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Sample records for biological image-adapted radiotherapy

  1. Dynamic contrast enhanced magnetic resonance imaging of bladder cancer and implications for biological image-adapted radiotherapy

    International Nuclear Information System (INIS)

    Purpose. To assess the role of image parameters derived from dynamic contrast enhanced magnetic resonance imaging (DCEMRI) in bladder cancer staging, and to investigate the potential use of such parameter images in biological image-adapted radiotherapy (RT). Materials and methods. High-resolution volumetric interpolated breath-hold (VIBE) DCEMRI of 26 patients diagnosed with bladder cancer was performed. DCEMRI parameters derived from tumor and muscle contrast uptake curves were extracted and subjected to correlation analysis with tumor volume as well as clinical, pathological, histological and T2-weighted MR tumor stage. For parameters showing a significant correlation with tumor stage, 3D malignancy maps were generated. As an initial step towards delivery of biologically adapted intensity modulated radiotherapy (IMRT) it was hypothesized that the malignancy map could be used as a RT dose prescription map. Simulating IMRT delivery with multi-leaf collimators (MLCs), idealized dose distributions, constituted by dose cubes, were adapted to the prescription map. The size of the dose cubes were varied to mimic MLCs of varying leaf width. The difference between the adapted and prescribed dose distributions was quantified by the root mean square deviation (RMSD). Results. No significant relationships were found between tumor volume and extracted DCEMRI parameters. The normalized area between tumor and muscle contrast uptake curves (nABC) evaluated from 0-180 seconds (nABC180) and 0-480s (nABC480) correlated significantly with tumor stage (p=0.047 and p=0.035, respectively). Dose prescription maps for 10 patients were generated from the nABC480. The RMSD between the prescribed and adapted dose distribution decreased with decreasing size of the dose cubes. Large interpatient variations in the RMSD and in the dependence of the RMSD on different dose cube sizes were found. Conclusions. The nABC180 and nABC480 may provide added value in staging of bladder cancer. High

  2. Basic radiotherapy physics and biology

    CERN Document Server

    Chang, David S; Das, Indra J; Mendonca, Marc S; Dynlacht, Joseph R

    2014-01-01

    This book is a concise and well-illustrated review of the physics and biology of radiation therapy intended for radiation oncology residents, radiation therapists, dosimetrists, and physicists. It presents topics that are included on the Radiation Therapy Physics and Biology examinations and is designed with the intent of presenting information in an easily digestible format with maximum retention in mind. The inclusion of mnemonics, rules of thumb, and reader-friendly illustrations throughout the book help to make difficult concepts easier to grasp. Basic Radiotherapy Physics and Biology is a

  3. Biological basis for modifying radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Standard radiotherapy is administered as a series of equal doses usually 5/week for several weeks, a process termed fractionation. Each equal dose 'fraction' kills the same proportion of cells. A common daily dose is 200 centiGray (previous terminology: 200 rad) which reduces tumor cell survival to about 50%. A similar dose administered the next day will further reduce survival by 50%, that is to 25% of the original population. This equal proportionate effect results in a logarithmic decline in total cell number with increase in number of dose fractions. Breaking the total dose into a series of dose fractions amplifies therapeutic differential between normal tissues and tumors for several reasons; 4 R's: repair of cellular injury, repopulation by surviving cells, redistribution within the division cycle, reoxygenation of the tumor. Additional modifications of fractionation aim at increasing the advantage already gained from standard fractionation. (author). 4 refs

  4. Evaluation of conformal radiotherapy techniques through physics and biologic criteria

    International Nuclear Information System (INIS)

    In the fight against cancer, different irradiation techniques have been developed based on technological advances and aiming to optimize the elimination of tumor cells with the lowest damage to healthy tissues. The radiotherapy planning goal is to establish irradiation technical parameters in order to achieve the prescribed dose distribution over the treatment volumes. While dose prescription is based on radiosensitivity of the irradiated tissues, the physical calculations on treatment planning take into account dosimetric parameters related to the radiation beam and the physical characteristics of the irradiated tissues. To incorporate tissue's radiosensitivity into radiotherapy planning calculations can help particularize treatments and establish criteria to compare and elect radiation techniques, contributing to the tumor control and the success of the treatment. Accordingly, biological models of cellular response to radiation have to be well established. This work aimed to study the applicability of using biological models in radiotherapy planning calculations to aid evaluating radiotherapy techniques. Tumor control probability (TCP) was studied for two formulations of the linear-quadratic model, with and without repopulation, as a function of planning parameters, as dose per fraction, and of radiobiological parameters, as the α/β ratio. Besides, the usage of biological criteria to compare radiotherapy techniques was tested using a prostate planning simulated with Monte Carlo code PENELOPE. Afterwards, prostate planning for five patients from the Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, USP, using three different techniques were compared using the tumor control probability. In that order, dose matrices from the XiO treatment planning system were converted to TCP distributions and TCP-volume histograms. The studies performed allow the conclusions that radiobiological parameters can significantly influence tumor control

  5. Biological effects and equivalent doses in radiotherapy: a software solution

    CERN Document Server

    Voyant, Cyril; Roustit, Rudy; Biffi, Katia; Marcovici, Celine Lantieri

    2013-01-01

    The limits of TDF (time, dose, and fractionation) and linear quadratic models have been known for a long time. Medical physicists and physicians are required to provide fast and reliable interpretations regarding the delivered doses or any future prescriptions relating to treatment changes. We therefore propose a calculation interface under the GNU license to be used for equivalent doses, biological doses, and normal tumor complication probability (Lyman model). The methodology used draws from several sources: the linear-quadratic-linear model of Astrahan, the repopulation effects of Dale, and the prediction of multi-fractionated treatments of Thames. The results are obtained from an algorithm that minimizes an ad-hoc cost function, and then compared to the equivalent dose computed using standard calculators in seven French radiotherapy centers.

  6. Biological optimization of heterogeneous dose distributions in systemic radiotherapy

    International Nuclear Information System (INIS)

    The standard computational method developed for internal radiation dosimetry is the MIRD (medical internal radiation dose) formalism, based on the assumption that tumor control is given by uniform dose and activity distributions. In modern systemic radiotherapy, however, the need for full 3D dose calculations that take into account the heterogeneous distribution of activity in the patient is now understood. When information on nonuniform distribution of activity becomes available from functional imaging, a more patient specific 3D dosimetry can be performed. Application of radiobiological models can be useful to correlate the calculated heterogeneous dose distributions to the current knowledge on tumor control probability of a homogeneous dose distribution. Our contribution to this field is the introduction of a parameter, the F factor, already used by our group in studying external beam radiotherapy treatments. This parameter allows one to write a simplified expression for tumor control probability (TCP) based on the standard linear quadratic (LQ) model and Poisson statistics. The LQ model was extended to include different treatment regimes involving source decay, incorporating the repair 'μ' of sublethal radiation damage, the relative biological effectiveness and the effective 'waste' of dose delivered when repopulation occurs. The sensitivity of the F factor against radiobiological parameters (α,β,μ) and the influence of the dose volume distribution was evaluated. Some test examples for 131I and 90Y labeled pharmaceuticals are described to further explain the properties of the F factor and its potential applications. To demonstrate dosimetric feasibility and advantages of the proposed F factor formalism in systemic radiotherapy, we have performed a retrospective planning study on selected patient case. F factor formalism helps to assess the total activity to be administered to the patient taking into account the heterogeneity in activity uptake and dose

  7. Biologically Weighted Quantities in Radiotherapy: an EMRP Joint Research Project

    Directory of Open Access Journals (Sweden)

    Rabus Hans

    2014-01-01

    Full Text Available Funded within the European Metrology Research Programme (EMRP [1], the joint research project “Biologically weighted quantities in radiotherapy” (BioQuaRT [2] aims to develop measurement and simulation techniques for determining the physical properties of ionising particle tracks on different length scales (about 2 nm to 10 μm, and to investigate the correlation of these track structure characteristics with the biological effects of radiation at the cellular level. Work package 1 develops micro-calorimeter prototypes for the direct measurement of lineal energy and will characterise their response for different ion beams by experiment and modelling. Work package 2 develops techniques to measure particle track structure on different length scales in the nanometre range as well as a measurement device integrating a silicon microdosimeter and a nanodosimeter. Work package 3 investigates the indirect effects of radiation based on probes for quantifying particular radical and reactive oxygen species (ROS. Work package 4 focuses on the biological aspects of radiation damage and will produce data on initial DNA damage and late effects for radiotherapy beams of different qualities. Work package 5 provides evaluated data sets of DNA cross-sections and develops a multi-scale model to address microscopic and nanometric track structure properties. The project consortium includes three linked researchers holding so-called Researcher Excellence Grants, who carry out ancillary investigations such as developing and benchmarking a new biophysical model for induction of early radiation damage and developing methods for the translation of quantities derived from particle track structure to clinical applications in ion beam therapy.

  8. Physical and biological basis of hadron radiotherapy. Book of abstracts

    International Nuclear Information System (INIS)

    The Workshop was a satellite event of the 14th International Congress of Radiation Research (ICRR-2011). It was held in Cracow, Poland, on the 2 and 3 September 2011, at the Collegium Novum of the Jagiellonian University. The Workshop organized, jointly by the Institute of Nuclear Physics of the Polish Academy of Sciences and the Polish Radiation Research Society, would provide its participants with an opportunity to discuss current topics in proton and carbon radiotherapy, clinical aspects of ion radiotherapy, ion beam dosimetry, unwanted patient exposure, radiobiology for ion radiotherapy and other relevant subjects. Book of Abstracts contains abstracts of 33 oral presentations and 12 posters.

  9. Biological modeling of gold nanoparticle enhanced radiotherapy for proton therapy

    International Nuclear Information System (INIS)

    Gold nanoparticles (GNPs) have shown potential as a radiosensitizer for radiation therapy using photon beams. Recently, experimental studies have been carried out using proton beams showing the GNP enhanced responses in proton therapy. In this work, we established a biological model to investigate the change in survival of irradiated cells due to the radiosensitizing effect of gold nanoparticles. Results for proton, megavoltage (MV) photon and kilovoltage (kV) photon beams are compared. For each particle source, we assessed various treatment depths, GNP cellular uptakes and sizes. We showed that kilovoltage photons caused the highest enhancement due to the high interaction probability between GNPs and kV photons. The cell survival fraction can be significantly reduced for both proton and MV photon irradiations if GNPs accumulate in the cell. For instance, the sensitizer enhancement ratio (SER) is 1.33 for protons in the middle of a spread out Bragg peak for 1 µM of internalized 50 nm GNPs. If the GNPs can all be internalized into the cell nucleus, the SER for proton therapy increases from 1.33 to 1.81. The results also show that for the same mass of GNPs in the cells, one can expect the greatest sensitization by smaller GNPs, i.e. a SER of 1.33 for 1 µM of internalized 50 nm GNPs and a SER of 3.98 for the same mass of 2 nm GNPs. We concluded that if the GNPs cannot be internalized into the cytoplasm, no GNP enhancement will be observed for proton treatment. Meanwhile, proton radiotherapy can potentially be enhanced with GNPs if they can be internalized into cells, and especially the cell nucleus. (paper)

  10. Radiation protection and secondary cancer prevention using biological radioprotectors in radiotherapy

    Directory of Open Access Journals (Sweden)

    Hamid Abdollahi

    2015-09-01

    Full Text Available Radiotherapy is the feasible treatment approach for many malignant diseases and cancers. New radiotherapy techniques such as ion therapy, stereotactic radiosurgery and intensity modulated radiation therapy deliver higher low dose radiation to large volume of normal tissues and are in debating as more secondary cancers inducers. A secondary cancer after radiotherapy is an important issue that reduces treatment efficiency and should be decreased. Radioprotective compounds are of importance in clinical radiation therapy for saving normal tissues. In the present study, we are so interest to introduce, suggest and review the application of biological radioprotectors in radiotherapy. We propose probiotics, prebiotics, gas, vitamin and nanoparticle producing microorganisms as new biological systems based radioprotectors to protect normal tissues. Also, we reviewed the main biological pathways, molecules and also radioadaptive response that act as radioprotectors. In this review we tried to address the secondary cancer induction by radiotherapy and also main biological radiation protection approaches, although there is a wealth of data in this subject.  

  11. Radiotherapy

    International Nuclear Information System (INIS)

    The need for radiotherapy research is exemplified by the 100,000 cancer patients who will fail treatment locally and/or regionally annually for the next several years but who would benefit from better local treatment modalities. Theoretically, all of the areas of investigation discussed in this projection paper have the potential to significantly improve local-regional treatment of cancer by radiotherapy alone or in combination with other modalities. In many of the areas of investigation discussed in this paper encouraging results have been obtained in cellular and animal tumor studies and in limited studies in humans as well. In the not too distant future the number of patients who would benefit from better local control may increase by tens of thousands if developments in chemotherapy and/or immunotherapy provide a means to eradicate disseminated microscopic foci of cancer. Thus the efforts to improve local-regional control take on even greater significance

  12. Biological dose representation for carbon-ion radiotherapy of unconventional fractionation

    OpenAIRE

    Kanematsu, Nobuyuki; Inaniwa, Taku

    2016-01-01

    In carbon-ion radiotherapy, single-beam delivery each day in alternate directions has been commonly practiced for operational efficiency, taking advantage of the Bragg peak and the relative biological effectiveness (RBE) for uniform dose conformation to a tumor. The treatment plans are usually evaluated with total RBE-weighted dose, which is however deficient in relevance to the biological effect in the linear-quadratic model due to its quadratic-dose term, or the dose-fractionation effect. I...

  13. Molecular PET imaging for biology-guided adaptive radiotherapy of head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hoeben, Bianca A. W.; Bussink, Johan; Kaanders, Johannes H. A. M. [Dept. of Radiation Oncology, Radboud Univ. Nijmegen Medical Centre, Nijmegen (Netherlands)], e-mail: b.hoeben@rther.umcn.nl; Oyen, Wim J. G. [Dept. of Nuclear Medicine, Radboud Univ. Nijmegen Medical Centre, Nijmegen (Netherlands); Troost, Esther G. C. [Maastro Clinic, GROW School for Oncology and Developmental Biology, Maastricht Univ. Medical Centre, Maastricht (Netherlands)

    2013-10-15

    Integration of molecular imaging PET techniques into therapy selection strategies and radiation treatment planning for head and neck squamous cell carcinoma (HNSCC) can serve several purposes. First, pre-treatment assessments can steer decisions about radiotherapy modifications or combinations with other modalities. Second, biology-based objective functions can be introduced to the radiation treatment planning process by co-registration of molecular imaging with planning computed tomography (CT) scans. Thus, customized heterogeneous dose distributions can be generated with escalated doses to tumor areas where radiotherapy resistance mechanisms are most prevalent. Third, monitoring of temporal and spatial variations in these radiotherapy resistance mechanisms early during the course of treatment can discriminate responders from non-responders. With such information available shortly after the start of treatment, modifications can be implemented or the radiation treatment plan can be adapted tailing the biological response pattern. Currently, these strategies are in various phases of clinical testing, mostly in single-center studies. Further validation in multicenter set-up is needed. Ultimately, this should result in availability for routine clinical practice requiring stable production and accessibility of tracers, reproducibility and standardization of imaging and analysis methods, as well as general availability of knowledge and expertise. Small studies employing adaptive radiotherapy based on functional dynamics and early response mechanisms demonstrate promising results. In this context, we focus this review on the widely used PET tracer 18F-FDG and PET tracers depicting hypoxia and proliferation; two well-known radiation resistance mechanisms.

  14. Biological systems: from water radiolysis to carbon ion radiotherapy

    Science.gov (United States)

    Beuve, Michael; Moreau, Jean-Michel; Rodriguez, Claire; Testa, Etienne

    2015-07-01

    Hadron therapy is an innovative cancer treatment method based on the acceleration of light ions at high energy. In addition to their interesting profile of dose deposition, which ensures accurate targeting of localized tumors, carbon ions offer biological properties that lead to an efficient treatment for radio- and chemo-resistant tumors and to provide a boost for tumors in hypoxia. This paper is a short review of the progress in theoretical, experimental, fundamental and applied research, aiming at understanding the origin of the biological benefits of light ions better. As a limit of such a vast and multidisciplinary domain, this review adopts the point of view of the physicists, leaning on results obtained in connection with CIMAP's IRRABAT platform.

  15. Influence of TACE combined with radioactive seed radiotherapy on primary liver cancer patients’ malignant biological indicators

    Institute of Scientific and Technical Information of China (English)

    Yao Liu; Yu Wang; Guang-Yan Lei; Xiao-Hong Yan; Qiao Yang; Hai-Ping Zhu; Yi Geng

    2016-01-01

    Objective:To analyze the influence of TACE combined with radioactive seed radiotherapy on primary liver cancer patients’ malignant biological indicators.Methods:A total of 112 cases of primary liver cancer patients who received treatment in our hospital, Xijing Hospital and Tumor Hospital of Shaanxi Province were chosen as research subjects and divided into control group (TACE therapy alone) with 63 cases in it and observation group (TACE combined with radioactive seed radiotherapy) with 49 cases according to different treatment, and then the levels of malignant biological indicators after 2 months of treatment were compared between two groups.Results:Serum VEGF, FGF and MMP levels of observation group after treatment were significantly lower than those of control group; serum AFP-L3, GP73, Sb7-H3, AFU and CatS levels were significantly lower than those of control group; serum ICAM-1, ESM-1 and uPA levels were lower than those of control group.Conclusion: TACE combined with radioactive seed radiotherapy can effectively reduce primary liver cancer patients’ serum malignant biological indicator levels, decrease the degree of malignancy of cancer cells and slow disease progression, and is an ideal treatment.

  16. Radiation biology: Major advances and perspectives for radiotherapy

    International Nuclear Information System (INIS)

    At the beginning of the 21. century, radiation biology is at a major turning point in its history. It must meet the expectations of the radiation oncologists, radiologists and the general public, but its purpose remains the same: to understand the molecular, cellular and tissue levels of lethal and carcinogenic effects of ionizing radiation in order to better protect healthy tissues and to develop treatments more effective against tumours. Four major aspects of radiobiology that marked this decade will be discussed: technological developments, the importance of signalling and repair of radiation-induced deoxyribonucleic acid (DNA) damage, the impact of individual factor in the response to radiation and the contribution of radiobiology to better choose innovative therapies such as proton-therapy or stereotactic body radiation therapy (SBRT). A translational radiobiology should emerge with the help of radiotherapists and radiation physicists and by facilitating access to the new radio and/or chemotherapy modalities. (authors)

  17. (RadioBiological Optimization of External-Beam Radiotherapy

    Directory of Open Access Journals (Sweden)

    Alan E. Nahum

    2012-01-01

    Full Text Available “Biological optimization” (BIOP means planning treatments using (radiobiological criteria and models, that is, tumour control probability and normal-tissue complication probability. Four different levels of BIOP are identified: Level I is “isotoxic” individualization of prescription dose at fixed fraction number. is varied to keep the NTCP of the organ at risk constant. Significant improvements in local control are expected for non-small-cell lung tumours. Level II involves the determination of an individualized isotoxic combination of and fractionation scheme. This approach is appropriate for “parallel” OARs (lung, parotids. Examples are given using our BioSuite software. Hypofractionated SABR for early-stage NSCLC is effectively Level-II BIOP. Level-III BIOP uses radiobiological functions as part of the inverse planning of IMRT, for example, maximizing TCP whilst not exceeding a given NTCP. This results in non-uniform target doses. The NTCP model parameters (reflecting tissue “architecture” drive the optimizer to emphasize different regions of the DVH, for example, penalising high doses for quasi-serial OARs such as rectum. Level-IV BIOP adds functional imaging information, for example, hypoxia or clonogen location, to Level III; examples are given of our prostate “dose painting” protocol, BioProp. The limitations of and uncertainties inherent in the radiobiological models are emphasized.

  18. Relative biological effectiveness (RBE) of proton beams in radiotherapy

    International Nuclear Information System (INIS)

    Treatment planning in proton therapy uses a generic value for the Relative Biological Efficiency (RBE) of 1.1 relative to 60Co gamma-rays throughout the Spread Out Bragg Peak (SOBP). We have studied the variation of the RBE at three positions in the SOBP of the 76 and 201 MeV proton beams used for cancer treatment at the Institut Curie Proton Therapy in Orsay (ICPO) in two human tumor cell lines using clonogenic cell death and the incidence of DNA double-strand breaks (DSB) as measured by pulse-field gel electrophoresis without and with endonuclease treatment to reveal clustered lesions as endpoints.The RBE for induced cell killing by the 76 MeV beam increased with depth in the SOBP. However for the 201 MeV protons it was close to that for 137Cs gamma-rays and did not vary significantly. The incidence of DSBs and clustered lesions was higher for protons than for 137Cs g-rays, but did not depend on the proton energy or the position in the SOBP. In the second part of our work, we have shown using cell clones made deficient for known repair genes by stable or transient shRNA transfection, that the D-NHEJ pathway determine the response to protons. The response of DNA damages created in the distal part of the 76 MeV SOBP suggests that those damages belong to the class of DNA 'complex lesions' (LMDS). It also appears that the particle fluence is a major determinant of the outcome of treatment in the distal part of the SOBP. (author)

  19. Improved normal tissue sparing in head and neck radiotherapy using biological cost function based-IMRT.

    Science.gov (United States)

    Anderson, N; Lawford, C; Khoo, V; Rolfo, M; Joon, D L; Wada, M

    2011-12-01

    Intensity-modulated radiotherapy (IMRT) has reduced the impact of acute and late toxicities associated with head and neck radiotherapy. Treatment planning system (TPS) advances in biological cost function based optimization (BBO) and improved segmentation techniques have increased organ at risk (OAR) sparing compared to conventional dose-based optimization (DBO). A planning study was undertaken to compare OAR avoidance in DBO and BBO treatment planning. Simultaneous integrated boost treatment plans were produced for 10 head and neck patients using both planning systems. Plans were compared for tar get coverage and OAR avoidance. Comparisons were made using the BBO TPS Monte Carlo dose engine to eliminate differences due to inherent algorithms. Target coverage (V95%) was maintained for both solutions. BBO produced lower OAR doses, with statistically significant improvement to left (12.3%, p = 0.005) and right parotid mean dose (16.9%, p = 0.004), larynx V50_Gy (71.0%, p = 0.005), spinal cord (21.9%, p < 0.001) and brain stem dose maximums (31.5%, p = 0.002). This study observed improved OAR avoidance with BBO planning. Further investigations will be undertaken to review any clinical benefit of this improved planned dosimetry.

  20. Hypo-fractionated treatment in radiotherapy: radio-biological models Tcp and NTCP

    International Nuclear Information System (INIS)

    At the present time the breast cancer in Mexico has the first place of incidence of the malignant neoplasia s in the women, and represents 11.34% of all the cancer cases. On the other hand, the treatments for cancer by means of ionizing radiations have been dominated under the approaches of the medical radio-oncologists which have been based on test and error by many years. The radio-biological models, as the Tcp, NTCP and dosimetric variables, for their clinical application in the conventional radiotherapy with hypo-fractionation have as purpose predicting personalized treatment plans that they present most probability of tumor control and minor probability of late reactions, becoming this way support tools in the decisions taking for the patient treatments planning of Medical Physicists and Radio-oncologists. (Author)

  1. Biological dose representation for carbon-ion radiotherapy of unconventional fractionation

    CERN Document Server

    Kanematsu, Nobuyuki

    2016-01-01

    In carbon-ion radiotherapy, single-beam delivery each day in alternate directions has been commonly practiced for operational efficiency, taking advantage of the Bragg peak and the relative biological effectiveness (RBE) for uniform dose conformation to a tumor. The treatment plans are usually evaluated with total RBE-weighted dose, which is however deficient in relevance to the biological effect in the linear-quadratic model due to its quadratic-dose term, or the dose-fractionation effect. In this study, we reformulate the extrapolated response dose (ERD), or synonymously BED, which normalizes the dose-fractionation and cell-repopulation effects as well as the RBE of treating radiation, based on inactivation of a single model cell system and a typical treating radiation in carbon-ion RT. The ERD distribution virtually represents the biological effect of the treatment regardless of radiation modality or fractionation scheme. We applied the ERD formulation to simplistic model treatments and to a preclinical su...

  2. Biologically effective doses of postoperative radiotherapy in the prevention of keloids. Dose-effect relationship

    International Nuclear Information System (INIS)

    Purpose: To review the recurrence rates of keloids after surgical excision followed by radiotherapy, and to answer the question whether after normalization of the dose, a dose-effect relationship could be derived. Material and Methods: A literature search was performed to identify studies dealing with the efficacy of various irradiation regimes for the prevention of keloids after surgery. Biologically effective doses (BEDs) of the various irradiation regimens were calculated using the linear-quadratic concept. A distinction between recurrence rates of keloids in the face and neck region and those in other parts of the body was made. Results: 31 reports were identified with PubMed with the search terms keloids, surgery, radiation therapy, radiotherapy. 13 reports were excluded, because no link could be found between recurrence rate and dose, or if less than ten patients per dose group. The recurrence rate for surgery only was 50-80%. For BED values >10 Gy the recurrence rate decreased as a function of BED. For BED values >30 Gy the recurrence rate was <10%. For a given dose, the recurrence rates of keloids in the sites with high stretch tension were not significantly higher than in sites without stretch tension. Conclusion: The results of this study indicate that for effectively treating keloids postoperatively, a relatively high dose must be applied in a short overall treatment time. The optimal treatment probably is an irradiation scheme resulting in a BED value of at least 30 Gy. A BED value of 30 Gy can be obtained with, for instance, a single acute dose of 13 Gy, two fractions of 8 Gy two fractions of 8 Gy or three fractions of 6 Gy, or a single dose of 27 Gy at low dose rate. The radiation treatment should be administered within 2 days after surgery. (orig.)

  3. Effect of contrast agent administration on consequences of dosimetry and biology in radiotherapy planning

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Ching-Jung [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, Tao-Yuan 333 Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital, Kwei-Shan, Tao-Yuan 333 Taiwan (China); Yang, Pei-Ying [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, Tao-Yuan 333 Taiwan (China); Chao, Tsi-Chian, E-mail: chaot@mail.cgu.edu.tw [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, Tao-Yuan 333 Taiwan (China); Tu, Shu-Ju, E-mail: sjtu@mail.cgu.edu.tw [Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, 259 Wen-Hua 1st Road, Kwei-Shan, Tao-Yuan 333 Taiwan (China)

    2015-06-01

    In the treatment planning of radiation therapy, patients may be administrated with contrast media in CT scanning to assist physicians for accurate delineation of the target or organs. However, contrast media are not used in patients during the treatment delivery. In particular, contrast media contain materials with high atomic numbers and dosimetric variations may occur between scenarios where contrast media are present in treatment planning and absent in treatment delivery. In this study we evaluate the effect of contrast media on the dosimetry and biological consequence. An analytical phantom based on AAPM TG 119 and five sets of CT images from clinical patients are included. Different techniques of treatment planning are considered, including 1-field AP, 2-field AP+PA, 4-field box, 7-field IMRT, and RapidArc. RapidArc is a recent technique of volumetric modulated arc therapy and is used in our study of contrast media in clinical scenarios. The effect of RapidArc on dosimetry and biological consequence for administration of contrast media in radiotherapy is not discussed previously in literature. It is shown that dose difference is reduced as the number of external beams is increased, suggesting RapidArc may be favored to be used in the treatment planning enhanced by contrast media. Linear trend lines are fitted for assessment of percent dose differences in the planning target volume versus concentrations of contrast media between plans where contrast media are present and absent, respectively.

  4. Stereotactic Body Radiotherapy for Oligometastasis: Opportunities for Biology to Guide Clinical Management.

    Science.gov (United States)

    Correa, Rohann J M; Salama, Joseph K; Milano, Michael T; Palma, David A

    2016-01-01

    Oligometastasis refers to a state of limited metastatic disease burden, in which surgical or ablative treatment to all known visible metastases holds promise to extend survival or even effect cure. Stereotactic body radiotherapy is a form of radiation treatment capable of delivering a high biologically effective dose of radiation in a highly conformal manner, with a favorable toxicity profile. Enthusiasm for oligometastasis ablation, however, should be counterbalanced against the limited supporting evidence. It remains unknown to what extent (if any) ablation influences survival or quality of life. Rising clinical equipoise necessitates the completion of randomized controlled trials to assess this, several of which are underway. However, a lack of clear identification criteria or biomarkers to define the oligometastatic state hampers optimal patient selection.This narrative review explores the evolutionary origins of oligometastasis, the steps of the metastatic process at which oligometastases may arise, and the biomolecular mediators of this state. It discusses clinical outcomes with treatment of oligometastases, ongoing trials, and areas of basic and translational research that may lead to novel biomarkers. These efforts should provide a clearer, biomolecular definition of oligometastatic disease and aid in the accurate selection of patients for ablative therapies. PMID:27441744

  5. Modelling beam transport and biological effectiveness to develop treatment planning for ion beam radiotherapy

    CERN Document Server

    Grzanka, Leszek

    2014-01-01

    Radiation therapy with carbon ions is a novel technique of cancer radiotherapy, applicable in particular to treating radioresistant tumours at difficult localisations. Therapy planning, where the medical physicist, following the medical prescription, finds the optimum distribution of cancer cells to be inactivated by their irradiation over the tumour volume, is a basic procedure of cancer radiotherapy. The main difficulty encountered in therapy planning for ion radiotherapy is to correctly account for the enhanced radiobiological effectiveness of ions in the Spread Out Bragg Peak (SOBP) region over the tumour volume. In this case, unlike in conventional radiotherapy with photon beams, achieving a uniform dose distribution over the tumour volume does not imply achieving uniform cancer cell inactivation. In this thesis, an algorithm of the basic element (kernel) of a treatment planning system (TPS) for carbon ion therapy is developed. The algorithm consists of a radiobiological part which suitably corrects for ...

  6. Evaluation of conformal radiotherapy techniques through physics and biologic criteria; Avaliacao de tecnicas radioterapicas conformacionais utilizando criterios fisicos e biologicos

    Energy Technology Data Exchange (ETDEWEB)

    Bloch, Jonatas Carrero

    2012-07-01

    In the fight against cancer, different irradiation techniques have been developed based on technological advances and aiming to optimize the elimination of tumor cells with the lowest damage to healthy tissues. The radiotherapy planning goal is to establish irradiation technical parameters in order to achieve the prescribed dose distribution over the treatment volumes. While dose prescription is based on radiosensitivity of the irradiated tissues, the physical calculations on treatment planning take into account dosimetric parameters related to the radiation beam and the physical characteristics of the irradiated tissues. To incorporate tissue's radiosensitivity into radiotherapy planning calculations can help particularize treatments and establish criteria to compare and elect radiation techniques, contributing to the tumor control and the success of the treatment. Accordingly, biological models of cellular response to radiation have to be well established. This work aimed to study the applicability of using biological models in radiotherapy planning calculations to aid evaluating radiotherapy techniques. Tumor control probability (TCP) was studied for two formulations of the linear-quadratic model, with and without repopulation, as a function of planning parameters, as dose per fraction, and of radiobiological parameters, as the α/β ratio. Besides, the usage of biological criteria to compare radiotherapy techniques was tested using a prostate planning simulated with Monte Carlo code PENELOPE. Afterwards, prostate planning for five patients from the Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, USP, using three different techniques were compared using the tumor control probability. In that order, dose matrices from the XiO treatment planning system were converted to TCP distributions and TCP-volume histograms. The studies performed allow the conclusions that radiobiological parameters can significantly influence tumor control

  7. Radiation biology: Major advances and perspectives for radiotherapy; Biologie des radiations: avancees majeures et perspectives pour la radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Joubert, A. [Societe Magelis, lotissement Bel-Air, 6, rue Frederic-Mistral, 84160 Cadenet (France); Vogin, G.; Granzotto, A. [CR-U1052, centre de recherche en cancerologie de Lyon, Inserm, batiment Cheney A, 28, rue Laennec, 69008 Lyon (France); Centre d' hadrontherapie etoile, 60, avenue Rockfeller, 69008 Lyon (France); Devic, C.; Viau, M.; Thomas, C.; Foray, N. [CR-U1052, centre de recherche en cancerologie de Lyon, Inserm, batiment Cheney A, 28, rue Laennec, 69008 Lyon (France); Maalouf, M. [CR-U1052, centre de recherche en cancerologie de Lyon, Inserm, batiment Cheney A, 28, rue Laennec, 69008 Lyon (France); Centre national d' etudes spatiales, 2, place Maurice-Quentin, 75039 Paris cedex 01 (France); Colin, C. [EA3738, faculte de medecine Lyon-Sud, 69921 Oullins (France); Service de radiologie, centre hospitalo-universitaire Lyon-Sud, chemin du Grand-Revoyet, 69495 Pierre-Benite (France)

    2011-08-15

    At the beginning of the 21. century, radiation biology is at a major turning point in its history. It must meet the expectations of the radiation oncologists, radiologists and the general public, but its purpose remains the same: to understand the molecular, cellular and tissue levels of lethal and carcinogenic effects of ionizing radiation in order to better protect healthy tissues and to develop treatments more effective against tumours. Four major aspects of radiobiology that marked this decade will be discussed: technological developments, the importance of signalling and repair of radiation-induced deoxyribonucleic acid (DNA) damage, the impact of individual factor in the response to radiation and the contribution of radiobiology to better choose innovative therapies such as proton-therapy or stereotactic body radiation therapy (SBRT). A translational radiobiology should emerge with the help of radiotherapists and radiation physicists and by facilitating access to the new radio and/or chemotherapy modalities. (authors)

  8. Validation of 3'-deoxy-3'-fluorine-18-fluorothymidine positron emission tomography for image-guidance in biologically adaptive radiotherapy

    Science.gov (United States)

    Axente, Marian

    Accelerated tumor cell repopulation during radiation therapy is one of the leading causes for low survival rates of head-and-neck cancer patients. The therapeutic effectiveness of radiotherapy could be improved by selectively targeting proliferating tumor subvolumes with higher doses of radiation. Positron emission tomography (PET) imaging with 3'-deoxy-3 '-18F-fluorothymidine (FLT) has shown great potential as a non-invasive approach to characterizing the proliferation status of tumors. This thesis focuses on histopathological validation of FLT PET imaging specifically for image-guidance applications in biologically adaptive radiotherapy. The lack of experimental data supporting the use of FLT PET imaging for radiotherapy guidance is addressed by developing a novel methodology for histopathological validation of PET imaging. Using this new approach, the spatial concordance between the intratumoral pattern of FLT uptake and the spatial distribution of cell proliferation is demonstrated in animal tumors. First, a two-dimensional analysis is conducted comparing the microscopic FLT uptake as imaged with autoradiography and the distribution of active cell proliferation markers imaged with immunofluorescent microscopy. It was observed that when tumors present a pattern of cell proliferation that is highly dispersed throughout the tumor, even high-resolution imaging modalities such as autoradiography could not accurately determine the extent and spatial distribution of proliferative tumor subvolumes. While microscopic spatial coincidence between high FLT uptake regions and actively proliferative subvolumes was demonstrated in tumors with highly compartmentalized/aggregated features of cell proliferation, there were no conclusive results across the entire set of utilized tumor specimens. This emphasized the need for addressing the limited resolution of FLT PET when imaging microscopic patterns of cell proliferation. This issue was emphasized in the second part of the

  9. DIFFERENCE IN BIOLOGICAL CHARACTERISTICS AND SENSITIVITY TO CHEMOTHERAPY AND RADIOTHERAPY BETWEEN INTRAHEPATIC AND EXTRAHEPATIC CHOLANGIOCARCINOMA CELLS IN VITRO

    Institute of Scientific and Technical Information of China (English)

    Xiao-ran He; Xiao-peng Wu

    2008-01-01

    Objective To investigate and compare the biological characteristics and sensitivity to chemotherapy and radiother-apy of intrahepatic and extrahepatie cholangiocarcinoma cells in vitro.Methods The intrahepatic and extrahepatie eholangiocarcinoma cell lines were established, and cells with steady passage were chosen to study the biological characteristics including morphology, growth dynamics, chromosome, and levels of cancer antigen (CA)125, CA 19-9, alpha-fetoprotein (AFP), and carcino-embryonic antigen (CEA).M.eanwhile, MTT assay was used to determine the sensitivity of both kinds of cells to 6 chemotherapeutic drugs, inclu-ding cisplatin, paclitaxel, harringtonine, 5-fluorouracil, vincristine, and aelacimomycin, and the inhibitory rate of ceils under the irradiation of 10 Gy ray was also measured.Reanlts The intrahepatic cholangiocarcinoma cells were mostly fusiform in shape, and extrahepatic eholangiocar-cinoma cells were mostly round or polygon in shape. Their doubling time was 26. 3 hours and 23.1 hours, respectively.Their average number of chromosomes was 59 (range, 38-84) and 67 (range, 49-103 ), respectively. The chromo-some karyotypes of most intrahepatlc ebolangiocarcinoma cells were hyperdiploid and hypotriploid, while hypertriploid was predominant in extrahepatic cholangioearcinoma cells. The level of CA 125 in supernatant of extrahepatic cholangio-carcinoma cells increased obviously, while levels of other determined tumor markers in both kinds of cells were all with-in normal range. The intrahepatic cholangiocarcinoma cells were low sensitive to cisplatin and paclitaxel, but not sensi-tive to the other 4 chemotherapeutic drugs. The extrahepatic cholangiocarcinoma cells were high sensitive to eisplatin,but not sensitive to the other 5 drugs. Both kinds of cells had poor sensitivity to radiotherapy.Conelusions Intrahepatic and extrahepatie cbolangiocareinoma cells show differences in shape, doubling time,chromosome karyotype, tumor marker level, and

  10. Outcome of radiation biology in radiotherapy. Past and future directions; Applications cliniques des recherches en radiobiologie. Etat des lieux et perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Hennequin, C. [Hopital Saint-Louis, Service d' Oncologie-Radiotherapie, 75 - Paris (France); Favaudon, V. [Centre Universitaire d' Orsay, Institut Curie, Section de Recherche, Lab. Raymond-Latarjet, Unite 350 Inserm, 91 (France)

    2000-10-01

    Over the last ten years the impact of fundamental radiation biology into daily radiotherapy has been of concern chiefly to fractionation, prediction of radiation response, tumour oxygenation, intrinsic radiosensitivity including genetic approaches, and the determinants of the outcome of chemoradiotherapy combinations. Future goals will rely on sophisticated approaches, based on the progress of molecular and cellular biology and the characterization of new targets for radiation. Some of these novel advances will be discussed. (authors)

  11. Cells responsible for tumor surveillance in man: effects of radiotherapy, chemotherapy, and biologic response modifiers

    International Nuclear Information System (INIS)

    Currently, the most probable theory of tumor surveillance is neither the existence of any tumor-specific, antigen-dependent, T-cell-mediated cytotoxic effect that could eliminate spontaneous tumors in man and that could be used for some kind of vaccination against tumors, nor the complete absence of any surveillance or defense systems against tumors. What is probable is the cooperation of a number of antigen-independent, relatively weakly cytotoxic or possibly only cytostatic humoral and cellular effects, including nutritional immunity, tumor necrosis factor, certain cytokines, and the cytotoxic effects mediated by macrophages, NK cells, NK-like cells, and certain stimulated T-cells. One question remaining to be solved is why these antigen-independent effects do not attack normal cells. A number of plausible hypotheses are discussed. The hypothetical surveillance system is modulated both by traditional cancer treatment and by attempts at immunomodulation. Radiotherapy reduced the T-helper cell function for almost a decade, but not those of macrophages or NK cells. T-cell changes have no prognostic implication, supporting, perhaps, the suggestion of a major role for macrophages and NK cells. Cyclic adjuvant chemotherapy reduces the peripheral lymphocyte population and several lymphocyte functions but not NK activity. Most of the parameters were normalized some years following treatment, but NK activity remained elevated and Th/Ts cell ratio was still decreased. This might possibly be taken to support the surveillance role of NK cells. Bestatin increases the frequency of lymphocytes forming rosettes with sheep red blood cells (but not their mitogenic responses), enhances NK activity, and augments the phagocytic capacity of granulocytes and monocytes (but not their cytotoxic activity). 154 references

  12. [Innovation in adjuvant radiotherapy for breast cancer: new biologic parameters, a perspective for treatment tailoring].

    Science.gov (United States)

    Belkacémi, Y

    2009-01-01

    In the adjuvant setting, whole breast radiation therapy (RT) delivering 50 Gy in 5 weeks with or without a boost to the tumor bed remains the standard of care. RT indications and volume definition are generally dependant on existing prognostic factors. Except in particular cases, RT technique does not vary according to the patient or tumor biology profiles in terms of total dose, dose per fraction, fractionation, and RT duration. The challenge is to define new parameters or tumor biology profiles that will allow patient selection for more tailored RT than the 5 to 7 week standard schedules. The future issue is to define biological markers able to screen patients and tumors according to their high metastatic potential (in which the primary therapeutic challenge may not be locoregional control) and those patients that have a particular radiosensitivity to ionizing radiation for higher benefit/risk ratio. Thus, it is probable that patient profiles, tumor biology markers and gene expression profiling could provide in future an added value to conventional markers to predict patients at high-risk of local and distant recurrences who need tailored treatment or a particular sequence of adjuvant therapy.

  13. IsoBED: a tool for automatic calculation of biologically equivalent fractionation schedules in radiotherapy using IMRT with a simultaneous integrated boost (SIB) technique

    OpenAIRE

    Benassi Marcello; Pedrini Massimo; Abate Armando; Bruzzaniti Vicente; Strigari Lidia

    2011-01-01

    Abstract Background An advantage of the Intensity Modulated Radiotherapy (IMRT) technique is the feasibility to deliver different therapeutic dose levels to PTVs in a single treatment session using the Simultaneous Integrated Boost (SIB) technique. The paper aims to describe an automated tool to calculate the dose to be delivered with the SIB-IMRT technique in different anatomical regions that have the same Biological Equivalent Dose (BED), i.e. IsoBED, compared to the standard fractionation....

  14. Biologically adapted radiotherapy and evaluation of non-uniform dose distributions

    Energy Technology Data Exchange (ETDEWEB)

    Soevik, Aaste

    2007-07-01

    Radiation therapy plays an integral part in cancer management. Over the last decade, the fraction of patients in the Nordic countries receiving radiation therapy at some stage in their disease has increased by around 50%, and approximately half of the treatments arc given with curative intent. While only 20% of patients with primary tumors receive radiation therapy as the only form of treatment, curative radiation therapy given in combination with other treatment modalities has been shown to be of benefit for the majority of the most common cancers. The future requirements for radiation therapy are expected to increase along with the increase in cancer incidence. The aim of curing the patient is not always achieved, due to distant metastasis and/or lack of locoregional control. Locoregional failure occurs when the delivered tumor dose fails to eradicate the cancer cells, and can result from a radioresistant subpopulation of tumor cells. As the tumor dose is limited by the probability of inducing normal tissue complications, novel treatment strategies are needed to improve locoregional tumor control. Over the recent years, there has been an increasing interest in complex treatment delivery strategies in radiation therapy. Intensity modulated radiation therapy (IMRT) can be used to provide a distribution of radiation dose that conforms closely to irregularly shaped tumors, while sparing the surrounding normal tissues. However, IMRT can also be used to deliver non-uniform dose distributions, based on patient specific biological information, i.e. biologically conformal radiation therapy (BCRT). Functional and molecular imaging can be used to demonstrate both the distribution of and the extent of heterogeneity in parameters that influence tumor radiation sensitivity. Non-invasive images of radiobiological parameters form the basis of biologically conformal radiation therapy and are needed to create individually optimized radiation therapy plans. Recent advances in the

  15. Image adaptive RST invariant watermark using pseudo-Zernike moments

    Institute of Scientific and Technical Information of China (English)

    Leida LI; Baolong GUO

    2008-01-01

    Rotation, scaling and translation (RST) attacks can desynchronize watermark detection, which causes failure in many watermarking systems. In this paper, an image adaptive RST invariant watermark (AWPZM) is proposed by using the rotation invariant property of pseudo-Zernike moments (PZM) and odd-even quantization. PZM of the original image is computed first, and then those suitable for watermark generation are selected. Then, magnitudes of them are odd-even quantized to generate the watermark. In detection, a normalized hamming function is employed to determine the similarity of the watermark. Experimental results show its robustness to rotation and scaling. For traditional attacks, such as JPEG compression, added noise and filtering, the similarities are all above 0.95.

  16. Robust Digital Image-Adaptive Watermarking Using BSS Based

    Directory of Open Access Journals (Sweden)

    Sangeeta d. Jadhav

    2010-03-01

    Full Text Available In a digital watermarking scheme, it is not convenient to carry the original image all the time in order to detect the owner's signature from the watermarked image. Moreover, for those applications that require different watermark for different copies, it is preferred to utilize some kind of watermark-independent algorithm for extraction process i.e. dewatermarking. Watermark embedding is performed in the blue channel, as it is less sensitive to human visual system .This paper proposes a new color image watermarking method ,which adopts Blind Source Separation (BSS technique for watermark extraction. Single level Discrete Wavelet Transform(DWT is used for embedding . The novelty of our scheme lies in determining the mixing matrix for BSS model during embedding. The determination of mixing matrix using Quasi-Newton’s (BFGS technique is based on texture analysis which uses energy as metric. This makes our method image adaptive to embed the watermark into original image so as not to bring about a perceptible change in the marked image. BSS based on Joint diagonalization of the time delayed covariance matrices algorithm is used for the extraction of watermark. The proposed method, undergoing different experiments, has shown its robustness against many attacks including rotation ,low pass filtering, salt n pepper noise addition and compression. The robustness evaluation is also carried out with respect to the spatial domain embedding.

  17. Raster image adaptation for mobile devices using profiles

    Science.gov (United States)

    Rosenbaum, René; Hamann, Bernd

    2012-02-01

    Focusing on digital imagery, this paper introduces a strategy to handle heterogeneous hardware in mobile environments. Constrained system resources of most mobile viewing devices require contents that are tailored to the requirements of the user and the capabilities of the device. Appropriate image adaptation is still an unsolved research question. Due to the complexity of the problem, available solutions are either too resource-intensive or inflexible to be more generally applicable. The proposed approach is based on scalable image compression and progressive refinement as well as data and user profiles. A scalable image is created once and used multiple times for different kinds of devices and user requirements. Profiles available on the server side allow for an image representation that is adapted to the most important resources in mobile computing: screen space, computing power, and the volume of the transmitted data. Options for progressively refining content thereby allow for a fluent viewing experience during adaptation. Due to its flexibility and low complexity, the proposed solution is much more general compared to related approaches. To document the advantages of our approach we provide empirical results obtained in experiments with an implementation of the method.

  18. Hypo-fractionated treatment in radiotherapy: radio-biological models Tcp and NTCP; Tratamiento hipofraccionado en radioterapia: modelos radiobiologicos TCP y NTCP

    Energy Technology Data Exchange (ETDEWEB)

    Astudillo V, A. J.; Mitsoura, E. [Universidad Autonoma del Estado de Mexico, Facultad de Medicina, Paseo Tollocan s/n, 50180 Toluca, Estado de Mexico (Mexico); Paredes G, L. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Resendiz G, G., E-mail: lydia.paredes@inin.gob.mx [Hospital Medica Sur, Departamento de Radioterapia, Puente de Piedra 150, Col. Toriello Guerra, 14050 Mexico D. F. (Mexico)

    2014-08-15

    At the present time the breast cancer in Mexico has the first place of incidence of the malignant neoplasia s in the women, and represents 11.34% of all the cancer cases. On the other hand, the treatments for cancer by means of ionizing radiations have been dominated under the approaches of the medical radio-oncologists which have been based on test and error by many years. The radio-biological models, as the Tcp, NTCP and dosimetric variables, for their clinical application in the conventional radiotherapy with hypo-fractionation have as purpose predicting personalized treatment plans that they present most probability of tumor control and minor probability of late reactions, becoming this way support tools in the decisions taking for the patient treatments planning of Medical Physicists and Radio-oncologists. (Author)

  19. Challenges in using 18 F-fluorodeoxyglucose-PET-CT to define a biological radiotherapy boost volume in locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    The best method of identifying regions within pancreatic tumours that might benefit from an increased radiotherapy dose is not known. We investigated the utility of pre-treatment FDG-PET in predicting the spatial distribution of residual metabolic activity following chemoradiotherapy (CRT) in locally advanced pancreatic cancer (LAPC). 17 patients had FDG-PET/CT scans at baseline and six weeks post-CRT. Tumour segmentation was performed at 40% and 50% of SUVmax at baseline and 60%, 70%, 80% and 90% post-CRT. FDG-PET scans were non-rigidly registered to the radiotherapy planning CT using the CT component of the FDG-PET/CT. Percentage overlap of the post-CRT volumes with the pre-CRT volumes with one another and the gross tumour volume (GTV) was calculated. SUVmax decreased during CRT (median pre- 8.0 and post- 3.6, p < 0.0001). For spatial correlation analysis, 9 pairs of scans were included (Four were excluded following complete metabolic response, one patient had a non-FDG avid tumour, one had no post-CRT imaging, one had diffuse FDG uptake that could not be separated from normal tissues and one had an elevated blood glucose). The Pre40% and 50% of SUVmax volumes covered a mean of 50.8% and 30.3% of the GTV respectively. The mean% overlap of the 90%, 80%, 70%, 60% of SUVmax post-CRT with the Pre40% and Pre50% volumes were 83.3%, 84.0%, 83.7%, 77.9% and 77.8%, 69.9%, 74.5%, 64.8% respectively. Regions of residual metabolic activity following CRT can be predicted from the baseline FDG-PET and could aid definition of a biological target volume for non-uniform dose prescriptions

  20. IsoBED: a tool for automatic calculation of biologically equivalent fractionation schedules in radiotherapy using IMRT with a simultaneous integrated boost (SIB technique

    Directory of Open Access Journals (Sweden)

    Benassi Marcello

    2011-05-01

    Full Text Available Abstract Background An advantage of the Intensity Modulated Radiotherapy (IMRT technique is the feasibility to deliver different therapeutic dose levels to PTVs in a single treatment session using the Simultaneous Integrated Boost (SIB technique. The paper aims to describe an automated tool to calculate the dose to be delivered with the SIB-IMRT technique in different anatomical regions that have the same Biological Equivalent Dose (BED, i.e. IsoBED, compared to the standard fractionation. Methods Based on the Linear Quadratic Model (LQM, we developed software that allows treatment schedules, biologically equivalent to standard fractionations, to be calculated. The main radiobiological parameters from literature are included in a database inside the software, which can be updated according to the clinical experience of each Institute. In particular, the BED to each target volume will be computed based on the alpha/beta ratio, total dose and the dose per fraction (generally 2 Gy for a standard fractionation. Then, after selecting the reference target, i.e. the PTV that controls the fractionation, a new total dose and dose per fraction providing the same isoBED will be calculated for each target volume. Results The IsoBED Software developed allows: 1 the calculation of new IsoBED treatment schedules derived from standard prescriptions and based on LQM, 2 the conversion of the dose-volume histograms (DVHs for each Target and OAR to a nominal standard dose at 2Gy per fraction in order to be shown together with the DV-constraints from literature, based on the LQM and radiobiological parameters, and 3 the calculation of Tumor Control Probability (TCP and Normal Tissue Complication Probability (NTCP curve versus the prescribed dose to the reference target.

  1. Practical aspects and uncertainty analysis of biological effective dose (BED) regarding its three-dimensional calculation in multiphase radiotherapy treatment plans

    Energy Technology Data Exchange (ETDEWEB)

    Kauweloa, Kevin I., E-mail: Kauweloa@livemail.uthscsa.edu; Gutierrez, Alonso N.; Bergamo, Angelo; Stathakis, Sotirios; Papanikolaou, Nikos; Mavroidis, Panayiotis [Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 and Cancer Therapy and Research Center, San Antonio, Texas 78229 (United States)

    2014-07-15

    Purpose: There is a growing interest in the radiation oncology community to use the biological effective dose (BED) rather than the physical dose (PD) in treatment plan evaluation and optimization due to its stronger correlation with radiobiological effects. Radiotherapy patients may receive treatments involving a single only phase or multiple phases (e.g., primary and boost). Since most treatment planning systems cannot calculate the analytical BED distribution in multiphase treatments, an approximate multiphase BED expression, which is based on the total physical dose distribution, has been used. The purpose of this paper is to reveal the mathematical properties of the approximate BED formulation, relative to the true BED. Methods: The mathematical properties of the approximate multiphase BED equation are analyzed and evaluated. In order to better understand the accuracy of the approximate multiphase BED equation, the true multiphase BED equation was derived and the mathematical differences between the true and approximate multiphase BED equations were determined. The magnitude of its inaccuracies under common clinical circumstances was also studied. All calculations were performed on a voxel-by-voxel basis using the three-dimensional dose matrices. Results: Results showed that the approximate multiphase BED equation is accurate only when the dose-per-fractions (DPFs) in both the first and second phases are equal, which occur when the dose distribution does not significantly change between the phases. In the case of heterogeneous dose distributions, which significantly vary between the phases, there are fewer occurrences of equal DPFs and hence the inaccuracy of the approximate multiphase BED is greater. These characteristics are usually seen in the dose distributions being delivered to organs at risk rather than to targets. Conclusions: The finding of this study indicates that the true multiphase BED equation should be implemented in the treatment planning

  2. Proceedings of 19. symposium on experimental radiotherapy and clinical radiobiology

    International Nuclear Information System (INIS)

    The proceedings include review contributions on radio-oncology, and new radiation technologies and molecular prediction; and poster sessions on the following topics: hypoxia; molecular mechanisms of radiation resistance; molecular targeting; DNA repair; biological imaging; biology of experimental radiations; normal tissue toxicity; modern radiotherapy; tumor hypoxia and metabolic micro milieu; immune system and radiotherapy.

  3. Postmastectomy radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shikama, Naoto; Koguchi, Masahiko; Sasaki, Shigeru; Kaneko, Tomoki; Shinoda, Atsunori; Nishikawa, Atsushi [Shinshu Univ., Matsumoto, Nagano (Japan). School of Medicine

    2000-10-01

    Since there have been few reports on postmastectomy radiotherapy having a high evidence level in Japan, the significance of postoperative radiotherapy and the irradiation techniques were reviewed based on reports from Western countries. Authors focused on the indications for postoperative irradiation, irradiation methods (irradiation sites, irradiation techniques; prosthetics, methods of irradiating the chest wall and lymph nodes, timing of irradiation), and complications, and discuss them. The factors thought to be adaptable to postmastectomy radiotherapy have been listed. Axillary lymph node metastasis and the size of the primary focus are thought to be important factors in locoregional recurrence. The chest wall and the supraclavicular lymph nodes are the usual sites of irradiation after mastectomy. The irradiation method consists of tangential irradiation of the chest wall and single-field irradiation of the supraclavicular lymph nodes, with 46-50 Gy in fractional doses of 1.8-2 Gy x 5/w is administered for 4.5-5.5 weeks. The timing of irradiation in the West is generally after chemotherapy. Adverse radiation effects include ischemic heart disease, pneumonitis, arm edema, rib fractures, and brachial plexus paralysis. The frequency of these complications is increased by the combined use of chemotherapy or surgery. The breast cancer cure rate in Japan is generally better than in the West. It remains to be determined whether the clinical data from Europe and America are applicable to the treatment of breast cancer in Japan. To address this issue, a clinical investigation should be performed in Japan with close cooperation between surgeons, physicians, pathologists, and radiotherapists. (K.H.)

