treatment programs have been implemented throughout the United States. Increasingly, the number of new programs under development is growing. Proton beam therapy has the potential for improving tumor control and survival through dose escalation. It also has potential for reducing harm to normal organs through dose reduction. However, proton beam therapy is more costly than conventional x-ray therapy. This increased cost may be offset by improved function, improved quality of life, and reduced costs related to treating the late effects of therapy. Clinical research opportunities are abundant to determine which patients will gain the most benefit from proton beam therapy. We review the clinical case for proton beam therapy. Proton beam therapy is a technically advanced and promising form of radiation therapy

  7. The clinical case for proton beam therapy

    Directory of Open Access Journals (Sweden)

    Foote Robert L

    2012-10-01

    Full Text Available Abstract Over the past 20 years, several proton beam treatment programs have been implemented throughout the United States. Increasingly, the number of new programs under development is growing. Proton beam therapy has the potential for improving tumor control and survival through dose escalation. It also has potential for reducing harm to normal organs through dose reduction. However, proton beam therapy is more costly than conventional x-ray therapy. This increased cost may be offset by improved function, improved quality of life, and reduced costs related to treating the late effects of therapy. Clinical research opportunities are abundant to determine which patients will gain the most benefit from proton beam therapy. We review the clinical case for proton beam therapy. Summary sentence Proton beam therapy is a technically advanced and promising form of radiation therapy.

  8. Radiation therapy apparatus having retractable beam stopper

    International Nuclear Information System (INIS)

    Coad, G.L.

    1983-01-01

    This invention relates to a radiation therapy apparatus which utilized a linear translation mechanism for positioning a beam stopper. An apparatus is described wherein the beam stopper is pivotally attached to the therapy machine with an associated drive motor in such a way that the beam stopper retracts linearly

  9. Fragmentation in Carbon Therapy Beams

    CERN Document Server

    Charara, Y M

    2010-01-01

    The state of the art Monte Carlo code HETC-HEDS was used to simulate spallation products, secondary neutron, and secondary proton production in A-150 Tissue Equivalent Plastic phantoms to investigate fragmentation of carbon therapy beams. For a 356 MeV/Nucleon carbon ion beam, production of charged particles heavier than protons was 0.24 spallation products per incident carbon ion with atomic numbers ranging from 1 through 5 (hydrogen to boron). In addition, there were 4.73 neutrons and 2.95 protons produced per incident carbon ion. Furthermore, as the incident energy increases, the neutron production rate increases at a rate of 20% per 10 MeV/nucleon. Secondary protons were created at a rate between 2.62-2.87 per carbon ion, while spallation products were created at a rate between 0.20-0.24 per carbon ion.

  10. Ion Beam Therapy in Europe

    International Nuclear Information System (INIS)

    Kraft, Gerhard

    2009-01-01

    At present, seven facilities in Europe treat deep-seated tumors with particle beams, six with proton beams and one with carbon ions. Three of these facilities are in Moscow, St. Petersburg and Dubna, Russia. Other facilities include the TSL Uppsala, Sweden, CPO Orsay, France, and PSI Villigen, Switzerland, all for proton therapy, and GSI, Darmstadt, Germany, which utilizes carbon ions only. But only two of these facilities irradiate with scanned ion beams: the Paul Scherer Institute (PSI), Villigen (protons) and the Gesellschaft fuer Schwerionenforschung (GSI), Darmstadt. These two facilities are experimental units within physics laboratories and have developed the technique of intensity-modulated beam scanning in order to produce irradiation conforming to a 3-D target. There are three proton centers presently under construction in Munich, Essen and Orsay, and the proton facility at PSI has added a superconducting accelerator connected to an isocentric gantry in order to become independent of the accelerator shared with the physics research program. The excellent clinical results using carbon ions at National Institute of Radiological Science (NIRS) in Chiba and GSI have triggered the construction of four new heavy-ion therapy projects (carbon ions and protons), located in Heidelberg, Pavia, Marburg and Kiel. The projects in Heidelberg and Pavia will begin patient treatment in 2009, and the Marburg and Kiel projects will begin in 2010 and 2011, respectively. These centers use different accelerator designs but have the same kind of treatment planning system and use the same approach for the calculation of the biological effectiveness of the carbon ions as developed at GSI [1]. There are many other planned projects in the works. Do not replace the word ''abstract,'' but do replace the rest of this text. If you must insert a hard line break, please use Shift+Enter rather than just tapping your ''Enter'' key. You may want to print this page and refer to it as a style

  11. Proton beam therapy control system

    Science.gov (United States)

    Baumann, Michael A [Riverside, CA; Beloussov, Alexandre V [Bernardino, CA; Bakir, Julide [Alta Loma, CA; Armon, Deganit [Redlands, CA; Olsen, Howard B [Colton, CA; Salem, Dana [Riverside, CA

    2008-07-08

    A tiered communications architecture for managing network traffic in a distributed system. Communication between client or control computers and a plurality of hardware devices is administered by agent and monitor devices whose activities are coordinated to reduce the number of open channels or sockets. The communications architecture also improves the transparency and scalability of the distributed system by reducing network mapping dependence. The architecture is desirably implemented in a proton beam therapy system to provide flexible security policies which improve patent safety and facilitate system maintenance and development.

  12. Partial breast radiation therapy - external beam

    Science.gov (United States)

    Carcinoma of the breast - partial radiation therapy; Partial external beam radiation - breast; Intensity-modulated radiation therapy - breast cancer; IMRT - breast cancer WBRT; Adjuvant partial breast - IMRT; APBI - IMRT; ...

  13. The basis of the particle beam therapy

    International Nuclear Information System (INIS)

    Katoh, Hiroyuki

    2015-01-01

    The particle beam therapy has the excellent physical and biological characteristics that are very different from the X-ray used mainly in conventional radiotherapy. Therefore, the particle therapy can treat loco-regional lesions more strongly with less toxicity than conventional radiotherapy. In recent years in Japan, we can use proton and carbon ion as a particle beam therapy. In this article, we describe the overview of the basis, the advantage and weak points about the particle beam therapy, and the differences between proton and carbon ion therapy. (author)

  14. MR Cholangiography: Axial TSE-T2 Sequence Evaluation in the Diagnosis of Choledocholithiasis

    International Nuclear Information System (INIS)

    Alustiza, J. M.; Gervas, C.; Garcia, E.; Recondo, J. A.

    2003-01-01

    To evaluate diagnostic precision of the axial TSE-T2 sequence in the diagnosis of choledocholithiasis. Retrospective analysis of all those MR cholangiography studies performed in our center between January 1998 and June 1999 which were later subjected to conventional cholangiography (intraoperative) as a golden standard. A total of 39 patients was studied. Imaging parameters of the sequence evaluated, fat-suppressed TSE-T2 in the axial plane, were as follows: TE 100 ms, TR 1.800 ms, turbo factor 23 FOV 375 mm, NSA 4, 228 x 256 matrix, respiratory compensation, number of slices 35, slice thickness 3 mm, contiguous slices, scan duration 5'4''. Without having been informed as to the cholangiography result, two radiologists independently analyzed this sequence in order to determine the presence of choledocholithiasis. Their results were latter compared with those of the conventional cholangiography. The sensitivity, specificity and agreement between results were all calculated. 21 patients had choledocholithiasis. The analyzed sequence presented sensitivity 81%, specificity 89%, and agreement between radiologists 98%, Kappa index 0.949. The axial sequence TSE-T2 is reliable for choledocholithiasis diagnosis. (Author) 9 refs

  15. A pencil beam algorithm for helium ion beam therapy.

    Science.gov (United States)

    Fuchs, Hermann; Strobele, Julia; Schreiner, Thomas; Hirtl, Albert; Georg, Dietmar

    2012-11-01

    To develop a flexible pencil beam algorithm for helium ion beam therapy. Dose distributions were calculated using the newly developed pencil beam algorithm and validated using Monte Carlo (MC) methods. The algorithm was based on the established theory of fluence weighted elemental pencil beam (PB) kernels. Using a new real-time splitting approach, a minimization routine selects the optimal shape for each sub-beam. Dose depositions along the beam path were determined using a look-up table (LUT). Data for LUT generation were derived from MC simulations in water using GATE 6.1. For materials other than water, dose depositions were calculated by the algorithm using water-equivalent depth scaling. Lateral beam spreading caused by multiple scattering has been accounted for by implementing a non-local scattering formula developed by Gottschalk. A new nuclear correction was modelled using a Voigt function and implemented by a LUT approach. Validation simulations have been performed using a phantom filled with homogeneous materials or heterogeneous slabs of up to 3 cm. The beams were incident perpendicular to the phantoms surface with initial particle energies ranging from 50 to 250 MeV/A with a total number of 10(7) ions per beam. For comparison a special evaluation software was developed calculating the gamma indices for dose distributions. In homogeneous phantoms, maximum range deviations between PB and MC of less than 1.1% and differences in the width of the distal energy fall off of the Bragg-Peak from 80% to 20% of less than 0.1 mm were found. Heterogeneous phantoms using layered slabs satisfied a γ-index criterion of 2%/2mm of the local value except for some single voxels. For more complex phantoms using laterally arranged bone-air slabs, the γ-index criterion was exceeded in some areas giving a maximum γ-index of 1.75 and 4.9% of the voxels showed γ-index values larger than one. The calculation precision of the presented algorithm was considered to be sufficient

  16. Dosimetry of proton therapy beam

    International Nuclear Information System (INIS)

    Andric, S.

    1996-01-01

    Review of basic dosimetry of proton therapy treatment are presented with a goal to further development of the center for proton therapy planed in the frame of accelerator installation TESLA, which construction has been going on in the Vinca Institute. The basic of existing international recommendation for proton dosimetry, related both to dosimeter choice and calibration, as well as to absorbed dose determination methods, are presented. Recommendation statement and supposition in the future proton therapy practice belongs to the basic elements of developed conceptual program for proton therapy usage

  17. Fan beam intensity modulated proton therapy

    Science.gov (United States)

    Hill, Patrick M.

    A fan beam proton therapy is developed which delivers intensity modulated proton therapy using distal edge tracking. The system may be retrofit onto existing proton therapy gantries without alterations to infrastructure in order to improve treatments through intensity modulation. A novel range and intensity modulation system is designed using acrylic leaves that are inserted or retracted from subsections of the fan beam. Leaf thicknesses are chosen in a base-2 system and motivated in a binary manner. Dose spots from individual beam channels range between 1 and 5 cm. Integrated collimators attempting to limit crosstalk among beam channels are investigated, but found to be inferior to uncollimated beam channel modulators. A treatment planning system performing data manipulation in MATLAB and dose calculation in MCNPX is developed. Beamlet dose is calculated on patient CT data and a fan beam source is manually defined to produce accurate results. An energy deposition tally follows the CT grid, allowing straightforward registration of dose and image data. Simulations of beam channels assume that a beam channel either delivers dose to a distal edge spot or is intensity modulated. A final calculation is performed separately to determine the deliverable dose accounting for all sources of scatter. Treatment plans investigate the effects that varying system parameters have on dose distributions. Beam channel apertures may be as large as 20 mm because the sharp distal falloff characteristic of proton dose provides sufficient intensity modulation to meet dose objectives, even in the presence of coarse lateral resolution. Dose conformity suffers only when treatments are delivered from less than 10 angles. Jaw widths of 1--2 cm produce comparable dose distributions, but a jaw width of 4 cm produces unacceptable target coverage when maintaining critical structure avoidance. Treatment time for a prostate delivery is estimated to be on the order of 10 minutes. Neutron production

  18. Cyclotron for Beam Therapy Application

    CERN Document Server

    Alenitsky, Yu G; Karamysheva, G A; Kostromin, S A; Mitsyn, G V; Molokanov, A G; Onishchenko, L M; Samsonov, E V; Vorozhtsov, S B; Zaplatin, N L

    2005-01-01

    The basic parameters of the proton isochronous cyclotron on the fixed energy are considered. The energy of protons is $E_{p}\\sim $ 220~MeV, intensity of the extracted beam is $I_{p}\\sim $ 0.1~$\\mu$A. The cyclotron is projected on the basis of compact magnet with four sectors and the diameter of poles 300 cm. Two dees of the accelerating system are located in valleys.

  19. Review of electron beam therapy physics

    International Nuclear Information System (INIS)

    Hogstrom, Kenneth R; Almond, Peter R

    2006-01-01

    For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed. (review)

  20. Review of electron beam therapy physics.

    Science.gov (United States)

    Hogstrom, Kenneth R; Almond, Peter R

    2006-07-07

    For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed.

  1. Principles and practice of proton beam therapy

    CERN Document Server

    Das, Indra J

    2015-01-01

    Commissioned by The American Association of Physicists in Medicine (AAPM) for their June 2015 Summer School, this is the first AAPM monograph printed in full color. Proton therapy has been used in radiation therapy for over 70 years, but within the last decade its use in clinics has grown exponentially. This book fills in the proton therapy gap by focusing on the physics of proton therapy, including beam production, proton interactions, biology, dosimetry, treatment planning, quality assurance, commissioning, motion management, and uncertainties. Chapters are written by the world's leading medical physicists who work at the pioneering proton treatment centers around the globe. They share their understandings after years of experience treating thousands of patients. Case studies involving specific cancer treatments show that there is some art to proton therapy as well as state-of-the-art science. Even though the focus lies on proton therapy, the content provided is also valuable to heavy charged particle th...

  2. Fan-beam intensity modulated proton therapy

    International Nuclear Information System (INIS)

    Hill, Patrick; Westerly, David; Mackie, Thomas

    2013-01-01

    Purpose: This paper presents a concept for a proton therapy system capable of delivering intensity modulated proton therapy using a fan beam of protons. This system would allow present and future gantry-based facilities to deliver state-of-the-art proton therapy with the greater normal tissue sparing made possible by intensity modulation techniques.Methods: A method for producing a divergent fan beam of protons using a pair of electromagnetic quadrupoles is described and particle transport through the quadrupole doublet is simulated using a commercially available software package. To manipulate the fan beam of protons, a modulation device is developed. This modulator inserts or retracts acrylic leaves of varying thickness from subsections of the fan beam. Each subsection, or beam channel, creates what effectively becomes a beam spot within the fan area. Each channel is able to provide 0–255 mm of range shift for its associated beam spot, or stop the beam and act as an intensity modulator. Results of particle transport simulations through the quadrupole system are incorporated into the MCNPX Monte Carlo transport code along with a model of the range and intensity modulation device. Several design parameters were investigated and optimized, culminating in the ability to create topotherapy treatment plans using distal-edge tracking on both phantom and patient datasets.Results: Beam transport calculations show that a pair of electromagnetic quadrupoles can be used to create a divergent fan beam of 200 MeV protons over a distance of 2.1 m. The quadrupole lengths were 30 and 48 cm, respectively, with transverse field gradients less than 20 T/m, which is within the range of water-cooled magnets for the quadrupole radii used. MCNPX simulations of topotherapy treatment plans suggest that, when using the distal edge tracking delivery method, many delivery angles are more important than insisting on narrow beam channel widths in order to obtain conformal target coverage

  3. Fan-beam intensity modulated proton therapy.

    Science.gov (United States)

    Hill, Patrick; Westerly, David; Mackie, Thomas

    2013-11-01

    This paper presents a concept for a proton therapy system capable of delivering intensity modulated proton therapy using a fan beam of protons. This system would allow present and future gantry-based facilities to deliver state-of-the-art proton therapy with the greater normal tissue sparing made possible by intensity modulation techniques. A method for producing a divergent fan beam of protons using a pair of electromagnetic quadrupoles is described and particle transport through the quadrupole doublet is simulated using a commercially available software package. To manipulate the fan beam of protons, a modulation device is developed. This modulator inserts or retracts acrylic leaves of varying thickness from subsections of the fan beam. Each subsection, or beam channel, creates what effectively becomes a beam spot within the fan area. Each channel is able to provide 0-255 mm of range shift for its associated beam spot, or stop the beam and act as an intensity modulator. Results of particle transport simulations through the quadrupole system are incorporated into the MCNPX Monte Carlo transport code along with a model of the range and intensity modulation device. Several design parameters were investigated and optimized, culminating in the ability to create topotherapy treatment plans using distal-edge tracking on both phantom and patient datasets. Beam transport calculations show that a pair of electromagnetic quadrupoles can be used to create a divergent fan beam of 200 MeV protons over a distance of 2.1 m. The quadrupole lengths were 30 and 48 cm, respectively, with transverse field gradients less than 20 T/m, which is within the range of water-cooled magnets for the quadrupole radii used. MCNPX simulations of topotherapy treatment plans suggest that, when using the distal edge tracking delivery method, many delivery angles are more important than insisting on narrow beam channel widths in order to obtain conformal target coverage. Overall, the sharp distal

  4. Ion beam therapy fundamentals, technology, clinical applications

    CERN Document Server

    2012-01-01

    The book provides a detailed, up-to-date account of the basics, the technology, and the clinical use of ion beams for radiation therapy. Theoretical background, technical components, and patient treatment schemes are delineated by the leading experts that helped to develop this field from a research niche to its current highly sophisticated and powerful clinical treatment level used to the benefit of cancer patients worldwide. Rather than being a side-by-side collection of articles, this book consists of related chapters. It is a common achievement by 76 experts from around the world. Their expertise reflects the diversity of the field with radiation therapy, medical and accelerator physics, radiobiology, computer science, engineering, and health economics. The book addresses a similarly broad audience ranging from professionals that need to know more about this novel treatment modality or consider to enter the field of ion beam therapy as a researcher. However, it is also written for the interested public an...

  5. Thermionic system evaluation test (TSET) facility construction: A United States and Russian effort

    International Nuclear Information System (INIS)

    Wold, S.K.

    1993-01-01

    The Thermionic System Evaluation Test (TSET) is a ground test of an unfueled Russian TOPAZ-II in-core thermionic space reactor powered by electric heaters. The facility that will be used for testing of the TOPAZ-II systems is located at the New Mexico Engineering Research Institute (NMERI) complex in Albuquerque, NM. The reassembly of the Russian test equipment is the responsibility of International Scientific Products (ISP), a San Jose, CA, company and Inertek, a Russian corporation, with support provided by engineers and technicians from Phillips Laboratory (PL), Sandia National Laboratories (SNL), Los Alamos National Laboratory (LANL), and the University of New Mexico (UNM). This test is the first test to be performed under the New Mexico Strategic Alliance agreement. This alliance consists of the PL, SNL, LANL, and UNM. The testing is being funded by the Strategic Defense Initiative Organization (SDIO) with the PL responsible for project execution

  6. Repeated proton beam therapy for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Hashimoto, Takayuki; Tokuuye, Koichi; Fukumitsu, Nobuyoshi; Igaki, Hiroshi; Hata, Masaharu; Kagei, Kenji; Sugahara, Shinji; Ohara, Kiyoshi; Matsuzaki, Yasushi; Akine, Yasuyuki

    2006-01-01

    Purpose: To retrospectively evaluate the safety and effectiveness of repeated proton beam therapy for newly developed or recurrent hepatocellular carcinoma (HCC). Methods and Materials: From June 1989 through July 2000, 225 patients with HCC underwent their first course of proton beam therapy at University of Tsukuba. Of them, 27 with 68 lesions who had undergone two or more courses were retrospectively reviewed in this study. Median interval between the first and second course was 24.5 months (range 3.3-79.8 months). Median total dose of 72 Gy in 16 fractions and 66 Gy in 16 fractions were given for the first course and the rest of the courses, respectively. Results: The 5-year survival rate and median survival period from the beginning of the first course for the 27 patients were 55.6% and 62.2 months, respectively. Five-year local control rate for the 68 lesions was 87.8%. Of the patients, 1 with Child-Pugh class B and another with class C before the last course suffered from acute hepatic failure. Conclusions: Repeated proton beam therapy for HCC is safe when the patient has a target in the peripheral region of the liver and liver function is Child-Pugh class A

  7. MR Cholangiography: Axial TSE-T2 Sequence Evaluation in the Diagnosis of Choledocholithiasis; Colangiografia RM: evaluacion de la secuencia TSE-T2 axial en la deteccion de coledocolitiasis

    Energy Technology Data Exchange (ETDEWEB)

    Alustiza, J. M.; Gervas, C.; Garcia, E.; Recondo, J. A. [Hospital Donostia. San Sebastian (Spain)

    2003-07-01

    To evaluate diagnostic precision of the axial TSE-T2 sequence in the diagnosis of choledocholithiasis. Retrospective analysis of all those MR cholangiography studies performed in our center between January 1998 and June 1999 which were later subjected to conventional cholangiography (intraoperative) as a golden standard. A total of 39 patients was studied. Imaging parameters of the sequence evaluated, fat-suppressed TSE-T2 in the axial plane, were as follows: TE 100 ms, TR 1.800 ms, turbo factor 23 FOV 375 mm, NSA 4, 228 x 256 matrix, respiratory compensation, number of slices 35, slice thickness 3 mm, contiguous slices, scan duration 5'4''. Without having been informed as to the cholangiography result, two radiologists independently analyzed this sequence in order to determine the presence of choledocholithiasis. Their results were latter compared with those of the conventional cholangiography. The sensitivity, specificity and agreement between results were all calculated. 21 patients had choledocholithiasis. The analyzed sequence presented sensitivity 81%, specificity 89%, and agreement between radiologists 98%, Kappa index 0.949. The axial sequence TSE-T2 is reliable for choledocholithiasis diagnosis. (Author) 9 refs.

  8. External beam radiation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Forman, Jeffrey D.

    1996-01-01

    Purpose/Objectives: The intent of this course is to review the issues involved in the management of non-metastatic adenocarcinoma of the prostate. -- The value of pre-treatment prognostic factors including stage, grade and PSA value will be presented, and their value in determining therapeutic strategies will be discussed. -- Controversies involving the simulation process and treatment design will be presented. The value of CT scanning, Beams-Eye View, 3-D planning, intravesicle, intraurethral and rectal contrast will be presented. The significance of prostate and patient movement and strategies for dealing with them will be presented. -- The management of low stage, low to intermediate grade prostate cancer will be discussed. The dose, volume and timing of irradiation will be discussed as will the role of neo-adjuvant hormonal therapy, neutron irradiation and brachytherapy. The current status of radical prostatectomy and cryotherapy will be summarized. Treatment of locally advanced, poorly differentiated prostate cancer will be presented including a discussion of neo-adjuvant and adjuvant hormones, dose-escalation and neutron irradiation. -- Strategies for post-radiation failures will be presented including data on cryotherapy, salvage prostatectomy and hormonal therapy (immediate, delayed and/or intermittent). New areas for investigation will be reviewed. -- The management of patients post prostatectomy will be reviewed. Data on adjuvant radiation and therapeutic radiation for biochemical or clinically relapsed patients will be presented. This course hopes to present a realistic and pragmatic overview for treating patients with non-metastatic prostatic cancer

  9. Materials for neutron beam optimization for boron neutron capture therapy

    International Nuclear Information System (INIS)

    Matsumoto, Tetsuo

    2001-01-01

    Several prospective materials (neutron filter/moderator, beam reflector, gamma ray shielding and beam collimator) were studied with a view to generating thermal and epithermal neutron beams suited for boron neutron capture therapy (BNCT). The beams are delivered from the thermal and thermalizing column exits situated on two opposite faces of a TRIGA-II type reactor. An investigation was performed with Monte Carlo calculations from a viewpoint of obtaining sufficiently intense thermal and epithermal neutron beams separately, and little adulterated both with neutrons of extraneous energy ranges and with gamma rays. High-density graphite (G) would be the most suitable material for thermal neutron beams as a neutron filter/moderator, and the combination of aluminum (Al) and aluminum fluoride (AlF 3 ) for epithermal neutron beams. The graphite would be also the most promising material for thermal neutron beams as a beam reflector while for epithermal neutron beams the choice would be lead fluoride (PbF 2 ). The PbF 2 would be also the most suitable material for epithermal neutron beams as a gamma ray shielding, and bismuth (Bi) for thermal neutron beam. The PbF 2 would be also the most useful material for epithermal neutron beam as a beam collimator while for thermal neutron beam the choice would be the graphite. The epithermal neutron beam for BNCT could be optimized with the progressive use of PbF 2 . (author)

  10. Synchrotron accelerator technology for proton beam therapy with high accuracy

    International Nuclear Information System (INIS)

    Hiramoto, Kazuo

    2009-01-01

    Proton beam therapy was applied at the beginning to head and neck cancers, but it is now extended to prostate, lung and liver cancers. Thus the need for a pencil beam scanning method is increasing. With this method radiation dose concentration property of the proton beam will be further intensified. Hitachi group has supplied a pencil beam scanning therapy system as the first one for M. D. Anderson Hospital in United States, and it has been operational since May 2008. Hitachi group has been developing proton therapy system to correspond high-accuracy proton therapy to concentrate the dose in the diseased part which is located with various depths, and which sometimes has complicated shape. The author described here on the synchrotron accelerator technology that is an important element for constituting the proton therapy system. (K.Y.)

  11. Nanoscale insights into ion-beam cancer therapy

    CERN Document Server

    2017-01-01

    This book provides a unique and comprehensive overview of state-of-the-art understanding of the molecular and nano-scale processes that play significant roles in ion-beam cancer therapy. It covers experimental design and methodology, and reviews the theoretical understanding of the processes involved. It offers the reader an opportunity to learn from a coherent approach about the physics, chemistry and biology relevant to ion-beam cancer therapy, a growing field of important medical application worldwide. The book describes phenomena occurring on different time and energy scales relevant to the radiation damage of biological targets and ion-beam cancer therapy from the molecular (nano) scale up to the macroscopic level. It illustrates how ion-beam therapy offers the possibility of excellent dose localization for treatment of malignant tumours, minimizing radiation damage in normal tissue whilst maximizing cell-killing within the tumour, offering a significant development in cancer therapy. The full potential ...

  12. Review of ion beam therapy: Present and Future

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, Jose R.

    2000-06-01

    First therapy efforts at the Bevalac using neon ions took place in the 70's and 80's. Promising results led to construction of HIMAC in Chiba Japan, and more recently to therapy trials at GSI. Both these facilities are now treating patients with carbon beams. Advances in both accelerator technology and beam delivery have taken place at these two centers. Plans are well along for new facilities in Europe and Japan.

  13. Neutron capture therapy beams at the MIT Research Reactor

    International Nuclear Information System (INIS)

    Choi, J.R.; Clement, S.D.; Harling, O.K.; Zamenhof, R.G.

    1990-01-01

    Several neutron beams that could be used for neutron capture therapy at MITR-II are dosimetrically characterized and their suitability for the treatment of glioblastoma multiforme and other types of tumors are described. The types of neutron beams studied are: (1) those filtered by various thicknesses of cadmium, D2O, 6Li, and bismuth; and (2) epithermal beams achieved by filtration with aluminum, sulfur, cadmium, 6Li, and bismuth. Measured dose vs. depth data are presented in polyethylene phantom with references to what can be expected in brain. The results indicate that both types of neutron beams are useful for neutron capture therapy. The first type of neutron beams have good therapeutic advantage depths (approximately 5 cm) and excellent in-phantom ratios of therapeutic dose to background dose. Such beams would be useful for treating tumors located at relatively shallow depths in the brain. On the other hand, the second type of neutron beams have superior therapeutic advantage depths (greater than 6 cm) and good in-phantom therapeutic advantage ratios. Such beams, when used along with bilateral irradiation schemes, would be able to treat tumors at any depth in the brain. Numerical examples of what could be achieved with these beams, using RBEs, fractionated-dose delivery, unilateral, and bilateral irradiation are presented in the paper. Finally, additional plans for further neutron beam development at MITR-II are discussed

  14. Radiotherapy for ocular lesions by electron beam therapy

    International Nuclear Information System (INIS)

    Miyaishi, Kazuo

    1981-01-01

    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 appliance of conventional X ray therapy has been gradually abandaned 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, 4000 - 5000 rads in total is applied by 8 MeV electron twice a week method. 3) For orbitar lymphoid neoplasm, Cobalt-60 γ ray or Linac X ray is applied together with electron beam. 4) For embryonal rhabdomyosarcoma, adenoid cystic cancer etc., the therapy for whole body is necessary. 5) For benign tumors, a small dose at a time is applied for a long time. (author)

  15. Application of the pencil-beam redefinition algorithm in heterogeneous media for proton beam therapy

    Science.gov (United States)

    Egashira, Y.; Nishio, T.; Hotta, K.; Kohno, R.; Uesaka, M.

    2013-02-01

    In proton beam therapy, changes in the proton range due to lateral heterogeneity may cause serious errors in the dose distribution. In the present study, the pencil-beam redefinition algorithm (PBRA) was applied to proton beam therapy to address the problem of lateral density heterogeneity. In the calculation, the phase-space parameters were characterized for multiple range (i.e. proton energy) bins for given pencil beams. The particles that were included in each pencil beam were transported and redefined periodically until they had stopped. The redefined beams formed a detouring path that was different from that of the non-redefined pencil beams, and the path of each redefined beam was straight. The results calculated by the PBRA were compared with measured proton dose distributions in a heterogeneous slab phantom and an anthropomorphic phantom. Through the beam redefinition process, the PBRA was able to predict the measured proton-detouring effects. Therefore, the PBRA may allow improved calculation accuracy when dealing with lateral heterogeneities in proton therapy applications.

  16. Development of a compact synchrotron for proton beam therapy

    International Nuclear Information System (INIS)

    Ebina, Futaro; Umezawa, Masumi; Nishiuchi, Hideaki; Aoki, Takamichi; Hiramoto, Kazuo; Matsuda, Koji; Umegaki, Kikuo; Furusaka, Michihiro

    2016-01-01

    This research aims to develop a compact synchrotron dedicated for proton beam therapy using a scanning irradiation method. The effective length and magnetic uniformity of the bending magnets in the synchrotron were analyzed by 3D static magnetic field calculations. The calculation results indicate that the shape of the bending magnet satisfies the specification for beam stability. A push-pull multi-feed driven technique allows shortening the length of the FINEMET RF acceleration cavity for the synchrotron from 600 mm to 450 mm. The circumference of the synchrotron is 18 m, which is the world's most compact size for proton beam therapy. (author)

  17. Beam Phase Detection for Proton Therapy Accelerators

    CERN Document Server

    Aminov, Bachtior; Getta, Markus; Kolesov, Sergej; Pupeter, Nico; Stephani, Thomas; Timmer, J

    2005-01-01

    The industrial application of proton cyclotrons for medical applications has become one of the important contributions of accelerator physics during the last years. This paper describes an advanced vector demodulating technique used for non-destructive measurements of beam intensity and beam phase over 360°. A computer controlled I/Q-based phase detector with a very large dynamic range of 70 dB permits the monitoring of beam intensity, phase and eventually energy for wide range of beam currents down to -130 dBm. In order to avoid interference from the fundamental cyclotron frequency the phase detection is performed at the second harmonic frequency. A digital low pass filter with adjustable bandwidth and steepness is implemented to improve accuracy. With a sensitivity of the capacitive pickup in the beam line of 30 nV per nA of proton beam current at 250 MeV, accurate phase and intensity measurements can be performed with beam currents down to 3.3 nA.

  18. Anesthesia for pediatric external beam radiation therapy

    International Nuclear Information System (INIS)

    Fortney, Jennifer T.; Halperin, Edward C.; Hertz, Caryn M.; Schulman, Scott R.

    1999-01-01

    Background: For very young patients, anesthesia is often required for radiotherapy. This results in multiple exposures to anesthetic agents over a short period of time. We report a consecutive series of children anesthetized for external beam radiation therapy (EBRT). Methods: Five hundred twelve children ≤ 16 years old received EBRT from January 1983 to February 1996. Patient demographics, diagnosis, anesthesia techniques, monitoring, airway management, complications, and outcome were recorded for the patients requiring anesthesia. Results: One hundred twenty-three of the 512 children (24%) required 141 courses of EBRT with anesthesia. Anesthetized patients ranged in age from 20 days to 11 years (mean 2.6 ± 1.8 ). The frequency of a child receiving EBRT and requiring anesthesia by age cohort was: ≤ 1 year (96%), 1-2 years (93%), 2-3 years (80%), 3-4 years (51%), 4-5 years (36%), 5-6 years (13%), 6-7 years (11%), and 7-16 years (0.7%). Diagnoses included: primary CNS tumor (28%), retinoblastoma (27%), neuroblastoma (20%), acute leukemia (9%), rhabdomyosarcoma (6%), and Wilms' tumor (4%). Sixty-three percent of the patients had been exposed to chemotherapy prior to EBRT. The mean number of anesthesia sessions per patient was 22 ± 16. Seventy-eight percent of the treatment courses were once daily and 22% were twice daily. Anesthesia techniques included: short-acting barbiturate induction + inhalation maintenance (21%), inhalation only (20%), ketamine (19%), propofol only (12%), propofol induction + inhalation maintenance (7%), ketamine induction + inhalation maintenance (6%), ketamine or short-acting barbiturate induction + inhalation maintenance (6%). Monitoring techniques included: EKG (95%), O 2 saturation (93%), fraction of inspired O 2 (57%), and end-tidal CO 2 (55%). Sixty-four percent of patients had central venous access. Eleven of the 74 children with a central line developed sepsis (15%): 6 of the 11 were anesthetized with propofol (55%), 4 with a

  19. A proton beam delivery system for conformal therapy and intensity modulated therapy

    International Nuclear Information System (INIS)

    Yu Qingchang

    2001-01-01

    A scattering proton beam delivery system for conformal therapy and intensity modulated therapy is described. The beam is laterally spread out by a dual-ring double scattering system and collimated by a program-controlled multileaf collimator and patient specific fixed collimators. The proton range is adjusted and modulated by a program controlled binary filter and ridge filters

  20. The Thermionic System Evaluation Test (TSET): Descriptions, limitations, and the involvement of the space nuclear power community

    International Nuclear Information System (INIS)

    Morris, D.B.

    1993-01-01

    Project and test planning for the Thermionic System Evaluation Test (TSET) Project began in August 1990. Since the formalization of the contract agreement two years ago, the TOPAZ-II testing hardware was delivered in May 1992. In the months since the delivery of the test hardware, Russians and Americans working side-by-side installed the equipment and are preparing to begin testing in early 1993. The procurement of the Russian TOPAZ-II unfueled thermionic space nuclear power system (SNP) provides a unique opportunity to understand a complete thermionic system and enhances the possibility for further study of this type of power conversion for space applications. This paper will describe the program and test article, facility and test article limitations, and how the government and industry are encouraged to be involved in the program

  1. Salvage proton beam therapy in local recurrent uveal melanoma.

    Science.gov (United States)

    Riechardt, Aline I; Cordini, Dino; Dobner, Bianca; Seibel, Ira; Gundlach, Enken; Rehak, Matus; Hager, Annette; Stark, Roland; Moser, Lutz; Joussen, Antonia M

    2014-11-01

    To evaluate survival and ocular outcome in recurrent uveal melanoma treated with proton beam therapy as salvage therapy. Retrospective, interventional case series. We evaluated 48 patients with local recurrence of uveal melanoma after primary treatment with brachytherapy, transpupillary thermotherapy, proton beam therapy, laser photocoagulation, CyberKnife radiation, or photodynamic therapy. All patients received proton beam therapy as a salvage therapy at the Helmholtz Zentrum Berlin between July 2000 and December 2010. Kaplan-Meier analysis was used to obtain survival rates. The Kaplan-Meier estimator for local tumor control was 92.1% at 10 years after secondary treatment with proton beam therapy. Local recurrence developed in 3 patients; 1 of them underwent enucleation. During follow-up, 20.8% of the patients died (16.7% of metastasis, 4.1% of other causes or not specified). The most frequent surgical interventions were phacoemulsification (20.8%) and pars plana vitrectomy (10.4%). The Kaplan-Meier estimators were 77.4% for survival and 70.1% for the absence of metastasis 10 years after the primary treatment. Proton beam therapy as a salvage treatment resulted in high local tumor control rates in recurrent uveal melanoma, especially if the primary therapy was transpupillary thermotherapy or plaque brachytherapy. Preservation of the globe was possible in most patients. Enucleations were indicated only in case of re-recurrences of uveal melanoma, but not because of secondary complications like intractable pain or secondary glaucoma. Retreatment was associated with vision deterioration, but loss of vision remained exceptional. Further larger prospective studies are needed to confirm the presented results of our retrospective analysis. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Use of an electron reflector to improve dose uniformity at the vertex during total skin electron therapy

    International Nuclear Information System (INIS)

    Peters, V.G.

    2000-01-01

    Purpose: The vertex of the scalp is always tangentially irradiated during total skin electron therapy (TSET). This study was conducted to determine the dose distribution at the vertex for a commonly used irradiation technique and to evaluate the use of an electron reflector, positioned above the head, as a means of improving the dose uniformity. Methods and Materials: Phantoms, simulating the head of a patient, were irradiated using our standard procedure for TSET. The technique is a six-field irradiation using dual angled electron beams at a treatment distance of 3.6 meters. Vertex dosimetry was performed using ionization methods and film. Measurements were made for an unmodified 6 MeV electron beam and for a 4 MeV beam obtained by placing an acrylic scattering plate in the beam line. Studies were performed to examine the effect of electron scattering on vertex dose when a lead reflector, 50 x 50 cm in area, was positioned above the phantom. Results: The surface dose at the vertex, in the absence of the reflector, was found to be less than 40% of the prescribed skin dose. Use of the lead reflector increased this value to 73% for the 6 MeV beam and 99% for the degraded 4 MeV beam. Significant improvements in depth dose were also observed. The dose enhancement is not strongly dependent on reflector distance or angulation since the reflector acts as a large source of broadly scattered electrons. Conclusion: The vertex may be significantly underdosed using standard techniques for total skin electron therapy. Use of an electron reflector improves the dose uniformity at the vertex and may reduce or eliminate the need for supplemental irradiation

  3. Treatment Planning for Ion Beam Therapy

    Science.gov (United States)

    Jäkel, Oliver

    The special aspects of treatment planning for ion beams are outlined in this chapter, starting with positioning and immobilization of the patient, describing imaging and segmentation, definition of treatment parameters, dose calculation and optimization, and, finally, plan assessment, verification, and quality assurance.

  4. Study on external beam radiation therapy

    International Nuclear Information System (INIS)

    Kim, Mi Sook; Yoo, Seoung Yul; Yoo, Hyung Jun; Ji, Young Hoon; Lee, Dong Han; Lee, Dong Hoon; Choi, Mun Sik; Yoo, Dae Heon; Lee, Hyo Nam; Kim, Kyeoung Jung

    1999-04-01

    To develop the therapy technique which promote accuracy and convenience in external radiation therapy, to obtain the development of clinical treatment methods for the global competition. The contents of the R and D were 1. structure, process and outcome analysis in radiation therapy department. 2. Development of multimodality treatment in radiation therapy 3. Development of computation using networking techniques 4. Development of quality assurance (QA) system in radiation therapy 5. Development of radiotherapy tools 6. Development of intraoperative radiation therapy (IORT) tools. The results of the R and D were 1. completion of survey and analysis about Korea radiation therapy status 2. Performing QA analysis about ICR on cervix cancer 3. Trial of multicenter randomized study on lung cancers 4. Setting up inter-departmental LAN using MS NT server and Notes program 5. Development of ionization chamber and dose-rate meter for QA in linear accelerator 6. Development on optimized radiation distribution algorithm for multiple slice 7. Implementation on 3 dimensional volume surface algorithm and 8. Implementation on adaptor and cone for IORT

  5. Study on external beam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sook; Yoo, Seoung Yul; Yoo, Hyung Jun; Ji, Young Hoon; Lee, Dong Han; Lee, Dong Hoon; Choi, Mun Sik; Yoo, Dae Heon; Lee, Hyo Nam; Kim, Kyeoung Jung

    1999-04-01

    To develop the therapy technique which promote accuracy and convenience in external radiation therapy, to obtain the development of clinical treatment methods for the global competition. The contents of the R and D were 1. structure, process and outcome analysis in radiation therapy department. 2. Development of multimodality treatment in radiation therapy 3. Development of computation using networking techniques 4. Development of quality assurance (QA) system in radiation therapy 5. Development of radiotherapy tools 6. Development of intraoperative radiation therapy (IORT) tools. The results of the R and D were 1. completion of survey and analysis about Korea radiation therapy status 2. Performing QA analysis about ICR on cervix cancer 3. Trial of multicenter randomized study on lung cancers 4. Setting up inter-departmental LAN using MS NT server and Notes program 5. Development of ionization chamber and dose-rate meter for QA in linear accelerator 6. Development on optimized radiation distribution algorithm for multiple slice 7. Implementation on 3 dimensional volume surface algorithm and 8. Implementation on adaptor and cone for IORT.

  6. Overview of Light-Ion Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Chu, William T.

    2006-03-16

    treatment volume compared to those in conventional (photon) treatments. Wilson wrote his personal account of this pioneering work in 1997. In 1954 Cornelius Tobias and John Lawrence at the Radiation Laboratory (former E.O. Lawrence Berkeley National Laboratory) of the University of California, Berkeley performed the first therapeutic exposure of human patients to hadron (deuteron and helium ion) beams at the 184-Inch Synchrocyclotron. By 1984, or 30 years after the first proton treatment at Berkeley, programs of proton radiation treatments had opened at: University of Uppsala, Sweden, 1957; the Massachusetts General Hospital-Harvard Cyclotron Laboratory (MGH/HCL), USA, 1961; Dubna (1967), Moscow (1969) and St Petersburg (1975) in Russia; Chiba (1979) and Tsukuba (1983) in Japan; and Villigen, Switzerland, 1984. These centers used the accelerators originally constructed for nuclear physics research. The experience at these centers has confirmed the efficacy of protons and light ions in increasing the tumor dose relative to normal tissue dose, with significant improvements in local control and patient survival for several tumor sites. M.R. Raju reviewed the early clinical studies. In 1990, the Loma Linda University Medical Center in California heralded in the age of dedicated medical accelerators when it commissioned its proton therapy facility with a 250-MeV synchrotron. Since then there has been a relatively rapid increase in the number of hospital-based proton treatment centers around the world, and by 2006 there are more than a dozen commercially-built facilities in use, five new facilities under construction, and more in planning stages. In the 1950s larger synchrotrons were built in the GeV region at Brookhaven (3-GeV Cosmotron) and at Berkeley (6-GeV Bevatron), and today most of the world's largest accelerators are synchrotrons. With advances in accelerator design in the early 1970s, synchrotrons at Berkeley and Princeton accelerated ions with atomic numbers

  7. Overview of Light-Ion Beam Therapy

    International Nuclear Information System (INIS)

    Chu, William T.

    2006-01-01

    compared to those in conventional (photon) treatments. Wilson wrote his personal account of this pioneering work in 1997. In 1954 Cornelius Tobias and John Lawrence at the Radiation Laboratory (former E.O. Lawrence Berkeley National Laboratory) of the University of California, Berkeley performed the first therapeutic exposure of human patients to hadron (deuteron and helium ion) beams at the 184-Inch Synchrocyclotron. By 1984, or 30 years after the first proton treatment at Berkeley, programs of proton radiation treatments had opened at: University of Uppsala, Sweden, 1957; the Massachusetts General Hospital-Harvard Cyclotron Laboratory (MGH/HCL), USA, 1961; Dubna (1967), Moscow (1969) and St Petersburg (1975) in Russia; Chiba (1979) and Tsukuba (1983) in Japan; and Villigen, Switzerland, 1984. These centers used the accelerators originally constructed for nuclear physics research. The experience at these centers has confirmed the efficacy of protons and light ions in increasing the tumor dose relative to normal tissue dose, with significant improvements in local control and patient survival for several tumor sites. M.R. Raju reviewed the early clinical studies. In 1990, the Loma Linda University Medical Center in California heralded in the age of dedicated medical accelerators when it commissioned its proton therapy facility with a 250-MeV synchrotron. Since then there has been a relatively rapid increase in the number of hospital-based proton treatment centers around the world, and by 2006 there are more than a dozen commercially-built facilities in use, five new facilities under construction, and more in planning stages. In the 1950s larger synchrotrons were built in the GeV region at Brookhaven (3-GeV Cosmotron) and at Berkeley (6-GeV Bevatron), and today most of the world's largest accelerators are synchrotrons. With advances in accelerator design in the early 1970s, synchrotrons at Berkeley and Princeton accelerated ions with atomic numbers between 6 and 18, at

  8. Dose reporting in ion beam therapy. Proceedings of a meeting

    International Nuclear Information System (INIS)

    2007-06-01

    Following the pioneering work in Berkeley, USA, ion beam therapy for cancer treatment is at present offered in Chiba and Hyogo in Japan, and Darmstadt in Germany. Other facilities are coming close to completion or are at various stages of planning in Europe and Japan. In all these facilities, carbon ions have been selected as the ions of choice, at least in the first phase. Taking into account this fast development, the complicated technical and radiobiological research issues involved, and the hope it raises for some types of cancer patients, the IAEA and the International Commission on Radiation Units and measurements (ICRU) jointly sponsored a technical meeting held in Vienna, 23-24 June 2004. That first meeting was orientated mainly towards radiobiology: the relative biological effectiveness (RBE) of carbon ions versus photons, and related issues. One of the main differences between ion beam therapy and other modern radiotherapy techniques (such as proton beam therapy or intensity modulated radiation therapy) is related to radiobiology and in particular the increased RBE of carbon ions compared to both protons and photons (i.e., high linear energy transfer (LET) versus low LET radiation). Another important issue for international agencies and commissions, such as the IAEA and the ICRU, is a worldwide agreement and harmonisation for reporting the treatments. In order to evaluate the merits of ion beam therapy, it is essential that the treatments be reported in a similar/comparable way in all centres so that the clinical reports and protocols can be understood and interpreted without ambiguity by the radiation therapy community in general. For the last few decades, the ICRU has published several reports containing recommendations on how to report external photon beam or electron beam therapy, and brachytherapy. A report on proton beam therapy, jointly prepared by the ICRU and the IAEA, is now completed and is being published in the ICRU series. In line with this

  9. Fermi surface and effect of high magnetic fields on the metal-semimetal Peierls-like transition of (TSeT)2Cl

    International Nuclear Information System (INIS)

    Laukhin, V.; Audouard, Allan; Vignolles, David; Drigo, Lois; Alemany, Pere; Canadell, Enric

    2014-01-01

    Resistance measurements in pulsed magnetic fields up to 55 T as well as a first-principles DFT calculation of the Fermi surface for the organic metal (TSeT) 2 Cl have been performed to investigate its metal-semimetal phase transition. The results obtained are in line with the imperfect nesting that can be inferred from both the observed metallic behavior of the resistivity at low temperature and the previously reported Shubnikov-de Haas oscillations due to small carrier pockets. The DFT study points out the possibility that the LUMO bands of the TSeT donor may interact with the HOMO ones and modify the shape of the Fermi surface under pressure

  10. Therapy tumor with the heavy ions beam

    International Nuclear Information System (INIS)

    Dang Bingrong; Wei Zengquan; Li Wenjian

    2002-01-01

    As physical characteristic of heavy ions Bragg peak, therapy tumor with heavy ions is becoming advanced technology. So, many countries have developed the technology and used to treat tumor, the societal and economic effects are beneficial to people. The authors show the development, present situation and information of research in world of advanced radiotherapy with heavy ions

  11. Proportional counter measurements in neutron therapy beams

    International Nuclear Information System (INIS)

    Menzel, H.G.

    1984-01-01

    Dosimetry for clinical neutron therapy requires a characterization of radiation quality in addition to the specification of absorbed dose. Generally, a very simple approach has been adopted which consists in separating total absorbed dose into neutron and photon fractions. This is explained by the requirement of clinical dosimetry to apply methods suitable for routine measurements, by the lack of generally accepted improved alternatives, and by the fact that radiation quality is only one of several problems in neutron therapy not sufficiently solved. Spectra measured with low-pressure tissue-equivalent proportional counters (experimental microdosimetry) provide a detailed description of the physical properties of the radiation field at neutron therapy facilities. These descriptions are suitable for explaining the influence of different parameters (collimation, field size, phantom) on radiation quality. Although the physical properties of the radiation field as described by the measured microdosimetric distributions and quantities are not the only properties relevant for radiation effects, in general there are reasons to believe that they provide a suitable radiation quality characterization for the limited range of applications in neutron therapy. (author)

  12. A Monte Carlo code for ion beam therapy

    CERN Multimedia

    Anaïs Schaeffer

    2012-01-01

    Initially developed for applications in detector and accelerator physics, the modern Fluka Monte Carlo code is now used in many different areas of nuclear science. Over the last 25 years, the code has evolved to include new features, such as ion beam simulations. Given the growing use of these beams in cancer treatment, Fluka simulations are being used to design treatment plans in several hadron-therapy centres in Europe.   Fluka calculates the dose distribution for a patient treated at CNAO with proton beams. The colour-bar displays the normalized dose values. Fluka is a Monte Carlo code that very accurately simulates electromagnetic and nuclear interactions in matter. In the 1990s, in collaboration with NASA, the code was developed to predict potential radiation hazards received by space crews during possible future trips to Mars. Over the years, it has become the standard tool to investigate beam-machine interactions, radiation damage and radioprotection issues in the CERN accelerator com...

  13. Proton and heavy ion beam (charged particle therapy)

    International Nuclear Information System (INIS)

    Kanai, Tatsuaki

    2003-01-01

    There are distinguished therapeutic irradiation facilities of proton and heavy ion beam in Japan. The beam, due to its physical properties, is advantageous for focusing on the lesion in the body and for reducing the exposure dose to normal tissues, relative to X-ray. This makes it possible to irradiate the target lesion with the higher dose. The present review describes physical properties of the beam, equipments for the therapeutic irradiation, the respiratory-gated irradiation system, the layer-stacking irradiation system, therapy planning, and future prospect of the therapy. More than 1,400 patients have received the therapy in National Institute of Radiological Sciences (NIRS) and given a good clinical outcome. The targets are cancers of the head and neck, lung, liver, uterine and prostate, and osteosarcoma. The therapy of osteosarcoma is particularly important, which bringing about the high cure rate. Severe adverse effects are not seen with exception for the digestive tract ulcer. Many attempts like the respiratory-gated and layer-stacking systems and to shorten the therapy period to within 1 week are in progress. (N.I.)

  14. Proton beam therapy how protons are revolutionizing cancer treatment

    CERN Document Server

    Yajnik, Santosh

    2013-01-01

    Proton beam therapy is an emerging technology with promise of revolutionizing the treatment of cancer. While nearly half of all patients diagnosed with cancer in the US receive radiation therapy, the majority is delivered via electron accelerators, where photons are used to irradiate cancerous tissue. Because of the physical properties of photon beams, photons may deposit energy along their entire path length through the body. On the other hand, a proton beam directed at a tumor travels in a straight trajectory towards its target, gives off most of its energy at a defined depth called the Bragg peak, and then stops. While photons often deposit more energy within the healthy tissues of the body than within the cancer itself, protons can deposit most of their cancer-killing energy within the area of the tumor. As a result, in the properly selected patients, proton beam therapy has the ability to improve cure rates by increasing the dose delivered to the tumor and simultaneously reduce side-effects by decreasing...

  15. 21 CFR 892.5710 - Radiation therapy beam-shaping block.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiation therapy beam-shaping block. 892.5710... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5710 Radiation therapy beam-shaping block. (a) Identification. A radiation therapy beam-shaping block is a device made of a highly...

  16. Nano-scale processes behind ion-beam cancer therapy

    Science.gov (United States)

    Surdutovich, Eugene; Garcia, Gustavo; Mason, Nigel; Solov'yov, Andrey V.

    2016-04-01

    This topical issue collates a series of papers based on new data reported at the third Nano-IBCT Conference of the COST Action MP1002: Nanoscale Insights into Ion Beam Cancer Therapy, held in Boppard, Germany, from October 27th to October 31st, 2014. The Nano-IBCT COST Action was launched in December 2010 and brought together more than 300 experts from different disciplines (physics, chemistry, biology) with specialists in radiation damage of biological matter from hadron-therapy centres, and medical institutions. This meeting followed the first and the second conferences of the Action held in October 2011 in Caen, France and in May 2013 in Sopot, Poland respectively. This conference series provided a focus for the European research community and has highlighted the pioneering research into the fundamental processes underpinning ion beam cancer therapy. Contribution to the Topical Issue "COST Action Nano-IBCT: Nano-scale Processes Behind Ion-Beam Cancer Therapy", edited by Andrey V. Solov'yov, Nigel Mason, Gustavo Garcia and Eugene Surdutovich.

  17. The Effectiveness of Technology-Supported Exercise Therapy for Low Back Pain: A Systematic Review.

    Science.gov (United States)

    Matheve, Thomas; Brumagne, Simon; Timmermans, Annick A A

    2017-05-01

    Various technological systems have been developed to assist exercise therapy for low back pain. The aim of this systematic review was to provide an overview and to assess the effectiveness of the available technology-supported exercise therapy (TSET) programs for low back pain. The electronic databases Pubmed, Embase, Cochrane Central Register of Controlled Trials, PEDro, IEEE, and ACM were searched until January 2016. Randomized controlled trials (RCTs) using electronic technological systems simultaneously with exercise therapy for patients with low back pain were included. Twenty-five RCTs met the inclusion criteria. Seventeen studies involved patients with chronic low back pain, and electromyography biofeedback was the most prevalent type of technological support. This review shows that TSET seems to improve pain, disability, and quality of life for patients with low back pain, and that a standard treatment combined with an additional TSET program might be superior to a standard treatment alone. However, TSET seems not more effective compared to other interventions or a placebo intervention for improving these outcomes, which may partially be explained by the analytical approach of the current TSET-programs. For most technologies, only a limited number of RCTs are available, making it difficult to draw firm conclusions about the effectiveness of individual technological systems.

  18. Trabeculectomy in patients with uveal melanoma after proton beam therapy.

    Science.gov (United States)

    Riechardt, Aline I; Cordini, Dino; Rehak, Matus; Hager, Annette; Seibel, Ira; Böker, Alexander; Gundlach, Enken; Heufelder, Jens; Joussen, Antonia M

    2016-07-01

    Retrospective evaluation of intraocular pressure, use of topical and systemic anti-glaucoma medication, secondary complications, local tumor control and survival in patients treated with trabeculectomy for the regulation of the intraocular pressure (IOP) after proton beam therapy for uveal melanoma. In this retrospective clinical case series we evaluated the follow-up of 15 patients receiving a trabeculectomy as surgical treatment if the IOP could not be lowered adequately by medications or laser surgery. All patients had received proton beam therapy for uveal melanoma at the Helmholtz-Zentrum Berlin between 1998 and 2010. The median IOP decreased significantly from 35 mmHg ± 8.8 before TE to 16 mmHg ± 8.2 (=52.3 %) six months after TE (Wilcoxon-Mann-Whitney-U Test, p<0.01). None of the patients needed any glaucoma medication six months after trabeculectomy. Two patients developed local recurrence during follow-up, which were independent of the trabeculectomy. One patient had to be enucleated due to intractable pain and suspected remaining tumor activity. One patient died due to metastasis. Trabeculectomy is an option in intractable glaucoma in patients with uveal melanoma after proton beam therapy in single cases. Secondary interventions are common. Inoculation metastases are possible. Secure local tumor control must be a prerequisite for filtrating operations.

  19. Total skin electron therapy as treatment for epitheliotropic lymphoma in a dog.

    Science.gov (United States)

    Santoro, Domenico; Kubicek, Lyndsay; Lu, Bo; Craft, William; Conway, Julia

    2017-04-01

    Mycosis fungoides (MF) is an uncommon cutaneous neoplasm in dogs. Treatment options are limited. Total skin electron therapy (TSET) has been suggested as a possible therapy for canine MF. To describe the use of TSET as palliative treatment for MF in a dog. An adult dog, previously diagnosed with nonepidermolytic ichthyosis, was presented with generalized erythroderma, alopecia and erosions. Histopathology revealed a densely cellular, well-demarcated, unencapsulated infiltrate extending from the epidermis to the mid-dermis compatible with MF. The infiltrate exhibited epitheliotropism multifocally for the epidermis, infundibula and adnexa. Due to a lack of response to chemotherapy, TSET was elected. Six megavoltage electrons were delivered using a 21EX Varian linear accelerator. A dose of 6 Gy was delivered to the skin surface and a 100 cm skin to surface distance was used for dog setup. The treatment time for the cranial half treatment was 3 h. The treatment was divided in two sessions (cranial and caudal halves of the body) 15 days apart. Clinical and histopathological complete remission was achieved and the dog was kept in remission with no additional treatments for 19 months before relapse and development of Sézary syndrome. To the best of the authors' knowledge, this is the first case reporting the use of TSET for medically refractory canine MF with post treatment follow-up. This case suggests that the use of TSET may be an effective palliative treatment for canine MF. © 2017 ESVD and ACVD.

  20. Dosimetric consequences of pencil beam width variations in scanned beam particle therapy

    International Nuclear Information System (INIS)

    Chanrion, M A; Ammazzalorso, F; Wittig, A; Engenhart-Cabillic, R; Jelen, U

    2013-01-01

    Scanned ion beam delivery enables the highest degree of target dose conformation attainable in external beam radiotherapy. Nominal pencil beam widths (spot sizes) are recorded during treatment planning system commissioning. Due to changes in the beam-line optics, the actual spot sizes may differ from these commissioning values, leading to differences between planned and delivered dose. The purpose of this study was to analyse the dosimetric consequences of spot size variations in particle therapy treatment plans. For 12 patients with skull base tumours and 12 patients with prostate carcinoma, scanned-beam carbon ion and proton treatment plans were prepared and recomputed simulating spot size changes of (1) ±10% to simulate the typical magnitude of fluctuations, (2) ±25% representing the worst-case scenario and (3) ±50% as a part of a risk analysis in case of fault conditions. The primary effect of the spot size variation was a dose deterioration affecting the target edge: loss of target coverage and broadening of the lateral penumbra (increased spot size) or overdosage and contraction of the lateral penumbra (reduced spot size). For changes ⩽25%, the resulting planning target volume mean 95%-isodose line coverage (CI-95%) deterioration was ranging from negligible to moderate. In some cases changes in the dose to adjoining critical structures were observed. (paper)

  1. Pitfalls of tungsten multileaf collimator in proton beam therapy

    International Nuclear Information System (INIS)

    Moskvin, Vadim; Cheng, Chee-Wai; Das, Indra J.

    2011-01-01

    Purpose: Particle beam therapy is associated with significant startup and operational cost. Multileaf collimator (MLC) provides an attractive option to improve the efficiency and reduce the treatment cost. A direct transfer of the MLC technology from external beam radiation therapy is intuitively straightforward to proton therapy. However, activation, neutron production, and the associated secondary cancer risk in proton beam should be an important consideration which is evaluated. Methods: Monte Carlo simulation with FLUKA particle transport code was applied in this study for a number of treatment models. The authors have performed a detailed study of the neutron generation, ambient dose equivalent [H*(10)], and activation of a typical tungsten MLC and compared with those obtained from a brass aperture used in a typical proton therapy system. Brass aperture and tungsten MLC were modeled by absorber blocks in this study, representing worst-case scenario of a fully closed collimator. Results: With a tungsten MLC, the secondary neutron dose to the patient is at least 1.5 times higher than that from a brass aperture. The H*(10) from a tungsten MLC at 10 cm downstream is about 22.3 mSv/Gy delivered to water phantom by noncollimated 200 MeV beam of 20 cm diameter compared to 14 mSv/Gy for the brass aperture. For a 30-fraction treatment course, the activity per unit volume in brass aperture reaches 5.3 x 10 4 Bq cm -3 at the end of the last treatment. The activity in brass decreases by a factor of 380 after 24 h, additional 6.2 times after 40 days of cooling, and is reduced to background level after 1 yr. Initial activity in tungsten after 30 days of treating 30 patients per day is about 3.4 times higher than in brass that decreases only by a factor of 2 after 40 days and accumulates to 1.2 x 10 6 Bq cm -3 after a full year of operation. The daily utilization of the MLC leads to buildup of activity with time. The overall activity continues to increase due to 179 Ta with

  2. Fast pencil beam dose calculation for proton therapy using a double-Gaussian beam model

    Directory of Open Access Journals (Sweden)

    Joakim eda Silva

    2015-12-01

    Full Text Available The highly conformal dose distributions produced by scanned proton pencil beams are more sensitive to motion and anatomical changes than those produced by conventional radiotherapy. The ability to calculate the dose in real time as it is being delivered would enable, for example, online dose monitoring, and is therefore highly desirable. We have previously described an implementation of a pencil beam algorithm running on graphics processing units (GPUs intended specifically for online dose calculation. Here we present an extension to the dose calculation engine employing a double-Gaussian beam model to better account for the low-dose halo. To the best of our knowledge, it is the first such pencil beam algorithm for proton therapy running on a GPU. We employ two different parametrizations for the halo dose, one describing the distribution of secondary particles from nuclear interactions found in the literature and one relying on directly fitting the model to Monte Carlo simulations of pencil beams in water. Despite the large width of the halo contribution, we show how in either case the second Gaussian can be included whilst prolonging the calculation of the investigated plans by no more than 16%, or the calculation of the most time-consuming energy layers by about 25%. Further, the calculation time is relatively unaffected by the parametrization used, which suggests that these results should hold also for different systems. Finally, since the implementation is based on an algorithm employed by a commercial treatment planning system, it is expected that with adequate tuning, it should be able to reproduce the halo dose from a general beam line with sufficient accuracy.

  3. Ion spectroscopy for improvement of the physical beam model for therapy planning in ion beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Arico, Giulia

    2016-11-23

    Helium and carbon ions enable a more conformal dose distribution, narrower penumbra and higher relative biological effectiveness than photon and proton radiotherapy. However, they may undergo nuclear fragmentation in the patient tissues and the arising secondary fragments affect the delivered biological dose distributions. Currently there is a lack of data regarding ion nuclear fragmentation. One reason is the large size (up to some meters) of the experimental setups required for the investigations. In this thesis a new method is presented, which makes use of versatile pixelated semiconductor detectors (Timepix). This method is based on tracking of single particles and pattern recognition of their signals in the detectors. Measurements were performed at the HIT facility. The mixed radiation field arising from 430 MeV/u carbon ion beams and 221 MeV/u helium ion beams in water and in PMMA targets was investigated. The amounts of primary (carbon or helium) ions detected behind targets with the same water equivalent thickness (WET) were found to be in agreement within the statistical uncertainties. However, more fragments (differences up to 20% in case of H) and narrower lateral particle distributions were measured behind the PMMA than the water targets. The spectra of ions behind tissue surrogates and corresponding water targets with the same WET were analysed. The results obtained with adipose and inner bone surrogates and with the equivalent water phantoms were found to be consistent within the uncertainties. Significant differences in the results were observed in the case of lung and cortical bone surrogates when compared to the water phantoms. The experimental results were compared to FLUKA Monte Carlo simulations. This comparison could contribute to enhance the ion interaction models currently implemented for {sup 12}C and {sup 4}He ion beams.

  4. Status of the Medaustron Ion Beam Therapy centre

    CERN Document Server

    Dorda, U; Osmic, F; Benedikt, M

    2012-01-01

    MedAustron is a synchrotron based light-ion beam therapy centre for cancer treatment as well as for clinical and non-clinical research currently in its construction phase. The accelerator design is based on the CERN-PIMMS study and its technical implementation by CNAO. This paper presents a status overview over the whole project detailing the achieved progress of the building construction & technical infrastructure installation in Wiener Neustadt, Austria, as well as of the accelerator development, performed at CERN and partially at PSI. The design and procurement status and future planning of the various accelerator components is elaborated.

  5. Alanine EPR dosimeter response in proton therapy beams

    International Nuclear Information System (INIS)

    Gall, K.; Serago, C.; Desrosiers, M.; Bensen, D.

    1997-01-01

    We report a series of measurements directed to assess the suitability of alanine as a mailable dosimeter for dosimetry quality assurance of proton radiation therapy beams. These measurements include dose-response of alanine at 140 MeV, and comparison of response vs energy with a parallel plate ionization chamber. All irradiations were made at the Harvard Cyclotron Laboratory, and the dosimeters were read at NIST. The results encourage us that alanine could be expected to serve as a mailable dosimeter with systematic error due to differential energy response no greater than 3% when doses of 25 Gy are used. (Author)

  6. Quantitative analysis of beam delivery parameters and treatment process time for proton beam therapy

    International Nuclear Information System (INIS)

    Suzuki, Kazumichi; Gillin, Michael T.; Sahoo, Narayan; Zhu, X. Ronald; Lee, Andrew K.; Lippy, Denise

    2011-01-01

    Purpose: To evaluate patient census, equipment clinical availability, maximum daily treatment capacity, use factor for major beam delivery parameters, and treatment process time for actual treatments delivered by proton therapy systems. Methods: The authors have been recording all beam delivery parameters, including delivered dose, energy, range, spread-out Bragg peak widths, gantry angles, and couch angles for every treatment field in an electronic medical record system. We analyzed delivery system downtimes that had been recorded for every equipment failure and associated incidents. These data were used to evaluate the use factor of beam delivery parameters, the size of the patient census, and the equipment clinical availability of the facility. The duration of each treatment session from patient walk-in and to patient walk-out of the treatment room was measured for 82 patients with cancers at various sites. Results: The yearly average equipment clinical availability in the last 3 yrs (June 2007-August 2010) was 97%, which exceeded the target of 95%. Approximately 2200 patients had been treated as of August 2010. The major disease sites were genitourinary (49%), thoracic (25%), central nervous system (22%), and gastrointestinal (2%). Beams have been delivered in approximately 8300 treatment fields. The use factor for six beam delivery parameters was also evaluated. Analysis of the treatment process times indicated that approximately 80% of this time was spent for patient and equipment setup. The other 20% was spent waiting for beam delivery and beam on. The total treatment process time can be expressed by a quadratic polynomial of the number of fields per session. The maximum daily treatment capacity of our facility using the current treatment processes was estimated to be 133 ± 35 patients. Conclusions: This analysis shows that the facility has operated at a high performance level and has treated a large number of patients with a variety of diseases. The use

  7. Expanding options in radiation oncology: neutron beam therapy

    International Nuclear Information System (INIS)

    Cohen, L.

    1982-01-01

    Twelve years experience with neutron beam therapy in Britain, the USA, Europe and Japan shows that local control is achievable in late-stage epidermoid cancer somewhat more frequently than with conventional radiotherapy. Tumours reputed to be radioresistant (salivary gland, bladder, rectosigmoid, melanoma, bone and soft-tissue sarcomas) have proved to be particularly responsive to neutrons. Pilot studies in brain and pancreatic tumours suggest promising new approaches to management of cancer in these sites. The availability of neutron therapy in the clinical environment opens new prospects for irradiation of 'radioresistant' tumours, permits more conservative cancer surgery, expands the use of elective chemotherapy and provides a wider range of options for cancer patients. (author)

  8. Improving Outcomes for Esophageal Cancer using Proton Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Chuong, Michael D. [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland (United States); Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Jabbour, Salma K. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Yu, Jen; Badiyan, Shahed [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland (United States); Merrell, Kenneth W. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland (United States); Li, Heng [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Verma, Vivek [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Lin, Steven H., E-mail: shlin@mdanderson.org [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2016-05-01

    Radiation therapy (RT) plays an essential role in the management of esophageal cancer. Because the esophagus is a centrally located thoracic structure there is a need to balance the delivery of appropriately high dose to the target while minimizing dose to nearby critical structures. Radiation dose received by these critical structures, especially the heart and lungs, may lead to clinically significant toxicities, including pneumonitis, pericarditis, and myocardial infarction. Although technological advancements in photon RT delivery like intensity modulated RT have decreased the risk of such toxicities, a growing body of evidence indicates that further risk reductions are achieved with proton beam therapy (PBT). Herein we review the published dosimetric and clinical PBT literature for esophageal cancer, including motion management considerations, the potential for reirradiation, radiation dose escalation, and ongoing esophageal PBT clinical trials. We also consider the potential cost-effectiveness of PBT relative to photon RT.

  9. Cutaneous complication after electron beam therapy in breast cancer

    Directory of Open Access Journals (Sweden)

    M Jalilian

    2005-11-01

    Full Text Available Background: Breast cancer is the most common cancer in women and the second cause of death among them. There are several treatment methods for breast cancer, one of which is radiation therapy. There are two important methods of radiation therapy: tangential field and single oppositional field. Main goal of this study is evaluation of factors that have a role in producing acute side effects such as skin burning in breast cancer patients treated by electron beam,in order to decrease these side effects. Methods: From 1/2003 through 7/2004, 200 consecutive patients were evaluated during 18 months in seid-al-shohad hospital, whose mean age was 49 years old. In this study a questionnaire was used including some questions about personal profile such as patient's name, address, registration number, age and some other factors. All patients who were candidated to enter in this investigation filled out the questionnaire at the end of radiation therapy. The patients were examined and their skin burning grades were evaluated by RTOG scale. Data were analyzed by chi-square test using SPSS 11 software. Results: None of patients showed grades O or 4 of burning. 31.5 % of Patients showed grade 1, 64.5 % showed grade 2, 4 % showed grade 3 of burning. There was statistically significant correlation between posterior axillary field and skin burning and there wasnot any meaning between the other factors. Conclusion: It is necessary to pay more attention to posterior axillary field planning including field size, location, photon energy, depth and dose of treatment. Keywords: breast cancer, electron beam radiation therapy, skin burning

  10. Beam tests on a proton linac booster for hadron therapy

    CERN Document Server

    De Martinis, C; Berra, P; Birattari, C; Calabretta, L; Crandall, K; Giove, D; Masullo, M R; Mauri, M; Rosso, E; Rovelli, A; Serafini, L; Szeless, Balázs; Toet, D Z; Vaccaro, Vittorio G; Weiss, M; Zennaro, R

    2002-01-01

    LIBO is a 3 GHz modular side-coupled proton linac booster designed to deliver beam energies up to 200 MeV, as required for the therapy of deep seated tumours. The injected beam of 50 to 70 MeV is produced by a cyclotron like those in several hospitals and research institutes. A full-scale prototype of the first module with an input/output energy of 62/74 MeV, respectively, was designed and built in 1999 and 2000. Full power RF tests were carried out successfully at CERN using a test facility at LIL at the end of the year 2000. In order to prove the feasibility of the acceleration process, an experimental setup with this module was installed at the INFN Laboratorio Nazionale del Sud (LNS) in Catania during 2001. The superconducting cyclotron provided the 62 MeV test beam. A compact solid-state RF modulator with a 4 MW klystron, made available by IBA-Scanditronix, was put into operation to power the linac. In this paper the main features of the accelerator are reviewed and the experimental results obtained duri...

  11. A beam monitor based on MPGD detectors for hadron therapy

    Science.gov (United States)

    Altieri, P. R.; Di Benedetto, D.; Galetta, G.; Intonti, R. A.; Mercadante, A.; Nuzzo, S.; Verwilligen, P.

    2018-02-01

    Remarkable scientific and technological progress during the last years has led to the construction of accelerator based facilities dedicated to hadron therapy. This kind of technology requires precise and continuous control of position, intensity and shape of the ions or protons used to irradiate cancers. Patient safety, accelerator operation and dose delivery should be optimized by a real time monitoring of beam intensity and profile during the treatment, by using non-destructive, high spatial resolution detectors. In the framework of AMIDERHA (AMIDERHA - Enhanced Radiotherapy with HAdron) project funded by the Ministero dell'Istruzione, dell'Università e della Ricerca (Italian Ministry of Education and Research) the authors are studying and developing an innovative beam monitor based on Micro Pattern Gaseous Detectors (MPDGs) characterized by a high spatial resolution and rate capability. The Monte Carlo simulation of the beam monitor prototype was carried out to optimize the geometrical set up and to predict the behavior of the detector. A first prototype has been constructed and successfully tested using 55Fe, 90Sr and also an X-ray tube. Preliminary results on both simulations and tests will be presented.

  12. Development of total-skin electron therapy at two energies

    International Nuclear Information System (INIS)

    Cox, R.S.; Heck, R.J.; Fessenden, P.; Karzmark, C.J.; Rust, D.C.

    1990-01-01

    Total-Skin Electron Therapy (TSET) modalities have been developed at two energies on a Varian Clinac 1800. The physical criteria for the beams were determined mainly from the requirement of continuing the Stanford treatment technique, which was 12 Total-Skin Electron Therapy portals combined in six pairs. The penetration of the lower energy mode matches that previously obtained at Stanford on the Varian Clinac 10, (about 4 mm for the 80% isodose contour in the 12-field treatment). The penetration of the higher energy mode is about 8 mm at the 80% contour. The Total-Skin Electron Therapy modes necessarily use electrons produced by the two standard electron-beam modes of lowest energy, nominally 6 and 9 MeV. Measurements to verify the beam specifications were carried out with diodes, a variety of ionization chambers, and a specially constructed circular phantom for film dosimetry. Initially, the penetration of the Total-Skin Electron Therapy beams was too large to match our criteria, so two methods of reducing it were explored: (a) the energies of the electron beams produced by the machine were reduced (which also reduced the energies of the corresponding standard electron modes) and (b) a large polymethylmethacrylate degrader (2.4 m X 1.2 m) 1 cm thick was placed just in front of the patient plane. Acceptable Total-Skin Electron Therapy beams could be produced by either method and the latter was finally used. The use of the standard dose monitoring system for the Total-Skin Electron Therapy modes considerably simplifies the daily treatment delivery as well as the implementation. However, the need for reasonable dose rates at the treatment plane (3.5 meters beyond the isocenter) requires dose rates of 24 Gy/min at the isocenter. Nevertheless, it is possible to use the internal dose monitor provided the problems associated with high dose rates are addressed

  13. The beam monitor system for heavy ion shallow in tumor therapy

    International Nuclear Information System (INIS)

    Tang Bin; Hu Zhengguo; Xu Zhiguo; Mao Ruishi; Zhang Xueheng; Tu Xiaolin; Guo Zhongyan; Sun Zhiyu; Wang Meng; Xiao Guoqing; Xu Hushan

    2008-01-01

    The program of heavy ion shallow tumor therapy has been started. The beam monitor system for the therapy is described in this paper. It is composed of plastic scintillator, which used to monitor the stability of beam intensity and control the irradiation dose, and PPAC which is to measure the beam homogeneity in the irradiation area. This system has shown good performance in the clinic experiments of the shallow tumor therapy. (authors)

  14. Treatment facilities, human resource development, and future prospect of particle beam therapy

    International Nuclear Information System (INIS)

    Tamaki, Tomoaki; Nakano, Takashi

    2015-01-01

    The number of particle beam therapy facilities is increasing globally. Among the countries practicing particle beam therapy, Japan is one of the leading countries in the field with four operating carbon-ion therapy facilities and ten operating proton therapy facilities. With the increasing number of particle beam therapy facilities, the human resource development is becoming extremely important, and there has been many such efforts including the Gunma University Program for Cultivating Global Leaders in Heavy Ion Therapeutics and Engineering, which aimed to educate and train the radiation oncologists, medical physicists, accelerator engineers, and radiation biologists to become global leaders in the field of particle beam therapy. In the future, the benefit and effectiveness of particle beam therapy should be discussed and elucidated objectively in a framework of comprehensive cancer care. (author)

  15. Selection of carbon beam therapy: biophysical models of carbon beam therapy.

    Science.gov (United States)

    Matsufuji, Naruhiro

    2018-03-01

    Variation in the relative biological effectiveness (RBE) within the irradiation field of a carbon beam makes carbon-ion radiotherapy unique and advantageous in delivering the therapeutic dose to a deep-seated tumor, while sparing surrounding normal tissues. However, it is crucial to consider the RBE, not only in designing the dose distribution during treatment planning, but also in analyzing the clinical response retrospectively. At the National Institute of Radiological Sciences, the RBE model was established based on the response of human salivary gland cells. The response was originally handled with a linear-quadratic model, and later with a microdosimetric kinetic model. Retrospective analysis with a tumor-control probability model of non-small cell cancer treatment revealed a steep dose response in the tumor, and that the RBE of the tumor was adequately estimated using the model. A commonly used normal tissue complication probability model has not yet fully been accountable for the variable RBE of carbon ions; however, analysis of rectum injury after prostate cancer treatment suggested a highly serial-organ structure for the rectum, and a steep dose response similar to that observed for tumors.

  16. Fast optimization and dose calculation in scanned ion beam therapy

    International Nuclear Information System (INIS)

    Hild, S.; Graeff, C.; Trautmann, J.; Kraemer, M.; Zink, K.; Durante, M.; Bert, C.

    2014-01-01

    Purpose: Particle therapy (PT) has advantages over photon irradiation on static tumors. An increased biological effectiveness and active target conformal dose shaping are strong arguments for PT. However, the sensitivity to changes of internal geometry complicates the use of PT for moving organs. In case of interfractionally moving objects adaptive radiotherapy (ART) concepts known from intensity modulated radiotherapy (IMRT) can be adopted for PT treatments. One ART strategy is to optimize a new treatment plan based on daily image data directly before a radiation fraction is delivered [treatment replanning (TRP)]. Optimizing treatment plans for PT using a scanned beam is a time consuming problem especially for particles other than protons where the biological effective dose has to be calculated. For the purpose of TRP, fast optimization and fast dose calculation have been implemented into the GSI in-house treatment planning system (TPS) TRiP98. Methods: This work reports about the outcome of a code analysis that resulted in optimization of the calculation processes as well as implementation of routines supporting parallel execution of the code. To benchmark the new features, the calculation time for therapy treatment planning has been studied. Results: Compared to the original version of the TPS, calculation times for treatment planning (optimization and dose calculation) have been improved by a factor of 10 with code optimization. The parallelization of the TPS resulted in a speedup factor of 12 and 5.5 for the original version and the code optimized version, respectively. Hence the total speedup of the new implementation of the authors' TPS yielded speedup factors up to 55. Conclusions: The improved TPS is capable of completing treatment planning for ion beam therapy of a prostate irradiation considering organs at risk in this has been overseen in the review process. Also see below 6 min

  17. Salvage proton beam therapy for recurrent iris melanoma: outcome and side effects.

    Science.gov (United States)

    Riechardt, Aline I; Klein, Julian P; Cordini, Dino; Heufelder, Jens; Rehak, Matus; Seibel, Ira; Joussen, Antonia M

    2018-02-20

    This study aims to analyze the effect of salvage proton beam therapy for the treatment of recurrent iris melanoma. In this clinical case series, we retrospectively analyzed the data of eight patients who underwent proton beam therapy of the whole anterior segment as salvage therapy between 2000 and 2016 for recurrent iris melanoma after resection, ruthenium brachytherapy, or sector proton beam therapy. Two patients received salvage proton beam therapy for repeated tumor relapse. All patients were observed and prepared for proton beam therapy at the Charité and irradiated at the Helmholtz-Zentrum Berlin where they received 50 cobalt Gray equivalents (CGE) in four daily fractions. We investigated survival rates and ocular outcome. Median follow-up after salvage proton beam therapy was 39 months. No local recurrence was detected during follow-up. One patient died from hepatic metastases 5.5 years after salvage therapy. Secondary glaucoma occurred in seven out of eight patients during follow-up. Two patients had chronic corneal erosion and two other patients presented with corneal decompensation, necessitating Descemet membrane endothelial keratoplasty (DMEK), and perforating keratoplasty. Median visual acuity was 0.2 logMAR before salvage proton beam therapy and 0.7 logMAR at the end of follow-up. Whole anterior segment salvage proton beam therapy has effectively controlled recurrent iris melanoma in our patients, but has been associated with a high incidence of radiation-induced corneal impairment and secondary glaucoma requiring extensive secondary treatment.

  18. Research advances in proton beam therapy for hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    DAI Shuyang

    2013-10-01

    Full Text Available Hepatocellular carcinoma (HCC, one of the most common malignancies with high prevalence and mortality rate, usually results in poor prognosis and limited survival. A comprehensive analysis on the number and location of tumors, Child-Pugh grade, and Barcelona Clinic Liver Cancer stage will help the development of suitable treatment programs and improve prediction of prognosis. A majority of patients are complicated by cirrhosis, enlarged tumor, multiple lesions, vascular invasion, and even cancer embolus in the portal vein. With the growth of knowledge about the radiation tolerance of normal tissue and the advances in radiotherapy techniques, radiotherapy has become an important tool for step-down therapy and adjuvant therapy for liver cancer. Proton beam therapy (PBT is emerging as a novel radiotherapy for the management of HCC, which, benefiting from the effect of Bragg Peak from PBT, effectively decreases the toxicity of traditional radiotherapies to the liver and does little harm to the uninvolved liver tissue or the surrounding structures while intensifying the destruction in targeted malignant lesions. Furthermore, several previous studies on the treatment of HCC with PBT revealed excellent local control. The distinctive biophysical attributes of PBT in the treatment of HCC, as well as the available literature regarding clinical outcomes and toxicity of using PBT for HCC, are reviewed. Current evidence provides limited indications for PBT, which suggests that further study on the relationship between liver function and PBT is required to gain further insight into its indication and standardization.

  19. Charged particle therapy with mini-segmented beams

    Directory of Open Access Journals (Sweden)

    F. Avraham eDilmanian

    2015-12-01

    Full Text Available One of the fundamental attributes of proton therapy and carbon ion therapy is the ability of these charged particles to spare tissue distal to the targeted tumor. This significantly reduces normal tissue toxicity and has the potential to translate to a wider therapeutic index. Although, in general, particle therapy also reduces dose to the proximal tissues, particularly in the vicinity of the target, dose to the skin and to other very superficial tissues tends to be higher than that of megavoltage x-rays. The methods presented here, namely Interleaved carbon minibeams and Radiosurgery with arrays of proton and light ion minibeams, both utilize beams segmented into arrays of parallel minibeams of about 0.3 mm incident beam size. These minibeam arrays spare tissues, as demonstrated by synchrotron x-ray experiments. An additional feature of particle minibeams is their gradual broadening due to multiple Coulomb scattering as they penetrate tissues. In the case of interleaved carbon minibeams, which do not broaden much, two arrays of planar carbon minibeams that remain parallel at target depth, are aimed at the target from 90º angles and made to interleave at the target to produce a solid radiation field within the target. As a result the surrounding tissues are exposed only to individual carbon minibeam arrays and are therefore spared. The method was used in four-directional geometry at the NASA Space Radiation Laboratory to ablate a 6.5-mm target in a rabbit brain at a single exposure with 40 Gy physical absorbed dose. Contrast-enhanced magnetic resonance imaging and histology six month later showed very focal target necrosis with nearly no damage to the surrounding brain. As for minibeams of protons and light ions, for which the minibeam broadening is substantial, measurements at MD Anderson Cancer Center in Houston, Texas, and Monte Carlo simulations showed that the broadening minibeams will merge with their neighbors at a certain tissue depth

  20. Electron beam therapy with coil-generated magnetic fields

    International Nuclear Information System (INIS)

    Nardi, Eran; Barnea, Gideon; Ma, Chang-Ming

    2004-01-01

    This paper presents an initial study on the issues involved in the practical implementation of the use of transverse magnetic fields in electron beam therapy. By using such magnetic fields the dose delivered to the tumor region can increase significantly relative to that deposited to the healthy tissue. Initially we calculated the magnetic fields produced by the Helmholtz coil and modified Helmholtz coil configurations. These configurations, which can readily be used to generate high intensity magnetic fields, approximate the idealized magnetic fields studied in our previous publications. It was therefore of interest to perform a detailed study of the fields produced by these configurations. Electron beam dose distributions for 15 MeV electrons were calculated using the ACCEPTM code for a 3T transverse magnetic field produced by the modified Helmholtz configuration. The dose distribution was compared to those obtained with no magnetic field. The results were similar to those obtained in our previous work, where an idealized step function magnetic field was used and a 3T field was shown to be the optimal field strength. A simpler configuration was also studied in which a single external coil was used to generate the field. Electron dose distributions are also presented for a given geometry and given magnetic field strength using this configuration. The results indicate that this method is more difficult to apply to radiotherapy due to its lack of symmetry and its irregularity. For the various configurations dealt with here, a major problem is the need to shield the magnetic field in the beam propagation volume, a topic that must be studied in detail

  1. MedAustron - Ion-Beam Therapy and Research Center

    International Nuclear Information System (INIS)

    Schreiner, Thomas; Seemann, Rolf

    2015-01-01

    MedAustron is a synchrotron-based light-ion beam therapy center for cancer treatment as well as for clinical and non-clinical research, currently in the commissioning phase in Wiener Neustadt, Austria. Recently, the first proton beam was transported successfully to one of the four irradiation rooms. Whilst the choice of basic machine parameters was driven by medical requirements, i.e. 60 MeV protons and 120 MeV/A to 400 MeV/A carbon ions, the accelerator complex design was also optimized to offer flexibility for research operation. The potential of the synchrotron is being exploited to increase the maximum proton energy far beyond the medical needs to up to 800 MeV, for experimental physics applications, mainly in the areas of proton scattering and detector research. The accelerator layout allows for the installation of up to four ion source-spectrometer units, to provide various ion types besides the clinical used protons and carbon ions. Besides experimental physics, the two main non-clinical research disciplines are medical radiation physics and radiation biology. To decouple research and medical operation, a dedicated irradiation room for non-clinical research was included providing the installation of different experiments. In addition, several labs have been equipped with appropriate devices for preparing and analyzing radio-biological samples. This presentation gives a status overview over the whole project and highlights the non-clinical research opportunities at MedAustron. (Author)

  2. Fast Pencil Beam Dose Calculation for Proton Therapy Using a Double-Gaussian Beam Model.

    Science.gov (United States)

    da Silva, Joakim; Ansorge, Richard; Jena, Rajesh

    2015-01-01

    The highly conformal dose distributions produced by scanned proton pencil beams (PBs) are more sensitive to motion and anatomical changes than those produced by conventional radiotherapy. The ability to calculate the dose in real-time as it is being delivered would enable, for example, online dose monitoring, and is therefore highly desirable. We have previously described an implementation of a PB algorithm running on graphics processing units (GPUs) intended specifically for online dose calculation. Here, we present an extension to the dose calculation engine employing a double-Gaussian beam model to better account for the low-dose halo. To the best of our knowledge, it is the first such PB algorithm for proton therapy running on a GPU. We employ two different parameterizations for the halo dose, one describing the distribution of secondary particles from nuclear interactions found in the literature and one relying on directly fitting the model to Monte Carlo simulations of PBs in water. Despite the large width of the halo contribution, we show how in either case the second Gaussian can be included while prolonging the calculation of the investigated plans by no more than 16%, or the calculation of the most time-consuming energy layers by about 25%. Furthermore, the calculation time is relatively unaffected by the parameterization used, which suggests that these results should hold also for different systems. Finally, since the implementation is based on an algorithm employed by a commercial treatment planning system, it is expected that with adequate tuning, it should be able to reproduce the halo dose from a general beam line with sufficient accuracy.

  3. Intraoperative electron beam radiation therapy (IOEBRT) for carcinoma of the exocrine pancreas

    International Nuclear Information System (INIS)

    Dobelbower, R.R. Jr.; Konski, A.A.; Merrick, H.W. III; Bronn, D.G.; Schifeling, D.; Kamen, C.

    1991-01-01

    The abdominal cavities of 50 patients were explored in a specially constructed intraoperative radiotherapy operating amphitheater at the Medical College of Ohio. Twenty-six patients were treated with intraoperative and postoperative precision high dose external beam therapy, 12 with intraoperative irradiation but no external beam therapy, and 12 with palliative surgery alone. All but two patients completed the postoperative external beam radiation therapy as initially prescribed. The median survival time for patients treated with palliative surgery alone was 4 months, and that for patients treated with intraoperative radiotherapy without external beam therapy was 3.5 months. Patients undergoing intraoperative irradiation and external beam radiation therapy had a median survival time of 10.5 months. Four patients died within 30 days of surgery and two patients died of gastrointestinal hemorrhage 5 months posttreatment

  4. Total skin electron beam therapy for cutaneous lymphomas and leukemias

    International Nuclear Information System (INIS)

    Nisce, L.Z.; Chu, F.C.H.; Lee, H.S.; Filippa, D.; Kempin, S.; Coleman, M.

    1982-01-01

    Total skin electron beam therapy (TSEB) was used in the treatment of 33 patients with lymphoma and 13 patients with leukemia involving extensive segments of the skin surface. Twenty-two of 23 had lesions as a primary manifestation of lymphoma (primary cutaneous lymphoma-PCL) and 11 developed cutaneous lesions following disseminated nodal lymphoma (secondary cutaneous lymphoma-SCL). A once weekly fractionation scheme was employed to irradiate the entire skin surface with 3.5 to 4 MeV electron beam from a 6 MeV linear accelerator. During each weekly session, 400 rad were delivered to the entire skin and a complete course consisted of 4-6 consecutive weekly sessions. The majority of patients have been previously treated elsewhere for various periods and all patients have been at risk for a median of 12 months, range from 12-117 months following TSEB. Striking predominance of the diffuse pattern (76%) was demonstrated in both the PCL and SCL. There was extracutaneous involvement in 63% (13/22) of the PCL, nodal or visceral at onset of TSEB; median follow-up was 24 months, range 6-117 months; 20/22 (90%) of all patients obtained prompt relief of symptoms and complete regression of cutaneous lesions. Duration of cutaneous remission ranged from 6-96 months, median 18 months; in general, duration was adversly influenced by the presence of visceral involvement at onset of TSEB. Although cutaneous response among the patients with SCL and leukemia was equally good, many of these patients were treated for palliation because of rapid progression of their disease. Once weekly treatments were highly effective, well-tolerated and no untoward immediate or late effects have been noted in the bone marrow or normal skin irradiated

  5. LHCB: A LHCb-VELO module as beam quality monitor for proton therapy beam at the Clatterbridge Centre for Oncology

    CERN Multimedia

    Casse, G; Patel, G D; Smith, N A; Kacperek, A; Marsland, B

    2010-01-01

    The progress in detector technology, driven by the needs of particle tracking and vertexing in the present LHC and its upgrade (sLHC), has led to the design of silicon sensors with low mass, high granularity, high speed and unprecedented radiation hardness. The sensors designed for such a harsh environment can be profitably used for instrumenting the control systems of therapeutic hadron beams. The high granularity and readout clock speed are well suited for monitoring continuous beam currents. The low mass allows reduced interference with the beam whilst monitoring its profile with high precision. The high resolution and sensitivity to minimum ionising particles allows monitoring of the beam spot position by measurement of the halo in real time, without any interference with the beam spot used in therapy.

  6. 3D printed plastics for beam modulation in proton therapy

    International Nuclear Information System (INIS)

    Lindsay, C; Hoehr, C; Kumlin, J; Schaffer, P; Jirasek, A; Lee, R; Martinez, D M

    2015-01-01

    Two 3D printing methods, fused filament fabrication (FFF) and PolyJet™ (PJ) were investigated for suitability in clinical proton therapy (PT) energy modulation. Measurements of printing precision, printed density and mean stopping power are presented. FFF is found to be accurate to 0.1 mm, to contain a void fraction of 13% due to air pockets and to have a mean stopping power dependent on geometry. PJ was found to print accurate to 0.05 mm, with a material density and mean stopping power consistent with solid poly(methyl methacrylate) (PMMA). Both FFF and PJ were found to print significant, sporadic defects associated with sharp edges on the order of 0.2 mm. Site standard PT modulator wheels were printed using both methods. Measured depth-dose profiles with a 74 MeV beam show poor agreement between PMMA and printed FFF wheels. PJ printed wheel depth-dose agreed with PMMA within 1% of treatment dose except for a distal falloff discrepancy of 0.5 mm. (note)

  7. Early experience of proton beam therapy combined with chemotherapy for locally advanced oropharyngeal cancer

    International Nuclear Information System (INIS)

    Ishikawa, Youjirou; Nakamura, Tatsuya; Takada, Akinori; Takayama, Kanako; Makita, Chiyoko; Suzuki, Motohisa; Azami, Yusuke; Kikuchi, Yasuhiro; Fuwa, Nobukazu

    2013-01-01

    Between 2009 and 2012, 10 patients with advanced oropharyngeal cancer underwent proton therapy combined with chemotherapy. The initial results of this therapy were 8 complete response (CR) and 2 partial response (PR), local recurrence was detected 1 patient. Proton beam therapy combined with chemotherapy is thought to be an effective treatment for locally advanced oropharyngeal cancer. (author)

  8. Proton Beam Therapy and Concurrent Chemotherapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Steven H., E-mail: shlin@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Komaki, Ritsuko; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wei, Caimiao [Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Myles, Bevan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Guo Xiaomao [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Palmer, Matthew [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Swisher, Stephen G.; Hofstetter, Wayne L. [Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Cox, James D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-07-01

    Purpose: Proton beam therapy (PBT) is a promising modality for the management of thoracic malignancies. We report our preliminary experience of treating esophageal cancer patients with concurrent chemotherapy (CChT) and PBT (CChT/PBT) at MD Anderson Cancer Center. Methods and Materials: This is an analysis of 62 esophageal cancer patients enrolled on a prospective study evaluating normal tissue toxicity from CChT/PBT from 2006 to 2010. Patients were treated with passive scattering PBT with two- or three-field beam arrangement using 180 to 250 MV protons. We used the Kaplan-Meier method to assess time-to-event outcomes and compared the distributions between groups using the log-rank test. Results: The median follow-up time was 20.1 months for survivors. The median age was 68 years (range, 38-86). Most patients were males (82%) who had adenocarcinomas (76%) and Stage II-III disease (84%). The median radiation dose was 50.4 Gy (RBE [relative biologic equivalence]) (range, 36-57.6). The most common grade 2 to 3 acute toxicities from CChT/PBT were esophagitis (46.8%), fatigue (43.6%), nausea (33.9%), anorexia (30.1%), and radiation dermatitis (16.1%). There were two cases of grade 2 and 3 radiation pneumonitis and two cases of grade 5 toxicities. A total of 29 patients (46.8%) received preoperative CChT/PBT, with one postoperative death. The pathologic complete response (pCR) rate for the surgical cohort was 28%, and the pCR and near CR rates (0%-1% residual cells) were 50%. While there were significantly fewer local-regional recurrences in the preoperative group (3/29) than in the definitive CChT/PBT group (16/33) (log-rank test, p = 0.005), there were no differences in distant metastatic (DM)-free interval or overall survival (OS) between the two groups. Conclusions: This is the first report of patients treated with PBT/CChT for esophageal cancer. Our data suggest that this modality is associated with a few severe toxicities, but the pathologic response and clinical

  9. Intraoperative electron beam therapy and external photon beam therapy with lumpectomy as primary treatment for early breast cancer

    International Nuclear Information System (INIS)

    Dobelbower, R.R.; Merrick, H.W.; Eltaki, A.; Bronn, D.G.

    1989-01-01

    Between 1984 and 1988, seven women with breast cancer were treated with intraoperative electron beam therapy (IOEBT). All patients were Caucasian. Patient age ranged from 37 to 62 (median 53) years. Histopathology was infiltrating duct carcinoma (6/7) or medullary carcinoma (1/7). Four tumors were staged T1 N0 MO, one T1 N1 MO, one T2 N1 MO, and one lesion was recurrent. At the time of primary lumpectomy or axillary node dissection, a dose of 10 or 15 Gy IOEBT was administered to the tumor bed with 6 or 9 MeV electrons through the lumpectomy wound. All patients received 45 or 50 Gy over five to six weeks with 6 MV photons to the breast and, in four patients, to the regional nodes. Three patients received adjuvant chemotherapy and tamoxifen. No post-operative complications were observed. All patients are alive as of August, 1989, with no evidence of recurrent disease. Excellent cosmesis is the rule. Clinical and technical aspects of treatment are presented along with the rationale for the use of IOEBT in the primary definitive radiotherapeutic management of early breast cancer

  10. Faraday cup dosimetry in a proton therapy beam without collimation

    International Nuclear Information System (INIS)

    Grusell, Erik; Isacsson, Ulf; Montelius, Anders; Medin, Joakim

    1995-01-01

    A Faraday cup in a proton beam can give an accurate measurement of the number of protons collected by the cup. It is shown that the collection efficiency with a proper design can be close to unity. To be able to calibrate an ionization chamber from such a measurement, as is recommended in some dosimetry protocols, the energy spectrum of the proton beam must be accurately known. This is normally not the case when the lateral beam extension is defined by collimators. Therefore a method for relating an ionization chamber measurement in an uncollimated beam to the total number of protons in the beam has been developed and is described together with experimental results from calibrating an ionization chamber using this method in the therapeutic beam in Uppsala. This method is applicable to ionization chambers of any shape and the accuracy is estimated to be 1.6% (1 SD). (Author)

  11. A Monte Carlo-based treatment-planning tool for ion beam therapy

    CERN Document Server

    Böhlen, T T; Dosanjh, M; Ferrari, A; Haberer, T; Parodi, K; Patera, V; Mairan, A

    2013-01-01

    Ion beam therapy, as an emerging radiation therapy modality, requires continuous efforts to develop and improve tools for patient treatment planning (TP) and research applications. Dose and fluence computation algorithms using the Monte Carlo (MC) technique have served for decades as reference tools for accurate dose computations for radiotherapy. In this work, a novel MC-based treatment-planning (MCTP) tool for ion beam therapy using the pencil beam scanning technique is presented. It allows single-field and simultaneous multiple-fields optimization for realistic patient treatment conditions and for dosimetric quality assurance for irradiation conditions at state-of-the-art ion beam therapy facilities. It employs iterative procedures that allow for the optimization of absorbed dose and relative biological effectiveness (RBE)-weighted dose using radiobiological input tables generated by external RBE models. Using a re-implementation of the local effect model (LEM), theMCTP tool is able to perform TP studies u...

  12. Preparation of pediatric patients for treatment with proton beam therapy

    International Nuclear Information System (INIS)

    Mizumoto, Masashi; Oshiro, Yoshiko; Ayuzawa, Kaoru; Miyamoto, Toshio; Okumura, Toshiyuki; Fukushima, Takashi; Fukushima, Hiroko; Ishikawa, Hitoshi; Tsuboi, Koji; Sakurai, Hideyuki

    2015-01-01

    Purpose: Anesthesia is often used in proton beam therapy (PBT) for pediatric patients and this may prolong the treatment time. The aim of the study was to examine preparation of pediatric patients to allow smooth performance of PBT. Material and methods: Preparation was initiated 1–2 days before treatment planning CT and continued for 10 days. The patient first visited the facility to become familiar with the treatment room and staff. As the second step, the patient stayed in the treatment bed for a certain time with their mother, and then stayed on the treatment bed alone. Special fixtures painted with characters, music, and gifts were also prepared. Results: From 2010 to 2014, 111 pediatric patients underwent PBT. These patients were divided into 3 groups: 40 who could follow instructions well (group A, median age: 13.6 years old), 60 who could communicate, but found it difficult to stay alone for a long time (group B, median age: 4.6 years old), and 11 who could not follow instructions (group C, median age: 1.6 years old). Preparation was used for patients in group B. The mean treatment times in groups A, B and C were 13.6, 17.1, and 15.6 min, respectively, on PBT treatment days 2–6, and 11.8, 13.0, and 16.9 min, respectively, for the last 5 days of PBT treatment. The time reduction was significant in group B (p = 0.003). Conclusion: Preparation is useful for pediatric patients who can communicate. This approach allows PBT to be conducted more smoothly over a shorter treatment time

  13. Beam dynamics study in the C235 cyclotron for proton therapy

    International Nuclear Information System (INIS)

    Karamysheva, G.A.; Kostromin, S.A.

    2008-01-01

    Study of the beam dynamics in the C235 cyclotron dedicated to the proton therapy is presented. Results of the computer simulations of the particle motion in the measured magnetic field are given. Study of the resonance influence on the acceleration process was carried out. The corresponding tolerances on the magnetic field imperfections and transverse beam parameters were defined using these simulations

  14. Role of beam orientation optimization in intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Pugachev, Andrei; Li, Jonathan G.; Boyer, Arthur L.; Hancock, Steven L.; Le, Quynh-Thu; Donaldson, Sarah S.; Lei Xing

    2001-01-01

    Purpose: To investigate the role of beam orientation optimization in intensity-modulated radiation therapy (IMRT) and to examine the potential benefits of noncoplanar intensity-modulated beams. Methods and Materials: A beam orientation optimization algorithm was implemented. For this purpose, system variables were divided into two groups: beam position (gantry and table angles) and beam profile (beamlet weights). Simulated annealing was used for beam orientation optimization and the simultaneous iterative inverse treatment planning algorithm (SIITP) for beam intensity profile optimization. Three clinical cases were studied: a localized prostate cancer, a nasopharyngeal cancer, and a paraspinal tumor. Nine fields were used for all treatments. For each case, 3 types of treatment plan optimization were performed: (1) beam intensity profiles were optimized for 9 equiangular spaced coplanar beams; (2) orientations and intensity profiles were optimized for 9 coplanar beams; (3) orientations and intensity profiles were optimized for 9 noncoplanar beams. Results: For the localized prostate case, all 3 types of optimization described above resulted in dose distributions of a similar quality. For the nasopharynx case, optimized noncoplanar beams provided a significant gain in the gross tumor volume coverage. For the paraspinal case, orientation optimization using noncoplanar beams resulted in better kidney sparing and improved gross tumor volume coverage. Conclusion: The sensitivity of an IMRT treatment plan with respect to the selection of beam orientations varies from site to site. For some cases, the choice of beam orientations is important even when the number of beams is as large as 9. Noncoplanar beams provide an additional degree of freedom for IMRT treatment optimization and may allow for notable improvement in the quality of some complicated plans

  15. SU-E-T-577: Obliquity Factor and Surface Dose in Proton Beam Therapy

    International Nuclear Information System (INIS)

    Das, I; Andersen, A; Coutinho, L

    2015-01-01

    Purpose: The advantage of lower skin dose in proton beam may be diminished creating radiation related sequalae usually seen with photon and electron beams. This study evaluates the surface dose as a complex function of beam parameters but more importantly the effect of beam angle. Methods: Surface dose in proton beam depends on the beam energy, source to surface distance, the air gap between snout and surface, field size, material thickness in front of surface, atomic number of the medium, beam angle and type of nozzle (ie double scattering, (DS), uniform scanning (US) or pencil beam scanning (PBS). Obliquity factor (OF) is defined as ratio of surface dose in 0° to beam angle Θ. Measurements were made in water phantom at various beam angles using very small microdiamond that has shown favorable beam characteristics for high, medium and low proton energy. Depth dose measurements were performed in the central axis of the beam in each respective gantry angle. Results: It is observed that surface dose is energy dependent but more predominantly on the SOBP. It is found that as SSD increases, surface dose decreases. In general, SSD, and air gap has limited impact in clinical proton range. High energy has higher surface dose and so the beam angle. The OF rises with beam angle. Compared to OF of 1.0 at 0° beam angle, the value is 1.5, 1.6, 1,7 for small, medium and large range respectively for 60 degree angle. Conclusion: It is advised that just like range and SOBP, surface dose should be clearly understood and a method to reduce the surface dose should be employed. Obliquity factor is a critical parameter that should be accounted in proton beam therapy and a perpendicular beam should be used to reduce surface dose

  16. Beam orientation optimization for intensity-modulated radiation therapy using mixed integer programming

    Energy Technology Data Exchange (ETDEWEB)

    Yang Ruijie [Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences/Peking Union Medical College, PO Box 2258, Beijing 100021 (China); Dai Jianrong [Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences/Peking Union Medical College, PO Box 2258, Beijing 100021 (China); Yang Yong [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA 15232 (United States); Hu Yimin [Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences/Peking Union Medical College, PO Box 2258, Beijing 100021 (China)

    2006-08-07

    The purpose of this study is to extend an algorithm proposed for beam orientation optimization in classical conformal radiotherapy to intensity-modulated radiation therapy (IMRT) and to evaluate the algorithm's performance in IMRT scenarios. In addition, the effect of the candidate pool of beam orientations, in terms of beam orientation resolution and starting orientation, on the optimized beam configuration, plan quality and optimization time is also explored. The algorithm is based on the technique of mixed integer linear programming in which binary and positive float variables are employed to represent candidates for beam orientation and beamlet weights in beam intensity maps. Both beam orientations and beam intensity maps are simultaneously optimized in the algorithm with a deterministic method. Several different clinical cases were used to test the algorithm and the results show that both target coverage and critical structures sparing were significantly improved for the plans with optimized beam orientations compared to those with equi-spaced beam orientations. The calculation time was less than an hour for the cases with 36 binary variables on a PC with a Pentium IV 2.66 GHz processor. It is also found that decreasing beam orientation resolution to 10{sup 0} greatly reduced the size of the candidate pool of beam orientations without significant influence on the optimized beam configuration and plan quality, while selecting different starting orientations had large influence. Our study demonstrates that the algorithm can be applied to IMRT scenarios, and better beam orientation configurations can be obtained using this algorithm. Furthermore, the optimization efficiency can be greatly increased through proper selection of beam orientation resolution and starting beam orientation while guaranteeing the optimized beam configurations and plan quality.

  17. Ion-optical studies for a range adaptation method in ion beam therapy using a static wedge degrader combined with magnetic beam deflection

    International Nuclear Information System (INIS)

    Chaudhri, Naved; Saito, Nami; Bert, Christoph; Franczak, Bernhard; Steidl, Peter; Durante, Marco; Schardt, Dieter; Rietzel, Eike

    2010-01-01

    Fast radiological range adaptation of the ion beam is essential when target motion is mitigated by beam tracking using scanned ion beams for dose delivery. Electromagnetically controlled deflection of a well-focused ion beam on a small static wedge degrader positioned between two dipole magnets, inside the beam delivery system, has been considered as a fast range adaptation method. The principle of the range adaptation method was tested in experiments and Monte Carlo simulations for the therapy beam line at the GSI Helmholtz Centre for Heavy Ions Research. Based on the simulations, ion optical settings of beam deflection and realignment of the adapted beam were experimentally applied to the beam line, and additional tuning was manually performed. Different degrader shapes were employed for the energy adaptation. Measured and simulated beam profiles, i.e. lateral distribution and range in water at isocentre, were analysed and compared with the therapy beam values for beam scanning. Deflected beam positions of up to ±28 mm on degrader were performed which resulted in a range adaptation of up to ±15 mm water equivalence (WE). The maximum deviation between the measured adapted range from the nominal range adaptation was below 0.4 mm WE. In experiments, the width of the adapted beam at the isocentre was adjustable between 5 and 11 mm full width at half maximum. The results demonstrate the feasibility/proof of the proposed range adaptation method for beam tracking from the beam quality point of view.

  18. Ion-optical studies for a range adaptation method in ion beam therapy using a static wedge degrader combined with magnetic beam deflection

    Science.gov (United States)

    Chaudhri, Naved; Saito, Nami; Bert, Christoph; Franczak, Bernhard; Steidl, Peter; Durante, Marco; Rietzel, Eike; Schardt, Dieter

    2010-06-01

    Fast radiological range adaptation of the ion beam is essential when target motion is mitigated by beam tracking using scanned ion beams for dose delivery. Electromagnetically controlled deflection of a well-focused ion beam on a small static wedge degrader positioned between two dipole magnets, inside the beam delivery system, has been considered as a fast range adaptation method. The principle of the range adaptation method was tested in experiments and Monte Carlo simulations for the therapy beam line at the GSI Helmholtz Centre for Heavy Ions Research. Based on the simulations, ion optical settings of beam deflection and realignment of the adapted beam were experimentally applied to the beam line, and additional tuning was manually performed. Different degrader shapes were employed for the energy adaptation. Measured and simulated beam profiles, i.e. lateral distribution and range in water at isocentre, were analysed and compared with the therapy beam values for beam scanning. Deflected beam positions of up to ±28 mm on degrader were performed which resulted in a range adaptation of up to ±15 mm water equivalence (WE). The maximum deviation between the measured adapted range from the nominal range adaptation was below 0.4 mm WE. In experiments, the width of the adapted beam at the isocentre was adjustable between 5 and 11 mm full width at half maximum. The results demonstrate the feasibility/proof of the proposed range adaptation method for beam tracking from the beam quality point of view.

  19. The FLUKA code for application of Monte Carlo methods to promote high precision ion beam therapy

    CERN Document Server

    Parodi, K; Cerutti, F; Ferrari, A; Mairani, A; Paganetti, H; Sommerer, F

    2010-01-01

    Monte Carlo (MC) methods are increasingly being utilized to support several aspects of commissioning and clinical operation of ion beam therapy facilities. In this contribution two emerging areas of MC applications are outlined. The value of MC modeling to promote accurate treatment planning is addressed via examples of application of the FLUKA code to proton and carbon ion therapy at the Heidelberg Ion Beam Therapy Center in Heidelberg, Germany, and at the Proton Therapy Center of Massachusetts General Hospital (MGH) Boston, USA. These include generation of basic data for input into the treatment planning system (TPS) and validation of the TPS analytical pencil-beam dose computations. Moreover, we review the implementation of PET/CT (Positron-Emission-Tomography / Computed- Tomography) imaging for in-vivo verification of proton therapy at MGH. Here, MC is used to calculate irradiation-induced positron-emitter production in tissue for comparison with the +-activity measurement in order to infer indirect infor...

  20. Opening and construction of facilities in succession for particle beam therapy of cancer

    International Nuclear Information System (INIS)

    Nakano, Takashi; Yamamoto, Kazutaka; Hishikawa, Yoshio; Totoki, Tadahide; Hoshino, Junichi; Aoki, Takashi; Yoshiyuki, Takeshi; Hirabayashi, Masayuki; Nakamura, Fumito

    2011-01-01

    This feature article describes the current state of practical particle beam therapy of cancer, its future prospect, recent opening/construction of its facilities and manufacturers' view with following 9 topics presented by relevant experts. Gunma University (topic 1) started the carbon ion therapy from Mar., 2010, and has treated more than 100 cancer patients to aim the treatment of about 600 patients/year after several years. Fukui Prefectural Hospital Proton Therapy Center (topic 2) started from this March with proton beams for patients with its therapeutic standard, in cooperation with insurance companies and hotels for patients' convenience. Medipolis Proton Therapy and Research Center (Kagoshima Pref.) (topic 3) started this year with proton beams for 13 patients hitherto with reference protocol of Hyogo Ion Beam Medical Center. A new stereotactic irradiation system of proton beams for breast cancer has been developed. Construction of Saga Heavy Ion Medical Accelerator in Tosu (Saga Pref.) (topic 4) began this year to be completed in 2013. Aizawa Hospital (Nagano Pref.) (topic 5) plans to introduce the small-sized proton accelerator-gantry system (Sumitomo Heavy Ind., Ltd.) aiming the practice in 2013. Association for Nuclear Technology in Medicine (topic 6) reports the trends of current and future construction inside/outside Japan. Manufacturers comment their respective business: high-speed scanning irradiation system, next generation handling system of patient and particle beam therapy information system by Toshiba (topic 7); designation of the whole heavy ion beam therapy system (with NIRS), proton beam (as in topic 5) and system of BNCT (boron neutron-capture therapy) (Kyoto Univ.) by Sumitomo Heavy Ind., Ltd. (topic 8); and small-size proton therapeutic machine with 4D tracing capability for patient's movement (Hokkaido Univ.) and with spot-scanning irradiation technique by Hitachi (topic 9). (author)

  1. Impact of beam angle choice on pencil beam scanning breath-hold proton therapy for lung lesions

    DEFF Research Database (Denmark)

    Gorgisyan, Jenny; Perrin, Rosalind; Lomax, Antony J

    2017-01-01

    was highly patient specific, with a median of 3.3 mm (range: 0.0-41.1 mm). Slightly larger WEPL differences were located around the lateral or lateral anterior/posterior beam angles. Linear models revealed that changes in dose were associated to the changes in WEPL and the tumor baseline shift (p ....05). CONCLUSIONS: WEPL changes and tumor baseline shift can serve as reasonable surrogates for dosimetric uncertainty of the target coverage and are well-suited for routine evaluation of plan robustness. The two lateral beam angles are not recommended to use for PBS proton therapy of lung cancer patients treated...

  2. Lying-on position of total skin electron therapy

    International Nuclear Information System (INIS)

    Wu Jiaming; Leung, Stephen Wan; Wang Chongjong; Chui Chenshou

    1997-01-01

    Purpose: A technique for whole-body electron therapy with the patient in a lying position has been developed. This technique allows Total Skin Electron Therapy (TSET) for those patients who were previously unable to be treated in a conventional standing position. Methods and Materials: This study was carried out on a Varian 2100C linear accelerator with a 6 MeV high dose rate electron beam. The collimator was open to a width of 36 x 36 cm. There were two main procedures, with six dual-field techniques: 1) two static AP/PA vertical dual fields (VDF): the patient laid on the floor transversely under the collimator when the gantry was in a vertical position. A 0.6 cm acrylic board was placed 15 cm away from the patient, then the gantry was rotated 25 deg. clockwise and counterclockwise to treat the patient in the supine and prone positions, respectively. 2) Four oblique junction fields (OJF): the patient laid on the floor in a prone and supine position parallel to the wave guide at (227 - body thickness x tan 60 deg. ) cm away from the vertical axis of the gantry, then the gantry was rotated 60 deg. toward the patient. A 0.6 cm acrylic board was placed 15 cm away from the patient perpendicular to the beam. The patient was move along the field central axis. It allowed the patient's body to be within the 160 cm effective treatment profile. When the patient's body axis move 5 deg. toward the lateral side of the field central axis, we could obtain a better dose distribution in the vertex of the scalp and the soles of the feet. The angle of the VDF was measured by chamber detectors to obtain the effective treatment profile. Likewise, the optimal profile for the OJF was determined by the same procedures. The Rando phantom was used to measure the superficial dose of the body. Results: The dimension of effective treatment profile for the VDF was 188 x 72 cm at 87% dose level. For the OJF, we had to move the patient along the field central axis to obtain the effective

  3. Potential clinical impact of laser-accelerated beams in cancer ion therapy

    Energy Technology Data Exchange (ETDEWEB)

    Obcemea, Ceferino

    2016-09-01

    In this article, I present three advantages of plasma-accelerated ion beams for cancer therapy. I discuss how: 1. low-emittance and well-collimated beams are advantageous in proximal normal tissue-sparing; 2. highly-peaked quasi-monoenergetic beams are ideal for fast energy selection and switching in Pencil Beam Scanning (PBS) as a treatment delivery; 3. high fluence and ultra-short pulse delivery produce collective excitations in the medium and enhance the stopping power. This in turn produces denser ionization track signatures (spurs, blobs, etc.) in target tumors, higher linear energy transfer, higher Bragg peak, and higher radiobiological effectiveness at the micro-level.

  4. Dosimetry auditing procedure with alanine dosimeters for light ion beam therapy

    DEFF Research Database (Denmark)

    Ableitinger, Alexander; Vatnitsky, Stanislav; Herrmann, Rochus

    2013-01-01

    Background and purpose In the next few years the number of facilities providing ion beam therapy with scanning beams will increase. An auditing process based on an end-to-end test (including CT imaging, planning and dose delivery) could help new ion therapy centres to validate their entire logistic...... of the biological dose is out of scope of the current work. Materials and methods The audit procedure was based on a homogeneous phantom that mimics the dimension of a head (20 × 20 × 21 cm3). The phantom can be loaded either with an ionisation chamber or 20 alanine dosimeters plus 2 radiochromic EBT films. Dose...... of about 3%. Conclusions Alanine dosimeters are suitable detectors for dosimetry audits in ion beam therapy and the presented end-to-end test is feasible. If further studies show similar results, this dosimetric audit could be implemented as a credentialing procedure for clinical proton and carbon beam...

  5. Novel imaging and quality assurance techniques for ion beam therapy a Monte Carlo study

    CERN Document Server

    Rinaldi, I; Jäkel, O; Mairani, A; Parodi, K

    2010-01-01

    Ion beams exhibit a finite and well defined range in matter together with an “inverted” depth-dose profile, the so-called Bragg peak. These favourable physical properties may enable superior tumour-dose conformality for high precision radiation therapy. On the other hand, they introduce the issue of sensitivity to range uncertainties in ion beam therapy. Although these uncertainties are typically taken into account when planning the treatment, correct delivery of the intended ion beam range has to be assured to prevent undesired underdosage of the tumour or overdosage of critical structures outside the target volume. Therefore, it is necessary to define dedicated Quality Assurance procedures to enable in-vivo range verification before or during therapeutic irradiation. For these purposes, Monte Carlo transport codes are very useful tools to support the development of novel imaging modalities for ion beam therapy. In the present work, we present calculations performed with the FLUKA Monte Carlo code and pr...

  6. SU-E-J-99: Reconstruction of Cone Beam CT Image Using Volumetric Modulated Arc Therapy Exit Beams

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, K; Goddard, L; Savacool, M; Mynampati, D; Godoy Scripes, P; Tome' , W [Montefiore Medical Center, Bronx, NY (United States); Kuo, H; Basavatia, A; Hong, L; Yaparpalvi, R; Kalnicki, S [Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY (United States)

    2014-06-01

    Purpose: To test the possibility of obtaining an image of the treated volume during volumetric modulated arc therapy (VMAT) with exit beams. Method: Using a Varian Clinac 21EX and MVCT detector the following three sets of detector projection data were obtained for cone beam CT reconstruction with and without a Catphan 504 phantom. 1) 72 projection images from 20 × 16 cm{sup 2} open beam with 3 MUs, 2) 72 projection images from 20 × 16 cm{sup 2} MLC closed beam with 14 MUs. 3) 137 projection images from a test RapicArc QA plan. All projection images were obtained in ‘integrated image’ mode. We used OSCaR code to reconstruct the cone beam CT images. No attempts were made to reduce scatter or artifacts. Results: With projection set 1) we obtained a good quality MV CBCT image by optimizing the reconstruction parameters. Using projection set 2) we were not able to obtain a CBCT image of the phantom, which was determined to be due to the variation of interleaf leakage with gantry angle. From projection set 3), we were able to obtain a weak but meaningful signal in the image, especially in the target area where open beam signals were dominant. This finding suggests that one might be able to acquire CBCT images with rough body shape and some details inside the irradiated target area. Conclusion: Obtaining patient images using the VMAT exit beam is challenging but possible. We were able to determine sources of image degradation such as gantry angle dependent interleaf leakage and beams with a large scatter component. We are actively working on improving image quality.

  7. Dosimetry of beams for negative pi-meson radiation therapy

    International Nuclear Information System (INIS)

    Dicello, J.F.

    1976-01-01

    Several new facilities have been built in the last few years which can produce high intensity beams of pions. As a result, a significant amount of new data related to pion dosimetry is available. Results of beam composition, beam shaping, and collimation are given along with depth dose curves and isodose contours. Experimental data which describe the radiation quality of pion beams and the change in radiation quality with position are presented. Experimental data determining the fraction of the dose resulting from neutrons are discussed. The present techniques used in pion dosimetry are summarized, and those areas of pion dosimetry which require additional effort in order to achieve routine treatment planning for patients are reviewed

  8. Proton beam therapy for localized prostate cancer 101: basics, controversies, and facts.

    Science.gov (United States)

    Wisenbaugh, Eric S; Andrews, Paul E; Ferrigni, Robert G; Schild, Steven E; Keole, Sameer R; Wong, William W; Vora, Sujay A

    2014-01-01

    Proton beam therapy for prostate cancer has become a source of controversy in the urologic community, and the rapid dissemination and marketing of this technology has led to many patients inquiring about this therapy. Yet the complexity of the technology, the cost, and the conflicting messages in the literature have left many urologists ill equipped to counsel their patients regarding this option. This article reviews the basic science of the proton beam, examines the reasons for both the hype and the controversy surrounding this therapy, and, most importantly, examines the literature so that every urologist is able to comfortably discuss this option with inquiring patients.

  9. Accelerator Based Neutron Beams for Neutron Capture Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yanch, Jacquelyn C.

    2003-04-11

    The DOE-funded accelerator BNCT program at the Massachusetts Institute of Technology has resulted in the only operating accelerator-based epithermal neutron beam facility capable of generating significant dose rates in the world. With five separate beamlines and two different epithermal neutron beam assemblies installed, we are currently capable of treating patients with rheumatoid arthritis in less than 15 minutes (knee joints) or 4 minutes (finger joints) or irradiating patients with shallow brain tumors to a healthy tissue dose of 12.6 Gy in 3.6 hours. The accelerator, designed by Newton scientific Incorporated, is located in dedicated laboratory space that MIT renovated specifically for this project. The Laboratory for Accelerator Beam Applications consists of an accelerator room, a control room, a shielded radiation vault, and additional laboratory space nearby. In addition to the design, construction and characterization of the tandem electrostatic accelerator, this program also resulted in other significant accomplishments. Assemblies for generating epithermal neutron beams were designed, constructed and experimentally evaluated using mixed-field dosimetry techniques. Strategies for target construction and target cooling were implemented and tested. We demonstrated that the method of submerged jet impingement using water as the coolant is capable of handling power densities of up to 6 x 10(sup 7) W/m(sup 2) with heat transfer coefficients of 10(sup 6)W/m(sup 2)-K. Experiments with the liquid metal gallium demonstrated its superiority compared with water with little effect on the neutronic properties of the epithermal beam. Monoenergetic proton beams generated using the accelerator were used to evaluate proton RBE as a function of LET and demonstrated a maximum RBE at approximately 30-40 keV/um, a finding consistent with results published by other researchers. We also developed an experimental approach to biological intercomparison of epithermal beams and

  10. Treatment of cancer of the pancreas by intraoperative electron beam therapy: physical and biological aspects

    International Nuclear Information System (INIS)

    Bagne, F.R.; Dobelbower, R.R. Jr.; Milligan, A.J.; Bronn, D.G.

    1989-01-01

    Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means of verification. Emphasis is placed on the collaboration and cooperation necessary for all members of the intraoperative radiation therapy team including surgeons, radiation therapists, medical physicists, anesthesiologists, technologists, and nurses.29 references

  11. Development of a Boron Neutron Capture Enhanced Fast Neutron Therapy Beam

    Energy Technology Data Exchange (ETDEWEB)

    Sweezy, Jeremy Ed [Georgia Tech

    2002-01-01

    The combination of fast neutron therapy and boron neutron capture therapy is currently under investigation at several fast neutron therapy centers worldwide. This treatment method, termed boron neutron capture enhanced fast neutron therapy (BNCEFNT) utilizes a boron containing drug to selectively increase the dose to the target tumor. BNCEFNT may be useful in the treatment of some radioresistant brain tumors, such as glioblastoma multiforme. A neutron therapy beam for boron neutron capture enhanced fast neutron therapy has been developed for the existing Fermilab Neutron Therapy Facility. This beam produces a significant dose enhancement due to the the boron neutron capture reaction. The beam was developed by designing a filter and collimator system using the Monte Carlo radiation transport code, MCNPX. The MCNPX code was benchmarked against depth-dose measurements of the standard treatment beam. The new BNCEFNT beam is filtered with 18.3-cm of low carbon steel and is collimated with steel. Measurements of the dose enhancement of the new BNCEFNT beam were performed with paired tissue equivalent ion chambers. One of the ion chambers has boron incorporated in the wall of the chamber to measure the dose due to boron neutron capture. The measured boron dose enhancement of the BNCEFNT beam is (16.3 ± 2.6)% per 100-ppm 10B for a 20-cm diameter beam and (10.0 ± 1.6)% per 100-ppm 10B for a 10-cm diameter beam. The dose rate of the new beam is reduced to 4.4% of the dose rate of the standard treatment beam. xxi A conceptual design that overcomes the reduced dose rate is also presented. This design uses a tungsten collimator placed near the patient, with a 1.5-cm tungsten filter just upstream of the collimator. Using graphite moderation of neutrons around the patient a percent dose enhancement of 15% can be attained with good collimation, for field sizes as small as 5 × 5 cm2 , and without a reduction in dose rate.

  12. Dosimetric properties of the fast neutron therapy beams at TAMVEC

    International Nuclear Information System (INIS)

    Almond, P.R.; Smith, A.R.; Smathers, J.R.; Otte, V.A.

    1975-01-01

    In October 1972, M.D. Anderson Hospital and Tumor Institute of the University of Texas System Cancer Center initiated a clinical trial of fast neutron radiotherapy using the cyclotron at Texas A and M University. Initially, the study used neutrons produced by bombarding beryllium with 16 MeV deuterons, but since March, 1973, neutrons from 50 MeV deuterons have been used. The dosimetric properties of the 30 MeV beams have also been measured for comparison with the neutron beams from D-T generators. The three beams are compared in terms of dose rate, skin sparing, depth dose and field flatness. Isodose curves for treatment planning were generated using the decrement line method and compared to curves measured by a computer controlled isodose plotter. This system was also used to measure the isodose curves for wedge fields. Dosimetry checks on various patients were made using silicon diodes as in vivo fast neutron dosimeters

  13. Total skin electron beam therapy in mycosis fungoides

    International Nuclear Information System (INIS)

    Terashima, Hiromi; Yamashita, Shigeru; Ishino, Yohichi; Suenaga, Yoshinori

    1988-01-01

    The studies using phantoms confirmed that the reduction of electron beam energy and minimization of X-ray contamination could be achieved when electron beam was interposed by an acrylic plate placed 20 cm anterior to a patient. Four patients of mycosis fungoides were treated with 8 MeV electron beam of a linear accelerator at UOEH Hospital from October 1981 to December 1986. Two of them were treated with this technique by placing 2 cm thick acrylic plate anterior to the patients and satisfactory results were obtained. Cutaneous lesions subsided remarkably with the dosage of 2000 cGy given in 2 months. Leucopenia due to bone marrow suppression was mild and the patients tolerated the treatment well. (author)

  14. Quantitative evaluation of potential irradiation geometries for carbon-ion beam grid therapy.

    Science.gov (United States)

    Tsubouchi, Toshiro; Henry, Thomas; Ureba, Ana; Valdman, Alexander; Bassler, Niels; Siegbahn, Albert

    2018-03-01

    Radiotherapy using grids containing cm-wide beam elements has been carried out sporadically for more than a century. During the past two decades, preclinical research on radiotherapy with grids containing small beam elements, 25 μm-0.7 mm wide, has been performed. Grid therapy with larger beam elements is technically easier to implement, but the normal tissue tolerance to the treatment is decreasing. In this work, a new approach in grid therapy, based on irradiations with grids containing narrow carbon-ion beam elements was evaluated dosimetrically. The aim formulated for the suggested treatment was to obtain a uniform target dose combined with well-defined grids in the irradiated normal tissue. The gain, obtained by crossfiring the carbon-ion beam grids over a simulated target volume, was quantitatively evaluated. The dose distributions produced by narrow rectangular carbon-ion beams in a water phantom were simulated with the PHITS Monte Carlo code. The beam-element height was set to 2.0 cm in the simulations, while the widths varied from 0.5 to 10.0 mm. A spread-out Bragg peak (SOBP) was then created for each beam element in the grid, to cover the target volume with dose in the depth direction. The dose distributions produced by the beam-grid irradiations were thereafter constructed by adding the dose profiles simulated for single beam elements. The variation of the valley-to-peak dose ratio (VPDR) with depth in water was thereafter evaluated. The separation of the beam elements inside the grids were determined for different irradiation geometries with a selection criterion. The simulated carbon-ion beams remained narrow down to the depths of the Bragg peaks. With the formulated selection criterion, a beam-element separation which was close to the beam-element width was found optimal for grids containing 3.0-mm-wide beam elements, while a separation which was considerably larger than the beam-element width was found advantageous for grids containing 0.5-mm

  15. Impact of Various Beam Parameters on Lateral Scattering in Proton and Carbon-ion Therapy.

    Science.gov (United States)

    Ebrahimi Loushab, M; Mowlavi, A A; Hadizadeh, M H; Izadi, R; Jia, S B

    2015-12-01

    In radiation therapy with ion beams, lateral distributions of absorbed dose in the tissue are important. Heavy ion therapy, such as carbon-ion therapy, is a novel technique of high-precision external radiotherapy which has advantages over proton therapy in terms of dose locality and biological effectiveness. In this study, we used Monte Carlo method-based Geant4 toolkit to simulate and calculate the effects of energy, shape and type of ion beams incident upon water on multiple scattering processes. Nuclear reactions have been taken into account in our calculation. A verification of this approach by comparing experimental data and Monte Carlo methods will be presented in an upcoming paper. Increasing particle energies, the width of the Bragg curve becomes larger but with increasing mass of particles, the width of the Bragg curve decreases. This is one of the advantages of carbon-ion therapy to treat with proton. The transverse scattering of dose distribution is increased with energy at the end of heavy ion beam range. It can also be seen that the amount of the dose scattering for carbon-ion beam is less than that of proton beam, up to about 160mm depth in water. The distortion of Bragg peak profiles, due to lateral scattering of carbon-ion, is less than proton. Although carbon-ions are primarily scattered less than protons, the corresponding dose distributions, especially the lateral dose, are not much less.

  16. Proton therapy posterior beam approach with pencil beam scanning for esophageal cancer. Clinical outcome, dosimetry, and feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Yue-Can [Shengjing Hospital of China Medical University, Department of Medical Oncology, Cancer Center, Shenyang (China); University of Washington Medical Center, Department of Radiation Oncology, 1959 NE Pacific Street, Campus Box 356043, Seattle, WA (United States); Vyas, Shilpa; Apisarnthanarax, Smith; Zeng, Jing [University of Washington Medical Center, Department of Radiation Oncology, 1959 NE Pacific Street, Campus Box 356043, Seattle, WA (United States); Dang, Quang; Schultz, Lindsay [Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA (United States); Bowen, Stephen R. [University of Washington Medical Center, Department of Radiation Oncology, 1959 NE Pacific Street, Campus Box 356043, Seattle, WA (United States); University of Washington Medical Center, Department of Radiology, Seattle, WA (United States); Shankaran, Veena [University of Washington Medical Center, Department of Medical Oncology, Seattle, WA (United States); Farjah, Farhood [University of Washington Medical Center, Department of Surgery, Division of Cardiothoracic Surgery, Seattle, WA (United States); University of Washington Medical Center, Department of Surgery, Surgical Outcomes Research Center, Seattle, WA (United States); Oelschlager, Brant K. [University of Washington Medical Center, Department of Surgery, Seattle, WA (United States)

    2016-12-15

    The aim of this study is to present the dosimetry, feasibility, and preliminary clinical results of a novel pencil beam scanning (PBS) posterior beam technique of proton treatment for esophageal cancer in the setting of trimodality therapy. From February 2014 to June 2015, 13 patients with locally advanced esophageal cancer (T3-4N0-2M0; 11 adenocarcinoma, 2 squamous cell carcinoma) were treated with trimodality therapy (neoadjuvant chemoradiation followed by esophagectomy). Eight patients were treated with uniform scanning (US) and 5 patients were treated with a single posterior-anterior (PA) beam PBS technique with volumetric rescanning for motion mitigation. Comparison planning with PBS was performed using three plans: AP/PA beam arrangement; PA plus left posterior oblique (LPO) beams, and a single PA beam. Patient outcomes, including pathologic response and toxicity, were evaluated. All 13 patients completed chemoradiation to 50.4 Gy (relative biological effectiveness, RBE) and 12 patients underwent surgery. All 12 surgical patients had an R0 resection and pathologic complete response was seen in 25 %. Compared with AP/PA plans, PA plans have a lower mean heart (14.10 vs. 24.49 Gy, P < 0.01), mean stomach (22.95 vs. 31.33 Gy, P = 0.038), and mean liver dose (3.79 vs. 5.75 Gy, P = 0.004). Compared to the PA/LPO plan, the PA plan reduced the lung dose: mean lung dose (4.96 vs. 7.15 Gy, P = 0.020) and percentage volume of lung receiving 20 Gy (V{sub 20}; 10 vs. 17 %, P < 0.01). Proton therapy with a single PA beam PBS technique for preoperative treatment of esophageal cancer appears safe and feasible. (orig.) [German] Wir stellen die Vergleichsdosimetrie, Realisierbarkeit und die vorlaeufigen klinischen Ergebnisse einer neuen Pencil-Beam-Scanning(-PBS)/Posterior-Beam-Methode innerhalb der Protonentherapie fuer Speiseroehrenkrebs im Setting einer trimodalen Therapie vor. Von Februar 2014 bis Juni 2015 erhielten 13 Patienten mit lokal fortgeschrittenem

  17. Analysis of Neutron Production in Passively Scattered Ion-Beam Therapy.

    Science.gov (United States)

    Heo, Seunguk; Yoo, Seunghoon; Song, Yongkeun; Kim, Eunho; Shin, Jaeik; Han, Soorim; Jung, Wongyun; Nam, Sanghee; Lee, Rena; Lee, Kitae; Cho, Sungho

    2017-07-01

    A new treatment facility for heavy ion therapy since 2010 was constructed. In the broad beam, a range shifter, ridge filter and multi leaf collimator (MLC) for the generation of the spread-out Bragg peak is used. In this case, secondary neutrons produced by the interactions of the ion field with beam-modifying devices (e.g. double-scattering system, beam shaping collimators and range compensators) are very important for patient safety. Therefore, these components must be carefully examined in the context of secondary neutron yield and associated secondary cancer risk. In this article, Monte Carlo simulation has been carried out with the FLUktuierende KAskade particle transport code, the fluence and distribution of neutron generation and the neutron dose equivalent from the broad beam components are compared using carbon and proton beams. As a result, it is confirmed that the yield of neutron production using a carbon beam from all components of the broad beam was higher than using a proton beam. The ambient dose by neutrons per heavy ion and proton ion from the MLC surface was 0.12-0.18 and 0.0067-0.0087 pSv, respectively, which shows that heavy ions generate more neutrons than protons. However, ambient dose per treatment 2 Gy, which means physical dose during treatment by ion beam, is higher than carbon beam because proton therapy needs more beam flux to make 2-Gy prescription dose. Therefore, the neutron production from the MLC, which is closed to the patient, is a very important parameter for patient safety. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Analysis of neutron production in passively scattered ion-beam therapy

    International Nuclear Information System (INIS)

    Heo, Seunguk; Yoo, Seunghoon; Song, Yongkeun; Kim, Eunho; Shin, Jaeik; Han, Soorim; Wongyun Jung; Nam, Sanghee; Lee, Rena; Lee, Kitae; Cho, Sungho

    2017-01-01

    A new treatment facility for heavy ion therapy since 2010 was constructed. In the broad beam, a range shifter, ridge filter and multi leaf collimator (MLC) for the generation of the spread-out Bragg peak is used. In this case, secondary neutrons produced by the interactions of the ion field with beam-modifying devices (e.g. double-scattering system, beam shaping collimators and range compensators) are very important for patient safety. Therefore, these components must be carefully examined in the context of secondary neutron yield and associated secondary cancer risk. In this article, Monte Carlo simulation has been carried out with the FLUktuierende KAskade particle transport code, the fluence and distribution of neutron generation and the neutron dose equivalent from the broad beam components are compared using carbon and proton beams. As a result, it is confirmed that the yield of neutron production using a carbon beam from all components of the broad beam was higher than using a proton beam. The ambient dose by neutrons per heavy ion and proton ion from the MLC surface was 0.12 0.18 and 0.0067 0.0087 pSv, respectively, which shows that heavy ions generate more neutrons than protons. However, ambient dose per treatment 2 Gy, which means physical dose during treatment by ion beam, is higher than carbon beam because proton therapy needs more beam flux to make 2-Gy prescription dose. Therefore, the neutron production from the MLC, which is closed to the patient, is a very important parameter for patient safety. (authors)

  19. Real-time beam monitoring in scanned proton therapy

    Science.gov (United States)

    Klimpki, G.; Eichin, M.; Bula, C.; Rechsteiner, U.; Psoroulas, S.; Weber, D. C.; Lomax, A.; Meer, D.

    2018-05-01

    When treating cancerous tissues with protons beams, many centers make use of a step-and-shoot irradiation technique, in which the beam is steered to discrete grid points in the tumor volume. For safety reasons, the irradiation is supervised by an independent monitoring system validating cyclically that the correct amount of protons has been delivered to the correct position in the patient. Whenever unacceptable inaccuracies are detected, the irradiation can be interrupted to reinforce a high degree of radiation protection. At the Paul Scherrer Institute, we plan to irradiate tumors continuously. By giving up the idea of discrete grid points, we aim to be faster and more flexible in the irradiation. But the increase in speed and dynamics necessitates a highly responsive monitoring system to guarantee the same level of patient safety as for conventional step-and-shoot irradiations. Hence, we developed and implemented real-time monitoring of the proton beam current and position. As such, we read out diagnostic devices with 100 kHz and compare their signals against safety tolerances in an FPGA. In this paper, we report on necessary software and firmware enhancements of our control system and test their functionality based on three exemplary error scenarios. We demonstrate successful implementation of real-time beam monitoring and, consequently, compliance with international patient safety regulations.

  20. System and method for dose verification and gamma ray imaging in ion beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mihailescu, Lucian

    2017-12-26

    This disclosure provides systems, methods, and apparatus related to ion beam therapy. In one aspect, a system includes a position sensitive detector and a collimator. The position sensitive detector configured to detect gamma rays generated by an ion beam interacting with a target. The collimator is positioned between the target and the position sensitive detector. The collimator includes a plurality of knife-edge slits, with a first knife-edge slit intersecting with a second knife-edge slit.

  1. Experience with high-energy electron beam therapy at the University of Chicago

    International Nuclear Information System (INIS)

    Griem, M.L.; Kuchnir, F.T.; Lanzl, L.H.; Skaggs, L.S.; Sutton, H.G.; Tokars, R.

    1979-01-01

    Current utilization of the linear accelerator as well as 5-year cumulative experience in radiotherapy is presented. Cutaneous lymphomas and mammary gland carcinomas were the prime experience region; however, cancers at other locations were treated with mixed-beam therapy; employing fast neutrons and photon beams. The technique appears promising for abdominal tumors and deep-seated malignancies. Carcinoma of the pancreas responds favorably to this technique

  2. T2-weighted endorectal magnetic resonance imaging of prostate cancer after external beam radiation therapy

    International Nuclear Information System (INIS)

    Westphalen, Antonio C.; Kurhanewicz, John; Cunha, Rui M.G.; Hsu, I-Chow; Kornak, John; Zhao, Shoujun; Coakley, Fergus V.

    2009-01-01

    Purpose: To retrospectively determine the accuracy of T2-weighted endorectal MR imaging in the detection of prostate cancer after external beam radiation therapy and to investigate the relationship between imaging accuracy and time since therapy. Materials and Methods: Institutional review board approval was obtained and the study was HIPPA compliant. We identified 59 patients who underwent 1.5 Tesla endorectal MR imaging of the prostate between 1999 and 2006 after definitive external beam radiation therapy for biopsy-proven prostate cancer. Two readers recorded the presence or absence of tumor on T2-weighted images. Logistic regression and Fisher's exact tests for 2x2 tables were used to determine the accuracy of imaging and investigate if accuracy differed between those imaged within 3 years of therapy (n = 25) and those imaged more than 3 years after therapy (n = 34). Transrectal biopsy was used as the standard of reference for the presence or absence of recurrent cancer. Results: Thirty-four of 59 patients (58%) had recurrent prostate cancer detected on biopsy. The overall accuracy of T2-weighted MR imaging in the detection cancer after external beam radiation therapy was 63% (37/59) for reader 1 and 71% for reader 2 (42/59). For both readers, logistic regression showed no difference in accuracy between those imaged within 3 years of therapy and those imaged more than 3 years after therapy (p = 0.86 for reader 1 and 0.44 for reader 2). Conclusion: T2-weighted endorectal MR imaging has low accuracy in the detection of prostate cancer after external beam radiation therapy, irrespective of the time since therapy. (author)

  3. T2-weighted endorectal magnetic resonance imaging of prostate cancer after external beam radiation therapy

    Directory of Open Access Journals (Sweden)

    Antonio C. Westphalen

    2009-04-01

    Full Text Available PURPOSE: To retrospectively determine the accuracy of T2-weighted endorectal MR imaging in the detection of prostate cancer after external beam radiation therapy and to investigate the relationship between imaging accuracy and time since therapy. MATERIAL AND METHODS: Institutional review board approval was obtained and the study was HIPPA compliant. We identified 59 patients who underwent 1.5 Tesla endorectal MR imaging of the prostate between 1999 and 2006 after definitive external beam radiation therapy for biopsy-proven prostate cancer. Two readers recorded the presence or absence of tumor on T2-weighted images. Logistic regression and Fisher’s exact tests for 2x2 tables were used to determine the accuracy of imaging and investigate if accuracy differed between those imaged within 3 years of therapy (n = 25 and those imaged more than 3 years after therapy (n = 34. Transrectal biopsy was used as the standard of reference for the presence or absence of recurrent cancer. RESULTS: Thirty-four of 59 patients (58% had recurrent prostate cancer detected on biopsy. The overall accuracy of T2-weighted MR imaging in the detection cancer after external beam radiation therapy was 63% (37/59 for reader 1 and 71% for reader 2 (42/59. For both readers, logistic regression showed no difference in accuracy between those imaged within 3 years of therapy and those imaged more than 3 years after therapy (p = 0.86 for reader 1 and 0.44 for reader 2. CONCLUSION: T2-weighted endorectal MR imaging has low accuracy in the detection of prostate cancer after external beam radiation therapy, irrespective of the time since therapy.

  4. T2-weighted endorectal magnetic resonance imaging of prostate cancer after external beam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Westphalen, Antonio C.; Kurhanewicz, John; Cunha, Rui M.G.; Hsu, I-Chow; Kornak, John; Zhao, Shoujun; Coakley, Fergus V. [University of California San Francisco, San Francisco, CA (United States). Dept. of Radiology. Abdominal Imaging Section], e-mail: antonio.westphalen@radiology.ucsf.edu

    2009-01-15

    Purpose: To retrospectively determine the accuracy of T2-weighted endorectal MR imaging in the detection of prostate cancer after external beam radiation therapy and to investigate the relationship between imaging accuracy and time since therapy. Materials and Methods: Institutional review board approval was obtained and the study was HIPPA compliant. We identified 59 patients who underwent 1.5 Tesla endorectal MR imaging of the prostate between 1999 and 2006 after definitive external beam radiation therapy for biopsy-proven prostate cancer. Two readers recorded the presence or absence of tumor on T2-weighted images. Logistic regression and Fisher's exact tests for 2x2 tables were used to determine the accuracy of imaging and investigate if accuracy differed between those imaged within 3 years of therapy (n = 25) and those imaged more than 3 years after therapy (n = 34). Transrectal biopsy was used as the standard of reference for the presence or absence of recurrent cancer. Results: Thirty-four of 59 patients (58%) had recurrent prostate cancer detected on biopsy. The overall accuracy of T2-weighted MR imaging in the detection cancer after external beam radiation therapy was 63% (37/59) for reader 1 and 71% for reader 2 (42/59). For both readers, logistic regression showed no difference in accuracy between those imaged within 3 years of therapy and those imaged more than 3 years after therapy (p = 0.86 for reader 1 and 0.44 for reader 2). Conclusion: T2-weighted endorectal MR imaging has low accuracy in the detection of prostate cancer after external beam radiation therapy, irrespective of the time since therapy. (author)

  5. A 4 MV flattening filter-free beam: commissioning and application to conformal therapy and volumetric modulated arc therapy

    International Nuclear Information System (INIS)

    Stevens, S W; Rosser, K E; Bedford, J L

    2011-01-01

    Recent studies have indicated that radiotherapy treatments undertaken on a flattening filter-free (FFF) linear accelerator have a number of advantages over treatments undertaken on a conventional linear accelerator. In addition, 4 MV photon beams may give improved isodose coverage for some treatment volumes at air/tissue interfaces, compared to when utilizing the clinical standard of 6 MV photons. In order to investigate these benefits, FFF beams were established on an Elekta Beam Modulator linear accelerator for 4 MV photons. Commissioning beam data were obtained for open and wedged fields. The measured data were then imported into a treatment planning system and a beam model was commissioned. The beam model was optimized to improve dose calculations at shallow, clinically relevant depths. Following verification, the beam model was utilized in a treatment planning study, including volumetric modulated arc therapy, for a selection of lung, breast/chest wall and larynx patients. Increased dose rates of around 800 MU min -1 were recorded for open fields (relative to 320 MU min -1 for filtered open fields) and reduced head scatter was inferred from output factor measurements. Good agreement between planned and delivered dose was observed in verification of treatment plans. The planning study indicated that with a FFF beam, equivalent (and in some cases improved) isodose profiles could be achieved for small lung and larynx treatment volumes relative to 4 MV filtered treatments. Furthermore, FFF treatments with wedges could be replicated using open fields together with an 'effective wedge' technique and isocentre shift. Clinical feasibility of a FFF beam was therefore demonstrated, with beam modelling, treatment planning and verification being successfully accomplished.

  6. Proton Beam Therapy for Non-Small Cell Lung Cancer: Current Clinical Evidence and Future Directions

    Energy Technology Data Exchange (ETDEWEB)

    Berman, Abigail T., E-mail: abigail.berman@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104 (United States); James, Sara St.; Rengan, Ramesh [Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195 (United States)

    2015-07-02

    Lung cancer is the leading cancer cause of death in the United States. Radiotherapy is an essential component of the definitive treatment of early-stage and locally-advanced lung cancer, and the palliative treatment of metastatic lung cancer. Proton beam therapy (PBT), through its characteristic Bragg peak, has the potential to decrease the toxicity of radiotherapy, and, subsequently improve the therapeutic ratio. Herein, we provide a primer on the physics of proton beam therapy for lung cancer, present the existing data in early-stage and locally-advanced non-small cell lung cancer (NSCLC), as well as in special situations such as re-irradiation and post-operative radiation therapy. We then present the technical challenges, such as anatomic changes and motion management, and future directions for PBT in lung cancer, including pencil beam scanning.

  7. Proton Beam Therapy for Non-Small Cell Lung Cancer: Current Clinical Evidence and Future Directions

    Directory of Open Access Journals (Sweden)

    Abigail T. Berman

    2015-07-01

    Full Text Available Lung cancer is the leading cancer cause of death in the United States. Radiotherapy is an essential component of the definitive treatment of early-stage and locally-advanced lung cancer, and the palliative treatment of metastatic lung cancer. Proton beam therapy (PBT, through its characteristic Bragg peak, has the potential to decrease the toxicity of radiotherapy, and, subsequently improve the therapeutic ratio. Herein, we provide a primer on the physics of proton beam therapy for lung cancer, present the existing data in early-stage and locally-advanced non-small cell lung cancer (NSCLC, as well as in special situations such as re-irradiation and post-operative radiation therapy. We then present the technical challenges, such as anatomic changes and motion management, and future directions for PBT in lung cancer, including pencil beam scanning.

  8. The potentials of proton beam radiation therapy in malignant lymphoma, thymoma and sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Bjoerk-Eriksson, Thomas [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology; Bjelkengren, Goeran [Univ. Hospital, Malmoe (Sweden). Dept. of Oncology; Glimelius, Bengt [Karolinska Inst., Stockholm (Sweden). Dept. of Oncology and Pathology; Akademiska sjukhuset, Uppsala (Sweden). Dept. of Oncology, Radiology and Clinical Immunology

    2005-12-01

    A group of Swedish oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy. The estimations have been based on current statistics of tumour incidence, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours and normal tissues. Besides sarcomas of the base of skull, which are classical sites for proton beam therapy, it is estimated that about 40 patients yearly in Sweden with sarcomas at other sites are candidates for proton beam therapy. About 20 patients each with malignant lymphomas, chiefly in the mediastinum, and thymomas are also candidates to decrease doses to surrounding heart and lungs.

  9. Shaping and monitoring of the mini-beam structures for the spatially fractionated hadron radiation therapy

    Directory of Open Access Journals (Sweden)

    I. Momot

    2016-06-01

    Full Text Available Design of collimators and their effectiveness for the purposes of the fractionated mini-beam hadron radiation therapy were evaluated by Monte Carlo simulations. The calculations have been performed for proton, carbon and oxygen ion beams at the energies relevant for medical applications. Micropixel metal and hybrid detectors were tested for measuring charged particles intensity distribution in multi-beam structures shaped by slit or matrix collimators exploring low energy proton beam at the Tandem generator (INR NASU, Kyiv. The results obtained illustrate reliable performance of the designed collimators as well as hybrid and metal microdetectors for measuring and imaging in real time the proton intensity distribution over mini-beam structures.

  10. Metrology and quality of radiation therapy dosimetry of electron, photon and epithermal neutron beams

    Energy Technology Data Exchange (ETDEWEB)

    Kosunen, A

    1999-08-01

    In radiation therapy using electron and photon beams the dosimetry chain consists of several sequential phases starting by the realisation of the dose quantity in the Primary Standard Dosimetry Laboratory and ending to the calculation of the dose to a patient. A similar procedure can be described for the dosimetry of epithermal neutron beams in boron neutron capture therapy (BNCT). To achieve the required accuracy of the dose delivered to a patient the quality of all steps in the dosimetry procedure has to be considered. This work is focused on two items in the dosimetry chains: the determination of the dose in the reference conditions and the evaluation of the accuracy of dose calculation methods. The issues investigated and discussed in detail are: a)the calibration methods of plane parallel ionisation chambers used in electron beam dosimetry, (b) the specification of the critical dosimetric parameter i.e. the ratio of stopping powers for water to air, (S I ?){sup water} {sub air}, in photon beams, (c) the feasibility of the twin ionization chamber technique for dosimetry in epithermal neutron beams applied to BNCT and (d) the determination accuracy of the calculated dose distributions in phantoms in electron, photon, and epithermal neutron beams. The results demonstrate that up to a 3% improvement in the consistency of dose determinations in electron beams is achieved by the calibration of plane parallel ionisation chambers in high energy electron beams instead of calibrations in {sup 60}Co gamma beams. In photon beam dosimetry (S I ?){sup water} {sub air} can be determined with an accuracy of 0.2% using the percentage dose at the 10 cm depth, %dd(10), as a beam specifier. The use of %odd(10) requires the elimination of the electron contamination in the photon beam. By a twin ionisation chamber technique the gamma dose can be determined with uncertainty of 6% (1 standard deviation) and the total neutron dose with an uncertainty of 15 to 20% (1 standard deviation

  11. Metrology and quality of radiation therapy dosimetry of electron, photon and epithermal neutron beams

    International Nuclear Information System (INIS)

    Kosunen, A.