  4. Dosimetry in radiotherapy. V.2

    International Nuclear Information System (INIS)

    A series of symposia on dosimetry in medicine and biology have been held by the IAEA in co-operation with WHO. The present symposium was the first one focusing on ''Dosimetry in Radiotherapy''. The papers presented reflected the different steps in the calibration chain such as the calibration standards established by the National Standards Laboratories and the conversion of the reading of calibrated instruments to the desired quantity, i.e. absorbed dose to water at a reference point in the user's beam at the radiotherapy clinic. The programme further examined the procedures necessary for optimization of the treatment of the patient, such as treatment planning methods, dose distribution studies, new techniques of dose measurement, improvements in the physical dose distributions/conformation therapy and special problems involved in total body treatments. Results of quality assurance in radiotherapy were presented from local hospitals as well as from national and international studies. Refs, figs and tabs

  5. Dosimetry in radiotherapy. V.1

    International Nuclear Information System (INIS)

    A series of symposia on dosimetry in medicine and biology have been held by the IAEA in co-operation with WHO. The present symposium was the first one focusing on ''Dosimetry in Radiotherapy''. The papers presented reflected the different steps in the calibration chain such as the calibration standards established by the National Standards Laboratories and the conversion of the reading of calibrated instruments to the desired quantity, i.e. absorbed dose to water at a reference point in the user's beam at the radiotherapy clinic. The programme further examined the procedures necessary for optimization of the treatment of the patient, such as treatment planning methods, dose distribution studies, new techniques of dose measurement, improvements in the physical dose distributions/conformation therapy and special problems involved in total body treatments. Results of quality assurance in radiotherapy were presented from local hospitals as well as from national and international studies. Refs, figs and tabs

  6. Small animal radiotherapy research platforms

    International Nuclear Information System (INIS)

    Advances in conformal radiation therapy and advancements in pre-clinical radiotherapy research have recently stimulated the development of precise micro-irradiators for small animals such as mice and rats. These devices are often kilovolt x-ray radiation sources combined with high-resolution CT imaging equipment for image guidance, as the latter allows precise and accurate beam positioning. This is similar to modern human radiotherapy practice. These devices are considered a major step forward compared to the current standard of animal experimentation in cancer radiobiology research. The availability of this novel equipment enables a wide variety of pre-clinical experiments on the synergy of radiation with other therapies, complex radiation schemes, sub-target boost studies, hypofractionated radiotherapy, contrast-enhanced radiotherapy and studies of relative biological effectiveness, to name just a few examples. In this review we discuss the required irradiation and imaging capabilities of small animal radiation research platforms. We describe the need for improved small animal radiotherapy research and highlight pioneering efforts, some of which led recently to commercially available prototypes. From this, it will be clear that much further development is still needed, on both the irradiation side and imaging side. We discuss at length the need for improved treatment planning tools for small animal platforms, and the current lack of a standard therein. Finally, we mention some recent experimental work using the early animal radiation research platforms, and the potential they offer for advancing radiobiology research. (topical review)

  7. Small animal radiotherapy research platforms

    Science.gov (United States)

    Verhaegen, Frank; Granton, Patrick; Tryggestad, Erik

    2011-06-01

    Advances in conformal radiation therapy and advancements in pre-clinical radiotherapy research have recently stimulated the development of precise micro-irradiators for small animals such as mice and rats. These devices are often kilovolt x-ray radiation sources combined with high-resolution CT imaging equipment for image guidance, as the latter allows precise and accurate beam positioning. This is similar to modern human radiotherapy practice. These devices are considered a major step forward compared to the current standard of animal experimentation in cancer radiobiology research. The availability of this novel equipment enables a wide variety of pre-clinical experiments on the synergy of radiation with other therapies, complex radiation schemes, sub-target boost studies, hypofractionated radiotherapy, contrast-enhanced radiotherapy and studies of relative biological effectiveness, to name just a few examples. In this review we discuss the required irradiation and imaging capabilities of small animal radiation research platforms. We describe the need for improved small animal radiotherapy research and highlight pioneering efforts, some of which led recently to commercially available prototypes. From this, it will be clear that much further development is still needed, on both the irradiation side and imaging side. We discuss at length the need for improved treatment planning tools for small animal platforms, and the current lack of a standard therein. Finally, we mention some recent experimental work using the early animal radiation research platforms, and the potential they offer for advancing radiobiology research.

  8. Higher Biologically Effective Dose of Radiotherapy Is Associated With Improved Outcomes for Locally Advanced Non–Small Cell Lung Carcinoma Treated With Chemoradiation: An Analysis of the Radiation Therapy Oncology Group

    International Nuclear Information System (INIS)

    Purpose: Patients treated with chemoradiotherapy for locally advanced non–small-cell lung carcinoma (LA-NSCLC) were analyzed for local-regional failure (LRF) and overall survival (OS) with respect to radiotherapy dose intensity. Methods and Materials: This study combined data from seven Radiation Therapy Oncology Group (RTOG) trials in which chemoradiotherapy was used for LA-NSCLC: RTOG 88-08 (chemoradiation arm only), 90-15, 91-06, 92-04, 93-09 (nonoperative arm only), 94-10, and 98-01. The radiotherapeutic biologically effective dose (BED) received by each individual patient was calculated, as was the overall treatment time-adjusted BED (tBED) using standard formulae. Heterogeneity testing was done with chi-squared statistics, and weighted pooled hazard ratio estimates were used. Cox and Fine and Gray’s proportional hazard models were used for OS and LRF, respectively, to test the associations between BED and tBED adjusted for other covariates. Results: A total of 1,356 patients were analyzed for BED (1,348 for tBED). The 2-year and 5-year OS rates were 38% and 15%, respectively. The 2-year and 5-year LRF rates were 46% and 52%, respectively. The BED (and tBED) were highly significantly associated with both OS and LRF, with or without adjustment for other covariates on multivariate analysis (p < 0.0001). A 1-Gy BED increase in radiotherapy dose intensity was statistically significantly associated with approximately 4% relative improvement in survival; this is another way of expressing the finding that the pool-adjusted hazard ratio for survival as a function of BED was 0.96. Similarly, a 1-Gy tBED increase in radiotherapy dose intensity was statistically significantly associated with approximately 3% relative improvement in local-regional control; this is another way of expressing the finding that the pool-adjusted hazard ratio as a function of tBED was 0.97. Conclusions: Higher radiotherapy dose intensity is associated with improved local-regional control

  9. Higher Biologically Effective Dose of Radiotherapy Is Associated With Improved Outcomes for Locally Advanced Non-Small Cell Lung Carcinoma Treated With Chemoradiation: An Analysis of the Radiation Therapy Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Machtay, Mitchell, E-mail: Mitchell.machtay@uhhospitals.org [University Hospitals/Case Western Reserve University, Cleveland, OH (United States); Bae, Kyounghwa [Radiation Therapy Oncology Group (RTOG) Department of Statistics, Philadelphia, PA (United States); Movsas, Benjamin [Henry Ford Hospital, Detroit, MI (United States); Paulus, Rebecca [Radiation Therapy Oncology Group (RTOG) Department of Statistics, Philadelphia, PA (United States); Gore, Elizabeth M. [Medical College of Wisconsin, Milwaukee, WI (United States); Komaki, Ritsuko [M.D. Anderson Cancer Center, Houston, TX (United States); Albain, Kathy [Loyola University Chicago Stritch School of Medicine, Maywood, IL (United States); Sause, William T. [LDS Hospital, Salt Lake City, UT (United States); Curran, Walter J. [Emory University, Atlanta, GA (United States)

    2012-01-01

    Purpose: Patients treated with chemoradiotherapy for locally advanced non-small-cell lung carcinoma (LA-NSCLC) were analyzed for local-regional failure (LRF) and overall survival (OS) with respect to radiotherapy dose intensity. Methods and Materials: This study combined data from seven Radiation Therapy Oncology Group (RTOG) trials in which chemoradiotherapy was used for LA-NSCLC: RTOG 88-08 (chemoradiation arm only), 90-15, 91-06, 92-04, 93-09 (nonoperative arm only), 94-10, and 98-01. The radiotherapeutic biologically effective dose (BED) received by each individual patient was calculated, as was the overall treatment time-adjusted BED (tBED) using standard formulae. Heterogeneity testing was done with chi-squared statistics, and weighted pooled hazard ratio estimates were used. Cox and Fine and Gray's proportional hazard models were used for OS and LRF, respectively, to test the associations between BED and tBED adjusted for other covariates. Results: A total of 1,356 patients were analyzed for BED (1,348 for tBED). The 2-year and 5-year OS rates were 38% and 15%, respectively. The 2-year and 5-year LRF rates were 46% and 52%, respectively. The BED (and tBED) were highly significantly associated with both OS and LRF, with or without adjustment for other covariates on multivariate analysis (p < 0.0001). A 1-Gy BED increase in radiotherapy dose intensity was statistically significantly associated with approximately 4% relative improvement in survival; this is another way of expressing the finding that the pool-adjusted hazard ratio for survival as a function of BED was 0.96. Similarly, a 1-Gy tBED increase in radiotherapy dose intensity was statistically significantly associated with approximately 3% relative improvement in local-regional control; this is another way of expressing the finding that the pool-adjusted hazard ratio as a function of tBED was 0.97. Conclusions: Higher radiotherapy dose intensity is associated with improved local-regional control

  10. Differential risk assessments from five hypoxia specific assays: The basis for biologically adapted individualized radiotherapy in advanced head and neck cancer patients

    DEFF Research Database (Denmark)

    Nordsmark, Marianne; Eriksen, Jesper Grau; Gebski, Val;

    2007-01-01

    PURPOSE: Hypoxia adversely relates with prognosis in human tumours. Five hypoxia specific predictive marker assays were compared and correlated with definitive radiotherapy. PATIENTS AND METHODS: Sixty-seven patients with advanced head and neck carcinomas were studied for pre-treatment plasma...... by competing risks HP(2.5) was the strongest variable to predict for loco-regional tumour control. CONCLUSION: There was diversity and lack of correlation among five different hypoxia assays within individual tumours. High plasma osteopontin, high HIF-1alpha and high proportion of tumour pO(2)2.5mmHg (HP(2...

  11. Specific aspects of radiotherapy of malignant tumors in childhood

    International Nuclear Information System (INIS)

    Based on the experience with radiotherapy of malignant tumors in 1839 children treated at the Oncological Clinic in Prague from 1946 to 1985, the conclusion is arrived at that some specific aspects of radiotherapy of tumors in children, such as kinetics and biological features are so important that it can be considered a special sub-discipline of clinical radiotherapy. An opinion is expressed about the application of irradiation in non-malignant affections in children. (author). 2 figs., 4 tabs., 25 refs

  12. Biologic

    CERN Document Server

    Kauffman, L H

    2002-01-01

    In this paper we explore the boundary between biology and the study of formal systems (logic). In the end, we arrive at a summary formalism, a chapter in "boundary mathematics" where there are not only containers but also extainers ><, entities open to interaction and distinguishing the space that they are not. The boundary algebra of containers and extainers is to biologic what boolean algebra is to classical logic. We show how this formalism encompasses significant parts of the logic of DNA replication, the Dirac formalism for quantum mechanics, formalisms for protein folding and the basic structure of the Temperley Lieb algebra at the foundations of topological invariants of knots and links.

  13. The potential of radiotherapy of lymphoma infiltrations of the CNS

    International Nuclear Information System (INIS)

    Radiotherapy is a very important element in the complex therapy of lymphomas of the central nervous system, significantly improving the results of the aggressive system chemotherapy. Irradiation of considerable tissue volumes and the application of rather high total doses are recommended. In view of the unfavorable prognosis and biological behavior of the tumor, the total treatment (including chemotherapy and radiotherapy) should be aggressive. (author)

  14. Optimisation in radiotherapy I. Defining the problem

    International Nuclear Information System (INIS)

    Optimisation in radiotherapy should incorporate a very wide set of variables, including the combinations of dose due to external beam radiotherapy, brachytherapy, internally administered radionuclides and the effects of chemotherapy, surgery, hyperthermia, other biological and chemical defenses, alternative treatment techniques, lifestyle and mental state of the patient, the economics of cancer treatment and consideration of tolerable levels of adverse effects and palliation. A full treatment optimisation would consider the influence and covariance of all these variables and any future techniques, as well as the complex constraints imposed by the biological systems being irradiated. This series of reviews concentrates on optimisation of radiotherapy through the treatment planning component of the treatment process - an area of radiotherapy research that has received a great deal of attention as the attached lists of references will testify. It hopes to provide the medical physics and engineering community (and hopefully the clinical community) with a background into the mathematical bases for the manipulation of radiation for clinical benefit. It also examines the potential benefits of research into these techniques in the light of recent approaches to optimisation in radiotherapy, and provides pointers to more concise accounts in the literature. In this first article, the incentive for radiotherapy optimisation research is established, and the actual radiotherapy optimisation problem (in terms of the manipulation of degrees of freedom in radiation delivery) is defined. The degrees of freedom associated with radiotherapy treatment are identified, and it is shown how these degrees of freedom translate into the mathematical parameters of the problem, including the dose distributions they produce. The constraints and objectives of the problem are also discussed from both physical and radiobiological perspectives. (author)

  15. Experimental radiotherapy and clinical radiobiology. Vol. 20. Proceedings

    International Nuclear Information System (INIS)

    The proceedings include contributions on the following issues: laser driven proton accelerators on the way for radiotherapy, radiobiological evaluation of new radiations; molecular factors of radiation response; biological targeting; EGFR epidermal growth factor receptor/targeting - combined internal and external irradiation, radiobiology of normal tissues; dose-volume histograms for the radiotherapy: curves without radiobiological relevance or important information for the therapy planning; HPV (human papilloma virus) and radiation sensitivity of HNSCC (head and neck squamous cell carcinomas): evidence, radiobiological mechanism, clinical consequences and perspectives; mechanisms of action and intertumoral heterogeneity of response to EGFR inhibition in radiotherapy of solid tumors; evaluation of biomarkers for radiotherapy.

  16. Radiotherapy for Hodgkin lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Specht, Lena [Rigshospitalet Copenhagen Univ. (Denmark). Depts. of Oncology and Haematology; Yahalom, Joachim (eds.) [Memorial Sloan-Kettering Cancer, New York, NY (United States). Dept. of Radiation Oncology

    2011-07-01

    This book deals in detail with all aspects of the best practice in modern radiotherapy for Hodgkin lymphoma. It provides the background and rationale for the inclusion of radiotherapy in today's combined-modality approach, including special clinical situations such as Hodgkin lymphoma in children, in the pregnant patient, and in the elderly. Radiotherapy planning using state-of-the-art imaging, target definition, planning software, and treatment equipment is expounded in detail. Acute and long-term side effects of radiotherapy are analyzed, and the implications for modern radiotherapy approaches in Hodgkin lymphomas are explained. (orig.)

  17. Radiotherapy for Hodgkin lymphoma

    International Nuclear Information System (INIS)

    This book deals in detail with all aspects of the best practice in modern radiotherapy for Hodgkin lymphoma. It provides the background and rationale for the inclusion of radiotherapy in today's combined-modality approach, including special clinical situations such as Hodgkin lymphoma in children, in the pregnant patient, and in the elderly. Radiotherapy planning using state-of-the-art imaging, target definition, planning software, and treatment equipment is expounded in detail. Acute and long-term side effects of radiotherapy are analyzed, and the implications for modern radiotherapy approaches in Hodgkin lymphomas are explained. (orig.)

  18. Anatomical imaging for radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Evans, Philip M [Joint Physics Department, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom)], E-mail: phil.evans@icr.ac.uk

    2008-06-21

    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  19. Robust image-adaptive data hiding using erasure and error correction.

    Science.gov (United States)

    Solanki, Kaushal; Jacobsen, Noah; Madhow, Upamanyu; Manjunath, B S; Chandrasekaran, Shivkumar

    2004-12-01

    Information-theoretic analyses for data hiding prescribe embedding the hidden data in the choice of quantizer for the host data. In this paper, we propose practical realizations of this prescription for data hiding in images, with a view to hiding large volumes of data with low perceptual degradation. The hidden data can be recovered reliably under attacks, such as compression and limited amounts of image tampering and image resizing. The three main findings are as follows. 1) In order to limit perceivable distortion while hiding large amounts of data, hiding schemes must use image-adaptive criteria in addition to statistical criteria based on information theory. 2) The use of local criteria to choose where to hide data can potentially cause desynchronization of the encoder and decoder. This synchronization problem is solved by the use of powerful, but simple-to-implement, erasures and errors correcting codes, which also provide robustness against a variety of attacks. 3) For simplicity, scalar quantization-based hiding is employed, even though information-theoretic guidelines prescribe vector quantization-based methods. However, an information-theoretic analysis for an idealized model is provided to show that scalar quantization-based hiding incurs approximately only a 2-dB penalty in terms of resilience to attack.

  20. Radiotherapy of Cervical Cancer.

    Science.gov (United States)

    Vordermark, Dirk

    2016-01-01

    Curative-intent radical radiotherapy of cervical cancer consists of external-beam radiotherapy, brachytherapy, and concomitant chemotherapy with cisplatin. For each element, new developments aim to improve tumor control rates or treatment tolerance. Intensity-modulated radiotherapy (IMRT) has been shown to reduce gastrointestinal toxicity and can be used to selectively increase the radiotherapy dose. Individualized, image-guided brachytherapy enables better adaptation of high-dose volumes to the tumor extension. Intensification of concomitant or sequential systemic therapy is under evaluation. PMID:27614991

  1. Antiproton radiotherapy

    CERN Document Server

    Bassler, Niels; Beyer, Gerd; DeMarco, John J.; Doser, Michael; Hajdukovic, Dragan; Hartley, Oliver; Iwamoto, Keisuke S.; Jakel, Oliver; Knudsen, Helge V.; Kovacevic, Sandra; Møller, Søren Pape; Overgaard, Jens; Petersen, Jørgen B.à; Solberg, Timothy D.; Sørensen, Brita S.; Vranjes, Sanja; Wouters, Bradly G.; Holzscheiter, Michael H.

    2008-01-01

    Antiprotons are interesting as a possible future modality in radiation therapy for the following reasons: When fast antiprotons penetrate matter, protons and antiprotons have near identical stopping powers and exhibit equal radiobiology well before the Bragg-peak. But when the antiprotons come to rest at the Bragg-peak, they annihilate, releasing almost 2 GeV per antiproton–proton annihilation. Most of this energy is carried away by energetic pions, but the Bragg-peak of the antiprotons is still locally augmented with ∼20–30 MeV per antiproton. Apart from the gain in physical dose, an increased relative biological effect also has been observed, which can be explained by the fact that some of the secondary particles from the antiproton annihilation exhibit high-LET properties. Finally, the weakly interacting energetic pions, which are leaving the target volume, may provide a real time feedback on the exact location of the annihilation peak. We have performed dosimetry experiments and investigated the rad...

  2. Joint, Image-Adaptive Compression and Watermarking by GABased Wavelet Localization: Optimal Trade-Off between Transmission Time and Security

    Directory of Open Access Journals (Sweden)

    M. M. Ramya

    2012-12-01

    Full Text Available Teleradiology using internet can offer patients in remote locations the benefit of diagnosis and advice by a super specialist present in a metropolis. However, exchange of vital information such as the clinical images and textual facts in the public network poses challenges of transmission of large volume of data as well as prevention of the distortion of the images. In this paper, a novel application system to jointly compress and watermark the medical images in a near-lossless, image-adaptive adaptive fashion is proposed to address these challenges. The system design uses genetic algorithm for adaptive wavelet coding to generate compressed data and integration of dual watermarks to realize the security and authentication of the compressed data. The GA-based image adaptive compression provides feasible way to obtain optimal compression ratio without compromising the image fidelity upon subsequent watermarking. A multi-gene approach, with one gene coding for the embedding strength of the robust watermark and the other for the number of bits for embedding the semi-fragile watermark is used for optimal image-adaptive watermarking. A multi-parameter fitness function is designed to address the conflicting requirements of image compression, authenticity and integrity associated with teleradiology. Experimental results show the ability of the system to detect tampering and to limit the peak error between the original and the watermarked images. Moreover, as the watermarking is performed on the compressed image, the overhead for watermarking gets reduced.

  3. Carbon-ion radiotherapy for marginal lymph node recurrences of cervical cancer after definitive radiotherapy: a case report

    International Nuclear Information System (INIS)

    Recurrences of cervical cancer after definitive radiotherapy often occur at common iliac or para-aortic lymph nodes as marginal lymph node recurrences. Patients with these recurrences have a chance of long-term survival by optimal re-treatment with radiotherapy. However, the re-irradiation often overlaps the initial and the secondary radiotherapy fields and can result in increased normal tissue toxicities in the bowels or the stomach. Carbon-ion radiotherapy, a form of particle beam radiotherapy using accelerated carbon ions, offers more conformal and sharp dose distribution than X-ray radiotherapy. Therefore, this approach enables the delivery of high radiation doses to the target while sparing its surrounding normal tissues. Marginal lymph node recurrences in common iliac lymph nodes after radiotherapy were treated successfully by carbon-ion radiotherapy in two patients. These two patients were initially treated with a combination of external beam radiotherapy and intracavitary and interstitial brachytherapy. However, the diseases recurred in the lymph nodes near the border of the initial radiotherapy fields after 22 months and 23 months. Because re-irradiation with X-ray radiotherapy may deliver high doses to a section of the bowels, carbon-ion radiotherapy was selected to treat the lymph node recurrences. A total dose of 48 Gy (RBE) in 12 fractions over 3 weeks was given to the lymph node recurrences, and the tumors disappeared completely with no severe acute toxicities. The two patients showed no evidence of disease for 75 months and 63 months after the initial radiotherapy and for 50 months and 37 months after the carbon-ion radiotherapy, respectively. No severe late adverse effects are observed in these patients. The two presented cases suggest that the highly conformal dose distribution of carbon-ion radiotherapy may be beneficial in the treatment of marginal lymph node recurrences after radiotherapy. In addition, the higher biological effect of carbon

  4. Experimental radiotherapy and clinical radiobiology. Vol. 19. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 19. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Dahm-Daphi, Jochen; Dikomey, Ekkehard; Petersen, Cordula; Rodemann, H. Peter; Zips, Daniel (eds.)

    2010-12-18

    The proceedings include review contributions on radio-oncology, and new radiation technologies and molecular prediction; and poster sessions on the following topics: hypoxia; molecular mechanisms of radiation resistance; molecular targeting; DNA repair; biological imaging; biology of experimental radiations; normal tissue toxicity; modern radiotherapy; tumor hypoxia and metabolic micro milieu; immune system and radiotherapy.

  5. Training logbook for radiotherapy.

    NARCIS (Netherlands)

    Hunter, R.; Maciejewski, B.; Leer, J.W.H.; Kinay, M.; Heeren, G.

    2004-01-01

    AIM: To develop a structured logbook for trainees in the medical specialty of radiotherapy with Europe that records the increasing experience throughout their training period. MATERIAL AND METHODS: A working party appointed by the European Board of Radiotherapy developed a draft version of a Europea

  6. [Radiotherapy of skin cancers].

    Science.gov (United States)

    Hennequin, C; Rio, E; Mahé, M-A

    2016-09-01

    The indications of radiotherapy for skin cancers are not clearly defined because of the lack of randomised trials or prospective studies. For basal cell carcinomas, radiotherapy frequently offers a good local control, but a randomized trial showed that surgery is more efficient and less toxic. Indications of radiotherapy are contra-indications of surgery for patients older than 60, non-sclerodermiform histology and occurring in non-sensitive areas. Adjuvant radiotherapy could be proposed to squamous cell carcinomas, in case of poor prognostic factors. Dose of 60 to 70Gy are usually required, and must be modulated to the size of the lesions. Adjuvant radiotherapy seems beneficial for desmoplastic melanomas but not for the other histological types. Prophylactic nodal irradiation (45 to 50Gy), for locally advanced tumours (massive nodal involvement), decreases the locoregional failure rate but do not increase survival. Adjuvant radiotherapy (50 to 56Gy) for Merckel cell carcinomas increases also the local control rate, as demonstrated by meta-analysis and a large epidemiological study. Nodal areas must be included, if there is no surgical exploration (sentinel lymph node dissection). Kaposi sarcomas are radiosensitive and could be treated with relatively low doses (24 to 30Gy). Also, cutaneous lymphomas are good indications for radiotherapy: B lymphomas are electively treated with limited fields. The role of total skin electron therapy for T-lymphomas is still discussed; but palliative radiotherapy is very efficient in case of cutaneous nodules. PMID:27522189

  7. Targeted tumor radiotherapy

    Directory of Open Access Journals (Sweden)

    Unak Perihan

    2002-01-01

    Full Text Available Targeted tumor radiotherapy is selectively delivery of curative doses of radiation to malignant sites. The aim of the targeted tumor radiotherapy is to use the radionuclides which have high LET particle emissions conjugated to appropriate carrier molecules. The radionuclides are selectively collected by tumor cells, depositing lethal doses to tumor cells while no admission occur to normal cells. In theory, targeted radiotherapy has several advantages over conventional radiotherapy since it allows a high radiation dose to be administered without causing normal tissue toxicity, although there are some limitations in the availability of appropriate targeting agents and in the calculations of administered doses. Therefore, for routine clinical applications more progress is still needed. In this article, the potential use of targeted tumor radiotherapy is briefly reviewed. More general aspects and considerations, such as potential radionuclides, mechanisms of tumor targeting was also outlined.

  8. To understand radiotherapy

    International Nuclear Information System (INIS)

    Dealing with the use of radiotherapy for adults, this guide indicates when a radiotherapy is suggested, how it acts, how the treatment is chosen, which are the professionals involved. It describes how an external radiotherapy takes place and its various techniques, the different types of side effects (general, specific to the treated zone, late effects). It indicates which organs can be treated by curie-therapy, the different curie-therapy treatment modalities, how a curie-therapy takes place and which are its side effects. It outlines how to better cope with radiotherapy (how to be supported, the important role of relatives, everyday life questions, rights). It indicates and comments the different measures adopted for the safety and quality of radiotherapy

  9. A novel smartphone ophthalmic imaging adapter: User feasibility studies in Hyderabad, India

    Directory of Open Access Journals (Sweden)

    Cassie A Ludwig

    2016-01-01

    Full Text Available Aim of Study: To evaluate the ability of ancillary health staff to use a novel smartphone imaging adapter system (EyeGo, now known as Paxos Scope to capture images of sufficient quality to exclude emergent eye findings. Secondary aims were to assess user and patient experiences during image acquisition, interuser reproducibility, and subjective image quality. Materials and Methods: The system captures images using a macro lens and an indirect ophthalmoscopy lens coupled with an iPhone 5S. We conducted a prospective cohort study of 229 consecutive patients presenting to L. V. Prasad Eye Institute, Hyderabad, India. Primary outcome measure was mean photographic quality (FOTO-ED study 1–5 scale, 5 best. 210 patients and eight users completed surveys assessing comfort and ease of use. For 46 patients, two users imaged the same patient's eyes sequentially. For 182 patients, photos taken with the EyeGo system were compared to images taken by existing clinic cameras: a BX 900 slit-lamp with a Canon EOS 40D Digital Camera and an FF 450 plus Fundus Camera with VISUPAC™ Digital Imaging System. Images were graded post hoc by a reviewer blinded to diagnosis. Results: Nine users acquired 719 useable images and 253 videos of 229 patients. Mean image quality was ≥ 4.0/5.0 (able to exclude subtle findings for all users. 8/8 users and 189/210 patients surveyed were comfortable with the EyeGo device on a 5-point Likert scale. For 21 patients imaged with the anterior adapter by two users, a weighted κ of 0.597 (95% confidence interval: 0.389–0.806 indicated moderate reproducibility. High level of agreement between EyeGo and existing clinic cameras (92.6% anterior, 84.4% posterior was found. Conclusion: The novel, ophthalmic imaging system is easily learned by ancillary eye care providers, well tolerated by patients, and captures high-quality images of eye findings.

  10. Advances of Precise Radiotherapy for Lung Cancer

    OpenAIRE

    Xin WANG; Xu, Feng; Wei, Yuquan

    2011-01-01

    At present lung tumor radiation therapy has entered the accurate radiotherapy era. Precise radiotherapy includes intensity modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT) and stereotactic body radiotherapy (SBRT). During the process of implementing precise radiotherapy, these problems should be fully considered to ensure executing precise radiotherapy accurately: patient positioning, controlling of the lung tumor motion, selecting of image techniques, PTV margin, dose prescrip...

  11. Biological and medical research with accelerated heavy ions at the Bevalac, 1974--1977. [Planning for use for radiotherapy and as radiation source for diagnostic radiography

    Energy Technology Data Exchange (ETDEWEB)

    Elam, S. (ed.)

    1977-04-01

    The Bevalac, a versatile high-energy heavy-ion accelerator complex, has been in operation for less than two years. A major purpose for which the Bevalac was constructed was to explore the possibility of heavy-ion teams for therapy for certain forms of cancer. Significant progress has been made in this direction. The National Cancer Institute has recognized the advantages that these and other accelerated particles offer, and heavy ions have been included in a long-term plan for particle therapy that will assess by means of controlled therapeutic tests the value of various modalities. Since accelerated heavy ions became available, the possibility of other contributions, not planned, became apparent. We are developig a new diagnostic method known as heavy-ion radiography that has greatly increased sensitivity for soft-tissue detail and that may become a powerful tool for localizing early tumors and metastases. We have discovered that radioactive beams are formed from fragmentation of stable deflected beams. Use of these autoradioactive beams is just beginning; however, we know that these beams will be helpful in localizing the region in the body where therapy is being delivered. In addition, it has been demonstrated that instant implantation of the radioactive beam allows direct measurements of blood perfusion rates in inaccessible parts of the body, and such a technique may become a new tool for the study of fast hot atom reactions in biochemistry, tracer biology and nuclear medicine. The Bevalac will also be useful for the continuation of previously developed methods for the control of acromegaly, Cushing's disease and, on a research basis, advanced diabetes mellitus with vascular disease. The ability to make small bloodless lesions in the brain and elsewhere with heavy-ion beams has great potential for nervous-system studies and perhaps later for radioneurosurgery.

  12. A biologically competitive 21 days hypofractionation scheme with weekly concomitant boost in breast cancer radiotherapy feasibility acute sub-acute and short term late effects

    International Nuclear Information System (INIS)

    Radiation therapy after lumpectomy is a standard part of breast conserving therapy for invasive breast carcinoma. The most frequently used schedule worldwide is 60 Gy in 30 fractions in 6 weeks, a time commitment that sporadically may dissuade some otherwise eligible women from undertaking treatment. The purpose and primary endpoint of this perspective study is to evaluate feasibility and short-term late toxicity in a hypofractionated whole breast irradiation schedule. Between February and October 2008 we treated 65 consecutive patients with operable invasive early-stage breast cancer with a hypofractionated schedule of external beam radiation therapy. All patients were assigned to 39 Gy in 13 fractions in 3 weeks to the whole breast plus a concomitant weekly boost dose to the lumpectomy cavity of 3 Gy in 3 fractions. All the patients had achieved a median follow up of 24 months (range 21-29 months). At the end of treatment 52% presented grade 0 acute toxicity 39% had grade 1 and 9% had grade 2. At 6 months with all the patients assessed there were 34% case of grade 1 subacute toxicity and 6% of grade 2. At 12 months 43% and 3% of patients presented with clinical grade 1 and grade 2 fibrosis respectively and 5% presented grade 1 hyperpigmentation. The remaining patients were free of side effects. At 24 months, with 56 assessed, just 2 patients (3%) showed grade 2 of late fibrosis. The clinical results observed showed a reasonably good feasibility of the accelerated hypofractionated schedule in terms of acute, subacute and short-term late toxicity. This useful 13 fractions with a concomitant boost schedule seems, in selected patients, a biologically acceptable alternative to the traditional 30 days regime

  13. Radiation sensitizations at DNA-level by chemical and biological agents. Coordinated programme on improvement of radiotherapy of cancer using modifiers of radiosensitivity of cells

    International Nuclear Information System (INIS)

    Radiation sensitization by chemical agents at DNA level is discussed. Procaine, Halothan and Metronidazole showed no significant effect on unscheduled DNA synthesis (UDS) in mouse spleen cells, investigated by autoradiography and no effect on rejoining of DNA single strand breaks after gamma or UV irradiation. Oxyphenbutazon and prednisolone reduced the replicative DNA synthesis in vitro and in vivo but there was only little effect on DNA repair in the in vivo experiments. These two substances showed also a small reduction in poly(ADP-ribose) synthesis (PAR synthesis). 5-methoxypsoralen (5-MOP) and 8-methoxypsoralen (8-MOP) in combination with UV irradiation showed that 5-MOP was more toxic than mutagen, but induced much less DNA crosslinks than 8-MOP. Autoradiographic studies of radiation sensitization by biological agents showed significant inhibition of UDS in Yoshida tumor cells after acute mycoplasma infection in rats. Nucleoid sedimentation studies showed only in the case of Yoshida tumor cells after mycoplasma infection a dramatic effect in the sedimentation behaviour. Sensitization of cells by changing chromatin structure was also studied. Benzamide, 3-NH2-benzamide, 3-Methoxybenzamide, Spermine, Theophyllin and Caffeine were tested in different concentrations on replicative DNA synthesis, UDS after UV irradiation and PAR synthesis Chinese hamster ovary cells. 5-Methoxybenzamide was the strongest sensitizer and inhibitor of the PAR synthesis, and was used in further experiments. Results of KFA Juelich on sensitization of a mamma-adenocarcinoma EO 771 on C57 B1 mice are given. Replicative DNA synthesis, DNA repair and PAR synthesis were compared in spleen cells and adenocarcinoma cells after treatment with 5-Methoxybenzamide. An inhibitory effect on UDS could be shown only in adenocarcinoma cells but not in the mice spleen cells

  14. Paradigm Shift in Radiation Biology/Radiation Oncology—Exploitation of the “H2O2 Effect” for Radiotherapy Using Low-LET (Linear Energy Transfer Radiation such as X-rays and High-Energy Electrons

    Directory of Open Access Journals (Sweden)

    Yasuhiro Ogawa

    2016-02-01

    Full Text Available Most radiation biologists/radiation oncologists have long accepted the concept that the biologic effects of radiation principally involve damage to deoxyribonucleic acid (DNA, which is the critical target, as described in “Radiobiology for the Radiologist”, by E.J. Hall and A.J. Giaccia [1]. Although the concepts of direct and indirect effects of radiation are fully applicable to low-LET (linear energy transfer radioresistant tumor cells/normal tissues such as osteosarcoma cells and chondrocytes, it is believed that radiation-associated damage to DNA does not play a major role in the mechanism of cell death in low-LET radiosensitive tumors/normal tissues such as malignant lymphoma cells and lymphocytes. Hall and Giaccia describe lymphocytes as very radiosensitive, based largely on apoptosis subsequent to irradiation. As described in this review, apoptosis of lymphocytes and lymphoma cells is actually induced by the “hydrogen peroxide (H2O2 effect”, which I propose in this review article for the first time. The mechanism of lymphocyte death via the H2O2 effect represents an ideal model to develop the enhancement method of radiosensitivity for radiation therapy of malignant neoplasms. In terms of imitating the high radiosensitivity of lymphocytes, osteosarcoma cells (representative of low-LET radioresistant cells might be the ideal model for indicating the conversion of cells from radioresistant to radiosensitive utilizing the H2O2 effect. External beam radiation such as X-rays and high-energy electrons for use in modern radiotherapy are generally produced using a linear accelerator. We theorized that when tumors are irradiated in the presence of H2O2, the activities of anti-oxidative enzymes such as peroxidases and catalase are blocked and oxygen molecules are produced at the same time via the H2O2 effect, resulting in oxidative damage to low-LET radioresistant tumor cells, thereby rendering them highly sensitive to irradiation. In this

  15. Paradigm Shift in Radiation Biology/Radiation Oncology-Exploitation of the "H₂O₂ Effect" for Radiotherapy Using Low-LET (Linear Energy Transfer) Radiation such as X-rays and High-Energy Electrons.

    Science.gov (United States)

    Ogawa, Yasuhiro

    2016-01-01

    Most radiation biologists/radiation oncologists have long accepted the concept that the biologic effects of radiation principally involve damage to deoxyribonucleic acid (DNA), which is the critical target, as described in "Radiobiology for the Radiologist", by E.J. Hall and A.J. Giaccia [1]. Although the concepts of direct and indirect effects of radiation are fully applicable to low-LET (linear energy transfer) radioresistant tumor cells/normal tissues such as osteosarcoma cells and chondrocytes, it is believed that radiation-associated damage to DNA does not play a major role in the mechanism of cell death in low-LET radiosensitive tumors/normal tissues such as malignant lymphoma cells and lymphocytes. Hall and Giaccia describe lymphocytes as very radiosensitive, based largely on apoptosis subsequent to irradiation. As described in this review, apoptosis of lymphocytes and lymphoma cells is actually induced by the "hydrogen peroxide (H₂O₂) effect", which I propose in this review article for the first time. The mechanism of lymphocyte death via the H₂O₂ effect represents an ideal model to develop the enhancement method of radiosensitivity for radiation therapy of malignant neoplasms. In terms of imitating the high radiosensitivity of lymphocytes, osteosarcoma cells (representative of low-LET radioresistant cells) might be the ideal model for indicating the conversion of cells from radioresistant to radiosensitive utilizing the H₂O₂ effect. External beam radiation such as X-rays and high-energy electrons for use in modern radiotherapy are generally produced using a linear accelerator. We theorized that when tumors are irradiated in the presence of H₂O₂, the activities of anti-oxidative enzymes such as peroxidases and catalase are blocked and oxygen molecules are produced at the same time via the H₂O₂ effect, resulting in oxidative damage to low-LET radioresistant tumor cells, thereby rendering them highly sensitive to irradiation. In this

  16. Paradigm Shift in Radiation Biology/Radiation Oncology—Exploitation of the “H2O2 Effect” for Radiotherapy Using Low-LET (Linear Energy Transfer) Radiation such as X-rays and High-Energy Electrons

    Science.gov (United States)

    Ogawa, Yasuhiro

    2016-01-01

    Most radiation biologists/radiation oncologists have long accepted the concept that the biologic effects of radiation principally involve damage to deoxyribonucleic acid (DNA), which is the critical target, as described in “Radiobiology for the Radiologist”, by E.J. Hall and A.J. Giaccia [1]. Although the concepts of direct and indirect effects of radiation are fully applicable to low-LET (linear energy transfer) radioresistant tumor cells/normal tissues such as osteosarcoma cells and chondrocytes, it is believed that radiation-associated damage to DNA does not play a major role in the mechanism of cell death in low-LET radiosensitive tumors/normal tissues such as malignant lymphoma cells and lymphocytes. Hall and Giaccia describe lymphocytes as very radiosensitive, based largely on apoptosis subsequent to irradiation. As described in this review, apoptosis of lymphocytes and lymphoma cells is actually induced by the “hydrogen peroxide (H2O2) effect”, which I propose in this review article for the first time. The mechanism of lymphocyte death via the H2O2 effect represents an ideal model to develop the enhancement method of radiosensitivity for radiation therapy of malignant neoplasms. In terms of imitating the high radiosensitivity of lymphocytes, osteosarcoma cells (representative of low-LET radioresistant cells) might be the ideal model for indicating the conversion of cells from radioresistant to radiosensitive utilizing the H2O2 effect. External beam radiation such as X-rays and high-energy electrons for use in modern radiotherapy are generally produced using a linear accelerator. We theorized that when tumors are irradiated in the presence of H2O2, the activities of anti-oxidative enzymes such as peroxidases and catalase are blocked and oxygen molecules are produced at the same time via the H2O2 effect, resulting in oxidative damage to low-LET radioresistant tumor cells, thereby rendering them highly sensitive to irradiation. In this review, this

  17. Spinal cord biological safety comparison of intensity modulated radiotherapy and conventional radiation therapy%脊柱适形调强放疗和普通放疗脊髓生物安全性的比较

    Institute of Scientific and Technical Information of China (English)

    锡林宝勒日; 徐万龙; 陈刚; 刘浩; 王若峥; 白靖平

    2010-01-01

    Objective To compare the spine intensity modulated radiation therapy (IMRT) and the conventional radiation therapy on the beagle spinal cord neurons,in order to prove the biological safety of IMRT of the spinal cord.Methods Twelve selected purebred beagles were randomly divided into 2 groups.A beagle clinical model of tumor was mimiced in the ninth and tenth thoracic vertebrae.Then the beagles were irradiated by 2 different models of intensity modulated radiotherapy and conventional radiation therapy,with the total irradiation doses of 50 and 70 Gy.The samples of spinal cord were taken out from the same position of the nine and tenth thoracic vertebrae at the third month after radiation.All the samples were observed by the electron microscope,and the Fas and HSP70 expression in spinal cord neurons were evaluated by immunohistochemistry method.Terminal deoxynucleatidyl transferase mediated dUTP nick and labeling (TUNEL) technique was used to examine the apoptotic cells in the spinal cord.Results The neurons in the spinal cord of IMRT group were mainly reversible injury,and those in the conventional radiation therapy were mainly apoptosis.Compared with the conventional radiation therapy group [50 Gy group,(7.3±1.1)% ;70 Gy group,(11.3 ±.4)%],the apoptosis rate of the spinal cord neurons of the intensity modulated radiotherapy group[50 Gy group,(1.2 ±0.7)%;70 Gy group(2.5 ±0.8)%] was much lower[(50 Gy group,t=0.022,P<0.05;70 Gy group,t=0.017,P<0.05)].The expression levels of Fas in the IMPT group(50 Gy group,4.6 ±0.8;70 Gy group,7.4 ±1.1)were also much lowerthan those in the other group(50 Gy group,15.1 4-6.4;70 Gy group,19.3 ±7.6.50 Gy group,t=0.231,P<0.05;70 Gy group,t:0.457,P<0.05),while the expression levels of HSP70 in the IMPT group(50 Gy group,9.1 ±0.8;70 Gy group,7.3±1.4)were much higher than those in the conventional radiation therapy group(50 Gy group,2.1 ±0.9;70 Gy group,1.7±0.3;50 Gy group,t=0.153,P<0.05;70 Gy group,t=0

  18. Foundations in radiological protection and radiotherapy

    International Nuclear Information System (INIS)

    The work is divided in three parts. The part 1 are a brief abstrac of some important concepts related with the cells. The part 2 speak in general of the biological effects of the ionizing radiations according to the recommendations of the international commission of radiological protection. The part 3 refer to radiobiological calculations applying the quadratic lineal pattern to the radiotherapy. These calculations are important in view of the fact that they are applied for the introduction of new outlines of treatments

  19. Advice concerning radiotherapy

    International Nuclear Information System (INIS)

    Dutch National cancer incidence figures were calculated by using the reliable data on cancer incidence in the Eindhoven area and population forecasts and information obtained from the Central Bureau of Statistics. Several radiotherapy departments suffer from under capacity (a lack of resources and understaffing). Data have also shown that 35% of cancer patients receive radiotherapy, instead of 50%. Calculations have been made by the committee on the present and future needs with regard to equipment and staff. In 1983, the number of megavoltage therapy units amounted to 38, but should have been 65. It should be 80 in 1990 and 90 in 2000. Since building and installing such equipment is a lengthy process a considerable effort is needed to make up for the arrears. The committee advocates the extension of the system of regional cooperation in cancer care (comprehensive cancer centres), in which radiotherapy departments play a crucial role. Working parties from the committee provided a comprehensive description of current radiotherapy practice with reference to physical, technical, clinical and management aspects. Another working party assessed the results of cancer treatment with regard to many different tumour sites. Recent and expected developments were analysed or indicated. The Radiotherapy Committee commissioned an external team to conduct a project to achieve a picture of future developments using methods different to those of the committee's. An interim advice has been added on this subject. (Auth.)

  20. [Prostate cancer external beam radiotherapy].

    Science.gov (United States)

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

    2016-09-01

    The prostate external beam radiotherapy techniques are described, when irradiating the prostate or after prostatectomy, with and without pelvic lymph nodes. The following parts are presented: indications of radiotherapy, total dose and fractionation, planning CT image acquisition, volume of interest delineation (target volumes and organs at risk) and margins, Intensity modulated radiotherapy planning and corresponding dose-volume constraints, and finally Image guided radiotherapy. PMID:27516051

  1. Nanoparticle-guided radiotherapy

    DEFF Research Database (Denmark)

    2012-01-01

    The present invention relates to a method and nano-sized particles for image guided radiotherapy (IGRT) of a target tissue. More specifically, the invention relates to nano-sized particles comprising X-ray-imaging contrast agents in solid form with the ability to block x-rays, allowing for simult......The present invention relates to a method and nano-sized particles for image guided radiotherapy (IGRT) of a target tissue. More specifically, the invention relates to nano-sized particles comprising X-ray-imaging contrast agents in solid form with the ability to block x-rays, allowing...... for simultaneous or integrated external beam radiotherapy and imaging, e.g., using computed tomography (CT)....

  2. Experimental radiotherapy and clinical radiobiology. Vol. 18. Proceedings

    International Nuclear Information System (INIS)

    The proceedings on experimental radiotherapy and clinical radiobiology contain two review articles (prediction of normal tissue reactions after radiotherapy, ?H2AX foci as a marker for DNA double-strand breaks) and 34 contributions to the following topics: Hypoxia and molecular mechanisms of radiation resistance; biological imaging of the tumor micromilieu; DNA repair, genomic instability and carcerogenesis; molecular factors of radiation resistance; actual controversial discussion on possible irradiation caused metastasis risk enhancement; EGFR inhibition and irradiation; biology of experimental radiation/ normal tissue toxicity

  3. Xerostomia induced by radiotherapy

    Directory of Open Access Journals (Sweden)

    Alimi D

    2015-08-01

    Full Text Available David Alimi Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USAWe read with great interest the excellent review on xerostomia induced by radiotherapy, by Pinna et al.1 The authors should be congratulated for a very detailed review of the physiopathology, clinical symptoms, and therapeutic management of an extremely difficult condition. Although we agree that the use of anticholinergic medication represents treatment, it requires the patient to have residual salivary gland function. Unfortunately, it is well established that in most cases radiotherapy destroys most of the salivary gland and associated salivary secretions.     

  4. Postoperative radiotherapy of prostate cancer; Radiotherapie postoperatoire des cancers de la prostate

    Energy Technology Data Exchange (ETDEWEB)

    Richaud, P.; Sargos, P.; Henriques Figueiredo, B. [Service de radiotherapie, centre regional de lutte contre le cancer, institut Bergonie, 33 - Bordeaux (France); Latorzeff, I. [Service de radiotherapie, clinique Pasteur, 31 - Toulouse (France); Mongiat-Artus, P. [Service d' urologie, hopital Saint-Louis, 75 - Paris (France); Houede, N. [Service d' oncologie medicale, centre regional de lutte contre le cancer, institut Bergonie, 33 - Bordeaux (France); Salomon, L. [Service d' urologie, 94 - Creteil (France); Wallerand, H. [Service d' urologie, faculte de medecine Victor-Segalen, CHU Pellegrin-Tripode, 33 - Bordeaux (France)

    2010-10-15

    After radical prostatectomy, the risk of biological recurrence at 5 years varies from 10 to 40 % and this natural evolution of the disease has led radiation therapy being proposed as a supplement to surgery. When the recurrence risk is essentially local, supplementary radiotherapy is justified in the aim of improving biological recurrence-free survival, local control, metastasis-free survival and specific and global survival, while respecting patient quality of life. Three recent studies, EORTC 22911, ARO 9602 and SWOG 8794 found a similar advantage for biological recurrence-free survival without higher major additional toxicity. However, only the SWOG 8794 study found a significant improvement for metastasis-free survival and global survival. In an adjuvant setting, the optimal moment to propose this postoperative radiotherapy remains uncertain: should it be proposed systematically to all pT3 R1 patients, running the risk of pointlessly treating patients who will never recur, or should it only be proposed at recurrence? The GETUG AFU 17 trial will provide answers to the question of the optimal moment for postoperative radiotherapy for pT3-4 R1 pN0 Nx patients with the objective of comparing an immediate treatment to a differed early treatment initiated at biological recurrence. (authors)

  5. Experimental radiotherapy and clinical radiobiology. Vol. 20. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 20. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Dahm-Daphi, Jochen; Dikomey, Ekkehard; Petersen, Cordula; Rodemannn, Hans-Peter; Zips, Daniel (eds.)

    2011-07-01

    The proceedings include contributions on the following issues: laser driven proton accelerators on the way for radiotherapy, radiobiological evaluation of new radiations; molecular factors of radiation response; biological targeting; EGFR epidermal growth factor receptor/targeting - combined internal and external irradiation, radiobiology of normal tissues; dose-volume histograms for the radiotherapy: curves without radiobiological relevance or important information for the therapy planning; HPV (human papilloma virus) and radiation sensitivity of HNSCC (head and neck squamous cell carcinomas): evidence, radiobiological mechanism, clinical consequences and perspectives; mechanisms of action and intertumoral heterogeneity of response to EGFR inhibition in radiotherapy of solid tumors; evaluation of biomarkers for radiotherapy.

  6. Big Data Analytics for Prostate Radiotherapy.

    Science.gov (United States)

    Coates, James; Souhami, Luis; El Naqa, Issam

    2016-01-01

    Radiation therapy is a first-line treatment option for localized prostate cancer and radiation-induced normal tissue damage are often the main limiting factor for modern radiotherapy regimens. Conversely, under-dosing of target volumes in an attempt to spare adjacent healthy tissues limits the likelihood of achieving local, long-term control. Thus, the ability to generate personalized data-driven risk profiles for radiotherapy outcomes would provide valuable prognostic information to help guide both clinicians and patients alike. Big data applied to radiation oncology promises to deliver better understanding of outcomes by harvesting and integrating heterogeneous data types, including patient-specific clinical parameters, treatment-related dose-volume metrics, and biological risk factors. When taken together, such variables make up the basis for a multi-dimensional space (the "RadoncSpace") in which the presented modeling techniques search in order to identify significant predictors. Herein, we review outcome modeling and big data-mining techniques for both tumor control and radiotherapy-induced normal tissue effects. We apply many of the presented modeling approaches onto a cohort of hypofractionated prostate cancer patients taking into account different data types and a large heterogeneous mix of physical and biological parameters. Cross-validation techniques are also reviewed for the refinement of the proposed framework architecture and checking individual model performance. We conclude by considering advanced modeling techniques that borrow concepts from big data analytics, such as machine learning and artificial intelligence, before discussing the potential future impact of systems radiobiology approaches.

  7. Advances of Precise Radiotherapy for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Xin WANG

    2011-11-01

    Full Text Available At present lung tumor radiation therapy has entered the accurate radiotherapy era. Precise radiotherapy includes intensity modulated radiotherapy (IMRT, image-guided radiotherapy (IGRT and stereotactic body radiotherapy (SBRT. During the process of implementing precise radiotherapy, these problems should be fully considered to ensure executing precise radiotherapy accurately: patient positioning, controlling of the lung tumor motion, selecting of image techniques, PTV margin, dose prescription and reporting, arrangement of beams, controlling of dose volume and treatment delivering.

  8. Erythropoietin and radiotherapy; Erythropoietine et radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Le Fur, E.; Albarghach, M.N.; Pradier, O. [CHU de Morvan, Dept. de radiotherapie, 29 - Brest (France)

    2010-01-15

    Erythropoietin (E.P.O.) is a glycoprotein hormone. This hormone is a growth factor for red blood cells precursors in the bone marrow. The decrease of oxygen partial pressure, a reduced number of erythrocytes caused by bleeding or excessive destruction, or increased tissues oxygen requirements lead to increased secretion of E.P.O.. Its action takes place on bone marrow erythroblastic cells through specific receptors. E.P.O. stimulates the proliferation of red cell precursors stem cells in the bone marrow, thus increasing their production in one to two weeks. The effectiveness of E.P.O. at increasing haemoglobin and improving patients quality of life has been demonstrated by several studies. However, its use in radiotherapy remains controversial. While tumour hypoxia caused by anaemia is a factor of radio resistance and thus a source of local failure, tumour expression of E.P.O. receptors presents a significant risk for tumour progression and neo-angiogenesis, which would be increased during the administration of E.P.O.. The purpose of this article is to answer the question: is there a place for E.P.O. in combination with radiotherapy in the management of cancer?

  9. Radiotherapy for craniopharyngioma.

    Science.gov (United States)

    Aggarwal, Ajay; Fersht, Naomi; Brada, Michael

    2013-03-01

    Radiotherapy remains the mainstay of multidisciplinary management of patients with incompletely resected and recurrent craniopharyngioma. Advances in imaging and radiotherapy technology offer new alternatives with the principal aim of improving the accuracy of treatment and reducing the volume of normal brain receiving significant radiation doses. We review the available technologies, their technical advantages and disadvantages and the published clinical results. Fractionated high precision conformal radiotherapy with image guidance remains the gold standard; the results of single fraction treatment are disappointing and hypofractionation should be used with caution as long term results are not available. There is insufficient data on the use of protons to assess the comparative efficacy and toxicity. The precision of treatment delivery needs to be coupled with experienced infrastructure and more intensive quality assurance to ensure best treatment outcome and this should be carried out within multidisciplinary teams experienced in the management of craniopharyngioma. The advantages of the combined skills and expertise of the team members may outweigh the largely undefined clinical gain from novel radiotherapy technologies.

  10. Bowel disease after radiotherapy

    International Nuclear Information System (INIS)

    The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery. (author)

  11. The efficacy of radiotherapy for vertebral hemangiomas.

    Science.gov (United States)

    Miszczyk, L; Ficek, K; Trela, K; Spindel, J

    2001-01-01

    Vertebral hemangiomas are benign, slowly growing tumors sometimes causing local pain in the spine and/or neurologic disorders. The present paper includes 14 cases of painful vertebral hemangiomas treated by radiotherapy. All patients were irradiated using standard fractionation scheme with a total dose 20-30 Gy. One month after the treatment complete pain relief was noted in 36% of cases, five months later in 67% of cases, but in the remaining cases partial pain relief was noted. No correlation between treatment outcome and different biological and technical factors was found. No dose-response relationship was noted. The results suggest that anti-inflamatory effect of radiation plays the major role in this kind of treatment and that radiotherapy for vertebral hemangiomas is easy, short and highly effective analgetic treatment modality.