    1999-08-01

    In radiation therapy using electron and photon beams the dosimetry chain consists of several sequential phases starting by the realisation of the dose quantity in the Primary Standard Dosimetry Laboratory and ending to the calculation of the dose to a patient. A similar procedure can be described for the dosimetry of epithermal neutron beams in boron neutron capture therapy (BNCT). To achieve the required accuracy of the dose delivered to a patient the quality of all steps in the dosimetry procedure has to be considered. This work is focused on two items in the dosimetry chains: the determination of the dose in the reference conditions and the evaluation of the accuracy of dose calculation methods. The issues investigated and discussed in detail are: a)the calibration methods of plane parallel ionisation chambers used in electron beam dosimetry, (b) the specification of the critical dosimetric parameter i.e. the ratio of stopping powers for water to air, (S I ?) water air , in photon beams, (c) the feasibility of the twin ionization chamber technique for dosimetry in epithermal neutron beams applied to BNCT and (d) the determination accuracy of the calculated dose distributions in phantoms in electron, photon, and epithermal neutron beams. The results demonstrate that up to a 3% improvement in the consistency of dose determinations in electron beams is achieved by the calibration of plane parallel ionisation chambers in high energy electron beams instead of calibrations in 60 Co gamma beams. In photon beam dosimetry (S I ?) water air can be determined with an accuracy of 0.2% using the percentage dose at the 10 cm depth, %dd(10), as a beam specifier. The use of %odd(10) requires the elimination of the electron contamination in the photon beam. By a twin ionisation chamber technique the gamma dose can be determined with uncertainty of 6% (1 standard deviation) and the total neutron dose with an uncertainty of 15 to 20% (1 standard deviation). To improve the accuracy

  12. Improved Beam Angle Arrangement in Intensity Modulated Proton Therapy Treatment Planning for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Cao, Wenhua; Lim, Gino J.; Li, Yupeng; Zhu, X. Ronald; Zhang, Xiaodong

    2015-01-01

    Purpose: This study investigates potential gains of an improved beam angle arrangement compared to a conventional fixed gantry setup in intensity modulated proton therapy (IMPT) treatment for localized prostate cancer patients based on a proof of principle study. Materials and Methods: Three patients with localized prostate cancer retrospectively selected from our institution were studied. For each patient, IMPT plans were designed using two, three and four beam angles, respectively, obtained from a beam angle optimization algorithm. Those plans were then compared with ones using two lateral parallel-opposed beams according to the conventional planning protocol for localized prostate cancer adopted at our institution. Results: IMPT plans with two optimized angles achieved significant improvements in rectum sparing and moderate improvements in bladder sparing against those with two lateral angles. Plans with three optimized angles further improved rectum sparing significantly over those two-angle plans, whereas four-angle plans found no advantage over three-angle plans. A possible three-beam class solution for localized prostate patients was suggested and demonstrated with preserved dosimetric benefits because individually optimized three-angle solutions were found sharing a very similar pattern. Conclusions: This study has demonstrated the potential of using an improved beam angle arrangement to better exploit the theoretical dosimetric benefits of proton therapy and provided insights of selecting quality beam angles for localized prostate cancer treatment

  13. Relative and absolute dosimetry of proton therapy beams

    International Nuclear Information System (INIS)

    Mazal, A.; Delacroix, S.; Bridier, A.; Daures, J.; Dolo, J.M.; Nauraye, C.; Ferrand, R.; Cosgrave, V.; Habrand, J.L.

    1995-01-01

    Different codes of practice are in use or under preparation by several groups and national or international societies, concerning the dosimetry of proton beams. In spite of a large number of experiences and the increasing interest on this field, there are still large incertitudes on some of the basic conversion and correction factors to get dose values from different measuring methods. In practice, dose uniformity between centers is searched and encouraged by intercomparisons using standard procedures. We present the characteristics and the results on proton dosimetry intercomparisons using calorimeters, Faraday cups and ion chambers, as well as on the use of other detectors like diodes, radiographic films and TLD. New detectors like diamond, scintillators, radiochromic films, alanine, gels, ... can give new solutions to particular problems, provided their response is not affected at the end of the proton range (higher LET region), and their resolution, range, linearity, cost, ... are well adapted to practical situations. Some examples of special challenges are non interfering measurements during treatments for quality control, in vivo measurements, small beams for stereotactic irradiations, scanned beams and correlations between dosimetry, microdosimetry and radiobiology

  14. External beam radiation therapy for recurrent sigmoid colorectal cancer. Retrospective analysis by group comparison between the radiation therapy alone and the radiation therapy combined with other therapies

    International Nuclear Information System (INIS)

    Churei, Hisahiko; Takeshita, Tsuyoshi; Hiraki, Yoshiyuki; Baba, Yasutaka; Hokotate, Hirohumi; Nakajo, Masayuki; Ohkubo, Kouichi; Miyaji, Noriaki

    1999-01-01

    The purpose of this study is to evaluate retrospectively clinical efficacy of curativeintent external beam radiation therapy for recurrent sigmoid colorectal cancer. As the radiation therapy of higher dose level combined with other therapies might improve pain control, tumor response, and prognosis, the total dose over 60 Gy was delivered except cases that were received surgery for the recurrent tumor. The study population consisted of 25 patients received the radiation therapy alone (RTA) and 24 patients received the radiation therapy combined with other one or two treatment modalities (RTC), which included surgery (tumor resection) in 15 cases, chemotherapy (low dose daily CDDP) in 13 cases, and hyperthermia in 6 cases. They received the radiation therapy from January, 1989 to June, 1996. Data on pain relief and tumor response were compared between the groups of RTA and RTC. The effect on pain relief was not different between the two groups. Tumor response appeared to be high in the patients combined with chemotherapy, but the difference was not statistically significant between the groups. There were no differences in the prognosis by the recurrent tumor size, the pain relief, and the tumor response. There was a statistically significant difference in the prognosis between the groups with and without extrapelvic distant metastases. A more effective treatment modality combined with the external radiation therapy is necessary to improve the clinical efficacy for the recurrent sigmoid colorectal cancer. (author)

  15. The potential of proton beam radiation therapy in lung cancer (including mesothelioma)

    Energy Technology Data Exchange (ETDEWEB)

    Bjelkengren, Goeran [Univ. Hospital, Malmoe (Sweden). Dept. of Oncology; Glimelius, Bengt [Karolinska Inst., Stockholm (Sweden). Dept. of Oncology and Pathology; Akademiska sjukhuset, Uppsala (Sweden). Dept. of Oncology, Radiology and Clinical Immunology

    2005-12-01

    A Swedish group of oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy. The estimations have been based on current statistics of tumour incidence, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours and normal tissues. It is estimated that about 350 patients with lung cancer and about 20 patients with mesothelioma annually may benefit from proton beam therapy.

  16. The influence of lateral beam profile modifications in scanned proton and carbon ion therapy: a Monte Carlo study

    CERN Document Server

    Parodi, K; Kraemer, M; Sommerer, F; Naumann, J; Mairani, A; Brons, S

    2010-01-01

    Scanned ion beam delivery promises superior flexibility and accuracy for highly conformal tumour therapy in comparison to the usage of passive beam shaping systems. The attainable precision demands correct overlapping of the pencil-like beams which build up the entire dose distribution in the treatment field. In particular, improper dose application due to deviations of the lateral beam profiles from the nominal planning conditions must be prevented via appropriate beam monitoring in the beamline, prior to the entrance in the patient. To assess the necessary tolerance thresholds of the beam monitoring system at the Heidelberg Ion Beam Therapy Center, Germany, this study has investigated several worst-case scenarios for a sensitive treatment plan, namely scanned proton and carbon ion delivery to a small target volume at a shallow depth. Deviations from the nominal lateral beam profiles were simulated, which may occur because of misaligned elements or changes of the beam optic in the beamline. Data have been an...

  17. Measurement of secondary radiation during ion beam therapy with the pixel detector Timepix

    Science.gov (United States)

    Martišíková, Mária; Jakubek, Jan; Granja, Carlos; Hartmann, Bernadette; Opálka, Lukáš; Pospíšil, Stanislav; Jäkel, Oliver

    2011-11-01

    In ion beam therapy the finite range of the ion beams in tissue and the presence of the Bragg-peak are exploited. Unpredictable changes in the patient`s condition can alter the range of the ion beam in the body. Therefore it is desired to verify the actual ion range during the treatment, preferably in a non-invasive way. Positron emission tomography (PET) has been used successfully to monitor the applied dose distributions. This method however suffers from limited applicability and low detection efficiency. In order to increase the detection efficiency and to decrease the uncertainties, in this study we investigate the possibility to measure secondary charged particles emerging from the patient during irradiation. An initial experimental study to register the particle radiation coming out of a patient phantom during the therapy was performed at the Heidelberg Ion Beam Therapy Center (HIT) in Germany. A static narrowly-focused beam of carbon ions was directed into a head phantom. The emerging secondary radiation was measured with the position-sensitive Timepix detector outside of the phantom. The detector, developed by the Medipix Collaboration, consists of a silicon sensor bump bonded to a pixelated readout chip (256 × 256 pixels with 55 μm pitch). Together with the USB-based readout interface, Timepix can operate as an active nuclear emulsion registering single particles online with 2D-track visualization. In this contribution we measured the signal behind the head phantom and investigated its dependence on the beam energy (corresponding to beam range in water 2-30 cm). Furthermore, the response was measured at four angles between 0 and 90 degrees. At all investigated energies some signal was registered. Its pattern corresponds to ions. Differences in the total amount of signal for different beam energies were observed. The time-structure of the signal is correlated with that of the incoming beam, showing that we register products of prompt processes. Such

  18. Measurement of secondary radiation during ion beam therapy with the pixel detector Timepix

    International Nuclear Information System (INIS)

    Martišíková, Mária; Hartmann, Bernadette; Jäkel, Oliver; Jakubek, Jan; Granja, Carlos; Opálka, Lukáš; Pospíšil, Stanislav

    2011-01-01

    In ion beam therapy the finite range of the ion beams in tissue and the presence of the Bragg-peak are exploited. Unpredictable changes in the patient's condition can alter the range of the ion beam in the body. Therefore it is desired to verify the actual ion range during the treatment, preferably in a non-invasive way. Positron emission tomography (PET) has been used successfully to monitor the applied dose distributions. This method however suffers from limited applicability and low detection efficiency. In order to increase the detection efficiency and to decrease the uncertainties, in this study we investigate the possibility to measure secondary charged particles emerging from the patient during irradiation. An initial experimental study to register the particle radiation coming out of a patient phantom during the therapy was performed at the Heidelberg Ion Beam Therapy Center (HIT) in Germany. A static narrowly-focused beam of carbon ions was directed into a head phantom. The emerging secondary radiation was measured with the position-sensitive Timepix detector outside of the phantom. The detector, developed by the Medipix Collaboration, consists of a silicon sensor bump bonded to a pixelated readout chip (256 × 256 pixels with 55 μm pitch). Together with the USB-based readout interface, Timepix can operate as an active nuclear emulsion registering single particles online with 2D-track visualization. In this contribution we measured the signal behind the head phantom and investigated its dependence on the beam energy (corresponding to beam range in water 2–30 cm). Furthermore, the response was measured at four angles between 0 and 90 degrees. At all investigated energies some signal was registered. Its pattern corresponds to ions. Differences in the total amount of signal for different beam energies were observed. The time-structure of the signal is correlated with that of the incoming beam, showing that we register products of prompt processes. Such

  19. Treatment of cancer of the pancreas by precision high dose (PHD) external photon beam and intraoperative electron beam therapy (IOEBT)

    International Nuclear Information System (INIS)

    Dobelbower, R.R. Jr.; Howard, J.M.; Bagne, F.R.; Eltaki, A.; Merrick, H.W. III

    1989-01-01

    Twenty-five patients with a diagnosis of unresectable adenocarcinoma of the pancreas were explored in the Clement O. Miniger (COMROC) IOEBT operating amphitheater at the Medical College of Ohio. Seventeen were treated with IOEBT (20-30 Gy, 15 or 18 meV electrons) PHD external beam radiation therapy (40-60 Gy, 1.8 Gy per fraction) plus appropriate operative biliary and gastrointestinal bypass procedures. No intraoperative complications were observed. Two patients died of causes that may have been treatment-related. Two patients developed abdominocutaneous fistulae. Pain was ameliorated in eleven of twelve patients. Jaundice was relieved in all patients. Four of ten patients with weight loss showed a reversal of that trend. Patient survival was not significantly different from that of patients treated with high-dose precision therapy alone

  20. Sweeping-window arc therapy: an implementation of rotational IMRT with automatic beam-weight calculation

    International Nuclear Information System (INIS)

    Cameron, C

    2005-01-01

    Sweeping-window arc therapy (SWAT) is a variation of intensity-modulated radiation therapy (IMRT) with direct aperture optimization (DAO) that is initialized with a leaf sequence of sweeping windows that move back and forth periodically across the target as the gantry rotates. This initial sequence induces modulation in the dose and is assumed to be near enough to a minimum to allow successful optimization, done with simulated annealing, without requiring excessive leaf speeds. Optimal beam weights are calculated analytically, with easy extension to allow for variable beam weights. In this paper SWAT is tested on a phantom model and clinical prostate case. For the phantom, constant and variable beam weights are used. Although further work (in particular, improving the dose model) is required, the results show SWAT to be a feasible approach to generating deliverable dynamic arc treatments that are optimized

  1. A Multiple-room, Continuous Beam Delivery, Hadron-therapy Installation

    Science.gov (United States)

    Méot, F.

    A proton-therapy hospital installation, based on multiple beam extraction systems from a fixed-field synchrotron, is presented and commented. Potential interest as hospital operation efficiency, as well as estimates of the impact of continuous, multiple-port extraction, on the cost of a session, are discussed.

  2. Comparison of LSO and BGO block detectors for prompt gamma imaging in ion beam therapy

    NARCIS (Netherlands)

    Hueso-Gonzalez, F.; Biegun, A. K.; Dendooven, P.; Enghardt, W.; Fiedler, F.; Golnik, C.; Heidel, K.; Kormoll, T.; Petzoldt, J.; Roemer, K. E.; Schwengner, R.; Wagner, A.; Pausch, G.

    A major weakness of ion beam therapy is the lack of tools for verifying the particle range in clinical routine. The application of the Compton camera concept for the imaging of prompt gamma rays, a by-product of the irradiation correlated to the dose distribution, is a promising approach for range

  3. Parallel processing of dose calculation for external photon beam therapy

    International Nuclear Information System (INIS)

    Kunieda, Etsuo; Ando, Yutaka; Tsukamoto, Nobuhiro; Ito, Hisao; Kubo, Atsushi

    1994-01-01

    We implemented external photon beam dose calculation programs into a parallel processor system consisting of Transputers, 32-bit processors especially suitable for multi-processor configuration. Two network conformations, binary-tree and pipeline, were evaluated for rectangular and irregular field dose calculation algorithms. Although computation speed increased in proportion to the number of CPU, substantial overhead caused by inter-processor communication occurred when a smaller computation load was delivered to each processor. On the other hand, for irregular field calculation, which requires more computation capability for each calculation point, the communication overhead was still less even when more than 50 processors were involved. Real-time responses could be expected for more complex algorithms by increasing the number of processors. (author)

  4. Practical use of a plastic scintillator for quality assurance of electron beam therapy

    Science.gov (United States)

    Yogo, Katsunori; Tatsuno, Yuya; Tsuneda, Masato; Aono, Yuki; Mochizuki, Daiki; Fujisawa, Yoshiki; Matsushita, Akihiro; Ishigami, Minoru; Ishiyama, Hiromichi; Hayakawa, Kazushige

    2017-06-01

    Quality assurance (QA) of clinical electron beams is essential for performing accurate and safe radiation therapy. However, with advances in radiation therapy, QA has become increasingly labor-intensive and time-consuming. In this paper, we propose a tissue-equivalent plastic scintillator for quick and easy QA of clinical electron beams. The proposed tool comprises a plastic scintillator plate and a charge-coupled device camera that enable the scintillation light by electron beams to be recorded with high sensitivity and high spatial resolution. Further, the Cerenkov image is directly subtracted from the scintillation image to discriminate Cerenkov emissions and accurately measure the dose profiles of electron beams with high spatial resolution. Compared with conventional methods, discrepancies in the depth profile improved from 7% to 2% in the buildup region via subtractive corrections. Further, the output brightness showed good linearity with dose, good reproducibility (deviations below 1%), and dose rate independence (within 0.5%). The depth of 50% dose measured with the tool, an index of electron beam quality, was within  ±0.5 mm of that obtained with an ionization chamber. Lateral brightness profiles agreed with the lateral dose profiles to within 4% and no significant improvement was obtained using Cerenkov corrections. Field size agreed to within 0.5 mm with those obtained with ionization chamber. For clinical QA of electron boost treatment, a disk scintillator that mimics the shape of a patient’s breast is applied. The brightness distribution and dose, calculated using a treatment planning system, was generally acceptable for clinical use, except in limited zones. Overall, the proposed plastic scintillator plate tool efficiently performs QA for electron beam therapy and enables simultaneous verification of output constancy, beam quality, depth, and lateral dose profiles during monthly QAs at lower doses of irradiation (small monitor units, MUs).

  5. Practical use of a plastic scintillator for quality assurance of electron beam therapy.

    Science.gov (United States)

    Yogo, Katsunori; Tatsuno, Yuya; Tsuneda, Masato; Aono, Yuki; Mochizuki, Daiki; Fujisawa, Yoshiki; Matsushita, Akihiro; Ishigami, Minoru; Ishiyama, Hiromichi; Hayakawa, Kazushige

    2017-06-07

    Quality assurance (QA) of clinical electron beams is essential for performing accurate and safe radiation therapy. However, with advances in radiation therapy, QA has become increasingly labor-intensive and time-consuming. In this paper, we propose a tissue-equivalent plastic scintillator for quick and easy QA of clinical electron beams. The proposed tool comprises a plastic scintillator plate and a charge-coupled device camera that enable the scintillation light by electron beams to be recorded with high sensitivity and high spatial resolution. Further, the Cerenkov image is directly subtracted from the scintillation image to discriminate Cerenkov emissions and accurately measure the dose profiles of electron beams with high spatial resolution. Compared with conventional methods, discrepancies in the depth profile improved from 7% to 2% in the buildup region via subtractive corrections. Further, the output brightness showed good linearity with dose, good reproducibility (deviations below 1%), and dose rate independence (within 0.5%). The depth of 50% dose measured with the tool, an index of electron beam quality, was within  ±0.5 mm of that obtained with an ionization chamber. Lateral brightness profiles agreed with the lateral dose profiles to within 4% and no significant improvement was obtained using Cerenkov corrections. Field size agreed to within 0.5 mm with those obtained with ionization chamber. For clinical QA of electron boost treatment, a disk scintillator that mimics the shape of a patient's breast is applied. The brightness distribution and dose, calculated using a treatment planning system, was generally acceptable for clinical use, except in limited zones. Overall, the proposed plastic scintillator plate tool efficiently performs QA for electron beam therapy and enables simultaneous verification of output constancy, beam quality, depth, and lateral dose profiles during monthly QAs at lower doses of irradiation (small monitor units, MUs).

  6. Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Penninkhof, Joan, E-mail: j.penninkhof@erasmusmc.nl [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Spadola, Sara [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna (Italy); Breedveld, Sebastiaan; Baaijens, Margreet [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Lanconelli, Nico [Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna (Italy); Heijmen, Ben [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands)

    2017-06-01

    Purpose and Objective: Propose a novel method for individualized selection of beam angles and treatment isocenter in tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: For each patient, beam and isocenter selection starts with the fully automatic generation of a large database of IMRT plans (up to 847 in this study); each of these plans belongs to a unique combination of isocenter position, lateral beam angle, and medial beam angle. The imposed hard planning constraint on patient maximum dose may result in plans with unacceptable target dose delivery. Such plans are excluded from further analyses. Owing to differences in beam setup, database plans differ in mean doses to organs at risk (OARs). These mean doses are used to construct 2-dimensional graphs, showing relationships between: (1) contralateral breast dose and ipsilateral lung dose; and (2) contralateral breast dose and heart dose (analyzed only for left-sided). The graphs can be used for selection of the isocenter and beam angles with the optimal, patient-specific tradeoffs between the mean OAR doses. For 30 previously treated patients (15 left-sided and 15 right-sided tumors), graphs were generated considering only the clinically applied isocenter with 121 tangential beam angle pairs. For 20 of the 30 patients, 6 alternative isocenters were also investigated. Results: Computation time for automatic generation of 121 IMRT plans took on average 30 minutes. The generated graphs demonstrated large variations in tradeoffs between conflicting OAR objectives, depending on beam angles and patient anatomy. For patients with isocenter optimization, 847 IMRT plans were considered. Adding isocenter position optimization next to beam angle optimization had a small impact on the final plan quality. Conclusion: A method is proposed for individualized selection of beam angles in tangential breast IMRT. This may be especially important for patients with cardiac risk factors or an

  7. On-line image guided radiation therapy using cone-beam CT (CBCT)

    International Nuclear Information System (INIS)

    Bak, Jin O; Park, Suk Won; Jeong, Kyung Keun; Keum, Ki Chang

    2006-01-01

    Using cone beam CT, we can compare the position of the patients at the simulation and the treatment. In on-line image guided radiation therapy, one can utilize this compared data and correct the patient position before treatments. Using cone beam CT, we investigated the errors induced by setting up the patients when use only the markings on the patients' skin. We obtained the data of three patients that received radiation therapy at the Department of Radiation Oncology in Chung-Ang University during August 2006 and October 2006. Just as normal radiation therapy, patients were aligned on the treatment couch after the simulation and treatment planning. Patients were aligned with lasers according to the marking on the skin that were marked at the simulation time and then cone beam CTs were obtained. Cone beam CTs were fused and compared with simulation CTs and the displacement vectors were calculated. Treatment couches were adjusted according to the displacement vector before treatments. After the treatment, positions were verified with kV X-ray (OBI system). In the case of head and neck patients, the average sizes of the setup error vectors, given by the cone beam CT, were 0.19 cm for the patient A and 0.18 cm for the patient B. The standard deviations were 0.15 cm and 0.21 cm, each. On the other hand, in the case of the pelvis patient, the average and the standard deviation were 0.37 cm and 01 cm. Through the on-line IGRT using cone beam CT, were could correct the setup errors that could occur in the conventional radiotherapy. The importance of the on-line IGRT should be emphasized in the case of 3D conformal therapy and intensity-modulated radiotherapy, which have complex target shapes and steep dose gradients

  8. Evolution of a beam dynamics model for the transport line in a proton therapy facility

    Science.gov (United States)

    Rizzoglio, V.; Adelmann, A.; Baumgarten, C.; Frey, M.; Gerbershagen, A.; Meer, D.; Schippers, J. M.

    2017-12-01

    During the conceptual design of an accelerator or beamline, first-order beam dynamics models are essential for studying beam properties. However, they can only produce approximate results. During commissioning, these approximate results are compared to measurements, which will rarely coincide if the model does not include the relevant physics. It is therefore essential that this linear model is extended to include higher-order effects. In this paper, the effects of particle-matter interaction have been included in the model of the transport lines in the proton therapy facility at the Paul Scherrer Institut (PSI) in Switzerland. The first-order models of these beamlines provide an approximated estimation of beam size, energy loss and transmission. To improve the performance of the facility, a more precise model was required and has been developed with opal (Object Oriented Parallel Accelerator Library), a multiparticle open source beam dynamics code. In opal, the Monte Carlo simulations of Coulomb scattering and energy loss are performed seamless with the particle tracking. Beside the linear optics, the influence of the passive elements (e.g., degrader, collimators, scattering foils, and air gaps) on the beam emittance and energy spread can be analyzed in the new model. This allows for a significantly improved precision in the prediction of beam transmission and beam properties. The accuracy of the opal model has been confirmed by numerous measurements.

  9. Cost-effectiveness analysis of cochlear dose reduction by proton beam therapy for medulloblastoma in childhood

    International Nuclear Information System (INIS)

    Hirano, Emi; Kawabuchi, Koichi; Fuji, Hiroshi; Onoe, Tsuyoshi; Kumar, Vinay; Shirato, Hiroki

    2014-01-01

    The aim of this study is to evaluate the cost-effectiveness of proton beam therapy with cochlear dose reduction compared with conventional X-ray radiotherapy for medulloblastoma in childhood. We developed a Markov model to describe health states of 6-year-old children with medulloblastoma after treatment with proton or X-ray radiotherapy. The risks of hearing loss were calculated on cochlear dose for each treatment. Three types of health-related quality of life (HRQOL) of EQ-5D, HUI3 and SF-6D were used for estimation of quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) for proton beam therapy compared with X-ray radiotherapy was calculated for each HRQOL. Sensitivity analyses were performed to model uncertainty in these parameters. The ICER for EQ-5D, HUI3 and SF-6D were $21 716/QALY, $11 773/QALY, and $20 150/QALY, respectively. One-way sensitivity analyses found that the results were sensitive to discount rate, the risk of hearing loss after proton therapy, and costs of proton irradiation. Cost-effectiveness acceptability curve analysis revealed a 99% probability of proton therapy being cost effective at a societal willingness-to-pay value. Proton beam therapy with cochlear dose reduction improves health outcomes at a cost that is within the acceptable cost-effectiveness range from the payer's standpoint. (author)

  10. Normal tissue tolerance to external beam radiation therapy: Skin

    International Nuclear Information System (INIS)

    Ginot, A.; Doyen, J.; Hannoun-Levi, J.M.; Courdi, A.

    2010-01-01

    Acute skin toxicity is frequent during radiation therapy and can lead to temporary arrest of the treatment. Chronic toxicity can occur and conduct to cosmetic problems. Alopecia is the most frequent toxicity concerning hair and is most of the time reversible. Several factors linked to patients influence skin toxicity, such as under-nutrition, old age, obesity, smoking, skin diseases, autoimmune diseases, failure of DNA reparation. Skin, hair and nail toxicities depend also on radiation schedule. Acute toxicity is greater when dose per fraction increases. Chronic and acute toxicities are more often when total dose increases. Under 45 Gy, the risk of severe skin toxicity is low, and begins above 50 Gy. Skin toxicity depends also on the duration of radiotherapy and split course schedules are associated with less toxicities. Irradiation surface seems to influence skin toxicity but interaction is more complex. Reirradiation is often feasible in case of cancer recurrence but with a risk of grade 3-4 toxicity above all in head and neck cancer. The benefit/risk ratio has to be always precisely evaluated. Permanent alopecia is correlated with the follicle dose. Modern techniques of radiation therapy allow to spare skin. (authors)

  11. Normal tissue tolerance to external beam radiation therapy: The mandible

    International Nuclear Information System (INIS)

    Berger, A.; Bensadoun, R.J.

    2010-01-01

    Describing dose constraints for organs at risk in external beam radiotherapy is a key-point in order to maximize the therapeutic ratio. In head and neck irradiation, mandible is frequently exposed to ionising radiation-related complications. Those complications will be exposed after a short description of anatomical and physiopathological aspects. A literature search was performed using the Pubmed-Medline database, with following keywords (Osteoradionecrosis, Radiotherapy, Mandible, Toxicity, Organ at risk, Trismus). Incidence and dose constraints will be reported. The incidence of osteoradionecrosis decreased since the 1990, but it remains a dreaded late complication of head and neck cancer radiotherapy. It essentially occurs with cumulative doses of 66 Gy on the mandible (standard fractionation) applied to a significant volume. Respecting oral care is crucial to avoid this kind of complication. The respect of the dose-constraint described should not lead to under treat tumor bed in a curative intent. Trismus related to ionising radiation is poorly described. Literature data cannot lead to describe precise dose constraints. (authors)

  12. Real-time dose compensation methods for scanned ion beam therapy of moving tumors

    International Nuclear Information System (INIS)

    Luechtenborg, Robert

    2012-01-01

    Scanned ion beam therapy provides highly tumor-conformal treatments. So far, only tumors showing no considerable motion during therapy have been treated as tumor motion and dynamic beam delivery interfere, causing dose deteriorations. One proposed technique to mitigate these deteriorations is beam tracking (BT), which adapts the beam position to the moving tumor. Despite application of BT, dose deviations can occur in the case of non-translational motion. In this work, real-time dose compensation combined with beam tracking (RDBT) has been implemented into the control system to compensate these dose changes by adaptation of nominal particle numbers during irradiation. Compared to BT, significantly reduced dose deviations were measured using RDBT. Treatment planning studies for lung cancer patients including the increased biological effectiveness of ions revealed a significantly reduced over-dose level (3/5 patients) as well as significantly improved dose homogeneity (4/5 patients) for RDBT. Based on these findings, real-time dose compensated re-scanning (RDRS) has been proposed that potentially supersedes the technically complex fast energy adaptation necessary for BT and RDBT. Significantly improved conformity compared to re-scanning, i.e., averaging of dose deviations by repeated irradiation, was measured in film irradiations. Simulations comparing RDRS to BT revealed reduced under- and overdoses of the former method.

  13. Normal tissue tolerance to external beam radiation therapy: The stomach

    International Nuclear Information System (INIS)

    Oberdiac, P.; Mineur, L.

    2010-01-01

    In the following article, we will discuss general issues relating to acute and late gastric's radiation toxicities. The tolerance of the stomach to complete or partial organ irradiation is more un-appreciated than for most other organs. We consulted the Medline database via PubMed and used the key words gastric - radiotherapy - toxicity. Currently, 60 Gy or less is prescribed in gastric radiation therapy. Acute clinical toxicity symptoms are predominantly nausea and vomiting. Although there is a general agreement that the whole stomach tolerance is for doses of 40 to 45 Gy without unacceptable complication, it is well established that a stomach dose of 35 Gy increases the risk of ulcer complications. (authors)

  14. Beam-on imaging of short-lived positron emitters during proton therapy

    Science.gov (United States)

    Buitenhuis, H. J. T.; Diblen, F.; Brzezinski, K. W.; Brandenburg, S.; Dendooven, P.

    2017-06-01

    In vivo dose delivery verification in proton therapy can be performed by positron emission tomography (PET) of the positron-emitting nuclei produced by the proton beam in the patient. A PET scanner installed in the treatment position of a proton therapy facility that takes data with the beam on will see very short-lived nuclides as well as longer-lived nuclides. The most important short-lived nuclide for proton therapy is 12N (Dendooven et al 2015 Phys. Med. Biol. 60 8923-47), which has a half-life of 11 ms. The results of a proof-of-principle experiment of beam-on PET imaging of short-lived 12N nuclei are presented. The Philips Digital Photon Counting Module TEK PET system was used, which is based on LYSO scintillators mounted on digital SiPM photosensors. A 90 MeV proton beam from the cyclotron at KVI-CART was used to investigate the energy and time spectra of PET coincidences during beam-on. Events coinciding with proton bunches, such as prompt gamma rays, were removed from the data via an anti-coincidence filter with the cyclotron RF. The resulting energy spectrum allowed good identification of the 511 keV PET counts during beam-on. A method was developed to subtract the long-lived background from the 12N image by introducing a beam-off period into the cyclotron beam time structure. We measured 2D images and 1D profiles of the 12N distribution. A range shift of 5 mm was measured as 6  ±  3 mm using the 12N profile. A larger, more efficient, PET system with a higher data throughput capability will allow beam-on 12N PET imaging of single spots in the distal layer of an irradiation with an increased signal-to-background ratio and thus better accuracy. A simulation shows that a large dual panel scanner, which images a single spot directly after it is delivered, can measure a 5 mm range shift with millimeter accuracy: 5.5  ±  1.1 mm for 1  ×  108 protons and 5.2  ±  0.5 mm for 5  ×  108 protons. This makes

  15. MO-A-BRB-03: Integration Issues in Electronic Charting for External Beam Therapy

    International Nuclear Information System (INIS)

    Sutlief, S.

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  16. Project and construction of energy degrading and scattering plates for electron beam radiotherapy for skin diseases

    International Nuclear Information System (INIS)

    Fonseca, Gabriel Paiva

    2010-01-01

    There are many radiosensitive epidermotropics diseases such as mycosis fungo-ids and the syndrome of Sezary, coetaneous neoplasics originated from type T lymphocytes. Several studies indicate the eradication of the disease when treated with linear accelerators emitting electron beams with energies between 4 to 10 MeV. However, this treatment technique presents innumerable technical challenges since the disease in general reaches all patient's body, becoming necessary not only a very large field size radiation beam, but also deliver superficial doses limited to the skin depth. To reach the uniformity in the dose distribution, many techniques had already been developed. Based on these previous studies and guided by the report no. 23 of the American Association of Physicists in Medi-cine (AAPM), the present study developed an energy scattering and degrading plates and made dosimetry (computational and experimental), supplying subsidies for a future installation of Total Skin Electron Therapy (TSET) at the Servico de Radioterapia do Hospital das Clinicas de Sao Paulo. As part of the plates design, first of all, the energy spectrum of the 6 MeV electron beam of the VARIAN 2100C accelerator was reconstructed through Monte Carlo simulations using the MCNP4C code and based on experimental data. Once the spectrum is built, several materials were analyzed for the plates design based on radial and axial dose distribution, production of rays-x and dose attenuation. The simulation results were validated by experimental measurements in order to obtain a large field of radiation with 200 cm x 80 cm that meets the specifications of the AAPM protocol. (author)

  17. Visual Outcomes of Parapapillary Uveal Melanomas Following Proton Beam Therapy

    International Nuclear Information System (INIS)

    Thariat, Juliette; Grange, Jean-Daniel; Mosci, Carlo; Rosier, Laurence; Maschi, Celia; Lanza, Francesco; Nguyen, Anh Minh; Jaspart, Franck; Bacin, Franck; Bonnin, Nicolas; Gaucher, David; Sauerwein, Wolfgang; Angellier, Gaelle; Hérault, Joel; Caujolle, Jean-Pierre

    2016-01-01

    Purpose: In parapapillary melanoma patients, radiation-induced optic complications are frequent and visual acuity is often compromised. We investigated dose-effect relationships for the optic nerve with respect to visual acuity after proton therapy. Methods and Materials: Of 5205 patients treated between 1991 and 2014, those treated using computed tomography (CT)-based planning to 52 Gy (prescribed dose, not accounting for relative biologic effectiveness correction of 1.1) in 4 fractions, with minimal 6-month follow-up and documented initial and last visual acuity, were included. Deterioration of ≥0.3 logMAR between initial and last visual acuity results was reported. Results: A total of 865 consecutive patients were included. Median follow-up was 69 months, mean age was 61.7 years, tumor abutted the papilla in 35.1% of patients, and tumor-to-fovea distance was ≤3 mm in 74.2% of patients. Five-year relapse-free survival rate was 92.7%. Visual acuity was ≥20/200 in 72.6% of patients initially and 47.2% at last follow-up. A wedge filter was used in 47.8% of the patients, with a positive impact on vision and no impact on relapse. Glaucoma, radiation-induced optic neuropathy, maculopathy were reported in 17.9%, 47.5%, and 33.6% of patients, respectively. On multivariate analysis, age, diabetes, thickness, initial visual acuity and percentage of macula receiving 26 Gy were predictive of visual acuity. Furthermore, patients irradiated to ≥80% of their papilla had better visual acuity when limiting the 50% (30-Gy) and 20% (12-Gy) isodoses to ≤2 mm and 6 mm of optic nerve length, respectively. Conclusions: A personalized proton therapy plan with optic nerve and macular sparing can be used efficiently with good oncological and functional results in parapapillary melanoma patients.

  18. Visual Outcomes of Parapapillary Uveal Melanomas Following Proton Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Thariat, Juliette, E-mail: jthariat@gmail.com [Department of Radiation Therapy, Cancer Center Antoine Lacassagne-Nice Sophia Antipolis University Hospital, Nice (France); Grange, Jean-Daniel [Department of Ophthalmology, Eye University Clinic la Croix Rousse, Lyon (France); Mosci, Carlo [Department of Ophthalmology, National Institute for Cancer Research, Mura Delle Cappucine, Genova (Italy); Rosier, Laurence [Eye Clinic, Centre d' Exploration et de Traitement de la Retine et de la Macula, Bordeaux (France); Maschi, Celia [Department of Ophthalmology, Eye University Clinic Pasteur 2, Nice (France); Lanza, Francesco [Department of Ophthalmology, National Institute for Cancer Research, Mura Delle Cappucine, Genova (Italy); Nguyen, Anh Minh [Department of Ophthalmology, Eye University Clinic la Croix Rousse, Lyon (France); Jaspart, Franck; Bacin, Franck; Bonnin, Nicolas [Department of Ophthalmology, Eye University Clinic Gabriel Montpied, Clermont Ferrand (France); Gaucher, David [Department of Ophthalmology, Eye University Clinic, Hopital Civil, Strasbourg (France); Sauerwein, Wolfgang [Department of Radiation Therapy, NCTeam, Strahlenklinik, Universitätsklinikum Essen, Essen (Germany); Angellier, Gaelle; Hérault, Joel [Department of Radiation Therapy, Cancer Center Antoine Lacassagne-Nice Sophia Antipolis University Hospital, Nice (France); Caujolle, Jean-Pierre [Department of Ophthalmology, Eye University Clinic Pasteur 2, Nice (France)

    2016-05-01

    Purpose: In parapapillary melanoma patients, radiation-induced optic complications are frequent and visual acuity is often compromised. We investigated dose-effect relationships for the optic nerve with respect to visual acuity after proton therapy. Methods and Materials: Of 5205 patients treated between 1991 and 2014, those treated using computed tomography (CT)-based planning to 52 Gy (prescribed dose, not accounting for relative biologic effectiveness correction of 1.1) in 4 fractions, with minimal 6-month follow-up and documented initial and last visual acuity, were included. Deterioration of ≥0.3 logMAR between initial and last visual acuity results was reported. Results: A total of 865 consecutive patients were included. Median follow-up was 69 months, mean age was 61.7 years, tumor abutted the papilla in 35.1% of patients, and tumor-to-fovea distance was ≤3 mm in 74.2% of patients. Five-year relapse-free survival rate was 92.7%. Visual acuity was ≥20/200 in 72.6% of patients initially and 47.2% at last follow-up. A wedge filter was used in 47.8% of the patients, with a positive impact on vision and no impact on relapse. Glaucoma, radiation-induced optic neuropathy, maculopathy were reported in 17.9%, 47.5%, and 33.6% of patients, respectively. On multivariate analysis, age, diabetes, thickness, initial visual acuity and percentage of macula receiving 26 Gy were predictive of visual acuity. Furthermore, patients irradiated to ≥80% of their papilla had better visual acuity when limiting the 50% (30-Gy) and 20% (12-Gy) isodoses to ≤2 mm and 6 mm of optic nerve length, respectively. Conclusions: A personalized proton therapy plan with optic nerve and macular sparing can be used efficiently with good oncological and functional results in parapapillary melanoma patients.

  19. Dosimetry of a prototype retractable eMLC for fixed-beam electron therapy

    International Nuclear Information System (INIS)

    Hogstrom, Kenneth R.; Boyd, Robert A.; Antolak, John A.; Svatos, Michelle M.; Faddegon, Bruce A.; Rosenman, Julian G.

    2004-01-01

    An electron multileaf collimator (eMLC) has been designed that is unique in that it retracts to 37 cm from the isocenter [63-cm source-to-collimator distance (SCD)] and can be deployed to distances of 20 and 10 cm from the isocenter (80 and 90 cm SCD, respectively). It is expected to be capable of arc therapy at 63 cm SCD; isocentric, fixed-beam therapy at 80 cm SCD; and source-to-surface distance (SSD), fixed-beam therapy at 90 cm SCD. In all positions, its leaves could be used for unmodulated or intensity-modulated therapy. Our goal in the present work is to describe the general characteristics of the eMLC and to demonstrate that its leakage characteristics and dosimetry are adequate for SSD, fixed-beam therapy as an alternative to Cerrobend cutouts with applicators once the prototype's leaves are motorized. Our eMLC data showed interleaf electron leakage at 15 MeV to be less than 0.1% based on a 0.0025 cm manufacturing tolerance, and lateral electron leakage at 5 and 15 MeV to be less than 2%. X-ray leakage through the leaves was 1.6% at 15 MeV. Our data showed that beam penumbra was independent of direction and leaf position. The dosimetric properties of square fields formed by the eMLC were very consistent with those formed by Cerrobend inserts in the 20x20 cm 2 applicator. Output factors exhibited similar field-size dependence. Airgap factors exhibited almost identical field-size dependence at two SSDs (105 and 110 cm), consistent with the common assumption that airgap factors are applicator independent. Percent depth-dose curves were similar, but showed variations up to 3% in the buildup region. The pencil-beam algorithm (PBA) fit measured data from the eMLC and applicator-cutout systems equally well, and the resulting two-dimensional (2-D) dose distributions, as predicted by the PBA, agreed well at common airgap distance. Simulating patient setups for breast and head and neck treatments showed that almost all fields could be treated using similar SSDs as

  20. The evaluation of properties for radiation therapy techniques with flattening filter-free beam and usefulness of time and economy to a patient with the radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Jang Hyeon; Won, Hui Su; Hong, Joo Wan; Chang, Nam Jun; Park, Jin Hong [Dept. of Radiation Oncology, Seoul national university Bundang hospital, Sungnam (Korea, Republic of)

    2014-12-15

    The aim of this study was to appraise properties for radiation therapy techniques and effectiveness of time and economy to a patient in the case of applying flattening filter-free (3F) and flattening filter (2F) beam to the radiation therapy. Alderson rando phantom was scanned for computed tomography image. Treatment plans for intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) and stereotactic body radiation therapy (SBRT) with 3F and 2F beam were designed for prostate cancer. To evaluate the differences between the 3F and 2F beam, total monitor units (MUs), beam on time (BOT) and gantry rotation time (GRT) were used and measured with TrueBeam{sup TM} STx and Surveillance And Measurement (SAM) 940 detector was used for photoneutron emitted by using 3F and 2F. To assess temporal and economical aspect for a patient, total treatment periods and medical fees were estimated. In using 3F beam, total MUs in IMRT plan increased the highest up to 34.0% and in the test of BOT, GRT and photoneutron, the values in SBRT plan decreased the lowest 39.8, 38.6 and 48.1%, respectively. In the temporal and economical aspect, there were no differences between 3F and 2F beam in all of plans and the results showed that 10 days and 169,560 won was lowest in SBRT plan. According as the results, total MUs increased by using 3F beam than 2F beam but BOT, GRT and photoneutron decreased. From above the results, using 3F beam can decrease intra-fraction setup error and risk of radiation-induced secondary malignancy. But, using 3F beam did not make the benefits of temporal and economical aspect for a patient with the radiation therapy.

  1. External-beam radiation therapy after surgical resection and intraoperative electron-beam radiation therapy for oligorecurrent gynecological cancer. Long-term outcome

    Energy Technology Data Exchange (ETDEWEB)

    Sole, C.V. [Hospital General Universitario Gregorio Maranon, Department of Oncology, Madrid (Spain); Complutense University, School of Medicine, Madrid (Spain); Instituto de Radiomedicina, Service of Radiation Oncology, Santiago (Chile); Hospital General Universitario Gregorio Maranon, Institute of Research Investigation, Madrid (Spain); Calvo, F.A. [Hospital General Universitario Gregorio Maranon, Department of Oncology, Madrid (Spain); Complutense University, School of Medicine, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Institute of Research Investigation, Madrid (Spain); Lozano, M.A.; Gonzalez-Sansegundo, C. [Hospital General Universitario Gregorio Maranon, Department of Oncology, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Service of Radiation Oncology, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Institute of Research Investigation, Madrid (Spain); Gonzalez-Bayon, L. [Hospital General Universitario Gregorio Maranon, Service of General Surgery, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Institute of Research Investigation, Madrid (Spain); Alvarez, A. [Hospital General Universitario Gregorio Maranon, Service of Radiation Oncology, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Institute of Research Investigation, Madrid (Spain); Lizarraga, S. [Hospital General Universitario Gregorio Maranon, Department of Gynecology, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Institute of Research Investigation, Madrid (Spain); Garcia-Sabrido, J.L. [Complutense University, School of Medicine, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Service of General Surgery, Madrid (Spain); Hospital General Universitario Gregorio Maranon, Department of Gynecology, Madrid (Spain)

    2014-02-15

    The goal of the present study was to analyze prognostic factors in patients treated with external-beam radiation therapy (EBRT), surgical resection and intraoperative electron-beam radiotherapy (IOERT) for oligorecurrent gynecological cancer (ORGC). From January 1995 to December 2012, 61 patients with ORGC [uterine cervix (52 %), endometrial (30 %), ovarian (15 %), vagina (3 %)] underwent IOERT (12.5 Gy, range 10-15 Gy), and surgical resection to the pelvic (57 %) and paraaortic (43 %) recurrence tumor bed. In addition, 29 patients (48 %) also received EBRT (range 30.6-50.4 Gy). Survival outcomes were estimated using the Kaplan-Meier method, and risk factors were identified by univariate and multivariate analyses. Median follow-up time for the entire cohort of patients was 42 months (range 2-169 months). The 10-year rates for overall survival (OS) and locoregional control (LRC) were 17 and 65 %, respectively. On multivariate analysis, no tumor fragmentation (HR 0.22; p = 0.03), time interval from primary tumor diagnosis to locoregional recurrence (LRR) < 24 months (HR 4.02; p = 0.02) and no EBRT at the time of pelvic recurrence (HR 3.95; p = 0.02) retained significance with regard to LRR. Time interval from primary tumor to LRR < 24 months (HR 2.32; p = 0.02) and no EBRT at the time of pelvic recurrence (HR 3.77; p = 0.04) showed a significant association with OS after adjustment for other covariates. External-beam radiation therapy at the time of pelvic recurrence, time interval for relapse ≥24 months and not multi-involved fragmented resection specimens are associated with improved LRC in patients with ORGC. As suggested from the present analysis a significant group of ORGC patients could potentially benefit from multimodality rescue treatment. (orig.)

  2. External-beam radiation therapy after surgical resection and intraoperative electron-beam radiation therapy for oligorecurrent gynecological cancer. Long-term outcome

    International Nuclear Information System (INIS)

    Sole, C.V.; Calvo, F.A.; Lozano, M.A.; Gonzalez-Sansegundo, C.; Gonzalez-Bayon, L.; Alvarez, A.; Lizarraga, S.; Garcia-Sabrido, J.L.

    2014-01-01

    The goal of the present study was to analyze prognostic factors in patients treated with external-beam radiation therapy (EBRT), surgical resection and intraoperative electron-beam radiotherapy (IOERT) for oligorecurrent gynecological cancer (ORGC). From January 1995 to December 2012, 61 patients with ORGC [uterine cervix (52 %), endometrial (30 %), ovarian (15 %), vagina (3 %)] underwent IOERT (12.5 Gy, range 10-15 Gy), and surgical resection to the pelvic (57 %) and paraaortic (43 %) recurrence tumor bed. In addition, 29 patients (48 %) also received EBRT (range 30.6-50.4 Gy). Survival outcomes were estimated using the Kaplan-Meier method, and risk factors were identified by univariate and multivariate analyses. Median follow-up time for the entire cohort of patients was 42 months (range 2-169 months). The 10-year rates for overall survival (OS) and locoregional control (LRC) were 17 and 65 %, respectively. On multivariate analysis, no tumor fragmentation (HR 0.22; p = 0.03), time interval from primary tumor diagnosis to locoregional recurrence (LRR) < 24 months (HR 4.02; p = 0.02) and no EBRT at the time of pelvic recurrence (HR 3.95; p = 0.02) retained significance with regard to LRR. Time interval from primary tumor to LRR < 24 months (HR 2.32; p = 0.02) and no EBRT at the time of pelvic recurrence (HR 3.77; p = 0.04) showed a significant association with OS after adjustment for other covariates. External-beam radiation therapy at the time of pelvic recurrence, time interval for relapse ≥24 months and not multi-involved fragmented resection specimens are associated with improved LRC in patients with ORGC. As suggested from the present analysis a significant group of ORGC patients could potentially benefit from multimodality rescue treatment. (orig.)

  3. Treatment planning, optimization, and beam delivery technqiues for intensity modulated proton therapy

    Science.gov (United States)

    Sengbusch, Evan R.

    Physical properties of proton interactions in matter give them a theoretical advantage over photons in radiation therapy for cancer treatment, but they are seldom used relative to photons. The primary barriers to wider acceptance of proton therapy are the technical feasibility, size, and price of proton therapy systems. Several aspects of the proton therapy landscape are investigated, and new techniques for treatment planning, optimization, and beam delivery are presented. The results of these investigations suggest a means by which proton therapy can be delivered more efficiently, effectively, and to a much larger proportion of eligible patients. An analysis of the existing proton therapy market was performed. Personal interviews with over 30 radiation oncology leaders were conducted with regard to the current and future use of proton therapy. In addition, global proton therapy market projections are presented. The results of these investigations serve as motivation and guidance for the subsequent development of treatment system designs and treatment planning, optimization, and beam delivery methods. A major factor impacting the size and cost of proton treatment systems is the maximum energy of the accelerator. Historically, 250 MeV has been the accepted value, but there is minimal quantitative evidence in the literature that supports this standard. A retrospective study of 100 patients is presented that quantifies the maximum proton kinetic energy requirements for cancer treatment, and the impact of those results with regard to treatment system size, cost, and neutron production is discussed. This study is subsequently expanded to include 100 cranial stereotactic radiosurgery (SRS) patients, and the results are discussed in the context of a proposed dedicated proton SRS treatment system. Finally, novel proton therapy optimization and delivery techniques are presented. Algorithms are developed that optimize treatment plans over beam angle, spot size, spot spacing

  4. BEAM DYNAMICS STUDIES FOR A COMPACT CARBON ION LINAC FOR THERAPY

    Energy Technology Data Exchange (ETDEWEB)

    Plastun, A.; Mustapha, B.; Nassiri, A.; Ostroumov, P.

    2016-05-01

    Feasibility of an Advanced Compact Carbon Ion Linac (ACCIL) for hadron therapy is being studied at Argonne National Laboratory in collaboration with RadiaBeam Technologies. The 45-meter long linac is designed to deliver 109 carbon ions per second with variable energy from 45 MeV/u to 450 MeV/u. S-band structure provides the acceleration in this range. The carbon beam energy can be adjusted from pulse to pulse, making 3D tumor scanning straightforward and fast. Front end accelerating structures such as RFQ, DTL and coupled DTL are designed to operate at lower frequencies. The design of the linac was accompanied with extensive end-to-end beam dynamics studies which are presented in this paper.

  5. Dosimetric characteristics of the thermal neutron beam facility for neutron capture therapy at Hanaro reactor

    International Nuclear Information System (INIS)

    Lee, Dong Han; Suh, Soheigh; Ji, Young Hoon

    2006-01-01

    The thermal neutron beam facility utilizing a typical tangential beam port for Neutron Capture Therapy was installed at the Hanaro, 30 MW multi-purpose research reactor. In order to determine the different dose components in phantoms irradiated with a mixed thermal neutron beam and gamma-ray for clinical applications, various techniques were applied including the use of activation foils, TLDs and ionization chambers. The water phantom was utilized in the measurement. The results of the measurement were compared with MCNP4B calculations. The thermal neutron fluxes were 1.02E9 and 6.07E8/cm 2 ·s at 10 and 20 mm depth in water, respectively. The gamma-ray dose rate was 5.10 Gy/hr at 20 mm depth in water. The result of this study can be used as basic data for subsequent BNCT clinical application. (author)

  6. SU-E-T-626: Practical Method to Implement Arc Therapy Using Scanned Particle Beams

    Energy Technology Data Exchange (ETDEWEB)

    Eley, J; Mehta, M; Molitoris, J; Langner, U; Langen, K [University of Maryland School of Medicine, Baltimore, MD (United States)

    2015-06-15

    Purpose: The purpose of this study was to propose a method to implement arc therapy that is compatible with existing particle therapy systems having gantries and pencil-beam scanning capacities. Furthermore, we sought to demonstrate expected benefits of this method for selected clival chordoma patients. Methods: We propose that a desired particle arc treatment plan can be discretized into a finite number of fixed beams and that only one (or a subset) of these beams be delivered in any single treatment fraction; the target should receive uniform dose during each fraction. For 3 clival-chordoma patients, robust-optimized, scanned proton beams were simulated to deliver 78 Gy (RBE) to clinical target volumes (CTVs), using either a single-field plan with a posterior-anterior (PA) beam or a discrete-arc plan with 16 beams that were equally spaced throughout a 360-degree axial arc. Dose-volume metrics were compared with emphasis on the brainstem, since risk of radiation necrosis there can often restrict application of tumoricidal doses for chordomas. Results: The mean volume of brainstem receiving a dose of 60 Gy (RBE) or higher (V60Gy) was 10.3±0.9 cm{sup 3} for the single-field plan and 4.7±1.8 cm{sup 3} for the discrete-arc plan, a reduction of 55% in favor of arcs. The mean dose to the brainstem was also reduced using arcs, by 18%, while the maximum dose was nearly identical for both methods. For the whole brain, V60Gy was reduced by 23%, in favor of arcs. Mean dose to the CTVs were nearly identical for both strategies, within 0.3%. Conclusion: Discrete arc treatments can be implemented using existing scanned particle-beam facilities. Aside from the physical advantages, the biological uncertainties of particle therapy, particularly high in the distal edge, can be reduced by arc therapy via rotational smearing, which may be of benefit for tumors near the brainstem.

  7. Impact of Spot Size and Beam-Shaping Devices on the Treatment Plan Quality for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Moteabbed, Maryam; Yock, Torunn I.; Depauw, Nicolas; Madden, Thomas M.; Kooy, Hanne M.; Paganetti, Harald

    2016-01-01

    Purpose: This study aimed to assess the clinical impact of spot size and the addition of apertures and range compensators on the treatment quality of pencil beam scanning (PBS) proton therapy and to define when PBS could improve on passive scattering proton therapy (PSPT). Methods and Materials: The patient cohort included 14 pediatric patients treated with PSPT. Six PBS plans were created and optimized for each patient using 3 spot sizes (∼12-, 5.4-, and 2.5-mm median sigma at isocenter for 90- to 230-MeV range) and adding apertures and compensators to plans with the 2 larger spots. Conformity and homogeneity indices, dose-volume histogram parameters, equivalent uniform dose (EUD), normal tissue complication probability (NTCP), and integral dose were quantified and compared with the respective PSPT plans. Results: The results clearly indicated that PBS with the largest spots does not necessarily offer a dosimetric or clinical advantage over PSPT. With comparable target coverage, the mean dose (D mean ) to healthy organs was on average 6.3% larger than PSPT when using this spot size. However, adding apertures to plans with large spots improved the treatment quality by decreasing the average D mean and EUD by up to 8.6% and 3.2% of the prescribed dose, respectively. Decreasing the spot size further improved all plans, lowering the average D mean and EUD by up to 11.6% and 10.9% compared with PSPT, respectively, and eliminated the need for beam-shaping devices. The NTCP decreased with spot size and addition of apertures, with maximum reduction of 5.4% relative to PSPT. Conclusions: The added benefit of using PBS strongly depends on the delivery configurations. Facilities limited to large spot sizes (>∼8 mm median sigma at isocenter) are recommended to use apertures to reduce treatment-related toxicities, at least for complex and/or small tumors.

  8. Getting Ready for Ion-Beam Therapy Research in Austria - Building-up Research in Parallel with a Facility

    International Nuclear Information System (INIS)

    Georg, Dietmar; Knaeusl; Kuess, Peter; Fuchs, Hermann; Poetter, Richard; Schreiner, Thomas

    2015-01-01

    With participation in ion-beam projects funded nationally or by the European Commission (EC), ion-beam research activities were started at the Medical University of Vienna in parallel with the design and construction of the ion-beam center MedAustron in Wiener Neustadt, 50 km from the Austrian capital. The current medical radiation physics research activities that will be presented comprise: (1) Dose calculation and optimization: ion-beam centers focus mostly on proton and carbon-ion therapy. However, there are other ion species with great potential for clinical applications. Helium ions are currently under investigation from a theoretical physics and biology perspective. (2) Image guided and adaptive ion-beam therapy: organ motion and anatomic changes have a severe influence in ion-beam therapy since variations in heterogeneity along the beam path have a significant impact on the particle range. Ongoing research focuses on possibilities to account for temporal variations of the anatomy during radiotherapy. Both during and between fractions also considering temporal variations in tumor biology. Furthermore, research focuses on particle therapy positron emission tomography (PT-PET) verification and the detection of prompt gammas for on-line verification of ion-beam delivery. (3) Basic and applied dosimetry: an end-to-end procedure was designed and successfully tested in both scanned proton and carbon-ion beams, which may also serve as a dosimetric credentialing procedure for clinical trials in the future. (Author)

  9. Initial clinical evaluation of PET-based ion beam therapy monitoring under consideration of organ motion.

    Science.gov (United States)

    Kurz, Christopher; Bauer, Julia; Unholtz, Daniel; Richter, Daniel; Herfarth, Klaus; Debus, Jürgen; Parodi, Katia

    2016-02-01

    Intrafractional organ motion imposes considerable challenges to scanned ion beam therapy and demands for a thorough verification of the applied treatment. At the Heidelberg Ion-Beam Therapy Center (HIT), the scanned ion beam delivery is verified by means of postirradiation positron-emission-tomography (PET) imaging. This work presents a first clinical evaluation of PET-based treatment monitoring in ion beam therapy under consideration of target motion. Three patients with mobile liver lesions underwent scanned carbon ion irradiation at HIT and postirradiation PET/CT (x-ray-computed-tomography) imaging with a commercial scanner. Respiratory motion was recorded during irradiation and subsequent image acquisition. This enabled a time-resolved (4D) calculation of the expected irradiation-induced activity pattern and, for one patient where an additional 4D CT was acquired at the PET/CT scanner after treatment, a motion-compensated PET image reconstruction. For the other patients, PET data were reconstructed statically. To verify the treatment, calculated prediction and reconstructed measurement were compared with a focus on the ion beam range. Results in the current three patients suggest that for motion amplitudes in the order of 2 mm there is no benefit from incorporating respiratory motion information into PET-based treatment monitoring. For a target motion in the order of 10 mm, motion-related effects become more severe and a time-resolved modeling of the expected activity distribution can lead to an improved data interpretation if a sufficient number of true coincidences is detected. Benefits from motion-compensated PET image reconstruction could not be shown conclusively at the current stage. The feasibility of clinical PET-based treatment verification under consideration of organ motion has been shown for the first time. Improvements in noise-robust 4D PET image reconstruction are deemed necessary to enhance the clinical potential.

  10. Laser-Driven Very High Energy Electron/Photon Beam Radiation Therapy in Conjunction with a Robotic System

    Directory of Open Access Journals (Sweden)

    Kazuhisa Nakajima

    2014-12-01

    Full Text Available We present a new external-beam radiation therapy system using very-high-energy (VHE electron/photon beams generated by a centimeter-scale laser plasma accelerator built in a robotic system. Most types of external-beam radiation therapy are delivered using a machine called a medical linear accelerator driven by radio frequency (RF power amplifiers, producing electron beams with an energy range of 6–20 MeV, in conjunction with modern radiation therapy technologies for effective shaping of three-dimensional dose distributions and spatially accurate dose delivery with imaging verification. However, the limited penetration depth and low quality of the transverse penumbra at such electron beams delivered from the present RF linear accelerators prevent the implementation of advanced modalities in current cancer treatments. These drawbacks can be overcome if the electron energy is increased to above 50 MeV. To overcome the disadvantages of the present RF-based medical accelerators, harnessing recent advancement of laser-driven plasma accelerators capable of producing 1-GeV electron beams in a 1-cm gas cell, we propose a new embodiment of the external-beam radiation therapy robotic system delivering very high-energy electron/photon beams with an energy of 50–250 MeV; it is more compact, less expensive, and has a simpler operation and higher performance in comparison with the current radiation therapy system.

  11. Proton therapy treatment monitoring with in-beam PET: Investigating space and time activity distributions

    Science.gov (United States)

    Brombal, L.; Barbosa, D.; Belcari, N.; Bisogni, M. G.; Camarlinghi, N.; Cristoforetti, L.; Guerra, A. Del; Fracchiolla, F.; Morrocchi, M.; Sportelli, G.; Righetto, R.; Schwarz, M.; Topi, A.; Rosso, V.

    2017-07-01

    In this study the possibility of retrieving composition information in proton therapy with a planar in-beam PET scanner is investigated. The analysis focuses both on spatial activity distributions and time dependence of the recorded signal. The experimental data taking was performed at the Trento Proton Therapy Center (IT) by irradiating three different phantoms. We show that different phantom compositions reflect into different activity profile shapes. We demonstrate that the analysis of the event rate can provide significant information on the phantom elemental composition, suggesting that elemental analysis could be used along with activity profile analysis to achieve a more accurate treatment monitoring.

  12. Evaluation of a GEM and CAT-based detector for radiation therapy beam monitoring

    International Nuclear Information System (INIS)

    Brahme, A.; Danielsson, M.; Iacobaeus, C.; Ostling, J.; Peskov, V.; Wallmark, M.

    2000-01-01

    We are developing a radiation therapy beam monitor for the Karolinska Institute. This monitor will consist of two consecutive detectors confined in one gas chamber: a 'keV-photon detector', which will allow diagnostic quality visualization of the patient, and a 'MeV-photon detector', that will measure the absolute intensity of the therapy beam and its position with respect to the patient. Both detectors are based on highly radiation resistant gas and solid photon to electron converters, combined with GEMs and a CAT as amplification structures. We have performed systematic studies of the high-rate characteristics of the GEM and the CAT, as well as tested the electron transfer through these electron multipliers and various types of converters. The tests show that the GEM and the CAT satisfy all requirements for the beam monitoring system. As a result of these studies we successfully developed and tested a full section of the beam monitor equipped with a MeV-photon converter placed between the GEM and the CAT

  13. The dosimetric Properties of Electron Beam Using Lyon Intraoperative Device for Intraoperative Radiation Therapy

    International Nuclear Information System (INIS)

    Kim, Kye Jun; Park, Kyung Ran; Lee, Jong Young; Kim, Hie Yeon; Sung, Ki Joon; Chu, Sung Sil

    1992-01-01

    We have studied the dosimetric properties of electron beam using Lyon intraoperative device for intraoperative radiation therapy. The dosimetry data had compiled in such a way that a quick and correct decision regarding the cone shape, energy, and accurate calculations could be made. Using 3 dimensional water phantom, we have got the following data: cone output ratios, surface dose, dmax, dgo, flatness, symmetry, beam profiles, isodose curve, and SSD correction factors. The cone output ratios were measured with straight and bevelled cone, respectively. As the cone size and the energy were reduced, the cone output ratios decreased rapidly. With the flattening filter, the surface dose increased by electron beam to 85.3%, 89.2%, and 93.4%, for 6MeV, 9MeV, and 12MeV, respectively. It is important to increase the surface dose to 90% or more. Inspite of diminishing dose rate and beam penetration, this flattening filter increases the treatment volume significantly. With the combination of the three levels collimation and the flattening filter, we achieved good homogeneity of the beam and better flatness and the diameter of the 90% isodose curve was increased. It is important to increase the area that is included in the 90% isodose level. The value of measured and calculated SSD correction factors did not agree over the clinically important range from 100 cm to 110 cm

  14. A novel beam optics concept in a particle therapy gantry utilizing the advantages of superconducting magnets

    International Nuclear Information System (INIS)

    Gerbershagen, Alexander; Meer, David; Schippers, Jacobus Maarten; Seidel, Mike

    2016-01-01

    A first order design of the beam optics of a superconducting proton therapy gantry beam is presented. The possibilities of superconducting magnets with respect to the beam optics such as strong fields, large apertures and superposition of different multipole fields have been exploited for novel concepts in a gantry. Since various techniques used in existing gantries have been used in our first design steps, some examples of the existing superconducting gantry designs are described and the necessary requirements of such a gantry are explained. The study of a gantry beam optics design is based on superconducting combined function magnets. The simulations have been performed in first order with the conventional beam transport codes. The superposition of strong dipole and quadrupole fields generated by superconducting magnets enables the introduction of locally achromatic bending sections without increasing the gantry size. A rigorous implementation of such beam optics concepts into the proposed gantry design dramatically increases the momentum acceptance compared to gantries with normal conducting magnets. In our design this large acceptance has been exploited by the implementation of a degrader within the gantry and a potential possibility to use the same magnetic field for all energies used in a treatment, so that the superconducting magnets do not have to vary their fields during a treatment. This also enables very fast beam energy changes, which is beneficial for spreading the Bragg peak over the thickness of the tumor. The results show an improvement of its momentum acceptance. Large momentum acceptance in the gantry creates a possibility to implement faster dose application techniques.

  15. A large area diamond-based beam tagging hodoscope for ion therapy monitoring

    Science.gov (United States)

    Gallin-Martel, M.-L.; Abbassi, L.; Bes, A.; Bosson, G.; Collot, J.; Crozes, T.; Curtoni, S.; Dauvergne, D.; De Nolf, W.; Fontana, M.; Gallin-Martel, L.; Hostachy, J.-Y.; Krimmer, J.; Lacoste, A.; Marcatili, S.; Morse, J.; Motte, J.-F.; Muraz, J.-F.; Rarbi, F. E.; Rossetto, O.; Salomé, M.; Testa, É.; Vuiart, R.; Yamouni, M.

    2018-01-01

    The MoniDiam project is part of the French national collaboration CLaRyS (Contrôle en Ligne de l'hAdronthérapie par RaYonnements Secondaires) for on-line monitoring of hadron therapy. It relies on the imaging of nuclear reaction products that is related to the ion range. The goal here is to provide large area beam detectors with a high detection efficiency for carbon or proton beams giving time and position measurement at 100 MHz count rates (beam tagging hodoscope). High radiation hardness and intrinsic electronic properties make diamonds reliable and very fast detectors with a good signal to noise ratio. Commercial Chemical Vapor Deposited (CVD) poly-crystalline, heteroepitaxial and monocrystalline diamonds were studied. Their applicability as a particle detector was investigated using α and β radioactive sources, 95 MeV/u carbon ion beams at GANIL and 8.5 keV X-ray photon bunches from ESRF. This facility offers the unique capability of providing a focused ( 1 μm) beam in bunches of 100 ps duration, with an almost uniform energy deposition in the irradiated detector volume, therefore mimicking the interaction of single ions. A signal rise time resolution ranging from 20 to 90 ps rms and an energy resolution of 7 to 9% were measured using diamonds with aluminum disk shaped surface metallization. This enabled us to conclude that polycrystalline CVD diamond detectors are good candidates for our beam tagging hodoscope development. Recently, double-side stripped metallized diamonds were tested using the XBIC (X Rays Beam Induced Current) set-up of the ID21 beamline at ESRF which permits us to evaluate the capability of diamond to be used as position sensitive detector. The final detector will consist in a mosaic arrangement of double-side stripped diamond sensors read out by a dedicated fast-integrated electronics of several hundreds of channels.

  16. A novel beam optics concept in a particle therapy gantry utilizing the advantages of superconducting magnets

    Energy Technology Data Exchange (ETDEWEB)

    Gerbershagen, Alexander; Meer, David; Schippers, Jacobus Maarten; Seidel, Mike [Paul Scherrer Institut (PSI), Villigen (Switzerland)

    2016-11-01

    A first order design of the beam optics of a superconducting proton therapy gantry beam is presented. The possibilities of superconducting magnets with respect to the beam optics such as strong fields, large apertures and superposition of different multipole fields have been exploited for novel concepts in a gantry. Since various techniques used in existing gantries have been used in our first design steps, some examples of the existing superconducting gantry designs are described and the necessary requirements of such a gantry are explained. The study of a gantry beam optics design is based on superconducting combined function magnets. The simulations have been performed in first order with the conventional beam transport codes. The superposition of strong dipole and quadrupole fields generated by superconducting magnets enables the introduction of locally achromatic bending sections without increasing the gantry size. A rigorous implementation of such beam optics concepts into the proposed gantry design dramatically increases the momentum acceptance compared to gantries with normal conducting magnets. In our design this large acceptance has been exploited by the implementation of a degrader within the gantry and a potential possibility to use the same magnetic field for all energies used in a treatment, so that the superconducting magnets do not have to vary their fields during a treatment. This also enables very fast beam energy changes, which is beneficial for spreading the Bragg peak over the thickness of the tumor. The results show an improvement of its momentum acceptance. Large momentum acceptance in the gantry creates a possibility to implement faster dose application techniques.

  17. Experiments and FLUKA simulations of $^{12}C$ and $^{16}O$ beams for therapy monitoring by means of in-beam Positron Emission Tomography

    CERN Document Server

    Sommerer,; Ferrari, A

    2007-01-01

    Since 1997 at the experimental C-12 ion therapy facility at Gesellschaft fuer Schwerionenforschung (GSI), Darmstadt, Germany, more than 350 patients have been treated. The therapy is monitored with a dedicated positron emission tomograph, fully integrated into the treatment site. The measured beta+-activity arises from inelastic nuclear interactions between the beam particles an the nuclei of the patients tissue. Because the monitoring is done during the irradiation the method is called in-beam PET. The underlying principle of this monitoring is a comparison between the measured activity and a simulated one. The simulations are presently done by the PETSIM code which is dedicated to C-12 beams. In future ion therapy centers like the Heidelberger Ionenstrahl Therapiezentrum (HIT), Heidelberg, Germany, besides C-12 also proton, $^3$He and O-16 beams will be used for treatment and the therapy will be monitored by means of in-beam PET. Because PETSIM is not extendable to other ions in an easy way, a code capable ...

  18. Application of the electron pencil beam redefinition algorithm to electron arc therapy.

    Science.gov (United States)

    Chi, Pai-Chun M; Hogstrom, Kenneth R; Starkschall, George; Boyd, Robert A; Tucker, Susan L; Antolak, John A

    2006-07-01

    This project investigated the potential of summing fixed-beam dose distributions calculated using the pencil-beam redefinition algorithm (PBRA) at small angular steps (1 degree) to model an electron arc therapy beam. The PRBA, previously modified to model skin collimation, was modified further by incorporating two correction factors. One correction factor that is energy, SSD (source-to-surface distance), and field-width dependent constrained the calculated dose output to be the same as the measured dose output for fixed-beam geometries within the range of field widths and SSDs encountered in arc therapy. Another correction factor (single field-width correction factor for each energy) compensated for large-angle scattering not being modeled, allowing a more accurate calculation of dose output at mid arc. The PBRA was commissioned to accurately calculate dose in a water phantom for fixed-beam geometries typical of electron arc therapy. Calculated central-axis depth doses agreed with measured doses to within 2% in the low-dose gradient regions and within 1-mm in the high-dose gradient regions. Off-axis doses agreed to within 2 mm in the high-dose gradient regions and within 3% in the low-dose gradient regions. Arced-beam calculations of dose output and depth dose at mid arc were evaluated by comparing to data measured using two cylindrical water phantoms with radii of 12 and 15 cm at 10 and 15 MeV. Dose output was measured for all combinations of phantom radii of curvature, collimator widths (4, 5, and 6 cm), and arc angles (0 degrees, 20 degrees, 40 degrees, 60 degrees, 80 degrees, and 90 degrees) for both beam energies. Results showed the calculated mid-arc dose output to agree within 2% of measurement for all combinations. For a 90 degree arc angle and 5 x 20 cm2 field size, the calculated mid-arc depth dose in the low-dose gradient region agreed to within 2% of measurement for all depths at 10 MeV and for depths greater than depth of dose maximum R100 at 15 Me

  19. A Study on clinical Considerations caused by inevitably Extended SSD for Electron beam therapy

    International Nuclear Information System (INIS)

    Lee, Jung Woo; Kim, Jeong Man

    1996-01-01

    We are often faced with the clinical situations that is inevitably extended SSD for electron beam therapy due to anatomical restriction or applicator structure. But there are some difficulties in accurately predicting output and properties. In electron beam treatment , unlike photon beam the decrease in output for extended SSD does not follow inverse-square law accurately because of a loss of side scatter equilibrium, which is particularly significant for small cone size and low energies. The purpose of our study is to analyze the output in changing with the energy, cone size, air gap beyond the standard SSD and to compare inverse-square law factor derived from calculated effective SSD, mominal SSD with measured output factor. In addition, we have analyzed the change of PDD for several cones with different SSDs which range from 100 cm to 120 cm with 5 cm step and with different energies(6 MeV, 9 MeV, 12 MeV, 16 MeV, 20 MeV). In accordance with our study, an extended SSD produces a significant change in beam output, negligible change in depth dose which range from 100 cm to 120 cm SSDs. In order to deliver the more accurate dose to the neoplastic tissue, first of all we recommend inverse-square law using the table of effective SSDs with cone sizes and energies respectively or simply to create a table of extended SSD air gap correction factor. The second we need to have an insight into some change of dose distribution including PPD, penumbra caused by extended SSD for electron beam therapy.

  20. New developments of 11C post-accelerated beams for hadron therapy and imaging

    CERN Document Server

    Augusto, R S; Wenander, F; Penescu, L; Orecchia, R; Parodi, K; Ferrari, A; Stora, T

    2016-01-01

    Hadron therapy was first proposed in 1946 and is by now widespread throughout the world, as witnessed with the design and construction of the CNAO, HIT, PROSCAN and MedAustron treatment centres, among others. The clinical interest in hadron therapy lies in the fact that it delivers precision treatment of tumours, exploiting the characteristic shape (the Bragg peak) of the energy deposition in the tissues for charged hadrons. In particular, carbon ion therapy is found to be biologically more effective, with respect to protons, on certain types of tumours. Following an approach tested at NIRS in Japan [1], carbon ion therapy treatments based on 12C could be combined or fully replaced with 11C PET radioactive ions post-accelerated to the same energy. This approach allows providing a beam for treatment and, at the same time, to collect information on the 3D distributions of the implanted ions by PET imaging. The production of 11C ion beams can be performed using two methods. A first one is based on the production...

  1. Pet imaging of dose distribution in proton-beam cancer therapy

    Directory of Open Access Journals (Sweden)

    Beebe-Wang Joanne

    2005-01-01

    Full Text Available Proton therapy is a treatment modality of increasing utility in clinical radiation oncology mostly because its dose distribution conforms more tightly to the target volume than X-ray radiation therapy. One important feature of proton therapy is that it produces a small amount of positron-emitting isotopes along the beam-path through the non-elastic nuclear interaction of protons with target nuclei such as 12C, 14N, and 16O. These radio isotopes, mainly 11C, 13N, and 15O, al low imaging the therapy dose distribution using positron emission tomography. The resulting positron emission tomography images provide a powerful tool for quality assurance of the treatment, especially when treating inhomogeneous organs such as the lungs or the head-and-neck, where the calculation of the dose distribution for treatment planning is more difficult. This pa per uses Monte Carlo simulations to predict the yield of positron emitters produced by a 250 MeV proton beam, and to simulate the productions of the image in a clinical PET scanner.

  2. Beam's-Eye-View Dosimetrics-Guided Inverse Planning for Aperture-Modulated Arc Therapy

    International Nuclear Information System (INIS)

    Ma Yunzhi; Popple, Richard; Suh, Tae-Suk; Xing Lei

    2009-01-01

    Purpose: To use angular beam's-eye-view dosimetrics (BEVD) information to improve the computational efficiency and plan quality of inverse planning of aperture-modulated arc therapy (AMAT). Methods and Materials: In BEVD-guided inverse planning, the angular space spanned by a rotational arc is represented by a large number of fixed-gantry beams with angular spacing of ∼2.5 degrees. Each beam is assigned with an initial aperture shape determined by the beam's-eye-view (BEV) projection of the planning target volume (PTV) and an initial weight. Instead of setting the beam weights arbitrarily, which slows down the subsequent optimization process and may result in a suboptimal solution, a priori knowledge about the quality of the beam directions derived from a BEVD is adopted to initialize the weights. In the BEVD calculation, a higher score is assigned to directions that allow more dose to be delivered to the PTV without exceeding the dose tolerances of the organs at risk (OARs) and vice versa. Simulated annealing is then used to optimize the segment shapes and weights. The BEVD-guided inverse planning is demonstrated by using two clinical cases, and the results are compared with those of a conventional approach without BEVD guidance. Results: An a priori knowledge-guided inverse planning scheme for AMAT is established. The inclusion of BEVD guidance significantly improves the convergence behavior of AMAT inverse planning and results in much better OAR sparing as compared with the conventional approach. Conclusions: BEVD-guidance facilitates AMAT treatment planning and provides a comprehensive tool to maximally use the technical capacity of the new arc therapeutic modality.

  3. A study of lateral fall-off (penumbra) optimisation for pencil beam scanning (PBS) proton therapy

    Science.gov (United States)

    Winterhalter, C.; Lomax, A.; Oxley, D.; Weber, D. C.; Safai, S.

    2018-01-01

    The lateral fall-off is crucial for sparing organs at risk in proton therapy. It is therefore of high importance to minimize the penumbra for pencil beam scanning (PBS). Three optimisation approaches are investigated: edge-collimated uniformly weighted spots (collimation), pencil beam optimisation of uncollimated pencil beams (edge-enhancement) and the optimisation of edge collimated pencil beams (collimated edge-enhancement). To deliver energies below 70 MeV, these strategies are evaluated in combination with the following pre-absorber methods: field specific fixed thickness pre-absorption (fixed), range specific, fixed thickness pre-absorption (automatic) and range specific, variable thickness pre-absorption (variable). All techniques are evaluated by Monte Carlo simulated square fields in a water tank. For a typical air gap of 10 cm, without pre-absorber collimation reduces the penumbra only for water equivalent ranges between 4-11 cm by up to 2.2 mm. The sharpest lateral fall-off is achieved through collimated edge-enhancement, which lowers the penumbra down to 2.8 mm. When using a pre-absorber, the sharpest fall-offs are obtained when combining collimated edge-enhancement with a variable pre-absorber. For edge-enhancement and large air gaps, it is crucial to minimize the amount of material in the beam. For small air gaps however, the superior phase space of higher energetic beams can be employed when more material is used. In conclusion, collimated edge-enhancement combined with the variable pre-absorber is the recommended setting to minimize the lateral penumbra for PBS. Without collimator, it would be favourable to use a variable pre-absorber for large air gaps and an automatic pre-absorber for small air gaps.

  4. Treatment of Head and Neck Paragangliomas With External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dupin, Charles, E-mail: c.dupin@bordeaux.unicancer.fr [Department of Radiotherapy, Comprehensive Cancer Center, Institut Bergonié, Bordeaux (France); Lang, Philippe [Department of Radiotherapy, Pitié Salpétrière, Paris (France); Dessard-Diana, Bernadette [Department of Radiotherapy, Hopital Européen Georges Pompidou, Paris (France); Simon, Jean-Marc; Cuenca, Xavier; Mazeron, Jean-Jacques; Feuvret, Loïc [Department of Radiotherapy, Pitié Salpétrière, Paris (France)

    2014-06-01

    Purpose: To retrospectively assess the outcomes of radiation therapy in patients with head and neck paragangliomas. Methods and Materials: From 1990 to 2009, 66 patients with 81 head and neck paragangliomas were treated by conventional external beam radiation therapy in 25 fractions at a median dose of 45 Gy (range, 41.4-68 Gy). One case was malignant. The median gross target volume and planning target volume were 30 cm{sup 3} (range, 0.9-243 cm{sup 3}) and 116 cm{sup 3} (range, 24-731 cm{sup 3}), respectively. Median age was 57.4 years (range, 15-84 years). Eleven patients had multicentric lesions, and 8 had family histories of paraganglioma. Paragangliomas were located in the temporal bone, the carotid body, and the glomus vagal in 51, 18, and 10 patients, respectively. Forty-six patients had exclusive radiation therapy, and 20 had salvage radiation therapy. The median follow-up was 4.1 years (range, 0.1-21.2 years). Results: One patient had a recurrence of temporal bone paraganglioma 8 years after treatment. The actuarial local control rates were 100% at 5 years and 98.7% at 10 years. Patients with multifocal tumors and family histories were significantly younger (42 years vs 58 years [P=.002] and 37 years vs 58 years [P=.0003], respectively). The association between family predisposition and multifocality was significant (P<.001). Two patients had cause-specific death within the 6 months after irradiation. During radiation therapy, 9 patients required hospitalization for weight loss, nausea, mucositis, or ophthalmic zoster. Two late vascular complications occurred (middle cerebral artery and carotid stenosis), and 2 late radiation-related meningiomas appeared 15 and 18 years after treatment. Conclusion: Conventional external beam radiation therapy is an effective and safe treatment option that achieves excellent local control; it should be considered as a first-line treatment of choice for head and neck paragangliomas.

  5. Local Recurrence After Primary Proton Beam Therapy in Uveal Melanoma: Risk Factors, Retreatment Approaches, and Outcome.

    Science.gov (United States)

    Seibel, Ira; Cordini, Dino; Rehak, Matus; Hager, Annette; Riechardt, Aline I; Böker, Alexander; Heufelder, Jens; Weber, Andreas; Gollrad, Johannes; Besserer, Angela; Joussen, Antonia M

    2015-10-01

    To evaluate the risk factors, recurrence rates, retreatments, and long-term patient outcomes following proton beam therapy for uveal melanoma. Retrospective interventional case series. All patients treated with primary proton beam therapy for uveal melanoma at the oncology service at Charité-Berlin and Helmholtz-Zentrum-Berlin between May 1998 and December 2008 were reviewed for local recurrence. Of 982 patients, 982 eyes matched the inclusion criteria. The data were obtained from electronic health records, operative reports, discharge letters, and radiation planning. Comparisons of fundus photographs and ultrasound measurements were performed to assess the growth pattern of the tumor and to determine the success of retreatment, in the case that a globe-retaining therapy was undertaken. Of 982 patients, 35 patients (3.6%) developed local recurrence. The median follow-up was 60.7 months (6.0-170.4 months). Local control rate was 96.4% and the overall eye retention rate was 95.0% in this cohort. Local recurrence was correlated with a higher risk for metastasis and reduced survival. Largest tumor diameter was identified as the sole statistically significant risk factor for local recurrence (P = .00001). All globe-retaining retreatment approaches for local recurrence, including proton beam therapy, brachytherapy, and transpupillary thermotherapy used for recurrences at the tumor margins, showed good local tumor control and similar metastasis-free survivals. This study showed that each globe-retaining retreatment approach can result in satisfying local tumor control. In case of early detection of local recurrence, preservation of the globe can be warranted. Therefore, regularly performed follow-ups should be ensured. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Dosimetry auditing procedure with alanine dosimeters for light ion beam therapy.

    Science.gov (United States)

    Ableitinger, Alexander; Vatnitsky, Stanislav; Herrmann, Rochus; Bassler, Niels; Palmans, Hugo; Sharpe, Peter; Ecker, Swantje; Chaudhri, Naved; Jäkel, Oliver; Georg, Dietmar

    2013-07-01

    In the next few years the number of facilities providing ion beam therapy with scanning beams will increase. An auditing process based on an end-to-end test (including CT imaging, planning and dose delivery) could help new ion therapy centres to validate their entire logistic chain of radiation delivery. An end-to-end procedure was designed and tested in both scanned proton and carbon ion beams, which may also serve as a dosimetric credentialing procedure for clinical trials in the future. The developed procedure is focused only on physical dose delivery and the validation of the biological dose is out of scope of the current work. The audit procedure was based on a homogeneous phantom that mimics the dimension of a head (20 × 20 × 21 cm(3)). The phantom can be loaded either with an ionisation chamber or 20 alanine dosimeters plus 2 radiochromic EBT films. Dose verification aimed at measuring a dose of 10Gy homogeneously delivered to a virtual-target volume of 8 × 8 × 12 cm(3). In order to interpret the readout of the irradiated alanine dosimeters additional Monte Carlo simulations were performed to calculate the energy dependent detector response of the particle fluence in the alanine detector. A pilot run was performed with protons and carbon ions at the Heidelberg Ion Therapy facility (HIT). The mean difference of the absolute physical dose measured with the alanine dosimeters compared with the expected dose from the treatment planning system was -2.4 ± 0.9% (1σ) for protons and -2.2 ± 1.1% (1σ) for carbon ions. The measurements performed with the ionisation chamber indicate this slight underdosage with a dose difference of -1.7% for protons and -1.0% for carbon ions. The profiles measured by radiochromic films showed an acceptable homogeneity of about 3%. Alanine dosimeters are suitable detectors for dosimetry audits in ion beam therapy and the presented end-to-end test is feasible. If further studies show similar results, this dosimetric audit could be

  7. SU-E-T-464: On the Equivalence of the Quality Correction Factor for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Sorriaux, J; Paganetti, H; Testa, M; Giantsoudi, D; Schuemann, J; Bertrand, D; Orban de Xivry, J.; Lee, J; Palmans, H; Vynckier, S; Sterpin, E

    2014-01-01

    Purpose: In current practice, most proton therapy centers apply IAEA TRS-398 reference dosimetry protocol. Quality correction factors (kQ) take into account in the dose determination process the differences in beam qualities used for calibration unit and for treatment unit. These quality correction factors are valid for specific reference conditions. TRS-398 reference conditions should be achievable in both scattered proton beams (i.e. DS) and scanned proton beams (i.e. PBS). However, it is not a priori clear if TRS-398 kQ data, which are based on Monte Carlo (MC) calculations in scattered beams, can be used for scanned beams. Using TOPAS-Geant4 MC simulations, the study aims to determine whether broad beam quality correction factors calculated in TRS-398 can be directly applied to PBS delivery modality. Methods: As reference conditions, we consider a 10×10×10 cm 3 homogeneous dose distribution delivered by PBS system in a water phantom (32/10 cm range/modulation) and an air cavity placed at the center of the spread-out-Bragg-peak. In order to isolate beam differences, a hypothetical broad beam is simulated. This hypothetical beam reproduces exactly the same range modulation, and uses the same energy layers than the PBS field. Ion chamber responses are computed for the PBS and hypothetical beams and then compared. Results: For an air cavity of 2×2×0.2 cm 3 , the ratio of ion chamber responses for the PBS and hypothetical beam qualities is 0.9991 ± 0.0016. Conclusion: Quality correction factors are insensitive to the delivery pattern of the beam (broad beam or PBS), as long as similar dose distributions are achieved. This investigation, for an air cavity, suggests that broad beam quality correction factors published in TRS-398 can be applied for scanned beams. J. Sorriaux is financially supported by a public-private partnership involving the company Ion Beam Applications (IBA)

  8. Proton beam characterization in the experimental room of the Trento Proton Therapy facility

    Science.gov (United States)

    Tommasino, F.; Rovituso, M.; Fabiano, S.; Piffer, S.; Manea, C.; Lorentini, S.; Lanzone, S.; Wang, Z.; Pasini, M.; Burger, W. J.; La Tessa, C.; Scifoni, E.; Schwarz, M.; Durante, M.

    2017-10-01

    As proton therapy is becoming an established treatment methodology for cancer patients, the number of proton centres is gradually growing worldwide. The economical effort for building these facilities is motivated by the clinical aspects, but might be also supported by the potential relevance for the research community. Experiments with high-energy protons are needed not only for medical physics applications, but represent also an essential part of activities dedicated to detector development, space research, radiation hardness tests, as well as of fundamental research in nuclear and particle physics. Here we present the characterization of the beam line installed in the experimental room of the Trento Proton Therapy Centre (Italy). Measurements of beam spot size and envelope, range verification and proton flux were performed in the energy range between 70 and 228 MeV. Methods for reducing the proton flux from typical treatments values of 106-109 particles/s down to 101-105 particles/s were also investigated. These data confirm that a proton beam produced in a clinical centre build by a commercial company can be exploited for a broad spectrum of experimental activities. The results presented here will be used as a reference for future experiments.

  9. Noncoplanar Beam Angle Class Solutions to Replace Time-Consuming Patient-Specific Beam Angle Optimization in Robotic Prostate Stereotactic Body Radiation Therapy

    International Nuclear Information System (INIS)

    Rossi, Linda; Breedveld, Sebastiaan; Aluwini, Shafak; Heijmen, Ben

    2015-01-01

    Purpose: To investigate development of a recipe for the creation of a beam angle class solution (CS) for noncoplanar prostate stereotactic body radiation therapy to replace time-consuming individualized beam angle selection (iBAS) without significant loss in plan quality, using the in-house “Erasmus-iCycle” optimizer for fully automated beam profile optimization and iBAS. Methods and Materials: For 30 patients, Erasmus-iCycle was first used to generate 15-, 20-, and 25-beam iBAS plans for a CyberKnife equipped with a multileaf collimator. With these plans, 6 recipes for creation of beam angle CSs were investigated. Plans of 10 patients were used to create CSs based on the recipes, and the other 20 to independently test them. For these tests, Erasmus-iCycle was also used to generate intensity modulated radiation therapy plans for the fixed CS beam setups. Results: Of the tested recipes for CS creation, only 1 resulted in 15-, 20-, and 25-beam noncoplanar CSs without plan deterioration compared with iBAS. For the patient group, mean differences in rectum D 1cc , V 60GyEq , V 40GyEq , and D mean between 25-beam CS plans and 25-beam plans generated with iBAS were 0.2 ± 0.4 Gy, 0.1% ± 0.2%, 0.2% ± 0.3%, and 0.1 ± 0.2 Gy, respectively. Differences between 15- and 20-beam CS and iBAS plans were also negligible. Plan quality for CS plans relative to iBAS plans was also preserved when narrower planning target volume margins were arranged and when planning target volume dose inhomogeneity was decreased. Using a CS instead of iBAS reduced the computation time by a factor of 14 to 25, mainly depending on beam number, without loss in plan quality. Conclusions: A recipe for creation of robust beam angle CSs for robotic prostate stereotactic body radiation therapy has been developed. Compared with iBAS, computation times decreased by a factor 14 to 25. The use of a CS may avoid long planning times without losses in plan quality

  10. Noncoplanar Beam Angle Class Solutions to Replace Time-Consuming Patient-Specific Beam Angle Optimization in Robotic Prostate Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Linda, E-mail: l.rossi@erasmusmc.nl; Breedveld, Sebastiaan; Aluwini, Shafak; Heijmen, Ben

    2015-07-15

    Purpose: To investigate development of a recipe for the creation of a beam angle class solution (CS) for noncoplanar prostate stereotactic body radiation therapy to replace time-consuming individualized beam angle selection (iBAS) without significant loss in plan quality, using the in-house “Erasmus-iCycle” optimizer for fully automated beam profile optimization and iBAS. Methods and Materials: For 30 patients, Erasmus-iCycle was first used to generate 15-, 20-, and 25-beam iBAS plans for a CyberKnife equipped with a multileaf collimator. With these plans, 6 recipes for creation of beam angle CSs were investigated. Plans of 10 patients were used to create CSs based on the recipes, and the other 20 to independently test them. For these tests, Erasmus-iCycle was also used to generate intensity modulated radiation therapy plans for the fixed CS beam setups. Results: Of the tested recipes for CS creation, only 1 resulted in 15-, 20-, and 25-beam noncoplanar CSs without plan deterioration compared with iBAS. For the patient group, mean differences in rectum D{sub 1cc}, V{sub 60GyEq}, V{sub 40GyEq}, and D{sub mean} between 25-beam CS plans and 25-beam plans generated with iBAS were 0.2 ± 0.4 Gy, 0.1% ± 0.2%, 0.2% ± 0.3%, and 0.1 ± 0.2 Gy, respectively. Differences between 15- and 20-beam CS and iBAS plans were also negligible. Plan quality for CS plans relative to iBAS plans was also preserved when narrower planning target volume margins were arranged and when planning target volume dose inhomogeneity was decreased. Using a CS instead of iBAS reduced the computation time by a factor of 14 to 25, mainly depending on beam number, without loss in plan quality. Conclusions: A recipe for creation of robust beam angle CSs for robotic prostate stereotactic body radiation therapy has been developed. Compared with iBAS, computation times decreased by a factor 14 to 25. The use of a CS may avoid long planning times without losses in plan quality.

  11. SU-F-J-197: A Novel Intra-Beam Range Detection and Adaptation Strategy for Particle Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Chen, M; Jiang, S; Shao, Y; Lu, W [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: In-vivo range detection/verification is crucial in particle therapy for effective and safe delivery. The state-of-art techniques are not sufficient for in-vivo on-line range verification due to conflicts among patient dose, signal statistics and imaging time. We propose a novel intra-beam range detection and adaptation strategy for particle therapy. Methods: This strategy uses the planned mid-range spots as probing beams without adding extra radiation to patients. Such choice of probing beams ensures the Bragg peaks to remain inside the tumor even with significant range variation from the plan. It offers sufficient signal statistics for in-beam positron emission tomography (PET) due to high positron activity of therapeutic dose. The probing beam signal can be acquired and reconstructed using in-beam PET that allows for delineation of the Bragg peaks and detection of range shift with ease of detection enabled by single-layered spots. If the detected range shift is within a pre-defined tolerance, the remaining spots will be delivered as the original plan. Otherwise, a fast re-optimization using range-shifted beamlets and accounting for the probing beam dose is applied to consider the tradeoffs posed by the online anatomy. Simulated planning and delivery studies were used to demonstrate the effectiveness of the proposed techniques. Results: Simulations with online range variations due to shifts of various foreign objects into the beam path showed successful delineation of the Bragg peaks as a result of delivering probing beams. Without on-line delivery adaptation, dose distribution was significantly distorted. In contrast, delivery adaptation incorporating detected range shift recovered well the planned dose. Conclusion: The proposed intra-beam range detection and adaptation utilizing the planned mid-range spots as probing beams, which illuminate the beam range with strong and accurate PET signals, is a safe, practical, yet effective approach to address range

  12. Superconducting toroidal combined-function magnet for a compact ion beam cancer therapy gantry

    International Nuclear Information System (INIS)

    Robin, D.S.; Arbelaez, D.; Caspi, S.; Sun, C.; Sessler, A.; Wan, W.; Yoon, M.

    2011-01-01

    A superconducting, combined-function, 5 T, 90°, toroidal magnet with a large bore is described in this paper. This magnet is designed to be the last and most difficult part of a compact superconducting magnet-based carbon gantry optics for ion beam cancer therapy. The relatively small size of this toroidal magnet allows for a gantry the size of which is smaller or at least comparable to that of a proton gantry. The gantry design places the toroidal magnet between the scanning magnets and the patient, that is the scanning magnets are placed midway through the gantry. By optimizing the coil winding configuration of this magnet, near point-to-parallel optics is achieved between the scanning magnets and the patient; while at the same time there is only a small distortion of the beam-shape when scanning. We show that the origin of the beam-shape distortion is the strong sextupole components, whose effects are greatly pronounced when the beam is widely steered in the magnet. A method to correct such an undesirable effect is suggested and demonstrated by a numerical particle tracking through the calculated three-dimensional magnetic field.

  13. Direct-aperture optimization applied to selection of beam orientations in intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Bedford, J L; Webb, S

    2007-01-01

    Direct-aperture optimization (DAO) was applied to iterative beam-orientation selection in intensity-modulated radiation therapy (IMRT), so as to ensure a realistic segmental treatment plan at each iteration. Nested optimization engines dealt separately with gantry angles, couch angles, collimator angles, segment shapes, segment weights and wedge angles. Each optimization engine performed a random search with successively narrowing step sizes. For optimization of segment shapes, the filtered backprojection (FBP) method was first used to determine desired fluence, the fluence map was segmented, and then constrained direct-aperture optimization was used thereafter. Segment shapes were fully optimized when a beam angle was perturbed, and minimally re-optimized otherwise. The algorithm was compared with a previously reported method using FBP alone at each orientation iteration. An example case consisting of a cylindrical phantom with a hemi-annular planning target volume (PTV) showed that for three-field plans, the method performed better than when using FBP alone, but for five or more fields, neither method provided much benefit over equally spaced beams. For a prostate case, improved bladder sparing was achieved through the use of the new algorithm. A plan for partial scalp treatment showed slightly improved PTV coverage and lower irradiated volume of brain with the new method compared to FBP alone. It is concluded that, although the method is computationally intensive and not suitable for searching large unconstrained regions of beam space, it can be used effectively in conjunction with prior class solutions to provide individually optimized IMRT treatment plans

  14. A nested partitions framework for beam angle optimization in intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    D'Souza, Warren D; Nazareth, Daryl P; Zhang, Hao H; Shi Leyuan; Meyer, Robert R

    2008-01-01

    Coupling beam angle optimization with dose optimization in intensity-modulated radiation therapy (IMRT) increases the size and complexity of an already large-scale combinatorial optimization problem. We have developed a novel algorithm, nested partitions (NP), that is capable of finding suitable beam angle sets by guiding the dose optimization process. NP is a metaheuristic that is flexible enough to guide the search of a heuristic or deterministic dose optimization algorithm. The NP method adaptively samples from the entire feasible region, or search space, and coordinates the sampling effort with a systematic partitioning of the feasible region at successive iterations, concentrating the search in promising subsets. We used a 'warm-start' approach by initiating NP with beam angle samples derived from an integer programming (IP) model. In this study, we describe our implementation of the NP framework with a commercial optimization algorithm. We compared the NP framework with equi-spaced beam angle selection, the IP method, greedy heuristic and random sampling heuristic methods. The results of the NP approach were evaluated using two clinical cases (head and neck and whole pelvis) involving the primary tumor and nodal volumes. Our results show that NP produces better quality solutions than the alternative considered methods

  15. A nested partitions framework for beam angle optimization in intensity-modulated radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    D' Souza, Warren D; Nazareth, Daryl P [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); Zhang, Hao H; Shi Leyuan [Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (United States); Meyer, Robert R [Computer Sciences Department, University of Wisconsin, Madison, WI (United States)], E-mail: dsouzaw@ohsu.edu

    2008-06-21

    Coupling beam angle optimization with dose optimization in intensity-modulated radiation therapy (IMRT) increases the size and complexity of an already large-scale combinatorial optimization problem. We have developed a novel algorithm, nested partitions (NP), that is capable of finding suitable beam angle sets by guiding the dose optimization process. NP is a metaheuristic that is flexible enough to guide the search of a heuristic or deterministic dose optimization algorithm. The NP method adaptively samples from the entire feasible region, or search space, and coordinates the sampling effort with a systematic partitioning of the feasible region at successive iterations, concentrating the search in promising subsets. We used a 'warm-start' approach by initiating NP with beam angle samples derived from an integer programming (IP) model. In this study, we describe our implementation of the NP framework with a commercial optimization algorithm. We compared the NP framework with equi-spaced beam angle selection, the IP method, greedy heuristic and random sampling heuristic methods. The results of the NP approach were evaluated using two clinical cases (head and neck and whole pelvis) involving the primary tumor and nodal volumes. Our results show that NP produces better quality solutions than the alternative considered methods.

  16. Therapy imaging: Limitations of imaging with high energy x-ray beams

    International Nuclear Information System (INIS)

    Munro, P.; Rawlinson, J.A.; Fenster, A.

    1987-01-01

    One of the major problems in radiation therapy is ensuring that the correct region of the patient receives the prescribed x-ray treatment and that the surrounding tissues are spared. One way to identify patient positioning errors is to make an image using the radiotherapy treatment beam. The authors have examine4d two of the factors that can influence the quality of images made with high energy x-ray beams: (i) the size of the x-ray source, and; (ii) the signal-to-noise characteristics of the detectors used to form images with high energy x-ray beams. They have developed a novel method of measuring the source distributions for /sup 60/Co machines and linear accelerators and from the measurements have been able to obtain the modulation transfer functions of their x-ray sources. They also measured the modulation transfer functions (MTFs) and the noise power spectra (NPS) of the x-ray detectors. Based on these measurements, the authors conclude that images made with high energy x-ray beams are limited by film granularity and that improved images can be obtained by alternative detector systems

  17. Proton beam deflection in MRI fields: Implications for MRI-guided proton therapy.

    Science.gov (United States)

    Oborn, B M; Dowdell, S; Metcalfe, P E; Crozier, S; Mohan, R; Keall, P J

    2015-05-01

    This paper investigates, via magnetic modeling and Monte Carlo simulation, the ability to deliver proton beams to the treatment zone inside a split-bore MRI-guided proton therapy system. Field maps from a split-bore 1 T MRI-Linac system are used as input to geant4 Monte Carlo simulations which model the trajectory of proton beams during their paths to the isocenter of the treatment area. Both inline (along the MRI bore) and perpendicular (through the split-bore gap) orientations are simulated. Monoenergetic parallel and diverging beams of energy 90, 195, and 300 MeV starting from 1.5 and 5 m above isocenter are modeled. A phase space file detailing a 2D calibration pattern is used to set the particle starting positions, and their spatial location as they cross isocenter is recorded. No beam scattering, collimation, or modulation of the proton beams is modeled. In the inline orientation, the radial symmetry of the solenoidal style fringe field acts to rotate the protons around the beam's central axis. For protons starting at 1.5 m from isocenter, this rotation is 19° (90 MeV) and 9.8° (300 MeV). A minor focusing toward the beam's central axis is also seen, but only significant, i.e., 2 mm shift at 150 mm off-axis, for 90 MeV protons. For the perpendicular orientation, the main MRI field and near fringe field act as the strongest to deflect the protons in a consistent direction. When starting from 1.5 m above isocenter shifts of 135 mm (90 MeV) and 65 mm (300 MeV) were observed. Further to this, off-axis protons are slightly deflected toward or away from the central axis in the direction perpendicular to the main deflection direction. This leads to a distortion of the phase space pattern, not just a shift. This distortion increases from zero at the central axis to 10 mm (90 MeV) and 5 mm (300 MeV) for a proton 150 mm off-axis. In both orientations, there is a small but subtle difference in the deflection and distortion pattern between protons fired parallel to the

  18. New developments of 11C post-accelerated beams for hadron therapy and imaging

    Science.gov (United States)

    Augusto, R. S.; Mendonca, T. M.; Wenander, F.; Penescu, L.; Orecchia, R.; Parodi, K.; Ferrari, A.; Stora, T.

    2016-06-01

    Hadron therapy was first proposed in 1946 and is by now widespread throughout the world, as witnessed with the design and construction of the CNAO, HIT, PROSCAN and MedAustron treatment centres, among others. The clinical interest in hadron therapy lies in the fact that it delivers precision treatment of tumours, exploiting the characteristic shape (the Bragg peak) of the energy deposition in the tissues for charged hadrons. In particular, carbon ion therapy is found to be biologically more effective, with respect to protons, on certain types of tumours. Following an approach tested at NIRS in Japan [1], carbon ion therapy treatments based on 12C could be combined or fully replaced with 11C PET radioactive ions post-accelerated to the same energy. This approach allows providing a beam for treatment and, at the same time, to collect information on the 3D distributions of the implanted ions by PET imaging. The production of 11C ion beams can be performed using two methods. A first one is based on the production using compact PET cyclotrons with 10-20 MeV protons via 14N(p,α)11C reactions following an approach developed at the Lawrence Berkeley National Laboratory [2]. A second route exploits spallation reactions 19F(p,X)11C and 23Na(p,X)11C on a molten fluoride salt target using the ISOL (isotope separation on-line) technique [3]. This approach can be seriously envisaged at CERN-ISOLDE following recent progresses made on 11C+ production [4] and proven post-acceleration of pure 10C3/6+ beams in the REX-ISOLDE linac [5]. Part of the required components is operational in radioactive ion beam facilities or commercial medical PET cyclotrons. The driver could be a 70 MeV, 1.2 mA proton commercial cyclotron, which would lead to 8.1 × 10711C6+ per spill. This intensity is appropriate using 11C ions alone for both imaging and treatment. Here we report on the ongoing feasibility studies of such approach, using the Monte Carlo particle transport code FLUKA [6,7] to simulate

  19. New developments of {sup 11}C post-accelerated beams for hadron therapy and imaging

    Energy Technology Data Exchange (ETDEWEB)

    Augusto, R.S., E-mail: r.s.augusto@cern.ch [European Organization for Nuclear Research – CERN, 1211 Geneva 23 (Switzerland); Ludwig Maximilians – University of Munich, Munich (Germany); Mendonca, T.M.; Wenander, F. [European Organization for Nuclear Research – CERN, 1211 Geneva 23 (Switzerland); Penescu, L. [MedAustron GmbH, Wiener Neustadt (Austria); Orecchia, R. [CNAO – Centro Nazionale di Adroterapia Oncologica per il trattamento dei tumori, Pavia (Italy); Parodi, K. [Ludwig Maximilians – University of Munich, Munich (Germany); Ferrari, A.; Stora, T. [European Organization for Nuclear Research – CERN, 1211 Geneva 23 (Switzerland)

    2016-06-01

    Hadron therapy was first proposed in 1946 and is by now widespread throughout the world, as witnessed with the design and construction of the CNAO, HIT, PROSCAN and MedAustron treatment centres, among others. The clinical interest in hadron therapy lies in the fact that it delivers precision treatment of tumours, exploiting the characteristic shape (the Bragg peak) of the energy deposition in the tissues for charged hadrons. In particular, carbon ion therapy is found to be biologically more effective, with respect to protons, on certain types of tumours. Following an approach tested at NIRS in Japan [1], carbon ion therapy treatments based on {sup 12}C could be combined or fully replaced with {sup 11}C PET radioactive ions post-accelerated to the same energy. This approach allows providing a beam for treatment and, at the same time, to collect information on the 3D distributions of the implanted ions by PET imaging. The production of {sup 11}C ion beams can be performed using two methods. A first one is based on the production using compact PET cyclotrons with 10–20 MeV protons via {sup 14}N(p,α){sup 11}C reactions following an approach developed at the Lawrence Berkeley National Laboratory [2]. A second route exploits spallation reactions {sup 19}F(p,X){sup 11}C and {sup 23}Na(p,X){sup 11}C on a molten fluoride salt target using the ISOL (isotope separation on-line) technique [3]. This approach can be seriously envisaged at CERN-ISOLDE following recent progresses made on {sup 11}C{sup +} production [4] and proven post-acceleration of pure {sup 10}C{sup 3/6+} beams in the REX-ISOLDE linac [5]. Part of the required components is operational in radioactive ion beam facilities or commercial medical PET cyclotrons. The driver could be a 70 MeV, 1.2 mA proton commercial cyclotron, which would lead to 8.1 × 10{sup 711}C{sup 6+} per spill. This intensity is appropriate using {sup 11}C ions alone for both imaging and treatment. Here we report on the ongoing feasibility

  20. Improvement of extraction efficiency from a compact synchrotron for proton beam therapy by applying particle tracking analysis

    International Nuclear Information System (INIS)

    Ebina, Futaro; Umezawa, Masumi; Hiramoto, Kazuo

    2013-01-01

    Various types of synchrotrons are used for particle beam therapy. In particle beam therapy, especially in proton beam therapy, downsizing of the accelerator system is a major concern. A compact synchrotron dedicated for proton beam therapy is presented. The synchrotron is horizontally weakly focusing and consists of 4 H-type zerogradient dipole magnets and 4 quadrupole magnets. The circumference of the ring is a little shorter than 18 m, and the energies are up to 230MeV. Beam extraction from the synchrotron is performed by RF-driven slow extraction technology. Two sextupole magnets set in adjacent straight sections form a horizontal separatrix which is fixed during the beam extraction. Horizontal RF voltage excites betatron oscillation of the circulating beam, and protons exceeding the separatrix are extracted by an electrostatic deflector and a horizontal septum dipole magnet. To achieve adequately high extraction efficiency, the relationship between the extraction efficiency and the horizontal chromaticity of the ring is analyzed by particle tracking simulation. The horizontal chromaticity with maximum extraction efficiency is half of the theoretical value because of the distortion of the horizontal separatrix for the extraction. With this chromaticity, the spiral-step of the extracted particle is independent of the momentum deviation of the particle, and the separatrix across the electrostatic septum electrodes is superpositioned.

  1. Proton therapy

    Science.gov (United States)

    Proton beam therapy; Cancer - proton therapy; Radiation therapy - proton therapy; Prostate cancer - proton therapy ... that use x-rays to destroy cancer cells, proton therapy uses a beam of special particles called ...

  2. Optimal Neutron Source and Beam Shaping Assembly for Boron Neutron Capture Therapy

    International Nuclear Information System (INIS)

    Vujic, J.; Greenspan, E.; Kastenber, W.E.; Karni, Y.; Regev, D.; Verbeke, J.M.; Leung, K.N.; Chivers, D.; Guess, S.; Kim, L.; Waldron, W.; Zhu, Y.

    2003-01-01

    There were three objectives to this project: (1) The development of the 2-D Swan code for the optimization of the nuclear design of facilities for medical applications of radiation, radiation shields, blankets of accelerator-driven systems, fusion facilities, etc. (2) Identification of the maximum beam quality that can be obtained for Boron Neutron Capture Therapy (BNCT) from different reactor-, and accelerator-based neutron sources. The optimal beam-shaping assembly (BSA) design for each neutron source was also to e obtained. (3) Feasibility assessment of a new neutron source for NCT and other medical and industrial applications. This source consists of a state-of-the-art proton or deuteron accelerator driving and inherently safe, proliferation resistant, small subcritical fission assembly

  3. Optimal Neutron Source and Beam Shaping Assembly for Boron Neutron Capture Therapy

    CERN Document Server

    Vujic, J L; Greenspan, E; Guess, S; Karni, Y; Kastenber, W E; Kim, L; Leung, K N; Regev, D; Verbeke, J M; Waldron, W L; Zhu, Y

    2003-01-01

    There were three objectives to this project: (1) The development of the 2-D Swan code for the optimization of the nuclear design of facilities for medical applications of radiation, radiation shields, blankets of accelerator-driven systems, fusion facilities, etc. (2) Identification of the maximum beam quality that can be obtained for Boron Neutron Capture Therapy (BNCT) from different reactor-, and accelerator-based neutron sources. The optimal beam-shaping assembly (BSA) design for each neutron source was also to e obtained. (3) Feasibility assessment of a new neutron source for NCT and other medical and industrial applications. This source consists of a state-of-the-art proton or deuteron accelerator driving and inherently safe, proliferation resistant, small subcritical fission assembly.

  4. Proton beam therapy in a patient with cutaneous T cell lymphoma of the penis

    International Nuclear Information System (INIS)

    Iijima, Shigeruko; Fujisawa, Yuji; Horiuchi, Sanae; Takahashi, Hideharu; Ueno, Kenichi; Kitagawa, Toshio; Mori, Naoyoshi.

    1987-01-01

    A 68-year-old man had multiple tumors as the relapse sign of cutaneous T cell lymphoma. The patient received proton beam therapy with a total dose of 21 Gy for local recurrent lymphoma on the ventral side of the penis. The tumor began to decrease, with concomitant erosion, by delivering 8 Gy. It completely disappeared at 4 days after the completion of irradiation schedule. The erosion was the severest at one month after that. Hematuria and difficulty in urination were not observed. Postmortem histology showed no evidence of viable cancer cells. The use of conventional radiation may induce radiation injuries to the surrounding critical organ, although lymphoma has been recognized as radiosensitive. In view of no evidence of urethral damage, as observed in this patient, proton beams are considered suitable in radiation treatment for the penis. (Namekawa, K.)

  5. In vivo pink-beam imaging and fast alignment procedure for rat brain tumor radiation therapy.

    Science.gov (United States)

    Nemoz, Christian; Kibleur, Astrid; Hyacinthe, Jean Noël; Berruyer, Gilles; Brochard, Thierry; Bräuer-Krisch, Elke; Le Duc, Géraldine; Brun, Emmanuel; Elleaume, Hélène; Serduc, Raphaël

    2016-01-01

    A fast positioning method for brain tumor microbeam irradiations for preclinical studies at third-generation X-ray sources is described. The three-dimensional alignment of the animals relative to the X-ray beam was based on the X-ray tomography multi-slices after iodine infusion. This method used pink-beam imaging produced by the ID17 wiggler. A graphical user interface has been developed in order to define the irradiation parameters: field width, height, number of angles and X-ray dose. This study is the first reporting an image guided method for soft tissue synchrotron radiotherapy. It allowed microbeam radiation therapy irradiation fields to be reduced by a factor of ∼20 compared with previous studies. It permitted more targeted, more efficient brain tumor microbeam treatments and reduces normal brain toxicity of the radiation treatment.

  6. Report on proton therapy according to good clinical practice at Hyogo Ion Beam Medical Center

    International Nuclear Information System (INIS)

    Murakami, Masao; Kagawa, Kazufumi; Hishikawa, Yoshio; Abe, Mitsuyuki

    2002-01-01

    The Hyogo Ion Beam Medical Center (HIBMC) is a hospital-based charged particle treatment facility. Having two treatment ion beams (proton and carbon) and five treatment rooms, it is a pioneer among particle institutes worldwide. In May 2001, proton therapy was started as a clinical study for patients with localized cancer originating in the head and neck, lung, liver, and prostate. The aim of this study was to investigate the safety, effectiveness, and stability of the treatment units and systems based on the evaluation of acute toxicity, tumor response, and working ratio of the machine, respectively. Six patients, including liver cancer in three, prostate cancer in two, and lung cancer in one, were treated. There was no cessation of therapy owing to machine malfunction. Full courses of proton therapy consisting of 154 portals in all six patients were given exactly as scheduled. None of the patients experienced severe acute reactions of more than grade 3 according to NCI-CTC criteria. Tumor response one month post-treatment was evaluable in five of the six patients, and was CR in 1 (prostate cancer), PR in 2 (lung cancer: 1, liver cancer: 1), and NC in 2 (liver cancer: 2). These results indicate that our treatment units and systems are safe and reliable enough for proton irradiation to be used for several malignant tumors localized in the body. (author)

  7. Total skin electron beam therapy as palliative treatment for cutaneous manifestations of advanced, therapy-refractory cutaneous lymphoma and leukemia

    International Nuclear Information System (INIS)

    Hauswald, Henrik; Zwicker, Felix; Rochet, Nathalie; Uhl, Matthias; Hensley, Frank; Debus, Jürgen; Herfarth, Klaus; Bischof, Marc

    2012-01-01

    To retrospectively access the outcome and toxicity of a total skin electron beam therapy (TSEBT) in patients with cutaneous lymphoma (CL) or leukemia. Treatment results of 25 patients (median age 63 years; 5 female, 20 male) with cutaneous manifestations of advanced and therapy-refractory CL (n = 21; T-cell lymphomas n = 18, B-cell lymphomas n = 3) stage IIB-IV or leukemia (n = 4; AML n = 2, CLL n = 1, PDC n = 1) treated between 1993 and 2010 were reviewed. All patients were symptomatic. The median total dose was 29Gy, applied in 29 fractions of median 1 Gy each. The median follow-up was 10 months. Palliation was achieved in 23 patients (92%). A clinical complete response was documented in 13 (52%) and a partial response in 10 patients (40%). The median time to skin progression was 5 months (range 1–18 months) and the actuarial one-year progression-free survival 35%. The median overall survival (OS) after the initiation of TSEBT was 10 months (range 1–46 months) and the actuarial one-year OS 45%. TSEBT related acute adverse events (grade 1 or 2) were observed in all patients during the treatment period. An acute grade 3 epitheliolysis developed in eight patients (32%). Long-term adverse events as a hyperpigmentation of the skin (grade 1 or 2) were documented in 19 patients (76%), and a hypohidrosis in seven patients (28%). For palliation of symptomatic cutaneous manifestations of advanced cutaneous lymphoma or leukemia, total skin electron beam therapy is an efficient and well tolerated considerable treatment option

  8. Brachytherapy or electron beam boost in conservation therapy of carcinoma of the breast: a nonrandomized comparison

    International Nuclear Information System (INIS)

    Perez, Carlos A.; Taylor, Marie E.; Halverson, Karen; Garcia, Delia; Kuske, Robert R.; Lockett, Mary Ann

    1996-01-01

    Purpose: The results of breast-conservation therapy using breast irradiation and a boost to the tumor excision site with either electron beam or interstitial 192 Ir implant are reviewed. Methods and Materials: A total of 701 patients with histologically confirmed Stage T1 and T2 carcinoma of the breast were treated with wide local tumor excision or quadrantectomy and breast irradiation. The breast was treated with tangential fields using 4 or 6 MV photons to deliver 48 to 50 Gy in 1.8 to 2 Gy daily dose, in five weekly fractions. In 80 patients the regional lymphatics were irradiated. In 342 patients with Stage T1 and 107 with Stage T2 tumors, boost to the primary tumor excision site was delivered with 9 MeV and, more frequently, with 12 MeV electrons. In 91 patients with Stage T1 and 38 patients with Stage T2 tumors an interstitial 192 Ir implant was performed. Tumor control, disease-free survival, cosmesis, and morbidity of therapy are reviewed. Minimum follow-up is 4 years (median, 5.6 years; maximum, 24 years). Results: The overall local tumor recurrence rates were 5% in the T1 and 11% in the T2 tumor groups. There was no significant difference in the breast relapse rate in patients treated with either electron beam or interstitial 192 Ir boost. Regional lymph node recurrences were 1% in patients with T1 and 5% with T2 tumors. Distant metastases were recorded in 5% of the T1 and 23% of the T2 groups. The 10-year actuarial disease-free survival rates were 87% for patients with T1 and 75% for patients with T2 tumors. Disease-free survival was exactly the same in patients receiving either electron beam or interstitial 192 Ir boost. Cosmesis was rated as excellent/good in 84% of patients with T1 tumors treated with electron beam and 81% of patients treated with interstitial implant, and 74 and 79%, respectively, in patients with T2 tumors. Conclusions: Breast-conservation therapy is an effective treatment for patients with T1 and T2 carcinoma of the breast. There

  9. In-phantom spectra and dose distributions from a high-energy neutron therapy beam

    Energy Technology Data Exchange (ETDEWEB)

    Benck, S. E-mail: benck@fynu.ucl.ac.be; D' Errico, F.; Denis, J.-M.; Meulders, J.-P.; Nath, R.; Pitcher, E.J

    2002-01-01

    In radiotherapy with external beams, healthy tissues surrounding the target volumes are inevitably irradiated. In the case of neutron therapy, the estimation of dose to the organs surrounding the target volume is particularly challenging, because of the varying contributions from primary and secondary neutrons and photons of different energies. The neutron doses to tissues surrounding the target volume at the Louvain-la-Neuve (LLN) facility were investigated in this work. At LLN, primary neutrons have a broad spectrum with a mean energy of about 30 MeV. The transport of a 10x10 cm{sup 2} beam through a water phantom was simulated by means of the Monte Carlo code MCNPX. Distributions of energy-differential values of neutron fluence, kerma and kerma equivalent were estimated at different locations in a water phantom. The evolution of neutron dose and dose equivalent inside the phantom was deduced. Measurements of absorbed dose and of dose equivalent were then carried out in a water phantom using an ionization chamber and superheated drop detectors (SDDs). On the beam axis, the calculations agreed well with the ionization chamber data, but disagreed significantly from the SDD data due to the detector's under-response to neutrons above 20 MeV. Off the beam axis, the calculated absorbed doses were significantly lower than the ionization chamber readings, since gamma fields were not accounted for. The calculated data are doses from neutron-induced charge particles, and these agreed with the values measured by the photon-insensitive SDDs. When exposed to the degraded spectra off the beam axis, the SDD offered reliable estimates of the neutron dose equivalent.

  10. Dependence of simulated positron emitter yields in ion beam cancer therapy on modeling nuclear fragmentation

    DEFF Research Database (Denmark)

    Lühr, Armin; Priegnitz, Marlen; Fiedler, Fine

    2014-01-01

    In ion beam cancer therapy, range verification in patients using positron emission tomography (PET) requires the comparison of measured with simulated positron emitter yields. We found that (1) changes in modeling nuclear interactions strongly affected the positron emitter yields and that (2) Monte...... Carlo simulations with SHIELD-HIT10A reasonably matched the most abundant PET isotopes 11C and 15O. We observed an ion-energy (i.e., depth) dependence of the agreement between SHIELD-HIT10A and measurement. Improved modeling requires more accurate measurements of cross-section values....

  11. Heavy charged particle radiobiology: using enhanced biological effectiveness and improved beam focusing to advance cancer therapy.

    Science.gov (United States)

    Allen, Christopher; Borak, Thomas B; Tsujii, Hirohiko; Nickoloff, Jac A

    2011-06-03

    Ionizing radiation causes many types of DNA damage, including base damage and single- and double-strand breaks. Photons, including X-rays and γ-rays, are the most widely used type of ionizing radiation in radiobiology experiments, and in radiation cancer therapy. Charged particles, including protons and carbon ions, are seeing increased use as an alternative therapeutic modality. Although the facilities needed to produce high energy charged particle beams are more costly than photon facilities, particle therapy has shown improved cancer survival rates, reflecting more highly focused dose distributions and more severe DNA damage to tumor cells. Despite early successes of charged particle radiotherapy, there is room for further improvement, and much remains to be learned about normal and cancer cell responses to charged particle radiation. 2011 Elsevier B.V. All rights reserved.

  12. Proposed parameters for a circular particle accelerator for proton beam therapy obtained by genetic algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Gustavo L.; Campos, Tarcísio P.R., E-mail: gustavo.lobato@ifmg.edu.br, E-mail: tprcampos@pq.cnpq.br, E-mail: gustavo.lobato@ifmg.edu.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear

    2017-07-01

    This paper brings to light optimized proposal for a circular particle accelerator for proton beam therapy purposes (named as ACPT). The methodology applied is based on computational metaheuristics based on genetic algorithms (GA) were used to obtain optimized parameters of the equipment. Some fundamental concepts in the metaheuristics developed in Matlab® software will be presented. Four parameters were considered for the proposed modeling for the equipment, being: potential difference, magnetic field, length and radius of the resonant cavity. As result, this article showed optimized parameters for two ACPT, one of them used for ocular radiation therapy, as well some parameters that will allow teletherapy, called in order ACPT - 65 and ACPT - 250, obtained through metaheuristics based in GA. (author)

  13. Low-dose (10-Gy) total skin electron beam therapy for cutaneous T-cell lymphoma

    DEFF Research Database (Denmark)

    Kamstrup, Maria R; Gniadecki, Robert; Iversen, Lars

    2015-01-01

    PURPOSE: Cutaneous T-cell lymphomas (CTCLs) are dominated by mycosis fungoides (MF) and Sézary syndrome (SS), and durable disease control is a therapeutic challenge. Standard total skin electron beam therapy (TSEBT) is an effective skin-directed therapy, but the possibility of retreatments...... is limited to 2 to 3 courses in a lifetime due to skin toxicity. This study aimed to determine the clinical effect of low-dose TSEBT in patients with MF and SS. METHODS AND MATERIALS: In an open clinical study, 21 patients with MF/SS stages IB to IV were treated with low-dose TSEBT over ... or a very good partial response rate (skin involvement with patches or plaques) documented in 57% of the patients. Median duration of overall cutaneous response was 174 days (5.8 months; range: 60-675 days). TSEBT-related acute adverse events (grade 1 or 2) were observed in 60% of patients. CONCLUSIONS...

  14. Proposed parameters for a circular particle accelerator for proton beam therapy obtained by genetic algorithm

    International Nuclear Information System (INIS)

    Campos, Gustavo L.; Campos, Tarcísio P.R.

    2017-01-01

    This paper brings to light optimized proposal for a circular particle accelerator for proton beam therapy purposes (named as ACPT). The methodology applied is based on computational metaheuristics based on genetic algorithms (GA) were used to obtain optimized parameters of the equipment. Some fundamental concepts in the metaheuristics developed in Matlab® software will be presented. Four parameters were considered for the proposed modeling for the equipment, being: potential difference, magnetic field, length and radius of the resonant cavity. As result, this article showed optimized parameters for two ACPT, one of them used for ocular radiation therapy, as well some parameters that will allow teletherapy, called in order ACPT - 65 and ACPT - 250, obtained through metaheuristics based in GA. (author)

  15. The use of intensity-modulated radiation therapy photon beams for improving the dose uniformity of electron beams shaped with MLC.

    Science.gov (United States)

    Mosalaei, Homeira; Karnas, Scott; Shah, Sheel; Van Doodewaard, Sharon; Foster, Tim; Chen, Jeff

    2012-01-01

    Electrons are ideal for treating shallow tumors and sparing adjacent normal tissue. Conventionally, electron beams are collimated by cut-outs that are time-consuming to make and difficult to adapt to tumor shape throughout the course of treatment. We propose that electron cut-outs can be replaced using photon multileaf collimator (MLC). Two major problems of this approach are that the scattering of electrons causes penumbra widening because of a large air gap, and available commercial treatment planning systems (TPSs) do not support MLC-collimated electron beams. In this study, these difficulties were overcome by (1) modeling electron beams collimated by photon MLC for a commercial TPS, and (2) developing a technique to reduce electron beam penumbra by adding low-energy intensity-modulated radiation therapy (IMRT) photons (4 MV). We used blocks to simulate MLC shielding in the TPS. Inverse planning was used to optimize boost photon beams. This technique was applied to a parotid and a central nervous system (CNS) clinical case. Combined photon and electron plans were compared with conventional plans and verified using ion chamber, film, and a 2D diode array. Our studies showed that the beam penumbra for mixed beams with 90 cm source to surface distance (SSD) is comparable with electron applicators and cut-outs at 100 cm SSD. Our mixed-beam technique yielded more uniform dose to the planning target volume and lower doses to various organs at risk for both parotid and CNS clinical cases. The plans were verified with measurements, with more than 95% points passing the gamma criteria of 5% in dose difference and 5 mm for distance to agreement. In conclusion, the study has demonstrated the feasibility and potential advantage of using photon MLC to collimate electron beams with boost photon IMRT fields. Copyright © 2012 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  16. SU-F-T-147: An Alternative Parameterization of Scatter Behavior Allows Significant Reduction of Beam Characterization for Pencil Beam Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Van den Heuvel, F; Fiorini, F; George, B [University of Oxford, Oxford (United Kingdom)

    2016-06-15

    Purpose: 1) To describe the characteristics of pencil beam proton dose deposition kernels in a homogenous medium using a novel parameterization. 2) To propose a method utilizing this novel parametrization to reduce the measurements and pre-computation required in commissioning a pencil beam proton therapy system. Methods: Using beam data from a clinical, pencil beam proton therapy center, Monte Carlo simulations were performed to characterize the dose depositions at a range of energies from 100.32 to 226.08 MeV in 3.6MeV steps. At each energy, the beam is defined at the surface of the phantom by a two-dimensional Normal distribution. Using FLUKA, the in-medium dose distribution is calculated in 200×200×350 mm cube with 1 mm{sup 3} tally volumes. The calculated dose distribution in each 200×200 slice perpendicular to the beam axis is then characterized using a symmetric alpha-stable distribution centered on the beam axis. This results in two parameters, α and γ, that completely describe shape of the distribution. In addition, the total dose deposited on each slice is calculated. The alpha-stable parameters are plotted as function of the depth in-medium, providing a representation of dose deposition along the pencil beam. We observed that these graphs are isometric through a scaling of both abscissa and ordinate map the curves. Results: Using interpolation of the scaling factors of two source curves representative of different beam energies, we predicted the parameters of a third curve at an intermediate energy. The errors are quantified by the maximal difference and provide a fit better than previous methods. The maximal energy difference between the source curves generating identical curves was 21.14MeV. Conclusion: We have introduced a novel method to parameterize the in-phantom properties of pencil beam proton dose depositions. For the case of the Knoxville IBA system, no more than nine pencil beams have to be fully characterized.

  17. Effect of Photon Beam Energy, Gold Nanoparticle Size and Concentration on the Dose Enhancement in Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Nahideh Gharehaghaji

    2013-02-01

    Full Text Available Introduction: Gold nanoparticles have been used as radiation dose enhancing materials in recent investigations. In the current study, dose enhancement effect of gold nanoparticles on tumor cells was evaluated using Monte Carlo (MC simulation. Methods: We used MCNPX code for MC modeling in the current study. A water phantom and a tumor region with a size of 1×1×1 cm3 loaded with gold nanoparticles were simulated. The macroscopic dose enhancement factor was calculated for gold nanoparticles with sizes of 30, 50, and 100 nm. Also, we simulated different photon beams including mono-energetic beams (50-120 keV, a Cobalt-60 beam, 6 & 18 MV photon beams of a conventional linear accelerator. Results: We found a dose enhancement factor (DEF of from 1.4 to 3.7 for monoenergetic kilovoltage beams, while the DEFs for megavoltage beams were negligible and less than 3% for all GNP sizes and concentrations. The optimum energy for higher DEF was found to be the 90 keV monoenergetic beam. The effect of GNP size was not considerable, but the GNP concentration had a substantial impact on achieved DEF in GNP-based radiation therapy. Conclusion: The results were in close agreement with some previous studies considering the effect of photon energy and GNP concentration on observed DEF. Application of GNP-based radiation therapy using kilovoltage beams is recommended.

  18. Proton therapy of prostate cancer by anterior-oblique beams: implications of setup and anatomy variations

    Science.gov (United States)

    Moteabbed, M.; Trofimov, A.; Sharp, G. C.; Wang, Y.; Zietman, A. L.; Efstathiou, J. A.; Lu, H.-M.

    2017-03-01

    Proton therapy of prostate by anterior beams could offer an attractive option for treating patients with hip prosthesis and limiting the high-dose exposure to the rectum. We investigated the impact of setup and anatomy variations on the anterior-oblique (AO) proton plan dose, and strategies to manage these effects via range verification and adaptive delivery. Ten patients treated by bilateral (BL) passive-scattering proton therapy (79.2 Gy in 44 fractions) who underwent weekly verification CT scans were selected. Plans with AO beams were additionally created. To isolate the effect of daily variations, initial AO plans did not include range uncertainty margins. The use of fixed planning margins and adaptive range adjustments to manage these effects was investigated. For each case, the planned dose was recalculated on weekly CTs, and accumulated on the simulation CT using deformable registration to approximate the delivered dose. Planned and accumulated doses were compared for each scenario to quantify dose deviations induced by variations. The possibility of estimating the necessary range adjustments before each treatment was explored by simulating the procedure of a diode-based in vivo range verification technique, which would potentially be used clinically. The average planned rectum, penile bulb and femoral heads mean doses were smaller for initial AO compared to BL plans (by 8.3, 16.1 and 25.9 Gy, respectively). After considering interfractional variations in AO plans, the target coverage was substantially reduced. The maximum reduction of V 79.2/D 95/D mean/EUD for AO (without distal margins) (25.3%/10.7/1.6/4.9 Gy, respectively) was considerably larger than BL plans. The loss of coverage was mainly related to changes in water equivalent path length of the prostate after fiducial-based setup, caused by discrepancies in patient anterior surface and bony-anatomy alignment. Target coverage was recovered partially when using fixed planning margins, and fully when

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-01

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

  20. Does hyrax expansion therapy affect maxillary sinus volume? A cone-beam computed tomography report

    Energy Technology Data Exchange (ETDEWEB)

    Darsey, Drew M.; English, Jeryl D.; Ellis, Randy K.; Akyalcin, Sercan [School of Dentistry, University of Texas Health Science Center at Houston, Houston (United States); Kau, Chung H [School of Dentistry, University of Alabama at Birmingham, Birmingham (United States)

    2012-06-15

    The aim of this study was to investigate the initial effects of maxillary expansion therapy with Hyrax appliance and to evaluate the related changes in maxillary sinus volume. Thirty patients (20 females, 10 males; 13.8 years) requiring maxillary expansion therapy, as part of their comprehensive orthodontic treatment, were examined. Each patient had cone-beam computed tomography (CBCT) images taken before (T1) and after (T2) maxillary expansion therapy with a banded Hyrax appliance. Multiplanar slices were used to measure linear dimensions and palatal vault angle. Volumetric analysis was used to measure maxillary sinus volumes. Student t tests were used to compare the pre- and post-treatment measurements. Additionally, differences between two age groups were compared with Mann-Whitney U test. The level of significance was set at p=0.05. Comparison of pre-treatment to post-treatment variables revealed significant changes in the transverse dimension related to both maxillary skeletal and dental structures and palatal vault angle, resulting in a widened palatal vault (p<0.05). Hard palate showed no significant movement in the vertical and anteroposterior planes. Nasal cavity width increased on a mean value of 0.93 mm(SD=0.23, p<0.05). Maxillary sinus volume remained virtually stable. No significant age differences were observed in the sample. Hyrax expansion therapy did not have a significant impact on maxillary sinus volume.

  1. Does hyrax expansion therapy affect maxillary sinus volume? A cone-beam computed tomography report

    International Nuclear Information System (INIS)

    Darsey, Drew M.; English, Jeryl D.; Ellis, Randy K.; Akyalcin, Sercan; Kau, Chung H

    2012-01-01

    The aim of this study was to investigate the initial effects of maxillary expansion therapy with Hyrax appliance and to evaluate the related changes in maxillary sinus volume. Thirty patients (20 females, 10 males; 13.8 years) requiring maxillary expansion therapy, as part of their comprehensive orthodontic treatment, were examined. Each patient had cone-beam computed tomography (CBCT) images taken before (T1) and after (T2) maxillary expansion therapy with a banded Hyrax appliance. Multiplanar slices were used to measure linear dimensions and palatal vault angle. Volumetric analysis was used to measure maxillary sinus volumes. Student t tests were used to compare the pre- and post-treatment measurements. Additionally, differences between two age groups were compared with Mann-Whitney U test. The level of significance was set at p=0.05. Comparison of pre-treatment to post-treatment variables revealed significant changes in the transverse dimension related to both maxillary skeletal and dental structures and palatal vault angle, resulting in a widened palatal vault (p<0.05). Hard palate showed no significant movement in the vertical and anteroposterior planes. Nasal cavity width increased on a mean value of 0.93 mm(SD=0.23, p<0.05). Maxillary sinus volume remained virtually stable. No significant age differences were observed in the sample. Hyrax expansion therapy did not have a significant impact on maxillary sinus volume.

  2. A New Technology for Fast Two-Dimensional Detection of Proton Therapy Beams

    Directory of Open Access Journals (Sweden)

    Robert Hollebeek

    2012-01-01

    chamber and specially designed amplifiers and readout electronics adapted to the requirements of the proton therapy environment and providing both excellent time and high spatial resolution are presented here. The device was irradiated at the Roberts Proton Therapy Center at the University of Pennsylvania. The system was operated with ionization gains between 10 and 200 and in low and intermediate dose-rate beams, and the digitized signal is found to be reproducible to 0.8%. Spatial resolution is determined to be 1.1 mm (1σ with a 1 ms time resolution. We resolve the range modulator wheel rotational frequency and the thicknesses of its segments and show that this information can be quickly measured owing to the high time resolution of the system. Systems of this type will be extremely useful in future treatment methods involving beams that change rapidly in time and spatial position. The Micromegas design resolves the high dose rate within a proton Bragg peak, and measurements agree with Geant4 simulations to within 5%.

  3. Four-Dimensional Patient Dose Reconstruction for Scanned Ion Beam Therapy of Moving Liver Tumors

    International Nuclear Information System (INIS)

    Richter, Daniel; Saito, Nami; Chaudhri, Naved; Härtig, Martin; Ellerbrock, Malte; Jäkel, Oliver; Combs, Stephanie E.; Habermehl, Daniel; Herfarth, Klaus; Durante, Marco; Bert, Christoph

    2014-01-01

    Purpose: Estimation of the actual delivered 4-dimensional (4D) dose in treatments of patients with mobile hepatocellular cancer with scanned carbon ion beam therapy. Methods and Materials: Six patients were treated with 4 fractions to a total relative biological effectiveness (RBE)–weighted dose of 40 Gy (RBE) using a single field. Respiratory motion was addressed by dedicated margins and abdominal compression (5 patients) or gating (1 patient). 4D treatment dose reconstructions based on the treatment records and the measured motion monitoring data were performed for the single-fraction dose and a total of 17 fractions. To assess the impact of uncertainties in the temporal correlation between motion trajectory and beam delivery sequence, 3 dose distributions for varying temporal correlation were calculated per fraction. For 3 patients, the total treatment dose was formed from the fractional distributions using all possible combinations. Clinical target volume (CTV) coverage was analyzed using the volumes receiving at least 95% (V 95 ) and 107% (V 107 ) of the planned doses. Results: 4D dose reconstruction based on daily measured data is possible in a clinical setting. V 95 and V 107 values for the single fractions ranged between 72% and 100%, and 0% and 32%, respectively. The estimated total treatment dose to the CTV exhibited improved and more robust dose coverage (mean V 95 > 87%, SD < 3%) and overdose (mean V 107 < 4%, SD < 3%) with respect to the single-fraction dose for all analyzed patients. Conclusions: A considerable impact of interplay effects on the single-fraction CTV dose was found for most of the analyzed patients. However, due to the fractionated treatment, dose heterogeneities were substantially reduced for the total treatment dose. 4D treatment dose reconstruction for scanned ion beam therapy is technically feasible and may evolve into a valuable tool for dose assessment

  4. Advances in 4D treatment planning for scanned particle beam therapy - report of dedicated workshops.

    Science.gov (United States)

    Bert, Christoph; Graeff, Christian; Riboldi, Marco; Nill, Simeon; Baroni, Guido; Knopf, Antje-Christin

    2014-12-01

    We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle therapy delivery and development. The first workshop resulted in a summary of recommendations for the treatment of mobile targets, along with a list of requirements to apply these guidelines clinically. The increased interest in the treatment of mobile tumors led to a continuously growing number of attendees: the 2012 edition counted more than 60 participants from 20 institutions and commercial vendors. The focus of research discussions among workshop participants progressively moved from 4D treatment planning to complete 4D treatments, aiming at effective and safe treatment delivery. Current research perspectives on 4D treatments include all critical aspects of time resolved delivery, such as in-room imaging, motion detection, beam application, and quality assurance techniques. This was motivated by the start of first clinical treatments of hepato cellular tumors with a scanned particle beam, relying on gating or abdominal compression for motion mitigation. Up to date research activities emphasize significant efforts in investigating advanced motion mitigation techniques, with a specific interest in the development of dedicated tools for experimental validation. Potential improvements will be made possible in the near future through 4D optimized treatment plans that require upgrades of the currently established therapy control systems for time resolved delivery. But since also these novel optimization techniques rely on the validity of the 4DCT, research focusing on alternative 4D imaging technique, such as MRI based 4DCT generation will continue.

  5. Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations

    Directory of Open Access Journals (Sweden)

    Mancosu Pietro

    2012-02-01

    Full Text Available Abstract Purpose To report the initial institute experience in terms of dosimetric and technical aspects in stereotactic body radiation therapy (SBRT delivered using flattening filter free (FFF beam in patients with liver lesions. Methods and Materials From October 2010 to September 2011, 55 consecutive patients with 73 primary or metastatic hepatic lesions were treated with SBRT on TrueBeam using FFF beam and RapidArc technique. Clinical target volume (CTV was defined on multi-phase CT scans, PET/CT, MRI, and 4D-CT. Dose prescription was 75 Gy in 3 fractions to planning target volume (PTV. Constraints for organs at risk were: 700 cc of liver free from the 15 Gy isodose, Dmax max 0.1 cc 15 Gy Results Forty-three patients with a single lesion, nine with two lesions and three with three lesions were treated with this protocol. Target and organs at risk objectives were met for all patients. Mean delivery time was 2.8 ± 1.0 min. Pre-treatment plan verification resulted in a Gamma Agreement Index of 98.6 ± 0.8%. Mean on-line co-registration shift of the daily CBCT to the simulation CT were: -0.08, 0.05 and -0.02 cm with standard deviations of 0.33, 0.39 and 0.55 cm in, vertical, longitudinal and lateral directions respectively. Conclusions SBRT for liver targets delivered by means of FFF resulted to be feasible with short beam on time.

  6. Robust Proton Pencil Beam Scanning Treatment Planning for Rectal Cancer Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Blanco Kiely, Janid Patricia, E-mail: jkiely@sas.upenn.edu; White, Benjamin M.

    2016-05-01

    Purpose: To investigate, in a treatment plan design and robustness study, whether proton pencil beam scanning (PBS) has the potential to offer advantages, relative to interfraction uncertainties, over photon volumetric modulated arc therapy (VMAT) in a locally advanced rectal cancer patient population. Methods and Materials: Ten patients received a planning CT scan, followed by an average of 4 weekly offline CT verification CT scans, which were rigidly co-registered to the planning CT. Clinical PBS plans were generated on the planning CT, using a single-field uniform-dose technique with single-posterior and parallel-opposed (LAT) fields geometries. The VMAT plans were generated on the planning CT using 2 6-MV, 220° coplanar arcs. Clinical plans were forward-calculated on verification CTs to assess robustness relative to anatomic changes. Setup errors were assessed by forward-calculating clinical plans with a ±5-mm (left–right, anterior–posterior, superior–inferior) isocenter shift on the planning CT. Differences in clinical target volume and organ at risk dose–volume histogram (DHV) indicators between plans were tested for significance using an appropriate Wilcoxon test (P<.05). Results: Dosimetrically, PBS plans were statistically different from VMAT plans, showing greater organ at risk sparing. However, the bladder was statistically identical among LAT and VMAT plans. The clinical target volume coverage was statistically identical among all plans. The robustness test found that all DVH indicators for PBS and VMAT plans were robust, except the LAT's genitalia (V5, V35). The verification CT plans showed that all DVH indicators were robust. Conclusions: Pencil beam scanning plans were found to be as robust as VMAT plans relative to interfractional changes during treatment when posterior beam angles and appropriate range margins are used. Pencil beam scanning dosimetric gains in the bowel (V15, V20) over VMAT suggest that using PBS to treat rectal

  7. SU-E-T-455: Characterization of 3D Printed Materials for Proton Beam Therapy

    International Nuclear Information System (INIS)

    Zou, W; Siderits, R; McKenna, M; Khan, A; Yue, N; McDonough, J; Yin, L; Teo, B; Fisher, T

    2014-01-01

    Purpose: The widespread availability of low cost 3D printing technologies provides an alternative fabrication method for customized proton range modifying accessories such as compensators and boluses. However the material properties of the printed object are dependent on the printing technology used. In order to facilitate the application of 3D printing in proton therapy, this study investigated the stopping power of several printed materials using both proton pencil beam measurements and Monte Carlo simulations. Methods: Five 3–4 cm cubes fabricated using three 3D printing technologies (selective laser sintering, fused-deposition modeling and stereolithography) from five printers were investigated. The cubes were scanned on a CT scanner and the depth dose curves for a mono-energetic pencil beam passing through the material were measured using a large parallel plate ion chamber in a water tank. Each cube was measured from two directions (perpendicular and parallel to printing plane) to evaluate the effects of the anisotropic material layout. The results were compared with GEANT4 Monte Carlo simulation using the manufacturer specified material density and chemical composition data. Results: Compared with water, the differences from the range pull back by the printed blocks varied and corresponded well with the material CT Hounsfield unit. The measurement results were in agreement with Monte Carlo simulation. However, depending on the technology, inhomogeneity existed in the printed cubes evidenced from CT images. The effect of such inhomogeneity on the proton beam is to be investigated. Conclusion: Printed blocks by three different 3D printing technologies were characterized for proton beam with measurements and Monte Carlo simulation. The effects of the printing technologies in proton range and stopping power were studied. The derived results can be applied when specific devices are used in proton radiotherapy

  8. A Novel Approach to Postmastectomy Radiation Therapy Using Scanned Proton Beams

    International Nuclear Information System (INIS)

    Depauw, Nicolas; Batin, Estelle; Daartz, Julianne; Rosenfeld, Anatoly; Adams, Judith; Kooy, Hanne; MacDonald, Shannon; Lu, Hsiao-Ming

    2015-01-01

    Purpose: Postmastectomy radiation therapy (PMRT), currently offered at Massachusetts General Hospital, uses proton pencil beam scanning (PBS) with intensity modulation, achieving complete target coverage of the chest wall and all nodal regions and reduced dose to the cardiac structures. This work presents the current methodology for such treatment and the ongoing effort for its improvements. Methods and Materials: A single PBS field is optimized to ensure appropriate target coverage and heart/lung sparing, using an in–house-developed proton planning system with the capability of multicriteria optimization. The dose to the chest wall skin is controlled as a separate objective in the optimization. Surface imaging is used for setup because it is a suitable surrogate for superficial target volumes. In order to minimize the effect of beam range uncertainties, the relative proton stopping power ratio of the material in breast implants was determined through separate measurements. Phantom measurements were also made to validate the accuracy of skin dose calculation in the treatment planning system. Additionally, the treatment planning robustness was evaluated relative to setup perturbations and patient breathing motion. Results: PBS PMRT planning resulted in appropriate target coverage and organ sparing, comparable to treatments by passive scattering (PS) beams but much improved in nodal coverage and cardiac sparing compared to conventional treatments by photon/electron beams. The overall treatment time was much shorter than PS and also shorter than conventional photon/electron treatment. The accuracy of the skin dose calculation by the planning system was within ±2%. The treatment was shown to be adequately robust relative to both setup uncertainties and patient breathing motion, resulting in clinically satisfying dose distributions. Conclusions: More than 25 PMRT patients have been successfully treated at Massachusetts General Hospital by using single-PBS fields

  9. A Novel Approach to Postmastectomy Radiation Therapy Using Scanned Proton Beams

    Energy Technology Data Exchange (ETDEWEB)

    Depauw, Nicolas, E-mail: ndepauw@partners.org [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Centre for Medical Radiation Physics, University of Wollongong, New South Wales (Australia); Batin, Estelle; Daartz, Julianne [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Rosenfeld, Anatoly [Centre for Medical Radiation Physics, University of Wollongong, New South Wales (Australia); Adams, Judith; Kooy, Hanne; MacDonald, Shannon; Lu, Hsiao-Ming [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-02-01

    Purpose: Postmastectomy radiation therapy (PMRT), currently offered at Massachusetts General Hospital, uses proton pencil beam scanning (PBS) with intensity modulation, achieving complete target coverage of the chest wall and all nodal regions and reduced dose to the cardiac structures. This work presents the current methodology for such treatment and the ongoing effort for its improvements. Methods and Materials: A single PBS field is optimized to ensure appropriate target coverage and heart/lung sparing, using an in–house-developed proton planning system with the capability of multicriteria optimization. The dose to the chest wall skin is controlled as a separate objective in the optimization. Surface imaging is used for setup because it is a suitable surrogate for superficial target volumes. In order to minimize the effect of beam range uncertainties, the relative proton stopping power ratio of the material in breast implants was determined through separate measurements. Phantom measurements were also made to validate the accuracy of skin dose calculation in the treatment planning system. Additionally, the treatment planning robustness was evaluated relative to setup perturbations and patient breathing motion. Results: PBS PMRT planning resulted in appropriate target coverage and organ sparing, comparable to treatments by passive scattering (PS) beams but much improved in nodal coverage and cardiac sparing compared to conventional treatments by photon/electron beams. The overall treatment time was much shorter than PS and also shorter than conventional photon/electron treatment. The accuracy of the skin dose calculation by the planning system was within ±2%. The treatment was shown to be adequately robust relative to both setup uncertainties and patient breathing motion, resulting in clinically satisfying dose distributions. Conclusions: More than 25 PMRT patients have been successfully treated at Massachusetts General Hospital by using single-PBS fields

  10. Initial Report of Pencil Beam Scanning Proton Therapy for Posthysterectomy Patients With Gynecologic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Lilie L., E-mail: lin@xrt.upenn.edu; Kirk, Maura; Scholey, Jessica; Taku, Nicolette; Kiely, Janid B.; White, Benjamin; Both, Stefan

    2016-05-01

    Purpose: To report the acute toxicities associated with pencil beam scanning proton beam radiation therapy (PBS) for whole pelvis radiation therapy in women with gynecologic cancers and the results of a dosimetric comparison of PBS versus intensity modulated radiation therapy (IMRT) plans. Methods and Materials: Eleven patients with posthysterectomy gynecologic cancer received PBS to the whole pelvis. The patients received a dose of 45 to 50.4 Gy relative biological effectiveness (RBE) in 1.8 Gy (RBE) daily fractions. Acute toxicity was scored according to the Common Terminology Criteria for Adverse Events, version 4. A dosimetric comparison between a 2-field posterior oblique beam PBS and an IMRT plan was conducted. The Wilcoxon signed rank test was used to assess the potential dosimetric differences between the 2 plans and PBS target coverage robustness relative to setup uncertainties. Results: The median patient age was 55 years (range 23-76). The primary site was cervical in 7, vaginal in 1, and endometrial in 3. Of the 11 patients, 7 received concurrent cisplatin, 1 each received sandwich carboplatin and paclitaxel chemotherapy, both sandwich and concurrent chemotherapy, and concurrent and adjuvant chemotherapy, and 1 received no chemotherapy. All patients completed treatment. Of the 9 patients who received concurrent chemotherapy, the rate of grade 2 and 3 hematologic toxicities was 33% and 11%, respectively. One patient (9%) developed grade 3 acute gastrointestinal toxicity; no patient developed grade ≥3 genitourinary toxicity. The volume of pelvic bone marrow, bladder, and small bowel receiving 10 to 30 Gy was significantly lower with PBS than with intensity modulated radiation therapy (P<.001). The target coverage for all PBS plans was robust relative to the setup uncertainties (P>.05) with the clinical target volume mean dose percentage received by 95% and 98% of the target volume coverage changes within 2% for the individual plans. Conclusions: Our

  11. 4D in-beam positron emission tomography for verification of motion-compensated ion beam therapy

    International Nuclear Information System (INIS)

    Parodi, Katia; Saito, Nami; Chaudhri, Naved; Richter, Christian; Durante, Marco; Enghardt, Wolfgang; Rietzel, Eike; Bert, Christoph

    2009-01-01

    Purpose: Clinically safe and effective treatment of intrafractionally moving targets with scanned ion beams requires dedicated delivery techniques such as beam tracking. Apart from treatment delivery, also appropriate methods for validation of the actual tumor irradiation are highly desirable. In this contribution the feasibility of four-dimensionally (space and time) resolved, motion-compensated in-beam positron emission tomography (4DibPET) was addressed in experimental studies with scanned carbon ion beams. Methods: A polymethyl methracrylate block sinusoidally moving left-right in beam's eye view was used as target. Radiological depth changes were introduced by placing a stationary ramp-shaped absorber proximal of the moving target. Treatment delivery was compensated for motion by beam tracking. Time-resolved, motion-correlated in-beam PET data acquisition was performed during beam delivery with tracking the moving target and prolonged after beam delivery first with the activated target still in motion and, finally, with the target at rest. Motion-compensated 4DibPET imaging was implemented and the results were compared to a stationary reference irradiation of the same treatment field. Data were used to determine feasibility of 4DibPET but also to evaluate offline in comparison to in-beam PET acquisition. Results: 4D in-beam as well as offline PET imaging was found to be feasible and offers the possibility to verify the correct functioning of beam tracking. Motion compensation of the imaged β + -activity distribution allows recovery of the volumetric extension of the delivered field for direct comparison with the reference stationary condition. Observed differences in terms of lateral field extension and penumbra in the direction of motion were typically less than 1 mm for both imaging strategies in comparison to the corresponding reference distributions. However, in-beam imaging retained a better spatial correlation of the measured activity with the delivered

  12. Optimization study for an epithermal neutron beam for boron neutron capture therapy at the University of Virginia Research Reactor

    International Nuclear Information System (INIS)

    Burns, T.D. Jr.