  12. Carbon ion radiotherapy for pancreatic cancer

    International Nuclear Information System (INIS)

    The Heavy Ion Medical Accelerator in Chiba (HIMAC) is the world's first heavy ion accelerator complex dedicated to medical use in a hospital environment. Carbon ion therapy offers the potential advantages of improved dose localization and enhanced biological effects. It has been suggested that carbon ion therapy is effective against radioresistant pancreatic cancer. In April 2000, clinical studies examining the treatment of pancreatic cancer with carbon ions were begun at the HIMAC. As of February 2010, 48 patients treated with preoperative carbon ion radiotherapy and 89 patients treated for locally advanced pancreatic cancer were enrolled into the clinical trials. Both protocols are still ongoing. The interim results of these clinical trials suggest that carbon ion radiotherapy provides good local control and offers a survival advantage for patients with otherwise hard to cure pancreatic cancer, without unacceptable morbidity. (author)

  13. Quality assurance in radiotherapy

    International Nuclear Information System (INIS)

    Good radiotherapy results and safety of treatment require the radiation to be optimally applied to a specified target area and the correct dose. According to international recommendations, the average uncertainty in therapeutic dose should not exceed 5%. The need for high precision in therapeutic dose requires quality assurance covering the entire radiotherapy process. Besides the physical and technical characteristics of the therapy equipment, quality assurance must include all radiotherapy equipment and procedures that are significant for the correct magnitude and precision of application of the therapeutic dose. The duties and responsibilities pertaining to various stages of treatment must also be precisely defined. These requirements may be best implemented through a quality system. The general requirements for supervision and quality assurance of medical radiation apparatus are prescribed in section 40 of the Radiation Act (592/1991, amendment 1142/1998) and in sections 18 and 32 of the Decree of the Ministry of Social Affairs and Health on the medical use of radiation (423/2000). Guide ST 2.2 imposes requirements on structural radiation shielding of radiotherapy equipment and the premises in which it is used, and on warning and safety arrangements. Guide ST 1.1 sets out the general safety principles for radiation practices and regulatory control procedure for the use of radiation. Guide ST 1.6 provides general requirements for operational measures in the use of radiation. This Guide sets out the duties of responsible parties (the party running a radiation practice) in respect of arranging and maintaining radiotherapy quality assurance. The principles set out in this Guide and Guide ST 6.3 may be applied to radionuclide therapy

  14. [Radiotherapy of breast cancer].

    Science.gov (United States)

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

    2016-09-01

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

  15. Radiotherapy of bronco-pulmonary cancer; Radiotherapie des cancers brochopulmonaires

    Energy Technology Data Exchange (ETDEWEB)

    Bourry, N.; Millardet, C.; Lapeyre, M.; Verrelle, P.; Gross, E.; Champeaux-Orange, E.; Lahbabi, K.; Galland, S.; Chomy, F.; Lagarde, P.; Blanchard, P

    2007-11-15

    Six oral communications as follow: tomography by positron emission with {sup 18}F-FDG and target volume determination in the non at small cells bronchi cancers: interest and limit; adjuvant radiotherapy in the non at small cells pulmonary cancers; pulmonary stereotaxic radiotherapy; the chemoradiotherapy of locally evolved bronco-pulmonary cancers; the mesothelioma: place of radiotherapy; predictive factors of the toxicity and the care of complications of thorax irradiation. (N.C.)

  16. Radiotherapy of cutaneous lymphomas; Radiotherapie des lymphomes cutanes

    Energy Technology Data Exchange (ETDEWEB)

    Kirova, Y.M.; Piedbois, Y.; Pan, Q.; Guo, J.P.; Le Bourgeois, J.P. [Hopital Henri-Mondor, 94 - Creteil (France). Dept. de cancerologie

    1999-03-01

    Radiotherapy plays an important role in the treatment of cutaneous lymphomas. In the treatment of Mycosis fungoides, total skin electron beam radiation therapy is efficient for patients with limited and superficial forms of the disease. Radiotherapy is also efficient for the locally advanced forms of non-epidermo-tropic lymphomas. The palliative radiotherapy is indicated for advanced, nodular and treatment resistant forms of cutaneous lymphomas and for voluminous lymphadenopathies. (authors)

  17. INL Advanced Radiotherapy Research Program Annual Report 2004

    Energy Technology Data Exchange (ETDEWEB)

    James Venhuizen

    2005-06-01

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

  18. External audit in radiotherapy dosimetry

    International Nuclear Information System (INIS)

    Quality audit forms an essential part of any comprehensive quality assurance programme. This is true in radiotherapy generally and in specific areas such as radiotherapy dosimetry. Quality audit can independently test the effectiveness of the quality system and in so doing can identify problem areas and minimize their possible consequences. Some general points concerning quality audit applied to radiotherapy are followed by specific discussion of its practical role in radiotherapy dosimetry, following its evolution from dosimetric intercomparison exercises to routine measurement-based on-going audit in the various developing audit networks both in the UK and internationally. Specific examples of methods and results are given from some of these, including the Scottish+ audit group. Quality audit in radiotherapy dosimetry is now well proven and participation by individual centres is strongly recommended. Similar audit approaches are to be encouraged in other areas of the radiotherapy process. (author)

  19. Radiotherapy for aggressive fibromatosis

    International Nuclear Information System (INIS)

    Purpose/Objective: To evaluate local control with radiotherapy for aggressive fibromatosis. Materials and Methods: Fifty-three patients with histologically confirmed aggressive fibromatosis were treated with radiotherapy at the University of Florida between March 1975 and June 1992. The minimum length of follow-up was 2 years; 88% of patients had follow-up for at least 5 years. Thirty-nine patients had lesions in an extremity and 14 patients had lesions in the trunk. Twenty-nine patients were treated for gross disease. Patients were treated with total doses between 35 Gy and 70 Gy; 83% of patients received 50 Gy to 60 Gy. Results: Local control was achieved in 23 of 29 patients (79%) treated for postoperative microscopic residual disease. Local control was achieved in 21 of 24 patients (88%) treated for gross disease; gross disease was controlled in 8 of 8 patients with previously untreated lesions, and in 13 of 16 patients treated for postoperative gross residual and recurrent disease. Overall, aggressive fibromatosis was locally controlled in 83% of treated patients. All 9 treatment failures occurred with extremity lesions 4 to 68 months after initiation of treatment. Of the 9 recurrences, 4 were out-of-field, 3 were in-field, and 4 occurred at the margin of the irradiated field. Salvage was successful in 8 of 9 patients in whom salvage was attempted with surgery alone or combined with postoperative radiotherapy. A functional limb was maintained in 38 of 39 patients with extremity or limb girdle lesions. The most serious complication of treatment was pathologic fracture, which occurred in 3 of 53 treated patients; all 3 fractures healed with conservative management. Conclusion: Radiotherapy is a valuable adjunct to surgery in the management of aggressive fibromatosis and can be used alone in patients with unresectable or inoperable disease

  20. Xerostomia induced by radiotherapy

    OpenAIRE

    Alimi, David

    2015-01-01

    David Alimi Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USAWe read with great interest the excellent review on xerostomia induced by radiotherapy, by Pinna et al.1 The authors should be congratulated for a very detailed review of the physiopathology, clinical symptoms, and therapeutic management of an extremely difficult condition. Although we agree that the use of anticholinergic medication represents treatment, it requires the patient to have resi...

  1. Adapting radiotherapy to hypoxic tumours

    Energy Technology Data Exchange (ETDEWEB)

    Malinen, Eirik [Department of Radiation Biology, Institute for Cancer Research, Norwegian Radium Hospital, Oslo (Norway); Soevik, Aste [Department of Medical Physics and Technology, Norwegian Radium Hospital, Oslo (Norway); Hristov, Dimitre [Siemens Medical Solutions Inc., Concord, CA (United States); Bruland, Oeyvind S [Department of Oncology, Norwegian Radium Hospital, Oslo (Norway); Olsen, Dag Rune [Department of Radiation Biology, Institute for Cancer Research, Norwegian Radium Hospital, Oslo (Norway)

    2006-10-07

    In the current work, the concepts of biologically adapted radiotherapy of hypoxic tumours in a framework encompassing functional tumour imaging, tumour control predictions, inverse treatment planning and intensity modulated radiotherapy (IMRT) were presented. Dynamic contrast enhanced magnetic resonance imaging (DCEMRI) of a spontaneous sarcoma in the nasal region of a dog was employed. The tracer concentration in the tumour was assumed related to the oxygen tension and compared to Eppendorf histograph measurements. Based on the pO{sub 2}-related images derived from the MR analysis, the tumour was divided into four compartments by a segmentation procedure. DICOM structure sets for IMRT planning could be derived thereof. In order to display the possible advantages of non-uniform tumour doses, dose redistribution among the four tumour compartments was introduced. The dose redistribution was constrained by keeping the average dose to the tumour equal to a conventional target dose. The compartmental doses yielding optimum tumour control probability (TCP) were used as input in an inverse planning system, where the planning basis was the pO{sub 2}-related tumour images from the MR analysis. Uniform (conventional) and non-uniform IMRT plans were scored both physically and biologically. The consequences of random and systematic errors in the compartmental images were evaluated. The normalized frequency distributions of the tracer concentration and the pO{sub 2} Eppendorf measurements were not significantly different. 28% of the tumour had, according to the MR analysis, pO{sub 2} values of less than 5 mm Hg. The optimum TCP following a non-uniform dose prescription was about four times higher than that following a uniform dose prescription. The non-uniform IMRT dose distribution resulting from the inverse planning gave a three times higher TCP than that of the uniform distribution. The TCP and the dose-based plan quality depended on IMRT parameters defined in the inverse

  2. Dosimetric comparison of carbon ion and X-ray radiotherapy for Stage IIIA non–small cell lung cancer

    Science.gov (United States)

    Kubo, Nobuteru; Saitoh, Jun-ichi; Shimada, Hirofumi; Shirai, Katsuyuki; Kawamura, Hidemasa; Ohno, Tatsuya; Nakano, Takashi

    2016-01-01

    The present study compared the dose–volume histograms of patients with Stage IIIA non–small cell lung cancer (NSCLC) treated with carbon ion radiotherapy with those of patients treated with X-ray radiotherapy. Patients with Stage IIIA NSCLC (n = 10 patients for each approach) were enrolled. Both radiotherapy plans were calculated with the same targets and organs at risk on the same CT. The treatment plan for the prophylactic lymph node and primary tumor (PTV1) delivered 40 Gy for X-ray radiotherapy and 40 Gy (relative biological effectiveness; RBE) for carbon ion radiotherapy. The total doses for the primary tumor and clinically positive lymph nodes (PTV2) were 60 Gy for X-ray radiotherapy and 60 Gy (RBE) for carbon ion radiotherapy. The homogeneity indexes for PTV1 and PTV2 were superior for carbon ion radiotherapy in comparison with X-ray radiotherapy (PTV1, 0.57 vs 0.65, P = 0.009; PTV2, 0.07 vs 0.16, P = 0.005). The normal lung mean dose, V5, V10 and V20 for carbon ion radiotherapy were 7.7 Gy (RBE), 21.4%, 19.7% and 17.0%, respectively, whereas the corresponding doses for X-ray radiotherapy were 11.9 Gy, 34.9%, 26.6% and 20.8%, respectively. Maximum spinal cord dose, esophageal maximum dose and V50, and bone V10, V30 and V50 were lower with carbon ion radiotherapy than with X-ray radiotherapy. The present study indicates that carbon ion radiotherapy provides a more homogeneous target dose and a lower dose to organs at risk than X-ray radiotherapy for Stage IIIA non–small cell lung cancer. PMID:27242341

  3. Breast Molecular Profiling and Radiotherapy Considerations.

    Science.gov (United States)

    Mahmoud, Omar; Haffty, Bruce G

    2016-01-01

    The last decade has seen major changes in the management of breast cancer. Heterogeneity regarding histology, therapeutic response, dissemination patterns, and patient outcome is evident. Molecular profiling provides an accurate tool to predict treatment outcome compared with classical clinicopathologic features. The genomic profiling unveiled the heterogeneity of breast cancer and identified distinct biologic subtypes. These advanced techniques were integrated into the clinical management; predicting systemic therapy benefit and overall survival. Utilizing genotyping to guide locoregional management decisions needs further characterization. In this chapter we will review available data on molecular classification of breast cancer, their association with locoregional outcome, their radiobiological properties and radiotherapy considerations. PMID:26987532

  4. Radiotherapy of presenile spinal osteoporosis

    International Nuclear Information System (INIS)

    Painfull conditions of presenile spinal osteoporosis may no longer respond to medication or physical therapy. Analgesic radiotherapy coupled with mild physical therapy and if necessary supported by orthopedic measures frequently results in pain relief and physical stability. Fifty-two cases of osteoporosis and osteoporotic spinal fractures illustrate how better longterm results are achieved by increasing the customary dosage and speeding up radiotherapy. (orig.)

  5. Plan optimization for stereotactic radiotherapy

    NARCIS (Netherlands)

    J.A. de Pooter (Jacobus Abraham)

    2008-01-01

    textabstractCancer is one of the leading causes of death in the world. Next to surgery and chemotherapy, radiotherapy is one of the most used treatment modalities for cancer. About 50% of the patients with cancer will be treated with radiotherapy during the management of their disease. In radiothera

  6. Radiotherapy for eyelid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Saika, Kazumi [Yokohama City Univ. (Japan). School of Medicine

    2001-05-01

    Some studies on radiotherapy for eyelid cancer have been reported, but the optimal radiation doses for different histological types and tumor sizes have not been detailed. So I studied the optimal radiation doses in radiotherapy for eyelid cancer. The patients were fourteen and histological diagnoses were made on the basis of biopsies or surgery before radiotherapy. Surgical cut margins were positive in 10 cases. In 5 of these cases, tumors were visible. There were 9 sebaceous adenocarcinomas (SAC), 4 squamous cell carcinomas (SCC), and 1 basal cell carcinoma (BCC). In 13 of 14 cases, radiation was applied to eyelids in which tumor-surgical cut margin distances were 3 mm or less. The eyeballs were covered with lead or tungsten shields, and the eyelids were irradiated with a total dose of 50 to 66.6 Gy. In 5 cases, radiation was applied prophylactically for ipsilateral pre-auricle lymph node areas. 11 of 13 cases were locally controlled. I gave greater radiation doses for SAC than for SCC or BCC. I also gave greater doses for in visible tumors than for invisible ones. In the acute phase dermatitis, inflammation of the cornea, conjunctivitis, etc. occurred but they were mild. Later reactions were decreased cilia, dry eye, inflammation of cornea, conjunctivitis, discomfort of the scar, etc. Cataracts were also seen, but they were of senile origen. Because 81.8% of the tumors were controlled, this radiation method was useful with salvage therapies to select an optimal radiation dose according to the differences among histological types and tumor sizes. 60% of visible tumors were also controlled so I think that radical therapy using radiation alone is possible. (author)

  7. Big Data Analytics for Prostate Radiotherapy.

    Science.gov (United States)

    Coates, James; Souhami, Luis; El Naqa, Issam

    2016-01-01

    Radiation therapy is a first-line treatment option for localized prostate cancer and radiation-induced normal tissue damage are often the main limiting factor for modern radiotherapy regimens. Conversely, under-dosing of target volumes in an attempt to spare adjacent healthy tissues limits the likelihood of achieving local, long-term control. Thus, the ability to generate personalized data-driven risk profiles for radiotherapy outcomes would provide valuable prognostic information to help guide both clinicians and patients alike. Big data applied to radiation oncology promises to deliver better understanding of outcomes by harvesting and integrating heterogeneous data types, including patient-specific clinical parameters, treatment-related dose-volume metrics, and biological risk factors. When taken together, such variables make up the basis for a multi-dimensional space (the "RadoncSpace") in which the presented modeling techniques search in order to identify significant predictors. Herein, we review outcome modeling and big data-mining techniques for both tumor control and radiotherapy-induced normal tissue effects. We apply many of the presented modeling approaches onto a cohort of hypofractionated prostate cancer patients taking into account different data types and a large heterogeneous mix of physical and biological parameters. Cross-validation techniques are also reviewed for the refinement of the proposed framework architecture and checking individual model performance. We conclude by considering advanced modeling techniques that borrow concepts from big data analytics, such as machine learning and artificial intelligence, before discussing the potential future impact of systems radiobiology approaches. PMID:27379211

  8. Big Data Analytics for Prostate Radiotherapy

    Science.gov (United States)

    Coates, James; Souhami, Luis; El Naqa, Issam

    2016-01-01

    Radiation therapy is a first-line treatment option for localized prostate cancer and radiation-induced normal tissue damage are often the main limiting factor for modern radiotherapy regimens. Conversely, under-dosing of target volumes in an attempt to spare adjacent healthy tissues limits the likelihood of achieving local, long-term control. Thus, the ability to generate personalized data-driven risk profiles for radiotherapy outcomes would provide valuable prognostic information to help guide both clinicians and patients alike. Big data applied to radiation oncology promises to deliver better understanding of outcomes by harvesting and integrating heterogeneous data types, including patient-specific clinical parameters, treatment-related dose–volume metrics, and biological risk factors. When taken together, such variables make up the basis for a multi-dimensional space (the “RadoncSpace”) in which the presented modeling techniques search in order to identify significant predictors. Herein, we review outcome modeling and big data-mining techniques for both tumor control and radiotherapy-induced normal tissue effects. We apply many of the presented modeling approaches onto a cohort of hypofractionated prostate cancer patients taking into account different data types and a large heterogeneous mix of physical and biological parameters. Cross-validation techniques are also reviewed for the refinement of the proposed framework architecture and checking individual model performance. We conclude by considering advanced modeling techniques that borrow concepts from big data analytics, such as machine learning and artificial intelligence, before discussing the potential future impact of systems radiobiology approaches. PMID:27379211

  9. Breast cancer radiotherapy: controversies and prospectives

    Institute of Scientific and Technical Information of China (English)

    YU Jin-ming; WANG Yong-sheng

    2008-01-01

    @@ Despite consensus on breast cancer radiotherapy, there are still some controversies over post-mastectomy radiotherapy (PMRT) in patients with 1-3 positive lymph nodes, accelerated partial breast irradiation (APBI), appropriate sequence of radiotherapy, chemotherapy and hormonal treatment, and radiotherapy after preoperative systemic therapy.

  10. (Biological dosimetry)

    Energy Technology Data Exchange (ETDEWEB)

    Preston, R.J.

    1990-12-17

    The traveler attended the 1st International Conference on Biological Dosimetry in Madrid, Spain. This conference was organized to provide information to a general audience of biologists, physicists, radiotherapists, industrial hygiene personnel and individuals from related fields on the current ability of cytogenetic analysis to provide estimates of radiation dose in cases of occupational or environmental exposure. There is a growing interest in Spain in biological dosimetry because of the increased use of radiation sources for medical and occupational uses, and with this the anticipated and actual increase in numbers of overexposure. The traveler delivered the introductory lecture on Biological Dosimetry: Mechanistic Concepts'' that was intended to provide a framework by which the more applied lectures could be interpreted in a mechanistic way. A second component of the trip was to provide advice with regard to several recent cases of overexposure that had been or were being assessed by the Radiopathology and Radiotherapy Department of the Hospital General Gregorio Maranon'' in Madrid. The traveler had provided information on several of these, and had analyzed cells from some exposed or purportedly exposed individuals. The members of the biological dosimetry group were referred to individuals at REACTS at Oak Ridge Associated Universities for advice on follow-up treatment.

  11. Fertility impairment in radiotherapy.

    Science.gov (United States)

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

    2016-01-01

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

  12. Advances in radiotherapy

    International Nuclear Information System (INIS)

    Radiation therapy is in the midst of a rebirth largely driven by the use of computers for treatment planning and beam delivery. The first edge of this renaissance was the advent of three-dimensional conformal radiation therapy (3-D CRT). This was enabled by the widespread availability and utilization of three-dimensional imaging such as computed tomography and magnetic resonance scanning, themselves products of the computer revolution. For the first time this allowed radiation oncologists to segment and visualize the tumor in association with it neighboring sensitive soft-tissue structures. Software tools to visualize the beam paths through the body enabled the beam directions and beam shapes to be manually optimized. Simultaneously, improved dose calculations utilizing the CT images of the patient anatomy produced more accurate distributions of dose. The dose was delivered with custom-shaped blocks or recently collimators with multiple leaves that allow complex shaped fields to be delivered without the need for block fabrication. In the last couple of decades new treatment delivery methodologies have emerged. The first has been stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) which is the purview of neurosurgeons (who call it SRS) as well as radiation oncologists (who usually call it SRT). SRS and SRT are premised on multiple beams focusing on one location typically with circular aperture collimators but increasingly with fields shaped by multi-leaved collimators. Often only a single treatment session (the usual for SRS) is used when the treatment volume is small, but for larger lesions several treatment sessions, or fractions, are used (most often for SRT) to allow for normal tissue repair. The new equipment market for SRS and SRT is about 10% of the total for radiation therapy. Intensity-modulated radiation therapy (IMRT) is the latest treatment methodology and its adoption has been extremely rapid, particularly in the United States. IMRT uses

  13. Radiotherapy in a public health

    International Nuclear Information System (INIS)

    The aim of our publication is to evaluate the state of radiotherapy, its role and place in oncology and in the public health system, in order to plan necessities. The cost and economical effectiveness are objectives of the current evaluation. Radiotherapy is strongly dependant of introducing new technologies and the need of gross capital investments. However, their relative cost is reduced due to their long-term use. Because of the serious delay of Bulgaria from the world standards in radiotherapy, the analysis is based on the data published in the scientific literature. The main tendencies and ideas for development are based on the analysis of The Swedish Council on Technology Assessment in Health Care (SBU) and the ESTRO QUARTS project. We use Swedish model for estimating the expenses, having in mind the conditions in Bulgaria (salary, management, patient cares). The main conclusions are: 1) Radiotherapy is basic curative and palliative method in oncology; 2) Bulgarian radiotherapy is at one of the last places in Europe (therapeutic units are 30 years old average, despite their recommended exploitation of 12-20 years); 3) In contradiction to the world tendencies delay grows during the last 10 years; 4) In countries with low or average GDP radiotherapy should be prioritized, due to its low cost in comparison to the other treatment methods in oncology; 5) The need of radiotherapy will continue to grow, this necessitate not only replacement of the old machines but increasing their number 3 times during the next few years; 6) It is necessary to form a modern radiotherapy centers, equipped with at least two compatible units, based on the currently existing radiotherapy departments. (authors)

  14. Chest wall desmoid tumours treated with definitive radiotherapy: a plan comparison of 3D conformal radiotherapy, intensity-modulated radiotherapy and volumetric-modulated arc radiotherapy

    OpenAIRE

    Liu, Jia; Ng, Diana; Lee, James; Stalley, Paul; Hong, Angela

    2016-01-01

    Purpose Definitive radiotherapy is often used for chest wall desmoid tumours due to size or anatomical location. The delivery of radiotherapy is challenging due to the large size and constraints of normal surrounding structures. We compared the dosimetry of 3D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc radiotherapy (VMAT) to evaluate the best treatment option. Methods and materials Ten consecutive patients with inoperable chest wall de...

  15. Challenges in integrating 18FDG PET-CT into radiotherapy planning of head and neck cancer.

    Science.gov (United States)

    Dandekar, P; Partridge, M; Kazi, R; Nutting, C; Harrington, K; Newbold, K

    2010-01-01

    Radiotherapy forms one of the major treatment modalities for head and neck cancers (HNC), and precision radiotherapy techniques, such as intensity-modulated radiotherapy require accurate target delineation to ensure success of the treatment. Conventionally used imaging modalities, such as X-ray computed tomography (CT) and magnetic resonance imaging are used to delineate the tumor. Imaging, such as positron emission tomography (PET)-CT, which combines the functional and anatomic modalities, is increasingly being used in the management of HNC. Currently, 18-fluorodeoxyglucose is the most commonly used radioisotope, which is accumulated in areas of high glucose uptake, such as the tumor tissue. Because most disease recurrences are within the high-dose radiotherapy volume, defining a biological target volume for radiotherapy boost is an attractive approach to improve the results. There are many challenges in employing the PET-CT for radiotherapy planning, such as patient positioning, target edge definition, and use of new PET tracers, which represent various functional properties, such as hypoxia, protein synthesis, and proliferation. The role of PET-CT for radiotherapy planning is ever expanding and more clinical data underlining the advantages and challenges in this approach are emerging. In this article, we review the current clinical evidence for the application of functional imaging to radiotherapy planning and discuss some of the current challenges and possible solutions that have been suggested to date.

  16. Adaptive Motion Compensation in Radiotherapy

    CERN Document Server

    Murphy, Martin J

    2011-01-01

    External-beam radiotherapy has long been challenged by the simple fact that patients can (and do) move during the delivery of radiation. Recent advances in imaging and beam delivery technologies have made the solution--adapting delivery to natural movement--a practical reality. Adaptive Motion Compensation in Radiotherapy provides the first detailed treatment of online interventional techniques for motion compensation radiotherapy. This authoritative book discusses: Each of the contributing elements of a motion-adaptive system, including target detection and tracking, beam adaptation, and pati

  17. TCR基因突变分析技术对癌症放疗患者生物剂量估算价值的探讨%Estimation value of TCR gene mutation analytical technique to the biological dose of radiotherapy patients

    Institute of Scientific and Technical Information of China (English)

    马娅; 侯殿俊; 刘伟; 赵蔚冲; 乔建伟; 李洁清; 封丽

    2011-01-01

    OBJECTIVE: To explore the feasibility of esti-mating the biological dose of radiotherapy patients by means of TCR gene mutation analysis. METHOD: Cultivate lymphocytes of 16 cancer patients received different irradiation doses and the control group (16 healthy people) respectively, then analysis TCR mutation frequency (TCRMF) and chromosome dicentric and centric ring (dic + r), and estimate the biological dose through the dose-effect curve which had cultivated. RESULTS: The mean of TCRMF for the patients before radiotherapy and the control group was 1. 853 × 10-4 and 1. 735 × 10-4 , respec-tively,with no statistical difference between them(P>0.05). But the TCRMF of patient after radiotherapy was increased in a dose-dependent trend. There was no statistical difference (F = 0.419 4,P>0. 05) between TCR mutation and chromosomal aberration analytical technique to estimate the whole equivalent dose of cancer patients. CONCLUSION: TCR gene mutation an-alytical technique can be used as a technology to estimate the genetic injury effect of radiotherapy patients,but need more data to consummate.%目的:探讨TCR突变分析技术估算放疗患者生物剂量的可行性.方法:分别取16例不同照射剂量的癌症患者和16例健康对照组的血样,进行细胞培养分析T淋巴细胞受体突变频率(TCRMF)以及染色体双着丝粒体和着丝粒环(双+环),并用已建立的生物剂量-效应曲线估算生物剂量.结果:16例癌症患者放疗前和对照组TCRMF的平均值分别为1.853×10-4和1.735×10-4,两组之间差异无统计学意义,P>0.05;癌症患者放疗后的TCRMF随着照射剂量的增加而增加,呈现一定的剂量效应关系,染色体双+环也随着照射剂量的增加而增加,两者的趋势基本一致.用TCR突变分析技术和染色体畸变分析技术,2种方法估算的肿瘤患者全身等效剂量差异无统计学意义,F=0.419 4,P>0.05.结论:TCR基因突变分析技术可以作为一种方法来估算放

  18. Experimental radiotherapy and clinical radiobiology. Vol. 22. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 25. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Krause, Mechthild [Universitaetsklinikum Technische Univ. Dresden (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radiologie; Cordes, Nils [Universitaetsklinikum Technische Univ. Dresden (Germany). OncoRay - Nationales Zentrum fuer Strahlenforschung in der Radioonkologie; Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany); Petersen, Cordula [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie; Rodemann, H. Peter [Universitaetsklinikum Tuebingen (Germany). Sektion fuer Strahlenbiologie; Rothkamm, Kai [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Lab. fuer Strahlentherapie und Experimentelle Radioonkologie; Zips, Daniel (ed.) [Tuebingen Univ. (Germany). Universitaetsklinik fuer Radioonkologie

    2016-05-01

    The proceedings of the 25th symposium on experimental radiotherapy and clinical radiobiology include papers on the following issues: radiotherapy individualization based on imaging; pre-clinic imaging and new experimental methods; methods and models, micromilieu and metabolism, combined therapy; secondary tumors following radiotherapy; radiogenic effects in normal tissue; resistance mechanism of tumors and normal tissue; personalized radio-oncology - which biological data are needed; pre-clinic and personalized radio-oncology; biomarkers - pre-clinic and translational; translational examinations for personalized radio-oncology.

  19. Radiotherapy in supratentorial gliomas. A study of 821 cases

    Energy Technology Data Exchange (ETDEWEB)

    Heesters, M. [Dept. of Radiotherapy, Groningen Univ. Hospital (Netherlands); Molenaar, W. [Dept. of Pathology, Groningen Univ. Hospital (Netherlands); Go, G.K. [Dept. of Neurosurgery, Groningen Univ. Hospital (Netherlands)

    2003-09-01

    Purpose: Analysis of the results of radiotherapy in a large group of cerebral gliomas with identification of prognostic factors and the outcome with respect to different decades of treatment. Patients and Methods: Two decades (1979-1999) of radiotherapy in supratentorial astrocytic and oligodendroglial tumors (n = 821) at the University Hospital Groningen were retrospectively evaluated. Prognostic factors for survival were analyzed. Two decades of radiotherapy treatment were compared with respect to radiotherapy dose and treatment-field design. Results: Glioblastoma multiforme, including gliosarcoma, was the most frequent supratentorial glioma (n = 442) with a poor survival, i.e., median survival time (MST) 7 months, especially in patients > 50 years of age and with poor performance. Patients with good performance were selected for radiotherapy with an optimum dose of 60 Gy local-field irradiation. However, in patients with poor prognosis, no radiotherapy was applied or a shorter treatment scheme was given. Anaplastic astrocytomas (n = 131) were treated in the same way as glioblastoma multiforme. Over time, a decrease in radiation dose (from 60 to 45 Gy) and from whole brain irradiation to local-field treatment was observed, following the literature. In low-grade gliomas, prognostic factors for survival were age, performance, and extent of resection. Gemistocytic astrocytoma (n = 15) had an inferior survival compared to astrocytoma (MST 46 vs. 54 months), but a superior survival compared to anaplastic astrocytoma (MST 10 months). The presence of an oligodendroglial component in a glioma implied a superior survival compared to the astrocytic gliomas. The inherent biology of the glioma is reflected by the study of recurrent tumors with progression to higher grades of malignancy in 32-40% and by the histology of recurrent oligodendroglial tumors. In comparing two decades of radiotherapy in gliomas, no differences in survival were observed despite the technological

  20. Radiotherapy in supratentorial gliomas. A study of 821 cases

    International Nuclear Information System (INIS)

    Purpose: Analysis of the results of radiotherapy in a large group of cerebral gliomas with identification of prognostic factors and the outcome with respect to different decades of treatment. Patients and Methods: Two decades (1979-1999) of radiotherapy in supratentorial astrocytic and oligodendroglial tumors (n = 821) at the University Hospital Groningen were retrospectively evaluated. Prognostic factors for survival were analyzed. Two decades of radiotherapy treatment were compared with respect to radiotherapy dose and treatment-field design. Results: Glioblastoma multiforme, including gliosarcoma, was the most frequent supratentorial glioma (n = 442) with a poor survival, i.e., median survival time (MST) 7 months, especially in patients > 50 years of age and with poor performance. Patients with good performance were selected for radiotherapy with an optimum dose of 60 Gy local-field irradiation. However, in patients with poor prognosis, no radiotherapy was applied or a shorter treatment scheme was given. Anaplastic astrocytomas (n = 131) were treated in the same way as glioblastoma multiforme. Over time, a decrease in radiation dose (from 60 to 45 Gy) and from whole brain irradiation to local-field treatment was observed, following the literature. In low-grade gliomas, prognostic factors for survival were age, performance, and extent of resection. Gemistocytic astrocytoma (n = 15) had an inferior survival compared to astrocytoma (MST 46 vs. 54 months), but a superior survival compared to anaplastic astrocytoma (MST 10 months). The presence of an oligodendroglial component in a glioma implied a superior survival compared to the astrocytic gliomas. The inherent biology of the glioma is reflected by the study of recurrent tumors with progression to higher grades of malignancy in 32-40% and by the histology of recurrent oligodendroglial tumors. In comparing two decades of radiotherapy in gliomas, no differences in survival were observed despite the technological

  1. Radiotherapy on hidradenocarcinoma

    Directory of Open Access Journals (Sweden)

    Issam Lalya

    2011-01-01

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

  2. Radiotherapy on hidradenocarcinoma

    Directory of Open Access Journals (Sweden)

    Issam Lalya

    2011-01-01

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

  3. MRI assisted radiotherapy planning

    International Nuclear Information System (INIS)

    To obtain the optimal radiation field, an MR simulation system (MRSS) has been developed. The system consists of an MR unit, a work station and a laser marking system. Phantom study concerned geographic distortion and the total accuracy of MRSS, the former revealed the result lesser than 1 mm within 90 mm-distance between MR slices and Center of magnetic field, the latter showed maximal errors 2 mm in the field size, and 3 mm in the iso-center. This system was applied to 15 patients with intracranial or head and neck lesions and all procedures were smoothly performed. To evaluate the usefulness of MRSS, 6 radiation oncologists compared the difference between MRSS and CT simulation system in setting radiation field. The results were satisfactory especially in cases with lesions the extent of which was unclear on CT images. It was considered that this system could support the radiotherapy planning for intracranial or head and neck lesions. (author)

  4. [Hepatic tumors and radiotherapy].

    Science.gov (United States)

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

    2016-09-01

    Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm). Tumor (and liver) movements induced by respiratory motions must be taken into account. Strict dosimetric criteria must be met with particular attention to the dose-volume histograms to liver and the hollow organs, including cases of SBRT. PMID:27521035

  5. Small animal image-guided radiotherapy: status, considerations and potential for translational impact

    OpenAIRE

    Butterworth, K. T.; Prise, K M; Verhaegen, F

    2014-01-01

    Radiation biology is being transformed by the implementation of small animal image-guided precision radiotherapy into pre-clinical research programmes worldwide. We report on the current status and developments of the small animal radiotherapy field, suggest criteria for the design and execution of effective studies and contend that this powerful emerging technology, used in combination with relevant small animal models, holds much promise for translational impact in radiation oncology.

  6. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno;

    2014-01-01

    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...

  7. Indications for Salivary Gland Radiotherapy.

    Science.gov (United States)

    Thomson, David J; Slevin, Nick J; Mendenhall, William M

    2016-01-01

    There is an established role for post-operative radiotherapy in the treatment of benign and malignant salivary gland tumours. For benign disease, the addition of radiotherapy improves local tumour control in cases with incomplete excision, involved surgical margins or multi-focal disease recurrence. After capsule rupture or spillage alone, surveillance should usually be advised. For malignant disease, post-operative radiotherapy is recommended for an advanced tumour stage, high-grade tumour, perineural or lympho-vascular invasion, close or positive resection margins, extra-parotid extension or lymph node involvement. The main benefit is increased loco-regional tumour control, although this may translate into a modest improvement in survival. The possible late side effects of parotid bed irradiation include skin changes, chronic otitis externa, sensorineural hearing loss, osteoradionecrosis and secondary malignancy. Severe complications are rare, but patients should be counselled carefully about the risks. Primary radiotherapy is unlikely to be curative and is reserved to cases in which resection would cause unacceptable functional or cosmetic morbidity or would likely result in subtotal resection (R2) or to patients with distant metastases to gain local tumour control. There are provisional data on the use of charged particle radiotherapy in this setting. Some patients may benefit from synchronous chemotherapy with radiotherapy, but this group is not defined, and data from comparative prospective studies are required before routine clinical use of this treatment. PMID:27093301

  8. Radiotherapy in prostate cancer. Innovative techniques and current controversies

    Energy Technology Data Exchange (ETDEWEB)

    Geinitz, Hans [Krankenhaus der Barmherzigen Schwestern, Linz (Austria). Dept. of Radiation Oncology; Linz Univ. (Austria). Medical Faculty; Roach, Mack III [California Univ., San Francisco, CA (United States). Dept. of Radiation Oncology; Van As, Nicholas (ed.) [The Institute of Cancer Research, Sutton Surrey (United Kingdom)

    2015-04-01

    Examines in detail the role of innovative radiation techniques in the management of prostate cancer, including IMRT, IGRT, BART, and modern brachytherapy. Explores a range of current controversies in patient treatment. Intended for both radiation oncologists and urologists. Radiation treatment is rapidly evolving owing to the coordinated research of physicists, engineers, computer and imaging specialists, and physicians. Today, the arsenal of ''high-precision'' or ''targeted'' radiotherapy includes multimodal imaging, in vivo dosimetry, Monte Carlo techniques for dose planning, patient immobilization techniques, intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), biologically adapted radiotherapy (BART), quality assurance methods, novel methods of brachytherapy, and, at the far end of the scale, particle beam radiotherapy using protons and carbon ions. These approaches are like pieces of a puzzle that need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of the above-mentioned innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer.

  9. Gene therapy and radiotherapy in malignant tumor

    International Nuclear Information System (INIS)

    Tumor treatment is one of the most important fields in medical research. Nowadays, a novel method which is combined gene therapy with radiotherapy plays an important role in the field of cancer research, and mainly includes immune gene therapy combined with radiotherapy, suicide gene therapy or tumor suppressor gene therapy combined with radiotherapy, antiangiogenesis gene therapy combined with radiotherapy and protective gene therapy combined with radiotherapy based on the technical features. This review summarized the current status of combined therapies of gene therapy and radiotherapy and possible mechanism. (authors)

  10. Radioprotectors in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nair, C.K.K. [Bhabha Atomic Research Centre, Mumbai (India); Parida, D.K.; Nomura, Taisei

    2001-03-01

    This review article focuses on clinically relevant radioprotectors and their mechanisms of radioprotection. Radiotherapy is the most common modality of human cancer therapy. Obtaining optimal results requires a judicious balance between the total dose of radiotherapy delivered and the threshold limit of critical surrounding normal tissues, and the normal tissues need to be protected against radiation injury to obtain better tumor control by using a higher dose. For this reason, radiation-protective agents play an important role in clinical radiotherapy. Radiation-protective agents can be classified into three groups: radioprotectors, adaptogens, and absorbents. The first group generally consists of sulfhydryl compounds and other antioxidants. They include several myelo-, entero-, and cerebro-protectors. Adaptogens act as promotors of radioresistance. They are natural protectors that offer chemical protection against low levels of ionizing radiation. Absorbents protect organs from internal radiation and chemicals. They include drugs that prevent incorporation of radioiodine by the thyroid gland and absorption of radionuclides. This article thoroughly describes the properties, mechanisms of action, and perspectives on clinical application of the following categories of radioprotectors: sulfhydryl compounds (e.g., cysteine, cysteamine, glutathione, AET, WR 2127, and other WR-compounds), antioxidants (e.g., tempace, Hoechst 33342, vitamin A, E, and C, TMG, melatonin), angiotensin-converting enzyme (ACE) inhibitors (e.g., captopril, elanopril, penicillamine, pentoxifylline, L-158, 809), cytoprotective agents (mesna, dexrazoxane, and amifostin), metalloelements (e.g., manganese chloride, cadmium salts, bismuth subnitrate), immunomodulators (gamma-interferon, polysaccharides AM5, AM218, heat-killed lactobacillus cells, broncho-vaxom, trehalose dicorynomycolate, and AS101), lipopolysaccharides and prostaglandins, plant extracts and compounds isolated from plants (curcmin

  11. Automatization in radiotherapy

    International Nuclear Information System (INIS)

    Data-processing in external radiotherapy has to be adapted to each local situation, taking into account the patients to be treated, the irradiation equipment, the data-processing centers available locally, regionally, and nationally, and the rentability of the data-processing system required. It should be recalled that most dosimetric methods used today can be treated manually, and the question of rentability has to be kept in mind when deciding to buy a data-processing system. The radiotherapist should, therefore, prepare a list of costs for each situation, and verify the validity of each programme proposed by the supplier. It is difficult to make a definite choice between the presently available systems. The radiotherapist has to choose in relation to his activity, his availability and the systems available to him. It can sometimes be more advantageous to have a terminal linked to a large computer, rather than to readapt a series of programmes for a data-processing system available locally: many such solutions, though original, cannot be 'exported'. It should be recalled that a large number of dosimetries can be obtained manually, and on the rare occasions when the aid of a computer is essential, the assistance of better equipped neighbouring centers can be obtained. The decision as to whether a data-processing system needs to be acquired has to take all these imperatives into account

  12. The origins of radiotherapy: discovery of biological effects of X-rays by Freund in 1897, Kienböck's crucial experiments in 1900, and still it is the dose.

    Science.gov (United States)

    Widder, Joachim

    2014-07-01

    The discovery of X-rays by Wilhelm Conrad Röntgen (1845-1923) was triggered by pursuing an anomalous phenomenon: arousal of fluorescence at a distance from tubes in which cathode rays were elicited, a phenomenon which suggested the existence of a new kind of ray other than cathode rays. The discovery of biological effects of these X-rays by Leopold Freund (1868-1943) was triggered by pursuit of the purportedly useless phenomenon of epilation and dermatitis ensuing from X-ray-diagnostic experiments that others had reported. The crucial experiments performed by Robert Kienböck (1871-1953) entailed the proof that X-ray-dose, not electric phenomena, was the active agent of biological effects ensuing when illuminating the skin using Röntgen tubes. For both the discovery of X-rays and the discovery of their biological effectiveness, priority did not matter, but understanding the physical and medico-biological significance of phenomena that others had ignored as a nuisance. Present discussions about the clinical relevance of improving the dose distribution including protons and other charged particles resemble those around 1900 to a certain degree.

  13. Review of potential improvements using MRI in the radiotherapy workflow

    Energy Technology Data Exchange (ETDEWEB)

    Torresin, Alberto; Brambilla, Maria Grazia; Monti, Angelo F.; Moscato, Alessio [Azienda Ospedale Niguarda Ca' Granda, Dept. of Medical Physics, Milano (Italy); Brockmann, Marc A. [University Hospital of the RWTH Aachen (Germany). Dept. of Diagnostic and Interventional Neuroradiology; University Medical Center Mannheim (Germany). Dept. of Neuroradiology; Schad, Lothar [University Medical Center Mannheim (Germany). Computer Assisted Clinical Medicine; Attenberger, Ulrike I. [University Medical Center Mannheim (Germany). Inst. of Clinical Radiology and Nuclear Medicine; Lohr, Frank [University Medical Center Mannheim (Germany). Dept. of Radiation Oncology

    2015-07-01

    The goal of modern radiotherapy is to deliver a lethal amount of dose to tissue volumes that contain a significant amount of tumour cells while sparing surrounding unaffected or healthy tissue. Online image guided radiotherapy with stereotactic ultrasound, fiducial-based planar X-ray imaging or helical/conebeam CT has dramatically improved the precision of radiotherapy, with moving targets still posing some methodical problems regarding positioning. Therefore, requirements for precise target delineation and identification of functional body structures to be spared by high doses become more evident. The identification of areas of relatively radioresistant cells or areas of high tumor cell density is currently under development. This review outlines the state of the art of MRI integration into treatment planning and its importance in follow up and the quantification of biological effects. Finally the current state of the art of online imaging for patient positioning will be outlined and indications will be given what the potential of integrated radiotherapy/online MRI systems is.

  14. Radiotherapy and skin tumors; Radiotherapie et tumeurs curanees

    Energy Technology Data Exchange (ETDEWEB)

    Calitchi, E.; KIrova, Y.; Le bourgeois, J.P. [Hopital Henri-Mondor, 94 - Creteil (France)

    1998-09-01

    Radiotherapy plays an important role in treatment of skin tumours. For skin carcinomas, external irradiation (kilo-voltage X-rays or electrons according to clinical characteristics) is more valuable than interstitial brachytherapy, which is recommended for tumours of the lip and of the nasal vestibule. In mycosis fungoides, total cutaneous electron beam radiation therapy is efficient for patients with limited superficial plaques. In the classical form of Kaposi`s sarcoma, radiotherapy can achieve local control-whereas it obtains good palliative results in the epidemic form. (author)

  15. Technological advances in radiotherapy for esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Milan; Vosmik; Jiri; Petera; Igor; Sirak; Miroslav; Hodek; Petr; Paluska; Jiri; Dolezal; Marcela; Kopacova

    2010-01-01

    Radiotherapy with concurrent chemotherapy and surgery represent the main treatment modalities in esophageal cancer.The goal of modern radiotherapy approaches,based on recent technological advances,is to minimize post-treatment complications by improving the gross tumor volume definition (positron emission tomography-based planning),reducing interfraction motion (image-guided radiotherapy) and intrafraction motion (respiratory-gated radiotherapy),and by better dose delivery to the precisely defined planning ...

  16. Hyperthermia and radiotherapy

    International Nuclear Information System (INIS)

    Combined hyperthermia (HT 45 min once or twice per week) and low dose radiotherapy (LDRT 30-34.5 Gy in 2-3 weeks) have been given to 182 locally recurrent or metastatic superficial tumours in 133 patients. Tumour response was analysed in 137 tumours in 100 patients. The overall complete response (CR) was 50% with a median duration (DCR) of 13±3 months. When mammary carcinoma, representing 62% of the treated tumours, were analysed, CR was 62% with a DCR of 14±4 months. In a comparative, non-randomized study, on 34 matched tumour pairs in 24 patients, treatment was given with LDRT+HT to the larger and the same LDRT to the smaller tumour, the patients acting as their own control. A significant difference in CR was obtained in favour of the combined treatment (p=0.0013 all diagnosis and p=0.0027 mammary carcinoma). There was no significant difference in DCR between the two modalities. No significant difference in CR was seen when tumours were randomely treated with HT once (CR 56%) or twice (CR 69%) per week combined with the same LDRT. Predictive factors for CR, multivariately analysed (15 parameters), in mammary carcinoma recurring in earlier irradiated regions, were; the present LDRT absorbed dose (p=0.02) and the average minimum temperature in the best HT session (p=0.03). Significant skin toxicity was seen in 28% of all the 182 heated regions. Prognostic factors for skin damage, multivariately analysed, were; the extension of the heated region (p=0.007) and the highest average maximum temperature in any of the HT sessions (p=0.04). Pain was in some way correlated to severe toxicity but was not considered to be an optimal monitor for HT as many patients with severe and moderate pain were without any serious skin reactions, while slight or no pain sometimes were associated with severe reactions. 401 refs

  17. Mucosal regeneration during radiotherapy

    International Nuclear Information System (INIS)

    Background and purpose: Regeneration of the aerodigestive mucosa is known to occur during conventionally fractionated radiotherapy. The circumstances surrounding its time of onset and magnitude are not well understood, however. Material and methods: Mucosal reactions were observed in 100 patients undergoing conventionally fractionated treatment at 2 Gy/day over 7 weeks and 88 receiving accelerated treatment at 1.8 Gy twice daily over 3(1(2)) weeks on the Trans Tasman Radiation Oncology Group head and neck cancer trials. Similar observations in 61 patients treated palliatively at dose rates between 0.8 and 240 Gy/h using ten 3.0-4.2 Gy fractions over 2 weeks are compared. Results: Several findings emerged from these studies: 1. Reactions evolved more quickly at oropharyngeal sites than in the hypopharynx. 2. Reactions at both sites evolved more rapidly at greater rates of dose accumulation. 3. The timing of reactions suggested the presence of a strong regenerative mucosal response that started before the manifestation of 'patchy' (grade II) mucosal reactions. 4. The regenerative response was strong enough to 'make good' damage accumulated at a rate of 2 Gy/day in over a third of cases. 5. The linear quadratic model without time correction failed to provide an adequate prediction of the frequency or intensity of mucosal reactions produced by any of the regimes. A simple model of the regenerative response is presented. Conclusions: This study suggests that the timing and magnitude of the regenerative response vary between sites and individuals but are linked to the amount of epithelial cellular depletion occurring during treatment

  18. Contribution of customised dosimetry for small animal to the treatments of cancers by metabolic radiotherapy

    International Nuclear Information System (INIS)

    This research thesis first reports a bibliographical study which addressed the use of ionizing radiations in cancer therapy (evolution from ionizing radiation to metabolic radiotherapy, biological and physical parameters, and absorbed dose in metabolic radiotherapy) and the role imagery has in customised dosimetry (absorbed dose calculation methods, determination of cumulative activity, dosimetric models for S factor calculation). Then, the author presents a software which has been specifically developed for the creation of dosimetric models, and reports its validation. He reports the comparison between different dosimetric models in the case of mice. He highlights two applications of the developed tool: radio-immunotherapy and metabolic radiotherapy. He finally proposes a general discussion on the impact of small animal dosimetry on metabolic radiotherapy

  19. Computerised tomography in radiotherapy planning

    International Nuclear Information System (INIS)

    This study evaluates the effectiveness of computed tomography as an adjunct to radiotherapy planning. Until recently, acquisition of accurate data concerning tumour anatomy lagged behind other developments in radiotherapy. With the advent of computer-tomography (CT), these data can be displayed and transmitted to a treatment planning computer. It is concluded that the greatest inaccuracies in the radiation treatment of patients are to be found in both the inadequate delineation of the target volume within the patient and changes in body outline relative to the target volume over the length of the irradiated volume. The technique was useful in various subgroups (pelvic, intra-thoracic and chest-wall tumours) and for those patients being treated palliatively. With an estimated improvement in cure rate of 4.5% and cost-effective factors of between 3.3 and 5, CT-assisted radiotherapy planning appears to be a worthwhile procedure. (orig.)

  20. Experimental radiotherapy and clinical radiobiology. Vol. 18. Proceedings; Experimentelle Strahlentherapie und Klinische Strahlenbiologie. Bd. 18. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Dahm-Daphi, Jochen; Dikomey, Ekkehard; Petersen, Cordula; Rodemann, H. Peter; Zips, Daniel (eds.)

    2009-07-15

    The proceedings on experimental radiotherapy and clinical radiobiology contain two review articles (prediction of normal tissue reactions after radiotherapy, ?H2AX foci as a marker for DNA double-strand breaks) and 34 contributions to the following topics: Hypoxia and molecular mechanisms of radiation resistance; biological imaging of the tumor micromilieu; DNA repair, genomic instability and carcerogenesis; molecular factors of radiation resistance; actual controversial discussion on possible irradiation caused metastasis risk enhancement; EGFR inhibition and irradiation; biology of experimental radiation/ normal tissue toxicity.

  1. Construction of a remote radiotherapy planning system

    International Nuclear Information System (INIS)

    We constructed a remote radiotherapy planning system, and we examined the usefulness of and faults in our system in this study. Two identical radiotherapy planning systems, one installed at our institution and the other installed at an affiliated hospital, were used for radiotherapy planning. The two systems were connected by a wide area network (WAN), using a leased line. Beam data for the linear accelerator at the affiliated hospital were installed in the two systems. During the period from December 2001 to December 2002, 43 remote radiotherapy plans were made using this system. Data were transmitted using a file transfer protocol (FTP) software program. The 43 radiotherapy plans examined in this study consisted of 13 ordinary radiotherapy plans, 28 radiotherapy plans sent to provide assistance for medical residents, and 2 radiotherapy plans for emergency cases. There were ten minor planning changes made in radiotherapy plans sent to provide assistance for medical residents. Our remote radiotherapy planning system based on WAN using a leased line is useful for remote radiotherapy, with advantages for both radiation oncologists and medical residents. (author)

  2. European Society for Radiation Biology 21. annual meeting

    International Nuclear Information System (INIS)

    The volume contains about 100 abstracts of lectures presented to the conference covering a large variety of topics like: Radiobiology as a base for radiotherapy, radiation carcinogenesis and cellular effects, late and secondary effects of radiotherapy, radioprotection and radiosensitization, heavy ions in radiobiology and space research, microdosimetry and biological dosimetry, radiation effects on the mature and the developing central nervous system, DNA damage and repair and cellular mutations, the imact of radiation on the environment, free radicals in radiation biology

  3. Thalassaemic osteoarthropathy treated with radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Davies, A.N. (King' s Coll. Hospital, London (United Kingdom))

    1993-11-01

    Patients with beta thalassaemia may develop a specific osteoarthropathy involving the feet. A number of different treatments for this condition have been tried, including rest, analgesia and hypertransfusion. We report a case of a patient with thalassaemic osteoarthropathy who responded to radiotherapy after failing conventional treatment. (author).

  4. Computerised tomography in radiotherapy planning

    NARCIS (Netherlands)

    P.C. Badcock (Peter)

    1983-01-01

    textabstractSuccessful radiotherapy practice depends on the irradiation of tumours such that their destruction follows without unacceptable damage of the surrounding normal tissues. Until recently the accurate acquisition of data concerning the tumour anatomy lagged behind other developments in radi

  5. Non-targeted effects of ionising radiation and radiotherapy.

    Science.gov (United States)

    Sjostedt, Svetlana; Bezak, Eva

    2010-09-01

    Modern radiobiology is undergoing rapid change due to new discoveries contradicting the target concept which is currently used to predict dose-response relationships. Thus relatively recently discovered radiation-induced bystander effects (RIBEs), that include additional death, mutation and radio-adaptation in non-irradiated cells, change our understanding of the target concept and broadens its boundaries. This can be significant from a radioprotection point of view and also has the potential to reassess radiation damage models currently used in radiotherapy. This article reviews briefly the general concepts of RIBEs such as the proposed underlying mechanisms of signal induction and propagation, experimental approaches and biological end points used to investigate these phenomena. It also summarises several mathematical models currently proposed in an attempt to quantify RIBE. The main emphasis of this article is to review and highlight the potential impact of the bystander phenomena in radiotherapy. PMID:20857259

  6. TOPICAL REVIEW: Anatomical imaging for radiotherapy

    Science.gov (United States)

    Evans, Philip M.