    1995-05-01

    The non-surgical brain cancer treatment modality, Boron Neutron Capture Therapy (BNCT), requires the use of an epithermal neutron beam. This purpose of this thesis was to design an epithermal neutron beam at the University of Virginia Research Reactor (UVAR) suitable for BNCT applications. A suitable epithermal neutron beam for BNCT must have minimal fast neutron and gamma radiation contamination, and yet retain an appreciable intensity. The low power of the UVAR core makes reaching a balance between beam quality and intensity a very challenging design endeavor. The MCNP monte carlo neutron transport code was used to develop an equivalent core radiation source, and to perform the subsequent neutron transport calculations necessary for beam model analysis and development. The code accuracy was validated by benchmarking output against experimental criticality measurements. An epithermal beam was designed for the UVAR, with performance characteristics comparable to beams at facilities with cores of higher power. The epithermal neutron intensity of this beam is 2.2 x 10 8 n/cm 2 · s. The fast neutron and gamma radiation KERMA factors are 10 x 10 -11 cGy·cm 2 /n epi and 20 x 10 -11 cGy·cm 2 /n epi , respectively, and the current-to-flux ratio is 0.85. This thesis has shown that the UVAR has the capability to provide BNCT treatments, however the performance characteristics of the final beam of this study were limited by the low core power

  13. Cataract development in patients treated with proton beam therapy for uveal melanoma.

    Science.gov (United States)

    Seibel, Ira; Cordini, Dino; Hager, Annette; Riechardt, Aline I; Rehak, Matus; Böker, Alexander; Böhmer, Dirk; Heufelder, Jens; Joussen, Antonia M

    2016-08-01

    To evaluate the incidence, risk factors, and dosages of proton beam therapy associated with cataract development, and long-term visual outcomes after treatment of uveal melanoma. All patients receiving primary proton beam therapy for uveal melanoma between 1998 and 2008 with no signs of cataract before irradiation were included. A minimum follow-up of 12 months was determined. Exclusion criteria included all applied adjuvant therapies such as intravitreal injections, laser photocoagulation, tumor resections, or re-irradiation. For subgroup analysis, we included all patients who underwent brachytherapy between 1998 and 2008 for uveal melanoma, considering the above mentioned inclusion and exclusion criteria. Two hundred and fifty-eight patients matched our inclusion criteria. Median follow-up was 72.6 months (12.0-167.4 months). Of these 258 patients, 71 patients (66.3 %) presented with cataract after 31.3 months (0.7-142.4 months), of whom 35 (20.4 %) required surgery after 24.2 (0.7-111.1 months) to ensure funduscopic tumor control. Kaplan-Meier estimates calculated a risk for cataract of 74.3 % after 5 years. There was no increase in metastasis or local recurrence in these patients. Patient's age was the sole independent statistically significant risk factor for cataract development. The probability of cataract occurrence significantly increased with doses to lens exceeding 15-20 CGE. Neither the appearance of cataract nor cataract surgery influenced long-term visual outcome. Cataract formation is the most frequent complication after irradiation. There is no benefit vis-a-vis brachytherapy with regard to cataract development. Data indicate a dose-effect threshold of 0.5 CGE for cataractogenesis, with significantly increasing risk above a dose of 15 CGE. Furthermore, cataract surgery can be performed without an increased risk for metastasis.

  14. External beam radiation therapy for squamous cell carcinoma of the soft palate

    International Nuclear Information System (INIS)

    Medini, Eitan; Medini, Allen; Gapany, Markus; Levitt, Seymour H.

    1997-01-01

    Purpose: External beam radiation therapy for carcinoma of the soft palate aims to achieve loco-regional control with normal speech, nasal function, swallowing mechanism, and minimal side effects such as nasal speech and regurgitation of food into the nasopharynx. In this report we present our results of radiotherapy in the treatment of 24 patients with squamous cell carcinoma of the soft palate. Methods and Materials: A total of 24 patients with squamous cell carcinoma of the soft palate were treated at the Veterans Administration Medical Center Minneapolis, MN, between February 1977 and May 1992. Of the 24 patients 2 had T1, 19 T2, 1 T3, and 2 had T4 lesions. Nineteen patients did not have clinical nodal disease, stage (N0), 1 had N1, 2 N2, and 2 N3 disease (Table 1). All the patients were treated by 4 MeV linear accelerator. A 1.75 Gy median dose was administered per fraction to a total of 70 Gy median dose. Bilateral opposed compensated shrinking fields technique was used. Results: The 3-year disease free survival rate after external beam radiation therapy was 100% (1 out of 1), 64.7% (11 out of 17), 100% (1 out of 1), and 0%, for patients with T1, T2, T3, and T4 disease, respectively. Salvage surgery for recurrent disease was successful in 57.1% (4 out of 7 patients). The ultimate 3-year disease free survival rate for the entire group, including surgical salvage, was 81% (17 out of 21). Conclusion: Radiation therapy alone in our institution resulted in tumor control and survival rates compare favorably to previously published reports in the literature. Surgery can be reserved as salvage procedure

  15. The impact of androgen deprivation therapy on setup errors during external beam radiation therapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Onal, Cem; Dolek, Yemliha; Ozdemir, Yurday [Baskent University, Faculty of Medicine, Adana Dr. Turgut Noyan Research and Treatment Centre, Department of Radiation Oncology, Adana (Turkey)

    2017-06-15

    To determine whether setup errors during external beam radiation therapy (RT) for prostate cancer are influenced by the combination of androgen deprivation treatment (ADT) and RT. Data from 175 patients treated for prostate cancer were retrospectively analyzed. Treatment was as follows: concurrent ADT plus RT, 33 patients (19%); neoadjuvant and concurrent ADT plus RT, 91 patients (52%); RT only, 51 patients (29%). Required couch shifts without rotations were recorded for each megavoltage (MV) cone beam computed tomography (CBCT) scan, and corresponding alignment shifts were recorded as left-right (x), superior-inferior (y), and anterior-posterior (z). The nonparametric Mann-Whitney test was used to compare shifts by group. Pearson's correlation coefficient was used to measure the correlation of couch shifts between groups. Mean prostate shifts and standard deviations (SD) were calculated and pooled to obtain mean or group systematic error (M), SD of systematic error (Σ), and SD of random error (σ). No significant differences were observed in prostate shifts in any direction between the groups. Shifts on CBCT were all less than setup margins. A significant positive correlation was observed between prostate volume and the z-direction prostate shift (r = 0.19, p = 0.04), regardless of ADT group, but not between volume and x- or y-direction shifts (r = 0.04, p = 0.7; r = 0.03, p = 0.7). Random and systematic errors for all patient cohorts and ADT groups were similar. Hormone therapy given concurrently with RT was not found to significantly impact setup errors. Prostate volume was significantly correlated with shifts in the anterior-posterior direction only. (orig.) [German] Ziel war zu untersuchen, ob Konfigurationsfehler bei der externen Radiotherapie (RT) des Prostatakarzinoms durch die Kombination aus Androgendeprivationstherapie (ADT) und RT beeinflusst werden. Retrospektiv wurden die Daten von 175 wegen eines Prostatakarzinoms behandelten Patienten

  16. Measurement of in-phantom neutron flux and gamma dose in Tehran research reactor boron neutron capture therapy beam line.

    Science.gov (United States)

    Bavarnegin, Elham; Sadremomtaz, Alireza; Khalafi, Hossein; Kasesaz, Yaser

    2016-01-01

    Determination of in-phantom quality factors of Tehran research reactor (TRR) boron neutron capture therapy (BNCT) beam. The doses from thermal neutron reactions with 14N and 10B are calculated by kinetic energy released per unit mass approach, after measuring thermal neutron flux using neutron activation technique. Gamma dose is measured using TLD-700 dosimeter. Different dose components have been measured in a head phantom which has been designed and constructed for BNCT purpose in TRR. Different in-phantom beam quality factors have also been determined. This study demonstrates that the TRR BNCT beam line has potential for treatment of superficial tumors.

  17. Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy

    International Nuclear Information System (INIS)

    Gunther, Jillian R.; Sato, Mariko; Chintagumpala, Murali; Ketonen, Leena; Jones, Jeremy Y.; Allen, Pamela K.; Paulino, Arnold C.; Okcu, M. Fatih; Su, Jack M.; Weinberg, Jeffrey; Boehling, Nicholas S.; Khatua, Soumen; Adesina, Adekunle; Dauser, Robert; Whitehead, William E.; Mahajan, Anita

    2015-01-01

    Purpose: The clinical significance of magnetic resonance imaging (MRI) changes after radiation therapy (RT) in children with ependymoma is not well defined. We compared imaging changes following proton beam radiation therapy (PBRT) to those after photon-based intensity modulated RT (IMRT). Methods and Materials: Seventy-two patients with nonmetastatic intracranial ependymoma who received postoperative RT (37 PBRT, 35 IMRT) were analyzed retrospectively. MRI images were reviewed by 2 neuroradiologists. Results: Sixteen PBRT patients (43%) developed postradiation MRI changes at 3.8 months (median) with resolution by 6.1 months. Six IMRT patients (17%) developed changes at 5.3 months (median) with 8.3 months to resolution. Mean age at radiation was 4.4 and 6.9 years for PBRT and IMRT, respectively (P=.06). Age at diagnosis (>3 years) and time of radiation (≥3 years) was associated with fewer imaging changes on univariate analysis (odds ratio [OR]: 0.35, P=.048; OR: 0.36, P=.05). PBRT (compared to IMRT) was associated with more frequent imaging changes, both on univariate (OR: 3.68, P=.019) and multivariate (OR: 3.89, P=.024) analyses. Seven (3 IMRT, 4 PBRT) of 22 patients with changes had symptoms requiring intervention. Most patients were treated with steroids; some PBRT patients also received bevacizumab and hyperbaric oxygen therapy. None of the IMRT patients had lasting deficits, but 2 patients died from recurrent disease. Three PBRT patients had persistent neurological deficits, and 1 child died secondarily to complications from radiation necrosis. Conclusions: Postradiation MRI changes are more common with PBRT and in patients less than 3 years of age at diagnosis and treatment. It is difficult to predict causes for development of imaging changes that progress to clinical significance. These changes are usually self-limiting, but some require medical intervention, especially those involving the brainstem

  18. Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gunther, Jillian R. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sato, Mariko; Chintagumpala, Murali [Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Ketonen, Leena [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jones, Jeremy Y. [Department of Pediatric Radiology, Texas Children' s Hospital, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Paulino, Arnold C. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Okcu, M. Fatih; Su, Jack M. [Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Weinberg, Jeffrey [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Boehling, Nicholas S. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Khatua, Soumen [Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Adesina, Adekunle [Department of Pathology, Baylor College of Medicine, Texas Children' s Hospital, Houston, Texas (United States); Dauser, Robert; Whitehead, William E. [Department of Neurosurgery, Texas Children' s Hospital, Houston, Texas (United States); Mahajan, Anita, E-mail: amahajan@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: The clinical significance of magnetic resonance imaging (MRI) changes after radiation therapy (RT) in children with ependymoma is not well defined. We compared imaging changes following proton beam radiation therapy (PBRT) to those after photon-based intensity modulated RT (IMRT). Methods and Materials: Seventy-two patients with nonmetastatic intracranial ependymoma who received postoperative RT (37 PBRT, 35 IMRT) were analyzed retrospectively. MRI images were reviewed by 2 neuroradiologists. Results: Sixteen PBRT patients (43%) developed postradiation MRI changes at 3.8 months (median) with resolution by 6.1 months. Six IMRT patients (17%) developed changes at 5.3 months (median) with 8.3 months to resolution. Mean age at radiation was 4.4 and 6.9 years for PBRT and IMRT, respectively (P=.06). Age at diagnosis (>3 years) and time of radiation (≥3 years) was associated with fewer imaging changes on univariate analysis (odds ratio [OR]: 0.35, P=.048; OR: 0.36, P=.05). PBRT (compared to IMRT) was associated with more frequent imaging changes, both on univariate (OR: 3.68, P=.019) and multivariate (OR: 3.89, P=.024) analyses. Seven (3 IMRT, 4 PBRT) of 22 patients with changes had symptoms requiring intervention. Most patients were treated with steroids; some PBRT patients also received bevacizumab and hyperbaric oxygen therapy. None of the IMRT patients had lasting deficits, but 2 patients died from recurrent disease. Three PBRT patients had persistent neurological deficits, and 1 child died secondarily to complications from radiation necrosis. Conclusions: Postradiation MRI changes are more common with PBRT and in patients less than 3 years of age at diagnosis and treatment. It is difficult to predict causes for development of imaging changes that progress to clinical significance. These changes are usually self-limiting, but some require medical intervention, especially those involving the brainstem.

  19. Optimizing the modified microdosimetric kinetic model input parameters for proton and 4He ion beam therapy application

    Science.gov (United States)

    Mairani, A.; Magro, G.; Tessonnier, T.; Böhlen, T. T.; Molinelli, S.; Ferrari, A.; Parodi, K.; Debus, J.; Haberer, T.

    2017-06-01

    Models able to predict relative biological effectiveness (RBE) values are necessary for an accurate determination of the biological effect with proton and 4He ion beams. This is particularly important when including RBE calculations in treatment planning studies comparing biologically optimized proton and 4He ion beam plans. In this work, we have tailored the predictions of the modified microdosimetric kinetic model (MKM), which is clinically applied for carbon ion beam therapy in Japan, to reproduce RBE with proton and 4He ion beams. We have tuned the input parameters of the MKM, i.e. the domain and nucleus radii, reproducing an experimental database of initial RBE data for proton and He ion beams. The modified MKM, with the best fit parameters obtained, has been used to reproduce in vitro cell survival data in clinically-relevant scenarios. A satisfactory agreement has been found for the studied cell lines, A549 and RENCA, with the mean absolute survival variation between the data and predictions within 2% and 5% for proton and 4He ion beams, respectively. Moreover, a sensitivity study has been performed varying the domain and nucleus radii and the quadratic parameter of the photon response curve. The promising agreement found in this work for the studied clinical-like scenarios supports the usage of the modified MKM for treatment planning studies in proton and 4He ion beam therapy.

  20. Improvements for extending the time between maintenance periods for the Heidelberg ion beam therapy center (HIT) ion sources.

    Science.gov (United States)

    Winkelmann, Tim; Cee, Rainer; Haberer, Thomas; Naas, Bernd; Peters, Andreas; Schreiner, Jochen

    2014-02-01

    The clinical operation at the Heidelberg Ion Beam Therapy Center (HIT) started in November 2009; since then more than 1600 patients have been treated. In a 24/7 operation scheme two 14.5 GHz electron cyclotron resonance ion sources are routinely used to produce protons and carbon ions. The modification of the low energy beam transport line and the integration of a third ion source into the therapy facility will be shown. In the last year we implemented a new extraction system at all three sources to enhance the lifetime of extraction parts and reduce preventive and corrective maintenance. The new four-electrode-design provides electron suppression as well as lower beam emittance. Unwanted beam sputtering effects which typically lead to contamination of the insulator ceramics and subsequent high-voltage break-downs are minimized by the beam guidance of the new extraction system. By this measure the service interval can be increased significantly. As a side effect, the beam emittance can be reduced allowing a less challenging working point for the ion sources without reducing the effective beam performance. This paper gives also an outlook to further enhancements at the HIT ion source testbench.

  1. The role of adjuvant external beam radiation therapy for papillary thyroid carcinoma invading the trachea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Suk; Choi, Jae Hyuck; Kim, Kwang Sik [Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of); and others

    2017-06-15

    To evaluate the effect of adjuvant external beam radiation therapy (EBRT) on local failure-free survival rate (LFFS) for papillary thyroid cancer (PTC) invading the trachea. Fifty-six patients with locally advanced PTC invading the trachea were treated with surgical resection. After surgery, 21 patients received adjuvant EBRT and radioactive iodine therapy (EBRT group) and 35 patients were treated with radioactive iodine therapy (control group). The age range was 26–87 years (median, 56 years). The median follow-up period was 43 months (range, 4 to 145 months). EBRT doses ranged from 50.4 to 66 Gy (median, 60 Gy). Esophagus invasion and gross residual disease was more frequent in the EBRT group. In the control group, local recurrence developed in 9 (9/35, 26%) and new distant metastasis in 2 (2/35, 6%) patients, occurring 4 to 68 months (median, 37 months) and 53 to 68 months (median, 60 months) after surgery, respectively. Two patients had simultaneous local recurrence and new distant metastasis. There was one local failure in the EBRT group at 18 months after surgery (1/21, 5%). The 5-year LFFS was 95% in the EBRT group and 63% in the control group (p = 0.103). In the EBRT group, one late grade 2 xerostomia was developed. Although, EBRT group had a higher incidence of esophagus invasion and gross residual disease, EBRT group showed a better 5-year LFFS. Adjuvant EBRT may have contributed to the better LFFS in these patients.

  2. An implantable radiation dosimeter for use in external beam radiation therapy

    International Nuclear Information System (INIS)

    Scarantino, Charles W.; Ruslander, David M.; Rini, Christopher J.; Mann, Gregory G.; Nagle, H. Troy; Black, Robert D.

    2004-01-01

    An implantable radiation dosimeter for use with external beam therapy has been developed and tested both in vitro and in canines. The device uses a MOSFET dosimeter and is polled telemetrically every day during the course of therapy. The device is designed for permanent implantation and also acts as a radiographic fiducial marker. Ten dogs (companion animals) that presented with spontaneous, malignant tumors were enrolled in the study and received an implant in the tumor CTV. Three dogs received an additional implant in collateral normal tissue. Radiation therapy plans were created for the animals and they were treated with roughly 300 cGy daily fractions until completion of the prescribed cumulative dose. The primary endpoints of the study were to record any adverse events due to sensor placement and to monitor any movement away from the point of placement. No adverse events were recorded. Unacceptable device migration was experienced in two subjects and a retention mechanism was developed to prevent movement in the future. Daily dose readings were successfully acquired in all subjects. A rigorous in vitro calibration methodology has been developed to ensure that the implanted devices maintain an accuracy of ±3.5% relative to an ionization chamber standard. The authors believe that an implantable radiation dosimeter is a practical and powerful tool that fosters individualized patient QA on a daily basis

  3. More than 10 years experience of beam monitoring with the Gantry 1 spot scanning proton therapy facility at PSI

    International Nuclear Information System (INIS)

    Lin Shixiong; Boehringer, Terence; Coray, Adolf; Grossmann, Martin; Pedroni, Eros

    2009-01-01

    Purpose: The beam monitoring equipments developed for the first PSI spot scanning proton therapy facility, Gantry 1, have been successfully used for more than 10 years. The purpose of this article is to summarize the author's experience in the beam monitoring technique for dynamic proton scanning. Methods: The spot dose delivery and verification use two independent beam monitoring and computer systems. In this article, the detector construction, electronic system, dosimetry, and quality assurance results are described in detail. The beam flux monitor is calibrated with a Faraday cup. The beam position monitoring is realized by measuring the magnetic fields of deflection magnets with Hall probes before applying the spot and by checking the beam position and width with an ionization strip chamber after the spot delivery. Results: The results of thimble ionization chamber dosimetry measurements are reproducible (with a mean deviation of less than 1% and a standard deviation of 1%). The resolution in the beam position measurement is of the order of a tenth of a millimeter. The tolerance of the beam position delivery and monitoring during scanning is less than 1.5 mm. Conclusions: The experiences gained with the successful operation of Gantry 1 represent a unique and solid background for the development of a new system, Gantry 2, in order to perform new advanced scanning techniques.

  4. More than 10 years experience of beam monitoring with the Gantry 1 spot scanning proton therapy facility at PSI

    Energy Technology Data Exchange (ETDEWEB)

    Lin Shixiong; Boehringer, Terence; Coray, Adolf; Grossmann, Martin; Pedroni, Eros [Center for Proton Therapy, Paul Scherrer Institute, CH-5232 Villigen PSI (Switzerland)

    2009-11-15

    Purpose: The beam monitoring equipments developed for the first PSI spot scanning proton therapy facility, Gantry 1, have been successfully used for more than 10 years. The purpose of this article is to summarize the author's experience in the beam monitoring technique for dynamic proton scanning. Methods: The spot dose delivery and verification use two independent beam monitoring and computer systems. In this article, the detector construction, electronic system, dosimetry, and quality assurance results are described in detail. The beam flux monitor is calibrated with a Faraday cup. The beam position monitoring is realized by measuring the magnetic fields of deflection magnets with Hall probes before applying the spot and by checking the beam position and width with an ionization strip chamber after the spot delivery. Results: The results of thimble ionization chamber dosimetry measurements are reproducible (with a mean deviation of less than 1% and a standard deviation of 1%). The resolution in the beam position measurement is of the order of a tenth of a millimeter. The tolerance of the beam position delivery and monitoring during scanning is less than 1.5 mm. Conclusions: The experiences gained with the successful operation of Gantry 1 represent a unique and solid background for the development of a new system, Gantry 2, in order to perform new advanced scanning techniques.

  5. Investigating the robustness of ion beam therapy treatment plans to uncertainties in biological treatment parameters

    CERN Document Server

    Boehlen, T T; Dosanjh, M; Ferrari, A; Fossati, P; Haberer, T; Mairani, A; Patera, V

    2012-01-01

    Uncertainties in determining clinically used relative biological effectiveness (RBE) values for ion beam therapy carry the risk of absolute and relative misestimations of RBE-weighted doses for clinical scenarios. This study assesses the consequences of hypothetical misestimations of input parameters to the RBE modelling for carbon ion treatment plans by a variational approach. The impact of the variations on resulting cell survival and RBE values is evaluated as a function of the remaining ion range. In addition, the sensitivity to misestimations in RBE modelling is compared for single fields and two opposed fields using differing optimization criteria. It is demonstrated for single treatment fields that moderate variations (up to +/-50\\%) of representative nominal input parameters for four tumours result mainly in a misestimation of the RBE-weighted dose in the planning target volume (PTV) by a constant factor and only smaller RBE-weighted dose gradients. Ensuring a more uniform radiation quality in the PTV...

  6. An examination of human factors in external beam radiation therapy: Findings and implications

    International Nuclear Information System (INIS)

    Henriksen, K.; Kaye, R.D.; Jones, R.E. Jr.; Morisseau, D.S.; Persensky, J.J.

    1994-01-01

    To better understand the contributing factors to human error in external beam radiation therapy, the US Nuclear Regulatory Commission has undertaken a series of human factors evaluations. A team of human factors specialists, assisted by a panel of radiation oncologists, medical physicists, and radiation technologists, conducted visits to 24 radiation oncology departments at community hospitals, university centers, and free-standing clinics. A function and task analysis was initially performed to guide subsequent evaluations in the areas of human-system interfaces, procedures, training and qualifications, and organizational policies and practices. Representative findings and implications for improvement are discussed within the context of a dynamic model which holds that misadministration likely results from the unanticipated interaction of several necessary but singly insufficient conditions

  7. Multiple courses of high-dose total skin electron beam therapy in the management of mycosis fungoides

    International Nuclear Information System (INIS)

    Becker, Mark; Hoppe, Richard T.; Knox, Susan J.

    1995-01-01

    Purpose: A retrospective analysis was undertaken to determine the indications for, the efficacy of, and the long-term complications of two courses of total skin electron beam therapy for mycosis fungoides. Methods and Materials: A retrospective analysis of 15 patients with the pathologic diagnosis of mycosis fungoides treated in the Department of Radiation Oncology at Stanford University Medical Center between 1968 and 1990 was performed. All patients received two courses of high-dose electron beam therapy to the skin. The mean dose for the total skin treatment for the first course was 32.6 Gy and 23.4 Gy for the second course of treatment. Results: Following the first course of total skin electron beam therapy, 11 of 15 had a complete response, with a mean duration of 11.6 months. All patients received adjuvant therapies between the first and second courses of high-dose total skin electron beam therapy. The mean interval between the first and the second courses of therapy was 41.3 months. Patients were restaged prior to commencement of their second course of high-dose total skin electron beam therapy, resulting in upstaging in six. The second course of therapy resulted in six complete responses and nine partial responses. Twelve of these patients have since died, 1 is lost to follow-up, and 2 are living with disease. The long-term side effects in the two living patients include pigmentation changes, alopecia, and diffuse xerosis. Conclusion: Delivery of two courses of total skin electron beam therapy is technically feasible, tolerable, and efficacious. The dose to the total skin was reduced for the second course of therapy in all cases. The criteria used to screen patients included initial good response to total skin electron treatment, long disease-free interval, exhaustion of other therapeutic modalities, and generalized skin involvement at relapse. Long-term toxicities were mild in severity and generally consisted of generalized xerosis, scattered

  8. Intravitreal bevacizumab for neovascular glaucoma in uveal melanoma treated by proton beam therapy.

    Science.gov (United States)

    Mahdjoubi, Amir; Najean, Marie; Lemaitre, Stéphanie; Dureau, Sylvain; Dendale, Rémi; Levy, Christine; Rouic, Livia Lumbroso-Le; Desjardins, Laurence; Cassoux, Nathalie

    2018-02-01

    To evaluate the efficacy of bevacizumab on reduction of the enucleation rate and control of intraocular pressure (IOP) in neovascular glaucoma (NVG)-complicating proton beam therapy for UM and to identify the determinants of the efficacy of bevacizumab. Retrospective comparative study of patients with rubeosis following proton therapy for uveal melanoma. Patients were divided into two groups: a bevacizumab group and a control group which comprised two subgroups: panretinal photocoagulation (PRP)/cryotherapy and observation subgroups. Bevacizumab was administered by three intravitreal injections at 1-month intervals. A second series of injections was administered when necessary. Data concerning IOP and the secondary enucleation rate were collected and compared between the two groups. Univariate and multivariate analyses were performed to determine predictive factors of response to bevacizumab. A total of 169 patients who developed rubeosis following proton therapy between 2006 and 2016 were included: 44 patients in the bevacizumab group and 125 in the control group (38 in the PRP/cryotherapy subgroup and 87 in the observation subgroup). The two groups presented the same baseline characteristics apart from hypertension, retro-equatorial site, and proximity of the optic disk, which were more frequent in the control group, while initial retinal detachment and larger tumor volume were more frequent in the bevacizumab group. After a mean follow-up of 31 months, IOP was less than 21 mmHg in 54.54% of patients after IVB versus 72.7% before treatment (p = 0.06). Statistical analysis did not reveal any statistically significant reduction of the enucleation rate in the bevacizumab group compared to the observational group, whereas the PRP/cryotherapy group showed better eye retention rate (p = 0.15). No enucleation was performed when IOP was bevacizumab. Despite the improvement of IOP level, intravitreal bevacizumab (IVB) did not reduce the overall enucleation rate in

  9. Application of semiconductors for dosimetry of fast-neutron therapy beam

    International Nuclear Information System (INIS)

    Yudelev, M.; Alyousef, K.; Brandon, J.; Perevertailo, V.; Lerch, M. L. F.; Rosenfeld, A. B.

    2004-01-01

    Two types of ion implanted miniature p-i-n diodes were tested in a d(48.5) + Be fast-neutron beam produced in the Detroit superconducting cyclotron. The increase in forward voltage drop caused by neutron-induced damage was correlated with neutron dose measured in a water phantom. The neutron and gamma dose components were predetermined using twin detector (Tissue-equivalent ion chamber paired with miniature Geiger-Mueller counter) method. The increase in the voltage drop for 1 mA injection current was monitored together with the cyclotron beam target current, thus the differential voltage drop could be defined precisely for given radiation dose. The average neutron sensitivities of tested diodes were 1.284 ± 0.014 and 0.528 ± 0.058 mV per cGy. The miniature detectors can be utilised in characterisation of small radiation fields and in the regions of high dose gradient as well as for in vivo dosimetry of the patients undergoing fast-neutron therapy. (authors)

  10. Design of a Compton camera for 3D prompt-{gamma} imaging during ion beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Roellinghoff, F., E-mail: roelling@ipnl.in2p3.fr [Universite de Lyon, F-69622 Lyon (France); Universite Lyon 1 and CNRS/IN2P3, UMR 5822, IPNL, F-69622 Villeurbanne (France); INSA-Lyon Laboratory of Nondestructive Testing using Ionizing Radiation (CNDRI), F-69621 Villeurbanne Cedex (France); Richard, M.-H., E-mail: mrichard@ipnl.in2p3.fr [Universite de Lyon, F-69622 Lyon (France); Universite Lyon 1 and CNRS/IN2P3, UMR 5822, IPNL, F-69622 Villeurbanne (France); INSA-Lyon Laboratory of Nondestructive Testing using Ionizing Radiation (CNDRI), F-69621 Villeurbanne Cedex (France); Chevallier, M.; Constanzo, J.; Dauvergne, D. [Universite de Lyon, F-69622 Lyon (France); Universite Lyon 1 and CNRS/IN2P3, UMR 5822, IPNL, F-69622 Villeurbanne (France); Freud, N. [INSA-Lyon Laboratory of Nondestructive Testing using Ionizing Radiation (CNDRI), F-69621 Villeurbanne Cedex (France); Henriquet, P.; Le Foulher, F. [Universite de Lyon, F-69622 Lyon (France); Universite Lyon 1 and CNRS/IN2P3, UMR 5822, IPNL, F-69622 Villeurbanne (France); Letang, J.M. [INSA-Lyon Laboratory of Nondestructive Testing using Ionizing Radiation (CNDRI), F-69621 Villeurbanne Cedex (France); Montarou, G. [LPC, CNRS/IN2P3, Clermont-F. University (France); Ray, C.; Testa, E.; Testa, M. [Universite de Lyon, F-69622 Lyon (France); Universite Lyon 1 and CNRS/IN2P3, UMR 5822, IPNL, F-69622 Villeurbanne (France); Walenta, A.H. [Uni-Siegen, FB Physik, Emmy-Noether Campus, D-57068 Siegen (Germany)

    2011-08-21

    We investigate, by means of Geant4 simulations, a real-time method to control the position of the Bragg peak during ion therapy, based on a Compton camera in combination with a beam tagging device (hodoscope) in order to detect the prompt gamma emitted during nuclear fragmentation. The proposed set-up consists of a stack of 2 mm thick silicon strip detectors and a LYSO absorber detector. The {gamma} emission points are reconstructed analytically by intersecting the ion trajectories given by the beam hodoscope and the Compton cones given by the camera. The camera response to a polychromatic point source in air is analyzed with regard to both spatial resolution and detection efficiency. Various geometrical configurations of the camera have been tested. In the proposed configuration, for a typical polychromatic photon point source, the spatial resolution of the camera is about 8.3 mm FWHM and the detection efficiency 2.5x10{sup -4} (reconstructable photons/emitted photons in 4{pi}). Finally, the clinical applicability of our system is considered and possible starting points for further developments of a prototype are discussed.

  11. In-phantom spectra and dose distributions from a high-energy neutron therapy beam

    CERN Document Server

    Benck, S; Denis, J M; Meulders, J P; Nath, R; Pitcher, E J

    2002-01-01

    In radiotherapy with external beams, healthy tissues surrounding the target volumes are inevitably irradiated. In the case of neutron therapy, the estimation of dose to the organs surrounding the target volume is particularly challenging, because of the varying contributions from primary and secondary neutrons and photons of different energies. The neutron doses to tissues surrounding the target volume at the Louvain-la-Neuve (LLN) facility were investigated in this work. At LLN, primary neutrons have a broad spectrum with a mean energy of about 30 MeV. The transport of a 10x10 cm sup 2 beam through a water phantom was simulated by means of the Monte Carlo code MCNPX. Distributions of energy-differential values of neutron fluence, kerma and kerma equivalent were estimated at different locations in a water phantom. The evolution of neutron dose and dose equivalent inside the phantom was deduced. Measurements of absorbed dose and of dose equivalent were then carried out in a water phantom using an ionization ch...

  12. Intraoperative electron-beam therapy for primary and recurrent retroperitoneal soft-tissue sarcoma

    International Nuclear Information System (INIS)

    Krempien, Robert; Roeder, Falk; Oertel, Susanne; Weitz, Juergen; Hensley, Frank W.; Timke, Carmen; Funk, Angela; Lindel, Katja; Harms, Wolfgang; Buchler, Markus W.; Debus, Juergen; Treiber, Martina

    2006-01-01

    Purpose: This study assesses the long-term outcome of patients with retroperitoneal soft-tissue sarcomas treated by maximal resection in combination with intraoperative electron-beam therapy (IOERT) and postoperative external-beam radiotherapy. Methods and Materials: From 1991 to 2004, 67 patients were treated with curative intent for primary (n = 26) or recurrent (n = 41) retroperitoneal soft-tissue sarcoma. All patients underwent maximal resection in combination with IOERT (mean dose, 15 Gy), 45 patients underwent additional postoperative EBRT, and 20 patients were previously irradiated. Results: The 5-year actuarial overall survival (OS), disease-free survival, local control (LC), and freedom from metastatic disease of all patients was 64%, 28%, 40%, and 50%, respectively. The 5-year LC inside the IOERT field was 72%. For patients who completed IOERT and EBRT after R0-resection 5-year and 10-year OS was 80%, and 5-year and 10-year LC was 100%. Only 1 of the 21 patients after R0-resection and only 8 of 34 patients after R1-resection compared with 9 of 12 patients after R2-resection experienced inside IOERT-field relapse. Grade II or higher late complications were seen in 21% of the patients, but only 2 patients required surgical intervention because of late complications. Conclusion: In selected patients, IOERT results in excellent local control and survival, with acceptable morbidity

  13. The accuracy assessment of PPS in fixed beam proton therapy: isocentric rotation movement

    International Nuclear Information System (INIS)

    Li Xinping; Zeng Xianwen; Xu Wenling; Li Jiamin; Lv Mingming

    2005-01-01

    Objective: To assess the accuracy of isocentric rotation movement of Patient Positioning System (PPS) in fixed beam proton therapy. Methods: A 2 mm-diameter radioopaque sphere was positioned above the couch and was aligned to room iso-center (ISO). 11 PPS angles were selected to make isocentric rotation test respectively. The displacement of the sphere to ISO were measured and calculated by Digital Image Positioning System (DIPS) respectively when PPS reached each designed position. Totally four group measurements were repeated at different time. all data were collected and statistical analysis were performed. Results: The maximum shifts are (0.29 ± 0.05) mm, (0.21 ± 0.04) mm and (-0.21 ± 0.04) mm on X, Y, Z axes at - 110 degree PPS position, the absolute displacement of the sphere to ISO is (0.41 ± 0.07) mm(1SD). The minimum shifts are (-0.03 ± 0.05) mm, (0.05 ± 0.05) mm and (0.00 ± 0.00) mm on three principle axes at 30 degree PPS position, the absolute displacement of the sphere to ISO is (0.05 ± 0.06) mm. Conclusion: The isocentric rotation movement is the linchpin to realize multi-angle isocentric irradiation in fixed beamproton therapy. It is a complicated combined movement including PPS rotation and PPS translations. Since the high demand in the of precision of patient positioning, the accuracy of this combined movement played important role in proton therapy. In our tests, all shifts are less than 0.5 mm, can reach the requirement of positioning accuracy in proton therapy. (authors)

  14. Local Recurrence After Uveal Melanoma Proton Beam Therapy: Recurrence Types and Prognostic Consequences

    International Nuclear Information System (INIS)

    Caujolle, Jean-Pierre; Paoli, Vincent; Chamorey, Emmanuel; Maschi, Celia; Baillif, Stéphanie; Herault, Joël; Gastaud, Pierre; Hannoun-Levi, Jean Michel

    2013-01-01

    Purpose: To study the prognosis of the different types of uveal melanoma recurrences treated by proton beam therapy (PBT). Methods and Materials: This retrospective study analyzed 61 cases of uveal melanoma local recurrences on a total of 1102 patients treated by PBT between June 1991 and December 2010. Survival rates have been determined by using Kaplan-Meier curves. Prognostic factors have been evaluated by using log-rank test or Cox model. Results: Our local recurrence rate was 6.1% at 5 years. These recurrences were divided into 25 patients with marginal recurrences, 18 global recurrences, 12 distant recurrences, and 6 extrascleral extensions. Five factors have been identified as statistically significant risk factors of local recurrence in the univariate analysis: large tumoral diameter, small tumoral volume, low ratio of tumoral volume over eyeball volume, iris root involvement, and safety margin inferior to 1 mm. In the local recurrence-free population, the overall survival rate was 68.7% at 10 years and the specific survival rate was 83.6% at 10 years. In the local recurrence population, the overall survival rate was 43.1% at 10 years and the specific survival rate was 55% at 10 years. The multivariate analysis of death risk factors has shown a better prognosis for marginal recurrences. Conclusion: Survival rate of marginal recurrences is superior to that of the other recurrences. The type of recurrence is a clinical prognostic value to take into account. The influence of local recurrence retreatment by proton beam therapy should be evaluated by novel studies

  15. Predictive risk factors for radiation retinopathy and optic neuropathy after proton beam therapy for uveal melanoma.

    Science.gov (United States)

    Seibel, Ira; Cordini, Dino; Hager, Annette; Tillner, Johanna; Riechardt, Aline I; Heufelder, Jens; Davids, Anja M; Rehak, Matus; Joussen, Antonia M

    2016-09-01

    This study was performed in order to evaluate the incidence of radiation retinopathy and optic neuropathy occurring after proton beam therapy for uveal melanoma. Included in this study were all patients who had been treated with primary proton beam therapy for uveal melanoma at the oncology service between May 1998 and June 2014 with a minimum follow-up of 12 months. Excluded were all patients who underwent re-irradiation, or vitrectomy due to exudative retinal detachment or for tumor-resection. During this period, 1127 patients matched the inclusion criteria, of whom 768 (68.1 %) and 463 (41.0 %) developed radiation retinopathy and optic neuropathy after a median time of 18.9 months (2.0-99.84 months) and 19.8 months (0.2-170.4 months), respectively. Mean follow-up was 53.4 months (12-170.4 months). Included were 558 men (49.5 %) and 569 women (50.5 %). Mean age was 61 years (16-89 years). Visual acuity slightly decreased from initial levels of 0.3 logMAR-0.4 logMAR in patients without developing any radiation-induced complication but severely decreased to 1.0 logMAR or 1.5 logMAR in the case of developing radiation retinopathy only or optic neuropathy, respectively. Independent risk factors for radiation retinopathy were a centrally (<2.5 mm from sensitive structures) located tumor or a thick tumor located more than 2.5 mm from sensitive structures, while those for radiation optic neuropathy comprised a short distance and applied dose to the optic disk. The risk for radiation retinopathy is higher in central uveal melanoma. Mid-/peripheral tumors are at high risk for radiation retinopathy and maculopathy if presenting with increased thickness.

  16. Improving efficiency and safety in external beam radiation therapy treatment delivery using a Kaizen approach.

    Science.gov (United States)

    Kapur, Ajay; Adair, Nilda; O'Brien, Mildred; Naparstek, Nikoleta; Cangelosi, Thomas; Zuvic, Petrina; Joseph, Sherin; Meier, Jason; Bloom, Beatrice; Potters, Louis

    Modern external beam radiation therapy treatment delivery processes potentially increase the number of tasks to be performed by therapists and thus opportunities for errors, yet the need to treat a large number of patients daily requires a balanced allocation of time per treatment slot. The goal of this work was to streamline the underlying workflow in such time-interval constrained processes to enhance both execution efficiency and active safety surveillance using a Kaizen approach. A Kaizen project was initiated by mapping the workflow within each treatment slot for 3 Varian TrueBeam linear accelerators. More than 90 steps were identified, and average execution times for each were measured. The time-consuming steps were stratified into a 2 × 2 matrix arranged by potential workflow improvement versus the level of corrective effort required. A work plan was created to launch initiatives with high potential for workflow improvement but modest effort to implement. Time spent on safety surveillance and average durations of treatment slots were used to assess corresponding workflow improvements. Three initiatives were implemented to mitigate unnecessary therapist motion, overprocessing of data, and wait time for data transfer defects, respectively. A fourth initiative was implemented to make the division of labor by treating therapists as well as peer review more explicit. The average duration of treatment slots reduced by 6.7% in the 9 months following implementation of the initiatives (P = .001). A reduction of 21% in duration of treatment slots was observed on 1 of the machines (P Kaizen approach has the potential to improve operational efficiency and safety with quick turnaround in radiation therapy practice by addressing non-value-adding steps characteristic of individual department workflows. Higher effort opportunities are identified to guide continual downstream quality improvements. Copyright © 2017 American Society for Radiation Oncology. Published by

  17. Beam configuration selection for robust intensity-modulated proton therapy in cervical cancer using Pareto front comparison.

    Science.gov (United States)

    van de Schoot, A J A J; Visser, J; van Kesteren, Z; Janssen, T M; Rasch, C R N; Bel, A

    2016-02-21

    The Pareto front reflects the optimal trade-offs between conflicting objectives and can be used to quantify the effect of different beam configurations on plan robustness and dose-volume histogram parameters. Therefore, our aim was to develop and implement a method to automatically approach the Pareto front in robust intensity-modulated proton therapy (IMPT) planning. Additionally, clinically relevant Pareto fronts based on different beam configurations will be derived and compared to enable beam configuration selection in cervical cancer proton therapy. A method to iteratively approach the Pareto front by automatically generating robustly optimized IMPT plans was developed. To verify plan quality, IMPT plans were evaluated on robustness by simulating range and position errors and recalculating the dose. For five retrospectively selected cervical cancer patients, this method was applied for IMPT plans with three different beam configurations using two, three and four beams. 3D Pareto fronts were optimized on target coverage (CTV D(99%)) and OAR doses (rectum V30Gy; bladder V40Gy). Per patient, proportions of non-approved IMPT plans were determined and differences between patient-specific Pareto fronts were quantified in terms of CTV D(99%), rectum V(30Gy) and bladder V(40Gy) to perform beam configuration selection. Per patient and beam configuration, Pareto fronts were successfully sampled based on 200 IMPT plans of which on average 29% were non-approved plans. In all patients, IMPT plans based on the 2-beam set-up were completely dominated by plans with the 3-beam and 4-beam configuration. Compared to the 3-beam set-up, the 4-beam set-up increased the median CTV D(99%) on average by 0.2 Gy and decreased the median rectum V(30Gy) and median bladder V(40Gy) on average by 3.6% and 1.3%, respectively. This study demonstrates a method to automatically derive Pareto fronts in robust IMPT planning. For all patients, the defined four-beam configuration was found optimal

  18. Beam configuration selection for robust intensity-modulated proton therapy in cervical cancer using Pareto front comparison

    International Nuclear Information System (INIS)

    Van de Schoot, A J A J; Visser, J; Van Kesteren, Z; Rasch, C R N; Bel, A; Janssen, T M

    2016-01-01

    The Pareto front reflects the optimal trade-offs between conflicting objectives and can be used to quantify the effect of different beam configurations on plan robustness and dose-volume histogram parameters. Therefore, our aim was to develop and implement a method to automatically approach the Pareto front in robust intensity-modulated proton therapy (IMPT) planning. Additionally, clinically relevant Pareto fronts based on different beam configurations will be derived and compared to enable beam configuration selection in cervical cancer proton therapy. A method to iteratively approach the Pareto front by automatically generating robustly optimized IMPT plans was developed. To verify plan quality, IMPT plans were evaluated on robustness by simulating range and position errors and recalculating the dose. For five retrospectively selected cervical cancer patients, this method was applied for IMPT plans with three different beam configurations using two, three and four beams. 3D Pareto fronts were optimized on target coverage (CTV D 99% ) and OAR doses (rectum V 30Gy ; bladder V 40Gy ). Per patient, proportions of non-approved IMPT plans were determined and differences between patient-specific Pareto fronts were quantified in terms of CTV D 99% , rectum V 30Gy and bladder V 40Gy to perform beam configuration selection. Per patient and beam configuration, Pareto fronts were successfully sampled based on 200 IMPT plans of which on average 29% were non-approved plans. In all patients, IMPT plans based on the 2-beam set-up were completely dominated by plans with the 3-beam and 4-beam configuration. Compared to the 3-beam set-up, the 4-beam set-up increased the median CTV D 99% on average by 0.2 Gy and decreased the median rectum V 30Gy and median bladder V 40Gy on average by 3.6% and 1.3%, respectively. This study demonstrates a method to automatically derive Pareto fronts in robust IMPT planning. For all patients, the defined four-beam configuration was found optimal in

  19. Adaptive radiation therapy for postprostatectomy patients using real-time electromagnetic target motion tracking during external beam radiation therapy.

    Science.gov (United States)

    Zhu, Mingyao; Bharat, Shyam; Michalski, Jeff M; Gay, Hiram A; Hou, Wei-Hsien; Parikh, Parag J

    2013-03-15

    Using real-time electromagnetic (EM) transponder tracking data recorded by the Calypso 4D Localization System, we report inter- and intrafractional target motion of the prostate bed, describe a strategy to evaluate treatment adequacy in postprostatectomy patients receiving intensity modulated radiation therapy (IMRT), and propose an adaptive workflow. Tracking data recorded by Calypso EM transponders was analyzed for postprostatectomy patients that underwent step-and-shoot IMRT. Rigid target motion parameters during beam delivery were calculated from recorded transponder positions in 16 patients with rigid transponder geometry. The delivered doses to the clinical target volume (CTV) were estimated from the planned dose matrix and the target motion for the first 3, 5, 10, and all fractions. Treatment adequacy was determined by comparing the delivered minimum dose (Dmin) with the planned Dmin to the CTV. Treatments were considered adequate if the delivered CTV Dmin is at least 95% of the planned CTV Dmin. Translational target motion was minimal for all 16 patients (mean: 0.02 cm; range: -0.12 cm to 0.07 cm). Rotational motion was patient-specific, and maximum pitch, yaw, and roll were 12.2, 4.1, and 10.5°, respectively. We observed inadequate treatments in 5 patients. In these treatments, we observed greater target rotations along with large distances between the CTV centroid and transponder centroid. The treatment adequacy from the initial 10 fractions successfully predicted the overall adequacy in 4 of 5 inadequate treatments and 10 of 11 adequate treatments. Target rotational motion could cause underdosage to partial volume of the postprostatectomy targets. Our adaptive treatment strategy is applicable to post-prostatectomy patients receiving IMRT to evaluate and improve radiation therapy delivery. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Complications after proton beam therapy for uveal malignant melanoma. A clinical and histopathologic study of five cases

    International Nuclear Information System (INIS)

    Kincaid, M.C.; Folberg, R.; Torczynski, E.; Zakov, Z.N.; Shore, J.W.; Liu, S.J.; Planchard, T.A.; Weingeist, T.A.

    1988-01-01

    Proton beam therapy for uveal malignant melanoma has been advocated as effective therapy because of documented reduction in tumor size and few clinical complications. However, some eyes have been removed because of adverse effects. The authors report the clinical courses and pathologic findings of five eyes enucleated after proton beam irradiation. Neovascular glaucoma had developed in three eyes, two eyes had vitreous hemorrhage, and two had extraocular extension. The tumors in the radiation treatment field showed continued postirradiation growth clinically in four of the five eyes, and mitotic activity histologically in all five cases. Two and one half years after irradiation, and nearly 2 years after subsequent enucleation, one of those two patients had biopsy-proven liver metastases, and later died. Despite the considerable success rate of proton beam irradiation, the potential for clinical complications and subsequent tumor growth remains

  1. SU-F-T-209: Multicriteria Optimization Algorithm for Intensity Modulated Radiation Therapy Using Pencil Proton Beam Scanning

    Energy Technology Data Exchange (ETDEWEB)

    Beltran, C; Kamal, H [Mayo Clinic, Rochester, MN (United States)

    2016-06-15

    Purpose: To provide a multicriteria optimization algorithm for intensity modulated radiation therapy using pencil proton beam scanning. Methods: Intensity modulated radiation therapy using pencil proton beam scanning requires efficient optimization algorithms to overcome the uncertainties in the Bragg peaks locations. This work is focused on optimization algorithms that are based on Monte Carlo simulation of the treatment planning and use the weights and the dose volume histogram (DVH) control points to steer toward desired plans. The proton beam treatment planning process based on single objective optimization (representing a weighted sum of multiple objectives) usually leads to time-consuming iterations involving treatment planning team members. We proved a time efficient multicriteria optimization algorithm that is developed to run on NVIDIA GPU (Graphical Processing Units) cluster. The multicriteria optimization algorithm running time benefits from up-sampling of the CT voxel size of the calculations without loss of fidelity. Results: We will present preliminary results of Multicriteria optimization for intensity modulated proton therapy based on DVH control points. The results will show optimization results of a phantom case and a brain tumor case. Conclusion: The multicriteria optimization of the intensity modulated radiation therapy using pencil proton beam scanning provides a novel tool for treatment planning. Work support by a grant from Varian Inc.

  2. Validated image fusion of dedicated PET and CT for external beam radiation and therapy in the head and neck area.

    NARCIS (Netherlands)

    Vogel, W.V.; Schinagl, D.A.X.; Dalen, J.A. van; Kaanders, J.H.A.M.; Oyen, W.J.G.

    2008-01-01

    AIM: Integration of positron emission tomography (PET) information into computer tomography (CT)- based intensity modulated external beam radiation therapy (IMRT) allows adaptation of the target volume to functional parameters, but only when the image registration procedure is reliable. The aim of

  3. SU-F-T-209: Multicriteria Optimization Algorithm for Intensity Modulated Radiation Therapy Using Pencil Proton Beam Scanning

    International Nuclear Information System (INIS)

    Beltran, C; Kamal, H

    2016-01-01

    Purpose: To provide a multicriteria optimization algorithm for intensity modulated radiation therapy using pencil proton beam scanning. Methods: Intensity modulated radiation therapy using pencil proton beam scanning requires efficient optimization algorithms to overcome the uncertainties in the Bragg peaks locations. This work is focused on optimization algorithms that are based on Monte Carlo simulation of the treatment planning and use the weights and the dose volume histogram (DVH) control points to steer toward desired plans. The proton beam treatment planning process based on single objective optimization (representing a weighted sum of multiple objectives) usually leads to time-consuming iterations involving treatment planning team members. We proved a time efficient multicriteria optimization algorithm that is developed to run on NVIDIA GPU (Graphical Processing Units) cluster. The multicriteria optimization algorithm running time benefits from up-sampling of the CT voxel size of the calculations without loss of fidelity. Results: We will present preliminary results of Multicriteria optimization for intensity modulated proton therapy based on DVH control points. The results will show optimization results of a phantom case and a brain tumor case. Conclusion: The multicriteria optimization of the intensity modulated radiation therapy using pencil proton beam scanning provides a novel tool for treatment planning. Work support by a grant from Varian Inc.

  4. A comparison of two methods for estimating the technical costs of external beam radiation therapy

    International Nuclear Information System (INIS)

    Hayman, James A.; Lash, Kathy A.; Tao, May L.; Halman, Marc A.

    2000-01-01

    Purpose: To accurately assess the cost-effectiveness of treatment with external beam radiation, it is necessary to have accurate estimates of its cost. One of the most common methods for estimating technical costs has been to convert Medicare charges into costs using Medicare Cost-to-Charge Ratios (CCR). More recently, health care organizations have begun to invest in sophisticated cost-accounting systems (CAS) that are capable of providing procedure-specific cost estimates. The purpose of this study was to examine whether these competing approaches result in similar cost estimates for four typical courses of external beam radiation therapy (EBRT). Methods and Materials: Technical costs were estimated for the following treatment courses: 1) a palliative 'simple' course of 10 fractions using a single field without blocks; 2) a palliative 'complex' course of 10 fractions using two opposed fields with custom blocks; 3) a curative course of 30 fractions for breast cancer using tangent fields followed by an electron beam boost; and 4) a curative course of 35 fractions for prostate cancer using CT-planning and a 4-field technique. Costs were estimated using the CCR approach by multiplying the number of units of each procedure billed by its Medicare charge and CCR and then summing these costs. Procedure-specific cost estimates were obtained from a cost-accounting system, and overall costs were then estimated for the CAS approach by multiplying the number of units billed by the appropriate unit cost estimate and then summing these costs. All costs were estimated using data from 1997. The analysis was also repeated using data from another academic institution to estimate their costs using the CCR and CAS methods, as well as the appropriate relative value units (RVUs) and conversion factor from the 1997 Medicare Fee Schedule to estimate Medicare reimbursement for the four treatment courses. Results: The estimated technical costs for the CCR vs. CAS approaches for the four

  5. A comparison of two methods for estimating the technical costs of external beam radiation therapy.

    Science.gov (United States)

    Hayman, J A; Lash, K A; Tao, M L; Halman, M A

    2000-05-01

    To accurately assess the cost-effectiveness of treatment with external beam radiation, it is necessary to have accurate estimates of its cost. One of the most common methods for estimating technical costs has been to convert Medicare charges into costs using Medicare Cost-to-Charge Ratios (CCR). More recently, health care organizations have begun to invest in sophisticated cost-accounting systems (CAS) that are capable of providing procedure-specific cost estimates. The purpose of this study was to examine whether these competing approaches result in similar cost estimates for four typical courses of external beam radiation therapy (EBRT). Technical costs were estimated for the following treatment courses: 1) a palliative "simple" course of 10 fractions using a single field without blocks; 2) a palliative "complex" course of 10 fractions using two opposed fields with custom blocks; 3) a curative course of 30 fractions for breast cancer using tangent fields followed by an electron beam boost; and 4) a curative course of 35 fractions for prostate cancer using CT-planning and a 4-field technique. Costs were estimated using the CCR approach by multiplying the number of units of each procedure billed by its Medicare charge and CCR and then summing these costs. Procedure-specific cost estimates were obtained from a cost-accounting system, and overall costs were then estimated for the CAS approach by multiplying the number of units billed by the appropriate unit cost estimate and then summing these costs. All costs were estimated using data from 1997. The analysis was also repeated using data from another academic institution to estimate their costs using the CCR and CAS methods, as well as the appropriate relative value units (RVUs) and conversion factor from the 1997 Medicare Fee Schedule to estimate Medicare reimbursement for the four treatment courses. The estimated technical costs for the CCR vs. CAS approaches for the four treatment courses were as follows

  6. Collimator rotation in volumetric modulated arc therapy for craniospinal irradiation and the dose distribution in the beam junction region

    International Nuclear Information System (INIS)

    Li, Qilin; Gu, Wendong; Mu, Jinming; Yin, Wenming; Gao, Min; Mo, Juncong; Pei, Honglei

    2015-01-01

    The purpose of this study was to investigate the role of beam collimator rotation in Volumetric Modulated Arc Therapy (VMAT) for craniospinal irradiation (CSI), and the impact on dose distribution in the beam junctions. Six adult patients were selected for the study. Six VMAT plans with different collimator angles were generated for each patient. The patients were treated in supine position with two beam isocenters. The plans were evaluated by analysis of Dose-Volume Histogram (DVHs) data for planning target volume (PTV) and organs at risk (OAR), and conformity index (CI) and homogeneity index (HI) for the target. Dose distributions in the beam junctions were examined carefully and experimentally validated in phantom, with measurement using an ion chamber array and film. The mean values of HI and CI for the plans with different beam collimator angles were not significantly different. The numbers of segments, monitor units (MUs) and the delivery time of the plans with 45° beam collimator were obviously higher than those in plans with other beam collimator angles. When collimator angle for both sets of beams were set at 0°, there was a 1 mm low dose gap measured in the junction region. By setting the collimator angle to 45°, only two isocenters were needed for the treatment of a target with the length up to 90 cm. The HI and CI of the plans were almost the same, regardless if the collimator angles were at 0°. The collimator angles for at least one set of beams should be off 0° in order to avoid a dose gap in the beam junction region. The online version of this article (doi:10.1186/s13014-015-0544-z) contains supplementary material, which is available to authorized users

  7. Rationale for and Preliminary Results of Proton Beam Therapy for Mediastinal Lymphoma

    International Nuclear Information System (INIS)

    Li Jing; Dabaja, Bouthaina; Reed, Valerie; Allen, Pamela K.; Cai, Haihong; Amin, Mayankkumar V.; Garcia, John A.; Cox, James D.

    2011-01-01

    Purpose: To evaluate the potential of three-dimensional proton beam therapy (3D-PBT) for reducing doses to normal structures in patients with mediastinal lymphomas compared with conventional photon radiation therapy (RT). Methods and Materials: We treated 10 consecutive patients with mediastinal masses from lymphomas with 3D-PBT between July 2007 and February 2009 to 30.6-50.4 cobalt-Gray equivalents (CGE). Of those patients, 7 had primary refractory or recurrent disease, and 8 had Hodgkin lymphoma. Dosimetric endpoints were compared with those from conventional RT plans. Results: PBT delivered lower mean doses to the lung (6.2 vs. 9.5 Gy), esophagus (9.5 vs. 22.3 Gy), and heart (8.8 vs. 17.7 Gy) but not the breasts (5.9 vs. 6.1 Gy) than did conventional RT. Percentages of lung, esophagus, heart, and coronary artery (particularly the left anterior descending artery) volumes receiving radiation were consistently lower in the 3D-PBT plans over a wide range of radiation doses. Of the 7 patients who had residual disease on positron emission tomography before PBT, 6 (86%) showed a complete metabolic response. Conclusions: In patients with mediastinal lymphomas, 3D-PBT produced significantly lower doses to the lung, esophagus, heart, and coronary arteries than did the current conventional RT. These lower doses would be expected to reduce the risk of late toxicities in these major organs.

  8. Prognostic Implications of Prostate Specific Antigen in Patients Following Fast Neutron Beam Therapy at Fermilab

    Energy Technology Data Exchange (ETDEWEB)

    Gagnon, James D. [Fermilab; Hatcher, Madeline A. [Fermilab; Gagnon, Patrick J. [Fermilab; Lennox, Arlene J. [Fermilab; Tanner, Andrew S. [Fermilab; Shafer, Jeffrey P. [Fermilab; Smoron, Geoffrey L. [Fermilab

    1996-01-01

    Preliminary results regarding prognostic implications of PSA in prostate cancer patients treated with the neutron beam at Fermilab have been published by Saroja et. al. (1) Seventy patients were included, in three groups. Group I included patients whose PSA decreased to the reference range of 0-4 ng/mL following therapy and stayed there. Group II included patients whose PSA dropped below 4 ng/mL and then increased. Group III included patients whose PSA remained elevated. This presentation updates that paper, now looking at 186 patients who had pretreatment PSA values available. The most significant result from analyzing Fermilab data appears to be the effect of neutron irradiation on local control, irrespective in some cases of subsequent changes in PSA value. The determination of local control is clinical rather than pathological, and only time and re-biopsy studies will allow us to know the efficacy of neutron therapy in locally controlling prostate cancer, independent of eventual outcome and PSA values. Fermilab data to date are very promising (2).

  9. Hadron-therapy beam monitoring: Towards a new generation of ultra-thin p-type silicon strip detectors

    Energy Technology Data Exchange (ETDEWEB)

    Bouterfa, M.; Aouadi, K. [Inst. of Information and Communication Technologies, Electronics and Applied Mathematics ICTEAM, Universite Catholique de Louvain, 1348 Louvain-la-Neuve (Belgium); Bertrand, D. [Particle Therapy Dept., Ion Beam Application IBA, 1348 Louvain-la-Neuve (Belgium); Olbrechts, B.; Delamare, R. [Inst. of Information and Communication Technologies, Electronics and Applied Mathematics ICTEAM, Universite Catholique de Louvain, 1348 Louvain-la-Neuve (Belgium); Raskin, J. P.; Gil, E. C. [Institut de Recherche en Mathematique et Physique IRMP, Universite Catholique de Louvain, 1348 Louvain-la-Neuve (Belgium); Flandre, D. [Inst. of Information and Communication Technologies, Electronics and Applied Mathematics ICTEAM, Universite Catholique de Louvain, 1348 Louvain-la-Neuve (Belgium)

    2011-07-01

    Hadron-therapy has gained increasing interest for cancer treatment especially within the last decade. System commissioning and quality assurance procedures impose to monitor the particle beam using 2D dose measurements. Nowadays, several monitoring systems exist for hadron-therapy but all show a relatively high influence on the beam properties: indeed, most devices consist of several layers of materials that degrade the beam through scattering and energy losses. For precise treatment purposes, ultra-thin silicon strip detectors are investigated in order to reduce this beam scattering. We assess the beam size increase provoked by the Multiple Coulomb Scattering when passing through Si, to derive a target thickness. Monte-Carlo based simulations show a characteristic scattering opening angle lower than 1 mrad for thicknesses below 20 {mu}m. We then evaluated the fabrication process feasibility. We successfully thinned down silicon wafers to thicknesses lower than 10 {mu}m over areas of several cm{sup 2}. Strip detectors are presently being processed and they will tentatively be thinned down to 20 {mu}m. Moreover, two-dimensional TCAD simulations were carried out to investigate the beam detector performances on p-type Si substrates. Additionally, thick and thin substrates have been compared thanks to electrical simulations. Reducing the pitch between the strips increases breakdown voltage, whereas leakage current is quite insensitive to strips geometrical configuration. The samples are to be characterized as soon as possible in one of the IBA hadron-therapy facilities. For hadron-therapy, this would represent a considerable step forward in terms of treatment precision. (authors)

  10. Hadron-therapy beam monitoring: Towards a new generation of ultra-thin p-type silicon strip detectors

    International Nuclear Information System (INIS)

    Bouterfa, M.; Aouadi, K.; Bertrand, D.; Olbrechts, B.; Delamare, R.; Raskin, J. P.; Gil, E. C.; Flandre, D.

    2011-01-01

    Hadron-therapy has gained increasing interest for cancer treatment especially within the last decade. System commissioning and quality assurance procedures impose to monitor the particle beam using 2D dose measurements. Nowadays, several monitoring systems exist for hadron-therapy but all show a relatively high influence on the beam properties: indeed, most devices consist of several layers of materials that degrade the beam through scattering and energy losses. For precise treatment purposes, ultra-thin silicon strip detectors are investigated in order to reduce this beam scattering. We assess the beam size increase provoked by the Multiple Coulomb Scattering when passing through Si, to derive a target thickness. Monte-Carlo based simulations show a characteristic scattering opening angle lower than 1 mrad for thicknesses below 20 μm. We then evaluated the fabrication process feasibility. We successfully thinned down silicon wafers to thicknesses lower than 10 μm over areas of several cm 2 . Strip detectors are presently being processed and they will tentatively be thinned down to 20 μm. Moreover, two-dimensional TCAD simulations were carried out to investigate the beam detector performances on p-type Si substrates. Additionally, thick and thin substrates have been compared thanks to electrical simulations. Reducing the pitch between the strips increases breakdown voltage, whereas leakage current is quite insensitive to strips geometrical configuration. The samples are to be characterized as soon as possible in one of the IBA hadron-therapy facilities. For hadron-therapy, this would represent a considerable step forward in terms of treatment precision. (authors)

  11. Malfunctions of Implantable Cardiac Devices in Patients Receiving Proton Beam Therapy: Incidence and Predictors

    Energy Technology Data Exchange (ETDEWEB)

    Gomez, Daniel R., E-mail: dgomez@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Poenisch, Falk [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Pinnix, Chelsea C. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sheu, Tommy [Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Memon, Nada [Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rozner, Marc A. [Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dougherty, Anne H. [Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-11-01

    Purpose: Photon therapy has been reported to induce resets of implanted cardiac devices, but the clinical sequelae of treating patients with such devices with proton beam therapy (PBT) are not well known. We reviewed the incidence of device malfunctions among patients undergoing PBT. Methods and Materials: From March 2009 through July 2012, 42 patients with implanted cardiac implantable electronic devices (CIED; 28 pacemakers and 14 cardioverter-defibrillators) underwent 42 courses of PBT for thoracic (23, 55%), prostate (15, 36%), liver (3, 7%), or base of skull (1, 2%) tumors at a single institution. The median prescribed dose was 74 Gy (relative biological effectiveness; range 46.8-87.5 Gy), and the median distance from the treatment field to the CIED was 10 cm (range 0.8-40 cm). Maximum proton and neutron doses were estimated for each treatment course. All CIEDs were checked before radiation delivery and monitored throughout treatment. Results: Median estimated peak proton and neutron doses to the CIED in all patients were 0.8 Gy (range 0.13-21 Gy) and 346 Sv (range 11-1100 mSv). Six CIED malfunctions occurred in 5 patients (2 pacemakers and 3 defibrillators). Five of these malfunctions were CIED resets, and 1 patient with a defibrillator (in a patient with a liver tumor) had an elective replacement indicator after therapy that was not influenced by radiation. The mean distance from the proton beam to the CIED among devices that reset was 7.0 cm (range 0.9-8 cm), and the mean maximum neutron dose was 655 mSv (range 330-1100 mSv). All resets occurred in patients receiving thoracic PBT and were corrected without clinical incident. The generator for the defibrillator with the elective replacement indicator message was replaced uneventfully after treatment. Conclusions: The incidence of CIED resets was about 20% among patients receiving PBT to the thorax. We recommend that PBT be avoided in pacing-dependent patients and that patients with any type of CIED receiving

  12. Malfunctions of Implantable Cardiac Devices in Patients Receiving Proton Beam Therapy: Incidence and Predictors

    International Nuclear Information System (INIS)

    Gomez, Daniel R.; Poenisch, Falk; Pinnix, Chelsea C.; Sheu, Tommy; Chang, Joe Y.; Memon, Nada; Mohan, Radhe; Rozner, Marc A.; Dougherty, Anne H.

    2013-01-01

    Purpose: Photon therapy has been reported to induce resets of implanted cardiac devices, but the clinical sequelae of treating patients with such devices with proton beam therapy (PBT) are not well known. We reviewed the incidence of device malfunctions among patients undergoing PBT. Methods and Materials: From March 2009 through July 2012, 42 patients with implanted cardiac implantable electronic devices (CIED; 28 pacemakers and 14 cardioverter-defibrillators) underwent 42 courses of PBT for thoracic (23, 55%), prostate (15, 36%), liver (3, 7%), or base of skull (1, 2%) tumors at a single institution. The median prescribed dose was 74 Gy (relative biological effectiveness; range 46.8-87.5 Gy), and the median distance from the treatment field to the CIED was 10 cm (range 0.8-40 cm). Maximum proton and neutron doses were estimated for each treatment course. All CIEDs were checked before radiation delivery and monitored throughout treatment. Results: Median estimated peak proton and neutron doses to the CIED in all patients were 0.8 Gy (range 0.13-21 Gy) and 346 Sv (range 11-1100 mSv). Six CIED malfunctions occurred in 5 patients (2 pacemakers and 3 defibrillators). Five of these malfunctions were CIED resets, and 1 patient with a defibrillator (in a patient with a liver tumor) had an elective replacement indicator after therapy that was not influenced by radiation. The mean distance from the proton beam to the CIED among devices that reset was 7.0 cm (range 0.9-8 cm), and the mean maximum neutron dose was 655 mSv (range 330-1100 mSv). All resets occurred in patients receiving thoracic PBT and were corrected without clinical incident. The generator for the defibrillator with the elective replacement indicator message was replaced uneventfully after treatment. Conclusions: The incidence of CIED resets was about 20% among patients receiving PBT to the thorax. We recommend that PBT be avoided in pacing-dependent patients and that patients with any type of CIED receiving

  13. SU-F-BRD-15: Quality Correction Factors in Scanned Or Broad Proton Therapy Beams Are Indistinguishable

    Energy Technology Data Exchange (ETDEWEB)

    Sorriaux, J; Lee, J [Molecular Imaging Radiotherapy & Oncology, Universite Catholique de Louvain, Brussels (Belgium); ICTEAM Institute, Universite catholique de Louvain, Louvain-la-Neuve (Belgium); Testa, M; Paganetti, H [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, Massachusetts (United States); Bertrand, D; Orban de Xivry, J [Ion Beam Applications, Louvain-la-neuve, Brabant Wallon (Belgium); Palmans, H [EBG MedAustron GmbH, Wiener Neustadt (Austria); National Physical Laboratory, Teddington (United Kingdom); Vynckier, S [Cliniques Universitaires Saint-Luc, Brussels (Belgium); Sterpin, E [Molecular Imaging Radiotherapy & Oncology, Universite Catholique de Louvain, Brussels (Belgium)

    2015-06-15

    Purpose: The IAEA TRS-398 code of practice details the reference conditions for reference dosimetry of proton beams using ionization chambers and the required beam quality correction factors (kQ). Pencil beam scanning (PBS) requires multiple spots to reproduce the reference conditions. The objective is to demonstrate, using Monte Carlo (MC) calculations, that kQ factors for broad beams can be used for scanned beams under the same reference conditions with no significant additional uncertainty. We consider hereafter the general Alfonso formalism (Alfonso et al, 2008) for non-standard beam. Methods: To approach the reference conditions and the associated dose distributions, PBS must combine many pencil beams with range modulation and shaping techniques different than those used in passive systems (broad beams). This might lead to a different energy spectrum at the measurement point. In order to evaluate the impact of these differences on kQ factors, ion chamber responses are computed with MC (Geant4 9.6) in a dedicated scanned pencil beam (Q-pcsr) producing a 10×10cm2 composite field with a flat dose distribution from 10 to 16 cm depth. Ion chamber responses are also computed by MC in a broad beam with quality Q-ds (double scattering). The dose distribution of Q -pcsr matches the dose distribution of Q-ds. k-(Q-pcsr,Q-ds) is computed for a 2×2×0.2cm{sup 3} idealized air cavity and a realistic plane-parallel ion chamber (IC). Results: Under reference conditions, quality correction factors for a scanned composite field versus a broad beam are the same for air cavity dose response, k-(Q-pcsr,Q-ds) =1.001±0.001 and for a Roos IC, k-(Q-pcsr,Q-ds) =0.999±0.005. Conclusion: Quality correction factors for ion chamber response in scanned and broad proton therapy beams are identical under reference conditions within the calculation uncertainties. The results indicate that quality correction factors published in IAEA TRS-398 can be used for scanned beams in the SOBP of a

  14. SU-F-BRD-15: Quality Correction Factors in Scanned Or Broad Proton Therapy Beams Are Indistinguishable

    International Nuclear Information System (INIS)

    Sorriaux, J; Lee, J; Testa, M; Paganetti, H; Bertrand, D; Orban de Xivry, J; Palmans, H; Vynckier, S; Sterpin, E

    2015-01-01

    Purpose: The IAEA TRS-398 code of practice details the reference conditions for reference dosimetry of proton beams using ionization chambers and the required beam quality correction factors (kQ). Pencil beam scanning (PBS) requires multiple spots to reproduce the reference conditions. The objective is to demonstrate, using Monte Carlo (MC) calculations, that kQ factors for broad beams can be used for scanned beams under the same reference conditions with no significant additional uncertainty. We consider hereafter the general Alfonso formalism (Alfonso et al, 2008) for non-standard beam. Methods: To approach the reference conditions and the associated dose distributions, PBS must combine many pencil beams with range modulation and shaping techniques different than those used in passive systems (broad beams). This might lead to a different energy spectrum at the measurement point. In order to evaluate the impact of these differences on kQ factors, ion chamber responses are computed with MC (Geant4 9.6) in a dedicated scanned pencil beam (Q-pcsr) producing a 10×10cm2 composite field with a flat dose distribution from 10 to 16 cm depth. Ion chamber responses are also computed by MC in a broad beam with quality Q-ds (double scattering). The dose distribution of Q -pcsr matches the dose distribution of Q-ds. k-(Q-pcsr,Q-ds) is computed for a 2×2×0.2cm 3 idealized air cavity and a realistic plane-parallel ion chamber (IC). Results: Under reference conditions, quality correction factors for a scanned composite field versus a broad beam are the same for air cavity dose response, k-(Q-pcsr,Q-ds) =1.001±0.001 and for a Roos IC, k-(Q-pcsr,Q-ds) =0.999±0.005. Conclusion: Quality correction factors for ion chamber response in scanned and broad proton therapy beams are identical under reference conditions within the calculation uncertainties. The results indicate that quality correction factors published in IAEA TRS-398 can be used for scanned beams in the SOBP of a high

  15. Impact of cradle immobilization on setup reproducibility during external beam radiation therapy for lung cancer

    International Nuclear Information System (INIS)

    Bentel, Gunilla C.; Marks, Lawrence B.; Krishnamurthy, Rupa

    1997-01-01

    Purpose: To compare the setup accuracy during fractionated radiation therapy for two patient groups with lung cancer treated with and without an immobilization cradle. Methods: Three hundred ninety-seven port films from 30 patients immobilized in the Alpha Cradle TM1 were compared with 329 port films from 30 patients who were not immobilized with the cradle. All patients were treated with curative intent for nonmetastatic lung cancer. The frequency of physician-requested isocenter shifts were compared in the two groups using a two-tailed chi-square test. Initial port films taken on the first day of treatment, routine films taken usually weekly during radiation therapy, and requested films taken after a requested shift were considered separately. The immobilization device consisted of a custom-made foam cradle that extended from above the head to the knees. Patients were generally treated with their arms above their heads, and treatment setup marks in the immobilized patients were placed on both the patients' skin and the immobilization cradle. For the noncradle patients, setup marks were placed only on the patients' skin. Results: For the routine films, the frequency of physician-requested isocenter shifts was lower in immobilized patients than in the nonimmobilized group (p = 0.139). Most of this reduction was seen on oblique fields (p = 0.038). No benefits were seen among initial or requested films. The two groups were well balanced with regard to stage, age, field size, and total dose. Conclusions: The use of aggressive immobilization improves the setup reproducibility in patients receiving external beam radiation therapy for lung cancer, especially during treatment with oblique fields. This improvement in treatment accuracy might improve the therapeutic ratio

  16. Long-Term Outcomes After Proton Beam Therapy for Sinonasal Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Russo, Andrea L.; Adams, Judith A.; Weyman, Elizabeth A.; Busse, Paul M.; Goldberg, Saveli I. [Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Varvares, Mark; Deschler, Daniel D.; Lin, Derrick T. [Head and Neck Surgical Oncology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts (United States); Delaney, Thomas F. [Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Chan, Annie W., E-mail: awchan@partners.org [Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2016-05-01

    Purpose: Squamous cell carcinoma (SCC) is the most common sinonasal cancer and is associated with one of the poor outcomes. Proton therapy allows excellent target coverage with maximal sparing of adjacent normal tissues. We evaluated the long-term outcomes in patients with sinonasal SCC treated with proton therapy. Methods and Materials: Between 1991 and 2008, 54 patients with Stage III and IV SCC of the nasal cavity and paranasal sinus received proton beam therapy at our institution to a median dose of 72.8 Gy(RBE). Sixty-nine percent underwent prior surgical resection, and 74% received elective nodal radiation. Locoregional control and survival probabilities were estimated with the Kaplan-Meier method. Multivariate analyses were performed using the Cox proportional-hazards model. Treatment toxicity was scored using the Common Terminology Criteria for Adverse Events version 4.0. Results: With a median follow-up time of 82 months in surviving patients, there were 10 local, 7 regional, and 11 distant failures. The 2-year and 5-year actuarial local control rate was 80%. The 2-year and 5-year rates of overall survival were 67% and 47%, respectively. Only smoking status was predictive for worse locoregional control, with current smokers having a 5-year rate of 23% compared with 83% for noncurrent smokers (P=.004). Karnofsky performance status ≤80 was the most significant factor predictive for worse overall survival in multivariate analysis (adjusted hazard ratio 4.5, 95% confidence interval 1.6-12.5, P=.004). There were nine grade 3 and six grade 4 toxicities, and no grade 5 toxicity. Wound adverse events constituted the most common grade 3-4 toxicity. Conclusions: Our long-term results show that proton radiation therapy is well tolerated and yields good locoregional control for SCC of the nasal cavity and paranasal sinus. Current smokers and patients with poor performance status had inferior outcomes. Prospective study is necessary to compare IMRT with proton

  17. PEMODELAN KOLIMATOR DI RADIAL BEAM PORT REAKTOR KARTINI UNTUK BORON NEUTRON CAPTURE THERAPY

    Directory of Open Access Journals (Sweden)

    Bemby Yulio Vallenry

    2015-03-01

    Full Text Available Salah satu metode terapi kanker adalah Boron Neutron Capture Therapy (BNCT. BNCT memanfaatkan tangkapan neutron oleh 10B yang terendapkan pada sel kanker. Keunggulan BNCT dibandingkan dengan terapi radiasi lainnya adalah tingkat selektivitas yang tinggi karena tingkatannya adalah sel. Pada penelitian ini dilakukan pemodelan kolimator di radial beamport reaktor Kartini sebagai dasar pemilihan material dan manufature kolimator sebagai sumber neutron untuk BNCT. Pemodelan ini dilakukan dengan simulasi menggunakan perangkat lunak Monte Carlo N-Particle versi 5 (MCNP 5. MCNP 5 adalah suatu paket program untuk memodelkan sekaligus menghitung masalah transpor partikel dengan mengikuti sejarah hidup neutron semenjak lahir, bertranspor pada bahan hingga akhirnya hilang karena mengalami reaksi penyerapan atau keluar dari sistem. Pemodelan ini menggunakan variasi material dan ukurannya agar menghasilkan nilai dari tiap parameter-parameter yang sesuai dengan rekomendasi I International Atomic Energy Agency (IAEA untuk BNCT, yaitu fluks neutron epitermal (Фepi > 9 n.cm-2.s-1, rasio antara laju dosis neutron cepat dan fluks neutron epitermal (Ḋf/Фepi 0,7. Berdasarkan hasil optimasi dari pemodelan ini, material dan ukuran penyusun kolimator yang didapatkan yaitu 0,75 cm Ni sebagai dinding kolimator, 22 cm Al sebagai moderator dan 4,5 cm Bi sebagai perisai gamma. Keluaran berkas radiasi yang dihasilkan dari pemodelan kolimator radial beamport yaitu Фepi = 5,25 x 106 n.cm-2s-1, Ḋf/Фepi =1,17 x 10-13 Gy.cm2.n-1, Ḋγ/Фepi = 1,70 x 10-12 Gy.cm2.n-1, Фth/Фepi = 1,51 dan J/Фepi = 0,731. Berdasarkan penelitian ini, hasil optimasi 5 parameter sebagai persyaratan kolimator untuk BNCT yang keluar dari radial beam port tidak sepenuhnya memenuhi kriteria yang direkomendasikan oleh IAEA sehingga perlu dilakukan penelitian lebih lanjut agar tercapainya persyaratan IAEA. Kata kunci: BNCT, radial beamport, MCNP 5, kolimator   One of the cancer therapy methods is

  18. Primary carcinoma of the gallbladder: role of external beam radiation therapy in patients with locally advanced tumor

    International Nuclear Information System (INIS)

    Uno, T.; Itami, J.; Aruga, M.; Araki, H.; Tani, M.; Kobori, O.