    2008-06-01

    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  7. Radiotherapy of corpus carcinoma

    International Nuclear Information System (INIS)

    96 women with primary carcinoma corporis uteri and 79 women after surgery were treated between 1965 - 1970 with different radiotherapeutic methods, in some cases in combination with cytostatics and gestagens. In the group of primary radiation best results were obtained with combination of intracavitary brachytherapy and external radiation (55% 5-years-survival), and in the postoperative group with external radiation alone (67% 5-years-survival). Late complications with 17% fibrosis in the parametrial tissue and 12% persistant diarrhea in the postoperative group needs strict individualization in therapy and requires exact knowledge on extention and biological behavior of the tumor. (author)

  8. Palliative radiotherapy: current status and future directions.

    Science.gov (United States)

    Sharma, Sonam; Hertan, Lauren; Jones, Joshua

    2014-12-01

    For nearly 100 years, palliative radiotherapy has been a time-efficient, effective treatment for patients with metastatic or advanced cancer in any area where local tumors are causing symptoms. Short courses including a single fraction of radiotherapy may be effective for symptom relief with minimal side effects and maximization of convenience for patient and family. With recent advances in imaging, surgery, and other local therapies as well as systemic cancer therapies, palliative radiotherapy has been used frequently in patients who may not yet have symptoms of advanced or metastatic cancer. In this setting, more prolonged radiotherapy courses and advanced radiotherapy techniques including intensity-modulated radiotherapy (IMRT) or stereotactic radiotherapy (SRT) may be useful in obtaining local control and durable palliative responses. This review will explore the use of radiotherapy across the spectrum of patients with advanced and metastatic cancer and delineate an updated, rational approach for the use of palliative radiotherapy that incorporates symptoms, prognosis, and other factors into the delivery of palliative radiotherapy. PMID:25499634

  9. Decommissioning of Radiotherapy Facilities

    International Nuclear Information System (INIS)

    Radiotherapy units containing high activity sealed radioactive sources of 60Co or 137Cs are mainly use for medical, research or calibration applications. After several half-lives of decay, the radionuclide source has to be changed or the unit is decommissioned if no longer required. Before starting a decommissioning project it is very important to look for documents relating to any sources held or installed in equipment. In general this should be no problem because the recommended working life of such sealed radioactive sources is limited to 10 or a maximum of 15 years. These time periods are short in comparison with other facilities like research laboratories or small reactors. These documents (source certificates) will be very helpful to plan the decommissioning because they say everything about the original activity of the source at a reference date, the type of the source and the manufacturer. The next step may be to contact the machine supplier or the source manufacturer, but be aware that neither may still be in existence or may have changed their type of business. In such cases, it is recommended to contact national or international sealed source manufacturers or suppliers for help. Sometimes it is also helpful to contact colleagues in other hospitals or research centres to ask for information about specialists in this topic. In general it is not useful, and even very dangerous, to try to decommission such a unit without expert help It is essential to have specialist tools and shielded containers to recover the source out of the unit. It is strongly recommended to invite the source removal specialist for a site visit to review the situation before starting any decommissioning process. A further problem can occur, if the source must be transported to a national storage centre or even an international storage facility, as the source must be packaged to meet international transport requirements. The end state of such a project should be an empty room where the

  10. Proton Radiotherapy for Pediatric Sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Ladra, Matthew M.; Yock, Torunn I., E-mail: tyock@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114 (United States)

    2014-01-14

    Pediatric sarcomas represent a distinct group of pathologies, with approximately 900 new cases per year in the United States alone. Radiotherapy plays an integral role in the local control of these tumors, which often arise adjacent to critical structures and growing organs. The physical properties of proton beam radiotherapy provide a distinct advantage over standard photon radiation by eliminating excess dose deposited beyond the target volume, thereby reducing both the dose of radiation delivered to non-target structures as well as the total radiation dose delivered to a patient. Dosimetric studies comparing proton plans to IMRT and 3D conformal radiation have demonstrated the superiority of protons in numerous pediatric malignancies and data on long-term clinical outcomes and toxicity is emerging. In this article, we review the existing clinical and dosimetric data regarding the use of proton beam radiation in malignant bone and soft tissue sarcomas.

  11. Radiotherapy in osseous metastasizing carcinoid

    International Nuclear Information System (INIS)

    In an 51-year old patient with a disseminately metastasizing bronchus carcinoid, percutaneous radiotherapy was employed as a palliative measure against most severe pain in the region of bone metastases. In all irradiated regions (entire vertebral column and both shoulders) good pain relief was achieved in 2 weeks, lasting until the end of the follow-up period (18 months after irradiation), by application of 30 Gy photon radiation. Correlated with the subjective pain relief was a reduction of the required quantity of analgesics, a reduction of the greatly increased activity of alkaline phosphatase in the serum, and roentgenological sclerosing of the metastatic bone lesions. This case report is intended to point to the possibility of employing radiotherapy in similar cases where medication has finally proved futile, since the rare reports in literature are mostly negative. (orig.)

  12. Experiment on radiotherapy of postnatal mastitis

    International Nuclear Information System (INIS)

    The results of radiotherapy of postnatal mastitis in 78 women are presented. It is shown that the radiotherapy is the method of choice. Application of radiotherapy at different stages of disease promotes either complete resolution of infiltration (1-2 irradiations) or stipulates the decrease in temperature, abatement of pains and improvement of general state (at the presence of purulent fusion of mammary tissue). X-ray therapy of postnatal mastitis has does not affect the lactational function of mammary gland

  13. Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer

    DEFF Research Database (Denmark)

    Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max;

    2014-01-01

    The TARGIT-A trial compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy (TARGIT) versus fractionated external beam radiotherapy (EBRT) for breast cancer. We report 5-year results for local recurrence and the first analysis of overall survival....

  14. Single fraction radiotherapy versus multiple fraction radiotherapy for bone metastases in prostate cancer patients: comparative effectiveness

    International Nuclear Information System (INIS)

    External beam radiotherapy (EBRT) is an effective treatment for symptomatic bone metastases from a variety of primary malignancies. Previous meta-analyses and systematic reviews have reported on the efficacy of EBRT on bone metastases from multiple primaries. This review is focused on the comparative effectiveness of single fraction radiotherapy versus multiple fraction radiotherapy for bone metastases in prostate cancer patients

  15. Gold coated lanthanide phosphate nanoparticles for targeted alpha generator radiotherapy.

    Directory of Open Access Journals (Sweden)

    Mark F McLaughlin

    Full Text Available Targeted radiotherapies maximize cytotoxicty to cancer cells. In vivo α-generator targeted radiotherapies can deliver multiple α particles to a receptor site dramatically amplifying the radiation dose delivered to the target. The major challenge with α-generator radiotherapies is that traditional chelating moieties are unable to sequester the radioactive daughters in the bioconjugate which is critical to minimize toxicity to healthy, non-target tissue. The recoil energy of the (225Ac daughters following α decay will sever any metal-ligand bond used to form the bioconjugate. This work demonstrates that an engineered multilayered nanoparticle-antibody conjugate can deliver multiple α radiations and contain the decay daughters of (225Ac while targeting biologically relevant receptors in a female BALB/c mouse model. These multi-shell nanoparticles combine the radiation resistance of lanthanide phosphate to contain (225Ac and its radioactive decay daughters, the magnetic properties of gadolinium phosphate for easy separation, and established gold chemistry for attachment of targeting moieties.

  16. Immediate side effects of large fraction radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Devereux, S.; Hatton, M.Q.F.; Macbeth, F.R. [Glasgow Western Infirmary (United Kingdom)

    1997-09-01

    The use of hypofractionated radiotherapy regiments is becoming more widely recognized in the palliation of non-small cell lung carcinoma (NSCLC). Anecdoctal reports of chest pain, rigors and fevers in the hours that follow radiotherapy led us to perform a survey estimating the frequency and severity of these symptoms following treatment to the thorax. We conclude that patients receiving palliative radiotherapy for bronchial carcinoma often develop significant symptoms in the hours following treatment. The timing and duration suggest a relationship with the radiotherapy, and we feel that patients should be warned of the possible occurrence of these symptoms. (author).

  17. Targeting IAP proteins in combination with radiotherapy

    International Nuclear Information System (INIS)

    The efficacy of radiotherapy critically depends on the activation of intrinsic cell death programs in cancer cells. This implies that evasion of cell death, a hallmark of human cancers, can contribute to radioresistance. Therefore, novel strategies to reactivate cell death programs in cancer cells are required in order to overcome resistance to radiotherapy. Since Inhibitor of Apoptosis (IAP) proteins are expressed at high levels in multiple cancers and block cell death induction at a central point, therapeutic targeting of IAP proteins represents a promising approach to potentiate the efficacy of radiotherapy. The current review discusses the concept of targeting IAP proteins in combination with radiotherapy

  18. TUMOR SUPPRESSOR GENE TP53 MUTATIONS IN ATYPICAL VASCULAR LESIONS OF THE BREAST SKIN FOLLOWING RADIOTHERAPY

    OpenAIRE

    Santi, Raffaella; Cetica, Valentina; Franchi, Alessandro; Pepi, Monica; Cesinaro, Anna Maria; Miracco, Clelia; Paglierani, Milena; De Giorgi, Vincenzo; Delfino, Chiara; Difonzo, Elisa Margherita; Pimpinelli, Nicola; Bianchi, Simonetta; Sardi, Iacopo; Santucci, Marco; Massi, Daniela

    2011-01-01

    Abstract Atypical vascular lesions (AVL) occurring at the site of radiotherapy represent an uncommon but well-documented complication in the setting of breast-conserving therapy for breast carcinoma. Although the biological behavior of AVL has been regarded to be benign, it has been suggested that AVL may represent a precursor of angiosarcoma. A better understanding of the biology of AVL is essential in order to assess appropriate patient management. The purpose of the present s...

  19. Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

  20. Radiotherapy and Brachytherapy : Proceedings of the NATO Advanced Study Institute on Physics of Modern Radiotherapy & Brachytherapy

    CERN Document Server

    Lemoigne, Yves

    2009-01-01

    This volume collects a series of lectures presented at the tenth ESI School held at Archamps (FR) in November 2007 and dedicated to radiotherapy and brachytherapy. The lectures focus on the multiple facets of radiotherapy in general, including external radiotherapy (often called teletherapy) as well as internal radiotherapy (called brachytherapy). Radiotherapy strategy and dose management as well as the decisive role of digital imaging in the associated clinical practice are developed in several articles. Grouped under the discipline of Conformal Radiotherapy (CRT), numerous modern techniques, from Multi-Leaf Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT), are explained in detail. The importance of treatment planning based upon patient data from digital imaging (Computed Tomography) is also underlined. Finally, despite the quasi- totality of patients being presently treated with gamma and X-rays, novel powerful tools are emerging using proton and light ions (like carbon ions) beams, bound to bec...

  1. Clinical advantages of carbon-ion radiotherapy

    Science.gov (United States)

    Tsujii, Hirohiko; Kamada, Tadashi; Baba, Masayuki; Tsuji, Hiroshi; Kato, Hirotoshi; Kato, Shingo; Yamada, Shigeru; Yasuda, Shigeo; Yanagi, Takeshi; Kato, Hiroyuki; Hara, Ryusuke; Yamamoto, Naotaka; Mizoe, Junetsu

    2008-07-01

    Carbon-ion radiotherapy (C-ion RT) possesses physical and biological advantages. It was started at NIRS in 1994 using the Heavy Ion Medical Accelerator in Chiba (HIMAC); since then more than 50 protocol studies have been conducted on almost 4000 patients with a variety of tumors. Clinical experiences have demonstrated that C-ion RT is effective in such regions as the head and neck, skull base, lung, liver, prostate, bone and soft tissues, and pelvic recurrence of rectal cancer, as well as for histological types including adenocarcinoma, adenoid cystic carcinoma, malignant melanoma and various types of sarcomas, against which photon therapy could be less effective. Furthermore, when compared with photon and proton RT, a significant reduction of overall treatment time and fractions has been accomplished without enhancing toxicities. Currently, the number of irradiation sessions per patient averages 13 fractions spread over approximately three weeks. This means that in a carbon therapy facility a larger number of patients than is possible with other modalities can be treated over the same period of time.

  2. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L; Carde, P; Mauch, P;

    1992-01-01

    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a glob...

  3. Radiological protection of the radiotherapy patient?

    International Nuclear Information System (INIS)

    We propose that the system and concepts of radiation protection should not be used with reference to radiotherapy patients. We justify this on conceptual grounds. The patient undergoing radiotherapy procedures, as prescribed by the medical practitioner, is protected by the quality assurance system legally required for medical exposures. (author)

  4. Successful radiotherapy of facial angiosarcoma.

    Science.gov (United States)

    Gkalpakiotis, S; Arenberger, P; Vohradnikova, O; Arenbergerova, M

    2008-11-01

    Cutaneous angiosarcoma of the face and scalp is a rare malignant vascular tumor that affects mostly Caucasian elderly males. At present, connections concerning the etiology of this neoplasm with radiation therapy, exposure to environmental carcinogens and chronic lymphedema have been described. Due to the difficult histologic evaluation, high local recurrence and tendency to early metastasing, angiosarcoma poses generally a very poor prognosis. We report the case of an 80-year-old patient who experienced successful removal of large, exophytic growing angiosarcoma of the face achieved with radiotherapy with long-term relapse-free survival. PMID:18986458

  5. Quality and safety in radiotherapy

    CERN Document Server

    Pawlicki, Todd

    2010-01-01

    The first text to focus solely on quality and safety in radiotherapy, this work encompasses not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. It includes contributions from experts both inside and outside the field to present a global view. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized as depending on both the processes and the people delivering the service. Divided into seven broad categories, the text covers: Quality Management

  6. Evaluation of Thyroid Disorders During Head-and-Neck Radiotherapy by Using Functional Analysis and Ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Bakhshandeh, Mohsen [Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Hashemi, Bijan, E-mail: bhashemi@modares.ac.ir [Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Mahdavi, Seyed Rabie [Department of Medical Physics, Faculty of Medical Sciences, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Nikoofar, Alireza [Department of Radiation Oncology, Hafte-Tir Hospital, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Edraki, Hamid Reza [Department of Radiology, Panzdahe-Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of); Kazemnejad, Anoshirvan [Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of)

    2012-05-01

    Purpose: To evaluate thyroid function and vascular changes during radiotherapy for patients with head and neck cancer. Methods and Materials: Fifty patients treated with primary or postoperative radiotherapy for various cancers in the head and neck region were prospectively evaluated. The serum samples (triiodothyronine [T3], thyroxine [T4], thyroid-stimulating hormone [TSH], free triiodothyronine [FT3], and free thyroxine [FT4]), the echo level of the thyroid gland, and color Doppler ultrasonography (CDU) parameters of the right inferior thyroid artery (RITA) of the patients were measured before and at regular intervals during radiotherapy. The thyroid gland dose-volume histograms of the patients were derived from their computed tomography-based treatment plans. Results: There was a significant fall in TSH level (p < 0.0001) but an increase in FT4 (p < 0.0001) and T4 (p < 0.022) levels during the radiotherapy course. The threshold dose required to produce significant changes was 12 Gy (Biologically Effective Dose in 2-Gy fractions, BED{sub 2}). There were significant rises in the patients' pulsatility index, resistive index, peak systolic velocity, blood volume flow levels, and RITA diameter (p < 0.0001), as detected by CDU during radiotherapy, compared to those parameters measured before the treatment. Hypoechogenicity and irregular echo patterns (p < 0.0001) were seen during radiotherapy compared to those before treatment. There was significant Pearson's correlation between the CDU parameters and T4, FT4, and TSH levels. Conclusions: Radiation-induced thyroiditis is regarded as primary damage to the thyroid gland. Thyroiditis can subsequently result in hypothyroidism or hyperthyroidism. Our results demonstrated that changes in thyroid vessels occur during radiotherapy delivered to patients. Vessel changes also can be attributed to the late effect of radiation on the thyroid gland. The hypoechogenicity and irregular echo patterns observed in patients

  7. Biological aspects of radiation in nuclear medicine

    International Nuclear Information System (INIS)

    Radiotherapy with unsealed radionuclides differs from external radiotherapy with regard to the radiation quality and energy range, the regional dose uniformity and the time course of irradiation regimen. External radiotherapy is planned precisely and can be applied to a target volume independently from blood flow during a course of irradiation fractions. In contrary, administered radiopharmaceuticals distribute according to their pharmacokinetic properties and generate a continuous irradiation corresponding to the effective halflife. The resulting dose rates are approximately 1 Gy/min and 1 Gy/h, respectively. The bio-kinetics of radiopharmaceuticals involves cellular accumulation and retention with highly variable affinity to specific organs that can be modulated as well. A remarkable dose gradient is found at the edge of volumes with enhanced uptake. The biological effect of an irradiation with decreasing intensity can be compared with the radiation effect caused by conventional fractionation with 2 Gy a day in external beam therapy by means of the linear-quadratic model. However, the experimental validation of this translation is still under investigation. Radionuclide therapy is usually performed in several cycles some month apart. This procedure fails to meet external radiotherapy. The vision of a combined external-internal radiotherapy requires efforts for a common dosimetry approach both in vitro and in vivo with a physical and biological verification of the results. (orig.)

  8. DEGRO 2009. Radiation oncology - medical physics - radiation biology. Abstracts; DEGRO 2009. Radioonkologie - Medizinische Physik - Strahlenbiologie. Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-06-15

    The special volume of the journal covers the abstracts of the DEGRO 2009 meeting on radiation oncology, medical physics, and radiation biology, covering the following topics: seldom diseases, gastrointestinal tumors, radiation reactions and radiation protection, medical care and science, central nervous system, medical physics, the non-parvicellular lung carcinomas, ear-nose-and throat, target-oriented radiotherapy plus ''X'', radio-oncology - young academics, lymphomas, mammary glands, modern radiotherapy, life quality and palliative radiotherapy, radiotherapy of the prostate carcinoma, imaging for planning and therapy, the digital documentation in clinics and practical experiences, NMR imaging and tomography, hadrons - actual status in Germany, urinal tract oncology, radiotoxicity.

  9. Quality control programme for radiotherapy

    International Nuclear Information System (INIS)

    A 3 years pilot programme started in January 2000 with 33 philanthropic cancer institutions that provides medical services to 60% of the patients from the national social security system. Brazil has today 161 radiotherapy services (144 operating with megavoltage equipment). These 33 institutions are distributed over 19 Brazilian states. The aim of this programme is: To create conditions to allow the participants to apply the radiotherapy with quality and efficacy; To promote up dating courses for the physicians, physicists and technicians of these 33 Institutions. With the following objectives: To recommend dosimetric and radiological protection procedures in order to guarantee the tumor prescribed dose and safe working conditions; To help in establishing and implementing these procedures. The main activities are: local quality control evaluations, postal TLD audits in reference conditions, postal TLD audits in off axis conditions and training. The local quality control program has already evaluated 22 institutions with 43 machines (25 Co-60 and 18 linear accelerators). In these visits we perform dosimetric, electrical, mechanical and safety tests. As foreseen, we found more problems among the old Co-60 machines i.e., field flatness, size, symmetry and relative output factors; lasers positioning system alignment; optical distance indicator; radiation and light field coincidence; optical and mechanical distance indicators agreement, than among the linear accelerators i.e., field flatness and size; lasers positioning system alignment; tray interlocking and wedge filter factors

  10. Craniospinal radiotherapy in adult medulloblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Selek, U.; Zorlu, F.; Hurmuz, P.; Cengiz, M.; Gurkaynak, M. [Hacettepe Univ., Ankara (Turkey). Dept. of Radiation Oncology; Turker, A. [Hacettepe Univ., Ankara (Turkey). Dept. of Internal Medicine; Soylemezoglu, F. [Hacettepe Univ., Ankara (Turkey). Dept. of Pathology

    2007-05-15

    Purpose: To evaluate the outcome and prognostic factors of adult patients with medulloblastoma. Patients and Methods: 26 adult medulloblastoma patients with a median age of 27 were subjected to craniospinal radiotherapy. A dose of 30.6 Gy with 1.8 Gy/fraction/day was prescribed to M0 patients, while 36 Gy were to be applied in patients with positive cerebrospinal liquor findings. The posterior fossa was boosted to 54 Gy. While 20 patients underwent external-beam radiotherapy alone, only six received sequential adjuvant chemotherapy. Results: Male/female ratio was 1.2. Preradiotherapy Karnofsky performance status was recorded as median 100%. 50% were classified as poor risk (n = 10, subtotal resection; n = 3, M+). The median follow-up time was 46.5 months. The 5-year actuarial survival rates for recurrence-free, distant metastasis-free, disease-free, and overall survival were 82.5%, 90.8%, 73.5%, and 89.7%, respectively. Patient characteristics, treatment factors and tumor characteristics failed to show any significance in univariate analysis. Grade 3 or 4 late morbidities were not observed. Conclusion: Yet, the current standard of care seems to remain craniospinal irradiation after maximal surgical resection of the primary neoplasm without clear indications for adjuvant chemotherapy. (orig.)

  11. Optimization of human cancer radiotherapy

    CERN Document Server

    Swan, George W

    1981-01-01

    The mathematical models in this book are concerned with a variety of approaches to the manner in which the clinical radiologic treatment of human neoplasms can be improved. These improvements comprise ways of delivering radiation to the malignan­ cies so as to create considerable damage to tumor cells while sparing neighboring normal tissues. There is no unique way of dealing with these improvements. Accord­ ingly, in this book a number of different presentations are given. Each presentation has as its goal some aspect of the improvement, or optimization, of radiotherapy. This book is a collection of current ideas concerned with the optimization of human cancer radiotherapy. It is hoped that readers will build on this collection and develop superior approaches for the understanding of the ways to improve therapy. The author owes a special debt of thanks to Kathy Prindle who breezed through the typing of this book with considerable dexterity. TABLE OF CONTENTS Chapter GENERAL INTRODUCTION 1. 1 Introduction 1...

  12. Introduction to radiation biology

    International Nuclear Information System (INIS)

    This book is arranged in a logical sequence, starting from radiation physics and radiation chemistry, followed by molecular, subcellular and cellular effects and going on to the level of organism. Topics covered include applied radiobiology like modifiers of radiosensitivity, predictive assay, health physics, human genetics and radiopharmaceuticals. The topics covered are : 1. Radiation Physics, 2. Detection and Measurement of Radiation, 3. Radiation Chemistry, 4. DNA Damage and Repair, 5. Chromosomal Aberrations and Gene Mutations, 6. Cellular Radiobiology 7. Acute Radiation Effects, 8. Delayed Effects of Radiation, 9. Biological Basis of Radiotherapy, 10. Chemical Modifiers of Radiosensitivity, 11. Hyperthermia, 12. High LET Radiations in Cancer, Therapy, 13. Predictive Assays, 14. Radiation Effects on Embryos, 15. Human Radiation Genetics, 16. Radiolabelled Compounds in Biology and Medicine and 17. Radiological Health

  13. The Confluence of Stereotactic Ablative Radiotherapy and Tumor Immunology

    Directory of Open Access Journals (Sweden)

    Steven Eric Finkelstein

    2011-01-01

    Full Text Available Stereotactic radiation approaches are gaining more popularity for the treatment of intracranial as well as extracranial tumors in organs such as the liver and lung. Technology, rather than biology, is driving the rapid adoption of stereotactic body radiation therapy (SBRT, also known as stereotactic ablative radiotherapy (SABR, in the clinic due to advances in precise positioning and targeting. Dramatic improvements in tumor control have been demonstrated; however, our knowledge of normal tissue biology response mechanisms to large fraction sizes is lacking. Herein, we will discuss how SABR can induce cellular expression of MHC I, adhesion molecules, costimulatory molecules, heat shock proteins, inflammatory mediators, immunomodulatory cytokines, and death receptors to enhance antitumor immune responses.

  14. Psychological and physical distress of cancer patients during radiotherapy

    CERN Document Server

    König, A

    2001-01-01

    Purpose: patients undergoing radiotherapy have physical and psychological symptoms related to the underlying disease and the treatment. In order to give the best possible support to the patients, more knowledge about the amount and the changing of distress in the course of radiotherapy is of essentially importance. Methods: The distress was measured in a consecutive sample of cancer patients (n=82) undergoing radiotherapy. Each patient was given the EORTC-QLQ-C30, the HADS and a special questionnaire which ascertain radiotherapy-specific items before starting the radiotherapy, at the onset of radiotherapy, in the third week of radiotherapy and 3 weeks after the end of radiotherapy. Results: within the first week of treatment the psychological distress of the patients is increasing; 98.8 % of the patients are 'moderate distressed', 46 % 'severe distressed'. General physical symptoms seem not to be affected by the radiotherapy, there is no changing. The distress caused by the organization of the radiotherapy is...

  15. Customized mold radiotherapy with prosthetic apparatus for oral cancers

    International Nuclear Information System (INIS)

    Eight patients (6 males, 2 females; median age, 78 years; age range, 31-94 years) were treated by mold radiotherapy with a prosthetic apparatus for oral cancers between October 2006 and March 2013. The primary sites were the tongue in 3 cases, hard palate and buccal mucosa in 2 cases each, and oral floor in 1 case. The type of treatment consisted of radical radiotherapy and palliative radiotherapy in 2 cases each, and preoperative radiotherapy, postoperative radiotherapy, additional radiotherapy after external beam radiotherapy and systemic chemotherapy in 1 case each. Patients received 40-50 Gy in 8-10 fractions with mold radiotherapy. Two patients who received radical radiotherapy showed no signs of recurrence or metastasis. The present therapy contributed to patients' palliative, postoperative, and preoperative therapy. Mold radiotherapy with a prosthetic appliance was performed safely and was a useful treatment for several types of oral cancer. (author)

  16. Integrative radiation systems biology.

    Science.gov (United States)

    Unger, Kristian

    2014-01-01

    Maximisation of the ratio of normal tissue preservation and tumour cell reduction is the main concept of radiotherapy alone or combined with chemo-, immuno- or biologically targeted therapy. The foremost parameter influencing this ratio is radiation sensitivity and its modulation towards a more efficient killing of tumour cells and a better preservation of normal tissue at the same time is the overall aim of modern therapy schemas. Nevertheless, this requires a deep understanding of the molecular mechanisms of radiation sensitivity in order to identify its key players as potential therapeutic targets. Moreover, the success of conventional approaches that tried to statistically associate altered radiation sensitivity with any molecular phenotype such as gene expression proofed to be somewhat limited since the number of clinically used targets is rather sparse. However, currently a paradigm shift is taking place from pure frequentistic association analysis to the rather holistic systems biology approach that seeks to mathematically model the system to be investigated and to allow the prediction of an altered phenotype as the function of one single or a signature of biomarkers. Integrative systems biology also considers the data from different molecular levels such as the genome, transcriptome or proteome in order to partially or fully comprehend the causal chain of molecular mechanisms. An example for the application of this concept currently carried out at the Clinical Cooperation Group "Personalized Radiotherapy in Head and Neck Cancer" of the Helmholtz-Zentrum München and the LMU Munich is described. This review article strives for providing a compact overview on the state of the art of systems biology, its actual challenges, potential applications, chances and limitations in radiation oncology research working towards improved personalised therapy concepts using this relatively new methodology. PMID:24411063

  17. Integrative radiation systems biology

    International Nuclear Information System (INIS)

    Maximisation of the ratio of normal tissue preservation and tumour cell reduction is the main concept of radiotherapy alone or combined with chemo-, immuno- or biologically targeted therapy. The foremost parameter influencing this ratio is radiation sensitivity and its modulation towards a more efficient killing of tumour cells and a better preservation of normal tissue at the same time is the overall aim of modern therapy schemas. Nevertheless, this requires a deep understanding of the molecular mechanisms of radiation sensitivity in order to identify its key players as potential therapeutic targets. Moreover, the success of conventional approaches that tried to statistically associate altered radiation sensitivity with any molecular phenotype such as gene expression proofed to be somewhat limited since the number of clinically used targets is rather sparse. However, currently a paradigm shift is taking place from pure frequentistic association analysis to the rather holistic systems biology approach that seeks to mathematically model the system to be investigated and to allow the prediction of an altered phenotype as the function of one single or a signature of biomarkers. Integrative systems biology also considers the data from different molecular levels such as the genome, transcriptome or proteome in order to partially or fully comprehend the causal chain of molecular mechanisms. An example for the application of this concept currently carried out at the Clinical Cooperation Group “Personalized Radiotherapy in Head and Neck Cancer” of the Helmholtz-Zentrum München and the LMU Munich is described. This review article strives for providing a compact overview on the state of the art of systems biology, its actual challenges, potential applications, chances and limitations in radiation oncology research working towards improved personalised therapy concepts using this relatively new methodology

  18. The development of radiotherapy in Slovenia

    International Nuclear Information System (INIS)

    The historical data on the development of radiotherapy in Slovenia are presented from its first use in this county in 1902 until the present. The Institute of Oncology in Ljubljana was established in 1938 with the intention of providing a sound development of radium and roentgen cancer treatment. After World War II, the development of radiotherapy was dynamic, which is evident from the data on new radiation sources in external beam therapy (accelerators, telecobalt units), in brachytherapy (various sealed radioisotopes) as well as in the introduction of therapy with unsealed radioisotopes. In 1947, a Chair of Oncology and Radiotherapy was instituted at the Medical Faculty of the University of Ljubljana (with the seat at the Institute of Oncology). In 1955, radiotherapy and oncology were officially recognized as separate branches of medicine requiring special obligatory postgraduate residency training. Within the Medical Society of Slovenia, the Section for Radiotherapy was established in 1987. The following year, the Section for Radiotherapy of Slovenia became a member of the European Society for Therapeutic Radiology and Oncology. Considering the size of population of Slovenia (nearly 2 million), it was reasonable that by this time radiotherapy became almost completely concentrated in one central institution, the Institute of Oncology, whose core and cohesive activity were represented in the multidisciplinary cancer treatment approach

  19. [Current status and perspectives of radiotherapy for esophageal cancer].

    Science.gov (United States)

    Wu, S X; Wang, L H

    2016-09-23

    Esophageal cancer is one of the most common cancers in China. More than 80% of esophageal cancer patients are diagnosed at a late stage and are not eligible for surgery. Radiotherapy is one of the most important modalities in esophageal cancer treatment. Here we reviewed the advances in esophageal cancer radiotherapy and radiotherapy-based combined-modality therapy, such as optimization of radiation dose and target volume, application of precise radiotherapy technique and the integration of radiotherapy with chemotherapy and targeted therapy.

  20. Radiotherapy in the management of early breast cancer

    OpenAIRE

    Wang, Wei

    2013-01-01

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

  1. Adjuvant radiotherapy for gallbladder cancer: A dosimetric comparison of conformal radiotherapy and intensity-modulated radiotherapy

    Institute of Scientific and Technical Information of China (English)

    Xiao-Nan Sun; Qi Wang; Ben-Xing Gu; Yan-Hong Zhu; Jian-Bin Hu; Guo-Zhi Shi; Shu Zheng

    2011-01-01

    AIM: To assess the efficacy and toxicity of conformal radiotherapy (CRT) and compare with intensity-modulated radiotherapy (IMRT) in the treatment of gallbladder cancer.METHODS: Between November 2003 and January 2010, 20 patients with gallbladder cancer were treated with CRT with or without chemotherapy after surgical resection. Preliminary survival data were collected and examined using both Kaplan-Meier and actuarial analysis. Demographic and treatment parameters were collected. All patients were planned to receive 46-56 Gy in 1.8 or 2.0 Gy per fraction. CRT planning was compared with IMRT.RESULTS: The most common reported acute toxicities requiring medication (Radiation Therapy Oncology Group, Radiation Therapy Oncology Group Grade2) were nausea (10/20 patients) and diarrhea (3/20).There were no treatment-related deaths. Compared with CRT planning, IMRT significantly reduced the volume of right kidney receiving > 20 Gy and the volume of liver receiving > 30 Gy. IMRT has a negligible impact on the volume of left kidney receiving > 20 Gy. The 95% of prescribed dose for a planning tumor volume using either 3D CRT or IMRT planning were 84.0% ±6.7%, 82.9% ± 6.1%, respectively (P > 0.05).CONCLUSION: IMRT achieves similar excellent target coverage as compared with CRT planning, while reducingthe mean liver dose and volume above threshold dose. IMRT offers better sparing of the right kidney compared with CRT planning, with a significantly lower mean dose and volume above threshold dose.

  2. Radiotherapy for solitary plasmacytoma and multiple myeloma

    International Nuclear Information System (INIS)

    Solitary plasmacytoma and multiple myeloma require a differentiated radiotherapy. The irradiation for plasmacytoma with an adequate total dose (medullary 40-50 Gy or extramedullary 50-60 Gy) leads to a high degree of local control with a low rate of side effects. In cases of multiple myeloma radiotherapy will achieve effective palliation, both in terms of recalcification as well as reduction of neurological symptoms and analgesia. In terms of analgesia the rule is the higher the single dose fraction the faster the reduction of pain. As part of a conditioning treatment prior to stem cell transplantation radiotherapy contributes to the establishment of a graft versus myeloma effect (GVM). (orig.)

  3. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L.; Carde, P.; Mauch, P.;

    1992-01-01

    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a global...... be reduced, and that the stress of experiencing a relapse is avoided in many patients. The major argument against the use of chemotherapy up front is: that by careful staging and selection of patients and by careful radiotherapy techniques the number of patients exposed to potentially toxic chemotherapy may...

  4. PET and optimization of the radiotherapy: How? Which tracers? For what to make?; TEP et optimisation de la radiotherapie: comment? Quels traceurs? Pour quoi faire?

    Energy Technology Data Exchange (ETDEWEB)

    Giammarile, F. [Centre Hospitalier Lyon-Sud, Faculte de Medecine, EA 3738, Service de Medecine Nucleaire, 69 - Pierre-Benite (France)

    2007-09-15

    The objective of the radiotherapy is to deliver a maximum amount of ionizing radiation in tumour target volume while sparing the irradiation of neighbouring healthy tissues, using anatomical imaging. The addition of functional metabolic information provided by the PET- F.D.G. (fluorodeoxyglucose)made has emerged a new concept, that of biological target volume (B.T.V.). Thus, a PET-CT examination performed by a hybrid system under the same conditions that of a simulation of radiotherapy, makes it possible to obtain at the same time: the tumour staging, the acquisition of the anatomical data for dosimetry and the definition of the B.T.V.. Therefore, PET- F.D.G. will carry out a personalized treatment, with optimization of the amount of irradiation (with an aim of increasing the effectiveness of the conformational radiotherapy and of decreasing toxicity within healthy tissues) and to reduce interobserver variability in the definition of tumour target volumes. On the whole, the information provided by PET- F.D.G. can involve: suppression of the radiotherapy treatment; change of the amount of irradiation; change of dosimetry; change of therapeutic optics. Future integration of new radiopharmaceuticals, exploring the functional modifications of the tissue, will allow a better targeting of the irradiation. (author)

  5. Single fraction radiotherapy versus multiple fraction radiotherapy for bone metastases in prostate cancer patients: comparative effectiveness

    Directory of Open Access Journals (Sweden)

    Yoon F

    2014-11-01

    Full Text Available Frederick Yoon,1 Gerard C Morton2 1Simcoe Muskoka Regional Cancer Centre, Royal Victoria Regional Health Centre, Barrie, ON, Canada; 2Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada Abstract: External beam radiotherapy (EBRT is an effective treatment for symptomatic bone metastases from a variety of primary malignancies. Previous meta-analyses and systematic reviews have reported on the efficacy of EBRT on bone metastases from multiple primaries. This review is focused on the comparative effectiveness of single fraction radiotherapy versus multiple fraction radiotherapy for bone metastases in prostate cancer patients. Keywords: radiotherapy, bone, metastases, prostate, comparative effectiveness

  6. Dosimetric comparison of three-dimensional conformal radiotherapy, intensity modulated radiotherapy, and helical tomotherapy for lung stereotactic body radiotherapy

    OpenAIRE

    Rajesh Ashok Kinhikar; Ghadi, Yogesh G.; Priyadarshini Sahoo; Sarbani Ghosh Laskar; Deshpande, Deepak D; Shrivastava, Shyam K.; Jaiprakash Agarwal

    2015-01-01

    To compare the treatment plans generated with three-dimensional conformal radiation therapy (3DCRT), intensity modulated radiotherapy (IMRT), and helical tomotherapy (HT) for stereotactic body radiotherapy of lung, twenty patients with medically inoperable (early nonsmall cell lung cancer) were retrospectively reviewed for dosimetric evaluation of treatment delivery techniques (3DCRT, IMRT, and HT). A dose of 6 Gy per fraction in 8 fractions was prescribed to deliver 95% of the prescription d...

  7. Unstable chromosome aberrations on peripheral blood lymphocytes from patients with cervical uterine cancer following radiotherapy

    International Nuclear Information System (INIS)

    Absorbed dose determination is an important step for risk assessment related to an exposure to ionizing radiation. However, physical dosimetry cannot be always performed, principally in the case of retrospective estimates. In this context, the use of bioindicators (biological effects) has been proposed, which defines the so-called biological dosimetry. In particular, scoring of unstable chromosomes aberrations (dicentrics, centric rings and fragments) of peripheral blood lymphocytes, while is the most reliable biological method for estimating individual exposure to ionizing radiation. In this work, blood samples from 5 patients, with cervical uterine cancer, were evaluated after partial-body radiotherapy with a source of 69 Co. For this, conventional cytogenetic method was employed, based on Giemsa coloration and fluorescence in situ hybridization, in order to correlate the frequency of unstable chromosome aberrations of blood lymphocytes with absorbed dose, as a result of the radiotherapy. A good agreement was observed between the frequency of chromosome aberrations scored and the values of dose previously calculated by physical dosimetry during patient's radiotherapy. The results presented in this work point out the importance of concerning analyses of unstable chromosome aberrations as biological dosimeter in the investigation of partial-body exposure to ionizing radiation. (author)

  8. Dermatologic radiotherapy and breast cancer

    International Nuclear Information System (INIS)

    This study was set up to provide quantitative data to evaluate unsubstantiated claims that improper dermatologic radiation techniques may cause breast cancer. A thin mylar window ionization rate meter placed at the location of the right breast of an Alderson-RANDO anthropomorphic phantom was used to measure direct and scatter radiation reaching the female breast during radiotherapy of the facial region (as given for acne). The results indicate that scatter doses are very small; they are influenced by radiation quality and the use or nonuse of a treatment cone. Quantitative risk estimates show that the very small risk of breast cancer induction can be reduced even further by the use of proper radiation protection measures. (orig.)

  9. Tomodensitometry images: integration in radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dessy, F.; Hoornaert, M.T. [Jolimont Hospital, Haine Saint Paul (France). Cancer and Nuclear Medicine Dept.; Malchair, F. [Biomed Engineering, Boncelles (France)

    1995-12-01

    With a view to utilization of CT scan images in radiotherapy, the effective energy and the linearity of four different scanners (Siemens somatom CR, HiQS, Plus and Picker PQ 2000) and two non standard scanners, simulators with CT option (Webb 1990) (Varian Ximatron and Oldelft Simulx CT) has been measured using the method described by White and Speller in 1980. When the linearity relation in presented using the density or the electron density as the abscissa, a blurred area where two different components of equal density or electron density can have two different Hounsfield`s numbers. Using the linearity relation, the density of Rando`s lung heterogeneity is determined. We calculated a treatment planning (TP) using this value and made a comparison between the TP and the real absorbed dose with was measured using diodes. The comparison between the TP and the relative Absorbed doses showed a difference of up to 4.5%.

  10. Palliative radiotherapy for multiple myeloma

    International Nuclear Information System (INIS)

    This study reviews the experience of palliative radiotherapy to patients with multiple myeloma to define the optimal dose for pain relief. The records of 31 patients (66 sites) with multiple myeloma irradiated for palliation at Kumamoto University hospital between 1985 and 1994 were reviewed. Total dose ranged from 8 to 50 Gy, with a mean of 32.2 Gy. Symptoms included pain (78.1%), neurological abnormalities (28.1%), and palpable masses (34.3%). Symptomatic remission was obtained in 45 of 46 evaluable sites (97.8%). Complete remission of symptoms were obtained in 28.3%, and partial remission in 69.6%. According to fraction size, there was no significant difference between 3-5 Gy and 1.8-2 Gy. The incidence of complete remission increased when a total dose of more than 20 Gy was given. When the quality of life is considered, hypofractionation was recommended for the palliative radiation therapy of multiple myeloma. (author)

  11. Radiotherapy. 2. rev. ed.; Strahlentherapie

    Energy Technology Data Exchange (ETDEWEB)

    Wannenmacher, Michael; Debus, Juergen [Radiologische Klinik, Heidelberg (Germany). Abteilung fuer Radioonkologie und Strahlentherapie; Wenz, Frederik (ed.) [Universitaetsmedizin Mannheim (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    2013-07-01

    The purpose of this medical specialty book, besides presenting the state of the art in clinical radiotherapy and radiooncology, is to explain the basic principles of medical physics and radiobiology. Following a number of chapters on general topics and theory it provides detailed coverage of the individual organ systems, briefly addressing future aspects in the process. The authors relate their view that radiooncology as a medical specialty will continue to be under pressure to change and that it will take continuous innovation to secure its status within the interdisciplinary context around the treatment of cancer patients. The authors of this, the textbook's second edition, have dedicated much space to modern methods and techniques in order to do justice to these developments.

  12. [Radiotherapy of benign intracranial tumors].

    Science.gov (United States)

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

    2016-09-01

    Most of the benign intracranial tumors are meningiomas, vestibular schwannomas, pituitary adenomas, craniopharyngiomas, and glomus tumors. Some of them grow very slowly, and can be observed without specific treatment, especially if they are asymptomatic. Symptomatic or growing tumors are treated by surgery, which is the reference treatment. When surgery is not possible, due to the location of the lesion, or general conditions, radiotherapy can be applied, as it is if there is a postoperative growing residual tumor, or a local relapse. Indications have to be discussed in polydisciplinary meetings, with precise evaluation of the benefit and risks of the treatments. The techniques to be used are the most modern ones, as multimodal imaging and image-guided radiation therapy. Stereotactic treatments, using fractionated or single doses depending on the size or the location of the tumors, are commonly realized, to avoid as much a possible the occurrence of late side effects. PMID:27523417

  13. Pregnancy and radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Cancer in pregnancy is relatively uncommon but breast cancer is one of the most common malignancy occur with pregnancy. Prescribed doses of radiotherapy are significantly higher than those of diagnostic procedures. Fetal exposure and damage can occur during radiotherapy within target area. Because of those risks, radiotherapy during pregnancy is basically has to avoid. Even though, feral damage depends on fetal dose and has some threshold dose. Practically, even in stochastic effect, there are some minimal doses. A most important point is careful estimation of fetal dose before radiation. The physician has to inform the patient about risk and benefit of radiotherapy to fetus and to mother and have an ethical balance to help the mother and family to make a final decision. (author)

  14. The radiotherapy affects the cognitive processes

    International Nuclear Information System (INIS)

    Researchers from the medical center of the free university of Amsterdam report that the radiotherapy can hinder the cognitive functions of patients affected by cerebral tumors treated after a surgery. Even low dose radiation could contribute in their opinion, to the progressive cognitive decline of patients suffering of low grade gliomas, the most commune cerebral tumor. To get these conclusions, 65 patients, whom half of them received a radiotherapy, had a neurological and psychological evaluation twelve years after their treatment. Results: 53% of patients treated by radiotherapy present disorders of attention, memory, execution and speed of information treatment against 27% of these ones that received an only surgery. The researchers conclude to the necessity to take into account this risk in the choice of treatment, or even to avoid radiotherapy in this precise case. (N.C.)

  15. Radiological protection and its organization in radiotherapy

    International Nuclear Information System (INIS)

    By means of a research carried out in Radiotherapy Centers in Mexico City, divided in 7 public institutions and 5 private, aspects related to the radiological safety and its organization in radiotherapy were evaluated. The population being studied was: medical and technical personnel, that works in the selected radiotherapy centers. The survey was made with 36 dichotomic variables, being obtained 90 surveys. The personnel characteristics are: 76% works for more than 3 years in radiotherapy, 93% has updated information about radiological protection, 67% knows the general radiological safety regulations, 93% knows the radiological emergency project and 95% makes use of personal dosemeter. As result of this research we found that the main problems that the radiological protection have are: lack of personnel training in radiological protection, although the 93% states to have updated information, the few number of persons that takes part in clinical meetings and professional associations. (authors). 7 refs., 3 tabs

  16. Radiation dosimetry in radiotherapy with internal emitters

    Energy Technology Data Exchange (ETDEWEB)

    Stabin, Michael G. [Oak Ridge Inst. for Science and Education, TN (United States)

    1997-12-31

    Full text. Radiation dosimetry radionuclides are currently being labeled to various biological agents used in internal emitter radiotherapy. This talk will review the various technologies and types of radiolabel in current use, with focus on the characterization of the radiation dose to the various important tissues of the body. Methods for obtaining data, developing kinetic models, and calculating radiation doses will be reviewed. Monoclonal antibodies are currently being labeled with both alpha and beta emitting radionuclides in attempts to find effective agents against cancer. Several radionuclides are also being used as bone pain palliation agents. These agents must be studied in clinical trials to determine the biokinetics and radiation dosimetry prior to approval for general use. In such studies, it is important to ensure the collection of the appropriate kinds of data and to collect the data at appropriate time intervals. The uptake and retention of activity in all significant source organs and in excreta be measured periodically (with at least 2 data points phase of uptake or clearance). Then, correct dosimetry methods must be applied - the best available methods for characterizing the radionuclide kinetic and for estimating the dosimetry in the various organs of the body especially the marrow, should be used. Attempts are also under way to develop methods for estimating true patient-specific dosimetry. Cellular and animal studies are also. Valuable in evaluating the efficacy of the agents in shrinking or eliminating tumors; some results from such studies will also be discussed. The estimation of radiation doses to patients in therapy with internal emitters involves several complex phases of analysis. Careful attention to detail and the use of the best available methods are essential to the protection of the patient and a successful outcome

  17. Blisters - an unusual effect during radiotherapy.

    Science.gov (United States)

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

    2013-11-01

    The skin reaction to radiation is regularly monitored in order to detect enhanced radiosensitivity of the patient, unexpected interactions (e.g. with drugs) or any inadvertent overdosage. It is important to distinguish secondary disease from radiation reaction to provide adequate treatment and to avoid unnecessary discontinuation of radiotherapy. A case of bullous eruption or blisters during radiotherapy of the breast is presented. Differential diagnoses bullous pemphigoid, pemphigus vulgaris, and bullous impetigo are discussed and treatment described. PMID:24158604

  18. Radiotherapy and immune reaction of oncologic patients

    International Nuclear Information System (INIS)

    Represented is a review of data accumulated in literature (1970-1976) on oppression of protection of oncologic patients and more oppression of immune reactions during radiotherapy. Underlined is the significance of studying immune homeostasis in a clinic of radiotherapy to evaluate total resistance of patients before the beginning and in the process of treatment. The prognostic significance of immunodepressive disturbances in patients with malignant tumors is elucidated

  19. Breast cancer radiotherapy and cardiac risk

    OpenAIRE

    Anusheel Munshi; Kaustav Talapatra; Debanarayan Dutta

    2011-01-01

    Breast cancer is the leading cause of morbidity and mortality in women in the developed world and its incidence in the developing world is on the rise. Management of breast cancer requires a multimodality approach and an integration of the services of surgery, radiation, and medical oncology. Radiotherapy after mastectomy or breast conservation leads to reduction in local recurrence by two-thirds. Recent trials and metaanalyses have also demonstrated overall survival benefit with radiotherapy...

  20. The result of radiotherapy for pituitary adenoma

    International Nuclear Information System (INIS)

    To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. The study involved a retrospective review of outcome in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median: 97 months). Seventeen were men and 10 were women. The numbers of functioning and non-functioning pituitary adenoma were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy(median: 5040cGy) were delivered over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. For radiation therapy alone, the 5 YSR was 100% and progression free survival rate was 85.8%. The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy , the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose, radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statistically significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluable patients with hyperprolactinoma achieved normalization in 4 and decrement in 5 patients. Only 2 patients developed mild degree of panhypopituitarism. The radiotherapy appears to be effective in controlling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherapy was comparable. There was a trend toward high recurrence rate in patients with nonfunctioning or prolactin secreting tumor and larger radiation field sizes. (author)

  1. Possibilities and limits of radiotherapy in larynx carcinoma. Moeglichkeiten und Grenzen der Radiotherapie des Larynxkarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Fietkau, R.; Sauer, R. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik)

    1992-01-01

    Early stage glottic carcinoma can be treated with primary radiotherapy reaching equally good results compared to primary surgery; for supraglottic carcinoma surgery offers only slight advantages over primary radiotherapy. Tumor control for recurrences is considerably improved by salvage surgery. The use of primary radiotherapy allows improved or at least preserved voice and reduced rated of acute complications and late treatment sequelae. However, treatment duration is longer and probably more expensive compared to function preservation microlaryngoscopic surgery. Which treatment approach is chosen, depends in individual patient factors and specific conditions in the clinical setting. In any case, primary radiotherapy deserves a stronger say in the early stage tumor situation. In our institution early stage supraglottic carcinoma undergo primary surgery. Advanced carcinomas (T2b and more) are rarely suited for primary radiotherapy with the exception of some very confined T3 tumors. Surgical approaches should be favoured, since they provide a detailed pathological tumor staging including R-classification, which would be lacking using primary radiotherapy. There are clear reasons to treat the lymph nodes for glottic carcinomas stage T2b and more and for all supraglottic carcinomas with radiotherapy. Specific risk factors are: tumor at the margins of the incision (R1), infiltration of the cartilage and pre-epiglottic space, paratracheal and subglottic extension more than 1 cm, perineural invasion, grade III and IV as well as emergency tracheostomy. Postoperative radiotherapy should be given to the lymph nodes for all positive neck-dissections. New therapeutic approaches are on the horizon, which may improve thee results of radiotherapy even for advanced larynx carcinomas, like hyperfractionation radiotherapy and simultaneous radio-chemotherapy combined enoral resection and postoperative radiotherapy may yield larynx preservation even for advanced stages. (orig./MG).

  2. Radiotherapy of adult nodal non Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    The role of radiotherapy in the treatment of nodal non-Hodgkin's lymphoma has been modified by the introduction of efficient chemotherapy and the development of different pathological classifications. The recommended treatment of early-stage aggressive lymphomas is primarily a combination chemotherapy. The interest of adjuvant radiotherapy remains unclear and has to be established through large prospective trials. If radiation therapy has to be delivered, the historical results of exclusive radiation therapy showed that involved-fields and a dose of 35-40 Gy (daily fraction of 1.8 Gy, 5 days a week) are the optimal schedule. The interest of radiotherapy in the treatment of advanced-stage aggressive lymphoma is yet to be proven. Further studies had to stratify localized stages according to the factors of the International Prognostic Index. For easy-stage low-grade lymphoma, radiotherapy remains the standard treatment. However, the appropriate technique to use is controversial. Involved-field irradiation at a dose of 35 Gy seems to be the optimal schedule, providing a 10 year disease-free survival rate of 50 % and no major toxicity. There is no standard indication of radiotherapy in the treatment advanced-stage low-grade lymphoma. For 'new' nodal lymphoma's types, the indication of radiotherapy cannot be established (mantle-zone lymphoma, marginal zone B-cell lymphoma) or must take into account the natural history (Burkitt's lymphoma, peripheral T-cell lymphoma) and the sensibility to others therapeutic methods. (authors)

  3. Breast cancer biology for the radiation oncologist

    Energy Technology Data Exchange (ETDEWEB)

    Strauss, Jonathan [Northwestern Univ., Chicago, IL (United States). Dept. of Radiation Oncology; Small, William [Loyola Univ. Chicago, Maywood, IL (United States). Stritch School of Medicine, Cardianl Bernardin Cancer Center; Woloschak, Gayle E. (ed.) [Northwestern Univ. Feinberg, Chicago, IL (United States). School of Medicine

    2015-10-01

    This is the first textbook of its kind devoted to describing the biological complexities of breast cancer in a way that is relevant to the radiation oncologist. Radiation Oncology has long treated breast cancer as a single biological entity, with all treatment decisions being based on clinical and pathologic risk factors. We are now beginning to understand that biological subtypes of breast cancer may have different risks of recurrence as well as different intrinsic sensitivity to radiotherapy. Multi-gene arrays that have for years been used to predict the risk of distant recurrence and the value of systemic chemotherapy may also have utility in predicting the risk of local recurrence. Additionally, the targeted agents used to treat breast cancer may interact with radiotherapy in ways that can be beneficial or undesirable. All of these emerging issues are extensively discussed in this book, and practical evidence-based treatment recommendations are presented whenever possible.

  4. Effects of Radiotherapy in the treatment of multiple myeloma: a retrospective analysis of a Single Institution

    International Nuclear Information System (INIS)

    Palliative irradiation of osteolytic lesions is a considerable component in the treatment for patients with multiple myeloma. In this study, we analyzed the efficacy of irradiation in these patients. We retrospectively analyzed 153 patients with multiple myeloma who were admitted to our department between 1989 and 2013. According to the staging system of Durie & Salmon 116 patients were classified as stage III. 107/153 patients were treated with radiotherapy of at least one and up to 6 bony lesions at different times. In order to evaluate the effect of local radiotherapy on pain relief and bone recalcification a uni- and multivariate analysis was performed using a binary logistic regression model to correct for multiple measurements. Complete information on dose, fractionation and volume of radiotherapy was available from 81 patients treated in 136 target volumes for pain relief, and from 69 patients treated in 108 target volumes for recalcification. Total radiation doses varied between 8 Gy to 50 Gy (median dose 25 Gy in 2.5 Gy fractions, 5 times a week). Radiotherapy resulted in complete local pain relief in 31% and partial local pain relief in 54% of the patients. In the univariate analysis, higher total radiation doses (p = 0.023) and higher age (p = 0.014) at the time of radiotherapy were significantly associated with a higher likelihood of pain relief, whereas no significant association was detected for concurrent systemic treatment, type and stage of myeloma and location of bone lesions. The same variables were independent predictors for pain relief in the multivariate analysis. Recalcification was observed in 48% of irradiated bone lesions. In the uni- and multivariate analysis higher radiation doses were significantly associated (p = 0.048) with an increased likelihood of recalcification. Side effects of radiotherapy were generally mild. Higher total biological radiation doses were associated with better pain relief and recalcification in this

  5. Biological Threats

    Science.gov (United States)

    ... Workplace Plans School Emergency Plans Main Content Biological Threats Biological agents are organisms or toxins that can ... for Disease Control and Prevention . Before a Biological Threat Unlike an explosion, a biological attack may or ...

  6. The place radiotherapy alone with respect to surgery and radiotherapy in locally advanced vulva cancers

    International Nuclear Information System (INIS)

    The author report a study which aimed at evaluating the place or radiotherapy associated with surgery and of radiotherapy without surgery when taking into care locally advanced vulva cancers. The study is based on 46 cases. After 24 months, different aspects, such as recurrence and survival, have been assessed. It appears that there is no survival difference without recurrences between both sets. Short communication

  7. [(18)F]Fluoroethyltyrosine- positron emission tomography-guided radiotherapy for high-grade glioma

    OpenAIRE

    Ratib Osman; Dipasquale Giovanna; Nouet Philippe; Rouzaud Michel; Haller Guy; Casanova Nathalie; Buchegger Franz; Zilli Thomas; Weber Damien C; Zaidi Habib; Vees Hansjorg; Miralbell Raymond

    2008-01-01

    Abstract Background To compare morphological gross tumor volumes (GTVs), defined as pre- and postoperative gadolinium enhancement on T1-weighted magnetic resonance imaging to biological tumor volumes (BTVs), defined by the uptake of 18F fluoroethyltyrosine (FET) for the radiotherapy planning of high-grade glioma, using a dedicated positron emission tomography (PET)-CT scanner equipped with three triangulation lasers for patient positioning. Methods Nineteen patients with malignant glioma were...