    1996-01-01

    Several reports have demonstrated that occasional long-term survival might be obtained with external beam radiation therapy in patients with gallbladder cancer. However, there are few reports which evaluate the local effect of irradiation. The aim of our study was to investigate the local effect of radiation therapy and to evaluate its role for locally advanced gallbladder cancer. Twenty-two patients with locally advanced gallbladder cancer were treated with high-dose external beam radiation therapy. Tumor resection was performed in 5 patients, palliative surgery in 5, and the remaining 12 patients were treated by radiation therapy alone. Overall survival was 36% at 1 year, 18% at 3 years and 14% at 5 years. All but 2 patients developed undergone tumor resection, partial response was obtained in 4 patients and no response in 13. Survival times in patients who achieved partial response were 14, 26, 47 and 99 months, whereas those of no response were 1 to 12 months with a mean of 4.8 months. Survival between these 2 groups (partial vs. no response) showed significant difference (p=0.0008, logrank test). It is concluded that high-dose external beam radiation therapy could improve survival in some patients with unresectable gallbladder cancer. (orig.) [de

  19. Basic Principles of Creation of Topometrical Cards of Beam Therapy in the Cases of High-grade Malignant Supratentorial Gliomas

    International Nuclear Information System (INIS)

    Liepa, Z.; Platkajis, A.; Apskalne, D.

    2007-01-01

    Background. High-grade malignant supratentorial gliomas: anaplastic astrocytomas (AA), anaplastic oligodendrogliomas (AO), anaplastic oligoatrocitomas (AOA), anaplastic ependimomas (AE), glioblastomas (GB) and other less occasional forms of gliomas are approximately 1,82% of all cases of malignant tumors. Life expectancy for such patients still is very low, for several forms of tumors -12-18 months. High-grade malignant gliomas need for combined approach, and one part of such approach is beam therapy. For reaching qualitative results of beam therapy, method of topometrical planning of beam therapy is crucial, because it allow planning therapy due to anatomic features of every patient. The aim of work was comparison of basic principles of creation of 2-dimensional (2D) and 3-dimensional (3D) topometrical cards of beam therapy. Material and methods. In the process of research, analyse of creation of 2D and 3D cards for patients in period 2000-2005 were made. For creation of 2D cards pelviometer, conturometer of head (Picture 1), pictures of tests of brains in the biggest cross - section of tumor (Picture 2) were used. For creation 3D cards computertomography LightSpeed Rt, which is suitable for topometry (Picture 3), planning system of 3D reconstruction ECLIPSE (Picture 4), 3D reconstruction by data from pre - surgery and/or after - surgery tests of brain (Picture 5), and matching in format of DICOM (Picture 6) were used. In this research 214 patients with supratentorial malign gliomas were covered (Table 1,2). Results. In 98 cases 2D topometrical cards were made, which allows creating only two contrary areas of entry of beams or two areas of entry under angle (Picture 7, 8). In 55 cases in 2D topographic cards two contrary areas of entry were made and in 43 cases plan of beam therapy with areas of entry under angle were made. 3D cards anatomic features of patient as well as location of critical organs were taken into account (picture 10). In case of 3D the number of

  20. Optimization study for an epithermal neutron beam for boron neutron capture therapy at the University of Virginia Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Burns, Jr., Thomas Dean [Univ. of Virginia, Charlottesville, VA (United States)

    1995-05-01

    The non-surgical brain cancer treatment modality, Boron Neutron Capture Therapy (BNCT), requires the use of an epithermal neutron beam. This purpose of this thesis was to design an epithermal neutron beam at the University of Virginia Research Reactor (UVAR) suitable for BNCT applications. A suitable epithermal neutron beam for BNCT must have minimal fast neutron and gamma radiation contamination, and yet retain an appreciable intensity. The low power of the UVAR core makes reaching a balance between beam quality and intensity a very challenging design endeavor. The MCNP monte carlo neutron transport code was used to develop an equivalent core radiation source, and to perform the subsequent neutron transport calculations necessary for beam model analysis and development. The code accuracy was validated by benchmarking output against experimental criticality measurements. An epithermal beam was designed for the UVAR, with performance characteristics comparable to beams at facilities with cores of higher power. The epithermal neutron intensity of this beam is 2.2 x 108 n/cm2 • s. The fast neutron and gamma radiation KERMA factors are 10 x 10-11cGy•cm2/nepi and 20 x 10-11 cGy•cm2/nepi , respectively, and the current-to-flux ratio is 0.85. This thesis has shown that the UVAR has the capability to provide BNCT treatments, however the performance characteristics of the final beam of this study were limited by the low core power.

  1. A Study of volumetric modulated arc therapy for stereotactic body radiation therapy in case of multi-target liver cancer using flattening filter free beam

    International Nuclear Information System (INIS)

    Yeom, Mi Sook; Yoon, In Ha; Hong, Dong Gi; Back, Geum Mun

    2015-01-01

    Stereotactic body radiation therapy (SBRT) has proved its efficacy in several patient populations with primary and metastatic limited tumors. Because SBRT prescription is high dose level than Conventional radiation therapy. SBRT plan is necessary for effective Organ at risk (OAR) protection and sufficient Planning target volume (PTV) dose coverage. In particular, multi-target cases may result excessive doses to OAR and hot spot due to dose overlap. This study evaluate usefulness of Volumetric modulated arc therapy (VMAT) in dosimetric and technical considerations using Flattening filter free (FFF) beam. The treatment plans for five patients, being treated on TrueBeam STx(Varian™, USA) with VMAT using 10MV FFF beam and Standard conformal radiotherapy (CRT) using 15MV Flattening filter (FF) beam. PTV, liver, duodenum, bowel, spinal cord, esophagus, stomach dose were evaluated using the dose volume histogram(DVH). Conformity index(CI), homogeneity index(HI), Paddick's index(PCI) for the PTV was assessed. Total Monitor unit (MU) and beam on time was assessed. Average value of CI, HI and PCI for PTV was 1.381±0.028, 1.096±0.016, 0.944±0.473 in VMAT and 1.381± 0.042, 1.136±0.042, 1.534±0.465 in CRT respectively. OAR dose in CRT plans evaluated 1.8 times higher than VMAT. Total MU in VMAT evaluated 1.3 times increase than CRT. Average beam on time was 6.8 minute in VMAT and 21.3 minute in CRT respectively. OAR dose in CRT plans evaluated 1.8 times higher than VMAT. Total MU in VMAT evaluated 1.3 times increase than CRT. Average beam on time was 6.8 minute in VMAT and 21.3 minute in CRT. VMAT for SBRT in multi-target liver cancer using FFF beam is effective treatment techniqe in dosimetric and technical considerations. VMAT decrease intra-fraction error due to treatment time shortening using high dose rate of FFF beam

  2. A Study of volumetric modulated arc therapy for stereotactic body radiation therapy in case of multi-target liver cancer using flattening filter free beam

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Mi Sook; Yoon, In Ha; Hong, Dong Gi; Back, Geum Mun [Dept. of Radiation Oncology, ASAN Medical Center, Seoul (Korea, Republic of)

    2015-06-15

    Stereotactic body radiation therapy (SBRT) has proved its efficacy in several patient populations with primary and metastatic limited tumors. Because SBRT prescription is high dose level than Conventional radiation therapy. SBRT plan is necessary for effective Organ at risk (OAR) protection and sufficient Planning target volume (PTV) dose coverage. In particular, multi-target cases may result excessive doses to OAR and hot spot due to dose overlap. This study evaluate usefulness of Volumetric modulated arc therapy (VMAT) in dosimetric and technical considerations using Flattening filter free (FFF) beam. The treatment plans for five patients, being treated on TrueBeam STx(Varian™, USA) with VMAT using 10MV FFF beam and Standard conformal radiotherapy (CRT) using 15MV Flattening filter (FF) beam. PTV, liver, duodenum, bowel, spinal cord, esophagus, stomach dose were evaluated using the dose volume histogram(DVH). Conformity index(CI), homogeneity index(HI), Paddick's index(PCI) for the PTV was assessed. Total Monitor unit (MU) and beam on time was assessed. Average value of CI, HI and PCI for PTV was 1.381±0.028, 1.096±0.016, 0.944±0.473 in VMAT and 1.381± 0.042, 1.136±0.042, 1.534±0.465 in CRT respectively. OAR dose in CRT plans evaluated 1.8 times higher than VMAT. Total MU in VMAT evaluated 1.3 times increase than CRT. Average beam on time was 6.8 minute in VMAT and 21.3 minute in CRT respectively. OAR dose in CRT plans evaluated 1.8 times higher than VMAT. Total MU in VMAT evaluated 1.3 times increase than CRT. Average beam on time was 6.8 minute in VMAT and 21.3 minute in CRT. VMAT for SBRT in multi-target liver cancer using FFF beam is effective treatment techniqe in dosimetric and technical considerations. VMAT decrease intra-fraction error due to treatment time shortening using high dose rate of FFF beam.

  3. SU-F-T-242: A Method for Collision Avoidance in External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Buzurovic, I; Cormack, R [Dana-Farber/Brigham and Women’s Cancer Center, Harvard Medical School, Boston, MA (United States)

    2016-06-15

    Purpose: We proposed a method for collision avoidance (CA) in external beam radiation therapy (EBRT). The method encompasses the analysis of all positions of the moving components of the beam delivery system such as the treatment table and gantry, including patient specific information obtained from the CT images. This method eliminates the need for time-consuming dry-runs prior to the actual treatments. Methods: The QA procedure for EBRT requires that the collision should be checked prior to treatment. We developed a system capable of a rigorous computer simulation of all moving components including positions of the couch and gantry during the delivery, position of the patients, and imaging equipment. By running this treatment simulation it is possible to quantify and graphically represent all positions and corresponding trajectories of all points of the moving parts during the treatment delivery. The development of the workflow for implementation of the CA includes several steps: a) derivation of combined dynamic equation of motion of the EBRT delivery systems, b) developing the simulation model capable of drawing the motion trajectories of the specific points, c) developing the interface between the model and the treatment plan parameters such as couch and gantry parameters for each field. Results: The patient CT images were registered to the treatment couch so the patient dimensions were included into the simulation. The treatment field parameters were structured in the xml-file which was used as the input into the dynamic equations. The trajectories of the moving components were plotted on the same graph using the dynamic equations. If the trajectories intersect that was the signal that collision exists. Conclusion: This CA method was proved to be effective in the simulation of treatment delivery. The proper implementation of this system can potentially improve the QA program and increase the efficacy in the clinical setup.

  4. Quality assurance in proton beam therapy using a plastic scintillator and a commercially available digital camera.

    Science.gov (United States)

    Almurayshid, Mansour; Helo, Yusuf; Kacperek, Andrzej; Griffiths, Jennifer; Hebden, Jem; Gibson, Adam

    2017-09-01

    In this article, we evaluate a plastic scintillation detector system for quality assurance in proton therapy using a BC-408 plastic scintillator, a commercial camera, and a computer. The basic characteristics of the system were assessed in a series of proton irradiations. The reproducibility and response to changes of dose, dose-rate, and proton energy were determined. Photographs of the scintillation light distributions were acquired, and compared with Geant4 Monte Carlo simulations and with depth-dose curves measured with an ionization chamber. A quenching effect was observed at the Bragg peak of the 60 MeV proton beam where less light was produced than expected. We developed an approach using Birks equation to correct for this quenching. We simulated the linear energy transfer (LET) as a function of depth in Geant4 and found Birks constant by comparing the calculated LET and measured scintillation light distribution. We then used the derived value of Birks constant to correct the measured scintillation light distribution for quenching using Geant4. The corrected light output from the scintillator increased linearly with dose. The system is stable and offers short-term reproducibility to within 0.80%. No dose rate dependency was observed in this work. This approach offers an effective way to correct for quenching, and could provide a method for rapid, convenient, routine quality assurance for clinical proton beams. Furthermore, the system has the advantage of providing 2D visualization of individual radiation fields, with potential application for quality assurance of complex, time-varying fields. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  5. Determination of Endpoint Energy and Bremsstrahlung Spectra for High-Energy Radiation-Therapy Beams

    Science.gov (United States)

    Landry, Danny Joe

    Few attempts have been made to experimentally determine thick-target bremsstrahlung spectra of megavoltage therapy beams. For spectral studies using the Compton scattering technique, sodium iodine (NaI) detectors with relatively poor energy resolution have been used. Other experimental techniques for determining spectra are generally not suited for a clinical environment with the inherent time and space constraints. To gather more spectral information than previously obtained in the region near the endpoint energy, the use of a high-resolution intrinsic-germanium (Ge) detector was proposed. A response function matrix was determined from experimentally obtained pulse height distributions on the multichannel analyzer. The distributions were for nine various monoenergetic sources between 280 adn 1525 keV. The response function was used to convert the measured pulse height distributions to photon flux spectra using an iterative approximation technique with a computer. Photon flux spectra from the Sagittaire Linear Accelerator were obtained at average-electron endpoint energies of 15, 20, and 25 MeV. Two spectra were measured at the 25 MeV setting; one spectrum was measured along the central axis and one spectrum at 4(DEGREES) off axis. Photon spectra were also obtained for a Van de Graaff generator at the nominal endpoint energies of 2.2, 2.35, and 2.5 MeV. The results for both the linac and the Van de Graaff generator were compared with theoretical spectra and previously measured spectra where available. Also, photon spectra from a Theratron-80 (('60)Co) unit were determined for three field sizes and for a 10 x 10 cm. field with a lucite tray or a 45(DEGREES) wedge in the beam. The resulting spectra were compared to previously measured ('60)Co spectra.

  6. Determination of absorbed dose calibration factors for therapy level electron beam ionization chambers.

    Science.gov (United States)

    McEwen, M R; Williams, A J; DuSautoy, A R

    2001-03-01

    Over several years the National Physical Laboratory (NPL) has been developing an absorbed dose calibration service for electron beam radiotherapy. To test this service, a number of trial calibrations of therapy level electron beam ionization chambers have been carried out during the last 3 years. These trials involved 17 UK radiotherapy centres supplying a total of 46 chambers of the NACP, Markus, Roos and Farmer types. Calibration factors were derived from the primary standard calorimeter at seven energies in the range 4 to 19 MeV with an estimated uncertainty of +/-1.5% at the 95% confidence level. Investigations were also carried out into chamber perturbation, polarity effects, ion recombination and repeatability of the calibration process. The instruments were returned to the radiotherapy centres for measurements to be carried out comparing the NPL direct calibration with the 1996 IPEMB air kerma based Code of Practice. It was found that, in general, all chambers of a particular type showed the same energy response. However, it was found that polarity and recombination corrections were quite variable for Markus chambers-differences in the polarity correction of up to 1% were seen. Perturbation corrections were obtained and were found to agree well with the standard data used in the IPEMB Code. The results of the comparison between the NPL calibration and IPEMB Code show agreement between the two methods at the +/-1% level for the NACP and Farmer chambers, but there is a significant difference for the Markus chambers of around 2%. This difference between chamber types is most likely to be due to the design of the Markus chamber.

  7. The CBS-The Most Cost Effective and High Performance Carbon Beam Source Dedicated for a New Generation Cancer Therapy

    CERN Document Server

    Kumada, Masayuki; Leivichev, E B; Parkhomchuk, Vasily; Podgorny, Fedor; Rastigeev, Sergey; Reva, Vladimir B; Skrinsky, Aleksander Nikolayevich; Vostrikov, Vladimir

    2005-01-01

    A Carbon ion beam is a superior tool to x-rays or a proton beam in both physical and biological doses in treating a cancer. A Carbon beam has an advantage in treating radiation resistant and deep-seated tumors. Its radiological effect is of a mitotic independent nature. These features improve hypofractionation, typically reducing the number of irradiations per patient from 35 to a few. It has been shown that a superior QOL(Quality Of Life) therapy is possible by a carbon beam.The only drawback is its high cost. Nevertheless, tens of Prefectures and organizations are eagerly considering the possibility of having a carbon ion therapy facility in Japan. Germany, Austria, Italy, China, Taiwan and Korea also desire to have one.A carbon beam accelerator of moderate cost is about 100 Million USD. With the "CBS" design philosophy, which will be described in this paper, the cost could be factor of 2 or 3 less, while improving its performance more than standard designs. Novel extraction techniques, a new approach to a ...

  8. In-vivo dosimetric study of carcinoma of uterine cervix with FBX solution in external beam therapy

    International Nuclear Information System (INIS)

    Srinivas, Challapalli; Shenoy, K. Kamalaksh; Dinesh, M.; Savitha, K.S.; Kasturi, Dinesh Pai; Supe, S.S.; Nagesha, Y.N.

    1999-01-01

    To ensure accurate dose delivery to target site in external beam therapy and brachytherapy, various authors have conducted tests to assess the process of manual dose calculations. In vivo dosimetric measurement is one of these methods to verify these calculations. In this study, an attempt has been made to compare the manually calculated dose to dose estimated using a chemical dosimeter (FBX) solution (in-vivo method, using polypropylene vials), on 12 patients of carcinoma of uterine cervix in external beam therapy. Dose measured by FBX vial varies in the range of ± 2 to 6.75%, as compared with manual calculations. These variations seen may be attributed to the location of the vial position in the vagina, with reference to the beam axis (may not be horizontal), off axis position, manual calculation variations and reproducibility of the FBX system etc. FBX dosimetry offers itself as an in-vivo method to estimate the dose delivered to the target site in external beam therapy. (author)

  9. Preliminary results of the Gas Electron Multiplier (GEM) as real-time beam monitor in hadron therapy

    Energy Technology Data Exchange (ETDEWEB)

    Aza, E., E-mail: eleni.aza@cern.ch [CERN, Geneva 23, 1211 Geneva (Switzerland); AUTH, Department of Physics, 54124 Thessaloniki (Greece); Ciocca, M. [Fondazione CNAO, Strada Campeggi 53, 27100 Pavia (Italy); Murtas, F. [CERN, Geneva 23, 1211 Geneva (Switzerland); LNF-INFN, Via Fermi 40, 00044 Frascati (Italy); Puddu, S. [CERN, Geneva 23, 1211 Geneva (Switzerland); AEC-LHEP, University of Bern, Sidlerstrasse 5, 3012 Bern (Switzerland); Pullia, M. [Fondazione CNAO, Strada Campeggi 53, 27100 Pavia (Italy); Silari, M. [CERN, Geneva 23, 1211 Geneva (Switzerland)

    2017-01-01

    The use of proton and carbon ion beams in cancer therapy (also known as hadron therapy) is progressively growing worldwide due to their improved dose distributions, sparing of healthy tissues and (for carbon ions) increased radiobiological effectiveness especially for radio-resistant tumours. Strict Quality Assurance (QA) protocols need to be followed for guaranteeing the clinical beam specifications. The aim of this study was to assess the performance of a gaseous detector based on the Gas Electron Multiplier (GEM) technology for measuring the beam spot dimensions and the homogeneity of the scanned irradiation field, which are daily QA tasks commonly performed using radiochromic films. Measurements performed at the National Centre for Oncological Hadron Therapy (CNAO) in Pavia (Italy) showed that the detector is able to monitor the 2D beam image on-line with a pad granularity of 2 mm and a response proportional to the number of delivered particles. The dose homogeneity was measured with low deviation from the results obtained with radiochromic films.

  10. Dosimetric verification in water of a Monte Carlo treatment planning tool for proton, helium, carbon and oxygen ion beams at the Heidelberg Ion Beam Therapy Center

    Science.gov (United States)

    Tessonnier, T.; Böhlen, T. T.; Ceruti, F.; Ferrari, A.; Sala, P.; Brons, S.; Haberer, T.; Debus, J.; Parodi, K.; Mairani, A.

    2017-08-01

    The introduction of ‘new’ ion species in particle therapy needs to be supported by a thorough assessment of their dosimetric properties and by treatment planning comparisons with clinically used proton and carbon ion beams. In addition to the latter two ions, helium and oxygen ion beams are foreseen at the Heidelberg Ion Beam Therapy Center (HIT) as potential assets for improving clinical outcomes in the near future. We present in this study a dosimetric validation of a FLUKA-based Monte Carlo treatment planning tool (MCTP) for protons, helium, carbon and oxygen ions for spread-out Bragg peaks in water. The comparisons between the ions show the dosimetric advantages of helium and heavier ion beams in terms of their distal and lateral fall-offs with respect to protons, reducing the lateral size of the region receiving 50% of the planned dose up to 12 mm. However, carbon and oxygen ions showed significant doses beyond the target due to the higher fragmentation tail compared to lighter ions (p and He), up to 25%. The Monte Carlo predictions were found to be in excellent geometrical agreement with the measurements, with deviations below 1 mm for all parameters investigated such as target and lateral size as well as distal fall-offs. Measured and simulated absolute dose values agreed within about 2.5% on the overall dose distributions. The MCTP tool, which supports the usage of multiple state-of-the-art relative biological effectiveness models, will provide a solid engine for treatment planning comparisons at HIT.

  11. Dosimetric verification in water of a Monte Carlo treatment planning tool for proton, helium, carbon and oxygen ion beams at the Heidelberg Ion Beam Therapy Center.

    Science.gov (United States)

    Tessonnier, T; Böhlen, T T; Ceruti, F; Ferrari, A; Sala, P; Brons, S; Haberer, T; Debus, J; Parodi, K; Mairani, A

    2017-07-31

    The introduction of 'new' ion species in particle therapy needs to be supported by a thorough assessment of their dosimetric properties and by treatment planning comparisons with clinically used proton and carbon ion beams. In addition to the latter two ions, helium and oxygen ion beams are foreseen at the Heidelberg Ion Beam Therapy Center (HIT) as potential assets for improving clinical outcomes in the near future. We present in this study a dosimetric validation of a FLUKA-based Monte Carlo treatment planning tool (MCTP) for protons, helium, carbon and oxygen ions for spread-out Bragg peaks in water. The comparisons between the ions show the dosimetric advantages of helium and heavier ion beams in terms of their distal and lateral fall-offs with respect to protons, reducing the lateral size of the region receiving 50% of the planned dose up to 12 mm. However, carbon and oxygen ions showed significant doses beyond the target due to the higher fragmentation tail compared to lighter ions (p and He), up to 25%. The Monte Carlo predictions were found to be in excellent geometrical agreement with the measurements, with deviations below 1 mm for all parameters investigated such as target and lateral size as well as distal fall-offs. Measured and simulated absolute dose values agreed within about 2.5% on the overall dose distributions. The MCTP tool, which supports the usage of multiple state-of-the-art relative biological effectiveness models, will provide a solid engine for treatment planning comparisons at HIT.

  12. Phase II Radiation therapy oncology group trial of weekly paclitaxel and conventional external beam radiation therapy for supratentorial glioblastoma multiforme

    International Nuclear Information System (INIS)

    Langer, Corey J.; Ruffer, James; Rhodes, Harker; Paulus, Rebecca; Murray, Kevin; Movsas, Benjamin; Curran, Walter

    2001-01-01

    Purpose: Fractionated external beam radiotherapy (EBRT) ± carmustine (BCNU) is the standard of care for patients with glioblastoma multiforme (GBM), but survival results remain poor. Preclinical studies indicate synergy between RT and paclitaxel (TAX) in astrocytoma cell lines. Phase I studies in GBM have demonstrated a maximum tolerated dose for TAX of 225 mg/m 2 /3 h/week x 6, during EBRT, with no exacerbation of typical RT-induced toxicities. The Radiation Therapy Oncology Group (RTOG) therefore mounted a Phase II study to determine the feasibility and efficacy of conventional EBRT and concurrent weekly TAX at its MTD. Patients and Methods: Sixty-two patients with histologic diagnosis of GBM were enrolled from 8/16/96 through 3/21/97 in a multi-institutional Phase II trial of EBRT and TAX 225 mg/m 2 /3 h (1-3 h before EBRT), administered the first treatment day of each RT week. Total EBRT dose was 60 Gy (200 cGy/fraction), 5 days per week. A smaller treatment field, to include gross disease plus a margin only, was used after 46 Gy. Results: Sixty-one patients (98%) were evaluable. Median age was 55 years (range, 28-78). Seventy-four percent were ≥50 years. Recursive partitioning analysis (RPA) Classes III, IV, V, VI included 10 (17%), 21 (34%), 25 (41%), and 5 (8%) patients, respectively. Gross total resection was performed in only 16%. There was no Grade 3 or 4 neutropenia or thrombocytopenia. Hypersensitivity reactions precluding further use of TAX occurred in 4 patients. There were 2 instances of late neurotoxicity (4% Grade 3 or 4). Ninety-one percent of patients received treatment per protocol. Seventy-seven percent completed prescribed treatment (6 weeks). Of 35 patients with measurable disease, CR/PR was observed in 23%, MR in 17%, and SD in 43%. Seventeen percent demonstrated progression at first follow-up. Median potential follow-up time is 20 months. Median survival is 9.7 months, with median survivals for RPA classes III, IV, V, and VI of 16.3, 10

  13. Imaging doses in radiation therapy from kilovoltage cone-beam computed tomography

    Science.gov (United States)

    Hyer, Daniel Ellis

    Advances in radiation treatment delivery, such as intensity modulated radiation therapy (IMRT), have made it possible to deliver large doses of radiation with a high degree of conformity. While highly conformal treatments offers the advantage of sparing surrounding normal tissue, this benefit can only be realized if the patient is accurately positioned during each treatment fraction. The need to accurately position the patient has led to the development and use of gantry mounted kilovoltage cone-beam computed tomography (kV-CBCT) systems. These systems are used to acquire high resolution volumetric images of the patient which are then digitally registered with the planning CT dataset to confirm alignment of the patient on the treatment table. While kV-CBCT is a very useful tool for aligning the patient prior to treatment, daily use in a high fraction therapy regimen results in a substantial radiation dose. In order to quantify the radiation dose associated with CBCT imaging, an anthropomorphic phantom representing a 50th percentile adult male and a fiber-optic coupled (FOC) dosimetry system were both constructed as part of this dissertation. These tools were then used to directly measure organ doses incurred during clinical protocols for the head, chest, and pelvis. For completeness, the dose delivered from both the X-ray Volumetric Imager (XVI, Elekta Oncology Systems, Crawley, UK) and the On-Board Imager (OBI, Varian Medical Systems, Palo Alto, CA) were investigated. While this study provided a direct measure of organ doses for estimating risk to the patient, a practical method for estimating organ doses that could be performed with phantoms and dosimeters currently available at most clinics was also desired. To accomplish this goal, a 100 mm pencil ion chamber was used to measure the "cone beam dose index" (CBDI) inside standard CT dose index (CTDI) acrylic phantoms. A weighted CBDI (CBDIw), similar to the weighted CT dose index (CTDIw), was then calculated to

  14. Application of the Medipix2 technology to space radiation dosimetry and hadron therapy beam monitoring

    International Nuclear Information System (INIS)

    Pinsky, Lawrence; Stoffle, Nicholas; Empl, Anton; Jakubek, Jan; Pospisil, Stanislav; Leroy, Claude; Kitamura, Hisashi; Yasuda, Nakahiro; Uchihori, Yukio

    2011-01-01

    The Medipix2 Collaboration, based at CERN, has developed the TimePix version of the Medipix pixel readout chip, which has the ability to provide either an ADC or TDC capability separately in each of its 256 × 256 pixels. When coupled to a Si detector layer, the device is an excellent candidate for application as an active dosimeter for use in Space Radiation Environments. In order to facilitate such a development, data have been taken with Heavy Ions at the HIMAC facility in Chiba, Japan. In particular, the problem of determining the resolution of such a detector system with respect to heavy ions of differing charges and energies, but with similar dE/dx values has been explored for several ions. The ultimate problem is to parse the information in the pixel “footprint” images from the drift of the charge-cloud produced in the detector layer. In addition, with the use of convertor materials, the detector can be used as a neutron detector, and it has been used both as a charged particle and neutron detector to evaluate the detailed properties of the radiation fields produced by hadron therapy beams. The first space flight of a Medipix-based detector is currently planned for the first quarter of 2012 onboard the UK TechDemoSat-1 satellite as part of the LUCID project. The instrument to be flown is currently planned to have 5 TimePix versions of the Medipix2 detector deployed on 5 of the 6 faces of a cube with ∼3 cm on each side and enclosed by a 0.7 mm thick Al cylindrical cover. The planned orbit will have an altitude of 660 km and will be sun-synchronous with an inclination of 98°Current plans are for the instrument to be located on a vertical side of the satellite with one face upward, one downward, two opposed laterally and one facing in the forward direction with respect to the satellite’s velocity vector. As such, the instrument should be exposed to the outer belt electrons during polar passes as well as the South Atlantic Anomaly and ambient Galactic

  15. Clinical Implementation of Intrafraction Cone Beam Computed Tomography Imaging During Lung Tumor Stereotactic Ablative Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Li, Ruijiang; Han, Bin; Meng, Bowen [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Maxim, Peter G.; Xing, Lei; Koong, Albert C. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Diehn, Maximilian, E-mail: Diehn@Stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California (United States); Loo, Billy W., E-mail: BWLoo@Stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States)

    2013-12-01

    Purpose: To develop and clinically evaluate a volumetric imaging technique for assessing intrafraction geometric and dosimetric accuracy of stereotactic ablative radiation therapy (SABR). Methods and Materials: Twenty patients received SABR for lung tumors using volumetric modulated arc therapy (VMAT). At the beginning of each fraction, pretreatment cone beam computed tomography (CBCT) was used to align the soft-tissue tumor position with that in the planning CT. Concurrent with dose delivery, we acquired fluoroscopic radiograph projections during VMAT using the Varian on-board imaging system. Those kilovolt projections acquired during millivolt beam-on were automatically extracted, and intrafraction CBCT images were reconstructed using the filtered backprojection technique. We determined the time-averaged target shift during VMAT by calculating the center of mass of the tumor target in the intrafraction CBCT relative to the planning CT. To estimate the dosimetric impact of the target shift during treatment, we recalculated the dose to the GTV after shifting the entire patient anatomy according to the time-averaged target shift determined earlier. Results: The mean target shift from intrafraction CBCT to planning CT was 1.6, 1.0, and 1.5 mm; the 95th percentile shift was 5.2, 3.1, 3.6 mm; and the maximum shift was 5.7, 3.6, and 4.9 mm along the anterior-posterior, left-right, and superior-inferior directions. Thus, the time-averaged intrafraction gross tumor volume (GTV) position was always within the planning target volume. We observed some degree of target blurring in the intrafraction CBCT, indicating imperfect breath-hold reproducibility or residual motion of the GTV during treatment. By our estimated dose recalculation, the GTV was consistently covered by the prescription dose (PD), that is, V100% above 0.97 for all patients, and minimum dose to GTV >100% PD for 18 patients and >95% PD for all patients. Conclusions: Intrafraction CBCT during VMAT can provide

  16. Fast shading correction for cone beam CT in radiation therapy via sparse sampling on planning CT.

    Science.gov (United States)

    Shi, Linxi; Tsui, Tiffany; Wei, Jikun; Zhu, Lei

    2017-05-01

    The image quality of cone beam computed tomography (CBCT) is limited by severe shading artifacts, hindering its quantitative applications in radiation therapy. In this work, we propose an image-domain shading correction method using planning CT (pCT) as prior information which is highly adaptive to clinical environment. We propose to perform shading correction via sparse sampling on pCT. The method starts with a coarse mapping between the first-pass CBCT images obtained from the Varian TrueBeam system and the pCT. The scatter correction method embedded in the Varian commercial software removes some image errors but the CBCT images still contain severe shading artifacts. The difference images between the mapped pCT and the CBCT are considered as shading errors, but only sparse shading samples are selected for correction using empirical constraints to avoid carrying over false information from pCT. A Fourier-Transform-based technique, referred to as local filtration, is proposed to efficiently process the sparse data for effective shading correction. The performance of the proposed method is evaluated on one anthropomorphic pelvis phantom and 17 patients, who were scheduled for radiation therapy. (The codes of the proposed method and sample data can be downloaded from https://sites.google.com/view/linxicbct) RESULTS: The proposed shading correction substantially improves the CBCT image quality on both the phantom and the patients to a level close to that of the pCT images. On the phantom, the spatial nonuniformity (SNU) difference between CBCT and pCT is reduced from 74 to 1 HU. The root of mean square difference of SNU between CBCT and pCT is reduced from 83 to 10 HU on the pelvis patients, and from 101 to 12 HU on the thorax patients. The robustness of the proposed shading correction is fully investigated with simulated registration errors between CBCT and pCT on the phantom and mis-registration on patients. The sparse sampling scheme of our method successfully

  17. Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71.

    Science.gov (United States)

    Gibbons, John P; Antolak, John A; Followill, David S; Huq, M Saiful; Klein, Eric E; Lam, Kwok L; Palta, Jatinder R; Roback, Donald M; Reid, Mark; Khan, Faiz M

    2014-03-01

    A protocol is presented for the calculation of monitor units (MU) for photon and electron beams, delivered with and without beam modifiers, for constant source-surface distance (SSD) and source-axis distance (SAD) setups. This protocol was written by Task Group 71 of the Therapy Physics Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol defines the nomenclature for the dosimetric quantities used in these calculations, along with instructions for their determination and measurement. Calculations are made using the dose per MU under normalization conditions, D'0, that is determined for each user's photon and electron beams. For electron beams, the depth of normalization is taken to be the depth of maximum dose along the central axis for the same field incident on a water phantom at the same SSD, where D'0 = 1 cGy/MU. For photon beams, this task group recommends that a normalization depth of 10 cm be selected, where an energy-dependent D'0 ≤ 1 cGy/MU is required. This recommendation differs from the more common approach of a normalization depth of dm, with D'0 = 1 cGy/MU, although both systems are acceptable within the current protocol. For photon beams, the formalism includes the use of blocked fields, physical or dynamic wedges, and (static) multileaf collimation. No formalism is provided for intensity modulated radiation therapy calculations, although some general considerations and a review of current calculation techniques are included. For electron beams, the formalism provides for calculations at the standard and extended SSDs using either an effective SSD or an air-gap correction factor. Example tables and problems are included to illustrate the basic concepts within the presented formalism.

  18. Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71

    Energy Technology Data Exchange (ETDEWEB)

    Gibbons, John P., E-mail: john.gibbons@marybird.com [Department of Physics, Mary Bird Perkins Cancer Center, Baton Rouge, Louisiana 70809 (United States); Antolak, John A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota 55905 (United States); Followill, David S. [Department of Radiation Physics, UT M.D. Anderson Cancer Center, Houston, Texas 77030 (United States); Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania 15232 (United States); Klein, Eric E. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Lam, Kwok L. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109 (United States); Palta, Jatinder R. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298 (United States); Roback, Donald M. [Department of Radiation Oncology, Cancer Centers of North Carolina, Raleigh, North Carolina 27607 (United States); Reid, Mark [Department of Medical Physics, Fletcher-Allen Health Care, Burlington, Vermont 05401 (United States); Khan, Faiz M. [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota 55455 (United States)

    2014-03-15

    A protocol is presented for the calculation of monitor units (MU) for photon and electron beams, delivered with and without beam modifiers, for constant source-surface distance (SSD) and source-axis distance (SAD) setups. This protocol was written by Task Group 71 of the Therapy Physics Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol defines the nomenclature for the dosimetric quantities used in these calculations, along with instructions for their determination and measurement. Calculations are made using the dose per MU under normalization conditions, D{sub 0}{sup ′}, that is determined for each user's photon and electron beams. For electron beams, the depth of normalization is taken to be the depth of maximum dose along the central axis for the same field incident on a water phantom at the same SSD, where D{sub 0}{sup ′} = 1 cGy/MU. For photon beams, this task group recommends that a normalization depth of 10 cm be selected, where an energy-dependent D{sub 0}{sup ′} ≤ 1 cGy/MU is required. This recommendation differs from the more common approach of a normalization depth of d{sub m}, with D{sub 0}{sup ′} = 1 cGy/MU, although both systems are acceptable within the current protocol. For photon beams, the formalism includes the use of blocked fields, physical or dynamic wedges, and (static) multileaf collimation. No formalism is provided for intensity modulated radiation therapy calculations, although some general considerations and a review of current calculation techniques are included. For electron beams, the formalism provides for calculations at the standard and extended SSDs using either an effective SSD or an air-gap correction factor. Example tables and problems are included to illustrate the basic concepts within the presented formalism.

  19. Investigation on the neutron beam characteristics for boron neutron capture therapy with 3D and 2D transport calculations

    International Nuclear Information System (INIS)

    Kodeli, I.; Diop, C.M.; Nimal, J.C.

    1994-01-01

    In the framework of future Boron Neutron Capture Therapy (BNCT) experiments, where cells and animals irradiations are planned at the research reactor of Strasbourg University, the feasibility to obtain a suitable epithermal neutron beam is investigated. The neutron fluence and spectra calculations in the reactor are performed using the 3D Monte Carlo code TRIPOLI-3 and the 2D SN code TWODANT. The preliminary analysis of Al 2 O 3 and Al-Al 2 O 3 filters configurations are carried out in an attempt to optimize the flux characteristics in the beam tube facility. 7 figs., 7 refs

  20. Hounsfield unit recovery in clinical cone beam CT images of the thorax acquired for image guided radiation therapy

    DEFF Research Database (Denmark)

    Thing, Rune Slot; Bernchou, Uffe; Mainegra-Hing, Ernesto

    2016-01-01

    A comprehensive artefact correction method for clinical cone beam CT (CBCT) images acquired for image guided radiation therapy (IGRT) on a commercial system is presented. The method is demonstrated to reduce artefacts and recover CT-like Hounsfield units (HU) in reconstructed CBCT images of five...... lung cancer patients. Projection image based artefact corrections of image lag, detector scatter, body scatter and beam hardening are described and applied to CBCT images of five lung cancer patients. Image quality is evaluated through visual appearance of the reconstructed images, HU...

  1. Experimental and Monte Carlo-based determination of the beam quality specifier for TomoTherapyHD treatment units.

    Science.gov (United States)

    Howitz, S; Schwedas, M; Wiezorek, T; Zink, K

    2017-10-12

    Reference dosimetry by means of clinical linear accelerators in high-energy photon fields requires the determination of the beam quality specifier TPR 20,10 , which characterizes the relative particle flux density of the photon beam. The measurement of TPR 20,10 has to be performed in homogenous photon beams of size 10×10cm 2 with a focus-detector distance of 100cm. These requirements cannot be fulfilled by TomoTherapy treatment units from Accuray. The TomoTherapy unit provides a flattening-filter-free photon fan beam with a maximum field width of 40cm and field lengths of 1.0cm, 2.5cm and 5.0cm at a focus-isocenter distance of 85cm. For the determination of the beam quality specifier from measurements under nonstandard reference conditions Sauer and Palmans proposed experiment-based fit functions. Moreover, Sauer recommends considering the impact of the flattening-filter-free beam on the measured data. To verify these fit functions, in the present study a Monte Carlo based model of the treatment head of a TomoTherapyHD unit was designed and commissioned with existing beam data of our clinical TomoTherapy machine. Depth dose curves and dose profiles were in agreement within 1.5% between experimental and Monte Carlo-based data. Based on the fit functions from Sauer and Palmans the beam quality specifier TPR 20,10 was determined from field sizes 5×5cm 2 , 10×5cm 2 , 20×5cm 2 and 40×5cm 2 based on dosimetric measurements and Monte Carlo simulations. The mean value from all experimental values of TPR 20,10 resulted in TPR 20,10 ¯=0.635±0.4%. The impact of the non-homogenous field due to the flattening-filter-free beam was negligible for field sizes below 20×5cm 2 . The beam quality specifier calculated by Monte Carlo simulations was TPR 20,10 =0.628 and TPR 20,10 =0.631 for two different calculation methods. The stopping power ratio water-to-air s w,a Δ directly depends on the beam quality specifier. The value determined from all experimental TPR 20,10 data

  2. MO-A-BRB-01: Review of TG-262 Internal Survey of Practices in EMR for External Beam Therapy

    International Nuclear Information System (INIS)

    Mechalakos, J.

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  3. Impact of tissue specific parameters on the predition of the biological effectiveness for treatment planning in ion beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gruen, Rebecca Antonia

    2014-06-03

    Treatment planning in ion beam therapy requires a reliable estimation of the relative biological effectiveness (RBE) of the irradiated tissue. For the pilot project at GSI Helmholtzzentrum fuer Schwerionenforschung GmbH and at other European ion beam therapy centers RBE prediction is based on a biophysical model, the Local Effect Model (LEM). The model version in use, LEM I, is optimized to give a reliable estimation of RBE in the target volume for carbon ion irradiation. However, systematic deviations are observed for the entrance channel of carbon ions and in general for lighter ions. Thus, the LEM has been continuously developed to improve accuracy. The recent version LEM IV has proven to better describe in-vitro cell experiments. Thus, for the clinical application of LEM IV it is of interest to analyze potential differences compared to LEM I under treatment-like conditions. The systematic analysis presented in this work is aiming at the comparison of RBE-weighted doses resulting from different approaches and model versions for protons and carbon ions. This will facilitate the assessment of consequences for clinical application and the interpretation of clinical results from different institutions. In the course of this thesis it has been shown that the RBE-weighted doses predicted on the basis of LEM IV for typical situations representing chordoma treatments differ on average by less than 10 % to those based on LEM I and thus also allow a consistent interpretation of the clinical results. At Japanese ion beam therapy centers the RBE is estimated using their clinical experience from neutron therapy in combination with in-vitro measurements for carbon ions (HIMAC approach). The methods presented in this work allow direct comparison of the HIMAC approach and the LEM and thus of the clinical results obtained at Japanese and European ion beam therapy centers. Furthermore, the sensitivity of the RBE on the model parameters was evaluated. Among all parameters the

  4. Impact of tissue specific parameters on the predition of the biological effectiveness for treatment planning in ion beam therapy

    International Nuclear Information System (INIS)

    Gruen, Rebecca Antonia

    2014-01-01

    Treatment planning in ion beam therapy requires a reliable estimation of the relative biological effectiveness (RBE) of the irradiated tissue. For the pilot project at GSI Helmholtzzentrum fuer Schwerionenforschung GmbH and at other European ion beam therapy centers RBE prediction is based on a biophysical model, the Local Effect Model (LEM). The model version in use, LEM I, is optimized to give a reliable estimation of RBE in the target volume for carbon ion irradiation. However, systematic deviations are observed for the entrance channel of carbon ions and in general for lighter ions. Thus, the LEM has been continuously developed to improve accuracy. The recent version LEM IV has proven to better describe in-vitro cell experiments. Thus, for the clinical application of LEM IV it is of interest to analyze potential differences compared to LEM I under treatment-like conditions. The systematic analysis presented in this work is aiming at the comparison of RBE-weighted doses resulting from different approaches and model versions for protons and carbon ions. This will facilitate the assessment of consequences for clinical application and the interpretation of clinical results from different institutions. In the course of this thesis it has been shown that the RBE-weighted doses predicted on the basis of LEM IV for typical situations representing chordoma treatments differ on average by less than 10 % to those based on LEM I and thus also allow a consistent interpretation of the clinical results. At Japanese ion beam therapy centers the RBE is estimated using their clinical experience from neutron therapy in combination with in-vitro measurements for carbon ions (HIMAC approach). The methods presented in this work allow direct comparison of the HIMAC approach and the LEM and thus of the clinical results obtained at Japanese and European ion beam therapy centers. Furthermore, the sensitivity of the RBE on the model parameters was evaluated. Among all parameters the

  5. Adaptive planning using megavoltage fan-beam CT for radiation therapy with testicular shielding

    Energy Technology Data Exchange (ETDEWEB)

    Yadav, Poonam [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); School of Advance Sciences, Vellore Institue of Technology University, Vellore, Tamil Nadu (India); Kozak, Kevin [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Tolakanahalli, Ranjini [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); Ramasubramanian, V. [School of Advance Sciences, Vellore Institue of Technology University, Vellore, Tamil Nadu (India); Paliwal, Bhudatt R. [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); University of Wisconsin, Riverview Cancer Centre, Wisconsin Rapids, WI (United States); Welsh, James S. [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); Rong, Yi, E-mail: rong@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); University of Wisconsin, Riverview Cancer Centre, Wisconsin Rapids, WI (United States)

    2012-07-01

    This study highlights the use of adaptive planning to accommodate testicular shielding in helical tomotherapy for malignancies of the proximal thigh. Two cases of young men with large soft tissue sarcomas of the proximal thigh are presented. After multidisciplinary evaluation, preoperative radiation therapy was recommended. Both patients were referred for sperm banking and lead shields were used to minimize testicular dose during radiation therapy. To minimize imaging artifacts, kilovoltage CT (kVCT) treatment planning was conducted without shielding. Generous hypothetical contours were generated on each 'planning scan' to estimate the location of the lead shield and generate a directionally blocked helical tomotherapy plan. To ensure the accuracy of each plan, megavoltage fan-beam CT (MVCT) scans were obtained at the first treatment and adaptive planning was performed to account for lead shield placement. Two important regions of interest in these cases were femurs and femoral heads. During adaptive planning for the first patient, it was observed that the virtual lead shield contour on kVCT planning images was significantly larger than the actual lead shield used for treatment. However, for the second patient, it was noted that the size of the virtual lead shield contoured on the kVCT image was significantly smaller than the actual shield size. Thus, new adaptive plans based on MVCT images were generated and used for treatment. The planning target volume was underdosed up to 2% and had higher maximum doses without adaptive planning. In conclusion, the treatment of the upper thigh, particularly in young men, presents several clinical challenges, including preservation of gonadal function. In such circumstances, adaptive planning using MVCT can ensure accurate dose delivery even in the presence of high-density testicular shields.

  6. SU-E-T-353: Decoding the Beam Complexity in Intensity-Modulated Radiation Therapy Plans

    International Nuclear Information System (INIS)

    Du, W; Cho, S; Zhang, X; Hoffman, K; Kudchadker, R

    2014-01-01

    Purpose: Modern IMRT relies on computers to generate treatment plans of varied complexity. A highly complex treatment plan may use a large number of small and irregular beam apertures in order to achieve high dose conformity. However, excessive beam complexity can increase dosimetric uncertainty, prolong treatment time, and increase susceptibility to target or organ motion. In this study we sought to develop metrics to assess the complexity of IMRT beams and plans. Methods: Based the information of leaf positions and MU for each beam segment, we calculated the following beam complexity metrics: aperture area, shape irregularity, and beam modulation. Then these beam complexity metrics were averaged to obtain the corresponding plan complexity metrics, using the beam MUs as weighting factors. We evaluated and compared the beam and plan complexity scores for 65 IMRT plans from 3 sites (prostate, head and neck, and spine). We also studied how the plan complexity scores were affected by adjusting inverse planning parameters. Results: For prostate IMRT, the lateral beams had large MUs and smaller shape irregularity, while the anterior or posterior beams had larger modulation values. On average, the prostate IMRT plans had the smallest shape irregularity and beam modulation; the HN IMRT plans had the largest aperture area, shape irregularity, and beam modulation; and the spine stereotactic IMRT plans often had small aperture area, which may be associated with relatively large discrepancies between calculated and measures doses. The plan complexity increased as the number of optimization iterations and the number of beam segments increased and as the minimum segment area decreased. Conclusion: Complexity of IMRT beams and plans were quantified in terms of aperture area, shape irregularity and beam modulation. The complexity metrics varied among IMRT plans for different disease sites and were affected when the planning parameters were adjusted

  7. Definition of parameters for quality assurance of flattening filter free (FFF) photon beams in radiation therapy

    International Nuclear Information System (INIS)

    Fogliata, A.; Garcia, R.; Knöös, T.; Nicolini, G.; Clivio, A.; Vanetti, E.; Khamphan, C.; Cozzi, L.

    2012-01-01

    Purpose: Flattening filter free (FFF) beams generated by medical linear accelerators have recently started to be used in radiotherapy clinical practice. Such beams present fundamental differences with respect to the standard filter flattened (FF) beams, making the generally used dosimetric parameters and definitions not always viable. The present study will propose possible definitions and suggestions for some dosimetric parameters for use in quality assurance of FFF beams generated by medical linacs in radiotherapy. Methods: The main characteristics of the photon beams have been analyzed using specific data generated by a Varian TrueBeam linac having both FFF and FF beams of 6 and 10 MV energy, respectively. Results: Definitions for dose profile parameters are suggested starting from the renormalization of the FFF with respect to the corresponding FF beam. From this point the flatness concept has been translated into one of “unflatness” and other definitions have been proposed, maintaining a strict parallelism between FFF and FF parameter concepts. Conclusions: Ideas for quality controls used in establishing a quality assurance program when introducing FFF beams into the clinical environment are given here, keeping them similar to those used for standard FF beams. By following the suggestions in this report, the authors foresee that the introduction of FFF beams into a clinical radiotherapy environment will be as safe and well controlled as standard beam modalities using the existing guidelines.

  8. Computer-aided beam arrangement based on similar cases in radiation treatment-planning databases for stereotactic lung radiation therapy

    International Nuclear Information System (INIS)

    Magome, Taiki; Shioyama, Yoshiyuki; Arimura, Hidetaka

    2013-01-01

    The purpose of this study was to develop a computer-aided method for determination of beam arrangements based on similar cases in a radiotherapy treatment-planning database for stereotactic lung radiation therapy. Similar-case-based beam arrangements were automatically determined based on the following two steps. First, the five most similar cases were searched, based on geometrical features related to the location, size and shape of the planning target volume, lung and spinal cord. Second, five beam arrangements of an objective case were automatically determined by registering five similar cases with the objective case, with respect to lung regions, by means of a linear registration technique. For evaluation of the beam arrangements five treatment plans were manually created by applying the beam arrangements determined in the second step to the objective case. The most usable beam arrangement was selected by sorting the five treatment plans based on eight plan evaluation indices, including the D95, mean lung dose and spinal cord maximum dose. We applied the proposed method to 10 test cases, by using an RTP database of 81 cases with lung cancer, and compared the eight plan evaluation indices between the original treatment plan and the corresponding most usable similar-case-based treatment plan. As a result, the proposed method may provide usable beam arrangements, which have no statistically significant differences from the original beam arrangements (P>0.05) in terms of the eight plan evaluation indices. Therefore, the proposed method could be employed as an educational tool for less experienced treatment planners. (author)

  9. Chromatic energy filter and characterization of laser-accelerated proton beams for particle therapy

    Science.gov (United States)

    Hofmann, Ingo; Meyer-ter-Vehn, Jürgen; Yan, Xueqing; Al-Omari, Husam

    2012-07-01

    The application of laser accelerated protons or ions for particle therapy has to cope with relatively large energy and angular spreads as well as possibly significant random fluctuations. We suggest a method for combined focusing and energy selection, which is an effective alternative to the commonly considered dispersive energy selection by magnetic dipoles. Our method is based on the chromatic effect of a magnetic solenoid (or any other energy dependent focusing device) in combination with an aperture to select a certain energy width defined by the aperture radius. It is applied to an initial 6D phase space distribution of protons following the simulation output from a Radiation Pressure Acceleration model. Analytical formula for the selection aperture and chromatic emittance are confirmed by simulation results using the TRACEWIN code. The energy selection is supported by properly placed scattering targets to remove the imprint of the chromatic effect on the beam and to enable well-controlled and shot-to-shot reproducible energy and transverse density profiles.

  10. Application of the Medipix2 technology to space radiation dosimetry and hadron therapy beam monitoring

    International Nuclear Information System (INIS)

    Pinsky, Lawrence; Stoffle, Nicholas; Jakubek, Jan; Pospisil, Stanislav; Leroy, Claude; Gutierrez, Andrea; Kitamura, Hisashi; Yasuda, Nakahiro; Uchihori, Yulio

    2011-01-01

    The Medipix2 Collaboration, based at CERN, has developed the TimePix version of the Medipix pixel readout chip, which has the ability to provide either an ADC or TDC capability separately in each of its 256x256 pixels. When coupled to a Si detector layer, the device is an excellent candidate for application as an active dosimeter for use in space radiation environments. In order to facilitate such a development, data have been taken with heavy ions at the HIMAC facility in Chiba, Japan. In particular, the problem of determining the resolution of such a detector system with respect to heavy ions of differing charges and energies, but with similar dE/dx values has been explored for several ions. The ultimate problem is to parse the information in the pixel 'footprint' images from the drift of the charge cloud produced in the detector layer. In addition, with the use of convertor materials, the detector can be used as a neutron detector, and it has been used both as a charged particle and neutron detector to evaluate the detailed properties of the radiation fields produced by hadron therapy beams. New versions of the basic chip design are ongoing.

  11. PSA bounce phenomenon after External Beam Radiation Therapy for prostate cancer

    International Nuclear Information System (INIS)

    Roszkowski, K.; Makarewicz, R.

    2007-01-01

    Introduction to clinical practice of PSA antigen altered the therapeutic approach to treatment of prostate cancer. The PSA antigen was defined as sensitive marker for monitoring of prostate cancer. At treated with radiotherapy patients (EBRT) value of PSA nadir after treatment is the significant determinant of results of treatment statistically. Three consecutive PSA rise above the post-treatment nadir have been defined as biochemical failure by the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus panel. However a single rise in post-EBRT PSA level continues to be a source of considerable anxiety due to the intriguing uncertainty of relationship between PSA bouncing and disease relapse. The clinical practice show that growth of level PSA after radiotherapy was possible and does not it join with progression of disease. Phenomenon this was named as PSA-bounce. Various definitions of PSA bounce have been used in the literature. The authors in presented work represent the current state of knowledge on this phenomenon after use radical External Beam Radiation Therapy. (authors)

  12. SU-F-T-214: Re-Thinking the Useful Clinical Beam Energy in Proton Therapy: An Opportunity for Cost Reduction

    Energy Technology Data Exchange (ETDEWEB)

    Bentefour, El H [IBA, Advanced Technology Group, Louvain La Neuve (Belgium); Lu, H [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2016-06-15

    Purpose: We conducted a retrospective study of the useful clinical proton beam energy based on the beam range data of patients treated over the last 10 years at Massachusetts General Hospital Proton Therapy Center. Methods: Treatment field information were collected for all patients treated over the last 10 years (2005–2015) in the two gantry treatment rooms at MGH. The beam ranges for these fields were retrieved and categorized per treatment site. The 10 prostate patients that required the highest beam range (lateral fields) were selected. For these patients, anterior oblique beams (30–40 degrees) were simulated in a planning system to obtain the required beam ranges including the margins for potential range uncertainties. Results: There were a total of 4033 patients, treated with combined total of 23603 fields. All treatment indications were considered with the exception of ocular tumors generally treated in a fixed beam room. For all non-prostate treatments (21811 fields), only 5 fields for 4 patients (1-pancreas, 1-lumbar chordoma, 2-spine mets) required beam range greater than 25 cm. There were 446 prostate patients (1792 fields), with the required beam range from 22.3 to 29.0 cm; 386 of them had at least one of their lateral beam range greater than 25 cm. For the 10 prostate patients with highest lateral beam ranges (26 to 29 cm), their treatment with anterior oblique beams would drop the beam ranges below 25 cm (17.3 to 18.5 cm). Conclusion: if prostate patients are treated with anterior fields only, the useful maximum beam range is reduced to 25 cm. Thus a proton therapy system with maximum beam energy of 196 MeV is sufficient to treat all tumors sites with very rare exceptions (<0.1%). Designing such PT system would reduce the cost of proton therapy for hospitals and patients and increase the accessibility to the treatment.

  13. Evaluation of a 50-MV photon therapy beam from a racetrack microtron using MCNP4B Monte Carlo code

    International Nuclear Information System (INIS)

    Gudowska, I.; Svensson, R.

    2001-01-01

    High energy photon therapy beam from the 50 MV racetrack microtron has been evaluated using the Monte Carlo code MCNP4B. The spatial and energy distribution of photons, radial and depth dose distributions in the phantom are calculated for the stationary and scanned photon beams from different targets. The calculated dose distributions are compared to the experimental data using a silicon diode detector. Measured and calculated depth-dose distributions are in fairly good agreement, within 2-3% for the positions in the range 2-30 cm in the phantom, whereas the larger discrepancies up to 10% are observed in the dose build-up region. For the stationary beams the differences in the calculated and measured radial dose distributions are about 2-10%. (orig.)

  14. OPTIMIZATION OF THE EPITHERMAL NEUTRON BEAM FOR BORON NEUTRON CAPTURE THERAPY AT THE BROOKHAVEN MEDICAL RESEARCH REACTOR.

    Energy Technology Data Exchange (ETDEWEB)

    HU,J.P.; RORER,D.C.; RECINIELLO,R.N.; HOLDEN,N.E.

    2002-08-18

    Clinical trials of Boron Neutron Capture Therapy for patients with malignant brain tumor had been carried out for half a decade, using an epithermal neutron beam at the Brookhaven's Medical Reactor. The decision to permanently close this reactor in 2000 cut short the efforts to implement a new conceptual design to optimize this beam in preparation for use with possible new protocols. Details of the conceptual design to produce a higher intensity, more forward-directed neutron beam with less contamination from gamma rays, fast and thermal neutrons are presented here for their potential applicability to other reactor facilities. Monte Carlo calculations were used to predict the flux and absorbed dose produced by the proposed design. The results were benchmarked by the dose rate and flux measurements taken at the facility then in use.

  15. Total skin electron beam therapy for cutaneous T-cell lymphoma: a nationwide cohort study from Denmark

    DEFF Research Database (Denmark)

    Lindahl, Lise M; Kamstrup, Maria Rørbæk; Petersen, Peter M

    2011-01-01

    Background. Total skin electron beam therapy (TSEBT) is an effective palliative treatment for cutaneous T-cell lymphoma (CTCL). In the present study we reviewed the clinical response to TSEBT in Danish patients with CTCL. Material and methods. This retrospective study included 35 patients with CTCL......, the present study confirms that high-dose TSEBT is an effective, but generally not a curative therapy in the management of CTCL. High-dose treatment yielded significantly better results than low-dose treatment with 4 Gy. TSEBT offers significant palliation in most patients when other skin-directed or systemic...

  16. A Long Term Results of External Beam Radiation Therapy in Hemophilic Arthropathy of the Ankle in Children

    OpenAIRE

    Kong, Moonkyoo; Kang, Jin Oh; Choi, Jinhyun; Park, Seo Hyun

    2010-01-01

    Bleeding into joint space is critical to develop hemophilic arthropathy. To reduce the frequency of bleeding in the ankle joint of children with hemophilic arthropathy, low dose external beam irradiation was performed for 37 patients. Among them, 35 patients followed-up for longer than 1 yr (median 87 months) were enrolled for analysis. The average number of bleedings per month was 3.6 during one year prior to radiation therapy. After radiation therapy, it was decreased to 2.1 during the firs...

  17. Capability verification of the beam delivery system in the superficially-placed tumor therapy terminal at HIRFL

    International Nuclear Information System (INIS)

    Dai Zhongying; Li Qiang; Xiao Guoqing; Jin Xiaodong; Yan Zheng; Chinese Academy of Sciences, Beijing

    2007-01-01

    The passive beam delivery system in the superficially-placed tumor therapy terminal at Heavy Ion Research Facility in Lanzhou (HIRFL), which includes two orthogonal dipole magnets as scanning system, a motor-driven energy degrader as range-shifter, series of ridge filters as range modulator and a multileaf collimator, is introduced in detail. The capacities of its important components and the whole system have been verified experimentally. The tests of the ridge filter for extending Bragg peak and the range shifter for energy adjustment show both work well. To examine the passive beam delivery system, a beam shaping experiment were carried out, simulating a three-dimensional (3D) conformal irradiation to a tumor. The encouraging experimental result confirms that 3D layer-stacking conformal irradiation can be performed by means of the passive system. The validation of the beam delivery system establishes a substantial basis for upcoming clinical trial for superficially-placed tumors with heavy ions in the therapy terminal at HIRFL. (authors)

  18. Evaluation of alanine as a reference dosimeter for therapy level dose comparisons in megavoltage electron beams

    International Nuclear Information System (INIS)

    McEwen, Malcolm; Sharpe, Peter; Voros, Sandor

    2015-01-01

    When comparing absorbed dose standards from different laboratories (e.g. National Measurement Institutes, NMIs, for Key or Supplementary comparisons) it is rarely possible to carry out a direct comparison of primary standard instruments, and therefore some form of transfer detector is required. Historically, air-filled, unsealed ionization chambers have been used because of the long history of using these instruments, very good stability over many years, and ease of transport. However, the use of ion chambers for therapy-level comparisons is not without its problems. Findings from recent investigations suggest that ion chambers are prone to non-random variations, they are not completely robust to standard courier practices, and failure at any step in a comparison can render all measurements potentially useless. An alternative approach is to identify a transfer system that is insensitive to some of these concerns - effectively a dosimeter that is inexpensive, simple to use, robust, but with sufficient precision and of a size relevant to the disseminated quantity in question. The alanine dosimetry system has been successfully used in a number of situations as an audit dosimeter and therefore the purpose of this investigation was to determine whether alanine could also be used as the transfer detector for dosimetric comparisons, which require a lower value for the measurement uncertainty. A measurement protocol was developed for comparing primary standards of absorbed dose to water in high-energy electron beams using alanine pellets irradiated in a water-equivalent plastic phantom. A trial comparison has been carried out between three NMIs and has indicated that alanine is a suitable alternative to ion chambers, with the system used achieving a precision of 0.1%. Although the focus of the evaluation was on the performance of the dosimeter, the comparison results are encouraging, showing agreement at the level of the combined uncertainties (∼0.6%). Based on this

  19. Automated analysis of PET based in-vivo monitoring in ion beam therapy

    International Nuclear Information System (INIS)

    Kuess, P.

    2014-01-01

    Particle Therapy (PT)-PET is currently the only clinically approved in-vivo method for monitoring PT. Due to fragmentation processes in the patients' tissue and the beam projectiles, a beta plus activity distribution (BAD) can be measured during or shortly after the irradiation. The recorded activity map can not be directly compared to the planned dose distribution. However, by means of a Monte Carlo (MC) simulation it is possible to predict the measured BAD from a treatment plan (TP). Thus to verify a patient's treatment fraction the actual PET measurement can be compared to the respective BAD prediction. This comparison is currently performed by visual inspection which requires experienced evaluators and is rather time consuming. In this PhD thesis an evaluation tool is presented to compare BADs in an automated and objective way. The evaluation method was based on the Pearson's correlation coefficient (PCC) – an established measure in medical image processing – which was coded into a software tool. The patient data used to develop, test and validate the software tool were acquired at the GSI research facility where over 400 patient treatments with 12C were monitored by means of an in-beam PET prototype. The number of data sets was increased by artificially altering BAD to simulate different beam ranges. The automated detection tool was tested in head and neck (H&N), prostate, lung, and brain. To generate carbon ion TPs the treatment planning system TRiP98 was used for all cases. From these TPs the respective BAD predictions were derived. Besides the detection of range deviations by means of PT-PET also the automated detection of patient setup uncertainties was investigated. Although all measured patient data were recorded during the irradiation (in-beam) also scenarios performing PET scans shortly after the irradiation (in-room) were considered. To analyze the achievable precision of PT-PET with the automated evaluation tool based on

  20. Dosimetry for ocular proton beam therapy at the Harvard Cyclotron Laboratory based on the ICRU Report 59

    International Nuclear Information System (INIS)

    Newhauser, W.D.; Burns, J.; Smith, A.R.

    2002-01-01

    The Massachusetts General Hospital, the Harvard Cyclotron Laboratory (HCL), and the Massachusetts Eye and Ear Infirmary have treated almost 3000 patients with ocular disease using high-energy external-beam proton radiation therapy since 1975. The absorbed dose standard for ocular proton therapy beams at HCL was based on a fluence measurement with a Faraday cup (FC). A majority of proton therapy centers worldwide, however, use an absorbed dose standard that is based on an ionization chamber (IC) technique. The ion chamber calibration is deduced from a measurement in a reference 60 Co photon field together with a calculated correction factor that takes into account differences in a chamber's response in 60 Co and proton fields. In this work, we implemented an ionization chamber-based absolute dosimetry system for the HCL ocular beamline based on the recommendations given in Report 59 by the International Commission on Radiation Units and Measurements. Comparative measurements revealed that the FC system yields an absorbed dose to water value that is 1.1% higher than was obtained with the IC system. That difference is small compared with the experimental uncertainties and is clinically insignificant. In June of 1998, we adopted the IC-based method as our standard practice for the ocular beam

  1. A prospective, open-label study of low-dose total skin electron beam therapy in mycosis fungoides

    DEFF Research Database (Denmark)

    Kamstrup, Maria R; Specht, Lena; Skovgaard, Gunhild L

    2008-01-01

    causes and did not complete treatment. Acute side effects included desquamation, xerosis, and erythema of the skin. No severe side effects were observed. CONCLUSION: Low-dose total skin electron beam therapy can induce complete and partial responses in Stage IB-II mycosis fungoides; however, the duration......PURPOSE: To determine the effect of low-dose (4 Gy) total skin electron beam therapy as a second-line treatment of Stage IB-II mycosis fungoides in a prospective, open-label study. METHODS AND MATERIALS: Ten patients (6 men, 4 women, average age 68.7 years [range, 55-82 years......]) with histopathologically confirmed mycosis fungoides T2-T4 N0-N1 M0 who did not achieve complete remission or relapsed within 4 months after treatment with psoralen plus ultraviolet-A were included. Treatment consisted of low-dose total skin electron beam therapy administered at a total skin dose of 4 Gy given in 4...

  2. Experimental evaluation of a spatial resampling technique to improve the accuracy of pencil-beam dose calculation in proton therapy.

    Science.gov (United States)

    Egashira, Yusuke; Nishio, Teiji; Matsuura, Taeko; Kameoka, Satoru; Uesaka, Mitsuru

    2012-07-01

    In proton therapy, pencil-beam algorithms (PBAs) are the most widely used dose calculation methods. However, the PB calculations that employ one-dimensional density scaling neglect the effects of lateral density heterogeneity on the dose distributions, whereas some particles included in such pencil beams could overextend beyond the interface of the density heterogeneity. We have simplified a pencil-beam redefinition algorithm (PBRA), which was proposed for electron therapy, by a spatial resampling technique toward an application for proton therapy. The purpose of this study is to evaluate the calculation results of the spatial resampling technique in terms of lateral density heterogeneity by comparison with the dose distributions that were measured in heterogeneous slab phantoms. The pencil beams are characterized for multiple residual-range (i.e., proton energy) bins. To simplify the PBRA, the given pencil beams are resampled on one or two transport planes, in which smaller sub-beams that are parallel to each other are generated. We addressed the problem of lateral density heterogeneity comparing the calculation results to the dose distributions measured at different depths in heterogeneous slab phantoms using a two-dimensional detector. Two heterogeneity slab phantoms, namely, phantoms A and B, were designed for the measurements and calculations. In phantom A, the heterogeneity slab was placed close to the surface. On the other hand, in phantom B, it was placed close to the Bragg peak in the mono-energetic proton beam. In measurements, lateral dose profiles showed a dose reduction and increment in the vicinity of x = 0 mm in both phantoms at depths z = 142 and 161 mm due to lateral particle disequilibrium. In phantom B, these dose reduction∕increment effects were higher∕lower, respectively, than those in phantom A. This is because a longer distance from the surface to the heterogeneous slab increases the strength of proton scattering. Sub-beams, which were

  3. Experimental evaluation of a spatial resampling technique to improve the accuracy of pencil-beam dose calculation in proton therapy

    Energy Technology Data Exchange (ETDEWEB)

    Egashira, Yusuke; Nishio, Teiji; Matsuura, Taeko; Kameoka, Satoru; Uesaka, Mitsuru [Department of Bioengineering, Graduate School of Engineering, University of Tokyo, 2-11-16, Yayoi, Bunkyo-ku, Tokyo 113-8656 (Japan) and Japan Society for the Promotion of Science, Ichibancho 8, Chiyoda-ku, Tokyo 102-8472 (Japan); Particle Therapy Division, Research Center for Innovative Oncology, National Cancer Center, Kashiwa, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba 277-8577 (Japan); Department of Applied Molecular-Imaging Physics, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido 060-8638 (Japan); Particle Therapy Division, Research Center for Innovative Oncology, National Cancer Center, Kashiwa, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba 277-8577 (Japan); Department of Bioengineering, Graduate School of Engineering, University of Tokyo, 2-11-16, Yayoi, Bunkyo-ku, Tokyo 113-8656 (Japan)

    2012-07-15

    Purpose: In proton therapy, pencil-beam algorithms (PBAs) are the most widely used dose calculation methods. However, the PB calculations that employ one-dimensional density scaling neglect the effects of lateral density heterogeneity on the dose distributions, whereas some particles included in such pencil beams could overextend beyond the interface of the density heterogeneity. We have simplified a pencil-beam redefinition algorithm (PBRA), which was proposed for electron therapy, by a spatial resampling technique toward an application for proton therapy. The purpose of this study is to evaluate the calculation results of the spatial resampling technique in terms of lateral density heterogeneity by comparison with the dose distributions that were measured in heterogeneous slab phantoms. Methods: The pencil beams are characterized for multiple residual-range (i.e., proton energy) bins. To simplify the PBRA, the given pencil beams are resampled on one or two transport planes, in which smaller sub-beams that are parallel to each other are generated. We addressed the problem of lateral density heterogeneity comparing the calculation results to the dose distributions measured at different depths in heterogeneous slab phantoms using a two-dimensional detector. Two heterogeneity slab phantoms, namely, phantoms A and B, were designed for the measurements and calculations. In phantom A, the heterogeneity slab was placed close to the surface. On the other hand, in phantom B, it was placed close to the Bragg peak in the mono-energetic proton beam. Results: In measurements, lateral dose profiles showed a dose reduction and increment in the vicinity of x= 0 mm in both phantoms at depths z= 142 and 161 mm due to lateral particle disequilibrium. In phantom B, these dose reduction/increment effects were higher/lower, respectively, than those in phantom A. This is because a longer distance from the surface to the heterogeneous slab increases the strength of proton scattering. Sub-beams

  4. Optimal starting gantry angles using equiangular-spaced beams with intensity modulated radiation therapy for prostate cancer on RTOG 0126: A clinical study of 5 and 7 fields

    International Nuclear Information System (INIS)

    Potrebko, Peter S.; McCurdy, Boyd M.C.; Butler, James B.; El-Gubtan, Adel S.; Nugent, Zoann

    2007-01-01

    Background and Purpose: To investigate the effects of starting gantry angle and number of equiangular-spaced beams for prostate cancer radiotherapy on the Radiation Therapy Oncology Group (RTOG) 0126 protocol using intensity-modulated radiation therapy (IMRT). Materials and methods: Ten localized prostate cancer patients were prescribed to 79.2 Gy in 44 fractions. Static IMRT plans using five and seven equiangular-spaced beams were generated. The starting gantry angles were incremented by 5 o resulting in 15 (5 beams) and 11 (7 beams) plans per patient. Constant target coverage was ensured for all plans in order to isolate the variation in the rectal and bladder metrics as a function of starting gantry angle. Results: The variation with starting gantry angle in rectal metrics using 5 beams was statistically significant (p o and 50 o . Statistically insignificant differences were observed for the bladder metrics using 5 beams. There was little dosimetric variation in the rectal and bladder metrics with 7 beams. Nearly equivalent rectal V 75 Gy was achieved between 5 optimal equiangular-spaced beams starting at 20 o (class solution) and 7 equiangular-spaced beams starting at 0 o for most patients. Conclusions: The use of an optimal starting gantry angle for 5 equiangular-spaced beams, as indicated by a class solution in this study, will facilitate rectal sparing and can produce plans that are equivalent to those employing 7 equiangular-spaced beams

  5. Accelerator beam data commissioning equipment and procedures: Report of the TG-106 of the Therapy Physics Committee of the AAPM

    International Nuclear Information System (INIS)

    Das, Indra J.; Cheng, C.-W.; Watts, Ronald J.; Ahnesjoe, Anders; Gibbons, John; Li, X. Allen; Lowenstein, Jessica; Mitra, Raj K.; Simon, William E.; Zhu, Timothy C.