  8. Radiotherapy for pain management of bone metastases

    International Nuclear Information System (INIS)

    Purpose: This is the first Brazilian study intended to evaluate the response of pain relief with radiotherapy in three different fractionation and the clinical differences in managing pain in patients with painful bone metastases. Methods: Prospective study of patients with painful bone metastases referred to the Radiotherapy Sector of the Hospital de Cancer de Barretos for pain-relieving radiotherapy between March and December 2010. It is known that radiotherapy seems to alter the activation of osteoclast-mediated bone resorption, relieving pain in cases of painful bone metastases. Patients were assessed in relation to the status of pain intensity before and after the initiation of radiotherapy. Either a single fraction of 8Gy, five fractions of 4Gy or ten fractions of 3Gy were given. A visual analog scale (VAS) was applied by doctors, nurses and nursing technicians to assess pain intensity at each session of radiotherapy, and follow-up at 8, 30 and 90 days from the end of treatment. Results: We evaluated 92 consecutive patients, 48 male and 44 female, with a median age of 58 years. We found that 14% of patients referred from the Palliative Care or Clinical Oncology sectors need better pharmacological analgesia due to severe pain, compared with 40.5% of patients from the other sectors (p = 0.004). We also found that the onset of pain relief to patients receiving 10 fractions of 300cGy analgesia without changing the pre-radiotherapy analgesia occurred with significance after the fifth fraction. Improvement in pain experienced within 90 days of follow-up was found in eighty percent of patients, independent of fractionated radiotherapy, site of metastases and the clinical condition of the patient. Discussion/Conclusion: The Palliative Care and Clinical Oncology sectors expressed greater concern in regards to analgesia for the patient with painful bone metastases. Radiotherapy is an effective pain-relieving treatment in different fractionation studied, even though the

  9. Radiotherapy for pain management of bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Rezende Junior, Ismar de; Mattos, Marcos Duarte de; Nakamura, Ricardo; Lemes Junior, Joaquim; Vanzelli, Talita Lozano, E-mail: rezende.med@terra.com.br [Radioterapia do Hospital de Cancer de Barretos, SP (Brazil)

    2011-07-01

    Purpose: This is the first Brazilian study intended to evaluate the response of pain relief with radiotherapy in three different fractionation and the clinical differences in managing pain in patients with painful bone metastases. Methods: Prospective study of patients with painful bone metastases referred to the Radiotherapy Sector of the Hospital de Cancer de Barretos for pain-relieving radiotherapy between March and December 2010. It is known that radiotherapy seems to alter the activation of osteoclast-mediated bone resorption, relieving pain in cases of painful bone metastases. Patients were assessed in relation to the status of pain intensity before and after the initiation of radiotherapy. Either a single fraction of 8Gy, five fractions of 4Gy or ten fractions of 3Gy were given. A visual analog scale (VAS) was applied by doctors, nurses and nursing technicians to assess pain intensity at each session of radiotherapy, and follow-up at 8, 30 and 90 days from the end of treatment. Results: We evaluated 92 consecutive patients, 48 male and 44 female, with a median age of 58 years. We found that 14% of patients referred from the Palliative Care or Clinical Oncology sectors need better pharmacological analgesia due to severe pain, compared with 40.5% of patients from the other sectors (p = 0.004). We also found that the onset of pain relief to patients receiving 10 fractions of 300cGy analgesia without changing the pre-radiotherapy analgesia occurred with significance after the fifth fraction. Improvement in pain experienced within 90 days of follow-up was found in eighty percent of patients, independent of fractionated radiotherapy, site of metastases and the clinical condition of the patient. Discussion/Conclusion: The Palliative Care and Clinical Oncology sectors expressed greater concern in regards to analgesia for the patient with painful bone metastases. Radiotherapy is an effective pain-relieving treatment in different fractionation studied, even though the

  10. Surgery vs. radiotherapy in localized prostate cancer. Which is best?

    International Nuclear Information System (INIS)

    Surgery and radiotherapy are currently accepted alternatives for the treatment of localized prostate cancer. In the absence of relevant randomized trials no decision regarding the superiority of any of the given approaches can be made. Up to now several cohort-based approaches indicate similar outcomes for both treatments. Based on a new population based approach, Merglen and co-workers recently concluded that surgery would offer the best chance of long-term control in terms of 10-year survival for T1–T3 prostate cancer patients. Unfortunately the strength of this trial is limited by several shortcomings. Most importantly, issues of radiation dosage have not been taken into account. In addition, several relevant parameters including Gleason score and PSA are not well balanced between the arms and the assignment to arbitrary risk groups does not reflect the real biological behaviour. Thus, the data provided do not support the strong conclusion issued by the authors. Based on the data available, surgery and radiotherapy still have to be considered as equally effective

  11. Hypofractionated radiotherapy has the potential for second cancer reduction

    Directory of Open Access Journals (Sweden)

    Besserer Jürgen

    2010-02-01

    Full Text Available Abstract Background and Purpose A model for carcinoma and sarcoma induction was used to study the dependence of carcinogenesis after radiotherapy on fractionation. Materials and methods A cancer induction model for radiotherapy doses including fractionation was used to model carcinoma and sarcoma induction after a radiation treatment. For different fractionation schemes the dose response relationships were obtained. Tumor induction was studied as a function of dose per fraction. Results If it is assumed that the tumor is treated up to the same biologically equivalent dose it was found that large dose fractions could decrease second cancer induction. The risk decreases approximately linear with increasing fraction size and is more pronounced for sarcoma induction. Carcinoma induction decreases by around 10% per 1 Gy increase in fraction dose. Sarcoma risk is decreased by about 15% per 1 Gy increase in fractionation. It is also found that tissue which is irradiated using large dose fractions to dose levels lower than 10% of the target dose potentially develop less sarcomas when compared to tissues irradiated to all dose levels. This is not observed for carcinoma induction. Conclusions It was found that carcinoma as well as sarcoma risk decreases with increasing fractionation dose. The reduction of sarcoma risk is even more pronounced than carcinoma risk. Hypofractionation is potentially beneficial with regard to second cancer induction.

  12. Cancer risk following radiotherapy of cervical cancer: A preliminary report

    International Nuclear Information System (INIS)

    Women treated for cervical cancer were selected for study because (a) doses to body organs following radiotherapy can be accurately determined and vary sufficiently to permit dose-response evaluations, (b) organs remote from the cervix receive low-dose exposures in the range of current scientific interest, (c) treatment is relatively successful and many patients survive long enough to be at risk of late complications of radiotherapy, and (d) several nonexposed groups of women with cervical cancer are also available for comparison. In addition, population-based cancer registries provide an opportunity to inexpensively study large numbers of individuals over many decades. The careful procedures normally used by cancer registries to record second primary cancers facilitate the study of cancer incidence for which a wider view of radiation risk is expected than can be seen in investigations of mortality. Other special features of studies of cervical cancer patients include the ability to assess the effects of very large partial-body exposures, differences in organ sensitivities to radiation, interactions of radiation with biological factors such as age, and the duration of carcinogenic response

  13. Radiotherapy Treatment Planning for Testicular Seminoma

    Energy Technology Data Exchange (ETDEWEB)

    Wilder, Richard B., E-mail: richardbwilder@yahoo.com [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States); Buyyounouski, Mark K. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Efstathiou, Jason A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Beard, Clair J. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States)

    2012-07-15

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

  14. Stereotactic body radiotherapy for liver tumors. Principles and practical guidelines of the DEGRO Working Group on Stereotactic Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sterzing, Florian [Deutsches Krebsforschungszentrum (DKFZ), Klinische Kooperationseinheit Strahlentherapie, Heidelberg (Germany); Radiologische Universitaetsklinik, Abteilung fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany); Brunner, Thomas B. [Universitaetsklinikum Freiburg, Klinik fuer Strahlenheilkunde, Radiologische Klinik, Freiburg (Germany); Ernst, Iris; Greve, Burkhard [Universitaetsklinikum Muenster, Klinik fuer Strahlentherapie - Radioonkologie, Muenster (Germany); Baus, Wolfgang W. [Universitaetsklinikum Koeln, Klinik und Poliklinik fuer Strahlentherapie, Koeln (Germany); Herfarth, Klaus [Radiologische Universitaetsklinik, Abteilung fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany); Guckenberger, Matthias [UniversitaetsSpital Zuerich, Klinik fuer Radio-Onkologie, Zuerich (Switzerland)

    2014-10-15

    This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a practical guideline for safe and effective stereotactic body radiotherapy (SBRT) of liver tumors. The literature on the clinical evidence of SBRT for both primary liver tumors and liver metastases was reviewed and analyzed focusing on both physical requirements and special biological characteristics. Recommendations were developed for patient selection, imaging, planning, treatment delivery, motion management, dose reporting, and follow-up. Radiation dose constraints to critical organs at risk are provided. SBRT is a well-established treatment option for primary and secondary liver tumors associated with low morbidity. (orig.) [German] Die Arbeitsgruppe Stereotaxie der Deutschen Gesellschaft fuer Radioonkologie (DEGRO) legt hier eine Empfehlung zur sicheren und effektiven Durchfuehrung der SBRT von Lebertumoren vor. Eine Literaturrecherche zur Untersuchung der Evidenz der SBRT sowohl fuer primaere Lebertumore als auch fuer Lebermetastasen wurde durchgefuehrt. Auf dieser Basis werden Empfehlungen fuer technisch-physikalische Voraussetzungen wie auch fuer die taegliche Praxis der Leber-SBRT gegeben. Weiterhin werden radiobiologische Besonderheiten dieses Verfahrens dargestellt. Praktische Vorgaben werden fuer Patientenselektion, Bildgebung, Planung, Applikation, Bewegungsmanagement, Dosisdokumentation und Follow-up gegeben. Dosisempfehlungen fuer die kritischen Risikoorgane werden dargestellt. Die SBRT stellt eine etablierte Behandlungsmethode fuer primaere und sekundaere Lebertumore dar und ist mit niedriger Morbiditaet assoziiert. (orig.)

  15. Radiotherapy alone in breast cancer

    International Nuclear Information System (INIS)

    This retrospective analysis was conducted on breast cancer patients treated by radiotherapy alone at The Princess Margaret Hospital and at the Institut Gustave-Roussy. These patients had either operable tumours, but were unfit for general anesthesia, or had inoperable tumors due to local contraindications to surgery. Previous results showed that a radiation dose increase of 15 Gy can decrease the relative risk of tumour or lymph node recurrence twofold. In this third report, the same data were analyzed to determine the treatment-related complication rates and to correlate these to the radiation dose levels. Overall results were analyzed on 453 patients, but detailed analyses on complications were conducted on 372 patients not developing local recurrence in the first 6 months of follow-up. Each complication was graded on a 3-level previously defined scale. Most frequent complications were skin changes of different degrees, which were usually asymptomatic. More disabling complications were arm edema, impaired shoulder mobility, rib fractures and brachial plexopathy. The incidence of disabling complications was low. The only factor significantly increasing the risk of complications was the radiation dose level to the tumour and axilla. Technical factors such as overlapping fields should also be taken into account. As the more effective control of tumour and lymph nodes obtained in patients treated with higher radiation doses is counterbalanced by an increase in the complication rate, the dose to be delivered for each patient should be carefully chosen according to individual risk factors. (author). figs

  16. Post Pelvic Radiotherapy Bony Changes

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Seung Jae [Samsung Medical Center, Seoul (Korea, Republic of)

    2009-03-15

    There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as 8.2{approx}20% after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

  17. Post prostatectomy radiotherapy: our experience

    International Nuclear Information System (INIS)

    Full text: Background: Between 2000 and 2005, at Vidt Medical Center, 85 patients were treated with 3D and IMRT radiotherapy after undergoing radical prostatectomy for localized prostate adenocarcinoma. Objective: To evaluate biochemical recurrence and specific disease free survival and global survival. Materials and method: These patients were divided into two groups: those who engaged in what is called adjuvant therapy (20 patients), who after surgery had increased risk factors and / or persistence of the disease. These risk factors were positive margins, seminal vesicles involvement, capsule infiltration or persistent PSA. The other group were 65 patients referred to as rescue therapy: they were those that presented PSA increase after having undetectable levels as observed nadir after surgery, understanding > 0.2 ng / ml as a high value or palpable nodule on rectal touch with or without positive biopsy. Follow up was between 24 and 84 months, the dose delivered was between 6500 - 7000 cGy. Also evaluated the early and late toxicity, urinary and rectal, according to RTOG criteria. Conclusion: The results obtained confirm the benefits of postoperative radiation therapy for both groups of patients, showing a more favorable trend on those treated with adjuvant therapy. (authors)

  18. Radiotherapy for the vulvar cancer

    International Nuclear Information System (INIS)

    Fifteen patients who had primary vulvar cancer treated with radiotherapy as an initial treatment at Hyogo Medical Center for Adults and Hyogo Cancer Center from January 1971 to December 1990 are presented. Two patients were stage 0, one stage I, three stage II and nine stage III. Nine patients received electron irradiation with or without interstitial irradiation and intracavitary vaginal irradiation. Five patients received megavoltage X-ray irradiation using AP/PA parallel opposed fields including the pelvic nodes and perineum followed by boost irradiation of electrons, interstitial irradiation and intracavitary vaginal irradiation. The total dose delivered to the primary tumor ranged from 50 to 100 Gy (73 Gy on average). The actuarial 5-year survival rate of the patients was 43.6%. Complete regression (CR) was achieved in 60% of the patients. However, CR was not achieved in any of five patients with palpable inguinal nodes. In contrast, all the patients who had tumors of less than 2 cm in diameter achieved CR. Five of nine CR cases relapsed. First sites of failure were vagina, groin and vulvar region. Recurrence occurred more than four years after treatment in three cases. Necrosis occurred in five of nine CR cases. (author)

  19. Radiotherapy for the vulvar cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hirota, Saeko; Soejima, Toshinori; Motohara, Tomofumi (Hyogo Medical Center for Adults, Akashi (Japan)) (and others)

    1993-03-01

    Fifteen patients who had primary vulvar cancer treated with radiotherapy as an initial treatment at Hyogo Medical Center for Adults and Hyogo Cancer Center from January 1971 to December 1990 are presented. Two patients were stage 0, one stage I, three stage II and nine stage III. Nine patients received electron irradiation with or without interstitial irradiation and intracavitary vaginal irradiation. Five patients received megavoltage X-ray irradiation using AP/PA parallel opposed fields including the pelvic nodes and perineum followed by boost irradiation of electrons, interstitial irradiation and intracavitary vaginal irradiation. The total dose delivered to the primary tumor ranged from 50 to 100 Gy (73 Gy on average). The actuarial 5-year survival rate of the patients was 43.6%. Complete regression (CR) was achieved in 60% of the patients. However, CR was not achieved in any of five patients with palpable inguinal nodes. In contrast, all the patients who had tumors of less than 2 cm in diameter achieved CR. Five of nine CR cases relapsed. First sites of failure were vagina, groin and vulvar region. Recurrence occurred more than four years after treatment in three cases. Necrosis occurred in five of nine CR cases. (author).

  20. Can Aidi injection alleviate the toxicity and improve the clinical efficacy of radiotherapy in lung cancer?

    Science.gov (United States)

    Xiao, Zheng; Liang, Rui; Wang, Cheng-qiong; Xu, Shaofeng; Li, Nana; He, Yuejuan; Tang, Fushan; Chen, Ling; Ma, Hu

    2016-01-01

    Abstract Background/Introduction: Aidi injection plus radiotherapy is widely used for lung cancer in China. Can Aidi injection alleviate the toxicity and improve the clinical efficacy of radiotherapy in lung cancer? Has Aidi injection the attenuation and synergistic efficacy to radiotherapy? There is lack of strong evidence to prove it. Objectives: To reveal its real attenuation and synergistic efficacy to radiotherapy and provide sufficient evidence for adjuvant chemotherapy strategies to lung cancer, we systematically evaluated all related studies. Data Sources: We collected all studies about Aidi injection plus radiotherapy for lung cancer in Medline, Embase, Web of Science, China national knowledge infrastructure database (CNKI), Chinese scientific journals full-text database (VIP), Wanfang database, China biological medicine database (CBM) (established to June 2015), and Cochrane Central Register of Controlled Trials (June 2015), evaluated their quality according to the Cochrane evaluation handbook of randomized controlled trials (5.1.0), extracted data following the PICO principles and synthesized the data by Meta analysis. Results: Sixteen randomized controlled trials (RCTs) with 1192 lung cancer patients were included, with general methodological quality in most trials. The merged relative risk (RR) values and their 95% CI of meta-analysis for objective response rate (ORR), disease control rate (DCR), and quality of life (QOL) were as follows: 1.54, (1.39,1.70), 1.10 (1.02, 1.19), and 2.13 (1.68, 2.68). The merged RR values and their 95% CI of meta-analysis for myelosuppression and neutropenia, radiation pneumonitis, and radiation esophagitis were as follows: 0.51 (0.38, 0.69), 0.53 (0.42, 0.65), 0.52 (0.41, 0.67), and 0.52 (0.40, 0.68). All were statistically significant. The possibility of publication bias was small which objectively reported the results. Conclusions: The evidence available indicates that Aidi injection plus radiotherapy can significantly

  1. A neurosurgery/stereotactic radiotherapy dedicated PACS for conformal radiotherapy

    International Nuclear Information System (INIS)

    To realise conformal cerebral stereotactic irradiations we use a Neurosurgery/stereotactic dedicated PACS between two distant hospitals. It connects the stereotactic neurosurgery planification imaging system NEUROAXIS (Sopelem-Sofretec/Ste Anne Hospital) with the dosimetric TPS ARTEMIS-3D/Dosigray (Tenon Hospital). NEUROAXIS is a computer aided stereotactic biopsies and stereo-electroencephalographies, used by surgeons in operating room. The system determines the precise location data for Talairach radiological equipment (X ray source at 5 meters from film) and the geometry of scanner and MRI stereotactical referentials. It provides a full set of features for lesion localization, geometrical computations, surgical planifications, picture archiving, stereotactic angiography, CT and MRI image processing and networking. It sends images through the French public digital network ISDN (NUMERIS/France Telecom : 2x64 Kbits/s) from Ste Anne to Tenon Hospital. Stereotactic angiographic and CT images are reformatted into the DOSIGRAY image processing environment where 3-D dose distributions, displays and DVHs are computed to determine the optimal treatment. ARTEMIS-3D/Dosigray is a TPS for stereotactic radiotherapy devised by the Tenon Hospital for clinical methodology and 3D dose calculations, optimization software development and the Dosigray company for multimodality imaging, (2D(3D)) computer graphics for dose and anatomical representation and data networking. Communication within the radiation oncology department is provided by local area ETHERNET network, linking heterogeneous systems (Vaxstations-3200; Decstation (5000(240))) by means of different protocols. The works in progress are to send back via the same network the 3-D dose matrix to Neurosurgery department NEUROAXIS system. Our PACS is used since six months to treat patients. It has permitted to improve the treatment quality in comparison with our first version TPS ARTEMIS-3D

  2. Effect of low-level laser therapy on repair of the bone compromised by radiotherapy.

    Science.gov (United States)

    Batista, Jonas D; Zanetta-Barbosa, Darceny; Cardoso, Sérgio V; Dechichi, Paula; Rocha, Flaviana S; Pagnoncelli, Rogério M

    2014-11-01

    Radiotherapy (RDT) is commonly used for cancer treatment, but high doses of ionizing radiation can directly affect healthy tissues. Positive biological effects of low-level laser therapy (LLLT) on bone repair have been demonstrated; however, this effect on surgical defects of bone previously compromised by radiotherapy has not been evaluated. The aim of this study was to investigate the influence of LLLT (λ = 830 nm) in femur repair after ionizing radiation. Twenty Wistar rats were divided into four groups: control group (GC, n = 5) creation of bone defects (BDs) only; laser group (GL), with BD and LLLT (n = 5); radiotherapy group (GR), submitted to RDT and BD (n = 5); and radiotherapy and laser group (GRL), submitted to RDT, BD, and LLLT (n = 5). GL and GRL received punctual laser application (DE = 210 J/cm(2), P = 50 mW, t = 120 s, and beam diameter of 0.04 cm(2)) immediately after surgery, with 48-h interval during 7 days. Animals were euthanized at 7 days after surgery, and bone sections were evaluated morphometrically with conventional microscopy. Bone repair was only observed in nonirradiated bone, with significant improvement in GL in comparison to GC. GR and GRL did not present any bone neoformation. The result demonstrated a positive local biostimulative effect of LLLT in normal bone. However, LLLT was not able to revert the bone metabolic damage due to ionizing radiation.

  3. Genetic markers for prediction of normal tissue toxicity after radiotherapy

    DEFF Research Database (Denmark)

    Alsner, Jan; Andreassen, Christian Nicolaj; Overgaard, Jens

    2008-01-01

    haplotypes, and handling of confounding factors. Finally, candidate gene studies elucidating the genetic component of radiation-induced morbidity and the functional consequences of single nucleotide polymorphisms by studying intermediate phenotypes will be discussed. Udgivelsesdato: 2008-Apr......During the last decade, a number of studies have supported the hypothesis that there is an important genetic component to the observed interpatient variability in normal tissue toxicity after radiotherapy. This review summarizes the candidate gene association studies published so far on the risk...... of radiation-induced morbidity and highlights some recent successful whole-genome association studies showing feasibility in other research areas. Future genetic association studies are discussed in relation to methodological problems such as the characterization of clinical and biological phenotypes, genetic...

  4. Conformational radiotherapy in the case of prostate cancer: experience gained by the Blida Oncology Radiotherapy Department, Algeria; La radiotherapie conformationnelle dans le cancer de la prostate: experience du service de radiotherapie oncologique de Blida, Algerie

    Energy Technology Data Exchange (ETDEWEB)

    Ayad, M.; Abbas, L.; Mesli, S.; Boualga, K. [Centre anti cancer, Blida (Algeria)

    2010-10-15

    Conformational radiotherapy is used as the first method for the treatment of localized prostate cancers. It preserves some life quality and allows a significant reduction of the dose applied to healthy organs, and therefore a drastic reduction of late and severe effects of irradiation. The authors report a prospective study which aims at describing therapeutic modalities and assessing preliminary results in terms of biochemical control and toxicity. They discuss the results obtained on 34 patients who have been treated between January 2008 and January 2009. In comparison with conventional therapy, they observe an absence of grade 3 and 4 side effects, and a normalization of biological criteria which indicates a good tumour response. Short communication

  5. Surgery and radiotherapy in the treatment of cutaneous melanoma

    DEFF Research Database (Denmark)

    Testori, A; Rutkowski, P; Marsden, J;

    2009-01-01

    on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases....

  6. Correlative study on anemia and radiotherapy effects in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To study the effect of oxygen-carrying ability of blood efficacy of radiotherapy for patients with nasopharyngeal carcinoma. Methods: Altogether 161 cases of patients with nasopharyngeal carcinoma were classified according to severity of anemia, and Hb, RBC, MCH, HCT, MCV, MCHC and RDW were tested before, during and after radiotherapy. The patients were followed-up for up to 5 years, the relationship and mechanism among anemia, radiotherapy effects and survival rate was discussed. Results: The survival rate between anemia group and non-anemia group was different significantly (P<0.05). Anemia before radiotherapy, anemia appearance or anemia deterioration during radiotherapy were sensitive factors affecting radiotherapy results. The anemia more severe, the radiotherapy worse. Conclusion: Anemia-hypohemoglobinemia leads to decrease of oxygen-carrying capacity of blood, resulting in oxygen deficiency of tumor cells and their radiotherapy resistance. Therefore this method is worthy of further studies

  7. Image-guided and adaptive radiotherapy

    International Nuclear Information System (INIS)

    Image-guided radiotherapy (IGRT) aims to take into account anatomical variations occurring during irradiation by visualization of anatomical structures. It may consist of a rigid registration of the tumour by moving the patient, in case of prostatic irradiation for example. IGRT associated with intensity-modulated radiotherapy (IMRT) is strongly recommended when high-dose is delivered in the prostate, where it seems to reduce rectal and bladder toxicity. In case of significant anatomical deformations, as in head and neck tumours (tumour shrinking and decrease in volume of the salivary glands), re-planning appears to be necessary, corresponding to the adaptive radiotherapy. This should ideally be 'monitored' and possibly triggered based on a calculation of cumulative dose, session after session, compared to the initial planning dose, corresponding to the concept of dose-guided adaptive radiotherapy. The creation of 'planning libraries' based on predictable organ positions (as in cervical cancer) is another way of adaptive radiotherapy. All of these strategies still appear very complex and expensive and therefore require stringent validation before being routinely applied. (authors)

  8. Chemo-radiotherapy for malignant brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kochi, Masato; Ushio, Yukitaka [Kumamoto Univ. (Japan). School of Medicine

    2002-05-01

    Malignant gliomas: Randomized clinical trials conducted in the USA showed that radiotherapy plus chemotherapy with nitrosoureas offered a long-term survival advantage to patients younger than 60 years old with malignant gliomas. Combination chemotherapy, such as procarbazine/CCNU/vincristine (PCV) must be tested further, and intra-arterial chemotherapy with nitrosoureas offered no survival advantage. Combination chemotherapy with PCV showed efficacy for patients with anaplastic oligodendroglioma and anaplastic oligoastrocytoma. Medulloblastoma: The addition of chemotherapy to radiotherapy improved the survival of patients with poor risk medulloblastoma, and may reduce the required craniospinal radiation dose in patients with good risk medulloblastoma. Primary CNS lymphoma (PCNSL): Combination of chemotherapy with high-dose MTX and radiotherapy improved survival of patients with PCNSL; however, the neurotoxicity produced by this treatment modality is a serious problem in older patients. Intracranial germ cell tumors: The addition of chemotherapy to radiotherapy may produce long term survival with good quality of life in patients with germinoma. Neoadjuvant therapy consisting of chemotherapy and radiotherapy followed by complete surgical excision improved survival of patients with intracranial nongerminomatous germ cell tumors. (author)

  9. [Image-guided radiotherapy and partial delegation to radiotherapy technicians: Clermont-Ferrand experience].

    Science.gov (United States)

    Loos, G; Moreau, J; Miroir, J; Benhaïm, C; Biau, J; Caillé, C; Bellière, A; Lapeyre, M

    2013-10-01

    The various image-guided radiotherapy techniques raise the question of how to achieve the control of patient positioning before irradiation session and sharing of tasks between radiation oncologists and radiotherapy technicians. We have put in place procedures and operating methods to make a partial delegation of tasks to radiotherapy technicians and secure the process in three situations: control by orthogonal kV imaging (kV-kV) of bony landmarks, control by kV-kV imaging of intraprostatic fiducial goldmarkers and control by cone beam CT (CBCT) imaging for prostate cancer. Significant medical overtime is required to control these three IGRT techniques. Because of their competence in imaging, these daily controls can be delegated to radiotherapy technicians. However, to secure the process, initial training and regular evaluation are essential. The analysis of the comparison of the use of kV/kV on bone structures allowed us to achieve a partial delegation of control to radiotherapy technicians. Controlling the positioning of the prostate through the use and automatic registration of fiducial goldmarkers allows better tracking of the prostate and can be easily delegated to radiotherapy technicians. The analysis of the use of daily cone beam CT for patients treated with intensity modulated irradiation is underway, and a comparison of practices between radiotherapy technicians and radiation oncologists is ongoing to know if a partial delegation of this control is possible. PMID:24011600

  10. Long-Term Breast Cancer Patient Outcomes After Adjuvant Radiotherapy Using Intensity-Modulated Radiotherapy or Conventional Tangential Radiotherapy

    OpenAIRE

    Yang, Jen-Fu; Lee, Meei-Shyuan; Lin, Chun-Shu; Chao, Hsing-Lung; Chen, Chang-Ming; Lo, Cheng-Hsiang; Fan, Chao-Yueh; Tsao, Chih-Cheng; Huang, Wen-Yen

    2016-01-01

    Abstract The aim of the article is to analyze breast cancer patient clinical outcomes after long-term follow-up using intensity-modulated radiotherapy (IMRT) or conventional tangential radiotherapy (cRT). We retrospectively reviewed patients with stage 0–III breast cancer who received breast conserving therapy between April 2004 and December 2007. Of the 234 patients, 103 (44%) were treated with IMRT and 131 (56%) were treated with cRT. A total prescription dose of 45 to 50 Gy (1.8–2 Gy per f...

  11. Minimal requirements for quality controls in radiotherapy with external beams

    International Nuclear Information System (INIS)

    Physical dosimetric guidelines have been developed by the Italian National Institute of Health study group on quality assurance in radiotherapy to define protocols for quality controls in external beam radiotherapy. While the document does not determine strict rules or firm recommendations, it suggests minimal requirements for quality controls necessary to guarantee an adequate degree of accuracy in external beam radiotherapy

  12. Track structure modelling for ion radiotherapy

    CERN Document Server

    Korcyl, Marta

    2014-01-01

    In its broadest terms, doctoral dissertation entitled "Track structure modelling for ion radiotherapy" is part of the supporting research background in the development of the ambitious proton radiotherapy project currently under way at the Institute of Nuclear Physics PAN in Krak\\'ow. Another broad motivation was the desire to become directly involved in research on a topical and challenging subject of possibly developing a therapy planning system for carbon beam radiotherapy, based in its radiobiological part on the Track Structure model developed by prof. Robert Katz over 50 years ago. Thus, the general aim of this work was, firstly, to recapitulate the Track Structure model and to propose an updated and complete formulation of this model by incorporating advances made by several authors who had contributed to its development in the past. Secondly, the updated and amended (if necessary) formulation of the model was presented in a form applicable for use in computer codes which would constitute the "radiobio...

  13. External radiotherapy in a pleural mesothelioma tumor

    International Nuclear Information System (INIS)

    Pleural mesothelioma is an uncommon tumor compared with other thoracic malignancies and a 80% of the cases have asbestos exposure. From 1983 to 1992 we have examined patients suffering from malignant pleural mesothelioma treated with external radiotherapy. We treated 11 patients of which 9 were males and 2 were females. The most frequent symptom was the chest pain and all these patients underwent a torascoscopy followed by a pleasured. Of the 11 cases: 10 were malignant epithelial mesothelioma and 1 was a mixed pleural case. Afterwards, they were treated with external radiotherapy between 30 and 55 Gy, with few complications. At the moment, 5 patients are still alive and there is a survival rate of 50% at 24 and 60 months and of 25% at 120 months. We think that external radiotherapy is a good palliative treatment with few complications. (Author) 28 refs

  14. Radiotherapy: what are the patients' needs

    International Nuclear Information System (INIS)

    Although there is a substantial body of research into the impact of cancer therapies such as surgery and chemotherapy, little is known about the experiences of cancer patients receiving radiotherapy. Serial interviews with 39 patients undergoing radical radiotherapy to the oral cavity revealed that misunderstandings and groundless fears about this form of treatment were widespread. A majority were unprepared for the severity and duration of their side-effects. These results suggest that written information for patients about radiotherapy and its side-effects should be made available routinely. There is also scope for nutritional support. Finally, as a supplement to out-patient attendance, informal contact with the hospital in the immediate post-treatment phase would provide invaluable reassurance to patients. (author)

  15. Pelvic radiotherapy and sexual dysfunction in women

    DEFF Research Database (Denmark)

    Jensen, Pernille Tine; Froeding, Ligita Paskeviciute

    2015-01-01

    BACKGROUND: During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing...... of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. METHODS: An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological...... and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. RESULTS...

  16. Operations experience at the Bevalac radiotherapy facility

    International Nuclear Information System (INIS)

    During the first years of Bevalac operation the biomedical effort concentrated on radiobiology work, laying the foundation for patient radiotherapy. A dedicated radiotherapy area was created in 1978, and in 1979 full-scale patient treatment was begun. As of now over 500 treatments with carbon, neon and argon beams have been delivered to about 50 patients, some as boosts from other modalities and some as complete heavy ion treatments. Up to 12 patients per day have been treated in this facility. Continuing efforts in refining techniques and operating procedures are increasing efficiency and accuracy of treatments, and are contributing to the alleviation of scheduling difficulties caused by the unique requirements of radiotherapy with human patients

  17. Growth Laws in Cancer: Implications for Radiotherapy

    CERN Document Server

    Castorina, P; Gabriele, P; Guiot, C

    2006-01-01

    Comparing both, the more conventional Gompertz tumor growth law (GL) and the ``Universal'' law (UL), recently proposed and applied to cancer,we have investigated the growth law's implications on various radiotherapy regimen. According to GL, the surviving tumor cell fraction could be reduced 'ad libidum', independently of the initial tumor mass,simply by increasing the number of treatments. On the contrary, if tumor growth dynamics would indeed follow the Universal scaling law, there is a lower limit of the survival fraction that cannot be reduced any further regardless of the total number of treatments. This finding can explain the so called ``tumor size effect'' and re-emphasizes the importance of early diagnosis as it implies that radiotherapy may be successful provided the tumor mass at treatment onset is rather small. Taken together with our previous works, implications of these findings include revisiting standard radiotherapy regimen and overall treatment protocols.

  18. Conformal radiotherapy of prostate carcinoma: Procedure description

    Directory of Open Access Journals (Sweden)

    Erak Marko

    2011-01-01

    Full Text Available Introduction. Today, three-dimensional conformal radiotherapy is a standard way in the radical treatment of localized prostate cancer, and it is an alternative to the radical prostatectomy. This method of radiotherapy treatment is widely accepted in the treatment of prostate cancer patients, and provides irradiation of targeted volume (prostate, seminal vesicles with dose escalation sparing the surrounding healthy tissues (rectum, bladder at the same time. That is not possible with the conventional twodimension technique. Procedure description. Three-dimensional conformal radiotherapy is a volumetric, visual simulation according to the computed tomography slices; it defines the tumour and organ at risk individually in each patient. Results of several studies have shown that there is a significant decrease in the development of acute toxicity when prostate cancer patients are treated with conformal radiotherapy. High dose irradiation gives excellent results in treatment of localized prostate carcinoma and improves treatment results in the patients with locally advanced carcinoma of prostate. Discussion. Prostate carcinoma irradiation techniques have been changed dramatically during recent years. Data obtained by computed tomography are important since the size and shapes of the prostate as well as its anatomic relations towards the rectum and bladder are considerably different in individual patients. The three-dimension plan of irradiation can be designed for each patient individually by performing computed tomography technique when planning radiotherapy. Conclusion. The advanced planning systems for conformal radiotherapy can reconstruct the anatomic structures of pelvis in three-dimension technique on the basis of computed tomography scans, which provides better conformality between the irradiation beam and geometrical shape of the tumour with minimal irradiation of the surrounding healthy tissue.

  19. Radiotherapy in the management of Graves` ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sakata, Koh-ichi; Hareyama, Masato; Oouchi, Atsushi; Shidou, Mitsuo; Nagakura, Hisayasu; Morita, Kazuo; Osanai, Hajime; Ohtsuka, Kenji; Hinoda, Yuji [Sapporo Medical Univ. (Japan). School of Medicine

    1998-06-01

    To report the results of radiotherapy for patients with failure, adverse reactions or relative contraindications to the use of steroids or immunosuppressants, by using newly developed quantitative indexes. Fourteen female and six male patients with Graves` ophthalmopathy were treated with radiotherapy between 1989 and 1996. Prior to radiotherapy, eight patients received treatment with prednisone, four received immunosuppressants and four received a combination of both. Four patients with contraindications to steroids were initially managed with radiotherapy. Most of the patients received a dose of 24-28 Gy in 2 Gy fractions. We used the newly developed motility limitation index to assess extraocular motility. Treatment was well tolerated. There have been no late complications. All 12 patients with soft tissue signs such as edema, irritation, tearing and pain were improved. Proptosis did not improve or improved only slightly, 3 mm at best. However, proptosis in all but two has been stabilized and has not deteriorated in the follow-up period. Most of the patients have experienced an improvement of eye-muscle motility. Extraocular muscles that work for elevation were impaired more severely than the other muscles and this tended to remain. Of the 16 patients using steroids before or when radiotherapy was initiated, 15 were tapered off and only one patient required additional steroids, thus sparing the majority from steroid adverse reactions. Radiotherapy was effective in preventing exacerbations of active inflammatory ophthalmopathy in patients with Graves` disease with minimal morbidity and thus eliminated the adverse reactions associated with protracted corticosteroid use. The newly developed motility limitation index was useful in detecting delicate changes in motility of individual extraocular muscles. (author)

  20. Four and five dimensional radiotherapy with reference to prostate cancer - definitions, state of the art and further directions - an overview

    Energy Technology Data Exchange (ETDEWEB)

    Lennernaes, Bo (Dept. of Oncology, Sahlgrenska Hospital and Academy, Univ. of Gothenburg, Gothenburg (Sweden)), e-mail: bo.lennernas@telia.com; Castellanos, Enrique; Nilsson, Sten; Levitt, Seymour (Dept. of Oncology/Pathology, Karolinska Univ. Hospital and Institutet, Stockholm (Sweden))

    2011-06-15

    Radiotherapy (RT) always requires a compromise between tumor control and normal tissue side-effects. Technical innovation in radiation therapy (RT), such as three dimensional RT, is now established. Concerning prostate cancer (PC), it is reasonable to assume that RT of PC will increase in the future. The combination of small margins, a movable target (prostate), few fractions and high doses will probably demand dynamically positioning systems and in real time. This is called four dimensional radiotherapy (4DRT). Moreover, biological factors must be included in new treatments such as hypofractionation schedules. This new era is called five dimensional radiotherapy, 5DRT. In this paper we discuss new concepts in RT in respect to PC

  1. Transition from 2-D radiotherapy to 3-D conformal and intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    Cancer is one of the leading causes of death globally and radiotherapy is currently an essential component in the management of cancer patients, either alone or in combination with surgery or chemotherapy, both for cure or palliation. It is now recognized that safe and effective radiotherapy service needs not only substantial capital investment in radiotherapy equipment and specially designed facilities but also continuous investment in maintenance and upgrading of the equipment to comply with the technical progress, but also in training the staff. The recent IAEA-TECDOC publication 'Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects' provides general guidelines for designing and implementing radiotherapy services in Member States. Advances in computer technology have enabled the possibility of transitioning from basic 2- dimensional treatment planning and delivery (2-D radiotherapy) to a more sophisticated approach with 3-dimensional conformal radiotherapy (3-D CRT). Whereas 2-D radiotherapy can be applied with simple equipment, infrastructure and training, transfer to 3-D conformal treatments requires more resources in technology, equipment, staff and training. A novel radiation treatment approach using Intensity Modulated Radiation Therapy (IMRT) that optimizes the delivery of radiation to irregularly shaped tumour volumes demands even more sophisticated equipment and seamless teamwork, and consequentially more resources, advanced training and more time for treatment planning and verification of dose delivery than 3-D CRT. Whereas 3-D CRT can be considered as a standard, IMRT is still evolving. Due to the increased interest of Member States to the modern application of radiotherapy the IAEA has received a number of requests for guidance coming from radiotherapy departments that wish to upgrade their facilities to 3-D CRT and IMRT through Technical Cooperation programme. These requests are expected to increase

  2. Genetic indicators of radiotherapy normal tissue response

    International Nuclear Information System (INIS)

    Full text: The aims of this study are to identify a genetic signature for adverse normal tissue damage from clinical radiotherapy (RT) in breast cancer patients, and to characterize the differentially-regulated genes involved. We have chosen to use skin expression profiling for four main reasons; (1) skin is the tissue that expresses the damage and so is directly relevant to the investigation, (2) skin biopsies can be snap frozen to preserve and maintain the in vivo expression profile of the patient, (3) skin punch biopsies are minimally invasive which equates to a high participation rate from RT patients (4) radiosensitivity testing and similar assays of cultured cells have only a low correlation with clinical adverse reaction. We expect our molecular profiling approach will give insight into the inherent genetic status of the patient that has not been demonstrated in cellular assays. We have begun collecting and processing skin punch biopsies from unirradiated sites from informed, consenting patients with adverse (severe acute or late) reaction to the skin or subcutaneous tissue following a standard course of RT, and normal controls. We have profiled biopsies from 7 adverse normal tissue reaction patients and 4 controls. Analyses of this data has identified 202 differentially expressed genes (p<0.01) and a class prediction algorithm correctly identified as adverse reaction or normal reaction 6/7 (86%) of our test samples that it could predict. We plan to focus on the function of some of these genes to determine their biological and clinical relevance. This will include detailed analysis of several of the gene products in an effort to address why these genes are associated with clinical reaction and what signaling pathways are involved. We plan to expand our sample number to 50 severe normal tissue late reaction (RTOG Grade 3 or 4), 50 severe acute normal tissue reaction and 50 no late or acute reaction to RT (RTOG 0) patients. An expected outcome is to fabricate

  3. Care of patients undergoing external radiotherapy

    International Nuclear Information System (INIS)

    The anxiety and associated depression suffered by most patients undergoing radiotherapy is discussed and the possibilities open to the nurse to encourage and reassure patients thus facilitating physical care are considered. The general symptoms of anorexia, nausea, tiredness, skin problems, alopecia, bonemarrow depresssion and rapid tumour destruction are described and nursing care prescribed. The side-effects which may occur following radiation of the brain, head and neck region, eyes, oesophagus, lung, abdomen, pelvis, bones, skin, spine, and spinal cord are considered from the nursing standpoint. The specialised subject of radiotherapy in children is discussed briefly. (U.K.)

  4. Fatigue and radiotherapy. A literature review

    International Nuclear Information System (INIS)

    Fatigue is a common complaint for the cancer patient during and after radiotherapy, according to the published studies. Fatigue is a subjective symptom mostly underestimated by oncologists and other care givers. Etiology is complex, poorly understood in spite of obvious causes like insomnia, nausea, pain, depression, psychological distress, anemia, hypothyroidism, menopause disturbances, treatment adverse effects. Fatigue presents multi-factorial and multidimensional aspects. To evaluate it, many tools can be used as single-item, unidimensional and multidimensional instruments. Practically, the open discussion with the patient throughout radiotherapy is essential to define it. Taking charge fatigue requires its acknowledgement by radiotherapist, treatment of associated symptoms with a multidisciplinary approach. (authors)

  5. Radical radiotherapy for urinary bladder cancer

    DEFF Research Database (Denmark)

    Fokdal, Lars; von der Maase, Hans; Høyer, Morten

    2006-01-01

    The exact value of radiotherapy in the treatment of muscle-invasive       bladder cancer is difficult to establish, as most studies exploring this       issue are retrospective with different procedures for selecting patients       for treatment, as well as varying treatment strategies. An estimate...... of the       5-year overall survival rate following radiotherapy is approximately 35%       in consecutive-selected patients and approximately 25% in       negative-selected patients...

  6. Infantile hepatic hemangioendothelioma treated by radiotherapy

    International Nuclear Information System (INIS)

    Infantile hepatic hemangioendothelioma is a rare tumor of infancy, sometimes associated with cutaneous hemangiomatosis. It is clinically evident within the first six months after birth and can be life threatening because of heart failure, intraperitoneal hemorrhage or thrombocytopenia. In less severe forms spontaneous regression has been described. Current treatment may be surgical ligation of the hepatic artery, or pharmacological therapy with corticosteroids or radiotherapy. A 4-month infant is described, admitted with acute heart failure and huge hepatomegaly. Since a surgical approach was not possible and corticosteroid therapy failed to achieve the expected effect, radiotherapy was given with excellent results. (orig.)

  7. Some dosimetry problems in negative pion radiotherapy

    CERN Document Server

    Baarli, Johan

    1973-01-01

    Momentum beams of negative pions are considered for radiotherapy. It is shown that the measurement of dose in this respect presents problems which are different from those encountered when using the more usual type of radiation. This difference arises principally from the nuclear interaction processes produced when the negative pion comes to rest. These processes, which are superimposed on the Bragg peak of the beam, produce a complex mixture of charged particles together with a beam contamination of muons and electrons. Some experimental studies of depth dose distributions, dose estimates, and other parameters to be considered for radiotherapy of cancer with beams of negative pions are discussed.

  8. Second Study of Hyper-Fractionated Radiotherapy

    Directory of Open Access Journals (Sweden)

    R. Jacob

    1999-01-01

    Full Text Available Purpose and Method. Hyper-fractionated radiotherapy for treatment of soft tissue sarcomas is designed to deliver a higher total dose of radiation without an increase in late normal tissue damage. In a previous study at the Royal Marsden Hospital, a total dose of 75 Gy using twice daily 1.25 Gy fractions resulted in a higher incidence of late damage than conventional radiotherapy using 2 Gy daily fractions treating to a total of 60 Gy. The current trial therefore used a lower dose per fraction of 1.2 Gy and lower total dose of 72 Gy, with 60 fractions given over a period of 6 weeks.

  9. Radiotherapy-induced emesis. An overview

    Energy Technology Data Exchange (ETDEWEB)

    Feyer, P.; Buchali, A.; Hinkelbein, M.; Budach, V. [Department Radiotherapy, Humboldt-University Berlin (Germany); Zimmermann, J.S. [Department Radiotherapy, Christian Albrechts-University Kiel (Germany); Titlbach, O.J. [Department of Medicine I, Hospital Friedrichshain, Berlin (Germany)

    1998-11-01

    Background: A significant number of patients receiving radiotherapy experience the distressing side effects of emesis and nausea. These symptoms are some of the most distressing problems for the patients influencing their quality of life. Methods: International study results concerning radiotherapy-induced emesis are demonstrated. A German multicenter questionnaire examining the strategies to prevent or to treat radiotherapy-induced nausea and emesis is presented. An international analysis concerning incidence of emesis and nausea in fractionated radiotherapy patients is discussed. Finally the consensus of the consensus conference on antiemetic therapy from the Perugia International Cancer Conference V is introduced. Results: Untreated emesis can lead to complications like electrolyte disorders, dehydration, metabolic disturbances and nutrition problems with weight loss. Prophylactic antiemetics are often given to patients receiving single high-dose radiotherapy to the abdomen. A survey has revealed that antiemetic prophylaxis is not routinely offered to the patients receiving fractionated radiotherapy. However, there is a need for an effective treatment of emesis for use in this group of patients, too. In 20% of patients nausea and emesis can cause a treatment interruption because of an inadequate control of symptoms. Like in chemotherapy strategies there exist high, moderate, and low emetogenic treatment regimens in radiotherapy as well. The most emetogenic potential has the total body irradiation followed by radiotherapy to the abdomen. Radiotherapy induced emesis can be treated effectively with conventional antiemetics up to 50%. Conclusions: Studies with total body irradiation, fractionated treatment and high-dose single exposures have cleary demonstrated the value of 5-HT3-receptor antagonist antiemetics. There is a response between 60 and 97%. There is no difference in the efficacy of the different 5-HT3-antagonists. High-risk patients should be prophylactic

  10. The significance and impact of dosimetry audits in radiotherapy

    International Nuclear Information System (INIS)

    Overall, dosimetry audit has improved consistency in radiotherapy results and outcomes for patients and provided confidence to clinicians in the dosimetry supporting their practice. Its importance and impact is clearly recognised and its encouragement of and links to other wider radiotherapy audit has been significant. As it is estimated that a large number of the existing radiotherapy facilities world-wide have not yet participated in some level of independent external dose quality audit, the breadth of uptake of audit is to be encouraged. As the complexity of radiotherapy develops, the scope of what can be included in dosimetry and wider radiotherapy quality audits also needs to continue to increase

  11. The Significance and Impact of Dosimetry Audits in Radiotherapy

    International Nuclear Information System (INIS)

    Overall, dosimetry audit has improved consistency in radiotherapy results and outcomes for patients and provided confidence to clinicians in the dosimetry supporting their practice. Its importance and impact is clearly recognised and its encouragement of and links to other wider radiotherapy audit has been significant. As it is estimated that a large number of the existing radiotherapy facilities world-wide have not yet participated in some level of independent external dose quality audit, the breadth of uptake of audit is to be encouraged. As the complexity of radiotherapy develops, the scope of what can be included in dosimetry and wider radiotherapy quality audits also needs to continue to increase

  12. Advancements in radiotherapy for lung cancer in China

    Institute of Scientific and Technical Information of China (English)

    Lujun Zhao; Luhua Wang

    2015-01-01

    Lung cancer is the leading cause of death due to cancer in China. In recent years, great progress has been made in radiotherapy for lung cancer patients in China. The main advance-ments include the fol owing aspects:(1) stereotactic ablative radiotherapy for early stage non-smal cel lung cancer (NSCLC), (2) post-operative radiotherapy for NSCLC, (3) combined chemotherapy and radiotherapy for local y advanced NSCLC, (4) improved radiotherapy for advanced NSCLC, and 5) prediction of radiation-induced lung toxicity.

  13. A prospective study of urinary tract infection during pelvic radiotherapy

    International Nuclear Information System (INIS)

    The frequency of urinary tract infection before and during pelvic radiotherapy was studied prospectively in 172 patients who were not catherised and had not had instrumentation for at least 4 weeks prior to radiotherapy. The incidence of urinary tract infection prior to radiotherapy was 17% and a further 17% of patients develped a urinary tract infection during radiotherapy. Mid-stream specimens of urine (MSU) should be examined for infection on a weekly basis during pelvic radiotherapy not only to identify this additional 17% of patients but also to detect those patients who have persistent urinary tract infection in spite of treatment with appropriate antibiotics. (author). 6 refs.; 1 fig.; 4 tabs

  14. Film dosimetry in conformal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Danciu, C.; Proimos, B.S. [Patras Univ. (Greece). Dept. of Medical Physics

    1995-12-01

    Dosimetry, through a film sandwiched in a transverse cross-section of a solid phantom, is a method of choice in Conformal Radiotherapy because: (a) the blackness (density) of the film at each point offers a measure of the total dose received at that point, and (b) the film is easily calibrated by exposing a film strip in the same cross-section, through a stationary field. The film must therefore have the following properties: (a) it must be slow, in order not to be overexposed, even at a therapeutic dose of 200 cGy, and (b) the response of the film (density versus dose curve) must be independent of the photon energy spectrum. A few slow films were compared. It was found that the Kodak X-Omat V for therapy verification was the best choice. To investigate whether the film response was independent of the photon energy, response curves for six depths, starting from the depth of maximum dose to the depth of 25 cm, in solid phantom were derived. The vertical beam was perpendicular to the anterior surface of the phantom, which was at the distance of 100 cm from the source and the field was 15x15 cm at that distance. This procedure was repeated for photon beams emitted by a Cobalt-60 unit, two 6 MV and 15 MV Linear Accelerators, as well as a 45 MV Betatron. For each of those four different beams the film response was the same for all six depths. The results, as shown in the diagrams, are very satisfactory. The response curve under a geometry similar to that actually applied, when the film is irradiated in a transverse cross-section of the phantom, was derived. The horizontal beam was almost parallel (angle of 85) to the plane of the film. The same was repeated with the central ray parallel to the film (angle 90) and at a distance of 1.5 cm from the horizontal film. The field size was again 15x15 at the lateral entrance surface of the beam. The response curves remained the same, as when the beam was perpendicular to the films.

  15. Treatment results of radical radiotherapy of carcinoma uterine cervix using external beam radiotherapy and high dose rate intracavitary radiotherapy

    Directory of Open Access Journals (Sweden)

    Azad S

    2010-01-01

    Full Text Available Aim: To report the outcome of carcinoma cervix patients treated radically by external beam radiotherapy and high dose rate intracavitary radiotherapy. Material and Methods: From January 2005 to December 2006, a total of 709 newly diagnosed cases of carcinoma cervix were reported in our department. All cases were staged according to the International Federation of Gynecologist and Oncologist staging system. Out of 709 cases, 342 completed radical radiotherapy and were retrospectively analyzed for the presence of local residual disease, local recurrence, distant metastases, radiation reaction, and disease free survival. Results: There were 11(3.22%, 82(23.98%, 232(67.83%, and 17(4.97% patients in stages I, II, III, and IV, respectively. The median follow up time for all patients was 36 months (range 3 -54 months. The overall treatment time (OTT ranged from 52 to 69 days (median 58 days. The 3 year disease free survival rate was 81.8%, 70.7%, 40.08%, and 11.76% for stages I, II, III, and IV, respectively. There were 91 (26.6% cases with local residual diseases, 27(7.9% developed distant metastasis, and 18(5.26% pts had local recurrence. Discussion: The results of this study suggest that radical radiotherapy with HDR brachytherapy was appropriate for the treatment of early staged cancer of uterine cervix. For locally advanced cancer of cervix addition of concurrent chemotherapy, higher radiation doses, reduction of overall treatment time to less than 8 weeks, and use of latest radiotherapy techniques such as IMRT is recommended to improve the results.

  16. Dosimetric absorption of intensity-modulated radiotherapy compared with conventional radiotherapy in breast-conserving surgery

    OpenAIRE

    Lin, Yang; WANG, BENZHONG

    2014-01-01

    The aim of this study was to investigate the dosimetric benefits between intensity-modulated radiotherapy (IMRT) and conventional radiotherapy (CR) among patients receiving breast-conserving surgery. A dosimetric comparison of IMRT and CR was evaluated in 20 patients with early-stage breast cancer using a three-dimensional treatment planning system. The prescribed mammary gland dose was completed in 25 fractions with a total dose of 5,000 cGy. Homogeneity of the planning target volume (PTV), ...

  17. Similar Outcomes of Standard Radiotherapy and Hypofractionated Radiotherapy Following Breast-Conserving Surgery

    OpenAIRE

    Hou, Hai-Ling; Song, Yong-Chun; Li, Rui-Ying; Zhu, Li; Zhao, Lu-Jun; Yuan, Zhi-yong; You, Jin-Qiang; Chen, Zhong-Jie; Wang, Ping

    2015-01-01

    Background Adjuvant radiation therapy is commonly administered to breast cancer patients who received breast-conserving surgery. However, lengthy treatment times of standard radiotherapy pose certain challenges. Here, we performed a prospective controlled study comparing standard radiation to hypofractionated radiotherapy in terms of efficacy and outcome. Material/Methods Eighty breast cancer patients (tumor stage pT1-2N0-1M0) who had undergone breast-conservation surgery were randomly divide...

  18. Barriers to palliative radiotherapy referral: A Canadian perspective

    Energy Technology Data Exchange (ETDEWEB)

    Samant, Rajiv S.; Fitzgibbon, Edward; Meng, Joanne; Graham, Ian D. [Univ. of Ottawa. Ottawa, ON (Canada)

    2007-07-15

    Radiotherapy is an effective but underutilized treatment modality for cancer patients. We decided to investigate the factors influencing radiotherapy referral among family physicians in our region. A 30-item survey was developed to determine palliative radiotherapy knowledge and factors influencing referral. It was sent to 400 physicians in eastern Ontario (Canada) and the completed surveys were evaluated. The overall response rate was 50% with almost all physicians seeing cancer patients recently (97%) and the majority (80%) providing palliative care. Approximately 56% had referred patients for radiotherapy previously and 59% were aware of the regional community oncology program. Factors influencing radiotherapy referral included the following: waiting times for radiotherapy consultation and treatment, uncertainty about the benefits of radiotherapy, patient age, and perceived patient inconvenience. Physicians who referred patients for radiotherapy were more than likely to provide palliative care, work outside of urban centres, have hospital privileges and had sought advice from a radiation oncologist in the past. A variety of factors influence the referral of cancer patients for radiotherapy by family physicians and addressing issues such as long waiting times, lack of palliative radiotherapy knowledge and awareness of Cancer Centre services could increase the rate of appropriate radiotherapy patient referral.

  19. The Role of Radiotherapy in Acromegaly.

    Science.gov (United States)

    Hannon, Mark J; Barkan, Ariel L; Drake, William M

    2016-01-01

    Radiotherapy has, historically, played a central role in the management of acromegaly, and the last 30 years have seen substantial improvements in the technology used in the delivery of radiation therapy. More recently, the introduction of highly targeted radiotherapy, or 'radiosurgery', has further increased the therapeutic options available in the management of secretory pituitary tumors. Despite these developments, improvements in primary surgical outcomes, an increase in the range and effectiveness of medical therapy options, and long-term safety concerns have combined to dictate that, although still deployed in selected cases, the use of radiotherapy in the management of acromegaly has declined steadily over the past 2 decades. In this article, we review some of the main studies that have documented the efficacy of pituitary radiotherapy on growth hormone hypersecretion and summarize the data around its potential deleterious effects, including hypopituitarism, cranial nerve damage, and the development of radiation-related intracerebral tumors. We also give practical recommendations to guide its future use in patients with acromegaly, generally, as a third-line intervention after neurosurgical intervention in combination with various medical therapy options.

  20. Symptomatic vertebral hemangioma: Treatment with radiotherapy

    Directory of Open Access Journals (Sweden)

    Aich Ranen

    2010-01-01

    Full Text Available Background: Vertebrae are the second commonest site among skeletal locations affected by hemangioma, but only about one per cent becomes symptomatic throughout the life. Though surgery, intra vertebral injection of various sclerosing agents have been tried in treating this benign process, no general consensus regarding management has been reached. Radiotherapy is emerging as a low cost, simple, non-invasive but very effective modality of treatment of symptomatic vertebral hemangioma. Aim: This study aims to find out the role of external beam radiotherapy in alleviating the symptoms of symptomatic vertebral hemangiomas without compromising the quality of life. Materials and Methods: Seven consecutive patients with symptomatic vertebral hemangioma were treated with a fixed dose of external beam radiotherapy; and muscle power was assessed before, after treatment and during follow-up. Results: All patients showed improvement of muscle power, which increased with the passage of time. Pain relief with improvement of quality of life was obtained in all the patients. Conclusion: Effect of radiotherapy on vertebral hemangioma is dose-dependent and the dose limiting factor is the spinal cord tolerance. In the present era of IMRT, greater dose can be delivered to the parts of vertebra affected by the hemangioma without compromising the spinal cord tolerance and expected to give better results.

  1. Clinical research of teeth damage from radiotherapy

    International Nuclear Information System (INIS)

    Objective: To analyze various factors inducing teeth damage from radiotherapy and the preventive and treatment methods. Methods: One hundred cases of patients treated by radiotherapy were divided into two groups. In group one there were 60 cases whose teeth were irradiated during treatment; in group two there were 40 cases whose teeth were not irradiated during treatment. Results: The caries incidence was 60% for group one and 15% for group two (P<0.01). By auto-control in 15 patients, the caries incidence on the sick side was obviously higher than that of the healthy side. Hundred percent caries incidence was found in 6 cases who received a dosage of 70 Gy. Conclusion: The authors believe that radiation damage to the teeth is associated with the following factors: 1. The dosage and location of irradiation are closely related to caries incidence; 2. The active dentinoblasts are very sensitive to radiation; 3. Damage to the salivary glands from radiotherapy can result in reduction of salvia and pH value, leading to a high growth rate of Streptococcus mutans. Following preventive measures could be considered in future cases: to apply a caries prevention coating or protective dental crown and TPS, to adjust the dose and time of irradiation, to select conformal radiotherapy technique. The key points for protecting the teeth and salivary gland from caries and damage are protection of the proliferation ability of pulp cells, anti-inflammation, promotion of microcirculation, and strengthening body resistance

  2. Morbidity after ipsilateral radiotherapy for oropharyngeal cancer

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Overgaard, Marie; Grau, Cai

    2007-01-01

    INTRODUCTION: Radiotherapy for oropharyngeal cancer often causes severe side effects. If the primary tumour is localized to the tonsillar region, elective irradiation may be limited to the ipsilateral neck, sparring the contralateral normal tissues. We wanted to study the consequences of volume...

  3. Post-external radiotherapy hypothyroidism: 15 cases

    International Nuclear Information System (INIS)

    Post-external radiotherapy hypothyroidism: 15 cases. Hypothyroidism frequency is estimated to be between 10 and 45% after radiotherapy alone, and 40 to 67% after radiotherapy associated with thyroidectomy. This hypothyroidism is infra-clinical in 60% of the cases. Our study concerned 15 cases of hypothyroidism after external radiotherapy delivered between and 1991 and 1999. An irradiation of the cervical, cerebral and thorax regions was indicated for different types of cancers. Larynx carcinoma epidermoid was the most frequent cancer (seven cases); the radiation treatment used cobalt 60 with conventional fractionation, i.e., 2 Gy per treatment, five treatments a week. In nine cases, the hypothyroidism was discovered during a systematic examination; it was clinically evident in the six remaining cases. Hypothyroidism appeared after an irradiation dose average of 50 Gy (extremes 30-65 Gy). The average duration of the irradiation was about 7 weeks and the hypothyroidism appeared in a mean 22 months. In all cases, the substituting treatment was initiated with a favorable progression. Faced with the risk of hypothyroidism, it is necessary to check patients who have undergone external irradiation of the neck. (authors)

  4. Radiotherapy for prostate cancer and sexual health

    NARCIS (Netherlands)

    L. Incrocci (Luca)

    2015-01-01

    textabstractSexual dysfunction is very common after treatment of prostate cancer. Radiation therapy together with radical prostatectomy is the most effective treatment for localized disease. Percentages of erectile dysfunction (ED) reported in prospective studies after external-beam radiotherapy (RT

  5. Tumour-host dynamics under radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Placeres Jimenez, Rolando, E-mail: rpjcu@yahoo.com [Departamento de Fi' sica, Universidade Federal de Sao Carlos, Sao Carlos - SP (Brazil); Ortiz Hernandez, Eloy [Centre of Medicine and Complexity, Medical University Carlos J. Finlay, Carretera Central s/n, Camagueey (Cuba)

    2011-09-15

    Highlight: > Tumour-host interaction is modelled by Lotka-Volterra equations. > A brief review of the motion integral and analysis of linear stability is presented. > Radiotherapy is introduced into the model, using a periodic Dirac delta function. > A two-dimensional logistic map is derived from the modified Lotka-Volterra model. > It is shown that tumour can be controlled by a correct selection of therapy strategy. - Abstract: Tumour-host interaction is modelled by the Lotka-Volterra equations. Qualitative analysis and simulations show that this model reproduces all known states of development for tumours. Radiotherapy effect is introduced into the model by means of the linear-quadratic model and the periodic Dirac delta function. The evolution of the system under the action of radiotherapy is simulated and parameter space is obtained, from which certain threshold of effectiveness values for the frequency and applied doses are derived. A two-dimensional logistic map is derived from the modified Lotka-Volterra model and used to simulate the effectiveness of radiotherapy in different regimens of tumour development. The results show the possibility of achieving a successful treatment in each individual case by employing the correct therapeutic strategy.

  6. Clinical results in heavy particle radiotherapy

    International Nuclear Information System (INIS)

    The chapter presents an overview of the use of heavy particles in human cancer radiotherapy. The biophysical characteristics and rationale for using heavy charged particle therapy are explored. The clinical experience with carbon, neon, argon and helium are summarized for various types of tumors including carcinomas of the uterine cervix and lung, skin melanomas and metastatic sarcomas. No obvious normal tissue complications have appeared

  7. Magnetic resonance imaging in radiotherapy treatment planning

    NARCIS (Netherlands)

    Moerland, Marinus Adriaan

    2001-01-01

    From its inception in the early 1970's up to the present, magnetic resonance imaging (MRI) has evolved into a sophisticated technique, which has aroused considerable interest in var- ious subelds of medicine including radiotherapy. MRI is capable of imaging in any plane and does not use ionizing rad

  8. Prostate cancer radiotherapy 2002: the way forward.

    Science.gov (United States)

    Lukka, Himu; Pickles, Tom; Morton, Gerard; Catton, Charles; Souhami, Luis; Warde, Padraig

    2005-02-01

    In November 2000, the GU Radiation Oncologists of Canada had their first meeting, "Controversies in prostate cancer radiotherapy: consensus development". The success of this meeting prompted a second meeting, held in December 2002 to discuss "The Way Forward" in prostate radiotherapy. Radiation oncologists from across Canada were brought together and integrated with key opinion leaders in prostate cancer treatment from throughout North America. The group debated current controversies including: intensity modulated radiotherapy (IMRT), external beam hypofractionation, high dose-rate brachytherapy, and hormone therapy in the management of prostate cancer. The meeting also sought to identify and prioritize clinical trial opportunities and to highlight steps required to achieve these research goals. In summary, advances involving IMRT have enabled the use of higher radiation doses without increasing morbidity. With renewed interest in hypofractionated radiation schedules, the value of hypofractionation using IMRT was discussed and initial results from ongoing clinical trials were presented. The emerging role for high dose-rate brachytherapy in higher risk patients was also discussed. Based on existing preliminary evidence the group expressed enthusiasm for further investigation of the role for brachytherapy in intermediate to high-risk patients. Despite significant advances in radiotherapy, hormone therapy continues to play an important role in prostate cancer treatment for patients with intermediate and high-risk disease. Although evidence supports the effectiveness of hormone therapy, the optimal timing, and duration of hormonal treatment are unclear. Results from ongoing clinical trials will provide insight into these questions and will assist in the design of future clinical trials.

  9. The IAEA Quality Audits for Radiotherapy

    International Nuclear Information System (INIS)

    The IAEA/WHO thermoluminescent dosimetry (TLD) postal dose audit programme has been used for over 8000 radiotherapy beams throughout the world in over four decades of its operation. Records have been kept of the results of TLD audits since the inception of the programme. Analysis of these data has yielded much interesting information. In the early years, the TLD service recorded approximately 50% audited beams having adequate calibration. This percentage of acceptable results has now increased to 96%. Obviously, regular participation in dosimetry audit stimulates an improvement in dosimetry practices in radiation therapy in many hospitals worldwide. Another dosimetry audit programme for treatment planning (TPS audit) in external beam radiotherapy, which has been developed by the IAEA, assesses the radiotherapy workflow for conformal techniques, from patient data acquisition and computerized treatment planning to dose delivery. The IAEA supports national and subregional TPS audit activities to improve the quality and safety of dose calculation in radiotherapy. The third audit modality operated by the IAEA within the framework of the Quality Assurance Team for Radiation Oncology (QUATRO) is a comprehensive audit that reviews radiation oncology practices with the aim to improve quality. To date, over 50 QUATRO audits have been organized by the IAEA in radiation oncology centres in Europe, Africa, Asia and Latin America. QUATRO audits indicate and document areas for improvement and provide advice for further development of the audited centres. (author)

  10. Simple dose verification system for radiotherapy radiation

    International Nuclear Information System (INIS)

    The aim of this paper is to investigate an accurate and convenient quality assurance programme that should be included in the dosimetry system of the radiotherapy level radiation. We designed a mailed solid phantom and used TLD-100 chips and a Rexon UL320 reader for the purpose of dosimetry quality assurance in Taiwanese radiotherapy centers. After being assembled, the solid polystyrene phantom weighted only 375 g which was suitable for mailing. The Monte Carlo BEAMnrc code was applied in calculations of the dose conversion factor of water and polystyrene phantom: the dose conversion factor measurements were obtained by switching the TLDs at the same calibration depth of water and the solid phantom to measure the absorbed dose and verify the accuracy of the theoretical calculation results. The experimental results showed that the dose conversion factors from TLD measurements and the calculation values from the BEAMnrc were in good agreement with a difference within 0.5%. Ten radiotherapy centers were instructed to deliver to the TLDs on central beam axis absorbed dose of 2 Gy. The measured doses were compared with the planned ones. A total of 21 beams were checked. The dose verification differences under reference conditions for 60Co, high energy X-rays of 6, 10 and 15 MV were truly within 4% and that proved the feasibility of applying the method suggested in this work in radiotherapy dose verification

  11. Radiotherapy applied to tumours of the intracranial central nervous systems in the dog

    International Nuclear Information System (INIS)

    As domestic animals such as dogs are living older because of a better life quality and better cares, they may more frequently develop tumours in their intracranial central nervous system. In this research thesis, the author addresses this specific topic. He first recalls fundamental physical and biological aspects for the understanding of radiotherapy action mechanisms, and the modalities of such a treatment. He addresses the general study of intracranial central nervous system tumours in dogs: brief recall on anatomic and histological aspects, presentation of their classification and their prevalence, and precise descriptions of their characteristics. In the third part, the author reports clinical and para-clinical data which allow the diagnosis of an intracranial nervous tissue tumour. The last part presents different available therapeutic modalities, more particularly addresses the interest of radiotherapy in neuro-oncology, and compares published results

  12. Pre-clinical research in small animals using radiotherapy technology. A bidirectional translational approach

    International Nuclear Information System (INIS)

    For translational cancer research, pre-clinical in-vivo studies using small animals have become indispensable in bridging the gap between in-vitro cell experiments and clinical implementation. When setting up such small animal experiments, various biological, technical and methodical aspects have to be considered. In this work we present a comprehensive topical review based on relevant publications on irradiation techniques used for pre-clinical cancer research in mice and rats. Clinical radiotherapy treatment devices for the application of external beam radiotherapy and brachytherapy as well as dedicated research irradiation devices are feasible for small animal irradiation depending on the animal model and the experimental goals. In this work, appropriate solutions for the technological transfer of human radiation oncology to small animal radiation research are summarised. Additionally, important information concerning the experimental design is provided such that reliable and clinically relevant results can be attained.

  13. Post-radiotherapy locoregional recurrence of hyalinizing clear cell carcinoma of palate

    Directory of Open Access Journals (Sweden)

    Sonia Gon

    2013-01-01

    Full Text Available Clear cell carcinoma of the salivary glands is a rare tumor that represents less than 1% of all salivary tumors and is a new disease that is only recognized in recent years. It is rare and the standard treatment is still under investigation. This tumor often follows an indolent course and treatment includes wide surgical excision with or without adjuvant radiotherapy. Recurrence of the hyalinizing clear cell carcinoma (HCCC after complete surgical resection is uncommonly documented. We hereby report a case of post-radiotherapy locoregional recurrence of HCCC of the palate and recommend further clinicopathological study and long-term follow-up to document the biological behavior of this entity along with highlighting the role of special stains and immunohistochemistry in its diagnosis.

  14. Radiotherapy for the primary ocular adnexal lymphoma

    International Nuclear Information System (INIS)

    Objective: To study the pathological and clinical characteristics of primary lymphoma of ocular adnexae, analyze the treatment results and discuss the methods to prevent radiation complications. Methods: From Feb. 1995 to Feb. 2004, 25 patients with primary ocular adnexal lymphoma were treated in the second hospital and the forth hospital of Xuzhou, including 11 males and 14 females. The diagnosis was confirmed pathologically by biopsy in 19 patients and lumpectomy in 6 patients, including 22 mucosa-associated lymphoid tissue (MALT) lymphoma and 3 non-MALT lymphoma. According to the Ann Arbor Staging System, there were 21 patients with tumor in stage I E, 3 in stage II E and 1 in stage III E. The primary tumor was found in the eyelid or conjunctiva in 19 eyes and orbit in 9 eyes. Radiotherapy were given to 22 patients (25 eyes) by deep X-rays, 60Co γ-rays or mixed beams. The total irradiation dose ranged from 30.0 to 57.6 Gy. Kaplan-Meier method was used to calculate the survival rate and Logrank test was used to detect the difference between the different groups. Results: The 5-, 10-year accumulated survival rates (SR) of the whole group were 90% and 82%. The 10-year SR of patients with primary, eyelid or conjunctiva tumor and orbit tumor were 100% and 58% (P=0.032). The local control rates of the radiotherapy group and non-radiotherapy group were 92% and 33 % (P=0.006). The 10-year SR of patients with tumor completely removed and those with residues were 83% and 82% (P=0.907). The 10-year SR of MALT lymphoma and non-MALT lymphoma were 90.0% and 33.3% (P=0.009). After radiotherapy, 8 eyes (36%) had cataract formation and 7 eyes (28%) had xerophalmic symptoms. Conclusions: The results of radiothera- py for the primary ocular adnexal lymphoma are satisactory. The prognosis of patients with primary, eyelid or conjunctiva tumor is better than those with orbit tumor. The vast majority of the primary ocular adnexal lymphomas are MALT lymphomas. The survival rate of

  15. Randomised phase I/II study to evaluate carbon ion radiotherapy versus fractionated stereotactic radiotherapy in patients with recurrent or progressive gliomas: The CINDERELLA trial

    Directory of Open Access Journals (Sweden)

    Haselmann Renate

    2010-10-01

    Full Text Available Abstract Background Treatment of patients with recurrent glioma includes neurosurgical resection, chemotherapy, or radiation therapy. In most cases, a full course of radiotherapy has been applied after primary diagnosis, therefore application of re-irradiation has to be applied cauteously. With modern precision photon techniques such as fractionated stereotactic radiotherapy (FSRT, a second course of radiotherapy is safe and effective and leads to survival times of 22, 16 and 8 months for recurrent WHO grade II, III and IV gliomas. Carbon ions offer physical and biological characteristics. Due to their inverted dose profile and the high local dose deposition within the Bragg peak precise dose application and sparing of normal tissue is possible. Moreover, in comparison to photons, carbon ions offer an increased relative biological effectiveness (RBE, which can be calculated between 2 and 5 depending on the GBM cell line as well as the endpoint analyzed. Protons, however, offer an RBE which is comparable to photons. First Japanese Data on the evaluation of carbon ion radiation therapy for the treatment of primary high-grade gliomas showed promising results in a small and heterogeneous patient collective. Methods Design In the current Phase I/II-CINDERELLA-trial re-irradiation using carbon ions will be compared to FSRT applied to the area of contrast enhancement representing high-grade tumor areas in patients with recurrent gliomas. Within the Phase I Part of the trial, the Recommended Dose (RD of carbon ion radiotherapy will be determined in a dose escalation scheme. In the subsequent randomized Phase II part, the RD will be evaluated in the experimental arm, compared to the standard arm, FSRT with a total dose of 36 Gy in single doses of 2 Gy. Primary endpoint of the Phase I part is toxicity. Primary endpoint of the randomized part II is survival after re-irradiation at 12 months, secondary endpoint is progression-free survival. Discussion The

  16. Radiotherapy for cutaneous cancers with xeroderma pigmentosum

    International Nuclear Information System (INIS)

    Purpose. - To analyze the therapeutic results of cutaneous cancers on xeroderma pigmentosum through a series of 15 patients treated by radiotherapy. Patients and methods. - Between 1993 and 2006, 15 patients with xeroderma pigmentosum and having cutaneous cancers were treated in the Radiotherapy Department of university hospital Habib-Bourguiba of Sfax in Tunisia. Seventy-three percent of the cases occurred in male patients and the mean age of appearance of the first tumour was 18.2 years. Tumour histology was squamous cell carcinoma in 74% of the cases. The total number of cutaneous tumours was 84. Ten patients had a surgical resection. Four patients did not respond to chemotherapy. The modality of irradiation was decided according to the size, thickness and localization of the tumour. The dose of radiotherapy was 60 Gy or equivalent with classic irradiation. Results. - The total number of lesions treated with radiotherapy was 64. Forty-three lesions were treated with contact-therapy, ten with brachytherapy and 11 with cobalt-therapy. The following acute complications were observed: cutaneous infection (53.3% of patients), radio-epithelitis (80% of patients) and necroses (33.3% of patients). Evaluation after treatment showed a clinical complete remission in 73% of the cases. Late effects were noted in seven cases: telangiectasia and cutaneous atrophy. A recurrence in the irradiated zone was observed in one case. A nodal metastasis was observed in two cases. Another patient presented lung metastases. After a median follow up of 37.2 months, four patients died, seven are alive with cutaneous cancer and four are alive with complete remission. Conclusion. - Radiotherapy is a possible and effective therapeutic alternative. Dose and methods are not defined for xeroderma pigmentosum. (authors)

  17. Radical radiotherapy for T3 laryngeal cancers

    Energy Technology Data Exchange (ETDEWEB)

    Uno, T. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Itami, J. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Kotaka, K. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Toriyama, M. [International Medical Center of Japan, Tokyo (Japan). Dept. of Otolaryngology

    1996-08-01

    From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage. Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respecitvely. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy. (orig.) [Deutsch] Von 1974 bis 1992 wurden 37 zuvor nicht behandelte Patienten mit T3-Larynxkarzinomen (15 supraglottisch, 22 glottisch) primaer kurativ bestrahlt und, wenn erforderlich, einer Salvage-Operation unterzogen. Die Zwei-Jahres-Kontrollrate bei alleiniger Strahlentherapie, die Rate der Stimmerhaltung sowie die unter Einschluss der Operation erreichbare lokale Kontrollrate bei supraglottischen T3-Larynxkarzinomen betrugen 33%, 33% und 60%. Bei glottischen T3-Karzinomen wurden jeweils 32%, 23% und 77% erreicht. Die Fuenf-Jahres-Ueberlebensrate betrug 47% bei supraglottischen T3-Karzinomen und 77% bei den glottischen Karzinomen. Im Fall von supraglottischen Karzinomen erreichte keiner der vier Patienten mit subglottischer Tumorausdehnung eine lokale Kontrolle durch alleinige Strahlentherapie. Die lokoregionale rezidivfreie Zeit war bei den Patienten mit subglottischer Tumorausdehnung oder Tracheostomie vor Einleitung der

  18. Experimental and clinical studies with intraoperative radiotherapy

    International Nuclear Information System (INIS)

    Studies of normal tissue tolerance to intraoperative radiotherapy were done upon 65 dogs subjected to laparotomy and 11 million electron volt electron irradiation in doses ranging from zero to 5,000 rads. Results of studies indicated that intact aorta and vena cava tolerate up to 5,000 rads without loss of structural integrity. Ureteral fibrosis and stenosis develop at doses of 3,000 rads or more. Arterial anastomoses heal after doses of 4,500 rads, but fibrosis can lead to occlusion. Intestinal suture lines heal after doses of 4,500 rads. Bile duct fibrosis and stenosis develop at doses of 2,000 rads or more. Biliary-enteric anastomoses fail to heal at any dose level. A clinical trial of intraoperative radiotherapy combined with radical surgery was performed upon 20 patients with advanced malignant tumors which were considered unlikely to be cured by conventional therapies and which included carcinomas of the stomach, carcinomas of the pancreas, carcinomas involving the hilus of the liver, retroperitoneal sarcomas and osteosarcomas of the pelvis. All patients underwent resection of gross tumor, followed by intraoperative irradiation of the tumor bed and regional nodal basins. Some patients received additional postoperative external beam radiotherapy. Treatment mortality for combined operation and radiotherapy occurred in four of 20 patients. Postoperative complications occurred in four of the 16 surviving patients. Local tumor control was achieved in 11 of the 16 surviving patients, with an over-all median follow-up period of 18 months. The clinical trial suggested that intraoperative radiotherapy is a feasible adjunct to resection in locally advanced tumors, that the resulting mortality and morbidity is similar to that expected from operation alone and that local tumor control may be improved

  19. Reirradiation Human Spinal Cord Tolerance for Stereotactic Body Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sahgal, Arjun, E-mail: Arjun.sahgal@rmp.uhn.on.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Princess Margaret Hospital, University of Toronto, Toronto (Canada); Ma, Lijun [Department of Radiation Oncology, University of California San Francisco, San Francisco, CA (United States); Weinberg, Vivian [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, CA (United States); Gibbs, Iris C. [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Chao, Sam [Departments of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Chang, Ung-Kyu [Department of Neurosurgery, Korea Institute of Radiation and Medical Science, Seoul (Korea, Republic of); Werner-Wasik, Maria [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Angelov, Liliyanna [Departments of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Chang, Eric L. [Department of Radiation Oncology, M.D. Anderson Cancer Center, University of Texas, Houston, TX (United States); Sohn, Moon-Jun [Department of Neurosurgery, Inje University, Seoul (Korea, Republic of); Soltys, Scott G. [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Letourneau, Daniel [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto (Canada); Ryu, Sam [Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI (United States); Gerszten, Peter C. [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA (United States); Fowler, Jack [Departments of Human Oncology and Medical Physics, University of Wisconsin, WI (United States); Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto (Canada); and others

    2012-01-01

    Purpose: We reviewed the treatment for patients with spine metastases who initially received conventional external beam radiation (EBRT) and were reirradiated with 1-5 fractions of stereotactic body radiotherapy (SBRT) who did or did not subsequently develop radiation myelopathy (RM). Methods and Materials: Spinal cord dose-volume histograms (DVHs) for 5 RM patients (5 spinal segments) and 14 no-RM patients (16 spine segments) were based on thecal sac contours at retreatment. Dose to a point within the thecal sac that receives the maximum dose (P{sub max}), and doses to 0.1-, 1.0-, and 2.0-cc volumes within the thecal sac were reviewed. The biologically effective doses (BED) using {alpha}/{beta} = 2 Gy for late spinal cord toxicity were calculated and normalized to a 2-Gy equivalent dose (nBED = Gy{sub 2/2}). Results: The initial conventional radiotherapy nBED ranged from {approx}30 to 50 Gy{sub 2/2} (median {approx}40 Gy{sub 2/2}). The SBRT reirradiation thecal sac mean P{sub max} nBED in the no-RM group was 20.0 Gy{sub 2/2} (95% confidence interval [CI], 10.8-29.2), which was significantly lower than the corresponding 67.4 Gy{sub 2/2} (95% CI, 51.0-83.9) in the RM group. The mean total P{sub max} nBED in the no-RM group was 62.3 Gy{sub 2/2} (95% CI, 50.3-74.3), which was significantly lower than the corresponding 105.8 Gy{sub 2/2} (95% CI, 84.3-127.4) in the RM group. The fraction of the total P{sub max} nBED accounted for by the SBRT P{sub max} nBED for the RM patients ranged from 0.54 to 0.78 and that for the no-RM patients ranged from 0.04 to 0.53. Conclusions: SBRT given at least 5 months after conventional palliative radiotherapy with a reirradiation thecal sac P{sub max} nBED of 20-25 Gy{sub 2/2} appears to be safe provided the total P{sub max} nBED does not exceed approximately 70 Gy{sub 2/2}, and the SBRT thecal sac P{sub max} nBED comprises no more than approximately 50% of the total nBED.

  20. Reirradiation Human Spinal Cord Tolerance for Stereotactic Body Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: We reviewed the treatment for patients with spine metastases who initially received conventional external beam radiation (EBRT) and were reirradiated with 1–5 fractions of stereotactic body radiotherapy (SBRT) who did or did not subsequently develop radiation myelopathy (RM). Methods and Materials: Spinal cord dose–volume histograms (DVHs) for 5 RM patients (5 spinal segments) and 14 no-RM patients (16 spine segments) were based on thecal sac contours at retreatment. Dose to a point within the thecal sac that receives the maximum dose (Pmax), and doses to 0.1-, 1.0-, and 2.0-cc volumes within the thecal sac were reviewed. The biologically effective doses (BED) using α/β = 2 Gy for late spinal cord toxicity were calculated and normalized to a 2-Gy equivalent dose (nBED = Gy2/2). Results: The initial conventional radiotherapy nBED ranged from ∼30 to 50 Gy2/2 (median ∼40 Gy2/2). The SBRT reirradiation thecal sac mean Pmax nBED in the no-RM group was 20.0 Gy2/2 (95% confidence interval [CI], 10.8–29.2), which was significantly lower than the corresponding 67.4 Gy2/2 (95% CI, 51.0–83.9) in the RM group. The mean total Pmax nBED in the no-RM group was 62.3 Gy2/2 (95% CI, 50.3–74.3), which was significantly lower than the corresponding 105.8 Gy2/2 (95% CI, 84.3–127.4) in the RM group. The fraction of the total Pmax nBED accounted for by the SBRT Pmax nBED for the RM patients ranged from 0.54 to 0.78 and that for the no-RM patients ranged from 0.04 to 0.53. Conclusions: SBRT given at least 5 months after conventional palliative radiotherapy with a reirradiation thecal sac Pmax nBED of 20–25 Gy2/2 appears to be safe provided the total Pmax nBED does not exceed approximately 70 Gy2/2, and the SBRT thecal sac Pmax nBED comprises no more than approximately 50% of the total nBED.

  1. Computer simulation of tumour growth and cellular phase distribution prior to radiotherapy

    International Nuclear Information System (INIS)

    Full text: A study into the optimal fractionation and schedule in combined chemo-radiotherapy for head and neck cancer has imposed the development of a computer model of tumour growth. The model is based on biological parameters, and characterises tumour growth and eventual tumour regression when chemo-radiotherapy is used. Tumour growth starting from a single stem cell is modelled using the Monte Carlo method. The type of the cell function, their relative proportions on mitosis, their proliferative capacity, the duration of the four phases of the cell cycle, the mean cell cycle time, and the cell loss due to natural causes are the main parameters of the basic model. A Gaussian distribution function operates in establishing the cell cycle time, with a mean value of 26 hours, while the cell type is sampled from a uniform distribution. With the established model, the sensitivity of the developed tumour's cell population to the stem, proliferative and non proliferative ratio at mitosis was assessed. The present model accurately reflects the exponential distribution of cells along the cell cycle (70% cells in G1 phase, 15% in S, 10% in G2, 5% in M) of a developed tumour as described in the literature. The proportion of stem, finitely proliferating and resting cells during tumour growth is maintained within their biological limits (2% stem. 23% finitely proliferating, 75% nonproliferating cells). The ratio (R=3) between the time necessary to develop a clinically detectable tumour (109 cells) and the time to grow to its lethal size (1012 cells) is in accordance with the biological data when tumour volume is compared for the two periods (30 doublings and 10 doublings respectively). Computer simulation can illustrate the biological growth of a tumour and the cell distribution along the cell cycle. These distributions may than be used in the assessment of tumour response to radiotherapy and to specific chemotherapeutic agents. Copyright (2001) Australasian College of

  2. Combining Targeted Agents With Modern Radiotherapy in Soft Tissue Sarcomas

    Science.gov (United States)

    Wong, Philip; Houghton, Peter; Kirsch, David G.; Finkelstein, Steven E.; Monjazeb, Arta M.; Xu-Welliver, Meng; Dicker, Adam P.; Ahmed, Mansoor; Vikram, Bhadrasain; Teicher, Beverly A.; Coleman, C. Norman; Machtay, Mitchell; Curran, Walter J.

    2014-01-01

    Improved understanding of soft-tissue sarcoma (STS) biology has led to better distinction and subtyping of these diseases with the hope of exploiting the molecular characteristics of each subtype to develop appropriately targeted treatment regimens. In the care of patients with extremity STS, adjunctive radiation therapy (RT) is used to facilitate limb and function, preserving surgeries while maintaining five-year local control above 85%. In contrast, for STS originating from nonextremity anatomical sites, the rate of local recurrence is much higher (five-year local control is approximately 50%) and a major cause of death and morbidity in these patients. Incorporating novel technological advancements to administer accurate RT in combination with novel radiosensitizing agents could potentially improve local control and overall survival. RT efficacy in STS can be increased by modulating biological pathways such as angiogenesis, cell cycle regulation, cell survival signaling, and cancer-host immune interactions. Previous experiences, advancements, ongoing research, and current clinical trials combining RT with agents modulating one or more of the above pathways are reviewed. The standard clinical management of patients with STS with pretreatment biopsy, neoadjuvant treatment, and primary surgery provides an opportune disease model for interrogating translational hypotheses. The purpose of this review is to outline a strategic vision for clinical translation of preclinical findings and to identify appropriate targeted agents to combine with radiotherapy in the treatment of STS from different sites and/or different histology subtypes. PMID:25326640

  3. Technical advances in external radiotherapy for hepatocellular carcinoma.

    Science.gov (United States)

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

    2016-08-28

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

  4. Overview of radiotherapy resources in Beijing in 2010

    International Nuclear Information System (INIS)

    Objective: To investigate and analyze the resources of radiotherapy in Beijing, in order to provide reference for the subject development, resources allocation and professional training of radiotherapy. Methods: A questionnaire survey was conducted by on-site inspection, supplemented by telephone or e-mail investigation among the 33 hospitals with radiotherapy facilities to know the current status of distribution of radiotherapy institutions, radiotherapy facilities, human resources and number of patients treated. Results: There were 52 linear accelerators, 1 spiral CT machine, and 2 intraoperative radiotherapy machines in these 33 hospitals up to June 2010. Three-dimensional conformal or stereotactic radiotherapy was carried out in 31 hospitals, intensity modulated radiation therapy (IMRT) in 19, image guided radiation therapy (IGRT) in 6, and volumetric modulated arc therapy (VMRT) in 2. The number of professional personnel (except nurses) was 495, including 214 radiation oncologists, 78 radiotherapy physicists, and 203 radiotherapy technologists, and those with senior professional titles accounted for 52.3%, 17.9%, and 1.5%, respectively. Conclusions: Compared to the national level, the radiotherapy resources level is higher in Beijing, but the distribution of resources is imbalanced. The resource allocation should be optimized and training of the personnel should be strengthened so as to meet the growing needs of patients. (authors)

  5. Technical advances in external radiotherapy for hepatocellular carcinoma

    Science.gov (United States)

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

    2016-01-01

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

  6. Biological computation

    CERN Document Server

    Lamm, Ehud

    2011-01-01

    Introduction and Biological BackgroundBiological ComputationThe Influence of Biology on Mathematics-Historical ExamplesBiological IntroductionModels and Simulations Cellular Automata Biological BackgroundThe Game of Life General Definition of Cellular Automata One-Dimensional AutomataExamples of Cellular AutomataComparison with a Continuous Mathematical Model Computational UniversalitySelf-Replication Pseudo Code Evolutionary ComputationEvolutionary Biology and Evolutionary ComputationGenetic AlgorithmsExample ApplicationsAnalysis of the Behavior of Genetic AlgorithmsLamarckian Evolution Genet

  7. Evaluation of novel radiotherapy technologies: what evidence is needed to assess their clinical and cost effectiveness, and how should we get it?

    Science.gov (United States)

    van Loon, Judith; Grutters, Janneke; Macbeth, Fergus

    2012-04-01

    Technical innovations in radiation oncology--eg, intensity-modulated radiotherapy, stereotactic radiotherapy, and particle therapy--can be developed rapidly and introduced into the clinic even when costs associated with their use are much higher than those for conventional radiotherapy. Although clinical benefit is expected on the basis of superior biological and physical characteristics, data for clinical effectiveness of new radiotherapy techniques are scarce. Evidence from randomised clinical trials would be ideal but such studies focus mostly on new drugs. High investment costs and modifications over time make evaluation of novel radiotherapy technologies in clinical trials more complex. Here, we propose an algorithm for evaluation of the clinical and cost effectiveness of novel radiotherapy technologies. We suggest situations when randomised trials might be feasible and the type of trial that should be undertaken when they are not. Furthermore, we discuss the usefulness of dose-distribution models for estimation of expected clinical benefit and for selection of the patients' population with the highest expected benefit. Economic modelling, including the approach of real options analysis, can inform whether implementation of a technology should begin (based on available evidence) or be delayed (until further data are available), and it can indicate the best trial design and required sample size. PMID:22469127

  8. Evaluation of novel radiotherapy technologies: what evidence is needed to assess their clinical and cost effectiveness, and how should we get it?

    Science.gov (United States)

    van Loon, Judith; Grutters, Janneke; Macbeth, Fergus

    2012-04-01

    Technical innovations in radiation oncology--eg, intensity-modulated radiotherapy, stereotactic radiotherapy, and particle therapy--can be developed rapidly and introduced into the clinic even when costs associated with their use are much higher than those for conventional radiotherapy. Although clinical benefit is expected on the basis of superior biological and physical characteristics, data for clinical effectiveness of new radiotherapy techniques are scarce. Evidence from randomised clinical trials would be ideal but such studies focus mostly on new drugs. High investment costs and modifications over time make evaluation of novel radiotherapy technologies in clinical trials more complex. Here, we propose an algorithm for evaluation of the clinical and cost effectiveness of novel radiotherapy technologies. We suggest situations when randomised trials might be feasible and the type of trial that should be undertaken when they are not. Furthermore, we discuss the usefulness of dose-distribution models for estimation of expected clinical benefit and for selection of the patients' population with the highest expected benefit. Economic modelling, including the approach of real options analysis, can inform whether implementation of a technology should begin (based on available evidence) or be delayed (until further data are available), and it can indicate the best trial design and required sample size.

  9. European Society for Radiaton Biology - 19th annual meeting

    International Nuclear Information System (INIS)

    The proceedings contain 313 abstracts of papers. The topics covered include: biological radiation effects on lipids, hormones, fibroblasts, on bone healing, DNA repair, DNA synthesis, tumor cells, giant cell formation, on the lymphatic system, central nervous system and the hematopoietic system; determination of RBE; radioprotective agents; radiotherapy; dosimetry; radiation induced mutations; oxygen effects; radiosensitivity of tumor cells; hyperthermia and hypoxia effects on radiosensitivity; biological radiation effects on the growth of plants. (J.P.)

  10. A survey of techniques to reduce and manage external beam radiation-induced xerostomia in British oncology and radiotherapy departments

    Energy Technology Data Exchange (ETDEWEB)

    Macknelly, Andrew [Norfolk and Norwich University Hospital (United Kingdom); Day, Jane [Faculty of Health, Wellbeing and Science, University Campus Suffolk, Waterfront Building, Neptune Quay, Ipswich (United Kingdom)], E-mail: j.day@ucs.ac.uk

    2009-11-15

    ? - A feasibility study for locally advanced head and neck cancer patients treated with intensity-modulated radiotherapy. Clinical Oncology 2006;18(6):497-504, Braam P, Terhaard C, Roesnink J, Cornelis P, Raaijmakers C. Intensity-modulated radiotherapy significantly reduces xerostomia compared with conventional radiotherapy. International Journal of Radiation Oncology, Biology and Physics 2006, Wendt TG, Abbasi-Senger N, Salz H, Pinquart I, Koscelny S, Przetak S, et al. 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing. Radiation Oncology 2006;1:18. Available from: (http://www.ro-journal.com/content/1/1/18) [accessed on 21.11.06].]. This, in turn, offers increased normal tissue sparing than conventional radiotherapy [Ng M, Porceddu S, Milner A, Corry J, Hornby C, Hope G, et al. Parotid-sparing radiotherapy: does it really reduce xerostomia? Clinical Oncology 2005;17(8):610-7.]. The survey indicated that all three techniques, however, are still in use in oncology and radiotherapy departments, and several departments stated that financial considerations were hindering their move toward providing IMRT.

  11. A survey of techniques to reduce and manage external beam radiation-induced xerostomia in British oncology and radiotherapy departments

    International Nuclear Information System (INIS)

    ? - A feasibility study for locally advanced head and neck cancer patients treated with intensity-modulated radiotherapy. Clinical Oncology 2006;18(6):497-504, Braam P, Terhaard C, Roesnink J, Cornelis P, Raaijmakers C. Intensity-modulated radiotherapy significantly reduces xerostomia compared with conventional radiotherapy. International Journal of Radiation Oncology, Biology and Physics 2006, Wendt TG, Abbasi-Senger N, Salz H, Pinquart I, Koscelny S, Przetak S, et al. 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing. Radiation Oncology 2006;1:18. Available from: (http://www.ro-journal.com/content/1/1/18) [accessed on 21.11.06].]. This, in turn, offers increased normal tissue sparing than conventional radiotherapy [Ng M, Porceddu S, Milner A, Corry J, Hornby C, Hope G, et al. Parotid-sparing radiotherapy: does it really reduce xerostomia? Clinical Oncology 2005;17(8):610-7.]. The survey indicated that all three techniques, however, are still in use in oncology and radiotherapy departments, and several departments stated that financial considerations were hindering their move toward providing IMRT.

  12. Contribution of radiotherapy to the treatment of malignant tumors, 3. Combined drugs and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Niibe, Hideo; Takahashi, Iku; Tamaki, Yoshio (Gunma Univ., Maebashi (Japan). School of Medicine)

    1984-09-01

    Effects of cytotoxic agent, hormone, hypoxic cell sensitizer, and radiation protector combined with radiation therapy in cancer management were analysed. The results were as follows: 1) An increase in response was seen in 25% or more of tumor nodules given radiotherapy combined with misonidazole, anoxic cell sensitizer, compared with radiotherpy alone. But the drug was also found to be neurotoxic and peripheral neuropathy. 2) Evidence has been given that Amifostine may protect the mucosal damage from radiation when Amifostine prior to irradiation was administrated to patients with tumor in the head and neck or in the pelvis. 3) There were no difference between five year survival of radiotherapy alone and with chemotherapy for patients with stage I Non-Hodgkin lymphoma. Chemotherapy following radiotherapy for patients with stage II was more effective treatment method than radiotherapy alone. 4) Radiotherapy for patients with prostate cancer was performed to control only primary site. The success rates of local control were over 80%. The near future holds extensive promise for a combination of radiation therapy, cytotoxic chemotherapy, hormone therapy, hypoxic cell sensitizer, and radiation protectors. All of these when used in the appropriate circumstances may yield significant improvements in the therapeutic ratio and in the long-tern control of tumors.

  13. A detrimental effect of a combined chemotherapy-radiotherapy approach in children with diffuse intrinsic brain stem gliomas?

    International Nuclear Information System (INIS)

    Purpose: To compare the proportion of patients that survive at least 1 year following treatment with hyperfractionated radiotherapy (HRT) to a dose of 70.2 Gy on Pediatric Oncology Group (POG) study no. 8495 with that of patients treated with similar radiotherapy plus cisplatinum given by continuous infusion on weeks 1, 3, and 5 of radiotherapy on POG no. 9239. Methods and Materials: The eligibility criteria for the two studies were identical and included age 3 to 21 years, previously untreated tumor involving the brain stem of which two-thirds was in the pons, history less than 6 months, and clinical findings typical for diffuse intrinsic brain stem glioma, including cranial nerve deficits, long tract signs, and ataxia. The outcome of 57 patients who were treated at the 70.2 Gy dose level of POG no. 8495 between May 1986 and February 1988 was compared with that of 64 patients treated with identical radiotherapy plus cisplatinum on POG no. 9239 between June 1992 and March 1996. Results: The number of patients accrued to POG no. 9239 was determined to guarantee that the probability was at least 0.80 of correctly detecting that the 1-year survival rate exceeded that of patients on POG no. 8495 by 0.2. However, the z value for this test was -1.564, giving a p value of 0.9411. That is, there is almost sufficient evidence to conclude that survival for patients receiving HRT plus cisplatinum on POG no. 9239 was worse than that for patients receiving the same radiotherapy alone on POG no. 8495. Conclusion: The finding that patients who received cisplatinum given as a radiosensitizing agent concurrent with HRT fared less well than those receiving the same dose of HRT alone was unexpected and is clearly a cause for concern as many current protocols for patients with diffuse intrinsic brain stem gliomas call for use of chemotherapeutic and/or biological agents given concurrent with radiotherapy

  14. Preliminary Study of Stereotactic Radiotherapy for Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    From March 1997 to November 1999, 45 patients with lung cancer were treated by astereotactic radiotherapy, with 15 cases treated by a stereotactic radiotherapy alone, and 30 cases by the external radiotherapy plus stereotactic radiotherapy. The clinical target volume was 1.89-187. 26 cm3 with the median being 18. 17 cm3. The doses of plan target volume (PTV) edge was 16-30 Gy/2-3 times and the doses of center was 120 % to 150 % of PTV edge doses. The overall response rate was 84.4 % (38/45), with 11 complete response (CR) and 27 partial response (PR). This study confirmed that the stereotactic radiotherapy is a safe and effective therapy for lung cancer. For those early-stage patients who can tolerate neither operation nor even conventional radiotherapy for various reasons, it can both achieve therapeutic purpose and improve quality of life.

  15. Radical radiotherapy for carcinoma of the vulva

    International Nuclear Information System (INIS)

    A study was made of 58 patients with carcinoma of the vulva treated by radical radiotherapy between 1965 and 1982. The choice of treatment technique was influenced by site and extent of disease as well as the general condition of the patient. The crude 5-year survival was 26% (15/58). Local control was achieved in 40% of cases and was associated with tumour size of 4 cm or less. Radionecrosis occurred in nine cases but none of these required surgical intervention. Surgery remains the treatment of choice for carcinoma of the vulva. This report emphasizes that radical radiotherapy has a curative potential in those cases considered unsuitable for surgery and that the necrosis type and rate are within the limits of acceptable morbidity. (author)

  16. Radical radiotherapy for carcinoma of the vulva

    Energy Technology Data Exchange (ETDEWEB)

    Slevin, N.J.; Pointon, R.C.S.

    1989-02-01

    A study was made of 58 patients with carcinoma of the vulva treated by radical radiotherapy between 1965 and 1982. The choice of treatment technique was influenced by site and extent of disease as well as the general condition of the patient. The crude 5-year survival was 26% (15/58). Local control was achieved in 40% of cases and was associated with tumour size of 4 cm or less. Radionecrosis occurred in nine cases but none of these required surgical intervention. Surgery remains the treatment of choice for carcinoma of the vulva. This report emphasizes that radical radiotherapy has a curative potential in those cases considered unsuitable for surgery and that the necrosis type and rate are within the limits of acceptable morbidity.

  17. Radiotherapy of unicentric mediastinal Castleman's disease

    Institute of Scientific and Technical Information of China (English)

    Yue-Min Li; Yong-Dong Pu; Peng-Hui Liu; Yu-Hai Zhang; Huo-Sheng Xia; Liang-Liang Li; Yi-Mei Qu; Yong Wu; Shou-Yun Han; Guo-Qing Liao

    2011-01-01

    Castleman's disease is a slowly progressive and rare lymphoproliferative disorder. Here, we report a 55-year-old woman with superior mediastinal Castleman's disease being misdiagnosed for a long term. We found a 4.3 cm mass localized in the superior mediastinum accompanied with severe clinical symptoms. The patient underwent an exploratory laparotomy, but the mass failed to be totally excised. Pathologic examination revealed a mediastinal mass of Castleman's disease. After radiotherapy of 30 Gy by 15 fractions, the patient no longer presented previous symptoms. At 3 months after radiotherapy of 60 Gy by 30 fractions, Computed tomography of the chest showed significantly smaller mass, indicating partial remission. Upon a 10-month follow-up, the patient was alive and free of symptoms.

  18. [Personalized medicine in radiotherapy: practitioners' perception].

    Science.gov (United States)

    Britel, Manon; Foray, Nicolas; Préau, Marie

    2015-01-01

    This exploratory study was designed to investigate the representations of radiotherapists in relation to personalized medicine. On the basis of current?>' available radiotherapy predictive tests, we tried to understand how these tests could be used in routine radiotherapy practice and in what way this possible change of practices could affect the role of radiotherapists in treatment protocols. In the absence of any available data allowing the construction of a quantitative tool, qualitative data were recorded by individual interviews with radiotherapists. Based on textual data analysis, a second national quantitative phase was conducted using a self-administered questionnaire. Crossover analysis of the two datasets highlighted the interest of radiotherapists in personalized medicine and the use of predictive tests, while indicating certain limitations and concerns in relation to ethical issues related to personalized medicine in oncology and the physician's position. PMID:26752033

  19. Complications of radiotherapy in oncologic patients

    International Nuclear Information System (INIS)

    Reasons, mechanisms of development and features of clinical course of radiation response (injuries) in different organs and systems in patients with lung, uterus neck, mammary and thyroid gland cancer are described. Their clinical classification is presented. Dependences of frequency, severity and time of occurrence of radiation reactions (injuries) on the absorbed radiation dose value, time-dose-fractioning factor, localization and size of the neoplasm and on other parameters are demonstrated. Results of complex examination of oncologic patients with radiation reactions and injuries are presented. Principles of prophylactic medical examination of patients subjected to radiotherapy are described. Recommendation on the optimization of radiotherapy methods and prophylaxis of its complications are given. 56 refs.; 22 figs.; 4 tabs

  20. ARCON in experimental and clinical radiotherapy

    OpenAIRE

    Rojas Callejas, Ana Maria

    2004-01-01

    xHypoxia and repopulation of tumour clonogens are two important determinants of treatment outcome in radiotherapy. In general clinical evidence indicates that loco-regional control may be reduced with long overall treatment times and for tumours with low pre-treatment levels of oxygen. Experimental studies with normobaric carbogen and oxygen showed a two-fold enhancement of the efficacy of radiation in a mouse tumour model when combining oxygen with treatment acceleration. It was then demonst...

  1. Glioblastoma multiforme after radiotherapy for acromegaly

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-07-01

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

  2. Anaesthesia and monitoring for paediatric radiotherapy.

    OpenAIRE

    Sumner, E.

    1986-01-01

    Four hundred and sixty-nine anaesthetics were given to 27 children between the ages of 18 months and 5 years so that they could receive radiotherapy. When ketamine was used as the sole anaesthetic agent, the induction of anaesthesia was frequently stressful and traumatic, with problems and difficulties being encountered during 24% of anaesthetics. A change to an entirely gaseous method of inducing and maintaining anaesthesia resulted in a much more acceptable service being offered to the chil...

  3. Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients

    International Nuclear Information System (INIS)

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

  4. Radiotherapy in non-Hodgkin lymphomas

    International Nuclear Information System (INIS)

    The treatment of non-Hodgkin lymphomas (NHL) is discussed. The use of radiotherapy, chemotherapy or both in a combined therapy is studied considering several aspects as age of the patients (adults vs children), size and extension of the lymphoma, stage of the disease. It is mentioned that more advanced cases and those with more aggressive histology need combined modality treatments or even just chemotherapy. (M.A.C.)

  5. Hypofractionated whole breast radiotherapy: current perspectives

    OpenAIRE

    Koulis TA; Phan T; Olivotto IA

    2015-01-01

    Theodora A Koulis, Tien Phan, Ivo A Olivotto Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada Abstract: Adjuvant radiotherapy (RT) is an important part of breast cancer management but the dose and fractionation schedules used are variable. A total of 50 Gy in 25 daily fractions delivered over 5 weeks is often considered the "standard" adjuvant RT prescription. Hypofractionated regimes such as 42.5 Gy in 16 daily fractions or 40 Gy ...

  6. Radiotherapy in skin cancer - present day aspects

    International Nuclear Information System (INIS)

    Skin carcinomas (SC) are the leading ones in the structure of oncological morbidity in both genders in Bulgaria, as well as in white populations in the world. Regardless of their high frequency, their treatment is successful and mortality due to SC has been reduced by 20 - 30% during the last decades. In Bulgaria SC in 2003 comprise 9.3% of all oncological diseases in men and women. According to their frequency they occupy the second phase after lung cancer in men and breast cancer in women. The treatment of SC is realized applying various therapeutic approaches, distinguished as basic (radical) and alternative ones. The first include surgical treatment and radiotherapy (RT) (definitive or adjuvant) and the alternative ones - curettage and electro-coagulation, cryotherapy, local chemotherapy and immunotherapy, systemic chemotherapy, etc. When defining the therapeutic approach, the method affording the best chances of curing with acceptable cosmetic results should be selected. The present review is aimed at considering the contemporary aspects in RT of SC, including used radiotherapy methods and techniques, volumes, doses, fractionation, and achieved therapeutic effects. The indications for implementing definitive and adjuvant RT are given in detail. The applied radiotherapy methods - external beam RT and brachytherapy, are also discussed. The used planned radiotherapy volumes, doses, fractionation schemes, attained therapeutic effects and possible radiation reactions are considered as well. The curability of SC is high, exceeding 90% after adequate treatment. Regardless of the fact that RT has partially ceded its leading role in SC treatment, it still remains to be one of the basic and successful therapeutic approaches

  7. Subacute cutaneous lupus erythematosus triggered by radiotherapy

    OpenAIRE

    Kolm, I.; Pawlik, E; Eggmann, N.; Kamarachev, J; Kerl, K. (Kornelius); French, L E; Hofbauer, G.F.L.

    2013-01-01

    BACKGROUND: The origin of collagen autoimmune diseases is not fully understood. Some studies postulate a mechanism of molecular mimicry or heterologous immunity following viral infections triggering autoimmunity. Apart from infections, other exogenous factors such as visible light or X-rays have been reported to incite autoimmunity. CASE REPORT: We report a case of histologically and serologically confirmed subacute lupus erythematosus (SCLE) following radiotherapy for breast cancer. DI...

  8. Targeting Radiotherapy to Cancer by Gene Transfer

    OpenAIRE

    R. J. Mairs; Boyd, M.

    2003-01-01

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

  9. Radiotherapy treatment planning linear-quadratic radiobiology

    CERN Document Server

    Chapman, J Donald

    2015-01-01

    Understand Quantitative Radiobiology from a Radiation Biophysics PerspectiveIn the field of radiobiology, the linear-quadratic (LQ) equation has become the standard for defining radiation-induced cell killing. Radiotherapy Treatment Planning: Linear-Quadratic Radiobiology describes tumor cell inactivation from a radiation physics perspective and offers appropriate LQ parameters for modeling tumor and normal tissue responses.Explore the Latest Cell Killing Numbers for Defining Iso-Effective Cancer TreatmentsThe book compil

  10. MRI-guided radiotherapy for renal tumours

    OpenAIRE

    Stam, M.K.

    2013-01-01

    The current surgical treatment for renal cell carcinoma (RCC) experiences complications due to the invasiveness of the treatment. Minimally invasive alternative treatments, such as radiofrequency and cryogen ablation, have fewer complications but a lower local control. Radiotherapy is an established minimally- to non-invasive treatment and might improve morbidity or outcome for RCC patients. A precise radiation technique will be necessary since the kidney moves during respiration and is very ...

  11. Lymphocyte subpopulations in mammary cancer after radiotherapy

    International Nuclear Information System (INIS)

    B- and T-lymphocytes, identified by two methods of rosette-formation with sheep erythrocytes, fall to low levels within 1 week of the start of post-operative radiotherapy for cancer of the breast. Fifty-two such patients are compared with 34 age- and disease-matched patients treated by mastectomy alone. The B-lymphopenia reverts to normal levels by 10 months while the T-lymphopenia persists for at least 2 to 4 years

  12. Sacral plexus injury after radiotherapy for carcinoma of cervix

    Energy Technology Data Exchange (ETDEWEB)

    Stryker, J.A.; Sommerville, K.; Perez, R.; Velkley, D.E. (Pennsylvania State Univ., Hershey (USA))

    1990-10-01

    A 42-year-old woman developed lower extremity weakness and sensory loss 1 year after external and intracavitary radiotherapy for Stage IB carcinoma of cervix. She has been followed for 5 years posttreatment, and the neurologic abnormalities have persisted, but no evidence of recurrent carcinoma has been found. We believe this to be a rare case of sacral plexus radiculopathy developing as a late complication after radiotherapy. Suggestions are made for improving the radiotherapy technique to prevent this complication in future cases.