    2008-01-01

    For commissioning a linear accelerator for clinical use, medical physicists are faced with many challenges including the need for precision, a variety of testing methods, data validation, the lack of standards, and time constraints. Since commissioning beam data are treated as a reference and ultimately used by treatment planning systems, it is vitally important that the collected data are of the highest quality to avoid dosimetric and patient treatment errors that may subsequently lead to a poor radiation outcome. Beam data commissioning should be performed with appropriate knowledge and proper tools and should be independent of the person collecting the data. To achieve this goal, Task Group 106 (TG-106) of the Therapy Physics Committee of the American Association of Physicists in Medicine was formed to review the practical aspects as well as the physics of linear accelerator commissioning. The report provides guidelines and recommendations on the proper selection of phantoms and detectors, setting up of a phantom for data acquisition (both scanning and no-scanning data), procedures for acquiring specific photon and electron beam parameters and methods to reduce measurement errors (<1%), beam data processing and detector size convolution for accurate profiles. The TG-106 also provides a brief discussion on the emerging trend in Monte Carlo simulation techniques in photon and electron beam commissioning. The procedures described in this report should assist a qualified medical physicist in either measuring a complete set of beam data, or in verifying a subset of data before initial use or for periodic quality assurance measurements. By combining practical experience with theoretical discussion, this document sets a new standard for beam data commissioning

  6. A NOVEL, REMOVABLE, CERROBEND, BEAM-BLOCKING DEVICE FOR RADIATION THERAPY OF THE CANINE HEAD AND NECK: PILOT STUDY.

    Science.gov (United States)

    Kent, Michael S; Berlato, Davide; Vanhaezebrouck, Isabelle; Gordon, Ira K; Hansen, Katherine S; Theon, Alain P; Holt, Randall W; Trestrail, Earl A

    2017-01-01

    Radiation therapy of the head and neck can result in mucositis and other acute affects in the oral cavity. This prospective pilot study evaluated a novel, intraoral, beam-blocking device for use during imaging and therapeutic procedures. The beam-blocking device was made from a metal alloy inserted into a coated frozen dessert mold (Popsicle® Mold, Cost Plus World Market, Oakland, CA). The device was designed so that it could be inserted into an outer shell, which in turn allowed it to be placed or removed depending on the need due to beam configuration. A Farmer type ionization chamber and virtual water phantom were used to assess effects of field size on transmission. Six large breed cadaver dogs, donated by the owner after death, were recruited for the study. Delivered dose at the dorsal and ventral surfaces of the device, with and without the alloy block in place, were measured using radiochromic film. It was determined that transmission was field size dependent with larger field sizes leading to decreased attenuation of the beam, likely secondary to scatter. The mean and median transmission on the ventral surface without the beam-blocking device was 0.94 [range 0.94-0.96]. The mean and median transmission with the beam-blocking device was 0.52 [range 0.50-0.57]. The mean and median increase in dose due to backscatter on the dorsal surface of the beam-blocking device was 0.04 [range 0.02-0.04]. Findings indicated that this novel device can help attenuate radiation dose ventral to the block in dogs, with minimal backscatter. © 2016 American College of Veterinary Radiology.

  7. Low-dose megavoltage cone-beam CT for radiation therapy

    International Nuclear Information System (INIS)

    Pouliot, Jean; Bani-Hashemi, Ali; Chen, Josephine; Svatos, Michelle; Ghelmansarai, Farhad; Mitschke, Matthias; Aubin, Michele; Xia Ping; Morin, Olivier; Bucci, Kara; Roach, Mack; Hernandez, Paco; Zheng Zirao; Hristov, Dimitre; Verhey, Lynn

    2005-01-01

    Purpose: The objective of this work was to demonstrate the feasibility of acquiring low-exposure megavoltage cone-beam CT (MV CBCT) three-dimensional (3D) image data of sufficient quality to register the CBCT images to kilovoltage planning CT images for patient alignment and dose verification purposes. Methods and materials: A standard clinical 6-MV Primus linear accelerator, operating in arc therapy mode, and an amorphous-silicon (a-Si) flat-panel electronic portal-imaging device (EPID) were employed. The dose-pulse rate of a 6-MV Primus accelerator beam was windowed to expose an a-Si flat panel by using only 0.02 to 0.08 monitor units (MUs) per image. A triggered image-acquisition mode was designed to produce a high signal-to-noise ratio without pulsing artifacts. Several data sets were acquired for an anthropomorphic head phantom and frozen sheep and pig cadaver heads, as well as for a head-and-neck cancer patient on intensity-modulated radiotherapy (IMRT). For each CBCT image, a set of 90 to 180 projection images incremented by 1 deg to 2 deg was acquired. The two-dimensional (2D) projection images were then synthesized into a 3D image by use of cone-beam CT reconstruction. The resulting MV CBCT image set was used to visualize the 3D bony anatomy and some soft-tissue details. The 3D image registration with the kV planning CT was performed either automatically by application of a maximization of mutual information (MMI) algorithm or manually by aligning multiple 2D slices. Results: Low-noise 3D MV CBCT images without pulsing artifacts were acquired with a total delivered dose that ranged from 5 to 15 cGy. Acquisition times, including image readout, were on the order of 90 seconds for 180 projection images taken through a continuous gantry rotation of 180 deg . The processing time of the data required an additional 90 seconds for the reconstruction of a 256 3 cube with 1.0-mm voxel size. Implanted gold markers (1 mm x 3 mm) were easily visible for all exposure

  8. 4D offline PET-based treatment verification in ion beam therapy. Experimental and clinical evaluation

    International Nuclear Information System (INIS)

    Kurz, Christopher

    2014-01-01

    Due to the accessible sharp dose gradients, external beam radiotherapy with protons and heavier ions enables a highly conformal adaptation of the delivered dose to arbitrarily shaped tumour volumes. However, this high conformity is accompanied by an increased sensitivity to potential uncertainties, e.g., due to changes in the patient anatomy. Additional challenges are imposed by respiratory motion which does not only lead to rapid changes of the patient anatomy, but, in the cased of actively scanned ions beams, also to the formation of dose inhomogeneities. Therefore, it is highly desirable to verify the actual application of the treatment and to detect possible deviations with respect to the planned irradiation. At present, the only clinically implemented approach for a close-in-time verification of single treatment fractions is based on detecting the distribution of β + -emitter formed in nuclear fragmentation reactions during the irradiation by means of positron emission tomography (PET). For this purpose, a commercial PET/CT (computed tomography) scanner has been installed directly next to the treatment rooms at the Heidelberg Ion-Beam Therapy Center (HIT). Up to present, the application of this treatment verification technique is, however, still limited to static target volumes. This thesis aimed at investigating the feasibility and performance of PET-based treatment verification under consideration of organ motion. In experimental irradiation studies with moving phantoms, not only the practicability of PET-based treatment monitoring for moving targets, using a commercial PET/CT device, could be shown for the first time, but also the potential of this technique to detect motion-related deviations from the planned treatment with sub-millimetre accuracy. The first application to four exemplary hepato-cellular carcinoma patient cases under substantially more challenging clinical conditions indicated potential for improvement by taking organ motion into

  9. Optimized treatment parameters to account for interfractional variability in scanned ion beam therapy of lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Brevet, Romain

    2015-02-04

    Scanned ion beam therapy of lung tumors is severely limited in its clinical applicability by intrafractional organ motion, interference effects between beam and tumor motion (interplay) as well as interfractional anatomic changes. To compensate for dose deterioration by intrafractional motion, motion mitigation techniques, such as gating have been developed. The latter confines the irradiation to a predetermined breathing state, usually the stable end-exhale phase. However, optimization of the treatment parameters is needed to further improve target dose coverage and normal tissue sparing. The aim of the study presented in this dissertation was to determine treatment planning parameters that permit to recover good target coverage and homogeneity during a full course of lung tumor treatments. For 9 lung tumor patients from MD Anderson Cancer Center (MDACC), a total of 70 weekly time-resolved computed tomography (4DCT) datasets were available, which depict the evolution of the patient anatomy over the several fractions of the treatment. Using the GSI in-house treatment planning system (TPS) TRiP4D, 4D simulations were performed on each weekly 4DCT for each patient using gating and optimization of a single treatment plan based on a planning CT acquired prior to treatment. It was found that using a large beam spot size, a short gating window (GW), additional margins and multiple fields permitted to obtain the best results, yielding an average target coverage (V95) of 96.5%. Two motion mitigation techniques, one approximating the rescanning process (multiple irradiations of the target with a fraction of the planned dose) and one combining the latter and gating, were then compared to gating. Both did neither show an improvement in target dose coverage nor in normal tissue sparing. Finally, the total dose delivered to each patient in a simulation of a fractioned treatment was calculated and clinical requirements in terms of target coverage and normal tissue sparing were

  10. Randomized Clinical Trial Comparing Proton Beam Radiation Therapy with Transarterial Chemoembolization for Hepatocellular Carcinoma: Results of an Interim Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bush, David A., E-mail: dbush@llu.edu [Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, California (United States); Smith, Jason C. [Department of Diagnostic Radiology, Loma Linda University Medical Center, Loma Linda, California (United States); Slater, Jerry D. [Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, California (United States); Volk, Michael L. [Transplantation Institute and Liver Center, Loma Linda University Medical Center, Loma Linda, California (United States); Reeves, Mark E. [VA Loma Linda Health Care System, Loma Linda, California (United States); Cheng, Jason [Transplantation Institute and Liver Center, Loma Linda University Medical Center, Loma Linda, California (United States); Grove, Roger [Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, California (United States); Vera, Michael E. de [Transplantation Institute and Liver Center, Loma Linda University Medical Center, Loma Linda, California (United States)

    2016-05-01

    Purpose: To describe results of a planned interim analysis of a prospective, randomized clinical trial developed to compare treatment outcomes among patients with newly diagnosed hepatocellular carcinoma (HCC). Methods and Materials: Eligible subjects had either clinical or pathologic diagnosis of HCC and met either Milan or San Francisco transplant criteria. Patients were randomly assigned to transarterial chemoembolization (TACE) or to proton beam radiation therapy. Patients randomized to TACE received at least 1 TACE with additional TACE for persistent disease. Proton beam radiation therapy was delivered to all areas of gross disease to a total dose of 70.2 Gy in 15 daily fractions over 3 weeks. The primary endpoint was progression-free survival, with secondary endpoints of overall survival, local tumor control, and treatment-related toxicities as represented by posttreatment days of hospitalization. Results: At the time of this analysis 69 subjects were available for analysis. Of these, 36 were randomized to TACE and 33 to proton. Total days of hospitalization within 30 days of TACE/proton was 166 and 24 days, respectively (P<.001). Ten TACE and 12 proton patients underwent liver transplantation after treatment. Viable tumor identified in the explanted livers after TACE/proton averaged 2.4 and 0.9 cm, respectively. Pathologic complete response after TACE/proton was 10%/25% (P=.38). The 2-year overall survival for all patients was 59%, with no difference between treatment groups. Median survival time was 30 months (95% confidence interval 20.7-39.3 months). There was a trend toward improved 2-year local tumor control (88% vs 45%, P=.06) and progression-free survival (48% vs 31%, P=.06) favoring the proton beam treatment group. Conclusions: This interim analysis indicates similar overall survival rates for proton beam radiation therapy and TACE. There is a trend toward improved local tumor control and progression-free survival with proton beam. There are

  11. Adjuvant Proton Beam Therapy in the Management of Thymoma: A Dosimetric Comparison and Acute Toxicities.

    Science.gov (United States)

    Parikh, Rahul R; Rhome, Ryan; Hug, Eugen; Tsai, Henry; Cahlon, Oren; Chon, Brian; Goenka, Anuj

    2016-09-01

    We evaluated the dosimetric differences between proton beam therapy (PBT) and intensity modulated radiation therapy (IMRT) for resected thymoma. We simultaneously report our early clinical experience with PBT in this cohort. We identified 4 patients with thymoma or thymic carcinoma treated at our center from 2012 to 2014 who completed adjuvant PBT to a median dose of 57.0 cobalt Gy equivalents (CGE; range, 50.4-66.6 CGE) after definitive resection. Adjuvant radiation was indicated for positive (n = 3) or close margin (n = 1). Median age was 45 (range, 32-70) years. Stages included II (n = 2), III (n = 1), and IVA (n = 1). Analogous IMRT plans were generated for each patient for comparison, and preset dosimetric endpoints were evaluated. Early toxicities were assessed according to retrospective chart review. Compared with IMRT, PBT was associated with lower mean doses to the lung (4.6 vs. 8.1 Gy; P = .02), esophagus (5.4 vs. 20.6 Gy; P = .003), and heart (6.0 vs. 10.4 Gy; P = .007). Percentages of lung, esophagus, and heart receiving radiation were consistently lower in the PBT plans over a wide range of radiation doses. There was no difference in mean breast dose (2.68 vs. 3.01 Gy; P = .37). Of the 4 patients treated with PBT, 3 patients experienced Grade 1 radiation dermatitis, and 1 patient experienced Grade 2 dermatitis, which resolved after treatment. With a median follow-up of 5.5 months, there were no additional Grade ≥ 2 acute or subacute toxicities, including radiation pneumonitis. PBT is clinically well tolerated after surgical resection of thymoma, and is associated with a significant reduction in dose to critical structures without compromising coverage of the target volume. Prospective evaluation and longer follow-up is needed to assess clinical outcomes and late toxicities. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. The Evolution of External Beam Radiation Therapy (EBRT) from a Technological Perspective.

    Science.gov (United States)

    Detorie, Nicholas

    2008-03-01

    Since the discovery of x-rays by Roentgen in 1895 ionizing radiations have been used as a treatment for cancer. Such treatments have been based on either implantation of radioactive materials at the site of disease or by aiming external radiation beams at the diseased site. This later method is referred to as teletherapy because the beams originate from a location outside of the body distant from the disease site itself. A brief review of the basic radiation biology will be given to illustrate the rationale for therapeutic use of ionizing radiations and the effects of beam energy and beam type- particulate or photon. The remainder of the presentation will focus on the technological teletherapy developments supported by the required physical properties of the beams and their associated characteristics that make them suitable for patient treatments. Chronological highlights will include the following sources or devices: superficial x-rays, orthovaltage x-rays, megavoltage x-rays and Cobalt 60 photons, electron beams, neutron beams, negative pi mesons, protons, and heavy ions. The presentation will illustrate how the physical beam properties have been incorporated into modern radiation treatment devices, many of which are equipped with radiation imaging capability. Such devices include: linacs equipped with multileaf collimators for beam shaping and intensity modulation, the Gamma Knife for precise and accurate irradiation of brain tumors or arterial-venous malformations (AVM), the robotic arm based Cyber Knife, and the Helical Tomotherapy unit.

  13. Can multiparametric MRI replace Roach equations in staging prostate cancer before external beam radiation therapy?

    Energy Technology Data Exchange (ETDEWEB)

    Girometti, Rossano, E-mail: rgirometti@sirm.org [Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia − via Colugna, 50–33100, Udine (Italy); Signor, Marco Andrea, E-mail: marco.signor@asuiud.sanita.fvg.it [Department of Oncological Radiation Therapy, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Piazzale S. M. della Misericordia, 15–33100, Udine (Italy); Pancot, Martina, E-mail: martypancot@libero.it [Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia − via Colugna, 50–33100, Udine (Italy); Cereser, Lorenzo, E-mail: lcereser@sirm.org [Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia − via Colugna, 50–33100, Udine (Italy); Zuiani, Chiara, E-mail: chiara.zuiani@uniud.it [Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia − via Colugna, 50–33100, Udine (Italy)

    2016-12-15

    Purpose: To investigate the agreement between Roach equations (RE) and multiparametric magnetic resonance imaging (mpMRI) in assessing the T-stage of prostate cancer (PCa). Materials and methods: Seventy-three patients with biopsy-proven PCa and previous RE assessment prospectively underwent mpMRI on a 3.0T magnet before external beam radiation therapy (EBRT). Using Cohen’s kappa statistic, we assessed the agreement between RE and mpMRI in defining the T-stage (≥T3 vs.T ≤ 2) and risk category according to the National comprehensive cancer network criteria (≤intermediate vs. ≥high). We also calculated sensitivity and specificity for ≥T3 stage in an additional group of thirty-seven patients with post-prostatectomy histological examination (mpMRI validation group). Results: The agreement between RE and mpMRI in assessing the T stage and risk category was moderate (k = 0.53 and 0.56, respectively). mpMRI changed the T stage and risk category in 21.9% (95%C.I. 13.4–33-4) and 20.5% (95%C.I. 12.3–31.9), respectively, prevalently downstaging PCa compared to RE. Sensitivity and specificity for ≥T3 stage in the mpMRI validation group were 81.8% (95%C.I. 65.1–91.9) and 88.5% (72.8–96.1). Conclusion: RE and mpMRI show moderate agreement only in assessing the T-stage of PCa, translating into an mpMRI-induced change in risk assessment in about one fifth of patients. As supported by high sensitivity/specificity for ≥T3 stage in the validation group, the discrepancy we found is in favour of mpMRI as a tool to stage PCa before ERBT.

  14. Proton Beam Therapy of Stage II and III Non-Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nakayama, Hidetsugu, E-mail: hnakayam@tokyo-med.ac.jp [Proton Medical Research Center, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, Tokyo Medical University, Shinjuku, Tokyo (Japan); Satoh, Hiroaki [Department of Respiratory Medicine, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki (Japan); Sugahara, Shinji [Proton Medical Research Center, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, Tokyo Medical University, Shinjuku, Tokyo (Japan); Kurishima, Koichi [Department of Respiratory Medicine, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki (Japan); Tsuboi, Koji; Sakurai, Hideyuki [Proton Medical Research Center, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki (Japan); Ishikawa, Shigemi [Department of Thoracic Surgery, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki (Japan); Tokuuye, Koichi [Proton Medical Research Center, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki (Japan); Department of Radiation Oncology, Tokyo Medical University, Shinjuku, Tokyo (Japan)

    2011-11-15

    Purpose: The present retrospective study assessed the role of proton beam therapy (PBT) in the treatment of patients with Stage II or III non-small-cell lung cancer who were inoperable or ineligible for chemotherapy because of co-existing disease or refusal. Patients and Methods: Between November 2001 and July 2008, PBT was given to 35 patients (5 patients with Stage II, 12 with Stage IIIA, and 18 with Stage IIIB) whose median age was 70.3 years (range, 47.4-85.4). The median proton dose given was 78.3 Gy (range, 67.1-91.3) (relative biologic effectiveness). Results: Local progression-free survival for Stage II-III patients was 93.3% at 1 year and 65.9% at 2 years during a median observation period of 16.9 months. Four patients (11.4%) developed local recurrence, 13 (37.1%) developed regional recurrence, and 7 (20.0%) developed distant metastases. The progression-free survival rate for Stage II-III patients was 59.6% at 1 year and 29.2% at 2 years. The overall survival rate of Stage II-III patients was 81.8% at 1 year and 58.9% at 2 years. Grade 3 or greater toxicity was not observed. A total of 15 patients (42.9%) developed Grade 1 and 6 (17.1%) Grade 2 toxicity. Conclusion: PBT for Stage II-III non-small-cell lung cancer without chemotherapy resulted in good local control and low toxicity. PBT has a definite role in the treatment of patients with Stage II-III non-small-cell lung cancer who are unsuitable for surgery or chemotherapy.

  15. Feature-based plan adaptation for fast treatment planning in scanned ion beam therapy

    International Nuclear Information System (INIS)

    Chen Wenjing; Gemmel, Alexander; Rietzel, Eike

    2013-01-01

    We propose a plan adaptation method for fast treatment plan generation in scanned ion beam therapy. Analysis of optimized treatment plans with carbon ions indicates that the particle number modulation of consecutive rasterspots in depth shows little variation throughout target volumes with convex shape. Thus, we extract a depth-modulation curve (DMC) from existing reference plans and adapt it for creation of new plans in similar treatment situations. The proposed method is tested with seven CT serials of prostate patients and three digital phantom datasets generated with the MATLAB code. Plans are generated with a treatment planning software developed by GSI using single-field uniform dose optimization for all the CT datasets to serve as reference plans and ‘gold standard’. The adapted plans are generated based on the DMC derived from the reference plans of the same patient (intra-patient), different patient (inter-patient) and phantoms (phantom-patient). They are compared with the reference plans and a re-positioning strategy. Generally, in 1 min on a standard PC, either a physical plan or a biological plan can be generated with the adaptive method provided that the new target contour is available. In all the cases, the V95 values of the adapted plans can achieve 97% for either physical or biological plans. V107 is always 0 indicating no overdosage, and target dose homogeneity is above 0.98 in all cases. The dose received by the organs at risk is comparable to the optimized plans. The plan adaptation method has the potential for on-line adaptation to deal with inter-fractional motion, as well as fast off-line treatment planning, with either the prescribed physical dose or the RBE-weighted dose. (paper)

  16. Low-dose total skin electron beam therapy for cutaneous lymphoma : Minimal risk of acute toxicities.

    Science.gov (United States)

    Kroeger, Kai; Elsayad, Khaled; Moustakis, Christos; Haverkamp, Uwe; Eich, Hans Theodor

    2017-12-01

    Low-dose total skin electron beam therapy (TSEBT) is attracting increased interest for the effective palliative treatment of primary cutaneous T‑cell lymphoma (pCTCL). In this study, we compared toxicity profiles following various radiation doses. We reviewed the records of 60 patients who underwent TSEBT for pCTCL between 2000 and 2016 at the University Hospital of Munster. The treatment characteristics of the radiotherapy (RT) regimens and adverse events (AEs) were then analyzed and compared. In total, 67 courses of TSEBT were administered to 60 patients. Of these patients, 34 (51%) received a standard dose with a median surface dose of 30 Gy and 33 patients (49%) received a low dose with the median surface dose of 12 Gy (7 salvage low-dose TSEBT courses were administered to 5 patients). After a median follow-up of 15 months, the overall AE rate was 100%, including 38 patients (57%) with grade 2 and 7 (10%) with grade 3 AEs. Patients treated with low-dose TSEBT had significantly fewer grade 2 AEs than those with conventional dose regimens (33 vs. 79%, P dose regimen compared to those with the conventional dose regimens (6 vs. 15%, P = 0.78). Multiple/salvage low-dose TSEBT courses were not associated with an increased risk of acute AEs. Low-dose TSEBT regimens are associated with significantly fewer grade 2 acute toxicities compared with conventional doses of TSEBT. Repeated/Salvage low-dose TSEBT, however, appears to be tolerable and can even be applied safely in patients with cutaneous relapses.

  17. Revisiting Low-Dose Total Skin Electron Beam Therapy in Mycosis Fungoides

    Energy Technology Data Exchange (ETDEWEB)

    Harrison, Cameron, E-mail: cameronh@stanford.edu [Department of Dermatology, Stanford Cancer Center, Stanford, California (United States); Young, James; Navi, Daniel [Department of Dermatology, Stanford Cancer Center, Stanford, California (United States); Riaz, Nadeem [Department of Radiation Oncology, Stanford Cancer Center, Stanford, California (United States); Lingala, Bharathi; Kim, Youn [Department of Dermatology, Stanford Cancer Center, Stanford, California (United States); Hoppe, Richard [Department of Radiation Oncology, Stanford Cancer Center, Stanford, California (United States)

    2011-11-15

    Purpose: Total skin electron beam therapy (TSEBT) is a highly effective treatment for mycosis fungoides (MF). The standard course consists of 30 to 36 Gy delivered over an 8- to 10-week period. This regimen is time intensive and associated with significant treatment-related toxicities including erythema, desquamation, anhydrosis, alopecia, and xerosis. The aim of this study was to identify a lower dose alternative while retaining a favorable efficacy profile. Methods and Materials: One hundred two MF patients were identified who had been treated with an initial course of low-dose TSEBT (5-<30 Gy) between 1958 and 1995. Patients had a T stage classification of T2 (generalized patch/plaque, n = 51), T3 (tumor, n = 29), and T4 (erythrodermic, n = 22). Those with extracutaneous disease were excluded. Results: Overall response (OR) rates (>50% improvement) were 90% among patients with T2 to T4 disease receiving 5 to <10 Gy (n = 19). In comparison, OR rates between the 10 to <20 Gy and 20 to <30 Gy subgroups were 98% and 97%, respectively. There was no significant difference in median progression free survival (PFS) in T2 and T3 patients when stratified by dose group, and PFS in each was comparable to that of the standard dose. Conclusions: OR rates associated with low-dose TSEBT in the ranges of 10 to <20 Gy and 20 to <30 Gy are comparable to that of the standard dose ({>=} 30 Gy). Efficacy measures including OS, PFS, and RFS are also favorable. Given that the efficacy profile is similar between 10 and <20 Gy and 20 and <30 Gy, the utility of TSEBT within the lower dose range of 10 to <20 Gy merits further investigation, especially in the context of combined modality treatment.

  18. Phase space generation for proton and carbon ion beams for external users’ applications at the Heidelberg Ion Therapy Center

    Directory of Open Access Journals (Sweden)

    Thomas eTessonnier

    2016-01-01

    Full Text Available In the field of radiation therapy, accurate and robust dose calculation is required. For this purpose, precise modeling of the irradiation system and reliable computational platforms are needed. At the Heidelberg Ion Therapy Center (HIT, the beamline has been already modeled in the FLUKA Monte Carlo code. However, this model was kept confidential for disclosure reasons and was not available for any external team. The main goal of this study was to create efficiently phase space (PS files for proton and carbon ion beams, for all energies and foci available at HIT. PS are representing the characteristics of each particle recorded (charge, mass, energy, coordinates, direction cosines, generation at a certain position along the beam path. In order to achieve this goal, keeping a reasonable data size but maintaining the requested accuracy for the calculation, we developed a new approach of beam PS generation with the Monte-Carlo code FLUKA. The generated PS were obtained using an infinitely narrow beam and recording the desired quantities after the last element of the beamline, with a discrimination of primaries or secondaries. In this way, a unique PS can be used for each energy to accommodate the different foci by combining the narrow-beam scenario with a random sampling of its theoretical Gaussian beam in vacuum. PS can also reproduce the different patterns from the delivery system, when properly combined with the beam scanning information. MC simulations using PS have been compared to simulations including the full beamline geometry and have been found in very good agreement for several cases (depth dose distributions, lateral dose profiles, with relative dose differences below 0.5%. This approach has also been compared with measured data of ion beams with different energies and foci, resulting in a very satisfactory agreement. Hence, the proposed approach was able to fulfill the different requirements and has demonstrated its capability for

  19. Induction chemotherapy with docetaxel, cisplatin and S-1 followed by proton beam therapy concurrent with cisplatin in patients with T4b nasal and sinonasal malignancies

    International Nuclear Information System (INIS)

    Okano, Susumu; Tahara, Makoto; Zenda, Sadamoto

    2012-01-01

    For the treatment of patients with T4b nasal and sinonasal malignancies, definitive chemoradiotherapy was contraindicated due to the risk of brain damage and blindness. However, combination chemotherapy with docetaxel, cisplatin and S-1 is well tolerated and effective. We conducted a retrospective analysis to evaluate the efficacy and feasibility of induction chemotherapy using docetaxel, cisplatin and S-1 followed by proton beam therapy concurrent with cisplatin. Thirteen patients treated with docetaxel, cisplatin and S-1 were analyzed. Docetaxel, cisplatin and S-1 consisted of 60-70 mg/m 2 /day docetaxel on day 1, 70 mg/m 2 /day cisplatin on day 1 and 60-80 mg/m 2 /day S-1 on days 1-14. Treatment was repeated every 3-4 weeks with a maximum number of three treatment cycles. According to the response to docetaxel, cisplatin and S-1, patients received either proton beam therapy concurrent with 20 mg/m 2 /day cisplatin on days 1-4 every 3 weeks or proton beam therapy alone. Neutropenia represented the most common Grade 3/4 hematological toxicity (76.9%), while the most frequently observed non-hematological toxicity was nausea (23.0%). After the completion of docetaxel, cisplatin and S-1, the overall response rate was 38.4% (5 of 13), with 1 patient achieving complete response and 4 patients achieving partial response. Subsequently, 10 patients received proton beam therapy concurrent with cisplatin, 2 received proton beam therapy alone and 1 received palliative radiation. No severe toxicity was observed during proton beam therapy. After the completion of proton beam therapy, 11 patients (84.6%) achieved complete response and no brain damage or blindness occurred. Induction chemotherapy with docetaxel, cisplatin and S-1 followed by proton beam therapy concurrent with cisplatin is well tolerated and displays promising antitumor activity that warrants further investigation. (author)

  20. Beyond the conventional role of external-beam radiation therapy for skeletal metastases: new technologies and stereotactic directions.

    Science.gov (United States)

    Yu, H-H M; Hoffe, S E

    2012-04-01

    Radiation therapy is a common and effective treatment modality in the management of skeletal metastases. Recent advances in technology permitting delivery of an ablative radiation dose with an image-guided stereotactic approach improve the therapeutic threshold. The authors reviewed the literature on conventional external-beam radiation therapy and summarized the emerging data about image-guided stereotactic body radiation therapy (SBRT) for vertebral oligometastasis. Pain control can be achieved effectively with conventional external-beam radiation therapy and may be further improved with image-guided spinal SBRT. Image-guided SBRT allows delivery of an ablative radiation dose with minimal toxicity, may potentially improve local tumor control, and may enhance clinical outcomes for histologies that are considered radioresistant. However, further understanding of long-term normal tissue toxicity is lacking. Radiotherapy options are expanding for patients with skeletal metastases. Image-guided spinal SBRT can deliver a safe ablative radiation dose to improve pain control and potentially local tumor control. Randomized clinical trials are ongoing to assess clinical benefits and outcome with spinal SBRT.

  1. SU-F-T-197: Investigating Optimal Oblique-Beam Arrangement for Bilateral Metallic Prosthesis Prostate Cancer in Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Rana, S; Tesfamicael, B; Park, S [McLaren Proton Therapy Center, Karmanos Cancer Institute at McLaren-Flint, Flint, MI (United States); Zheng, Y; Singh, H; Twyford, T [Procure Proton Therapy Center, Oklahoma City, OK (United States); Cheng, C [Vantage Oncology, West Hills, CA (United States)

    2016-06-15

    Purpose: The main purpose of this study is to investigate the optimum oblique-beam arrangement for bilateral metallic prosthesis prostate cancer treatment in pencil beam scanning (PBS) proton therapy. Methods: A computed tomography dataset of bilateral metallic prosthesis prostate cancer case was selected for this retrospective study. A total of four beams (rightanterior- oblique [RAO], left-anterior-oblique [LAO], left-posterior-oblique [LPO], and right-posterior-oblique [RPO]) were selected for treatment planning. PBS plans were generated using multi-field-optimization technique for a total dose of 79.2 Gy[RBE] to be delivered in 44 fractions. Specifically, five different PBS plans were generated based on 2.5% ± 2 mm range uncertainty using five different beam arrangements (i)LAO+RAO+LPO+RPO, (ii)LAO+RAO, (iii)LPO+RPO, (iv)RAO+LPO, and (v)LAO+RPO. Each PBS plan was optimized by applying identical dose-volume constraints to the PTV, rectum, and bladder. Treatment plans were then compared based on the dose-volume histograms results. Results: The PTV coverage was found to be greater than 99% in all five plans. The homogeneity index (HI) was found to be almost identical (range, 0.03–0.04). The PTV mean dose was found to be comparable (range, 81.0–81.1 Gy[RBE]). For the rectum, the lowest mean dose (8.0 Gy[RBE]) and highest mean dose (31.1 Gy[RBE]) were found in RAO+LAO plan and LPO+RPO plan, respectively. LAO+RAO plan produced the most favorable dosimetric results of the rectum in the medium-dose region (V50) and high-dose region (V70). For the bladder, the lowest (5.0 Gy[RBE]) and highest mean dose (10.3 Gy[RBE]) were found in LPO+RPO plan and RAO+LAO plan, respectively. Other dosimetric results (V50 and V70) of the bladder were slightly better in LPO+RPO plan than in other plans. Conclusion: Dosimetric findings from this study suggest that two anterior-oblique proton beams arrangement (LAO+RAO) is a more favorable option with the possibility of reducing rectal

  2. Audit of high energy therapy beams in hospital oncology departments by the National Radiation Laboratory

    International Nuclear Information System (INIS)

    Smyth, V.G.

    1994-02-01

    In 1993 the output of every high energy radiotherapy beam used clinically in New Zealand was measured by National Radiation Laboratory (NRL) staff using independent dosimetry equipment. The purpose of this was to audit the dosimetry that is used by hospital physicists for the basis of patient treatments, and to uncover any errors that may be clinically significant. This report analyses the uncertainties involved in comparing the NRL and hospital measurements, and presents the results of the 1993 audit. The overall uncertainty turns out to be about 1.5%. The results for linear accelerator photon beams are consistent with a purely random variation within this uncertainty. Electron beams show some small errors beyond the expected uncertainty. Gamma beams have the potential to be the most accurately measured, but in practice are less accurately measured than linear accelerator beams. None of the disagreements indicated an error of clinical significance. 8 refs., 3 figs., 2 tabs

  3. In vivo pink-beam imaging and fast alignment procedure for rat brain lesion microbeam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Serduc, Raphaël, E-mail: raph.serduc@gmail.com; Berruyer, Gilles; Brochard, Thierry; Renier, Michel; Nemoz, Christian [European Synchrotron Radiation Facility, F38043 Grenoble (France)

    2010-05-01

    A fast 50 µm-accuracy alignment procedure has been developed for the radiosurgery of brain lesions in rats, using microbeam radiation therapy. A fast 50 µm-accuracy alignment procedure has been developed for the radiosurgery of brain lesions in rats, using microbeam radiation therapy. In vivo imaging was performed using the pink beam (35–60 keV) produced by the ID17 wiggler at the ESRF opened at 120 mm and filtered. A graphical user interface has been developed in order to define the irradiation field size and to position the target with respect to the skull structures observed in X-ray images. The method proposed here allows tremendous time saving by skipping the swap from white beam to monochromatic beam and vice versa. To validate the concept, the somatosensory cortex or thalamus of GAERS rats were irradiated under several ports using this alignment procedure. The magnetic resonance images acquired after contrast agent injection showed that the irradiations were selectively performed in these two expected brain regions. Image-guided microbeam irradiations have therefore been realised for the first time ever, and, thanks to this new development, the ID17 biomedical beamline provides a major tool allowing brain radiosurgery trials on animal patients.

  4. Optimisation of pulse shape discrimination using EJ299-33 for high energy neutron detection in proton beam therapy

    Science.gov (United States)

    Chung, S.; Kacperek, A.; Speller, R.; Gutierrez, A.

    2017-11-01

    It is widely understood that proton beam therapy has considerable clinical benefits over photon therapy for treating certain types of tumours. Protons deposit most of their energy in a very localised area, the so-called Bragg peak, sparing surrounding healthy tissue and critical organs from radiation. However, secondary neutrons and gamma rays are generated in the beam nozzle and inside the patient. Clinically, it is highly desirable to monitor the neutron dose the patient is exposed to, and this requires a neutron detector sensitive to high energies. EJ299-33 is a solid plastic scintillator capable of discriminating neutrons from gamma rays using pulse shape analysis of scintillation light. EJ299-33 has the potential to detect neutrons with energies up to 100 MeV and does not present leakage and flammability hazards generally associated with liquid scintillators. Experimental measurements with 60Co, 137Cs and 241AmBe sources were performed to calibrate and optimise pulse shape discrimination parameters. We also performed experimental measurements at the Clatterbridge Cancer Centre in a 60 MeV passive scattered beam to detect high energy neutrons.

  5. A set cover approach to fast beam orientation optimization in intensity modulated radiation therapy for total marrow irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chieh-Hsiu Jason; Aleman, Dionne M [Department of Mechanical and Industrial Engineering, University of Toronto, 5 King' s College Road, Toronto, ON M5S 3G8 (Canada); Sharpe, Michael B, E-mail: chjlee@mie.utoronto.ca, E-mail: aleman@mie.utoronto.ca, E-mail: michael.sharpe@rmp.uhn.on.ca [Princess Margaret Hospital, Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, ON M5G 2M9 (Canada)

    2011-09-07

    The beam orientation optimization (BOO) problem in intensity modulated radiation therapy (IMRT) treatment planning is a nonlinear problem, and existing methods to obtain solutions to the BOO problem are time consuming due to the complex nature of the objective function and size of the solution space. These issues become even more difficult in total marrow irradiation (TMI), where many more beams must be used to cover a vastly larger treatment area than typical site-specific treatments (e.g., head-and-neck, prostate, etc). These complications result in excessively long computation times to develop IMRT treatment plans for TMI, so we attempt to develop methods that drastically reduce treatment planning time. We transform the BOO problem into the classical set cover problem (SCP) and use existing methods to solve SCP to obtain beam solutions. Although SCP is NP-Hard, our methods obtain beam solutions that result in quality treatments in minutes. We compare our approach to an integer programming solver for the SCP to illustrate the speed advantage of our approach.

  6. Proton Beam Therapy Versus Conformal Photon Radiation Therapy for Childhood Craniopharyngioma: Multi-institutional Analysis of Outcomes, Cyst Dynamics, and Toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, Andrew J. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Greenfield, Brad [Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas (United States); Mahajan, Anita [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Paulino, Arnold C. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas (United States); Okcu, M. Fatih [Department of Pediatrics, Texas Children' s Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Chintagumpala, Murali [Department of Pediatrics, Texas Children' s Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas (United States); Kahalley, Lisa S. [Section of Psychology, Texas Children' s Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas (United States); McAleer, Mary F.; McGovern, Susan L. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Whitehead, William E. [Department of Neurosurgery, Texas Children' s Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas (United States); Grosshans, David R., E-mail: dgrossha@mdanderson.org [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2014-10-01

    Purpose: We compared proton beam therapy (PBT) with intensity modulated radiation therapy (IMRT) for pediatric craniopharyngioma in terms of disease control, cyst dynamics, and toxicity. Methods and Materials: We reviewed records from 52 children treated with PBT (n=21) or IMRT (n=31) at 2 institutions from 1996-2012. Endpoints were overall survival (OS), disease control, cyst dynamics, and toxicity. Results: At 59.6 months' median follow-up (PBT 33 mo vs IMRT 106 mo; P<.001), the 3-year outcomes were 96% for OS, 95% for nodular failure-free survival and 76% for cystic failure-free survival. Neither OS nor disease control differed between treatment groups (OS P=.742; nodular failure-free survival P=.546; cystic failure-free survival P=.994). During therapy, 40% of patients had cyst growth (20% requiring intervention); immediately after therapy, 17 patients (33%) had cyst growth (transient in 14), more commonly in the IMRT group (42% vs 19% PBT; P=.082); and 27% experienced late cyst growth (32% IMRT, 19% PBT; P=.353), with intervention required in 40%. Toxicity did not differ between groups. On multivariate analysis, cyst growth was related to visual and hypothalamic toxicity (P=.009 and .04, respectively). Patients given radiation as salvage therapy (for recurrence) rather than adjuvant therapy had higher rates of visual and endocrine (P=.017 and .024, respectively) dysfunction. Conclusions: Survival and disease-control outcomes were equivalent for PBT and IMRT. Cyst growth is common, unpredictable, and should be followed during and after therapy, because it contributes to late toxicity. Delaying radiation therapy until recurrence may result in worse visual and endocrine function.

  7. Prospective study of proton-beam radiation therapy for limited-stage small cell lung cancer.

    Science.gov (United States)

    Rwigema, Jean-Claude M; Verma, Vivek; Lin, Liyong; Berman, Abigail T; Levin, William P; Evans, Tracey L; Aggarwal, Charu; Rengan, Ramesh; Langer, Corey; Cohen, Roger B; Simone, Charles B

    2017-11-01

    Existing data supporting the use of proton-beam therapy (PBT) for limited-stage small cell lung cancer (LS-SCLC) are limited to a single 6-patient case series. This is the first prospective study to evaluate clinical outcomes and toxicities of PBT for LS-SCLC. This study prospectively analyzed patients with primary, nonrecurrent LS-SCLC definitively treated with PBT and concurrent chemotherapy from 2011 to 2016. Clinical backup intensity-modulated radiotherapy (IMRT) plans were generated for each patient and were compared with PBT plans. Outcome measures included local control (LC), recurrence-free survival (RFS), and overall survival (OS) rates and toxicities. Thirty consecutive patients were enrolled and evaluated. The median dose was 63.9 cobalt gray equivalents (range, 45-66.6 cobalt gray equivalents) in 33 to 37 fractions delivered daily (n = 18 [60.0%]) or twice daily (n = 12 [40.0%]). The concurrent chemotherapy was cisplatin/etoposide (n = 21 [70.0%]) or carboplatin/etoposide (n = 9 [30.0%]). In comparison with the backup IMRT plans, PBT allowed statistically significant reductions in the cord, heart, and lung mean doses and the volume receiving at least 5 Gy but not in the esophagus mean dose or the lung volume receiving at least 20 Gy. At a median follow-up of 14 months, the 1-/2-year LC and RFS rates were 85%/69% and 63%/42%, respectively. The median OS was 28.2 months, and the 1-/2-year OS rates were 72%/58%. There was 1 case each (3.3%) of grade 3 or higher esophagitis, pneumonitis, anorexia, and pericardial effusion. Grade 2 pneumonitis and esophagitis were seen in 10.0% and 43.3% of patients, respectively. In the first prospective registry study and largest analysis to date of PBT for LS-SCLC, PBT was found to be safe with a limited incidence of high-grade toxicities. Cancer 2017;123:4244-4251. © 2017 American Cancer Society. © 2017 American Cancer Society.

  8. Total skin high-dose-rate electron therapy dosimetry using TG-51

    International Nuclear Information System (INIS)

    Gossman, Michael S.; Sharma, Subhash C.

    2004-01-01

    An approach to dosimetry for total skin electron therapy (TSET) is discussed using the currently accepted TG-51 high-energy calibration protocol. The methodology incorporates water phantom data for absolute calibration and plastic phantom data for efficient reference dosimetry. The scheme is simplified to include the high-dose-rate mode conversion and provides support for its use, as it becomes more available on newer linear accelerators. Using a 6-field, modified Stanford technique, one may follow the process for accurate determination of absorbed dose

  9. Applications of linac-mounted kilovoltage Cone-beam Computed Tomography in modern radiation therapy: A review.

    Science.gov (United States)

    Srinivasan, Kavitha; Mohammadi, Mohammad; Shepherd, Justin

    2014-01-01

    The use of Cone-beam Computed Tomography (CBCT) in radiotherapy is increasing due to the widespread implementation of kilovoltage systems on the currently available linear accelerators. Cone beam CT acts as an effective Image-Guided Radiotherapy (IGRT) tool for the verification of patient position. It also opens up the possibility of real-time re-optimization of treatment plans for Adaptive Radiotherapy (ART). This paper reviews the most prominent applications of CBCT (linac-mounted) in radiation therapy, focusing on CBCT-based planning and dose calculation studies. This is followed by a concise review of the main issues associated with CBCT, such as imaging artifacts, dose and image quality. It explores how medical physicists and oncologists can best apply CBCT for therapeutic applications.

  10. Clinical features of refractory radiation esophageal ulcer after proton beam therapy and its management in a patient with esophageal cancer

    International Nuclear Information System (INIS)

    Hisakura, Katsuji; Terashima, Hideo; Nagai, Kentaro

    2012-01-01

    It has been reported that proton beam therapy is an effective treatment method for patients with locally confined esophageal cancer. However, there seems to be serious problems related to post-radiotherapy (RT) esophageal ulcers. We treated 7 patients who developed post-RT esophageal ulcers with the earliest symptom of esophageal stenosis, which was observed 7-17 months (median, 10.0) after completion of RT. Five of the patients had unhealed ulcers leading to lethal events such as perforation or penetration. The mean time between the appearance of the earliest symptom and lethal episode was no more than 2 months (mean, 2.1). The first 3 patients who underwent conservative therapies died from severe complications caused by perforation or penetration of post-RT esophageal ulcers. In the case of 2 consecutive patients, we performed surgical treatment as soon as possible since there were indications of penetration in post-RT developed esophageal ulcers. Therefore, they could be cured by a salvage operation which was subtotal esophagectomy using the stomach for esophageal replacement. Through the above-mentioned experience, we discussed surgical management for esophageal ulcers after proton beam therapy. (author)

  11. Physics and radiobiology of heavy charged particles in relation to the use of ion beams for therapy

    International Nuclear Information System (INIS)

    Kraft, G.; Haberer, T.; Schardt, D.; Scholz, M.

    1993-07-01

    Heavy charged particles are the most advanced tool of an external subcutane radiotherapy of deep seated tumors. Small angular- and lateral-scattering and the increase of the energy deposition with penetration depth are the physical basis for a more efficient tumor targeting. High biological efficiency in the tumor is the prerequisite for a successful treatment of tumors radioresistant against sparsely ionizing radiation. The possibility to perform target conform irradiation and to control the achieved/actual distribution using PET techniques guarantees that biological highly efficient stepping particles can be restricted to the tumor volume only. Although the physical and radiobiological properties of ion beams are very favourable for therapy, the necessity to produce these particles in an accelerator restricts a general application of heavy ions up to now. Presently the heavy ion accelerator SIS at GSI is the only source of heavy ion beams, sufficient in energy and intensity for therapy. A therapy unit is in preparation at GSI, the status of this project is given at the end of the paper. (orig.)

  12. Cone beam CT imaging with limited angle of projections and prior knowledge for volumetric verification of non-coplanar beam radiation therapy: a proof of concept study

    International Nuclear Information System (INIS)

    Meng, Bowen; Xing, Lei; Han, Bin; Koong, Albert; Chang, Daniel; Li, Ruijiang; Cheng, Jason

    2013-01-01

    Non-coplanar beams are important for treatment of both cranial and noncranial tumors. Treatment verification of such beams with couch rotation/kicks, however, is challenging, particularly for the application of cone beam CT (CBCT). In this situation, only limited and unconventional imaging angles are feasible to avoid collision between the gantry, couch, patient, and on-board imaging system. The purpose of this work is to develop a CBCT verification strategy for patients undergoing non-coplanar radiation therapy. We propose an image reconstruction scheme that integrates a prior image constrained compressed sensing (PICCS) technique with image registration. Planning CT or CBCT acquired at the neutral position is rotated and translated according to the nominal couch rotation/translation to serve as the initial prior image. Here, the nominal couch movement is chosen to have a rotational error of 5° and translational error of 8 mm from the ground truth in one or more axes or directions. The proposed reconstruction scheme alternates between two major steps. First, an image is reconstructed using the PICCS technique implemented with total-variation minimization and simultaneous algebraic reconstruction. Second, the rotational/translational setup errors are corrected and the prior image is updated by applying rigid image registration between the reconstructed image and the previous prior image. The PICCS algorithm and rigid image registration are alternated iteratively until the registration results fall below a predetermined threshold. The proposed reconstruction algorithm is evaluated with an anthropomorphic digital phantom and physical head phantom. The proposed algorithm provides useful volumetric images for patient setup using projections with an angular range as small as 60°. It reduced the translational setup errors from 8 mm to generally <1 mm and the rotational setup errors from 5° to <1°. Compared with the PICCS algorithm alone, the integration of rigid

  13. Comparación de las técnicas Kato-Katz, TSET y TSR en el diagnóstico de infección por Fasciola hepatica en humanos

    Directory of Open Access Journals (Sweden)

    Nelson Uribe Delgado

    2012-12-01

    Full Text Available Introducción: La Fasciolosis es una enfermedad causada por el parásito Fasciola hepatica, que afecta primordialmente a bovinos, ovinos, caprinos y en algunas zonas de forma endémica a los humanos. En la investigación clínica y epidemiológica de fasciolosis humana es importante contar con técnicas coprológicas de diagnóstico de alta sensibilidad y especificidad. Objetivo: realizar la comparación de tres técnicas coprológicas para el diagnóstico de infección por Fasciola hepatica en humanos. Metodología: se procesaron 200 gramos de materia fecal de humanos contaminada experimentalmente con huevos de F. hepatica que se obtuvieron de análisis anteriores con muestras de ganado bovino y ovino. La muestra se dividió en 10 partes iguales; a cada una de estas muestras se les realizó la técnicas de Kato-Katz, técnica de sedimentación espontánea en tubo (TSET y técnica de sedimentación rápida (TSR. Finalmente, la lectura de las muestras se basó en el diseño metodológico del doble ciego. Resultados: se encontró que la técnica de sedimentación rápida fue la más sensible de las tres evaluadas, detectándose positividad en 7,5 muestras de 10 analizadas; seguida por la técnica de Kato-Katz con 4,5 muestras y en último lugar la técnica de sedimentación espontánea en Tubo que mostró solo un resultado positivo. Conclusión: en este trabajo se encontró que la técnica de sedimentación rápida constituye la herramienta de elección para el profesional porque es la más sensible de las tres; además de ser sencilla, económica y de fácil aplicación en laboratorios de niveles uno y dos de complejidad para realizar un diagnóstico satisfactorio de fasciolosis humana. Salud UIS 2012; 44 (3: 7-12

  14. Neoadjuvant hormonal therapy and external-beam radiotherapy versus external-beam irradiation alone for prostate cancer. A quality-of-life analysis

    Energy Technology Data Exchange (ETDEWEB)

    Pinkawa, Michael; Piroth, Marc D.; Asadpour, Branka; Gagel, Bernd; Fischedick, Karin; Siluschek, Jaroslav; Kehl, Mareike; Krenkel, Barbara; Eble, Michael J. [RWTH Aachen (Germany). Dept. of Radiotherapy

    2009-02-15

    To evaluate the impact of neoadjuvant hormonal therapy (NHT) on quality of life after external-beam radiotherapy (EBRT) for prostate cancer. A group of 170 patients (85 with and 85 without NHT) has been surveyed prospectively before EBRT (70.2-72 Gy), at the last day of EBRT, a median time of 2 months and 15 months after EBRT using a validated questionnaire (Expanded Prostate Cancer Index Composite). Pairs with and without NHT (median treatment time of 3.5 months before EBRT) were matched according to the respective planning target volume and prostate volume. Before EBRT, significantly lower urinary function/bother, sexual function and hormonal function/bother scores were found for patients with NHT. More than 1 year after EBRT, only sexual function scores remained lower. In a multivariate analysis, NHT and adjuvant hormonal therapy (HT) versus NHT only (hazard ratio 14; 95% confidence interval 2.7-183; p = 0.02) and luteinizing hormone-releasing hormone (LHRH) agonists versus antiandrogens (hazard ratio 3.6; 95% confidence interval 1.1-12; p = 0.04) proved to be independent risk factors for long-term erectile dysfunction (no or very poor ability to have an erection). With the exception of sexual function (additional adjuvant HT and application of LHRH analog independently adverse), short-term NHT was not found to decrease quality of life after EBRT for prostate cancer. (orig.)

  15. Fred: a GPU-accelerated fast-Monte Carlo code for rapid treatment plan recalculation in ion beam therapy

    Science.gov (United States)

    Schiavi, A.; Senzacqua, M.; Pioli, S.; Mairani, A.; Magro, G.; Molinelli, S.; Ciocca, M.; Battistoni, G.; Patera, V.

    2017-09-01

    Ion beam therapy is a rapidly growing technique for tumor radiation therapy. Ions allow for a high dose deposition in the tumor region, while sparing the surrounding healthy tissue. For this reason, the highest possible accuracy in the calculation of dose and its spatial distribution is required in treatment planning. On one hand, commonly used treatment planning software solutions adopt a simplified beam-body interaction model by remapping pre-calculated dose distributions into a 3D water-equivalent representation of the patient morphology. On the other hand, Monte Carlo (MC) simulations, which explicitly take into account all the details in the interaction of particles with human tissues, are considered to be the most reliable tool to address the complexity of mixed field irradiation in a heterogeneous environment. However, full MC calculations are not routinely used in clinical practice because they typically demand substantial computational resources. Therefore MC simulations are usually only used to check treatment plans for a restricted number of difficult cases. The advent of general-purpose programming GPU cards prompted the development of trimmed-down MC-based dose engines which can significantly reduce the time needed to recalculate a treatment plan with respect to standard MC codes in CPU hardware. In this work, we report on the development of fred, a new MC simulation platform for treatment planning in ion beam therapy. The code can transport particles through a 3D voxel grid using a class II MC algorithm. Both primary and secondary particles are tracked and their energy deposition is scored along the trajectory. Effective models for particle-medium interaction have been implemented, balancing accuracy in dose deposition with computational cost. Currently, the most refined module is the transport of proton beams in water: single pencil beam dose-depth distributions obtained with fred agree with those produced by standard MC codes within 1-2% of the

  16. First full-beam PET acquisitions in proton therapy with a modular dual-head dedicated system

    Science.gov (United States)

    Sportelli, G.; Belcari, N.; Camarlinghi, N.; Cirrone, G. A. P.; Cuttone, G.; Ferretti, S.; Kraan, A.; Ortuño, J. E.; Romano, F.; Santos, A.; Straub, K.; Tramontana, A.; Del Guerra, A.; Rosso, V.

    2014-01-01

    During particle therapy irradiation, positron emitters with half-lives ranging from 2 to 20 min are generated from nuclear processes. The half-lives are such that it is possible either to detect the positron signal in the treatment room using an in-beam positron emission tomography (PET) system, right after the irradiation, or to quickly transfer the patient to a close PET/CT scanner. Since the activity distribution is spatially correlated with the dose, it is possible to use PET imaging as an indirect method to assure the quality of the dose delivery. In this work, we present a new dedicated PET system able to operate in-beam. The PET apparatus consists in two 10 cm × 10 cm detector heads. Each detector is composed of four scintillating matrices of 23 × 23 LYSO crystals. The crystal size is 1.9 mm × 1.9 mm × 16 mm. Each scintillation matrix is read out independently with a modularized acquisition system. The distance between the two opposing detector heads was set to 20 cm. The system has very low dead time per detector area and a 3 ns coincidence window, which is capable to sustain high single count rates and to keep the random counts relatively low. This allows a new full-beam monitoring modality that includes data acquisition also while the beam is on. The PET system was tested during the irradiation at the CATANA (INFN, Catania, Italy) cyclotron-based proton therapy facility. Four acquisitions with different doses and dose rates were analysed. In all cases the random to total coincidences ratio was equal or less than 25%. For each measurement we estimated the accuracy and precision of the activity range on a set of voxel lines within an irradiated PMMA phantom. Results show that the inclusion of data acquired during the irradiation, referred to as beam-on data, improves both the precision and accuracy of the range measurement with respect to data acquired only after irradiation. Beam-on data alone are enough to give precisions better than 1 mm

  17. TU-CD-304-07: Intensity Modulated Electron Beam Therapy Employing Small Fields in Virtual Scanning Mode

    International Nuclear Information System (INIS)

    Rodrigues, A; Yin, F; Wu, Q; Liang, B

    2015-01-01

    Purpose: Dynamic electron radiation therapies such as dynamic electron arc radiotherapy (DEAR) utilize small fields to provide target conformity and fluence modulation. The purpose of this study is to demonstrate the feasibility of virtual scanning mode using small fields. Methods: Monte Carlo simulations (EGSnrc/BEAMnrc/DOSXYZnrc) were performed using validated Varian TrueBeam phase space files for electron beam energies of 6, 9, 12, and 16 MeV and square/circular fields (1×1/1, 2×2/2, 3×3/3, 4×4/4, 5×5/5 cm 2 /cm diameter). Resulting dose distributions (kernels) were used for subsequent calculations. The following analyses were performed: (1) Comparison of composite square fields and reference 10×10 cm 2 dose distributions and (2) Scanning beam deliveries for square and circular fields realized as the convolution of kernels and scanning pattern. Preliminary beam weight and pattern optimization were also performed. Two linear scans of 10 cm with/without overlap were modeled. Comparison metrics included depth and orthogonal profiles at dmax. Results: (1) Composite fields regained reference depth dose profiles for most energies and fields within 5%. Smaller kernels and higher energies increased dose in the build-up and Bremsstrahlung region (30%, 16MeV and 1×1 cm 2 ), while reference dmax was maintained for all energies and composite fields. Smaller kernels (<2×2 cm 2 ) maintained penumbra and field size within 0.2 cm, and flatness within 2%. Deterioration of penumbra for larger kernels (5×5 cm 2 ) were observed. Balancing desirable dosimetry and efficiencies suggests that smaller kernels are used at edges and larger kernels in the center of the target. (2) Beam weight optimization improved cross-plane penumbra (0.2 cm) and increased the field size (0.4 cm) on average. In-plane penumbra and field size remained unchanged. Overlap depended on kernel size and optimal overlap resulted in flatness ±2%. Conclusion: Dynamic electron beam therapy in virtual

  18. TU-FG-BRB-12: Real-Time Visualization of Discrete Spot Scanning Proton Therapy Beam for Quality Assurance

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, Y [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo, Hokkaido (Japan); Jenkins, C; Yang, Y; Xing, L [Stanford University, Stanford, California (United States); Yoshimura, T; Fujii, Y [Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido (Japan); Umegaki, K [Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Hokkaido (Japan)

    2016-06-15

    Purpose: With the growing adoption of proton beam therapy there is an increasing need for effective and user-friendly tools for performing quality assurance (QA) measurements. The speed and versatility of spot-scanning proton beam (PB) therapy systems present unique challenges for traditional QA tools. To address these challenges a proof-of-concept system was developed to visualize, in real-time, the delivery of individual spots from a spot-scanning PB in order to perform QA measurements. Methods: The PB is directed toward a custom phantom with planar faces coated with a radioluminescent phosphor (Gd2O2s:Tb). As the proton beam passes through the phantom visible light is emitted from the coating and collected by a nearby CMOS camera. The images are processed to determine the locations at which the beam impinges on each face of the phantom. By so doing, the location of each beam can be determined relative to the phantom. The cameras are also used to capture images of the laser alignment system. The phantom contains x-ray fiducials so that it can be easily located with kV imagers. Using this data several quality assurance parameters can be evaluated. Results: The proof-of-concept system was able to visualize discrete PB spots with energies ranging from 70 MeV to 220 MeV. Images were obtained with integration times ranging from 20 to 0.019 milliseconds. If not limited by data transmission, this would correspond to a frame rate of 52,000 fps. Such frame rates enabled visualization of individual spots in real time. Spot locations were found to be highly correlated (R{sup 2}=0.99) with the nozzle-mounted spot position monitor indicating excellent spot positioning accuracy Conclusion: The system was shown to be capable of imaging individual spots for all clinical beam energies. Future development will focus on extending the image processing software to provide automated results for a variety of QA tests.

  19. TU-FG-BRB-12: Real-Time Visualization of Discrete Spot Scanning Proton Therapy Beam for Quality Assurance

    International Nuclear Information System (INIS)

    Matsuzaki, Y; Jenkins, C; Yang, Y; Xing, L; Yoshimura, T; Fujii, Y; Umegaki, K

    2016-01-01

    Purpose: With the growing adoption of proton beam therapy there is an increasing need for effective and user-friendly tools for performing quality assurance (QA) measurements. The speed and versatility of spot-scanning proton beam (PB) therapy systems present unique challenges for traditional QA tools. To address these challenges a proof-of-concept system was developed to visualize, in real-time, the delivery of individual spots from a spot-scanning PB in order to perform QA measurements. Methods: The PB is directed toward a custom phantom with planar faces coated with a radioluminescent phosphor (Gd2O2s:Tb). As the proton beam passes through the phantom visible light is emitted from the coating and collected by a nearby CMOS camera. The images are processed to determine the locations at which the beam impinges on each face of the phantom. By so doing, the location of each beam can be determined relative to the phantom. The cameras are also used to capture images of the laser alignment system. The phantom contains x-ray fiducials so that it can be easily located with kV imagers. Using this data several quality assurance parameters can be evaluated. Results: The proof-of-concept system was able to visualize discrete PB spots with energies ranging from 70 MeV to 220 MeV. Images were obtained with integration times ranging from 20 to 0.019 milliseconds. If not limited by data transmission, this would correspond to a frame rate of 52,000 fps. Such frame rates enabled visualization of individual spots in real time. Spot locations were found to be highly correlated (R 2 =0.99) with the nozzle-mounted spot position monitor indicating excellent spot positioning accuracy Conclusion: The system was shown to be capable of imaging individual spots for all clinical beam energies. Future development will focus on extending the image processing software to provide automated results for a variety of QA tests.

  20. Accuracy of a Cone-Beam CT Virtual Parenchymal Perfusion Algorithm for Liver Cancer Targeting during Intra-arterial Therapy.

    Science.gov (United States)

    Derbel, Haytham; Kobeiter, Hicham; Pizaine, Guillaume; Ridouani, Fourat; Luciani, Alain; Radaelli, Alessandro; Van der Sterren, William; Chiaradia, Mélanie; Tacher, Vania

    2018-02-01

    To evaluate accuracy of virtual parenchymal perfusion (VPP) algorithm developed for targeting liver cancer during intra-arterial therapy (IAT) using cone-beam CT guidance. VPP was retrospectively applied to 15 patients who underwent IAT for liver cancer. Virtual territory (VT) was estimated after positioning a virtual injection point on nonselective dual-phase (DP) cone-beam CT images acquired during hepatic arteriography at the same position chosen for selective treatment. Targeted territory (TT) was used as the gold standard and was defined by parenchymal phase enhancement of selective DP cone-beam CT performed before treatment start. Qualitative evaluation of anatomic conformity between VT and TT was performed using a 3-rank scale (poor, acceptable, excellent) by 3 double-blinded readers. VT and TT were also quantitatively compared using spatial overlap-based (Dice similarity coefficient [DSC], sensitivity, and positive predictive value), distance-based (mean surface distance [MSD]), and volume-based (absolute volume error and correlation between pairwise volumes) metrics. Interreader agreement was evaluated for the 2 evaluation methods. Eighteen DP cone-beam CT scans were performed. Qualitative evaluation showed excellent overlap between VT and TT in 88.9%-94.4%, depending on the readers. DSC was 0.78 ± 0.1, sensitivity was 80%, positive predictive value was 83%, and MSD was 5.1 mm ± 2.4. Absolute volume error was 15%, and R 2 Pearson correlation factor was 0.99. Interreader agreement was good for both qualitative and quantitative evaluations. VPP algorithm is accurate and reliable in identification of liver arterial territories during IAT using cone-beam CT guidance. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  1. SU-E-T-14: A Feasibility Study of Using Modified AP Proton Beam for Post-Operative Pancreatic Cancer Therapy

    International Nuclear Information System (INIS)

    Ding, X; Witztum, A; Kenton, O; Younan, F; Dormer, J; Kremmel, E; Lin, H; Liu, H; Tang, S; Both, S; Kassaee, A; Avery, S

    2014-01-01

    Purpose: Due to the unpredictability of bowel gas movement, the PA beam direction is always favored for robust proton therapy in post-operative pancreatic cancer treatment. We investigate the feasibility of replacing PA beam with a modified AP beam to take the bowel gas uncertainty into account. Methods: Nine post-operative pancreatic cancer patients treated with proton therapy (5040cGy, 28 fractions) in our institution were randomly selected. The original plan uses PA and lateral direction passive-scattering proton beams. Beam weighting is about 1:1. All patients received weekly verification CTs to assess the daily variations(total 17 verification CTs). The PA direction beam was replaced by two other groups of AP direction beam. Group AP: takes 3.5% range uncertainty into account. Group APmod: compensates the bowel gas uncertainty by expanding the proximal margin to 2cm more. The 2cm margin was acquired from the average bowel diameter in from 100 adult abdominal CT scans near pancreatic region (+/- 5cm superiorly and inferiorly). Dose Volume Histograms(DVHs) of the verification CTs were acquired for robustness study. Results: Without the lateral beam, Group APmod is as robust as Group PA. In Group AP, more than 10% of iCTV D98/D95 were reduced by 4–8%. LT kidney and Liver dose robustness are not affected by the AP/PA beam direction. There is 10% of chance that RT kidney and cord will be hit by AP proton beam due to the bowel gas. Compared to Group PA, APmod plan reduced the dose to kidneys and cord max significantly, while there is no statistical significant increase in bowel mean dose. Conclusion: APmod proton beam for the target coverage could be as robust as the PA direction without sacrificing too much of bowel dose. When the AP direction beam has to be selected, a 2cm proximal margin should be considered

  2. Preliminary assessment of LiF and alanine detectors for the dosimetry of proton therapy beams

    International Nuclear Information System (INIS)

    Fattibene, P.; Calicchia, A.; De Angelis, C.; Onori, S.; Egger, E.

    1996-01-01

    An experimental intercomparison between the proton response of LiF TLD-100 and alanine detectors is reported. The investigations were performed with LiF chips and alanine pellets in a 62 MeV proton beam at the Paul Scherrer Institut in Villigen (CH). Results were compared with reference dosimetry provided by Markus type parallel plate ionization chamber. The response of the detectors was studied, in a phantom, at different beam penetration depths in pristine and modulated beams. For both alanine and TL detectors, within the experimental uncertainty of the measurements, no significant energy dependence in the response was observed down to the Bragg peak region. The sensitivity of alanine and LiF detectors to protons was measured in the centre of modulated Bragg peak and no significant difference was found with respect to 60 Co. Contrary to LiF, alanine also offers a remarkable tissue equivalence which favours its choice for in-phantom dosimetry. (author)

  3. Photon beam audits for radiation therapy clinics: A pilot mailed dosemeter study in Turkey

    International Nuclear Information System (INIS)

    Yegingil, Z.; DeWerd, L. A.; Davis, S. D.; Hammer, C.; Kunugi, K.

    2012-01-01

    A thermoluminescent dosemeter (TLD) mailed dose audit programme was performed at five radiotherapy clinics in Turkey. The intercomparison was organised by the Univ. of Wisconsin Radiation Calibration Laboratory (UWRCL), which was responsible for the technical aspects of the study including reference irradiations, distribution, collection and evaluation. The purpose of these audits was to perform an independent dosimetry check of the radiation beams using TLDs sent by mail. Acrylic holders, each with five TLD chips inside and instructions for their irradiation to specified absorbed dose to water of 2 Gy, were mailed to all participating clinics. TLD irradiations were performed with a 6 MV linear accelerator and 60 Co photon beams. The deviations from the TL readings of UWRCL were calculated. Discrepancies inside the limits of ±5 % between the participant-stated dose, and the TLD-measured dose were considered acceptable. One out of 10 beams checked was outside this limit, with a difference of 5.8 %. (authors)

  4. New developments of 11C post-accelerated beams for hadron therapy and imaging

    OpenAIRE

    Augusto, R.S.; Mendonca, T.M.; Wenander, F.; Penescu, L.; Orecchia, R.; Parodi, K.; Ferrari, A.; Stora, T.

    2016-01-01

    Hadron therapy was first proposed in 1946 and is by now widespread throughout the world, as witnessed with the design and construction of the CNAO, HIT, PROSCAN and MedAustron treatment centres, among others. The clinical interest in hadron therapy lies in the fact that it delivers precision treatment of tumours, exploiting the characteristic shape (the Bragg peak) of the energy deposition in the tissues for charged hadrons. In particular, carbon ion therapy is found to be biologically more e...

  5. Accuracy of cranial coplanar beam therapy using an oblique, stereoscopic x-ray image guidance system

    International Nuclear Information System (INIS)

    Vinci, Justin P.; Hogstrom, Kenneth R.; Neck, Daniel W.

    2008-01-01

    A system for measuring two-dimensional (2D) dose distributions in orthogonal anatomical planes in the cranium was developed and used to evaluate the accuracy of coplanar conformal therapy using ExacTrac image guidance. Dose distributions were measured in the axial, sagittal, and coronal planes using a CIRS (Computerized Imaging Reference Systems, Inc.) anthropomorphic head phantom with a custom internal film cassette. Sections of radiographic Kodak EDR2 film were cut, processed, and digitized using custom templates. Spatial and dosimetric accuracy and precision of the film system were assessed. BrainScan planned a coplanar-beam treatment to conformally irradiate a 2-cm-diameterx2-cm-long cylindrical planning target volume. Prior to delivery, phantom misalignments were imposed in combinations of ±8 mm offsets in each of the principal directions. ExacTrac x-ray correction was applied until the phantom was within an acceptance criteria of 1 mm/1 deg. (first two measurement sets) or 0.4 mm/0.4 deg. (last two measurement sets). Measured dose distributions from film were registered to the treatment plan dose calculations and compared. Alignment errors, displacement between midpoints of planned and measured 70% isodose contours (Δc), and positional errors of the 80% isodose line were evaluated using 49 2D film measurements (98 profiles). Comparison of common, but independent measurements of Δc showed that systematic errors in the measurement technique were 0.2 mm or less along all three anatomical axes and that random error averaged (σ±σ σ ) 0.29±0.06 mm for the acceptance criteria of 1 mm/1 deg. and 0.15±0.02 mm for the acceptance criteria of 0.4 mm/0.4 deg. . The latter was consistent with independent estimates that showed the precision of the measurement system was 0.3 mm (2σ). Values of Δc were as great as 0.9, 0.3, and 1.0 mm along the P-A, R-L, and I-S axes, respectively. Variations in Δc along the P-A axis were correlated to misalignments between laser

  6. Low-dose total skin electron beam therapy for cutaneous lymphoma. Minimal risk of acute toxicities

    Energy Technology Data Exchange (ETDEWEB)

    Kroeger, Kai; Elsayad, Khaled; Moustakis, Christos; Haverkamp, Uwe; Eich, Hans Theodor [University Hospital of Muenster, Department of Radiation Oncology, Muenster (Germany)

    2017-12-15

    Low-dose total skin electron beam therapy (TSEBT) is attracting increased interest for the effective palliative treatment of primary cutaneous T-cell lymphoma (pCTCL). In this study, we compared toxicity profiles following various radiation doses. We reviewed the records of 60 patients who underwent TSEBT for pCTCL between 2000 and 2016 at the University Hospital of Munster. The treatment characteristics of the radiotherapy (RT) regimens and adverse events (AEs) were then analyzed and compared. In total, 67 courses of TSEBT were administered to 60 patients. Of these patients, 34 (51%) received a standard dose with a median surface dose of 30 Gy and 33 patients (49%) received a low dose with the median surface dose of 12 Gy (7 salvage low-dose TSEBT courses were administered to 5 patients). After a median follow-up of 15 months, the overall AE rate was 100%, including 38 patients (57%) with grade 2 and 7 (10%) with grade 3 AEs. Patients treated with low-dose TSEBT had significantly fewer grade 2 AEs than those with conventional dose regimens (33 vs. 79%, P < 0.001). A lower grade 3 AE rate was also observed in patients who had received the low-dose regimen compared to those with the conventional dose regimens (6 vs. 15%, P = 0.78). Multiple/salvage low-dose TSEBT courses were not associated with an increased risk of acute AEs. Low-dose TSEBT regimens are associated with significantly fewer grade 2 acute toxicities compared with conventional doses of TSEBT. Repeated/Salvage low-dose TSEBT, however, appears to be tolerable and can even be applied safely in patients with cutaneous relapses. (orig.) [German] Eine niedrigdosierte Ganzhautelektronenbestrahlung (TSEBT) wird vermehrt zur effektiven palliativen Behandlung von Patienten mit primaer kutanen T-Zell-Lymphomen (pCTCL) eingesetzt. In dieser Studie vergleichen wir die Toxizitaetsprofile verschiedener Dosiskonzepte. Untersucht wurden 60 zwischen 2000 und 2016 am Universitaetsklinikum Muenster mittels TSEBT

  7. Effectiveness and safety of proton beam therapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Uk; Park, Joong-Won; Kim, Tae Hyun; Kim, Yeon-Joo; Woo, Sang Myung; Koh, Young-Hwan; Lee, Woo Jin; Park, Sang-Jae; Kim, Dae Yong; Kim, Chang-Min [National Cancer Center, Center for Liver Cancer, Research Institute and Hospital, Goyang-si, Gyeonggi-do (Korea, Republic of)

    2014-09-15

    To evaluate the clinical effectiveness and safety of proton beam therapy (PBT) in advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). Twenty-seven HCC patients with PVTT underwent PBT, including 22 patients with modified International Union Against Cancer (mUICC) stage IVA,five patients with stage IVB primary tumors, and 16 with main PVTT. A median dose of 55 GyE (range, 50-66 GyE) in 20-22 fractions was delivered to a target volume encompassing both the PVTT and primary tumor. Overall, treatment was well tolerated, with no toxicity of grade ≥ 3. Median overall survival (OS) times in all patients and in stage IVA patients were 13.2 months and 16 months, respectively. Assessments of PVTT response showed complete response in 0 of 27 (0 %) patients, partial response in 15 (55.6 %), stable disease in 10 (37 %), and progressive disease in 2 (7.4 %) patients, with an objective response rate of 55.6 %. PVTT responders showed significantly higher actuarial 1-year local progression-free survival (LPFS; 85.6 % vs. 51.3 %), relapse-free survival (RFS; 20 % vs. 0 %) and OS (80 % vs. 25 %) rates than nonresponders (p < 0.05 each). Multivariate analysis showed that PVTT response and mUICC stage were independent prognostic factors for OS. Our data suggest that PBT could improve LPFS, RFS, and OS in advanced HCC patients with PVTT and it is feasible and safe for these patients. (orig.) [German] In der vorliegenden Arbeit wurde versucht, die klinische Wirksamkeit und Sicherheit der Protonenstrahltherapie (PBT) fuer Patienten mit fortgeschrittenem Leberzellkarzinom (HCC) in Verbindung mit Portadertumorthrombosen (PVTT) zu bewerten. Ausgefuehrt wurde die PBT fuer 27 HCC-Patienten mit PVTT, einschliesslich 22 Patienten im mUICC-Stadium (''International Union Against Cancer'') IVA sowie 5 Patienten mit Primaertumor im Stadium IVB und 16 Patienten mit PVTT im primaeren Stadium nach der geaenderten UICC-Klassifikation. Eine

  8. Secondary radiation doses of intensity-modulated radiotherapy and proton beam therapy in patients with lung and liver cancer.

    Science.gov (United States)

    Kim, Seonkyu; Min, Byung Jun; Yoon, Myonggeun; Kim, Jinsung; Shin, Dong Ho; Lee, Se Byeong; Park, Sung Yong; Cho, Sungkoo; Kim, Dae Hyun

    2011-03-01

    To compare the secondary radiation doses following intensity-modulated radiotherapy (IMRT) and proton beam therapy (PBT) in patients with lung and liver cancer. IMRT and PBT were planned for three lung cancer and three liver cancer patients. The treatment beams were delivered to phantoms and the corresponding secondary doses during irradiation were measured at various points 20-50 cm from the beam isocenter using ion chamber and CR-39 detectors for IMRT and PBT, respectively. The secondary dose per Gy (i.e., a treatment dose of 1Gy) from PBT for lung and liver cancer, measured 20-50 cm from the isocenter, ranged from 0.17 to 0.086 mGy. The secondary dose per Gy from IMRT, however, ranged between 5.8 and 1.0 mGy, indicating that PBT is associated with a smaller dose of secondary radiation than IMRT. The internal neutron dose per Gy from PBT for lung and liver cancer, 20-50 cm from the isocenter, ranged from 0.03 to 0.008 mGy. The secondary dose from PBT is less than or compatible to the secondary dose from conventional IMRT. The internal neutron dose generated by the interaction between protons and body material is generally much less than the external neutron dose from the treatment head. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. Helium ions at the heidelberg ion beam therapy center: comparisons between FLUKA Monte Carlo code predictions and dosimetric measurements

    Science.gov (United States)

    Tessonnier, T.; Mairani, A.; Brons, S.; Sala, P.; Cerutti, F.; Ferrari, A.; Haberer, T.; Debus, J.; Parodi, K.

    2017-08-01

    In the field of particle therapy helium ion beams could offer an alternative for radiotherapy treatments, owing to their interesting physical and biological properties intermediate between protons and carbon ions. We present in this work the comparisons and validations of the Monte Carlo FLUKA code against in-depth dosimetric measurements acquired at the Heidelberg Ion Beam Therapy Center (HIT). Depth dose distributions in water with and without ripple filter, lateral profiles at different depths in water and a spread-out Bragg peak were investigated. After experimentally-driven tuning of the less known initial beam characteristics in vacuum (beam lateral size and momentum spread) and simulation parameters (water ionization potential), comparisons of depth dose distributions were performed between simulations and measurements, which showed overall good agreement with range differences below 0.1 mm and dose-weighted average dose-differences below 2.3% throughout the entire energy range. Comparisons of lateral dose profiles showed differences in full-width-half-maximum lower than 0.7 mm. Measurements of the spread-out Bragg peak indicated differences with simulations below 1% in the high dose regions and 3% in all other regions, with a range difference less than 0.5 mm. Despite the promising results, some discrepancies between simulations and measurements were observed, particularly at high energies. These differences were attributed to an underestimation of dose contributions from secondary particles at large angles, as seen in a triple Gaussian parametrization of the lateral profiles along the depth. However, the results allowed us to validate FLUKA simulations against measurements, confirming its suitability for 4He ion beam modeling in preparation of clinical establishment at HIT. Future activities building on this work will include treatment plan comparisons using validated biological models between proton and helium ions, either within a Monte Carlo

  10. The use of multi-gap resistive plate chambers for in-beam PET in proton and carbon ion therapy

    CERN Document Server

    Watts, David; Sauli, Fabio; Amaldi, Ugo

    2013-01-01

    On-line verification of the delivered dose during proton and carbon ion radiotherapy is currently a very desirable goal for quality assurance of hadron therapy treatment plans. In-beam positron emission tomography (ibPET), which can provide an image of the β+ activity induced in the patient during irradiation, which in turn is correlated to the range of the ion beam, is one of the modalities for achieving this goal. Application to hadron therapy requires that the scanner geometry be modified from that which is used in nuclear medicine. In particular, PET detectors that allow a sub-nanosecond time-of-flight (TOF) registration of the collinear photons have been proposed. Inclusion of the TOF information in PET data leads to more effective PET sensitivity. Considering the challenges inherent in the ibPET technique, namely limited β+ activity and the effect of biological washout due to blood flow, TOF-PET technologies are very attractive. In this context, the TERA Foundation is investigating the use of resistiv...

  11. Comparison of dose calculation algorithms for treatment planning in external photon beam therapy for clinical situations

    DEFF Research Database (Denmark)

    Knöös, Tommy; Wieslander, Elinore; Cozzi, Luca

    2006-01-01

    cancer cases. The TPSs were installed locally at different institutions and commissioned for clinical use based on local procedures. For the evaluation, beam qualities as identical as possible were used: low energy (6 MV) and high energy (15 or 18 MV) x-rays. All relevant anatomical structures were...

  12. Advances in 4D treatment planning for scanned particle beam therapy - report of dedicated workshops

    NARCIS (Netherlands)

    Bert, Christoph; Graeff, Christian; Riboldi, Marco; Nill, Simeon; Baroni, Guido; Knopf, Antje-Christin

    2014-01-01

    We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle

  13. Implementation of a system for external audits beam radiation therapy in terms of reference no

    International Nuclear Information System (INIS)

    Alonso Samper, Jose Luis; Dominguez, Lourdes; Alert Silva, Jose; Alfonso Laguardia, Rodolfo; Larrinaga Cortina, Eduardo; Garcia Yip, Fernando; Rodriguez Machado, Jorge; Morales Lopez, Jorge Luis; Silvestre Patallo, Ileana

    2009-01-01

    This paper presents our experience in implementing a external audit system for radiotherapy beam in no reference conditions with the use of CIRS and a summary of the measurements with him made.This paper presents our experience in implementing a external audit system for radiotherapy beam in no reference conditions with the use of CIRS and a summary of the measurements with him made. Centers were audited with external beam high-energy Co-60, 6 MV and 15 MV and were considered 4 treatment planning systems (TPS): AMEPLAN, Theraplan Plus, Precise Plan and MIRS to calculate doses prescribed in each test case. All measurements were acquired by the audit team using the anthropomorphic phantom CIRS, Semiflex chamber PTW 31010 and PTW electrometer STATES. The implementation and development of the external audits of beams radiotherapy in terms of 'no reference' has brought an improvement in both clinical aspects of treatment and the radiation safety and the quality control, has given us greater confidence and for this reason we believe has become essential. (Author)

  14. Maximum dose angle for oblique incidence on primary beam protective barriers in the design of medical radiation therapy facilities

    International Nuclear Information System (INIS)

    Fondevila, Damian; Arbiser, Silvio; Sansogne, Rosana; Brunetto, Monica; Dosoretz, Bernardo

    2008-01-01

    Primary barrier determinations for the shielding of medical radiation therapy facilities are generally made assuming normal beam incidence on the barrier, since this is geometrically the most unfavorable condition for that shielding barrier whenever the occupation line is allowed to run along the barrier. However, when the occupation line (for example, the wall of an adjacent building) runs perpendicular to the barrier (especially roof barrier), then two opposing factors come in to play: increasing obliquity angle with respect to the barrier increases the attenuation, while the distance to the calculation point decreases, hence, increasing the dose. As a result, there exists an angle (α max ) for which the equivalent dose results in a maximum, constituting the most unfavorable geometric condition for that shielding barrier. Based on the usual NCRP Report No. 151 model, this article presents a simple formula for obtaining α max , which is a function of the thickness of the barrier (t E ) and the equilibrium tenth-value layer (TVL e ) of the shielding material for the nominal energy of the beam. It can be seen that α max increases for increasing TVL e (hence, beam energy) and decreases for increasing t E , with a range of variation that goes from 13 to 40 deg for concrete barriers thicknesses in the range of 50-300 cm and most commercially available teletherapy machines. This parameter has not been calculated in the existing literature for radiotherapy facilities design and has practical applications, as in calculating the required unoccupied roof shielding for the protection of a nearby building located in the plane of the primary beam rotation

  15. SU-E-T-295: Simultaneous Beam Sampling and Aperture Shape Optimization for Station Parameter Optimized Radiation Therapy (SPORT)

    International Nuclear Information System (INIS)

    Zarepisheh, M; Li, R; Xing, L; Ye, Y; Boyd, S

    2014-01-01

    Purpose: Station Parameter Optimized Radiation Therapy (SPORT) was recently proposed to fully utilize the technical capability of emerging digital LINACs, in which the station parameters of a delivery system, (such as aperture shape and weight, couch position/angle, gantry/collimator angle) are optimized altogether. SPORT promises to deliver unprecedented radiation dose distributions efficiently, yet there does not exist any optimization algorithm to implement it. The purpose of this work is to propose an optimization algorithm to simultaneously optimize the beam sampling and aperture shapes. Methods: We build a mathematical model whose variables are beam angles (including non-coplanar and/or even nonisocentric beams) and aperture shapes. To solve the resulting large scale optimization problem, we devise an exact, convergent and fast optimization algorithm by integrating three advanced optimization techniques named column generation, gradient method, and pattern search. Column generation is used to find a good set of aperture shapes as an initial solution by adding apertures sequentially. Then we apply the gradient method to iteratively improve the current solution by reshaping the aperture shapes and updating the beam angles toward the gradient. Algorithm continues by pattern search method to explore the part of the search space that cannot be reached by the gradient method. Results: The proposed technique is applied to a series of patient cases and significantly improves the plan quality. In a head-and-neck case, for example, the left parotid gland mean-dose, brainstem max-dose, spinal cord max-dose, and mandible mean-dose are reduced by 10%, 7%, 24% and 12% respectively, compared to the conventional VMAT plan while maintaining the same PTV coverage. Conclusion: Combined use of column generation, gradient search and pattern search algorithms provide an effective way to optimize simultaneously the large collection of station parameters and significantly improves

  16. Dosimetric comparative analysis between 10 MV Megavoltage unidirectional beam and boron neutron capture therapy for brain tumors treatment

    International Nuclear Information System (INIS)

    Brandao, Samia F.; Campos, Tarcisio P.R.

    2011-01-01

    This paper present a comparative dosimetric analysis between boron neutron capture therapy and 10 MV megavoltage employed in brain tumor treatments, limited to a unidirectional beam. A computational phantom of a human head was developed to be used in computational simulations of the two protocols, conducted in MCNP5 code. This phantom represents several head's structures, mainly, the central nervous system and a tumor that represents a Glioblastoma Multiform - one of the most malignant and aggressive brain tumors. Absorbed and biological weighted dose rates and neutron fluency in the computational phantom were evaluated from the MCNP5 code. The biologically weighted dose rate to 10 MV megavoltage beam presented no specificity in deposited dose in tumor. The average total biologically weighted dose rate in tumor was 9.93E-04 RBE.Gy.h -1 /Mp.s -1 while in healthy tissue it was 8.67E-04 RBE.Gy.h -1 /Mp.s - 1. On the BNCT simulations the boron concentration was particularly relevant since the largest dose deposition happened in borate tissues. The average total biologically weighted dose rate in tumor was 3.66E-02 RBE.Gy.h -1 /Mp.s -1 while in healthy tissue it was 1.39E-03 RBE.Gy.h -1 /Mp.s -1 . In comparison to the 10 MV megavoltage beam, BNCT showed clearly a largest dose deposition in the tumor, on average, 37 times larger than in the megavoltage beam, while in healthy tissue that average was only 1,6 time larger in BNCT. (author)

  17. Characterization of a microDiamond detector in high-dose-per-pulse electron beams for intra operative radiation therapy.

    Science.gov (United States)

    Di Venanzio, C; Marinelli, Marco; Tonnetti, A; Verona-Rinati, G; Falco, M D; Pimpinella, M; Ciccotelli, A; De Stefano, S; Felici, G; Marangoni, F

    2015-12-01

    To characterize a synthetic diamond dosimeter (PTW Freiburg microDiamond 60019) in high dose-per-pulse electron beams produced by an Intra Operative Radiation Therapy (IORT) dedicated accelerator. The dosimetric properties of the microDiamond were assessed under 6, 8 and 9 MeV electron beams by a NOVAC11 mobile accelerator (Sordina IORT Technologies S.p.A.). The characterization was carried out with dose-per-pulse ranging from 26 to 105 mGy per pulse. The microDiamond performance was compared with an Advanced Markus ionization chamber and a PTW silicon diode E in terms of dose linearity, percentage depth dose (PDD) curves, beam profiles and output factors. A good linearity of the microDiamond response was verified in the dose range from 0.2 Gy to 28 Gy. A sensitivity of 1.29 nC/Gy was measured under IORT electron beams, resulting within 1% with respect to the one obtained in reference condition under (60)Co gamma irradiation. PDD measurements were found in agreement with the ones by the reference dosimeters, with differences in R50 values below 0.3 mm. Profile measurements evidenced a high spatial resolution of the microDiamond, slightly worse than the one of the silicon diode. The penumbra widths measured by the microDiamond resulted approximately 0.5 mm larger than the ones by the Silicon diode. Output factors measured by the microDiamond were found within 2% with those obtained by the Advanced Markus down to 3 cm diameter field sizes. The microDiamond dosimeter was demonstrated to be suitable for precise dosimetry in IORT applications under high dose-per-pulse conditions. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. SU-F-T-149: Development of the Monte Carlo Simulation Platform Using Geant4 for Designing Heavy Ion Therapy Beam Nozzle

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jae-ik; Yoo, SeungHoon; Cho, Sungho; Ho Kim, Eun; Song, Yongkeun; Jung, Won-Gyun [Korea Institute of Radiological and Medical Science, Seoul, Seoul (Korea, Republic of)

    2016-06-15

    Purpose: The significant issue of particle therapy such as proton and carbon ion was a accurate dose delivery from beam line to patient. For designing the complex delivery system, Monte Carlo simulation can be used for the simulation of various physical interaction in scatters and filters. In this report, we present the development of Monte Carlo simulation platform to help design the prototype of particle therapy nozzle and performed the Monte Carlo simulation using Geant4. Also we show the prototype design of particle therapy beam nozzle for Korea Heavy Ion Medical Accelerator (KHIMA) project in Korea Institute of Radiological and Medical Science(KIRAMS) at Republic of Korea. Methods: We developed a simulation platform for particle therapy beam nozzle using Geant4. In this platform, the prototype nozzle design of Scanning system for carbon was simply designed. For comparison with theoretic beam optics, the beam profile on lateral distribution at isocenter is compared with Mont Carlo simulation result. From the result of this analysis, we can expected the beam spot property of KHIMA system and implement the spot size optimization for our spot scanning system. Results: For characteristics study of scanning system, various combination of the spot size from accerlator with ridge filter and beam monitor was tested as simple design for KHIMA dose delivery system. Conclusion: In this report, we presented the part of simulation platform and the characteristics study. This study is now on-going in order to develop the simulation platform including the beam nozzle and the dose verification tool with treatment planning system. This will be presented as soon as it is become available.

  19. SU-F-T-149: Development of the Monte Carlo Simulation Platform Using Geant4 for Designing Heavy Ion Therapy Beam Nozzle

    International Nuclear Information System (INIS)

    Shin, Jae-ik; Yoo, SeungHoon; Cho, Sungho; Ho Kim, Eun; Song, Yongkeun; Jung, Won-Gyun

    2016-01-01

    Purpose: The significant issue of particle therapy such as proton and carbon ion was a accurate dose delivery from beam line to patient. For designing the complex delivery system, Monte Carlo simulation can be used for the simulation of various physical interaction in scatters and filters. In this report, we present the development of Monte Carlo simulation platform to help design the prototype of particle therapy nozzle and performed the Monte Carlo simulation using Geant4. Also we show the prototype design of particle therapy beam nozzle for Korea Heavy Ion Medical Accelerator (KHIMA) project in Korea Institute of Radiological and Medical Science(KIRAMS) at Republic of Korea. Methods: We developed a simulation platform for particle therapy beam nozzle using Geant4. In this platform, the prototype nozzle design of Scanning system for carbon was simply designed. For comparison with theoretic beam optics, the beam profile on lateral distribution at isocenter is compared with Mont Carlo simulation result. From the result of this analysis, we can expected the beam spot property of KHIMA system and implement the spot size optimization for our spot scanning system. Results: For characteristics study of scanning system, various combination of the spot size from accerlator with ridge filter and beam monitor was tested as simple design for KHIMA dose delivery system. Conclusion: In this report, we presented the part of simulation platform and the characteristics study. This study is now on-going in order to develop the simulation platform including the beam nozzle and the dose verification tool with treatment planning system. This will be presented as soon as it is become available.

  20. Preliminary comp arison of helical tomotherapy and mixed beams of unmodulated electrons and intensity modulated radiation therapy for treating superficial cancers of the parotid gland and nasal cavity

    Directory of Open Access Journals (Sweden)

    Blasi Olivier

    2011-12-01

    Full Text Available Abstract Background and Purpose To investigate combining unmodulated electron beams with intensity-modulated radiation therapy to improve dose distributions for superficial head and neck cancers, and to compare mixed beam plans with helical tomotherapy. Materials and methods Mixed beam and helical tomotherapy dose plans were developed for two patients with parotid gland tumors and two patients with nasal cavity tumors. Mixed beam plans consisted of various weightings of a enface electron beam and IMRT, which was optimized after calculation of the electron dose to compensate for heterogeneity in the electron dose distribution within the target volume. Results Helical tomotherapy plans showed dose conformity and homogeneity in the target volume that was equal to or better than the mixed beam plans. Electron-only plans tended to show the lowest doses to normal tissues, but with markedly worse dose conformity and homogeneity than in the other plans. However, adding a 20% IMRT dose fraction (i.e., IMRT:electron weighting = 1:4 to the electron plan restored target conformity and homogeneity to values comparable to helical tomotherapy plans, while maintaining lower normal tissue dose. Conclusions Mixed beam treatments offer some dosimetric advantages over IMRT or helical tomotherapy for target depths that do not exceed the useful range of the electron beam. Adding a small IMRT component (e.g., IMRT:electron weighting = 1:4 to electron beam plans markedly improved target dose homogeneity and conformity for the cases examined in this study.

  1. Preliminary comp arison of helical tomotherapy and mixed beams of unmodulated electrons and intensity modulated radiation therapy for treating superficial cancers of the parotid gland and nasal cavity

    International Nuclear Information System (INIS)

    Blasi, Olivier; Fontenot, Jonas D; Fields, Robert S; Gibbons, John P; Hogstrom, Kenneth R

    2011-01-01

    To investigate combining unmodulated electron beams with intensity-modulated radiation therapy to improve dose distributions for superficial head and neck cancers, and to compare mixed beam plans with helical tomotherapy. Mixed beam and helical tomotherapy dose plans were developed for two patients with parotid gland tumors and two patients with nasal cavity tumors. Mixed beam plans consisted of various weightings of a enface electron beam and IMRT, which was optimized after calculation of the electron dose to compensate for heterogeneity in the electron dose distribution within the target volume. Helical tomotherapy plans showed dose conformity and homogeneity in the target volume that was equal to or better than the mixed beam plans. Electron-only plans tended to show the lowest doses to normal tissues, but with markedly worse dose conformity and homogeneity than in the other plans. However, adding a 20% IMRT dose fraction (i.e., IMRT:electron weighting = 1:4) to the electron plan restored target conformity and homogeneity to values comparable to helical tomotherapy plans, while maintaining lower normal tissue dose. Mixed beam treatments offer some dosimetric advantages over IMRT or helical tomotherapy for target depths that do not exceed the useful range of the electron beam. Adding a small IMRT component (e.g., IMRT:electron weighting = 1:4) to electron beam plans markedly improved target dose homogeneity and conformity for the cases examined in this study

  2. Pencil-beam redefinition algorithm dose calculations for electron therapy treatment planning

    Science.gov (United States)

    Boyd, Robert Arthur

    2001-08-01

    The electron pencil-beam redefinition algorithm (PBRA) of Shiu and Hogstrom has been developed for use in radiotherapy treatment planning (RTP). Earlier studies of Boyd and Hogstrom showed that the PBRA lacked an adequate incident beam model, that PBRA might require improved electron physics, and that no data existed which allowed adequate assessment of the PBRA-calculated dose accuracy in a heterogeneous medium such as one presented by patient anatomy. The hypothesis of this research was that by addressing the above issues the PBRA-calculated dose would be accurate to within 4% or 2 mm in regions of high dose gradients. A secondary electron source was added to the PBRA to account for collimation-scattered electrons in the incident beam. Parameters of the dual-source model were determined from a minimal data set to allow ease of beam commissioning. Comparisons with measured data showed 3% or better dose accuracy in water within the field for cases where 4% accuracy was not previously achievable. A measured data set was developed that allowed an evaluation of PBRA in regions distal to localized heterogeneities. Geometries in the data set included irregular surfaces and high- and low-density internal heterogeneities. The data was estimated to have 1% precision and 2% agreement with accurate, benchmarked Monte Carlo (MC) code. PBRA electron transport was enhanced by modeling local pencil beam divergence. This required fundamental changes to the mathematics of electron transport (divPBRA). Evaluation of divPBRA with the measured data set showed marginal improvement in dose accuracy when compared to PBRA; however, 4% or 2mm accuracy was not achieved by either PBRA version for all data points. Finally, PBRA was evaluated clinically by comparing PBRA- and MC-calculated dose distributions using site-specific patient RTP data. Results show PBRA did not agree with MC to within 4% or 2mm in a small fraction (beam commissioning, documentation of accuracy, and calculational

  3. Clinical implementation of full Monte Carlo dose calculation in proton beam therapy

    International Nuclear Information System (INIS)

    Paganetti, Harald; Jiang, Hongyu; Parodi, Katia; Slopsema, Roelf; Engelsman, Martijn

    2008-01-01

    The goal of this work was to facilitate the clinical use of Monte Carlo proton dose calculation to support routine treatment planning and delivery. The Monte Carlo code Geant4 was used to simulate the treatment head setup, including a time-dependent simulation of modulator wheels (for broad beam modulation) and magnetic field settings (for beam scanning). Any patient-field-specific setup can be modeled according to the treatment control system of the facility. The code was benchmarked against phantom measurements. Using a simulation of the ionization chamber reading in the treatment head allows the Monte Carlo dose to be specified in absolute units (Gy per ionization chamber reading). Next, the capability of reading CT data information was implemented into the Monte Carlo code to model patient anatomy. To allow time-efficient dose calculation, the standard Geant4 tracking algorithm was modified. Finally, a software link of the Monte Carlo dose engine to the patient database and the commercial planning system was established to allow data exchange, thus completing the implementation of the proton Monte Carlo dose calculation engine ('DoC++'). Monte Carlo re-calculated plans are a valuable tool to revisit decisions in the planning process. Identification of clinically significant differences between Monte Carlo and pencil-beam-based dose calculations may also drive improvements of current pencil-beam methods. As an example, four patients (29 fields in total) with tumors in the head and neck regions were analyzed. Differences between the pencil-beam algorithm and Monte Carlo were identified in particular near the end of range, both due to dose degradation and overall differences in range prediction due to bony anatomy in the beam path. Further, the Monte Carlo reports dose-to-tissue as compared to dose-to-water by the planning system. Our implementation is tailored to a specific Monte Carlo code and the treatment planning system XiO (Computerized Medical Systems Inc

  4. Anticipated Intraoperative Electron Beam Boost, External Beam Radiation Therapy, and Limb-Sparing Surgical Resection for Patients with Pediatric Soft-Tissue Sarcomas of the Extremity: A Multicentric Pooled Analysis of Long-Term Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Sole, Claudio V., E-mail: cvsole@uc.cl [Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); School of Medicine, Complutense University, Madrid (Spain); Service of Radiation Oncology, Instituto de Radiomedicina, Santiago (Chile); Calvo, Felipe A. [Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); School of Medicine, Complutense University, Madrid (Spain); Polo, Alfredo [Service of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid (Spain); Cambeiro, Mauricio [Service of Radiation Oncology, Clínica Universidad de Navarra, Pamplona (Spain); Alvarez, Ana; Gonzalez, Carmen [Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); Gonzalez, Jose [Service of Pediatric Orthopedics and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); San Julian, Mikel [Service of Orthopedics and Traumatology, Clínica Universidad de Navarra, Pamplona (Spain); Martinez-Monge, Rafael [Service of Radiation Oncology, Clínica Universidad de Navarra, Pamplona (Spain)

    2014-09-01

    Purpose: To perform a joint analysis of data from 3 contributing centers within the intraoperative electron-beam radiation therapy (IOERT)-Spanish program, to determine the potential of IOERT as an anticipated boost before external beam radiation therapy in the multidisciplinary treatment of pediatric extremity soft-tissue sarcomas. Methods and Materials: From June 1993 to May 2013, 62 patients (aged <21 years) with a histologic diagnosis of primary extremity soft-tissue sarcoma with absence of distant metastases, undergoing limb-sparing grossly resected surgery, external beam radiation therapy (median dose 40 Gy) and IOERT (median dose 10 Gy) were considered eligible for this analysis. Results: After a median follow-up of 66 months (range, 4-235 months), 10-year local control, disease-free survival, and overall survival was 85%, 76%, and 81%, respectively. In multivariate analysis after adjustment for other covariates, tumor size >5 cm (P=.04) and R1 margin status (P=.04) remained significantly associated with local relapse. In regard to overall survival only margin status (P=.04) retained association on multivariate analysis. Ten patients (16%) reported severe chronic toxicity events (all grade 3). Conclusions: An anticipated IOERT boost allowed for external beam radiation therapy dose reduction, with high local control and acceptably low toxicity rates. The combined radiosurgical approach needs to be tested in a prospective trial to confirm these results.

  5. Radiobiological intercomparisons of fast neutron beams used for therapy in Japan and the United States

    International Nuclear Information System (INIS)

    Hall, E.J.; Withers, H.R.; Geraci, J.P.; Meyn, R.E.; Rasey, J.; Todd, P.; Sheline, G.E.

    1979-01-01

    A variety of portable biological systems have been used to intercompare the neutron beams used for radiotherapy in Japan and in the United States. The two neutron centers in Japan have been compared with the four in th United States; all of the machines differ in energy and consequently the biological effectiveness varies from one to another. The biological systems used included survival in three lines of mammalian cells cultured in vitro, the response of mouse skin, the survival of crypt cells in the mouse jejunum, and the loss of weight or DNA in the mouse testes. Based on the biological data, estimates have been made of the relative potency of the various neutron beams that will be invaluable when the time comes to evaluate clinical results

  6. Clinical significance of increased gelatinolytic activity in the rectal mucosa during external beam radiation therapy of prostate cancer

    International Nuclear Information System (INIS)

    Hovdenak, Nils; Wang Junru; Sung, C.-C.; Kelly, Thomas; Fajardo, Luis F.; Hauer-Jensen, Martin

    2002-01-01

    Purpose: Rectal toxicity (proctitis) is a dose-limiting factor in pelvic radiation therapy. Mucosal atrophy, i.e., net extracellular matrix degradation, is a prominent feature of radiation proctitis, but the underlying mechanisms are not known. We prospectively examined changes in matrix metalloproteinase (MMP)-2 and MMP-9 (gelatinase A and B) in the rectal mucosa during radiation therapy of prostate cancer, as well as the relationships of these changes with symptomatic, structural, and cellular evidence of radiation proctitis. Methods and Materials: Seventeen patients scheduled for external beam radiation therapy for prostate cancer were prospectively enrolled. Symptoms of gastrointestinal toxicity were recorded, and endoscopy with biopsy of the rectal mucosa was performed before radiation therapy, as well as 2 and 6 weeks into the treatment course. Radiation proctitis was assessed by endoscopic scoring, quantitative histology, and quantitative immunohistochemistry. MMP-2 and MMP-9 were localized immunohistochemically, and activities were determined by gelatin zymography. Results: Symptoms, endoscopic scores, histologic injury, and mucosal macrophages and neutrophils increased from baseline to 2 weeks. Symptoms increased further from 2 weeks to 6 weeks, whereas endoscopic and cellular evidence of proctitis did not. Compared to pretreatment values, there was increased total gelatinolytic activity of MMP-2 and MMP-9 at 2 weeks (p=0.02 and p=0.004, respectively) and 6 weeks (p=0.006 and p=0.001, respectively). Active MMP-2 was increased at both time points (p=0.0001 and p=0.002). Increased MMP-9 and MMP-2 at 6 weeks was associated with radiation-induced diarrhea (p=0.007 and p=0.02, respectively) and with mucosal neutrophil infiltration (rho=0.62). Conclusions: Pelvic radiation therapy causes increased MMP-2 and MMP-9 activity in the rectal mucosa. These changes correlate with radiation-induced diarrhea and granulocyte infiltration and may contribute to abnormal

  7. A beam monitoring and validation system for continuous line scanning in proton therapy

    Science.gov (United States)

    Klimpki, G.; Psoroulas, S.; Bula, C.; Rechsteiner, U.; Eichin, M.; Weber, D. C.; Lomax, A.; Meer, D.

    2017-08-01

    Line scanning represents a faster and potentially more flexible form of pencil beam scanning than conventional step-and-shoot irradiations. It seeks to minimize dead times in beam delivery whilst preserving the possibility of modulating the dose at any point in the target volume. Our second generation proton gantry features irradiations in line scanning mode, but it still lacks a dedicated monitoring and validation system that guarantees patient safety throughout the irradiation. We report on its design and implementation in this paper. In line scanning, we steer the proton beam continuously along straight lines while adapting the speed and/or current frequently to modulate the delivered dose. We intend to prevent delivery errors that could be clinically relevant through a two-stage system: safety level 1 monitors the beam current and position every 10 μs. We demonstrate that direct readings from ionization chambers in the gantry nozzle and Hall probes in the scanner magnets provide required information on current and position, respectively. Interlocks will be raised when measured signals exceed their predefined tolerance bands. Even in case of an erroneous delivery, safety level 1 restricts hot and cold spots of the physically delivered fraction dose to  ±36~mGy (±2% of 2~Gy biologically). In safety level 2—an additional, partly redundant validation step—we compare the integral line profile measured with a strip monitor in the nozzle to a forward-calculated prediction. The comparison is performed between two line applications to detect amplifying inaccuracies in speed and current modulation. This level can be regarded as an online quality assurance of the machine. Both safety levels use devices and functionalities already installed along the beamline. Hence, the presented monitoring and validation system preserves full compatibility of discrete and continuous delivery mode on a single gantry, with the possibility of switching between modes during the

  8. GATE Monte Carlo simulation in radiation therapy for complex and dynamic beams in IMRT

    International Nuclear Information System (INIS)

    Benhalouche, Saadia

    2014-01-01

    Radiotherapy is one of the three methods of cancer treatment along with surgery and chemotherapy. It has evolved with the development of treatment techniques such as IMRT and VMAT along with IGRT for patient positioning. The aim is to effectively treat tumors while limiting the dose to healthy organs. In our work, we use the GATE Monte Carlo simulation platform to model a LINAC for a 6 MV photon beam. The resulting model is then validated with a dosimetric study by calculating relevant parameters for the beam quality. The LINAC model is then used for simulating clinical IMRT treatment plans in the ORL domain. Simulation results are compared with experimental measurements. We also explored the possibility of modeling the LINAC portal imaging system. This technique referred to as MV-CBCT combine the LINAC source with a flat panel detector to acquire 3D images of the patient. This part was validated first by acquiring 2D projections on patient and anthropomorphic phantom, and by reconstructing 3D volumes. Here again, validation was performed by comparing simulated and actual images. As a second step, a dosimetric validation was done by evaluating the dose deposited by IMRT beams, by means of portal signal only. We show in the present work the ability of GATE to perform complex IMRT treatments and portal images as they are performed routinely for dosimetric quality control. (author) [fr

  9. Prevalence and Predicting Factors for Commonly Neglected Sexual Side Effects to External-Beam Radiation Therapy for Prostate Cancer.

    Science.gov (United States)

    Frey, Anders; Pedersen, Christian; Lindberg, Henriette; Bisbjerg, Rasmus; Sønksen, Jens; Fode, Mikkel

    2017-04-01

    Changes in sexual function other than erectile dysfunction are sparsely investigated after radiation therapy for prostate cancer. To investigate orgasmic dysfunction, urinary incontinence during sexual activity, changes in penile morphology, and sensory disturbances in the penis in patients with prostate cancer treated with external-beam radiation therapy (EBRT). In February 2015, men treated with EBRT at our center 3 months to 5 years previously (N = 519) received a study-specific questionnaire. This was developed from purpose-built questions and validated tools including the Erection Hardness Scale. All patients had received a radiation dose of 78 Gy. Androgen deprivation therapy was administered according to disease characteristics. Outcome measurements were prevalence rates and predictors of these side effects as identified by multivariate logistic regression analyses. One hundred nine patients were eligible (sexually active and had completed androgen deprivation therapy) for inclusion. Twenty-four percent reported anorgasmia, 44% reported a decreased intensity of their orgasms, and 40% reported that the time it took to reach orgasm had increased. Eleven percent reported anejaculation. Fifteen percent reported orgasm-associated pain. Only 4% reported urinary incontinence during sexual activity. Subjective penile length loss in excess of 1 cm was reported by 42%. Twelve percent reported an altered curvature of their penis after EBRT. Six percent reported painful erections. Twenty-seven percent reported decreased sensitivity in the penis after EBRT, 2% reported a cold sensation, and 2% reported paresthesia. Increasing time since final treatment increased the risk of penile sensory disturbances (odds ratio = 1.05; P = .028). Orgasmic dysfunction, changes in penile morphology, and sensory disturbances in the penis are common side effects of ERBT. Patients should be properly informed of the occurrence of these side effects before deciding which treatment to

  10. Impact of Concurrent Androgen Deprivation on Fiducial Marker Migration in External-beam Radiation Therapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tiberi, David A.; Carrier, Jean-Francois; Beauchemin, Marie-Claude; Nguyen, Thu Van; Beliveau-Nadeau, Dominic [Departement de Radio-Oncologie, Centre hospitalier de l' Universite de Montreal-Hopital Notre-Dame, Montreal, Quebec (Canada); Taussky, Daniel, E-mail: daniel.taussky.chum@ssss.gouv.qc.ca [Departement de Radio-Oncologie, Centre hospitalier de l' Universite de Montreal-Hopital Notre-Dame, Montreal, Quebec (Canada)

    2012-09-01

    Purpose: To determine the extent of gold fiducial marker (FM) migration in patients treated for prostate cancer with concurrent androgen deprivation and external-beam radiation therapy (EBRT). Methods and Materials: Three or 4 gold FMs were implanted in 37 patients with prostate adenocarcinoma receiving androgen deprivation therapy (ADT) in conjunction with 70-78 Gy. Androgen deprivation therapy was started a median of 3.9 months before EBRT (range, 0.3-12.5 months). To establish the extent of FM migration, the distance between each FM was calculated for 5-8 treatments once per week throughout the EBRT course. For each treatment, the distance between FMs was compared with the distance from the digitally reconstructed radiographs generated from the planning CT. A total of 281 treatments were analyzed. Results: The average daily migration was 0.8 {+-} 0.3 mm, with distances ranging from 0.2 mm-2.6 mm. Two of the 281 assessed treatments (0.7%) showed migrations >2 mm. No correlation between FM migration and patient weight or time delay between ADT and start of EBRT was found. There was no correlation between the extent of FM migration and prostate volume. Conclusion: This is the largest report of implanted FM migration in patients receiving concomitant ADT. Only 0.7% of the 281 treatments studied had significant marker migrations (>2 mm) throughout the course of EBRT. Consequently, the use of implanted FMs in these patients enables accurate monitoring of prostate gland position during treatment.

  11. Application of flat panel digital imaging for improvement of ocular melanoma patient set-up in proton beam therapy

    Science.gov (United States)

    Daftari, Inder K.; Essert, Timothy; Phillips, Theodore L.

    2009-01-01

    In order to reduce the dose to surrounding critical tissues and also minimize the probability of recurrence of the tumor the placement of radiation fields relative to patient anatomy is very essential in proton beam therapy of ocular tumors. To achieve this objective, patient setup and field placement have been verified before treatment by analyzing the portal images obtained with Polaroid film-camera system. The Polaroid films are becoming expensive and obsolete, making new methods of verifying the patient treatment position essential. The objective of this study was to implement an orthogonal flat panel digital imaging (FPDI) system as a tool to image-guided radiation therapy (IGRT) on the UC Davis cyclotron proton beam therapy line and to use the system for patient setup verification. The image quality of the system is sufficient to see an air hole with a diameter of 0.5 mm at a depth of 9 mm, in a 10 cm Lucite phantom. The subject contrast of the FPDI system varied from 16% to 29% by varying the size of the air hole in the phantom from 1 to 5 mm and changing the depth from 9 to 15 mm. The subject contrast for 0.5 mm air hole was 11%. The comparison of the setup variations as measured from Polaroid port films and FPDI was 0.1±0.7 mm in the X-direction, 0.2±0.2 mm in the Y-direction and 0.04±0.1 mm in Z-direction, respectively. The day-to-day positional variations in-patient set-ups were studied for 30 patients using the FPDI system. The patient position set-up on first day of treatment [defined by the X, Y, Z coordinates of the chair and head holder] was registered as the reference image. The comparison of day-to-day patient position with reference image indicated net translation along the three orthogonal axes as 0.3±1.88 mm in right-left direction, -0.3±1.78 in superior-inferior direction and -0.6±2.8 mm in anterior-posterior direction. The image quality of the FPDI system was sufficient to clearly reveal the radio-opaque markers on the digital image. In

  12. Comparison of quality of life in patients with nasopharyngeal carcinoma receiving conventional external beam radiation therapy versus intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    Zheng Lu; Yan Senxiang; Yan Danfang

    2011-01-01

    Objective: To compare the acute and late adverse events and quality of life (QOL) in patients with nasopharyngeal carcinomas receiving conventional external beam radiation therapy (RT) versus intensity modulated radiation therapy (IMRT). Methods: Ninety-one patients with newly diagnosed nasopharyngeal carcinoma treated in our institution between August 2008 and September 2010 were systemically reviewed, including 35 cases administered with conventional RT (RT group) and 56 cases with IMRT (IMRT group). Conjoint faciocervical fields plus tangential lower neck-supraclavicular field initially, and then shrinking preauricular portals plus electron beams to the neck were adopted in RT groups, with a total dose of 70 Gy/35 fractions.Nine coplanar fields were conducted in IMRT group with a total dose of 69.96 Gy/33 fractions. Acute and late adverse reactions were observed and compared between RT and IMRT groups, including acute reactions as xerostomia, odynophagia, dermatitis/mucositis and late events as dysphagia, trismus, hypothyroidism, optic/acoustic impairments, skin injury, hypodermal fibrosis, spinal myelitis and brain injury. Results: Compared with RT group, IMRT group showed less acute reactions in xerostomia, odynophagia, dysphagia and dermatitis and mucositis (χ 2 =85.73, 56.03, 26.58, 69.28, 55.99, P<0.05), and less late reactions in xerostomia, dysphagia, trismus, taste loss and skin injury (χ 2 =37.95, 7.48, 9.49, 9.49, 11.87, P<0.05), whereas the degree of acoustic/optic impairments and brain injury showed no difference in both groups. Conclusions: As compared to conventional RT, IMRT could decrease acute and some late side events, and improve the quality of life in patients with nasopharyngeal carcinoma. (authors)

  13. External Beam Boost for Cancer of the Cervix Uteri When Intracavitary Therapy Cannot Be Performed

    International Nuclear Information System (INIS)

    Barraclough, Lisa Helen; Swindell, Ric; Livsey, Jacqueline E.; Hunter, Robin D.; Davidson, Susan E.

    2008-01-01

    Purpose: To assess the outcome of patients treated with radical radiotherapy for cervical cancer who received an external beam boost, in place of intracavitary brachytherapy (ICT), after irradiation to the whole pelvis. Methods and Materials: Case notes were reviewed for all patients treated in this way in a single center between 1996 and 2004. Patient and tumor details, the reasons why ICT was not possible, and treatment outcome were documented. Results: Forty-four patients were identified. The mean age was 56.4 years (range, 26-88 years). Clinical International Federation of Gynecology and Obstetrics or radiologic stage for Stages I, II, III, and IV, respectively, was 16%, 48%, 27%, and 7%. A total radiation dose of 54-70 Gy was given (75% received ≥60 Gy). Reasons for ICT not being performed were technical limitations in 73%, comorbidity or isolation limitations in 23%, and patient choice in 4%. The median follow-up was 2.3 years. Recurrent disease was seen in 48%, with a median time to recurrence of 2.3 years. Central recurrence was seen in 16 of the 21 patients with recurrent disease. The 5-year overall survival rate was 49.3%. The 3-year cancer-specific survival rate by stage was 100%, 70%, and 42% for Stages I, II, and III, respectively. Late Grades 1 and 2 bowel, bladder, and vaginal toxicity were seen in 41%. Late Grade 3 toxicity was seen in 2%. Conclusion: An external beam boost is a reasonable option after external beam radiotherapy to the pelvis when it is not possible to perform ICT

  14. Proton beam radiotherapy for uveal melanoma: Results of Curie Institut-Orsay Proton Therapy Center (ICPO)

    International Nuclear Information System (INIS)

    Dendale, Remi; Lumbroso-Le Rouic, Livia; Noel, Georges; Feuvret, Loic; Levy, Christine; Delacroix, Sabine; Meyer, Anne; Nauraye, Catherine; Mazal, Alejandro; Mammar, Hamid; Garcia, Paul; D'Hermies, Francois; Frau, Eric; Plancher, Corine; Asselain, Bernard; Schlienger, Pierre; Mazeron, Jean Jacques; Desjardins, Laurence

    2006-01-01

    Purpose: This study reports the results of proton beam radiotherapy based on a retrospective series of patients treated for uveal melanoma at the Orsay Center. Methods and Materials: Between September 1991 and September 2001, 1,406 patients with uveal melanoma were treated by proton beam radiotherapy. A total dose of 60 cobalt Gray equivalent (CGE) was delivered in 4 fractions on 4 days. Survival rates were determined using Kaplan-Meier estimates. Prognostic factors were determined by multivariate analysis using the Cox model. Results: The median follow-up was 73 months (range, 24-142 months). The 5-year overall survival and metastasis-free survival rates were 79% and 80.6%, respectively. The 5-year local control rate was 96%. The 5-year enucleation for complications rate was 7.7%. Independent prognostic factors for overall survival were age (p < 0.0001), gender (p < 0.0003), tumor site (p < 0.0001), tumor thickness (p = 0.02), tumor diameter (p < 0.0001), and retinal area receiving at least 30 CGE (p = 0.003). Independent prognostic factors for metastasis-free survival were age (p = 0.0042), retinal detachment (p = 0.01), tumor site (p < 0.0001), tumor volume (p < 0.0001), local recurrence (p < 0.0001), and retinal area receiving at least 30 CGE (p = 0.002). Independent prognostic factors for local control were tumor diameter (p = 0.003) and macular area receiving at least 30 CGE (p = 0.01). Independent prognostic factors for enucleation for complications were tumor thickness (p < 0.0001) and lens volume receiving at least 30 CGE (p = 0.0002). Conclusion: This retrospective study confirms that proton beam radiotherapy ensures an excellent local control rate. Further clinical studies are required to decrease the incidence of postirradiation ocular complications

  15. Noninvasive referencing of intraocular tumors for external beam radiation therapy using optical coherence tomography: A proof of concept

    International Nuclear Information System (INIS)

    Rüegsegger, Michael B.; Steiner, Patrick; Kowal, Jens H.; Geiser, Dominik; Pica, Alessia; Aebersold, Daniel M.

    2014-01-01

    Purpose: External beam radiation therapy is currently considered the most common treatment modality for intraocular tumors. Localization of the tumor and efficient compensation of tumor misalignment with respect to the radiation beam are crucial. According to the state of the art procedure, localization of the target volume is indirectly performed by the invasive surgical implantation of radiopaque clips or is limited to positioning the head using stereoscopic radiographies. This work represents a proof-of-concept for direct and noninvasive tumor referencing based on anterior eye topography acquired using optical coherence tomography (OCT). Methods: A prototype of a head-mounted device has been developed for automatic monitoring of tumor position and orientation in the isocentric reference frame for LINAC based treatment of intraocular tumors. Noninvasive tumor referencing is performed with six degrees of freedom based on anterior eye topography acquired using OCT and registration of a statistical eye model. The proposed prototype was tested based on enucleated pig eyes and registration accuracy was measured by comparison of the resulting transformation with tilt and torsion angles manually induced using a custom-made test bench. Results: Validation based on 12 enucleated pig eyes revealed an overall average registration error of 0.26 ± 0.08° in 87 ± 0.7 ms for tilting and 0.52 ± 0.03° in 94 ± 1.4 ms for torsion. Furthermore, dependency of sampling density on mean registration error was quantitatively assessed. Conclusions: The tumor referencing method presented in combination with the statistical eye model introduced in the past has the potential to enable noninvasive treatment and may improve quality, efficacy, and flexibility of external beam radiotherapy of intraocular tumors

  16. Normal tissue tolerance to external beam radiation therapy: Brain and hypophysis

    International Nuclear Information System (INIS)

    Haberer, S.; Assouline, A.; Mazeron, J.J.

    2010-01-01

    Anticancer treatments-induced central nervous system neurotoxicity has become a major problem in recent years. Real advances in therapeutic results for cancer treatments have improved patients survival. Nowadays, central nervous system radiation therapy is widely prescribed, both for palliative and curative treatments in the management of malignant or benign tumors. Recent data on tolerance of normal central nervous system to radiation therapy are reviewed here, early and delayed radiation-induced effects are described and dose recommendations are suggested for clinical practice. (authors)

  17. Determination of absorbed dose in a proton beam for purposes of charged-particle radiation therapy

    International Nuclear Information System (INIS)

    Verhey, L.J.; Koehler, A.M.; McDonald, J.C.; Goitein, M.; Ma, I.C.; Schneider, R.J.; Wagner, M.

    1979-01-01

    Four methods are described by which absorbed dose has been measured in a proton beam extracted from the 160-MeV Harvard cyclotron. The standard dosimetry, used to determine doses for patient treatments, is based upon an absolute measurement of particle flux using a Faraday cup. Measurements have also been made using a parallel-plate ionization chamber; a thimble ionization chamber carying a 60 Co calibration traceable to NBS; and a tissue-equivalent calorimeter. The calorimeter, which provides an independent check of the dosimetry, agreed with the standard dosimetry at five widely different depths within a range from 0.8 to 2.6%

  18. A model-based analysis of a simplified beam-specific dose output in proton therapy with a single-ring wobbling system.

    Science.gov (United States)

    Kase, Yuki; Yamashita, Haruo; Numano, Masumi; Sakama, Makoto; Mizota, Manabu; Maeda, Yoshikazu; Tameshige, Yuji; Murayama, Shigeyuki

    2015-01-07

    In radiation therapy, it is necessary to preset a monitor unit in an irradiation control system to deliver a prescribed absolute dose to a reference point in the planning target volume. The purpose of this study was to develop a model-based monitor unit calculation method for proton-beam therapy with a single-ring wobbling system. The absorbed dose at a calibration point per monitor unit had been measured for each beam-specific measurement condition without a patient-specific collimator or range compensator before proton therapeutic irradiation at Shizuoka Cancer Center. In this paper, we propose a simplified dose output model to obtain the output ratio between a beam-specific dose and a reference field dose, from which a monitor unit for the proton treatment could be derived without beam-specific measurements. The model parameters were determined to fit some typical data measured in a proton treatment room, called a Gantry 1 course. Then, the model calculation was compared with 5456 dose output ratios that had been measured for 150-, 190- and 220 MeV therapeutic proton beams in two treatment rooms over the past decade. The mean value and standard deviation of the difference between the measurement and the model calculation were respectively 0.00% and 0.27% for the Gantry 1 course, and -0.25% and 0.35% for the Gantry 2 course. The model calculation was in good agreement with the measured beam-specific doses, within 1%, except for conditions less frequently used for treatment. The small variation for the various beam conditions shows the high long-term reproducibility of the measurement and high degree of compatibility of the two treatment rooms. Therefore, the model was expected to assure the setting value of the dose monitor for treatment, to save the effort required for beam-specific measurement, and to predict the dose output for new beam conditions in the future.

  19. Current status and perspective of heavy ion beam therapy for patients with pelvic recurrence after primarily resected rectal cancer

    International Nuclear Information System (INIS)

    Yamada, Shigeru; Yanagi, Tsuyoshi; Hara, Ryusuke; Yasuda, Shigeo; Kato, Hirotoshi; Kamada, Tadashi; Tsujii, Hirohiko

    2008-01-01

    This review describes the clinical features of recurrent rectal cancer (RC) and therapeutic properties of heavy ion beam (HIB, here, carbon ion beam) and outcome of its clinical trials with use of Heavy Ion Medical Accelerator in Chiba (HIMAC). The authors at first explain the statistics in Japan, clinical procession and therapy involving surgery, of primary and recurrent colorectal cancers. Then mentioned are characteristics of HIB for its class used for medical purpose, physical and biological properties. By February 2008, HIBs generated by HIMAC have been used to 3,819 patients with malignant diseases difficult for treatment with ordinary means hitherto like tumors of head and neck, brain, lung, esophagus, liver cells, prostate, uterine and bone/soft tissues. For patients with localized recurrent RC after surgery, as HIB therapy is promising for its high LET, phase I/II trial of HIB started in 2001 where 38 cases were enrolled, which defined a optimal dose of 73.6 GyE in 2004 with 3-year local control and survival of 81.8% and 75.0%, respectively, with scarce adverse effects. The phase II trial with the dose is now under progress as a pioneer medicare where, at present, 5-year local control of 93% and survival 57% are shown with scarce adverse event in 61 cases, which is thought to be better than any other radiotherapy outcome. Efforts are still being made for aiming wider application of HIB for recurrent RC like development of the spacer between the lesion and normal digestive tract to avoid the radiation exposure of the latter. (R.T.)

  20. Statistical modeling of the eye for multimodal treatment planning for external beam radiation therapy of intraocular tumors.

    Science.gov (United States)

    Rüegsegger, Michael B; Bach Cuadra, Meritxell; Pica, Alessia; Amstutz, Christoph A; Rudolph, Tobias; Aebersold, Daniel; Kowal, Jens H

    2012-11-15

    Ocular anatomy and radiation-associated toxicities provide unique challenges for external beam radiation therapy. For treatment planning, precise modeling of organs at risk and tumor volume are crucial. Development of a precise eye model and automatic adaptation of this model to patients' anatomy remain problematic because of organ shape variability. This work introduces the application of a 3-dimensional (3D) statistical shape model as a novel method for precise eye modeling for external beam radiation therapy of intraocular tumors. Manual and automatic segmentations were compared for 17 patients, based on head computed tomography (CT) volume scans. A 3D statistical shape model of the cornea, lens, and sclera as well as of the optic disc position was developed. Furthermore, an active shape model was built to enable automatic fitting of the eye model to CT slice stacks. Cross-validation was performed based on leave-one-out tests for all training shapes by measuring dice coefficients and mean segmentation errors between automatic segmentation and manual segmentation by an expert. Cross-validation revealed a dice similarity of 95%±2% for the sclera and cornea and 91%±2% for the lens. Overall, mean segmentation error was found to be 0.3±0.1 mm. Average segmentation time was 14±2 s on a standard personal computer. Our results show that the solution presented outperforms state-of-the-art methods in terms of accuracy, reliability, and robustness. Moreover, the eye model shape as well as its variability is learned from a training set rather than by making shape assumptions (eg, as with the spherical or elliptical model). Therefore, the model appears to be capable of modeling nonspherically and nonelliptically shaped eyes. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Statistical Modeling of the Eye for Multimodal Treatment Planning for External Beam Radiation Therapy of Intraocular Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Rueegsegger, Michael B. [ARTORG Center for Biomedical Engineering Research, University of Bern (Switzerland); Bach Cuadra, Meritxell [Department of Radiology, University Hospital Center (CHUV) and University of Lausanne (UNIL), Signal Processing Laboratory - LTS5, Ecole Polytechnique Federale de Lausanne (Switzerland); Pica, Alessia [Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern (Switzerland); Amstutz, Christoph A. [Department of Ophthalmology, University Hospital Zurich (Switzerland); Rudolph, Tobias [ARTORG Center for Biomedical Engineering Research, University of Bern (Switzerland); Aebersold, Daniel [Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern (Switzerland); Kowal, Jens H., E-mail: jens.kowal@artorg.unibe.ch [ARTORG Center for Biomedical Engineering Research, University of Bern (Switzerland)

    2012-11-15

    Purpose: Ocular anatomy and radiation-associated toxicities provide unique challenges for external beam radiation therapy. For treatment planning, precise modeling of organs at risk and tumor volume are crucial. Development of a precise eye model and automatic adaptation of this model to patients' anatomy remain problematic because of organ shape variability. This work introduces the application of a 3-dimensional (3D) statistical shape model as a novel method for precise eye modeling for external beam radiation therapy of intraocular tumors. Methods and Materials: Manual and automatic segmentations were compared for 17 patients, based on head computed tomography (CT) volume scans. A 3D statistical shape model of the cornea, lens, and sclera as well as of the optic disc position was developed. Furthermore, an active shape model was built to enable automatic fitting of the eye model to CT slice stacks. Cross-validation was performed based on leave-one-out tests for all training shapes by measuring dice coefficients and mean segmentation errors between automatic segmentation and manual segmentation by an expert. Results: Cross-validation revealed a dice similarity of 95% {+-} 2% for the sclera and cornea and 91% {+-} 2% for the lens. Overall, mean segmentation error was found to be 0.3 {+-} 0.1 mm. Average segmentation time was 14 {+-} 2 s on a standard personal computer. Conclusions: Our results show that the solution presented outperforms state-of-the-art methods in terms of accuracy, reliability, and robustness. Moreover, the eye model shape as well as its variability is learned from a training set rather than by making shape assumptions (eg, as with the spherical or elliptical model). Therefore, the model appears to be capable of modeling nonspherically and nonelliptically shaped eyes.

  2. Successful treatment of skin infiltration in childhood hematological malignancies with total skin electron beam therapy. A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Ohkawa, Masahito; Shikano, Takaaki; Ueno, Norihiro; Tsujii, Hirohiko; Tono-oka, Tatsuhito; Matsumoto, Takahide.

    1988-07-01

    Two children with cutaneous lymphoma and leukemia who were treated with total skin electron beam therapy (TSEB) are described here. Patient 1. A 7-year-old boy was admitted because of a mass over the bilateral parotis and anemia. The white blood cell count on admission was 5,000/ul. Bone marrow examination revealed 70 per cent monoblasts (M5a type by FAB classification). Complete remission was obtained following the regimen of daunomycin, cytosine arabinoside, 6-mercaptopurine and prednisolone. He was again admitted because of a skin nodule on the left thigh 19 months after initial diagnosis. A biopsy of the skin nodule demonstrated monoblastic infiltration. He received 20 Grays (Gy) to the left thigh and this led to resolution of the skin nodule. At that time, other skin nodules appeared on the right upper and lower extremities. He was treated with TSEB. Daily doses of 1 Gy were given twice a week with a 4 MeV electron beam and a total dose of 10 Gy was administered over a period of 4 weeks. Although he again had a isolated skin relapse on the right shoulder, he remained in remission for 6 years after completing TSEB. Patient 2. A 6-year-old boy was admitted because of multiple skin lesions. Physical examination revealed 22 discrete, indurated skin nodules. a biopsy of a skin nodule demonstrated lymphoblast infiltration, confirming the diagnosis of B cell cutaneous lymphoma (stage IV). He was treated with CHOP (consisting of cyclophosphamide, adriamycin, vincristine and prednisolone). After two courses of CHOP therapy, he was treated with TSEB using the same technique described above. To date, the patient remains in remission 5 years after initial diagnosis.

  3. Benefits, risks, and safety of external beam radiation therapy for breast cancer.

    Science.gov (United States)

    Brown, Lindsay C; Mutter, Robert W; Halyard, Michele Y

    2015-01-01

    Breast cancer is a common and complex disease often necessitating multimodality care. Breast cancer may be treated with surgical resection, radiotherapy (RT), and systemic therapy, including chemotherapy, hormonal therapy, and targeted therapies, or a combination thereof. In the past 50 years, RT has played an increasingly significant role in the treatment of breast cancer, resulting in improvements in locoregional control and survival for women undergoing mastectomy who are at high risk of recurrence, and allowing for breast conservation in certain settings. Although radiation provides significant benefit to many women with breast cancer, it is also associated with risks of toxicity, including cardiac and pulmonary toxicity, lymphedema, and secondary malignancy. RT techniques have advanced and continue to evolve dramatically, offering increased precision and reproducibility of treatment delivery and flexibility of treatment schedule. This increased sophistication of RT offers promise of improved outcomes by maintaining or improving efficacy, reducing toxicity, and increasing patient access and convenience. A review of the role of radiation therapy in breast cancer, its associated toxicities and efforts in toxicity reduction is presented.

  4. Nanoparticle-Assisted Scanning Focusing X-Ray Therapy with Needle Beam X Rays.

    Science.gov (United States)

    Davidson, R Andrew; Guo, Ting

    2016-01-01

    In this work, we show a new therapeutic approach using 40-120 keV X rays to deliver a radiation dose at the isocenter located many centimeters below the skin surface several hundred times greater than at the skin and how this dose enhancement can be augmented with nanomaterials to create several thousand-fold total dose enhancement effect. This novel approach employs a needle X-ray beam directed at the isocenter centimeters deep in the body while continuously scanning the beam to cover a large solid angle without overlapping at the skin. A Monte Carlo method was developed to simulate an X-ray dose delivered to the isocenter filled with X-ray absorbing and catalytic nanoparticles in a water phantom. An experimental apparatus consisting of a moving plastic phantom irradiated with a stationary 1 mm needle X-ray beam was built to test the theoretical predictions. X-ray films were used to characterize the dose profiles of the scanning X-ray apparatus. Through this work, it was determined that the X-ray dose delivered to the isocenter in a treatment voxel (t-voxel) underneath a 5 cm deep high-density polyethylene (HDPE) phantom was 295 ± 48 times greater than the surface dose. This measured value was in good agreement with the theoretical predicted value of 339-fold. Adding X-ray-absorbing nanoparticles, catalytic nanoparticles or both into the t-voxel can further augment the dose enhancement. For example, we predicted that adding 1 weight percentage (wp) of gold into water could increase the effective dose delivered to the target by onefold. Dose enhancement using 1 mm X-ray beam could reach about 1,600-fold in the t-voxel when 7.5 wp of 88 nm diameter silica-covered gold nanoparticles were added, which we showed in a previously published study can create a dose enhancement of 5.5 ± 0.46-fold without scanning focusing enhancement. Based on the experimental data from that study, mixing 0.02 wp 2.5 nm diameter small tetrakis hydroxymethyl phosphonium chloride (THPC

  5. Maximum proton kinetic energy and patient-generated neutron fluence considerations in proton beam arc delivery radiation therapy

    International Nuclear Information System (INIS)

    Sengbusch, E.; Perez-Andujar, A.; DeLuca, P. M. Jr.; Mackie, T. R.

    2009-01-01

    proton kinetic energy from 250 to 200 MeV decreases the total neutron energy fluence produced by stopping a monoenergetic pencil beam in a water phantom by a factor of 2.3. It is possible to significantly lower the requirements on the maximum kinetic energy of a compact proton accelerator if the ability to treat a small percentage of patients with rotational therapy is sacrificed. This decrease in maximum kinetic energy, along with the corresponding decrease in neutron production, could lower the cost and ease the engineering constraints on a compact proton accelerator treatment facility.

  6. Positron emission tomography for the dose monitoring of intra-fractionally moving targets in ion beam therapy

    International Nuclear Information System (INIS)

    Stuetzer, Kristin

    2014-01-01

    Ion beam therapy (IBT) is a promising treatment option in radiotherapy. The characteristic physical and biological properties of light ion beams allow for the delivery of highly tumor conformal dose distributions. Related to the sparing of surrounding healthy tissue and nearby organs at risk, it is feasible to escalate the dose in the tumor volume to reach higher tumor control and survival rates. Remarkable clinical outcome was achieved with IBT for radio-resistant, deep-seated, static and well fixated tumor entities. Presumably, more patients could benefit from the advantages of IBT if it would be available for more frequent tumor sites. Those located in the thorax and upper abdominal region are commonly subjected to intra-fractional, respiration related motion. Different motion-compensated dose delivery techniques have been developed for active field shaping with scanned pencil beams and are at least available under experimental conditions at the GSI Helmholtzzentrum fuer Schwerionenforschung (GSI) in Darmstadt, Germany. Since minor unexpected anatomical changes e.g. related to patient mispositioning, tumour shrinkage or tissue swelling could already lead to remarkable deviations between planned and delivered dose distribution, a valuable dose monitoring system is desired for IBT. So far, positron emission tomography (PET) is the only in vivo, in situ and non-invasive qualitative dose monitoring method applied under clinical conditions. Conclusions about the delivered dose distribution can be drawn indirectly from a comparison between two β + -activity distributions: the measured one and an expected one generated by a Monte-Carlo simulation. Dedicated phantoms mainly made up of polymethyl methacrylate (PMMA) and a motion table for regular one-dimensional (1D) motion patterns have been designed and manufactured for the experiments. Furthermore, the general applicability of the 4D MLEM algorithm for more complex motion patterns has been demonstrated by the

  7. Positron emission tomography for the dose monitoring of intra-fractionally moving targets in ion beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Stuetzer, Kristin

    2014-07-01

    Ion beam therapy (IBT) is a promising treatment option in radiotherapy. The characteristic physical and biological properties of light ion beams allow for the delivery of highly tumor conformal dose distributions. Related to the sparing of surrounding healthy tissue and nearby organs at risk, it is feasible to escalate the dose in the tumor volume to reach higher tumor control and survival rates. Remarkable clinical outcome was achieved with IBT for radio-resistant, deep-seated, static and well fixated tumor entities. Presumably, more patients could benefit from the advantages of IBT if it would be available for more frequent tumor sites. Those located in the thorax and upper abdominal region are commonly subjected to intra-fractional, respiration related motion. Different motion-compensated dose delivery techniques have been developed for active field shaping with scanned pencil beams and are at least available under experimental conditions at the GSI Helmholtzzentrum fuer Schwerionenforschung (GSI) in Darmstadt, Germany. Since minor unexpected anatomical changes e.g. related to patient mispositioning, tumour shrinkage or tissue swelling could already lead to remarkable deviations between planned and delivered dose distribution, a valuable dose monitoring system is desired for IBT. So far, positron emission tomography (PET) is the only in vivo, in situ and non-invasive qualitative dose monitoring method applied under clinical conditions. Conclusions about the delivered dose distribution can be drawn indirectly from a comparison between two β{sup +}-activity distributions: the measured one and an expected one generated by a Monte-Carlo simulation. Dedicated phantoms mainly made up of polymethyl methacrylate (PMMA) and a motion table for regular one-dimensional (1D) motion patterns have been designed and manufactured for the experiments. Furthermore, the general applicability of the 4D MLEM algorithm for more complex motion patterns has been demonstrated by the

  8. Electrostatic design and beam transport for a folded tandem electrostatic quadrupole accelerator facility for accelerator-based boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Thatar Vento, V., E-mail: Vladimir.ThatarVento@gmail.com [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina); Bergueiro, J.; Cartelli, D. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina); Valda, A.A. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. Irigoyen 3100 (1650), San Martin, Buenos Aires (Argentina); Kreiner, A.J. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. Irigoyen 3100 (1650), San Martin, Buenos Aires (Argentina)

    2011-12-15

    Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole (TESQ) accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT), we discuss here the electrostatic design of the machine, including the accelerator tubes with electrostatic quadrupoles and the simulations for the transport and acceleration of a high intensity beam.

  9. Assessment of organ dose reduction and secondary cancer risk associated with the use of proton beam therapy and intensity modulated radiation therapy in treatment of neuroblastomas

    International Nuclear Information System (INIS)

    Fuji, Hiroshi; Harada, Hideyuki; Asakura, Hirofumi; Nishimura, Tetsuo; Schneider, Uwe; Ishida, Yuji; Konno, Masahiro; Yamashita, Haruo; Kase, Yuki; Murayama, Shigeyuki; Onoe, Tsuyoshi; Ogawa, Hirofumi

    2013-01-01

    To compare proton beam therapy (PBT) and intensity-modulated radiation therapy (IMRT) with conformal radiation therapy (CRT) in terms of their organ doses and ability to cause secondary cancer in normal organs. Five patients (median age, 4 years; range, 2–11 years) who underwent PBT for retroperitoneal neuroblastoma were selected for treatment planning simulation. Four patients had stage 4 tumors and one had stage 2A tumor, according to the International Neuroblastoma Staging System. Two patients received 36 Gy, two received 21.6 Gy, and one received 41.4 Gy of radiation. The volume structures of these patients were used for simulations of CRT and IMRT treatment. Dose–volume analyses of liver, stomach, colon, small intestine, pancreas, and bone were performed for the simulations. Secondary cancer risks in these organs were calculated using the organ equivalent dose (OED) model, which took into account the rates of cell killing, repopulation, and the neutron dose from the treatment machine. In all evaluated organs, the mean dose in PBT was 20–80% of that in CRT. IMRT also showed lower mean doses than CRT for two organs (20% and 65%), but higher mean doses for the other four organs (110–120%). The risk of secondary cancer in PBT was 24–83% of that in CRT for five organs, but 121% of that in CRT for pancreas. The risk of secondary cancer in IMRT was equal to or higher than CRT for four organs (range 100–124%). Low radiation doses in normal organs are more frequently observed in PBT than in IMRT. Assessments of secondary cancer risk showed that PBT reduces the risk of secondary cancer in most organs, whereas IMRT is associated with a higher risk than CRT

  10. External beam radiation therapy and a low-dose-rate brachytherapy boost without or with androgen deprivation therapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Tobin J.; Hutchinson, Sean Z.; Shrinath, Kushagra; Cruz, Alex A.; Figura, Nicholas B.; Nethers, Kevin; Biagioli, Matthew C.; Fernandez, Daniel C.; Heysek, Randy V.; Wilder, Richard B., E-mail: richard.wilder@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States)

    2014-07-15

    Purpose: To assess outcomes with external beam radiation therapy (EBRT) and a low-dose-rate (LDR) brachytherapy boost without or with androgen deprivation therapy (ADT) for prostate cancer. Materials and Methods: From January 2001 through August 2011, 120 intermediate-risk or high-risk prostate cancer patients were treated with EBRT to a total dose of 4,500 cGy in 25 daily fractions and a palladium-103 LDR brachytherapy boost of 10,000 cGy (n = 90) or an iodine-125 LDR brachytherapy boost of 11,000 cGy (n = 30). ADT, consisting of a gonadotropin-releasing hormone agonist ± an anti-androgen, was administered to 29/92 (32%) intermediate-risk patients for a median duration of 4 months and 26/28 (93%) high-risk patients for a median duration of 28 months. Results: Median follow-up was 5.2 years (range, 1.1-12.8 years). There was no statistically-significant difference in biochemical disease-free survival (bDFS), distant metastasis-free survival (DMFS), or overall survival (OS) without or with ADT. Also, there was no statistically-significant difference in bDFS, DMFS, or OS with a palladium-103 vs. an iodine-125 LDR brachytherapy boost. Conclusions: There was no statistically-significant difference in outcomes with the addition of ADT, though the power of the current study was limited. The Radiation Therapy Oncology Group 0815 and 0924 phase III trials, which have accrual targets of more than 1,500 men, will help to clarify the role ADT in locally-advanced prostate cancer patients treated with EBRT and a brachytherapy boost. Palladium-103 and iodine-125 provide similar bDFS, DMFS, and OS. (author)

  11. Lack of Apparent Survival Benefit With Use of Androgen Deprivation Therapy in Patients With High-risk Prostate Cancer Receiving Combined External Beam Radiation Therapy and Brachytherapy.

    Science.gov (United States)

    Yang, David D; Muralidhar, Vinayak; Mahal, Brandon A; Nguyen, Paul L; Devlin, Phillip M; King, Martin T; Orio, Peter F

    2018-01-01

    Although level 1 evidence has demonstrated a survival benefit from the addition of androgen deprivation therapy (ADT) to external beam radiation therapy (EBRT) for patients with high-risk prostate cancer, the benefits of ADT with combined EBRT and brachytherapy for high-risk patients are unclear. We examined the association between ADT and overall survival in a national cohort of high-risk patients treated with EBRT with or without brachytherapy. We identified 46,325 men in the National Cancer Database with a diagnosis of high-risk prostate cancer (Gleason score 8-10, clinical stage T3-T4, or prostate-specific antigen >20 ng/mL) who were treated with EBRT with or without brachytherapy and ADT from 2004 through 2011. Multivariable Cox regression analysis adjusting for sociodemographic and clinicopathologic factors was used to identify the association between ADT and overall survival. The median follow-up period was 48.6 and 59.2 months for patients treated with EBRT only and combined modality RT, respectively. ADT was associated with an improvement in overall survival for the 85.0% (39,361) of the study cohort who underwent EBRT alone (adjusted hazard ratio 0.91, P=.001) but not for patients treated with combined modality RT (adjusted hazard ratio 1.05, P=.496), with a significant interaction (P interaction =.036). In contrast to the known survival benefit when ADT is given with EBRT, our results suggest that ADT might not improve survival for high-risk patients who undergo combined EBRT and brachytherapy. Given the significant adverse effects of ADT, in particular, with long-term therapy, a randomized controlled trial of combined EBRT and brachytherapy with or without ADT for select high-risk patients using a noninferiority design should be undertaken. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Electron beam therapy in squamous and basal cell carcinoma of the face

    International Nuclear Information System (INIS)

    Reinfuss, M.; Glinski, B.; Weiss, M.; Strzeszynski, J.

    1989-01-01

    This work is a retrospective study of 86 patients with squamous cell (51) and basal cell (35) carcinoma of the face. The median age was 67 years. The staging is as following: 31 cases T 1 and T 2 , 55 patients T 3 and T 4 . All patients were considered NO. Electron beam was used in all cases and energy ranged from 5 to 15 MeV depending on the thickness of the tumor. The total tumor dose was 60-70 Gy delivered in 6 weeks. In 7 cases of very old patients the authors have used concentrated irradiation: 3 patients received 21 Gy in one fraction and 4 patients 48 Gy in 8 fractions. 96.8% patients T 1 i T 2 are NED contrary to 56.4% T 3 i T 4 . Cosmetic results were considered as good in 52, fairly good in 7 and bad in 2 patients [fr

  13. Comparison of two methods of therapy level calibration at 60Co gamma beams

    International Nuclear Information System (INIS)

    Bjerke, H.; Jaervinen, H.; Grimbergen, T.W.M.; Grindborg, J.E.; Chauvenet, B.; Czap, L.; Ennow, K.; Moretti, C.; Rocha, P.

    1998-01-01

    The accuracy and traceability of the calibration of radiotherapy dosimeters is of great concern to those involved in the delivery of radiotherapy. It has been proposed that calibration should be carried out directly in terms of absorbed dose to water, instead of using the conventional and widely applied quantity of air kerma. In this study, the faithfulness in disseminating standards of both air kerma and absorbed dose to water were evaluated, through comparison of both types of calibration for three types of commonly used radiotherapy dosimeters at 60 Co gamma beams at a few secondary and primary standard dosimetry laboratories (SSDLs and PSDLs). A supplementary aim was to demonstrate the impact which the change in the method of calibration would have on clinical dose measurements at the reference point. Within the estimated uncertainties, both the air kerma and absorbed dose to water calibration factors obtained at different laboratories were regarded as consistent. As might be expected, between the SSDLs traceable to the same PSDL the observed differences were smaller (less than 0.5%) than between PSDLs or SSDLs traceable to different PSDLs (up to 1.5%). This can mainly be attributed to the reported differences between the primary standards. The calibration factors obtained by the two methods differed by up to about 1.5% depending on the primary standards involved and on the parameters of calculation used for 60 Co gamma radiation. It is concluded that this discrepancy should be settled before the new method of calibration at 60 Co gamma beams in terms of absorbed dose to water is taken into routine use. (author)

  14. Comparison of two methods of therapy level calibration at 60Co gamma beams

    International Nuclear Information System (INIS)

    Bjerke, H; Jaervinen, H; Grimbergen, T W M; Grindborg, J-E; Chauvenet, B; Czap, L; Ennow, K; Moretti, C; Rocha, P

    1998-01-01

    The accuracy and traceability of the calibration of radiotherapy dosimeters is of great concern to those involved in the delivery of radiotherapy. It has been proposed that calibration should be carried out directly in terms of absorbed dose to water, instead of using the conventional and widely applied quantity of air kerma. In this study, the faithfulness in disseminating standards of both air kerma and absorbed dose to water were evaluated, through comparison of both types of calibration for three types of commonly used radiotherapy dosimeters at 60 Co gamma beams at a few secondary and primary standard dosimetry laboratories (SSDLs and PSDLs). A supplementary aim was to demonstrate the impact which the change in the method of calibration would have on clinical dose measurements at the reference point. Within the estimated uncertainties, both the air kerma and absorbed dose to water calibration factors obtained at different laboratories were regarded as consistent. As might be expected, between the SSDLs traceable to the same PSDL the observed differences were smaller (less than 0.5%) than bet