  13. Direct costs of radiotherapy for rectal cancer: a microcosting study

    OpenAIRE

    Hanly, Paul; Céilleachair, Alan Ó; Skally, Máiréad; O’Neill, Ciaran; Sharp, Linda

    2015-01-01

    Background Radiotherapy provides significant benefits in terms of reducing risk of local recurrence and death from rectal cancer. Despite this, up-to-date cost estimates for radiotherapy are lacking, potentially inhibiting policy and decision-making. Our objective was to generate an up-to-date estimate of the cost of traditional radiotherapy for rectal cancer and model the impact of a range of potential efficiency improvements. Methods Microcosting methods were used to estimate total direct r...

  14. The role of image guidance in respiratory gated radiotherapy

    DEFF Research Database (Denmark)

    Korreman, Stine Sofia; Juhler-Nøttrup, Trine; Fredberg Persson, Gitte;

    2008-01-01

    Respiratory gating for radiotherapy beam delivery is a widely available technique, manufactured and sold by most of the major radiotherapy machine vendors. Respiratory gated beam delivery is intended to limit the irradiation of tumours moving with respiration to selected parts of the respiratory...... is therefore of utmost importance for the safe introduction of respiratory gating. In this short overview, suitable image guidance strategies for respiratory gated radiotherapy are reviewed for two cancer sites; breast cancer and lung tumours....

  15. Role of Radiotherapy in Modern Treatment of Hodgkin's Lymphoma

    OpenAIRE

    Kheng-Wei Yeoh; N. George Mikhaeel

    2011-01-01

    Hodgkin's Lymphoma was incurable until the advent of effective therapeutic radiation around the first half of the 20th century. As survival rates improved, the long-term toxicities from radiotherapy began to emerge. This together with the availability of effective chemotherapy has encouraged a combined modality approach for early-staged disease and the omission of radiotherapy in advanced-staged disease. The differing toxicities of radiotherapy and chemotherapy has promoted ongoing research t...

  16. Radiotherapy in the treatment of ameloblastoma

    International Nuclear Information System (INIS)

    There is a lack of well-documented evidence in the literature concerning the relative radioresponsiveness or radioresistance of ameloblastomas, although they are generally considered radioresistant. Most of the previous papers referring to this subject lack acceptable histopathologic proof of the diagnosis, adequate radiotherapeutic data, and/or follow-up information; many predate the use of megavoltage irradiation. The present article reports 5 cases of ameloblastoma that were treated by radiotherapy, 3 by megavoltage irradiation. All have been confirmed histologically by an oral pathologist, all have adequate radiotherapeutic data and, with one exception, adequate follow-up information. In addition, the reasons for our present lack of knowledge of this subject are discussed; objective criteria are presented for evaluating the results of radiotherapy on ameloblastomas; the only other series of ameloblastomas treated by megavoltage irradiation is analyzed. Although radiotherapy can reduce the size of an ameloblastoma, primarily that part of the tumor which has expanded the jaw or broken into the soft tissues, it does not appear to be an appropriate treatment for an operable ameloblastoma. Its main use is in inoperable cases, primarily in the posterior maxilla. (author)

  17. Whole body radiotherapy: A TBI-guideline

    Directory of Open Access Journals (Sweden)

    Quast Ulrich

    2006-01-01

    Full Text Available Total Body Irradiation (TBI is one main component in the interdisciplinary treatment of widely disseminated malignancies predominantly of haematopoietic diseases. Combined with intensive chemotherapy, TBI enables myeloablative high dose therapy and immuno-ablative conditioning treatment prior to subsequent transplantation of haematopoietic stem cells: bone marrow stem cells or peripheral blood progenitor stem cells. Jointly prepared by DEGRO and DGMP, the German Society of Radio-Oncology, and the German Association of Medical Physicists, this DEGRO/DGMP-Leitlinie Ganzkoerper-Strahlenbehandlung - DEGRO/DGMP Guideline Whole Body Radiotherapy, summarises the concepts, principles, facts and common methods of Total Body Irradiation and poses a set of recommendations for reliable and successful application of high dose large-field radiotherapy as essential part of this interdisciplinary, multi-modality treatment concept. The guideline is geared towards radio-oncologists, medical physicists, haematooncolo-gists, and all contributing to Whole Body Radiotherapy. To guide centres intending to start or actualise TBI criteria are included. The relevant treatment parameters are defined and a sample of a form is given for reporting TBI to international registries.

  18. Radiotherapy, the experience of the patients

    International Nuclear Information System (INIS)

    For the patient, a radiotherapy means heavy physical and mental strain. Just like any other medical therapy, radiotherapy demands active cooperation of the patient based on mutual exchange between the patient and the doctor who, in addition to his medical responsibilities, has to develop awareness of the patient's mental condition and the suitable response. This emphatic relationship may in turn and at times mean a heavy burden for the medical staff. The authors have evaluated for this book a great number of records, protocols and questionnaires accumulated in the course of their work with patients of the radiotherapy department. The book is intended as a source of reference and guidance and a help for all persons and staff involved, who have to cope with the situations encountered in daily work in the clinical departments. The book presents experience and information on a wide range of aspects and problems involved, as e.g.: Interpersonal relations, the patient's feeling of being in the hands of technology, the difficulty to keep the delicate balance between confidence and non-confidence, the significance of good relations in the clinic for a successful outcome of the therapy, the ways how mental crises can be handled. The material also includes information on a variety of accompanying therapies, both for the actual treatment periods as well as for post-treatment periods where they may be late effects to be mastered. (orig./CB)

  19. Accidental exposures in radiotherapy: an history

    International Nuclear Information System (INIS)

    Radiotherapy accidents are exceedingly rare. However, they may have major negative consequences: for health (and sometimes life) of victims as well as for the trust that patients put in radiotherapy and radiation oncolysis. Each accident must be pointed out, analysed and reported, in order to allow preventive actions, avoiding repetitive accidents. Through examples of majors accidents occurred all over the world in the last decades, affecting professionals, public or patients themselves, the necessity of transparency is demonstrated. The International Commission of Radiobiological Protection has drawn positive lessons from such accidents and insists on following recommendations: necessity of sufficient number and competent professionals, importance of continuous and initial education, information of professionals and, in general, a strict Quality Assurance program. It is clear that each radiotherapy center remains at risk for errors. It is essential to develop preventive procedures to avoid transformation of errors into accidents. In that context, complete and detailed description and reports of each anomaly or incident must be encouraged as it is done for sectors of aviation or nuclear industry. Radiation oncology must develop such a culture of transparency and of systematic report of all incident. (authors)

  20. Bariatric diagnostic CT scanning: A radiotherapy perspective

    International Nuclear Information System (INIS)

    Obesity is increasing in the United Kingdom. Equipment available for this patient group including wheelchairs, beds and hoists is becoming more common in the hospital environment; diagnostic imaging equipment that can accommodate bariatric patients has not increased at the same rate. Subsequently these service-users are often unable to receive “gold-standard” cross-sectional imaging within their patient-pathway. This paper highlights how a diagnostic imaging department has utilised wide-bore CT scanning equipment within the radiotherapy setting to ensure an equitable service for all service users. Through literature review and local experience, a standard operating procedure and scanning service has been developed. Areas explored include technical consideration of scanner design; patient positioning; image artefacts and intravenous contrast administration. Also investigated is patient wellbeing incorporating manual handling, respiration and psycho-social needs. Additionally, demonstration of how interprofessional collaboration by diagnostic and radiotherapy radiographers can ensure the best imaging experience and outcome for this patient group. - Highlights: • Rising obesity in the UK has highlighted a shortage of diagnostic imaging facilities. • Large bore CT scanners are the scanner of choice for radiotherapy planning. • Technical capability, manual handling and psycho-social issues have been explored. • Bariatric diagnostic imaging facilitated by inter-professional collaboration

  1. The United Kingdom's radiotherapy dosimetry audit network

    International Nuclear Information System (INIS)

    The first comprehensive national dosimetry intercomparison in the United Kingdom involving all UK radiotherapy centres was carried out in the late 1980s. Out of this a regular radiotherapy dosimetry audit network evolved in the early 1990s. The network is co-ordinated by the Institute of Physics and Engineering in Medicine and comprises eight co-operative regional groups. Audits are based on site visits using ionization chambers and epoxy resin water substitute phantoms. The basic audit methodology and phantom design follows that of the original national intercomparison exercise. However, most of the groups have evolved more complex methods, to extend the audit scope to include other parameters, other parts of the radiotherapy process and other treatment modalities. A number of the groups have developed phantoms to simulate various clinical treatment situations, enabling the sharing of phantoms and expertise between groups, but retaining a common base. Besides megavoltage external beam photon dosimetry, a number of the groups have also included the audit of kilovoltage X ray beams, electron beams and brachytherapy dosimetry. The National Physical Laboratory is involved in the network and carries out basic beam calibration audits to link the groups. The network is described and the methods and results are illustrated using the Scottish+ group as an example. (author)

  2. Guideline of stereotactic radiotherapy of body trunk

    International Nuclear Information System (INIS)

    The guideline is issued for safe and effective practice of the stereotactic radiotherapy of body trunk by giving appropriate methodologies and their theoretical backgrounds to radiological stuff concerned, such as doctors, technologists, physicists, quality assurance (QA)/quality control (QC) personnel, and nurses. The issue is motivated by the recent and expected increase of facilities conducting the therapy popularized from its approval by health insurance authorities in 2004, is based on the drafts by the Study Group for improving prognosis of the accurate 3-D radiotherapy organized in the MHLW and by Jap. 3-D Conformal External Beam Radiotherapy Group and, after edition by QA committee of Jap. Soc. Ther. Radiol. Oncol., is herein published by the Society. The guideline is composed mainly from 4 chapters of Introduction, Clinical practice, Physics and technology, and QA/QC of equipments and systems. The second chapter contains, concerning the therapy, its definition, contraindication, application to health insurance (applicable diseases and requirement), target setting, radiation dose and fractionation, risk organs (serial and parallel ones) and dose limits, and progress observation post therapy. The third chapter, its definition and methods, therapeutic planning, and actual performance, and the forth, the principle, essential concept, items particularly needed (dosimetry and mechanical/geometrical accuracy of equipments, equipments for therapy planning, and QA/QC of the system). The guideline is to be revised within 2-3 years hereafter. (R.T.)

  3. Clinico-statistical study on radiotherapy prostheses

    International Nuclear Information System (INIS)

    Various radiotherapy prostheses, including spacer, protector, carrier and mold, are frequently used for oral and maxillofacial cancer patients because they enhance the treatment efficacy of radiotherapy and protect adjacent normal tissue from irradiation. Therefore a clinical investigation was carried out on 310 cases of radiotherapy prostheses applied in our clinic from 1981 to 1995. The results were as follows: Sex ratio (male: female) of patients was 1.67: 1 and the number of the patients at the age of 60-69 was the largest. Spacer accounted for 81.0% of prostheses, followed by mold (10.6%), protector (5.5%) and carrier (2.9%). As for the site of malignant tumor, the tongue was 77.1% of all cases. External irradiation was already performed on 23.3% of all cases. Abutment teeth remained in 85.9% of 304 cases in which the prostheses were applied intraorally. The average time to make the prostheses was 12.4 days. As for the retention of the prosthesis to the mouth, a ball clasp was used most frequently in spacer and carrier, and overlay type was applied most frequently in mold and protector. As for the retention of shield to carrier in mold cases, mechanical interlocking of the resin parts of carrier and shield was 75.8% of the cases. (author)

  4. Multimedia educational services in stereotactic radiotherapy.

    Science.gov (United States)

    Bazioglou, M; Theodorou, K; Kappas, C

    1999-01-01

    The computer-based learning methods in medicine have been well established as stand-alone learning systems. Recently, these systems were enriched with the use of telematics technology to provide distance learning capabilities. Stereotactic radiotherapy is one of the most representative advanced radiotherapy techniques. Due to the multidisciplinary character of the technique and the rapid evolution of technology implemented, the demands in training have increased. The potential of interactive multimedia and Internet technologies for the achievement of distance learning capabilities in this domain are investigated. The realization of a computer-based educational program in stereotactic radiotherapy in a multimedia format is a new application in the computer-aided distance learning field. The system is built according to a client and server architecture, based on the Internet infrastructure, and composed of server nodes. The impact of the system may be described in terms of: time and transportation costs saving, flexibility in training (scheduling, rate and subject selection), online communication and interaction with experts, cost effective access to material (delivery or access by a large number of users and revision of the material by avoiding high costs of computer-based training systems and database development). PMID:10394345

  5. External quality audits in radiotherapy in Poland

    International Nuclear Information System (INIS)

    The Secondary Standard Dosimetry Laboratory (SSDL) of the Medical Physics Department of the Centre of Oncology in Warsaw is a continuation of the Radiation Measurements Laboratory created in 1937, following the suggestions of Marie Curie, the founder of the Institute. The present SSDL is a member of the WHO/IAEA international network and is periodically audited by the International Atomic Energy Agency. The SSDL is in charge of the calibration of all radiotherapy dosimeters in Poland, and it also co-ordinates all activities carried out in radiotherapy quality assurance programmes nation-wide. The External Audit Group (EAG) was set-up according to the recommendations of the IAEA, as a part of the SSDL. The EAG is in charge of the management of the project and organization of the TLD measurements. The SSDL takes the responsibilities of the metrological aspects of the programme. The results of the efforts, aimed at the development of a quality audit programme and methodology in radiotherapy, are presented

  6. Errors in Radiotherapy: Motivation for Development of New Radiotherapy Quality Assurance Paradigms

    International Nuclear Information System (INIS)

    Modern radiotherapy practice has rapidly evolved during the past decade, making use of many highly complex and/or automated processes for planning and delivery, including new techniques, like intensity-modulated radiotherapy driven by inverse planning optimization methods, or near real-time image-guided adaptive therapy based on fluoroscopic or tomographic imaging on the treatment machine. In spite of the modern technology, or potentially because of it in some instances, errors and other problems continue to have a significant impact on the field. This report reviews example errors and problems, discusses some of the quality assurance issues that these types of problems raise, and motivates the development of more modern and sophisticated approaches to assure quality for our clinical radiotherapy treatment methods

  7. Proton Radiotherapy for Pediatric Ewing’s Sarcoma: Initial Clinical Outcomes

    International Nuclear Information System (INIS)

    Purpose: Proton radiotherapy (PT) has been prescribed similarly to photon radiotherapy to achieve comparable disease control rates at comparable doses. The chief advantage of protons in this setting is to reduce acute and late toxicities by decreasing the amount of normal tissue irradiated. We report the preliminary clinical outcomes including late effects on our pediatric Ewing’s sarcoma patients treated with PT at the Francis H. Burr Proton Therapy Center at Massachusetts General Hospital (Boston, MA). Methods and Materials: This was a retrospective review of the medical records of 30 children with Ewing’s sarcoma who were treated with PT between April 2003 and April 2009. Results: A total of 14 male and 16 female patients with tumors in several anatomic sites were treated with PT at a median age of 10 years. The median dose was 54 Gy (relative biological effectiveness) with a median follow-up of 38.4 months. The 3-year actuarial rates of event-free survival, local control, and overall survival were 60%, 86%, and 89%, respectively. PT was acutely well tolerated, with mostly mild-to-moderate skin reactions. At the time of writing, the only serious late effects have been four hematologic malignancies, which are known risks of topoisomerase and anthracyline exposure. Conclusions: Proton radiotherapy was well tolerated, with few adverse events. Longer follow-up is needed to more fully assess tumor control and late effects, but the preliminary results are encouraging.

  8. South Asian Medicinal Compounds as Modulators of Resistance to Chemotherapy and Radiotherapy

    Directory of Open Access Journals (Sweden)

    N. Rajendra Prasad

    2016-03-01

    Full Text Available Cancer is a hyperproliferative disorder that involves transformation, dysregulation of apoptosis, proliferation, invasion, angiogenesis and metastasis. During the last 30 years, extensive research has revealed much about the biology of cancer. Chemotherapy and radiotherapy are the mainstays of cancer treatment, particularly for patients who do not respond to surgical resection. However, cancer treatment with drugs or radiation is seriously limited by chemoresistance and radioresistance. Various approaches and strategies are employed to overcome resistance to chemotherapy and radiation treatment. Many plant-derived phytochemicals have been investigated for their chemo- and radio-sensitizing properties. The peoples of South Asian countries such as India, Pakistan, Sri Lanka, Nepal, Bangladesh and Bhutan have a large number of medicinal plants from which they produce various pharmacologically potent secondary metabolites. The medicinal properties of these compounds have been extensively investigated and many of them have been found to sensitize cancer cells to chemo- and radio-therapy. This review focuses on the role of South Asian medicinal compounds in chemo- and radio-sensitizing properties in drug- and radio-resistant cancer cells. Also discussed is the role of South Asian medicinal plants in protecting normal cells from radiation, which may be useful during radiotherapy of tumors to spare surrounding normal cells.

  9. Dysphagia after radiotherapy: state of the art and prevention.

    Science.gov (United States)

    Servagi-Vernat, S; Ali, D; Roubieu, C; Durdux, C; Laccourreye, O; Giraud, P

    2015-02-01

    Adjuvant radiotherapy after surgery or exclusive radiotherapy, with or without concurrent chemotherapy is a valuable treatment option in the great majority of patients with head and neck cancer. Recent technical progress in radiotherapy has resulted in a decreased incidence of xerostomia. Another common toxicity of radiotherapy is dysphagia, which alters the nutritional status and quality of life of patients in remission. The objective of this review is to describe the physiology of swallowing function, the pathophysiology of radiation-induced dysphagia and the various strategies currently available to prevent this complication.

  10. Secondary effects of radiotherapy on the orofacial sphere

    International Nuclear Information System (INIS)

    The objective of this research is to determine the role of the dental surgeon in the taking into care of patients treated by head and neck radiotherapy. It also aims at giving information to the patient on secondary effects which radiotherapy may induce, and at determining which therapeutic behaviour to adopt to prevent or at least mitigate the appearance of complications. The author first presents some generalities on radiotherapy: presentation of upper aero-digestive tract cancers (surgery, radiotherapy, and chemotherapy), description of the different radiotherapy techniques (external radiotherapy, brachytherapy), discussion of factors influencing local secondary effects of radiotherapy. The second part addresses the specific case of early orofacial secondary effects, discusses their origin, clinic signs and prevention means: cutaneous effect, mucositis, xerostomia, candidiasis, taste disorders, relationship between early local reactions and anti-tumour treatment efficiency. The third part addresses late orofacial secondary effects: cervix sclerosis, limitation of mouth opening, dental effects, periodontal diseases, osteoradionecrosis. The last part discusses the evolution of radiotherapy: intensity modulated conformational radiotherapy, targeted therapeutics

  11. Genome-wide transcription responses to synchrotron microbeam radiotherapy.

    Science.gov (United States)

    Sprung, Carl N; Yang, Yuqing; Forrester, Helen B; Li, Jason; Zaitseva, Marina; Cann, Leonie; Restall, Tina; Anderson, Robin L; Crosbie, Jeffrey C; Rogers, Peter A W

    2012-10-01

    The majority of cancer patients achieve benefit from radiotherapy. A significant limitation of radiotherapy is its relatively low therapeutic index, defined as the maximum radiation dose that causes acceptable normal tissue damage to the minimum dose required to achieve tumor control. Recently, a new radiotherapy modality using synchrotron-generated X-ray microbeam radiotherapy has been demonstrated in animal models to ablate tumors with concurrent sparing of normal tissue. Very little work has been undertaken into the cellular and molecular mechanisms that differentiate microbeam radiotherapy from broad beam. The purpose of this study was to investigate and compare the whole genome transcriptional response of in vivo microbeam radiotherapy versus broad beam irradiated tumors. We hypothesized that gene expression changes after microbeam radiotherapy are different from those seen after broad beam. We found that in EMT6.5 tumors at 4-48 h postirradiation, microbeam radiotherapy differentially regulates a number of genes, including major histocompatibility complex (MHC) class II antigen gene family members, and other immunity-related genes including Ciita, Ifng, Cxcl1, Cxcl9, Indo and Ubd when compared to broad beam. Our findings demonstrate molecular differences in the tumor response to microbeam versus broad beam irradiation and these differences provide insight into the underlying mechanisms of microbeam radiotherapy and broad beam.

  12. Nuclides for radiotherapy: an overview

    International Nuclear Information System (INIS)

    With the emergence of new, biological vehicles of great organ specificity (e.g. steroid hormones, antibodies) the concept of systemic tumor therapy with the aid of radiotherapeutica has gained new momentum. In order to assess the options open for optimal adaptation of the radiation properties to the pharmacocinetics of a vehicle, a search was done to identify potentially useful therapeutic radionuclides. Main criteria for selection were half life, low gamma-yield and stable daughter nuclide. The resulting possibilities fall into 4 categories: 1) alpha-emitters (At-211); 2) beta/sup -/-emitters that can be prepared in a carrierfree fashion (P-32, S-35, As-77, Y-90, Ag-111, Pm-149, Tb-161, Lu-177), 3) beta/sup -/-emitters with carrier added (Pd-109, Pr-142, Gd-159, Er-169, Tm-172, Yb-175, Re-188, Ir-194, Pt-197) and 4) electron capture nuclides, emitting Auger-cascades (Cr-51, Ga-67, Ge-71, Br-77, Ru-97, Sb-119, I-123, Cs-129, Nd-140, Er-165, Ta-177, Hg-197, Tl-201). Among the 4th group some well known, diagnostically used nuclides are found. Their therapeutic use necessitates the precise localisation in or very near the genetic material of the cell to be killed; only there the destructive power of the very short range Auger-electrons can be used. For each of the selected nuclides a summary of decay data, possibilities of preparation and chemical reactivity for labelling of vehicles is given. (author)

  13. Pre-Radiotherapy dental evaluation criteria and treatment needs of oral side effects after head and neck radiotherapy

    International Nuclear Information System (INIS)

    The objective of this review is to present pre-radiotherapy evaluation criteria and the main needs for treatment of these patients after the radiation therapy. Were revised articles in English, Spanish and Portuguese language between 1995 and 2009 indexed in Pubmed and Scielo. The keywords were oral cancer and radiotherapy, complications in head and neck radiotherapy, oral pre-radiotherapy evaluation.The adverse complications of radiotherapy in head and neck area could be temporary or late. The late effects, such as radiation caries and osteorradionecrosis could be directly associated with the fact that previous dental evaluation was not performed and can severely affect the post-operatory quality of life. The participation of the dentist in the multidisciplinary team and dental evaluation of the patients that will receive radiotherapy in the head and neck area are of vital importance to improve the post-operatory quality of life of these patients

  14. Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

    International Nuclear Information System (INIS)

    The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy. Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups. Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS. Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy

  15. Biological modelling of the radiation dose escalation effect of regional hyperthermia in cervical cancer

    International Nuclear Information System (INIS)

    Locoregional hyperthermia combined with radiotherapy significantly improves locoregional control and overall survival for cervical tumors compared to radiotherapy alone. In this study biological modelling is applied to quantify the effect of radiosensitization for three cervical cancer patients to evaluate the improvement in equivalent dose for the combination treatment with radiotherapy and hyperthermia. The Linear-Quadratic (LQ) model extended with temperature-dependent LQ-parameters α and β was used to model radiosensitization by hyperthermia and to calculate the conventional radiation dose that is equivalent in biological effect to the combined radiotherapy and hyperthermia treatment. External beam radiotherapy planning was performed based on a prescription dose of 46Gy in 23 fractions of 2Gy. Hyperthermia treatment using the AMC-4 system was simulated based on the actual optimized system settings used during treatment. The simulated hyperthermia treatments for the 3 patients yielded a T50 of 40.1 °C, 40.5 °C, 41.1 °C and a T90 of 39.2 °C, 39.7 °C, 40.4 °C, respectively. The combined radiotherapy and hyperthermia treatment resulted in a D95 of 52.5Gy, 55.5Gy, 56.9Gy in the GTV, a dose escalation of 7.3–11.9Gy compared to radiotherapy alone (D95 = 45.0–45.5Gy). This study applied biological modelling to evaluate radiosensitization by hyperthermia as a radiation-dose escalation for cervical cancer patients. This model is very useful to compare the effectiveness of different treatment schedules for combined radiotherapy and hyperthermia treatments and to guide the design of clinical studies on dose escalation using hyperthermia in a multi-modality setting

  16. Fatigue and radiotherapy. A literature review; Fatigue et radiotherapie. Revue de la litterature

    Energy Technology Data Exchange (ETDEWEB)

    Dilhuydy, J.M.; Ouhtatou, F.; Laporte, C.; Nguyen, T.V.F.; Vendrely, V. [Institut Bergonie Centre Regional de Lutte Contre le Cancer, 33 - Bordeaux (France); Dilhuydy, J.M. [Federation Nationale des Centres de Lutte Contre le Cancer, FNCLCC, Groupe Rehabilitation, 75 - Paris (France); Dilhuydy, M.S. [Hopital Saint-Andre, Service de Medecine Interne, 33 - Bordeaux (France)

    2001-11-01

    Fatigue is a common complaint for the cancer patient during and after radiotherapy, according to the published studies. Fatigue is a subjective symptom mostly underestimated by oncologists and other care givers. Etiology is complex, poorly understood in spite of obvious causes like insomnia, nausea, pain, depression, psychological distress, anemia, hypothyroidism, menopause disturbances, treatment adverse effects. Fatigue presents multi-factorial and multidimensional aspects. To evaluate it, many tools can be used as single-item, unidimensional and multidimensional instruments. Practically, the open discussion with the patient throughout radiotherapy is essential to define it. Taking charge fatigue requires its acknowledgement by radiotherapist, treatment of associated symptoms with a multidisciplinary approach. (authors)

  17. Who risk profile in radiotherapy;Profil de risque en radiotherapie de l'OMS

    Energy Technology Data Exchange (ETDEWEB)

    Barton, M. [Universite de Nouvelle-Galles du Sud, Radiotherapie Oncologique, Sydney (Australia); Sharfiq, J.; Nobleet, D.; Lemer, C. [Universite de Nouvelle-Galles du Sud, Collaboration for Cancer Outcomes Research and Evaluation, Securite des Patients l' OMS (Australia)

    2009-12-15

    The different steps of a treatment in radiotherapy are: patient evaluation, decision to treat, prescription of the treatment protocol, positioning and immobilization, simulation, imaging and volume determination, planning and implementation of materials and software, transfer of treatment data, patient positioning, treatment realisation, treatment checking and follow-up. It exist processes of safety for any step of a radiotherapy realisation: patient identification, accreditation of equipment and processes, evaluation of the personnel competencies, quality assurance of equipment and management of the processes quality, redundancy during the data transfer, control of processes, errors reports and quality improvement, external controls, appropriateness of the workforce. (N.C.)

  18. Radiotherapy status in 2007. Key figures from the radiotherapy observatory 2006-2007

    International Nuclear Information System (INIS)

    This document briefly comments graphs and tables of data concerning the activity, the equipment and the human resources of French radiotherapy centres: numbers of public and private centres, numbers, types and age of installed accelerators, expected evolution of this stock, techniques used in external radiotherapy, numbers of the different involved professionals in the private sector or public sector. It indicates the status of these centres with respect to the different agreement criteria. The second part gives graphs and tables of data concerning the curie-therapy activity: curietherapy centres, medical treatment activities, used isotopes, types of curietherapy (high, low and pulsed rate)

  19. Nutritional assistance to patients during radiotherapy

    International Nuclear Information System (INIS)

    With the aim of assessing the possible benefits of nutritional therapy , 140 patients were prospectively studied during radiotherapy of the head and neck (81%) and esophageal cancer (19%). Mean age was 56.0 (17-80), with 114 males and 26 females. Duration of both nutrition and radiotherapy was 78.0 ± 45 days. Tube feeding was the primary modality in 50.7% of the population, and oral regimens in the remaining 49.3%, but associations between the methods were also used. Enteral diets were supplied under the supervision of a specialized tem for home alimentation (PROSNED). Compliance to the program was 100% and a lymphocyte count diminished along this period (1933 ± 1033 vs 1265 ± 688, p.0.001). A subjective improvement was reported by 84% of the population, and total calorie intake, that was below 60% of estimated needs in 100% of the cases initially, significantly improved to just 40% inadequate at the end of the observations. Radiotherapy was associated with mucositis in 21% of the patients, taste changes in 79%, xerostomy in 81%, anorexia in 66% and odinophagia in 59%. In the individuals selected for enteral feeding, side effects were represented by technical problems (20%) and gastrointestinal disorders (13%). All patients completed the nutritional support program and there was no mortality in this series. It is conclude that: early nutritional support during radiotherapy was able to maintain or improve the nutritional status; tube feeding, alone or in combination with oral diets, was indicated whenever appropriate and contributed to fulfillment of the energy requirements; reduction of total lymphocytes could not be prevented by the mentioned therapy; complications of enteral alimentation were mild and affected a small proportion of the population; troubles induced by radiotherapy were as frequent as expected, and tended to disturb the intake of the food; the compliance of the therapeutic plan was excellent and can be attributed to the efforts of the

  20. Risk of cancer formation by radiotherapy

    International Nuclear Information System (INIS)

    Described are the difference between exposures to radiation for medical purpose and to environmental radiation at low dose, estimation of carcinogenic risk by medical radiation, and notice for referring the risk at clinical practice. ICRP employs linear non-threshold (LNT) model for risk of cancer formation even at <200 mSv for safety, with a recognition that it is scientifically obscure. The model essentially stands on data of A-bomb survivors (the Gold Standard), where the relationship between 5-10% excess relative risk (ERR) of cancer formation and dose 0.05-2.5 Sv is linear. Analyses of the secondary carcinogenesis after radiotherapy have begun to be reported since around 2005: e.g., the secondary thyroid cancer risk in pediatric patients treated with radiotherapy has a peak at 20 Gy, suggesting the actual risk depends both on the linearity of carcinogenic increase and on the exponential probability of cell death increase. On this concept, the risk of cancer formation is not always linear to dose. At the practical radiotherapy, its secondary carcinogenic risk should be estimated not only on the dose but also on other factors such as the individual organ, patient's age and attainable age/time after the treatment. In treated teen-ager patients, ERRs of mortality/Gy are 2.28 for cancers of the skin of non-malignant melanoma, 1.32 of bladder and 1.21 of thyroid and in patients of fifties, 1.15 of bladder and lung. The EER tends to become lower as the treated age is older. Pediatric cancer patients to be treated with radiotherapy should be informed about the secondary cancer that the low dose risk given by ICRP is not always appropriate, a certain cancer risk has a peak dose, and ERR of cancer mortality is not a cancer risk of an organ. Many factors like anticancers and immuno-modifiers, modify the outcome of radiotherapy and should be carefully speculated for evaluating the outcome. (T.T.)

  1. Automatic image segmentation for treatment planning in radiotherapy; Segmentation automatique des images pour la planifi cation dosimetrique en radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Pasquiera, D. [Centre Galilee, polyclinique de la Louviere, 59 - Lille (France); Peyrodie, L. [Ecole des hautes etudes d' ingenieur, 59 - Lille (France); Laboratoire d' automatique, genie informatique et signal (LAGIS), Cite scientifi que, 59 - Villeneuve d' Ascq (France); Denis, F. [Centre Jean-Bernard, 72 - Le Mans (France); Pointreau, Y.; Bera, G. [Clinique d' oncologie radiotherapie, Centre Henry-S.-Kaplan, CHU Bretonneau, 37 - Tours (France); Lartigau, E. [Departement universitaire de radiotherapie, Centre O. Lambret, Universite Lille 2, 59 - Lille (France)

    2010-07-01

    One drawback of the growth in conformal radiotherapy and image-guided radiotherapy is the increased time needed to define the volumes of interest. This also results in inter- and intra-observer variability. However, developments in computing and image processing have enabled these tasks to be partially or totally automated. This article will provide a detailed description of the main principles of image segmentation in radiotherapy, its applications and the most recent results in a clinical context. (authors)

  2. Development of applicable software containing radiobiological and physical indices to evaluate radiotherapy planning

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seu Ran; Suh, Tae Suk [Dept. of Biomedical Engineering, The Catholic University of Korea, Seoul (Korea, Republic of); Park, Ji Yeon [Molecular Imaging Program at Stanford, Stafnord University, Richmond (United States)

    2014-11-15

    Adaptive radiation therapy (ART) provides more conformal dose distribution to the morphologically and physiologically changed tumor volumes during fractionated radiation therapy (RT). To develop an enhanced treatment plan evaluation tool based on multi-modality imaging which incorporates physical and radiobiological parameters, the software system was developed using MATLAB v.7.10.0499 (The Mathworks, Inc., Natick, MA). The application of plan evaluation can help the user choose more biologically optimal treatment plans and potentially predict treatment outcome more accurately. The radiotherapy planning based on the multi-modality images had more accurate results than that of based on only CT images in both physical and radiobiological perspectives.

  3. Preparation and preclinical evaluation of 211At-labelled compounds for α-particle radiotherapy

    International Nuclear Information System (INIS)

    The interest for α-particle emitters in internal radiotherapy is increasing due to improved conjugation chemistry. Experimental work has concentrated on 211At and 212Bi since these to nuclides have radiochemical and physical properties suitable for medical application. In this report it is demonstrated that biologically active 211At-labelled compounds can be prepared within a relatively short time allowing utilization of this 7.2 h α-particle. It is further shown that 211At-TP-3 treatment of human osteosarcoma in vitro gives promising therapeutic ratios. 76 refs., 5 figs., 3 tabs

  4. Preparation and preclinical evaluation of {sup 211}At-labelled compounds for {alpha}-particle radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, R.H.

    1994-12-31

    The interest for {alpha}-particle emitters in internal radiotherapy is increasing due to improved conjugation chemistry. Experimental work has concentrated on {sup 211}At and {sup 212}Bi since these to nuclides have radiochemical and physical properties suitable for medical application. In this report it is demonstrated that biologically active {sup 211}At-labelled compounds can be prepared within a relatively short time allowing utilization of this 7.2 h {alpha}-particle. It is further shown that {sup 211}At-TP-3 treatment of human osteosarcoma in vitro gives promising therapeutic ratios. 76 refs., 5 figs., 3 tabs.

  5. Human Papilloma Virus as a Biomarker for Personalized Head and Neck Cancer Radiotherapy

    DEFF Research Database (Denmark)

    Eriksen, Jesper Grau; Lassen, Pernille

    2016-01-01

    A dramatic increase in the incidence of HPV-related oropharyngeal cancer has been reported in some parts of the western world over the past 30 years. They constitute a clinically distinct subgroup of cancers in terms of molecular biology, patient characteristics, and treatment outcome. This chapter...... describes the molecular characteristics, epidemiology, and demographics of the HPV-related head and neck cancers and discuss available methods to detect HPV-related tumours. The impact of HPV-related biomarkers in clinical studies on radiotherapy only, altered fractionation, modulation of hypoxia...

  6. Predictive factors for the response of pulmonary tumours treated by robotic stereotactic radiotherapy

    International Nuclear Information System (INIS)

    The authors report a study which aimed at identifying factors influencing the response to radiotherapy performed in robotic stereotactic conditions with CyberKnife within the frame of treatment of primitive or secondary pulmonary tumours. Thirty eight stage I cancers, 22 metastases including 17 epidermoid carcinomas, and 43 adenocarcinomas have been treated this way. The analysis of data and results reveals that feminine gender, a biological dose greater than 140 Gy, and an age greater than 65 year old are associated with a better tumour response. Short communication

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

    Energy Technology Data Exchange (ETDEWEB)

    Messing, K.; Ferraris, J.; Bradley, W.E.; Swartz, J.; Seifert, A.M. (Universite du Quebec a Montreal (Canada))

    1989-10-01

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

  8. Carbon ion radiotherapy for sarcomas

    International Nuclear Information System (INIS)

    Principles of heavy ion therapy, its application to bone and soft tissue sarcomas and outline of its general state are described. The heavy ion therapy has advantages of its high dose distribution to the target and strong biological effect due to the Bragg peak formation and high linear energy transfer, respectively. The authors use carbon ion generated by Heavy Ion Medical Accelerator in Chiba (HIMAC) for the therapy of performance state 0-2 patients with the sarcomas unresectable, diagnosed pathologically, and of 60 y, 45% and teens, 8%) have been treated, whose tumor site has been the pelvis in 73%, volume >600 mL in 63%, tissue type of bone tumor in 70% (where cordoma has amounted to>200 cases). Five-year local control rate is found 71% and survival, 59%. In 175 therapeutically fresh cases with sacral cordoma of median age 67 y, with median clinical target volume 9 cm, treated with median dose 70.4 GyE/16 irradiations, the 8-y local control rate is found to be 69% and survival, 74%, within the median follow-up 54 months; with severe skin ulcer in 2 cases and deterioration of nervous dysfunction in 15 cases; suggesting the therapy is as effective and useful as surgical resection. At present, the therapy is not applicable to Japan health insurance. In the author's hospital, the heavy ion therapy has been conducted to total of >6,000 patients, which amounting to the largest number in the world. Now, 3 Japanese facilities can do the therapy as well and 3 countries in the world.(T.T.)

  9. Proposed pulsed neutron source for radiotherapy and radiography

    International Nuclear Information System (INIS)

    Conventional radiation therapy involves low Linear Energy Transfer (LET) radiations like high energy electrons and photons. The basic effects of these ionizing radiations are to destroy the ability of cells to divide, by damaging their DNA strands. For low LET radiations, the damage is induced primarily by activated radicals produced from atomic interactions. Over the energy range of therapeutically used X-rays, typically 100 keV to 25 MeV, approximately the same physical dose needs to be delivered at different energies to reach a given biological endpoint, resulting in similar Relative Biological Effectiveness (RBEs). High LET radiations such as protons, neutrons, however, result in biological damage that is generally larger per unit dose than for X-rays, resulting in an elevated RBE. In case of neutrons, the recoils and nuclear disintegration product contributes to the dose are responsible for a high energy transfer to the biologically active molecules and destroy them in turn. High RBE, LET characteristics and comparatively good Dose Distribution Advantage (DDA), are the main attractive feature of the neutron therapy. As the biological effectiveness of neutrons is high, the required tumor dose is about one third the dose required with photons. Moreover, the tumor cell damaged by low LET radiation has a good chance to repair and continue to grow, while for tumors treated by neutrons the chance for repairing of tumor is very small. Therefore, the neutron therapy is presently realized in two versions: Neutron Capture Therapy (NCT) and the Fast Neutron Therapy (FNT). In NCT, the isotope with large absorption cross-section for thermal/epithermal neutrons is introduced into the body mainly through the blood, while FNT uses fast neutron with high penetrability and treats the malignant tumors of the head, neck, dairy gland, osteogeneous sarcomas, etc. Therefore, in the present paper, considering the importance of the field, the 6 MeV electron accelerator based pulsed

  10. Dose response explorer: an integrated open-source tool for exploring and modelling radiotherapy dose-volume outcome relationships

    International Nuclear Information System (INIS)

    Radiotherapy treatment outcome models are a complicated function of treatment, clinical and biological factors. Our objective is to provide clinicians and scientists with an accurate, flexible and user-friendly software tool to explore radiotherapy outcomes data and build statistical tumour control or normal tissue complications models. The software tool, called the dose response explorer system (DREES), is based on Matlab, and uses a named-field structure array data type. DREES/Matlab in combination with another open-source tool (CERR) provides an environment for analysing treatment outcomes. DREES provides many radiotherapy outcome modelling features, including (1) fitting of analytical normal tissue complication probability (NTCP) and tumour control probability (TCP) models, (2) combined modelling of multiple dose-volume variables (e.g., mean dose, max dose, etc) and clinical factors (age, gender, stage, etc) using multi-term regression modelling, (3) manual or automated selection of logistic or actuarial model variables using bootstrap statistical resampling, (4) estimation of uncertainty in model parameters, (5) performance assessment of univariate and multivariate analyses using Spearman's rank correlation and chi-square statistics, boxplots, nomograms, Kaplan-Meier survival plots, and receiver operating characteristics curves, and (6) graphical capabilities to visualize NTCP or TCP prediction versus selected variable models using various plots. DREES provides clinical researchers with a tool customized for radiotherapy outcome modelling. DREES is freely distributed. We expect to continue developing DREES based on user feedback

  11. Dose response explorer: an integrated open-source tool for exploring and modelling radiotherapy dose volume outcome relationships

    Science.gov (United States)

    El Naqa, I.; Suneja, G.; Lindsay, P. E.; Hope, A. J.; Alaly, J. R.; Vicic, M.; Bradley, J. D.; Apte, A.; Deasy, J. O.

    2006-11-01

    Radiotherapy treatment outcome models are a complicated function of treatment, clinical and biological factors. Our objective is to provide clinicians and scientists with an accurate, flexible and user-friendly software tool to explore radiotherapy outcomes data and build statistical tumour control or normal tissue complications models. The software tool, called the dose response explorer system (DREES), is based on Matlab, and uses a named-field structure array data type. DREES/Matlab in combination with another open-source tool (CERR) provides an environment for analysing treatment outcomes. DREES provides many radiotherapy outcome modelling features, including (1) fitting of analytical normal tissue complication probability (NTCP) and tumour control probability (TCP) models, (2) combined modelling of multiple dose-volume variables (e.g., mean dose, max dose, etc) and clinical factors (age, gender, stage, etc) using multi-term regression modelling, (3) manual or automated selection of logistic or actuarial model variables using bootstrap statistical resampling, (4) estimation of uncertainty in model parameters, (5) performance assessment of univariate and multivariate analyses using Spearman's rank correlation and chi-square statistics, boxplots, nomograms, Kaplan-Meier survival plots, and receiver operating characteristics curves, and (6) graphical capabilities to visualize NTCP or TCP prediction versus selected variable models using various plots. DREES provides clinical researchers with a tool customized for radiotherapy outcome modelling. DREES is freely distributed. We expect to continue developing DREES based on user feedback.

  12. Radiotherapy in primary cerebral lymphoma; Radiotherapie des lymphomes primitifs du systeme nerveux central

    Energy Technology Data Exchange (ETDEWEB)

    Legros, L.; Benezery, K.; Lagrange, J.L. [Centre Antoine-Lacassagne, 06 - Nice (France). Dept. de Radiotherapie

    1999-03-01

    Primary cerebral lymphoma is a rare disease with an unfavorable prognosis. Whole brain radiotherapy has been the standard treatment, but neither the optimal radiation fields nor optimal dose level of the regimen are as yet firmly establisheD. From this review of the literature, it seems that the whole brain must be treated, and a boost to the area of the primary site must be discussed. With regard to dose, the radiation dose-response relationship is not clearly proven. Yet, a minimum dose of 40 Gy is necessary, and the maximum dose is set at 50 Gy because of late neurological sequelae. Because of the poor prognosis of this disease and the risk of late sequelae, other avenues have been explored. Chemotherapy has been studied, seem to have a survival advantage and combinations of radiotherapy and chemotherapy, especially with high-dose methotrexate. Because primary cerebral lymphoma is an uncommon disease, randomized clinical trials that compare radiotherapy alone to chemotherapy plus radiotherapy may not be feasible. Finally, even if chemotherapy seems to have a survival advantage, the regimen of chemotherapy is still a matter of debate. (authors)

  13. Mammography findings following electron intraoperative radiotherapy or external radiotherapy for breast cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, B.P.S.A., E-mail: pacebarbara@hotmail.com [Hospital das Clinicas da Universidade de Sao Paulo, Instituto de Radiologia, Av. Dr. Eneas de Carvalho Aguiar 255, 3o andar, Cerqueira Cesar, Sao Paulo, Sao Paulo 05403 001 (Brazil); Frasson, A.L., E-mail: alfrasson@hotmail.com [Servico de Mastologia, Hospital Sao Lucas da PUC do Rio Grande do Sul, Av. Ipiranga, 6690, conjunto 714, Jardim Botanico, Porto Alegre, Rio Grande Sul 90 610 000 (Brazil); Santos, M.M., E-mail: gringa2009@hotmail.com [Hospital Sao Lucas da PUC do Rio Grande do Sul, Av. Ipiranga, 6690, conjunto 714, Jardim Botanico, Porto Alegre, Rio Grande Sul 90 610 000 (Brazil); Barros, N. de, E-mail: nestor.barros@hotmail.com [Departamento de Radiologia, Hospital das Clinicas da Universidade de Sao Paulo, Instituto de Radiologia, Av. Dr. Eneas de Carvalho Aguiar 255, 3o andar, Cerqueira Cesar, Sao Paulo, Sao Paulo 05403 001 (Brazil)

    2011-08-15

    Radiotherapy following breast cancer conserving surgery decreases the risks of local recurrence. Because 85% of breast cancers relapse in or around the surgical bed there has been some debate on the need for irradiating the whole breast. Electron intraoperative radiotherapy (ELIOT) has been used as a viable alternative for conventional external radiotherapy (RT). While the former requires a single dose of 21 Gy in the tumoral bed, the latter requires 5-6 weeks of irradiation with a total dose of 50 Gy and a boost of 10 Gy that irradiates the surgical bed. Herein, we investigated whether any significant differences exist between the mammography findings obtained from patients submitted to one of the two techniques. Two groups of 30 patients each were included in this study. All patients had mammographies taken at 12 and 24 months after finishing treatment. The mammography findings evaluated were: cutaneous thickening (>2 mm), architectural distortion secondary to fibrosis, edema, calcifications (both benign and malignant), and fat necrosis. For all variables studied, there was no statistical difference between the two groups. This indicates that the mammography findings obtained in either 12- or 24-month follow-up periods after breast cancer conserving surgery are similar, regardless of which of the two radiotherapy techniques (ELIOT or RT) is employed as a treatment for breast cancer.

  14. Fractionated radiotherapy of intracranial meningiomas and neurinomas; Radiotherapie fractionnee des meningiomes et des neurinomes intracraniens

    Energy Technology Data Exchange (ETDEWEB)

    Maire, J.P.; Vendrely, V.; Bonichon, N. [Hopital Saint-Andre, Service d' oncologie-Radiotherapie, 33 - Bordeaux (France); Dautheribes, M. [Hopital Saint-Andre, Service de Neurochirurgie, 33 - Bordeaux (France); Darrouzet, V. [Hopital Saint-Andre, Service d' Otorhinoloryngologie, 33 - Bordeaux (France)

    2000-12-01

    In lost institutions, surgical excision remains the standard treatment of meningiomas and neurinomas; the aim of surgery is complete resection. However, total removal is not always feasible without significant morbidity and in some cases, the patient's condition contraindicates surgery. For incompletely excised tumors, recurrences will have consequences on neurological functions. There are now many reports in the literature confirming the fact that radiotherapy significantly decreases the incidence of recurrence of incompletely resected benign tumors and that it can replace surgery in some situations where an operation would involve considerable danger or permanent neurological damage: about 80 to 90% of such tumors are controlled with fractionated radiotherapy. Stereotaxic and three-dimensional treatment planning techniques increase local control and central nervous system tolerance so that the respective place of surgery and radiotherapy needs to be redefined, considering efficacy and morbidity of these two therapeutic means. In this article, we limit our remarks to fractionated radiotherapy and, after a review of the literature, we discuss the indications, volume evaluations and the techniques currently used. (authors)

  15. Radiotherapy: an interactive learning tool; Strahlentherapie: Ein interaktives Lernprogramm

    Energy Technology Data Exchange (ETDEWEB)

    Frenzel, T.; Kruell, A.; Schmidt, R.; Dobrucki, W.; Malys, B.

    1998-11-01

    The program is primarily intended for radiological medical technicians, student nurses, students of medicine and physics, and doctors. It is designed as a tool for vocational training and further training and gives comprehensive insight into the daily routines of a radiotherapy unit. The chapters deal with: fundamental biological aspects - fundamental physical aspects - radiation sources and irradiation systems - preparatory examinations - therapies and concepts - irradiation planning - irradiation performance - termination of irradiation treatment. For every page displayed, spoken texts and written, on-screen keywords, illustrations, animated sequences and a large number of videos have been combined in a way easy to digest. The software of the program permits handling also by learners less familiar with computer-based learning. (orig./) [Deutsch] Das Programm richtet sich in erster Linie an MTRAs, Schwesternschuelerinnen, Medizin- und Physikstudenten sowie Aerzte. Es wurde zur Aus- und Weiterbildung konzipiert und soll helfen, die Arbeitsablaeufe einer Strahlentherapieabteilung transparent zu machen. Die Kapitel lauten - biologische Grundlagen - physikalische Grundlagen - Bestrahlungsgeraete - vorbereitende Untersuchungen - Behandlungskonzept - Bestrahlungsplanung - Ausfuehrung der Bestrahlung sowie Ende der Strahlenbehandlung. Fuer jede Bildschirmseite sind gesprochener Text und auf dem Bildschirm ausgegebene Stichworte, Abbildungen, Animationen und eine Vielzahl von Videos in einpraegsamer Weise kombiniert worden. Das Programm wurde so konzipiert, dass es sich auch von Personen ohne grosse Computerkenntnisse bedienen laesst. (orig.)

  16. Salivary Gland. Photon beam and particle radiotherapy: Present and future.

    Science.gov (United States)

    Orlandi, Ester; Iacovelli, Nicola Alessandro; Bonora, Maria; Cavallo, Anna; Fossati, Piero

    2016-09-01

    Salivary gland cancers (SGCs) are rare diseases and their treatment depends upon histology, stage and site of origin. Radical surgery is the mainstay of treatment but radiotherapy (RT) plays a key role in both the postoperative and the inoperable setting, as well as in recurrent disease. In the absence of prospective randomized trials, a wide retrospective literature suggests postoperative RT (PORT) in patients with high risk pathological features. SGCs, and adenoid cystic carcinoma (ACC) in particular, are known to be radio-resistant tumors and should therefore respond well to particle beam therapy. Recently, excellent outcome has been reported with radical carbon ion RT (CIRT) in particular for ACC. Both modern photon- and hadron-based treatments are effective and are characterized by a favourable toxicity profile. But it is not clear whether one modality is superior to the other for disease control, due to the differences in patients' selection, techniques, fractionation schedules and outcome measurements among clinical experiences. In this paper, we review the role of photon and particle RT for malignant SGCs, discussing the difference between modalities in terms of biological and technical characteristics. RT dose and target volumes for different histologies (ACC versus non-ACC) have also been taken into consideration. PMID:27394087

  17. Auger Emitter Based Radiotherapy- A Possible New Treatment for Cancer

    DEFF Research Database (Denmark)

    Fredericia, Pil; Groesser, Torsten; Severin, Gregory;

    2014-01-01

    damage produced by Low-LET radiation used in current radiotherapy (2-3) Considerable efforts have been made in the past twenty years to develop Auger emitter-based radiotherapy However, previous studies lack precise measurement of RBE, which is the fundamental factor defining the relationship between...

  18. The place radiotherapy alone with respect to surgery and radiotherapy in locally advanced vulva cancers; Place de la radiotherapie seule par rapport a la chirurgie et la radiotherapie dans les cancers vulvaires localement evolues

    Energy Technology Data Exchange (ETDEWEB)

    Mansouri, S.; Naim, A.; Moukhlissi, M.; Tawfik, N.; Bouchbika, Z.; Benchekroun, N.; Jouhadi, H.; Sahraoui, S.; Benider, A. [Centre de radiotherapie-oncologie, centre hospitalier universitaire, Ibn-Rochd, Casablanca (Morocco)

    2011-10-15

    The author report a study which aimed at evaluating the place or radiotherapy associated with surgery and of radiotherapy without surgery when taking into care locally advanced vulva cancers. The study is based on 46 cases. After 24 months, different aspects, such as recurrence and survival, have been assessed. It appears that there is no survival difference without recurrences between both sets. Short communication

  19. Value of intraoperative radiotherapy in locally advanced rectal cancer

    NARCIS (Netherlands)

    Ferenschild, Floris T. J.; Vermaas, Maarten; Nuyttens, Joost J. M. E.; Graveland, Wilfried J.; Marinelli, Andreas W. K. S.; van der Sijp, Joost R.; Wiggers, Theo; Verhoef, Cornelis; Eggermont, Alexander M. M.; de Wilt, Johannes H. W.

    2006-01-01

    PURPOSE: This study was designed to analyze the results of a multimodality treatment using preoperative radiotherapy, followed by surgery and intraoperative radiotherapy in patients with primary locally advanced rectal cancer. METHODS: Between 1987 and 2002, 123 patients with initial unresectable an

  20. Rotational radiotherapy for prostate cancer in clinical practice

    DEFF Research Database (Denmark)

    Aznar, Marianne C; Petersen, Peter Meidahl; Logadottir, Ashildur;

    2010-01-01

    Radiotherapy is the standard treatment in locally advanced prostate cancer. The latest technological improvement is modulated rotational radiotherapy, where one single rotation of the treatment machine is used to conform the dose delivery to the target and spare organs at risk, requiring less than...

  1. Breast-conserving surgery and radiotherapy for early breast cancer

    International Nuclear Information System (INIS)

    From March 1987 through September 1989, a total of 31 patients with early breast cancer were treated with breat-conserving surgery and radiotherapy. As of February 1989, all patients are alive without recurrence. Cosmetic results were satisfactory (excellent; 25%, good; 75%) at 1 year after radiotherapy. Mild radiation pneumonitis requiring medication developed in 3 patients. (author)

  2. Modeling geometrical uncertainties for radiotherapy plan optimization without margins

    NARCIS (Netherlands)

    Budiarto, E.

    2015-01-01

    Radiotherapy is one of the methods used to treat cancer. One common approach for radiotherapy is exposing the patient to external beams of high-energy X-ray photons. Using the intensity-modulated radiation therapy (IMRT) technique, the fluence (radiation energy per unit area) of the radiation beams

  3. Is synthetic biology mechanical biology?

    Science.gov (United States)

    Holm, Sune

    2015-12-01

    A widespread and influential characterization of synthetic biology emphasizes that synthetic biology is the application of engineering principles to living systems. Furthermore, there is a strong tendency to express the engineering approach to organisms in terms of what seems to be an ontological claim: organisms are machines. In the paper I investigate the ontological and heuristic significance of the machine analogy in synthetic biology. I argue that the use of the machine analogy and the aim of producing rationally designed organisms does not necessarily imply a commitment to mechanical biology. The ideal of applying engineering principles to biology is best understood as expressing recognition of the machine-unlikeness of natural organisms and the limits of human cognition. The paper suggests an interpretation of the identification of organisms with machines in synthetic biology according to which it expresses a strategy for representing, understanding, and constructing living systems that are more machine-like than natural organisms.

  4. Postoperative external beam radiotherapy for medulloblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Ha Chung; Lee, Myung Za [College of Medicine, Hanyang Univ., Seoul (Korea, Republic of)

    2000-06-01

    This study was performed to evaluate the effectiveness and tolerance of craniospinal irradiation for patients with medulloblastoma and to define the optimal radiotherapeutic regimen. We retrospectively analyzed the records of 43 patients with medulloblastoma who were treated with external beam craniospinal radiotherapy at our institution between May, 1984 and April, 1998. Median follow up period was 47 months with range of 18 to 86 months. Twenty seven patients were male and sixteen patients were female, a male to female ratio of 1.7:1. Surgery consisted of biopsy alone in 5 patients, subtotal excision in 24 patients, and gross total excision in 14 patients. All of the patients were treated with craniospinal irradiation. All of the patients except four received fat least 5,000 cGy to the posterior fossa and forty patients received more than 3,000 cGy to the spinal cord. The overall survival rates at 5 and 7 years for entire group of patients were 67% and 56%, respectively. Corresponding disease free survival rates were 60% and 51%, respectively. The rates of disease control in the posterior fossa were 77% and 67% at 5 and 7 years. Gross total excision and subtotal excision resulted in 5 year overall survival rates of 76% and 66%, respectively. in contrast, those patients who had biopsy alone had a 5 year survival rate of only 40%. Posterior fossa was a component of failure in 11 of the 18 recurrences. Seven recurrences were isolated to the posterior fossa. Four patients had neuraxis recurrences, three had distant metastasis alone and four had multiple sites of failure, all involving the primary site. Craniospinal irradiation for patients with medulloblastoma is an effective adjuvant treatment without significant treatment related toxicities. There is room for improvement in terms of posterior fossa control, especially in biopsy alone patients. The advances in radiotherapy including hyperfractionation, stereotactic radiosurgery and 3D conformal radiotherapy would be

  5. Dosimetry audit of radiotherapy treatment planning systems

    International Nuclear Information System (INIS)

    In radiotherapy Treatment Planning Systems (TPS) various calculation algorithms are used. The accuracy of dose calculations has to be verified. Numerous phantom types, detectors and measurement methodologies are proposed to verify the TPS calculations with dosimetric measurements. A heterogeneous slab phantom has been designed within a Coordinated Research Project (CRP) of the IAEA. The heterogeneous phantom was developed in the frame of the IAEA CRP. The phantom consists of frame slabs made with polystyrene and exchangeable inhomogeneity slabs equivalent to bone or lung tissue. Special inserts allow to position thermoluminescent dosimeters (TLD) capsules within the polystyrene slabs below the bone or lung equivalent slabs and also within the lung equivalent material. Additionally, there are inserts that allow to position films or ionisation chamber in the phantom. Ten Polish radiotherapy centres (of 30 in total) were audited during on-site visits. Six different TPSs and five calculation algorithms were examined in the presence of inhomogeneities. Generally, most of the results from TLD were within 5 % tolerance. Differences between doses calculated by TPSs and measured with TLD did not exceed 4 % for bone and polystyrene equivalent materials. Under the lung equivalent material, on the beam axis the differences were lower than 5 %, whereas inside the lung equivalent material, off the beam axis, in some cases they were of around 7 %. The TLD results were confirmed with the ionisation chamber measurements. The comparison results of the calculations and the measurements allow to detect limitations of TPS calculation algorithms. The audits performed with the use of heterogeneous phantom and TLD seem to be an effective tool for detecting the limitations in the TPS performance or beam configuration errors at audited radiotherapy departments. (authors)

  6. Clinical treatment of lumbodorsal radiotherapy ulcers

    International Nuclear Information System (INIS)

    Objective: To summarize our experience in the treatment of 12 cases of severe lumbodorsal radio-therapy ulcers. Methods: Of the 12 cases, 4 were male and 8 female. The youngest patient was 29 and the oldest was 67 years old. Their injuries were mainly resulted from radiotherapy for costal metastasis of breast cancer, carcinoma of uterus and dorsal skin carcinoma or scar induced by 60Co γ-rays, deep X-rays or superficial accelerator electrons. Their local accumulative dose was 60-120 Gy. Palliative debridement was performed with partial excision of the ribs and spinous process. And then the defects were repaired with local skin flap in 2 cases, parascapular skin flap in 1 case and island musculocutaneous flap of latissimus dorsi muscle in 9 cases. Results: All the skin flaps and musculocutaneous flaps grafted on the wounds of the 12 cases survived (100%). Grade A healing was achieved in 11 cases of ulcer (91.7%) and grade B healing in 1 cases (8.3%). All the skin flaps and musculocutaneous flaps grafted survived and the ulcers never recurred. Conclusion: Severe lumbodorsal radiotherapy injury often results in complications. The authors performed palliative excision and repaired by transferring an axial skin flap or a musculocutaneous flap with good blood circulation selected in accordance with the principles of plastic surgery, which can effectively improve blood circulation and promote wound healing. Reverse musculocutaneous flap of latissimus dorsi muscle is an especially good material for reconstruction. It has axial blood vessel and proper thickness. It is broad and can be rotated with great range and the donor site can be sutured directly

  7. From image-guided radiotherapy to dose-guided radiotherapy; De la radiotherapie guidee par l'image a la radiotherapie guidee par la dose

    Energy Technology Data Exchange (ETDEWEB)

    Cazoulat, G.; Lesaunier, M.; Simon, A.; Haigron, P.; Acosta, O. [Inserm, U642, 35000 Rennes (France); LTSI, universite de Rennes-1, 35000 Rennes (France); Louvel, G.; Chajon, E.; Leseur, J. [Centre Eugene-Marquis, rue de La-Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France); Lafond, C.; De Crevoisier, R. [Inserm, U642, 35000 Rennes (France); LTSI, universite de Rennes-1, 35000 Rennes (France); Centre Eugene-Marquis, rue de La-Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes cedex (France)

    2011-12-15

    Purpose. - In case of tumour displacement, image-guided radiotherapy (IGRT) based on the use of cone beam CT (tomographie conique) allows replacing the tumour under the accelerator by rigid registration. Anatomical deformations require however re-planning, involving an estimation of the cumulative dose, session after session. This is the objective of this study. Patients and methods. - Two examples of arc-intensity modulated radiotherapy are presented: a case of prostate cancer (total dose = 80 Gy) with tomographie conique (daily prostate registration) and one head and neck cancer (70 Gy). For the head and neck cancer, the patient had a weekly scanner allowing a dose distribution calculation. The cumulative dose was calculated per voxel on the planning CT after deformation of the dose distribution (with trilinear interpolation) following the transformation given by a non-rigid registration step (Demons registration method) from: either the tomographie conique (prostate), or the weekly CT. The cumulative dose was eventually compared with the planned dose. Results. - In cases of prostate irradiation, the 'cumulative' dose corresponded to the planned dose to the prostate. At the last week of irradiation, it was above the planned dose for the rectum and bladder. The volume of rectal wall receiving more than 50 Gy (V50) was 20% at the planning and 26% at the end of treatment, increasing the risk of rectal toxicity (NTCP) of 14%. For the bladder wall, V50 were 73% and 82%, respectively. In head and neck, the 'cumulative' dose to the parotid exceeded the planned dose (mean dose increasing from 46 Gy to 54 Gy) from the 5. week of irradiation on, suggesting the need for re-planning within the first 5 weeks of radiotherapy. Conclusion. - The deformable registration estimates the cumulative dose delivered in the different anatomical structures. Validation on digital and physical phantoms is however required before clinical evaluation. (authors)

  8. WEE1 inhibition sensitizes osteosarcoma to radiotherapy

    Directory of Open Access Journals (Sweden)

    Helder Marco N

    2011-04-01

    Full Text Available Abstract Background The use of radiotherapy in osteosarcoma (OS is controversial due to its radioresistance. OS patients currently treated with radiotherapy generally are inoperable, have painful skeletal metastases, refuse surgery or have undergone an intralesional resection of the primary tumor. After irradiation-induced DNA damage, OS cells sustain a prolonged G2 cell cycle checkpoint arrest allowing DNA repair and evasion of cell death. Inhibition of WEE1 kinase leads to abrogation of the G2 arrest and could sensitize OS cells to irradiation induced cell death. Methods WEE1 expression in OS was investigated by gene-expression data analysis and immunohistochemistry of tumor samples. WEE1 expression in OS cell lines and human osteoblasts was investigated by Western blot. The effect of WEE1 inhibition on the radiosensitivity of OS cells was assessed by cell viability and caspase activation analyses after combination treatment. The presence of DNA damage was visualized using immunofluorescence microscopy. Cell cycle effects were investigated by flow cytometry and WEE1 kinase regulation was analyzed by Western blot. Results WEE1 expression is found in the majority of tested OS tissue samples. Small molecule drug PD0166285 inhibits WEE1 kinase activity. In the presence of WEE1-inhibitor, irradiated cells fail to repair their damaged DNA, and show higher levels of caspase activation. The inhibition of WEE1 effectively abrogates the irradiation-induced G2 arrest in OS cells, forcing the cells into premature, catastrophic mitosis, thus enhancing cell death after irradiation treatment. Conclusion We show that PD0166285, a small molecule WEE1 kinase inhibitor, can abrogate the G2 checkpoint in OS cells, pushing them into mitotic catastrophe and thus sensitizing OS cells to irradiation-induced cell death. This suggests that WEE1 inhibition may be a promising strategy to enhance the radiotherapy effect in patients with OS.

  9. Surgery Followed by Radiotherapy Versus Radiotherapy Alone for Metastatic Spinal Cord Compression From Unfavorable Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Rades, Dirk, E-mail: Rades.Dirk@gmx.net [Department of Radiation Oncology, University of Lubeck (Germany); Huttenlocher, Stefan [Department of Radiation Oncology, University of Lubeck (Germany); Bajrovic, Amira [Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf (Germany); Karstens, Johann H. [Department of Radiation Oncology, Medical University Hannover (Germany); Adamietz, Irenaeus A. [Department of Radiation Oncology, Ruhr University Bochum (Germany); Kazic, Nadja [Department of Radiation Oncology, University of Sarajevo (Bosnia and Herzegowina); Rudat, Volker [Department of Radiation Oncology, Saad Specialist Hospital Al Khobar (Saudi Arabia); Schild, Steven E. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States)

    2011-12-01

    Purpose: Despite a previously published randomized trial, controversy exists regarding the benefit of adding surgery to radiotherapy for metastatic spinal cord compression (MSCC). It is thought that patients with MSCC from relatively radioresistant tumors or tumors associated with poor functional outcome after radiotherapy alone may benefit from surgery. This study focuses on these tumors. Methods and Materials: Data from 67 patients receiving surgery plus radiotherapy (S+RT) were matched to 134 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for 10 factors and compared for motor function, ambulatory status, local control, and survival. Additional separate matched-pair analyses were performed for patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS) and patients receiving laminectomy (LE). Results: Improvement of motor function occurred in 22% of patients after S+RT and 16% after RT (p = 0.25). Posttreatment ambulatory rates were 67% and 61%, respectively (p = 0.68). Of nonambulatory patients, 29% and 19% (p = 0.53) regained ambulatory status. One-year local control rates were 85% and 89% (p = 0.87). One-year survival rates were 38% and 24% (p = 0.20). The matched-pair analysis of patients receiving LE showed no significant differences between both therapies. In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred more often after DDSS+RT than RT (28% vs. 19%, p = 0.024). Posttreatment ambulatory rates were 86% and 67% (p = 0.30); 45% and 18% of patients regained ambulatory status (p = 0.29). Conclusions: Patients with MSCC from an unfavorable primary tumor appeared to benefit from DDSS but not LE when added to radiotherapy in terms of improved functional outcome.

  10. Radiotherapy for cutaneous cancers with xeroderma pigmentosum; Radiotherapie des cancers cutanes au cours du xeroderma pigmentosum

    Energy Technology Data Exchange (ETDEWEB)

    Ben Salah, H.; Bahri, M.; Turki, H.; Abdelmoula, M.; Frikha, M.; Daoud, J. [Service de radiotherapie, CHU Habib-Bourguiba, route Majida-Bouleila, 3029 Sfax (Tunisia)

    2011-08-15

    Purpose. - To analyze the therapeutic results of cutaneous cancers on xeroderma pigmentosum through a series of 15 patients treated by radiotherapy. Patients and methods. - Between 1993 and 2006, 15 patients with xeroderma pigmentosum and having cutaneous cancers were treated in the Radiotherapy Department of university hospital Habib-Bourguiba of Sfax in Tunisia. Seventy-three percent of the cases occurred in male patients and the mean age of appearance of the first tumour was 18.2 years. Tumour histology was squamous cell carcinoma in 74% of the cases. The total number of cutaneous tumours was 84. Ten patients had a surgical resection. Four patients did not respond to chemotherapy. The modality of irradiation was decided according to the size, thickness and localization of the tumour. The dose of radiotherapy was 60 Gy or equivalent with classic irradiation. Results. - The total number of lesions treated with radiotherapy was 64. Forty-three lesions were treated with contact-therapy, ten with brachytherapy and 11 with cobalt-therapy. The following acute complications were observed: cutaneous infection (53.3% of patients), radio-epithelitis (80% of patients) and necroses (33.3% of patients). Evaluation after treatment showed a clinical complete remission in 73% of the cases. Late effects were noted in seven cases: telangiectasia and cutaneous atrophy. A recurrence in the irradiated zone was observed in one case. A nodal metastasis was observed in two cases. Another patient presented lung metastases. After a median follow up of 37.2 months, four patients died, seven are alive with cutaneous cancer and four are alive with complete remission. Conclusion. - Radiotherapy is a possible and effective therapeutic alternative. Dose and methods are not defined for xeroderma pigmentosum. (authors)

  11. Quality assurance in radiotherapy: analysis of the causes of not starting or early radiotherapy withdrawal

    International Nuclear Information System (INIS)

    The aim of this study was to analyse the reasons for not starting or for early of radiotherapy at the Radiation Oncology Department. All radiotherapy treatments from March 2010 to February 2012 were included. Early withdrawals from treatment those that never started recorded. Clinical, demographic and dosimetric variables were also noted. From a total of 3250 patients treated and reviewed, 121 (4%) did not start or complete the planned treatment. Of those, 63 (52%) did not receive any radiotherapy fraction and 58 (48%) did not complete the course, 74% were male and 26% were female. The mean age was 67 ± 13 years. The most common primary tumour was lung (28%), followed by rectum (16%). The aim of treatment was 62% radical and 38% palliative, 44% of patients had metastases; the most common metastatic site was bone, followed by brain. In 38% of cases (46 patients) radiotherapy was administered concomitantly with chemotherapy (10 cases (22%) were rectal cancers). The most common reason for not beginning or for early withdrawal of treatment was clinical progression (58/121, 48%). Of those, 43% died (52/121), 35 of them because of the progression of the disease and 17 from other causes. Incomplete treatment regimens were due to toxicity (12/121 (10%), of which 10 patients underwent concomitant chemotherapy for rectal cancer). The number of patients who did not complete their course of treatment is low, which shows good judgement in indications and patient selection. The most common reason for incomplete treatments was clinical progression. Rectal cancer treated with concomitant chemotherapy was the most frequent reason of the interruption of radiotherapy for toxicity

  12. Biology Notes.

    Science.gov (United States)

    School Science Review, 1982

    1982-01-01

    Presents procedures, exercises, demonstrations, and information on a variety of biology topics including labeling systems, biological indicators of stream pollution, growth of lichens, reproductive capacity of bulbous buttercups, a straw balance to measure transpiration, interaction of fungi, osmosis, and nitrogen fixation and crop production. (DC)

  13. Radiotherapy for head and neck cancer in elderly patients

    International Nuclear Information System (INIS)

    Background and purpose: Elderly patients with head and neck cancer may not be treated aggressively with radiotherapy, due to concerns regarding tolerance of treatment and toxicity. A retrospective study was undertaken of patients aged 80 years and over, treated by definitive radiotherapy for head and neck cancer. Material and methods: 98 patients aged 80-92 received radiotherapy for carcinoma of the head and neck between 1991 and 1995. All patients received beam directed radiotherapy with radical intent using an immobilisation shell. Results: Cancer specific survival was 59% and overall local control was 70% at 5 years. Both were significantly affected by T stage and site of disease. Cancer specific survival was comparable to that of patients aged below 80 years. Seven patients died within 6 months of the treatment. Three patients developed severe late toxicity. Metastatic disease occurred in eight patients. Conclusions: Radiotherapy is a beneficial and well tolerated treatment in elderly patients with carcinoma of the head and neck

  14. All delays before radiotherapy risk progression of Merkel cell carcinoma

    International Nuclear Information System (INIS)

    Prolonged waiting times for radiotherapy have resulted in many centres assigning priorities to various patient or diagnostic groups. A high risk of progression on a waiting list is one factor that would reasonably influence the priority. The present descriptive study of 27 patients with Merkel cell carcinoma (MCC) found that a median wait of 24 days for radiotherapy is associated with a high risk of progression. Eleven (41%) of 27 patients developed progressive disease, including five (45%) of 11 patients waiting for adjuvant radiotherapy. Patients treated adjuvantly also had longer waiting times prior to their initial radiotherapy consultation (median 41 days), which may have contributed to the rate of progression. Merkel cell carcinoma is an aggressive but curable malignancy and appropriate management should include efforts to minimize all potential delays prior to the commencement of radiotherapy. Copyright (2004) Blackwell Science Pty Ltd

  15. Faecal incontinence following radiotherapy for prostate cancer: A systematic review

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Høyer, Morten; Lundby, Lilli;

    2011-01-01

    BACKGROUND: Faecal incontinence (FI) after radiotherapy is a known phenomenon, but has received little attention to date. This article aimed to review current knowledge on faecal incontinence related to radiotherapy for prostate cancer. METHODS: PubMed was searched for English-language articles...... published from January 1966 to December 2009 using the primary keywords 'faecal incontinence', 'prostate cancer' and 'radiotherapy'. Prospective, retrospective and controlled trials reporting FI as a complication of radiotherapy for prostate cancer were included. The retrieved titles and abstracts were...... for this review. The incidence of faecal incontinence following radiotherapy for prostate cancer varied from 1.6% to 58%. The mechanism of faecal incontinence was not entirely clear but it is most likely due to injury to the nerve plexus of the rectal muscular layer. Correlation between rectal dose...

  16. PET/CT Based Dose Planning in Radiotherapy

    DEFF Research Database (Denmark)

    Berthelsen, Anne Kiil; Jakobsen, Annika Loft; Sapru, Wendy;

    2011-01-01

    radiotherapy planning with PET/CT prior to the treatment. The PET/CT, including the radiotherapy planning process as well as the radiotherapy process, is outlined in detail. The demanding collaboration between mould technicians, nuclear medicine physicians and technologists, radiologists and radiology......This mini-review describes how to perform PET/CT based radiotherapy dose planning and the advantages and possibilities obtained with the technique for radiation therapy. Our own experience since 2002 is briefly summarized from more than 2,500 patients with various malignant diseases undergoing...... technologists, radiation oncologists, physicists, and dosimetrists is emphasized. We strongly believe that PET/CT based radiotherapy planning will improve the therapeutic output in terms of target definition and non-target avoidance and will play an important role in future therapeutic interventions in many...

  17. Assessment of psychological responses in patients about to receive radiotherapy

    International Nuclear Information System (INIS)

    Radiotherapy is considered to be associated with psychological distress. We assessed the mental status, anxiety, and the factors associated with these in cancer patients about to receive radiotherapy. Hospitalized patients about to receive radiotherapy participated. Psychological status was assessed by a psychiatrist, based on interview about the type of anxiety related to cancer or radiotherapy as well as self-rating questionnaires. Eligible data were collected from 94 patients. The incidence of mental disorders was 20%. The total mood disturbance scores were significantly higher in patients with poor performance status. The most common type of anxiety regarding radiotherapy was acute adverse effect, and the predictors were palliative treatment and living alone. Mental disorders, mood disturbance, and anxiety in patients cannot be neglected in radiation oncology practice. Especially careful attention should be paid to patients with these predictive factors. (author)

  18. IMAGE-GUIDED RADIOTHERAPY AND -BRACHYTHERAPY FOR CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Suresh eDutta

    2015-03-01

    Full Text Available Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT, and 2-dimensional intracavitary brachytherapy.Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron emission tomography (PET and magnetic resonance imaging (MRI has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT, allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.

  19. Image-guided radiotherapy and -brachytherapy for cervical cancer.

    Science.gov (United States)

    Dutta, Suresh; Nguyen, Nam Phong; Vock, Jacqueline; Kerr, Christine; Godinez, Juan; Bose, Satya; Jang, Siyoung; Chi, Alexander; Almeida, Fabio; Woods, William; Desai, Anand; David, Rick; Karlsson, Ulf Lennart; Altdorfer, Gabor

    2015-01-01

    Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT), and 2-dimensional intracavitary brachytherapy. Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron-emission tomography and magnetic resonance imaging has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT) may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT), allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer. PMID:25853092

  20. Intensity-Modulated Radiotherapy of Sacral Chordoma

    Energy Technology Data Exchange (ETDEWEB)

    Thilmann, Christoph; Schulz-Ertner, Daniela; Zabel, Angelika; Herfarth, Klaus K.; Wannenmacher, Michael; Debus, Juergen [German Cancer Research Center, Heidelberg (Germany)

    2002-08-01

    In a case of partially resected sacral chordoma, the planning target volume (PTV) received 60 Gy and the gross target volume (GTV) 72 Gy using inversely planned, intensity-modulated, radiation therapy (IMRT). IMRT was compared with 3D-conformal radiotherapy (CRT). With IMRT, it was found that dose distribution is more homogeneous within the PTV outside the GTV and allows simultaneous dose escalation within the GTV. The volume of bowel receiving a dose higher than 40 Gy was reduced from 400cc with CRT to 220cc with IMRT. If particle therapy is not available, IMRT seems to be a promising alternative in the treatment of sacral chordomas.

  1. Carbon Ion Radiotherapy for Skull Base Chordoma

    OpenAIRE

    Mizoe, Jun–etsu; Hasegawa, Azusa; Takagi, Ryo; Bessho, Hiroki; Onda, Takeshi; Tsujii, Hirohiko

    2009-01-01

    Objective: To present the results of the clinical study of carbon ion radiotherapy (CIRT) for skull base and paracervical spine tumors at the National Institute of Radiological Sciences in Chiba, Japan. Methods: The study is comprised of three protocols: a pilot study, a phase I/II dose escalation study, and a phase II study. All the patients were treated by 16 fractions for 4 weeks with total doses of 48.0, 52.8, 57.6, and 60.8 Gy equivalents (GyE). Results: As a result of the dose escalatio...

  2. Postsurgical telecobalt radiotherapy of mammary carcinomas

    International Nuclear Information System (INIS)

    The first part of the study is a literature survey. The second part deals with patients and results of radiotherapy of the Klinik and Poliklinik fuer Radiologie der Universitaet Muenchen. The patients with mammary carcinomas, who were treated between 1960 and 1969 were classified according to the TNM classification or they were attributed to stage I or II or III. When the therapy was begun, the mean age of the patients was 55 years, 80% of the patients was between 40 and 60 years old, 45% of the patients were in stage I, 35% in stage II and almost 20% in stage III. (orig./MG)

  3. External beam radiotherapy for thyroid cancer

    International Nuclear Information System (INIS)

    The indications for and techniques of external beam radiotherapy for thyroid tumours can be clearly defined in relation to the histological type of tumour and stage of disease. Localized treatment for carcinoma can easily be accomplished as can wide field irradiation for lymphoma. However, when either extensive lateral neck disease is present or tumour extends into the superior mediastinum, it becomes difficult to adequately encompass the required volume without including the spinal cord. Several techniques are described which overcome this problem and thus allow a radical dose to be given without significant risk of transverse myelitis

  4. Hypothyroidism after radiotherapy for early glottic cancer

    International Nuclear Information System (INIS)

    Reported is the case of a 46-year-old male with hypothyroidism after radiotherapy for early glottic cancer, T1N0M0, Stage I. Six months after 60Co irradiation 66 Gy with the radiation field size of 5 x 5 cm was given, the clinical signs of acute hypothyroidism was presented. Retrospective CT examinations proved that over 80% of the total dose was irradiated to about 10% of whole thyroid volume. Since laboratory examinations revealed high serum level of thyrogobrin antibody, we postulated immunological mechanism was associated with the onset of hypothyroidism. (author)

  5. Classification, staging and radiotherapy of bronchial carcinoma

    International Nuclear Information System (INIS)

    This thesis reports a study performed to evaluate the stage classification of bronchial carcinoma published by Thomas in 1963. The study was done in the radiotherapy department of a teaching hospital, and had three parts: a comparative analysis of the classifications and stage divisions described in the literature on bronchial carcinoma; an evaluation of the theoretical basis of the classification system introduced by Thomas as well as of the practical applicability of the division into stages, with respect to the assessment of the prognosis and the choice of therapy; and an analysis of various aspects of irradiation as well as of a number of prognostic factors in bronchial carcinoma. (Auth.)

  6. Lymphoma of the prostate treated with radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ghose, A.; Baxter-Smith, D.C.; Eeles, H.; Udeshi, U. [Kidderminster Health Care NHS Trust (United Kingdom); Priestman, T.J. [Royal Hospital, Wolverhampton (United Kingdom)

    1995-12-01

    Primary prostatic lymphoma is a rare disease. We report a 73-year-old man who initially presented with features of bladder outflow obstruction. Histology revealed non-Hodgkin`s lymphoma. He was treated with radical radiotherapy with complete regression of disease. Although the follow-up period is, as yet, relatively short, the apparently good result in this patient supports the view of other recent reports that the outcome in this situation depends on the features of the individual disease rather than it being universally poor as had been previously suggested. (author).

  7. Basic immunology of antibody targeted radiotherapy

    International Nuclear Information System (INIS)

    Antibody targeted radiotherapy brings an important new treatment modality to Radiation oncology clinic. Radiation dose to tumor and normal tissues are determined by a complex interplay of antibody, antigen, tumor, radionuclide, and host-related factors. A basic understanding of these immunologic and physiologic factors is important to optimally utilize this therapy in the clinic. Preclinical and clinical studies need to be continued to broaden our understanding and to develop new strategies to further improve the efficacy of this promising form of targeted therapy

  8. Radiolabelling of monoclonal antibodies for radiotherapy. Thailand

    International Nuclear Information System (INIS)

    Nuclear medicine is now playing a great role not only in diagnostic application but also in therapy of cancer patients. Under the concept of targeted radiotherapy, a number of radiopharmaceuticals based on radiolabelled biomolecules had been evaluated for treatment of cancer by many investigators. Of these, monoclonal antibodies and some small specific peptides labelled with beta emitting radiometals such as Sm-153, Re-186, Re-188 or Y-90, are being introduced into clinical trials. The objective of this project is to develop laboratory procedures to label monoclonal antibodies, peptide or other proteins with beta emitting radionuclides to prepare radiopharmaceuticals for therapeutic purpose

  9. Radiolabelling of monoclonal antibodies for radiotherapy

    International Nuclear Information System (INIS)

    Nuclear medicine is now playing a great role not only in diagnostic application but also in therapy of cancer patients. Under the concept of targeted radiotherapy, a number of radiopharmaceuticals based on radiolabelled biomolecules had been evaluated for treatment of cancer by many investigators. Of these, monoclonal antibodies and some small specific peptides labelled with beta emitting radiometals such as Sm-153, Re-186, Re-188 or Y-90, are being introduced into clinical trials. The objective of this project is to develop laboratory procedures to label monoclonal antibodies, peptide or other proteins with beta emitting radionuclides to prepare radiopharmaceuticals for therapeutic purpose

  10. Dosimetric comparison of three-dimensional conformal radiotherapy, intensity modulated radiotherapy, and helical tomotherapy for lung stereotactic body radiotherapy

    Directory of Open Access Journals (Sweden)

    Rajesh Ashok Kinhikar

    2015-01-01

    Full Text Available To compare the treatment plans generated with three-dimensional conformal radiation therapy (3DCRT, intensity modulated radiotherapy (IMRT, and helical tomotherapy (HT for stereotactic body radiotherapy of lung, twenty patients with medically inoperable (early nonsmall cell lung cancer were retrospectively reviewed for dosimetric evaluation of treatment delivery techniques (3DCRT, IMRT, and HT. A dose of 6 Gy per fraction in 8 fractions was prescribed to deliver 95% of the prescription dose to 95% volume of planning target volume (PTV. Plan quality was assessed using conformity index (CI and homogeneity index (HI. Doses to critical organs were assessed. Mean CI with 3DCRT, IMRT, and HT was 1.19 (standard deviation [SD] 0.13, 1.18 (SD 0.11, and 1.08 (SD 0.04, respectively. Mean HI with 3DCRT, IMRT, and HT was 1.14 (SD 0.05, 1.08 (SD 0.02, and 1.07 (SD 0.04, respectively. Mean R50% values for 3DCRT, IMRT, and HT was 8.5 (SD 0.35, 7.04 (SD 0.45, and 5.43 (SD 0.29, respectively. D2cmwas found superior with IMRT and HT. Significant sparing of critical organs can be achieved with highly conformal techniques (IMRT and HT without compromising the PTV conformity and homogeneity.

  11. Dosimetric comparison of three-dimensional conformal radiotherapy, intensity modulated radiotherapy, and helical tomotherapy for lung stereotactic body radiotherapy.

    Science.gov (United States)

    Kinhikar, Rajesh Ashok; Ghadi, Yogesh G; Sahoo, Priyadarshini; Laskar, Sarbani Ghosh; Deshpande, Deepak D; Shrivastava, Shyam K; Agarwal, Jaiprakash

    2015-01-01

    To compare the treatment plans generated with three-dimensional conformal radiation therapy (3DCRT), intensity modulated radiotherapy (IMRT), and helical tomotherapy (HT) for stereotactic body radiotherapy of lung, twenty patients with medically inoperable (early nonsmall cell lung cancer) were retrospectively reviewed for dosimetric evaluation of treatment delivery techniques (3DCRT, IMRT, and HT). A dose of 6 Gy per fraction in 8 fractions was prescribed to deliver 95% of the prescription dose to 95% volume of planning target volume (PTV). Plan quality was assessed using conformity index (CI) and homogeneity index (HI). Doses to critical organs were assessed. Mean CI with 3DCRT, IMRT, and HT was 1.19 (standard deviation [SD] 0.13), 1.18 (SD 0.11), and 1.08 (SD 0.04), respectively. Mean HI with 3DCRT, IMRT, and HT was 1.14 (SD 0.05), 1.08 (SD 0.02), and 1.07 (SD 0.04), respectively. Mean R50% values for 3DCRT, IMRT, and HT was 8.5 (SD 0.35), 7.04 (SD 0.45), and 5.43 (SD 0.29), respectively. D2cm was found superior with IMRT and HT. Significant sparing of critical organs can be achieved with highly conformal techniques (IMRT and HT) without compromising the PTV conformity and homogeneity. PMID:26865754

  12. Mathematical modeling of liver metastases tumour growth and control with radiotherapy

    International Nuclear Information System (INIS)

    Generating an optimized radiation treatment plan requires understanding the factors affecting tumour control. Mathematical models of tumour dynamics may help in future studies of factors predicting tumour sensitivity to radiotherapy. In this study, a time-dependent differential model, incorporating biological cancer markers, is presented to describe pre-treatment tumour growth, response to radiation, and recurrence. The model uses Gompertzian-Exponential growth to model pre-treatment tumour growth. The effect of radiotherapy is handled by a realistic cell-kill term that includes a volume-dependent change in tumour sensitivity. Post-treatment, a Gompertzian, accelerated, delayed repopulation is employed. As proof of concept, we examined the fit of the model's prediction using various liver enzyme levels as markers of metastatic liver tumour growth in a liver cancer patient. A tumour clonogen population model was formulated. Each enzyme was coupled to the same tumour population, and served as surrogates of the tumour. This dynamical model was solved numerically and compared to the measured enzyme levels. By minimizing the mean-squared error of the model enzyme predictions, we determined the following tumour model parameters: growth rate prior to treatment was 0.52% per day; the fractional radiation cell kill for the prescribed dose (60 Gy in 15 fractions) was 42% per day, and the tumour repopulation rate was 2.9% per day. These preliminary results provided the basis to test the model in a larger series of patients, to apply biological markers for improving the efficacy of radiotherapy by determining the underlying tumour dynamics.

  13. Sexual dysfunction after radiotherapy for cancer of the cervix uteri

    Energy Technology Data Exchange (ETDEWEB)

    Ohkawa, R.; Takamizawa, H. (Chiba Univ. (Japan). School of Medicine); Arai, T.; Morita, S.

    1981-03-01

    Investigations of sexual consciousness and sexual dysfunction after radiotherapy for cancer of the cervix uteri were performed on patients of middle and old ages by questionnaires and questioning by doctors, and the following results were obtained. 1. Before radiotherapy, sexual activity was most prominent in their twenties and thirties. However, patients who were in fifties when this study was performed had most active sexual lives during the ages from 35 to 50 years. 2. Frequencies of sexual intercourse decreased markedly just before radiotherapy, and many patients received radiotherapy when sexual activity fell. 3. 32% of the patients have not experienced sexual intercourse after radiotherapy. 4. Decreases in the sex urge, sexuality, vaginal discharge, and frequency of sexual intercourse after radiotherapy were recognized in 77%, 77%, 70%, and 93% respectively. 5. Patients who became unwilling to maintain sexual lives after radiotherapy because of fear about recurrence or aggravation of cancer were 38% by questionaires and 49% by questioning by doctors. 6. Pains on sexual intercourse were found in 69% by questionaires and 49% by questionning by doctors. Most pains occurred at penis insertion and was thought to be due to atrophy and inflammation of vagina and external genitalia in most cases. 7. Both vaginal damage and sexual dysfunction in patients with radiotherapy following surgery for cancer of the cervix uteri, in patients with radiotherapy alone for cancer of the cervix uteri, and in patients with radiotherapy following surgery for cancer of the ovary and corpus uteri were marked, modest and mild, respectively. 8. Vaginal damage score was higher in patients treated more than 5 years before than those less than 2 years ago, but there were no differences in sexual dysfunction score between both groups.

  14. Anatomo-clinical target volumes (GTV and CTV) in radiotherapy; Volumes cibles anatomocliniques (GTV et CTV) en radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Kantor, G. [Institut Bergonie, Universite Victor-Segalen, Dept. de Radiotherapie, Centre Regional de Lutte Contre le Cancer, 33 - Bordeaux (France); Halimi, P. [Hopital Europeen Georges-Pompidou, Service de Radiologie, Faculte de Medecine Paris-5, 75 - Paris (France)

    2005-06-15

    In this issue will be tackled the development of tools (multi modules scanner and images fusion) and the analysis of volumes for cerebral tumors (head and neck). It seemed necessary to update this theme because of the ever more widespread use of conformation radiotherapy and new constraints of volumes definitions brought by radiotherapy with intensity modulation. (N.C.)

  15. Optimising the dosimetric quality and efficiency of post-prostatectomy radiotherapy: a planning study comparing the performance of volumetric-modulated arc therapy (VMAT) with an optimised seven-field intensity-modulated radiotherapy (IMRT) technique

    International Nuclear Information System (INIS)

    The purpose of this study was to compare and evaluate radiotherapy treatment plans using volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) for post-prostatectomy radiotherapy. The quality of radiotherapy plans for 10 patients planned and treated with a seven-field IMRT technique for biochemical failure post-prostatectomy were subsequently compared with 10 prospectively planned single-arc VMAT plans using the same computed tomography data set and treatment planning software. Plans were analysed using parameters to assess for target volume coverage, dose to organs at risk (OAR), biological outcomes, dose conformity and homogeneity, as well as the total monitor units (MU), planning and treatment efficiency. The mean results for the study population are reported for the purpose of comparison. For IMRT, the median dose to the planning target volume, V95% and D95% was 71.1 Gy, 98.9% and 68.3 Gy compared with 71.2 Gy, 99.2% and 68.6 Gy for VMAT. There was no significant difference in the conformity index or homogeneity index. The VMAT plans achieved better sparing of the rectum and the left and right femora with a reduction in the median dose by 7.9, 6.3 and 3.6 Gy, respectively. The total number of monitor units (MU) was reduced by 24% and treatment delivery time by an estimated 3 min per fraction without a significant increase in planning requirements. VMAT can achieve post-prostatectomy radiotherapy plans of comparable quality to IMRT with the potential to reduce dose to OAR and improve the efficiency of treatment delivery.

  16. Optimal fractionation in radiotherapy with multiple normal tissues.

    Science.gov (United States)

    Saberian, Fatemeh; Ghate, Archis; Kim, Minsun

    2016-06-01

    The goal in radiotherapy is to maximize the biological effect (BE) of radiation on the tumour while limiting its toxic effects on healthy anatomies. Treatment is administered over several sessions to give the normal tissue time to recover as it has better damage-repair capabilities than tumour cells. This is termed fractionation. A key problem in radiotherapy involves finding an optimal number of treatment sessions (fractions) and the corresponding dosing schedule. A major limitation of existing mathematically rigorous work on this problem is that it includes only a single normal tissue. Since essentially no anatomical region of interest includes only one normal tissue, these models may incorrectly identify the optimal number of fractions and the corresponding dosing schedule. We present a formulation of the optimal fractionation problem that includes multiple normal tissues. Our model can tackle any combination of maximum dose, mean dose and dose-volume type constraints for serial and parallel normal tissues as this is characteristic of most treatment protocols. We also allow for a spatially heterogeneous dose distribution within each normal tissue. Furthermore, we do not a priori assume that the doses are invariant across fractions. Finally, our model uses a spatially optimized treatment plan as input and hence can be seamlessly combined with any treatment planning system. Our formulation is a mixed-integer, non-convex, quadratically constrained quadratic programming problem. In order to simplify this computationally challenging problem without loss of optimality, we establish sufficient conditions under which equal-dosage or single-dosage fractionation is optimal. Based on the prevalent estimates of tumour and normal tissue model parameters, these conditions are expected to hold in many types of commonly studied tumours, such as those similar to head-and-neck and prostate cancers. This motivates a simple reformulation of our problem that leads to a closed

  17. Second cancer incidence risk estimates using BEIR VII models for standard and complex external beam radiotherapy for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Donovan, E. M.; James, H.; Bonora, M.; Yarnold, J. R.; Evans, P. M. [Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton SM2 5PT (United Kingdom); Physics Department, Ipswich Hospital NHS Foundation Trust, Ipswich IP4 5PD (United Kingdom); Department of Academic Radiotherapy, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton SM2 5PT, United Kingdom and School of Radiotherapy, University of Milan, Milan 20122 (Italy); Department of Academic Radiotherapy, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton SM2 5PT (United Kingdom); Centre for Vision Speech and Signal Processing, University of Surrey, Guildford GU2 7XH (United Kingdom)

    2012-10-15

    Purpose: To compare organ specific cancer incidence risks for standard and complex external beam radiotherapy (including cone beam CT verification) following breast conservation surgery for early breast cancer.Method: Doses from breast radiotherapy and kilovoltage cone beam CT (CBCT) exposures were obtained from thermoluminescent dosimeter measurements in an anthropomorphic phantom in which the positions of radiosensitive organs were delineated. Five treatment deliveries were investigated: (i) conventional tangential field whole breast radiotherapy (WBRT), (ii) noncoplanar conformal delivery applicable to accelerated partial beast irradiation (APBI), (iii) two-volume simultaneous integrated boost (SIB) treatment, (iv) forward planned three-volume SIB, and (v) inverse-planned three volume SIB. Conformal and intensity modulated radiotherapy methods were used to plan the complex treatments. Techniques spanned the range from simple methods appropriate for patient cohorts with a low cancer recurrence risk to complex plans relevant to cohorts with high recurrence risk. Delineated organs at risk included brain, salivary glands, thyroid, contralateral breast, left and right lung, esophagus, stomach, liver, colon, and bladder. Biological Effects of Ionizing Radiation (BEIR) VII cancer incidence models were applied to the measured mean organ doses to determine lifetime attributable risk (LAR) for ages at exposure from 35 to 80 yr according to radiotherapy techniques, and included dose from the CBCT imaging. Results: All LAR decreased with age at exposure and were lowest for brain, thyroid, liver, and bladder (<0.1%). There was little dependence of LAR on radiotherapy technique for these organs and for colon and stomach. LAR values for the lungs for the three SIB techniques were two to three times those from WBRT and APBI. Uncertainties in the LAR models outweigh any differences in lung LAR between the SIB methods. Constraints in the planning of the SIB methods ensured that

  18. Quantum Biology

    Directory of Open Access Journals (Sweden)

    Alessandro Sergi

    2009-06-01

    Full Text Available A critical assessment of the recent developmentsof molecular biology is presented.The thesis that they do not lead to a conceptualunderstanding of life and biological systems is defended.Maturana and Varela's concept of autopoiesis is briefly sketchedand its logical circularity avoided by postulatingthe existence of underlying living processes,entailing amplification from the microscopic to the macroscopic scale,with increasing complexity in the passage from one scale to the other.Following such a line of thought, the currently accepted model of condensed matter, which is based on electrostatics and short-ranged forces,is criticized. It is suggested that the correct interpretationof quantum dispersion forces (van der Waals, hydrogen bonding, and so onas quantum coherence effects hints at the necessity of includinglong-ranged forces (or mechanisms for them incondensed matter theories of biological processes.Some quantum effects in biology are reviewedand quantum mechanics is acknowledged as conceptually important to biology since withoutit most (if not all of the biological structuresand signalling processes would not even exist. Moreover, it is suggested that long-rangequantum coherent dynamics, including electron polarization,may be invoked to explain signal amplificationprocess in biological systems in general.

  19. The Radiobiological Basis for Improvements in Radiotherapy and Low Dose Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hei, Tom K

    2009-12-09

    Overall Goal: This conference grant was proposed to organize and host an international conference at Columbia University in New York to critically assess the cellular and molecular signaling events and tissue response following radiation damage. The conference would also serve as a venue to play tribute to the more than forty years contributions made by Professor Eric J. Hall to the radiation biology field. The goals of the meeting were to examine tumor hypoxia and sensitizer development; recent advances made in clinical radiotherapy; addressed several low dose phenomena, including genomic instability and bystander effects that are important in radiation risk assessment. Study and Results: The symposium was held on October 13th and 14th, 2008 at the Alfred Lerner Hall in the Morningside campus of Columbia University. The symposium, entitled “From Beans to Genes: A Forty Year Odyssey in Radiation Biology” was attended by more than 120 faculty, scientists, clinicians, fellows and students. The symposium, spanned over a day and a half, covered four scientific themes. These included tumor hypoxia and radiosensitizers; low dose radiation response; radiation biology in the practice of radiotherapy, and radiation hazard in space and genetic predisposition to cancer. The program of the symposium is as follow:

  20. Fractionated stereotactically guided radiotherapy for pharmacoresistant epilepsy

    International Nuclear Information System (INIS)

    Aim: This prospective study evaluated the efficiency of fractionated stereotactically guided radiotherapy as a treatment of pharmacoresistant temporal lobe epilepsy. Patients and Methods: Inclusion criteria were patients aged between 17 and 65 years with one-sided temporally located focus, without sufficient epilepsy control by, antiepileptic drugs or neurosurgery. Between 1997 and 1999, two groups of six patients each were treated with 21 Gy (7 times 3 Gy) and 30 Gy (15 times 2 Gy). Study end points were seizure frequency, intensity, seizure length and neuropsychological parameters. Results: All patients experienced a marked reduction in seizure frequency. The mean reduction of seizures was 37% (range 9-77%, i.e. seizures reduced from a monthly mean number of 11.75 to 7.52) at 18 months following radiation treatment and 46% (23-94%, i.e. 0.2-23 seizures per month) during the whole follow-up time. Seizure length was reduced in five out of eleven patients and intensity of seizures in seven out of eleven patients. Conclusion: Radiotherapy was identified as safe and effective for pharmacoresistant epilepsy since a very good reduction of seizure frequency was observed. It is no substitute for regular use of antiepileptic drugs, but means an appropriate alternative for patients with contraindication against neurosurgery or insufficient seizure reduction after neurosurgery. (orig.)

  1. Basic study of cancer immunity and radiotherapy

    International Nuclear Information System (INIS)

    With respect to anti-tumor effect of radiation, antigenicity and involvement of immunity of an individual with cancer were evaluated under both conditions of natural and insufficient immunity. In animal experiments, it is clear that immunity of the host, especially the function of T-cells, has much to do with the curability of cancer by radiotherapy. In some type of human cancer, not only the histological findings in its healing process following x-ray irradiation but a number of clinical and in vitro experimental results strongly suggest the presence of antigenicity of the T-cells, although it is quite little. The experiments made in a combination of human cancer and nude mice showed a possibility of non-T cells being involved in this mechanism irrespective of whether it is specific, non-specific or not having such an important role as T-cells. There are many problems left unsolved. However, radiotherapy of cancer should be undertaken by maintaining or further improving the immunity of the body in order to obtain good results. (Ueda, J.)

  2. Hypofractionated whole breast radiotherapy: current perspectives

    Directory of Open Access Journals (Sweden)

    Koulis TA

    2015-10-01

    Full Text Available Theodora A Koulis, Tien Phan, Ivo A Olivotto Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada Abstract: Adjuvant radiotherapy (RT is an important part of breast cancer management but the dose and fractionation schedules used are variable. A total of 50 Gy in 25 daily fractions delivered over 5 weeks is often considered the "standard" adjuvant RT prescription. Hypofractionated regimes such as 42.5 Gy in 16 daily fractions or 40 Gy in 15 daily fractions following breast-conserving surgery have proven to be equally effective and achieve similar or better cosmetic and normal tissue outcomes for both invasive and in situ diseases and when treating the regional nodes. Hypofractionation is more convenient for patients and less costly. However, certain patients at higher risk of RT late effects may benefit from a less intense, even more extended fractionation schedule. This review describes the indications for whole breast hypofractionated adjuvant RT for patients with breast cancer following breast-conserving surgery and proposes that hypofractionation should be the new "standard" for adjuvant breast cancer RT. Keywords: fractionation, breast cancer, cosmesis, radiotherapy

  3. Predicting toxicity in radiotherapy for prostate cancer.

    Science.gov (United States)

    Landoni, Valeria; Fiorino, Claudio; Cozzarini, Cesare; Sanguineti, Giuseppe; Valdagni, Riccardo; Rancati, Tiziana

    2016-03-01

    This comprehensive review addresses most organs at risk involved in planning optimization for prostate cancer. It can be considered an update of a previous educational review that was published in 2009 (Fiorino et al., 2009). The literature was reviewed based on PubMed and MEDLINE database searches (from January 2009 up to September 2015), including papers in press; for each section/subsection, key title words were used and possibly combined with other more general key-words (such as radiotherapy, dose-volume effects, NTCP, DVH, and predictive model). Publications generally dealing with toxicity without any association with dose-volume effects or correlations with clinical risk factors were disregarded, being outside the aim of the review. A focus was on external beam radiotherapy, including post-prostatectomy, with conventional fractionation or moderate hypofractionation (<4Gy/fraction); extreme hypofractionation is the topic of another paper in this special issue. Gastrointestinal and urinary toxicity are the most investigated endpoints, with quantitative data published in the last 5years suggesting both a dose-response relationship and the existence of a number of clinical/patient related risk factors acting as dose-response modifiers. Some results on erectile dysfunction, bowel toxicity and hematological toxicity are also presented. PMID:27068274

  4. Performance of different radiotherapy workload models

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to evaluate the performance of different radiotherapy workload models using a prospectively collected dataset of patient and treatment information from a single center. Methods and Materials: Information about all individual radiotherapy treatments was collected for 2 weeks from the three linear accelerators (linacs) in our department. This information included diagnosis code, treatment site, treatment unit, treatment time, fields per fraction, technique, beam type, blocks, wedges, junctions, port films, and Eastern Cooperative Oncology Group (ECOG) performance status. We evaluated the accuracy and precision of the original and revised basic treatment equivalent (BTE) model, the simple and complex Addenbrooke models, the equivalent simple treatment visit (ESTV) model, fields per hour, and two local standards of workload measurement. Results: Data were collected for 2 weeks in June 2001. During this time, 151 patients were treated with 857 fractions. The revised BTE model performed better than the other models with a mean vertical bar observed - predicted vertical bar of 2.62 (2.44-2.80). It estimated 88.0% of treatment times within 5 min, which is similar to the previously reported accuracy of the model. Conclusion: The revised BTE model had similar accuracy and precision for data collected in our center as it did for the original dataset and performed the best of the models assessed. This model would have uses for patient scheduling, and describing workloads and case complexity

  5. Voice after radiotherapy of the larynx carcinoma

    International Nuclear Information System (INIS)

    Background: The study presents the evaluation of the phonatory function of the larynx after radiotherapy. The research covered the patients from the rural areas of Poland who revealed neoplastic changes in the glottis area. Material and methods: The test group consisted of 45 men aged 41-78 years with the carcinoma of the larynx with T1 and T2 progression types of cancer, according to the TNM classification. The analysis of laryngeal tone was performed with the digital analyzer Kay Elemetrics Model CSL 4300 and Multi Dimensional Voice Program (MDVP). A stroboscopic test in all the patients with T1 progression revealed the reduction of vibrations. Results: The acoustic analysis of the voice in the pre-treatment group as compared with the control group allowed for differentiation of the following parameters of a definitely pathologic character: Jita, Jitter, RAP, PPQ, vFo, Shimmer, APQ, vAm, NHR, VTI, SPI, and DUV. Conclusions: In the acoustic analysis of voice in the post-radiotherapy group, the following parameters reached values close to the norm: JITA, JITT, RAP, PPQ, vF0, vAM, DUV, and Schimmer dB.

  6. Pulmonary oligometastases: Metastasectomy or stereotactic ablative radiotherapy?

    International Nuclear Information System (INIS)

    Background and purpose: Stereotactic ablative radiotherapy (SABR; or stereotactic body radiotherapy, SBRT) emerges as treatment option for pulmonary oligometastatic disease (OMD), but there are no studies comparing SABR with pulmonary metastasectomy (PME). We analysed consecutive patients referred via a university-hospital based multidisciplinary team. Material and methods: Patients were offered PME as first choice and SABR in case they were considered to be less suitable surgical candidates. Overall survival was the primary endpoint. Secondary endpoints were progression-free-survival, local control of treated metastases, and freedom-from-failure of a local-only treatment strategy without systemic therapy. Results: From 2007 until 2010, 110 patients were treated and analysed (PME, n = 68; SABR, n = 42). Median follow-up time was 43 months (minimally, 25). Estimated overall survival rates at one, three, and five years were 87%, 62%, and 41% for PME, and 98%, 60%, and 49% for SABR, respectively (logrank-test, p = 0.43). Local control at two years was 94% for SABR and 90% for PME. Progression-free survival was 17% at three years, but 43% of the patients still had not failed a local-only treatment strategy. Conclusions: Although SABR was second choice after PME, survival after PME was not better than after SABR. Prospective comparative studies are clearly required to define the role of both, SABR and PME in OMD

  7. Update on radiotherapy support for PNG

    International Nuclear Information System (INIS)

    Full text: PNG is a country of more than six million people and 15000 new cancer cases per year and radiotherapy is a vital tool for fighting cancer for its suffers. In May 2009, PNG recommenced radiotherapy treatments at Angau hospital in Lae. Technical support from Medical Physicists and Radiation Therapists has been provided remotely and onsite to ensure treatment quality and the continuation of this vital service over the past two years. In April 20 II, the ACPSEM was successful in obtaining federal funding for a volunteer Medical Physicist to visit Lae for 2 months. Volunteer assignment aims included urgent checks of the Co-60 treatment unit etc., commission low dose rate (LDR) cervix brachytherapy and establish remote treatment planning support protocols with Australian hospitals using the internet. The aim of the latter is to increase patient numbers treated, ensure treatment quality is maintained and allow further training of staff. Quality assurance checks of the Co-60 teletherapy unit show it is operating acceptably. There have been minor mechanical problems requiring service from Australia. Commissioning of the brachytherapy program is nearing completion and treatments are commencing shortly. Remote treatment planning support protocols are able to send treatment plan printouts, calculations and simulator films for checking to Australian hospitals.

  8. [Technical record in radiotherapy (author's transl)].

    Science.gov (United States)

    Le Dorze, C; Horiot, J C; Laugier, A

    1977-11-01

    The term "technical record in radiotherapy" is used to describe collected information relative to treatment using radiation. The subject of this session of the chapter of Radiotherapy of the Société Française de Radiologie was the intrinsic functions of this record and its extrinsic limitations. The extreme diversity of the current state of the record is a known fact. A majority of participants express the desire for uniformisation of the collection of data or even, as a second stage, to have a common record. A library of technical records was set up under the responsibility of the Centre Georges-François Leclerc at Dijon (J.C. Horiot). One broad conclusion was seen to emerge: the creation of a minimum common record including essential information to which could be added the more specific data of each radiotherapist and at each time of use. Prior agreement will be necessary with regard to the standardisation of apparatus and the expression of the dose. This session was of necessity merely a reflection of future needs and it is to be hoped that the good will which was obvious during the course of the discussion may produce concrete results in the months to come.

  9. Development of evaluation and performance verification technology for radiotherapy radiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. Y.; Jang, S. Y.; Kim, B. H. and others

    2005-02-15

    No matter how much the importance is emphasized, the exact assessment of the absorbed doses administered to the patients to treat the various diseases such as lately soaring malignant tumors with the radiotherapy practices is the most important factor. In reality, several over-exposed patients from the radiotherapy practice become very serious social issues. Especially, the development of a technology to exactly assess the high doses and high energies (In general, dose administered to the patients with the radiotherapy practices are very huge doses, and they are about three times higher than the lethal doses) generated by the radiation generators and irradiation equipment is a competing issue to be promptly conducted. Over fifty medical centers in Korea operate the radiation generators and irradiation equipment for the radiotherapy practices. However, neither the legal and regulatory systems to implement a quality assurance program are sufficiently stipulated nor qualified personnel who could run a program to maintain the quality assurance and control of those generators and equipment for the radiotherapy practices in the medical facilities are sufficiently employed. To overcome the above deficiencies, a quality assurance program such as those developed in the technically advanced countries should be developed to exactly assess the doses administered to patients with the radiotherapy practices and develop the necessary procedures to maintain the continuing performance of the machine or equipment for the radiotherapy. The QA program and procedures should induce the fluent calibration of the machine or equipment with quality, and definitely establish the safety of patients in the radiotherapy practices. In this study, a methodology for the verification and evaluation of the radiotherapy doses is developed, and several accurate measurements, evaluations of the doses delivered to patients and verification of the performance of the therapy machine and equipment are

  10. Development of evaluation and performance verification technology for radiotherapy radiation

    International Nuclear Information System (INIS)

    No matter how much the importance is emphasized, the exact assessment of the absorbed doses administered to the patients to treat the various diseases such as lately soaring malignant tumors with the radiotherapy practices is the most important factor. In reality, several over-exposed patients from the radiotherapy practice become very serious social issues. Especially, the development of a technology to exactly assess the high doses and high energies (In general, dose administered to the patients with the radiotherapy practices are very huge doses, and they are about three times higher than the lethal doses) generated by the radiation generators and irradiation equipment is a competing issue to be promptly conducted. Over fifty medical centers in Korea operate the radiation generators and irradiation equipment for the radiotherapy practices. However, neither the legal and regulatory systems to implement a quality assurance program are sufficiently stipulated nor qualified personnel who could run a program to maintain the quality assurance and control of those generators and equipment for the radiotherapy practices in the medical facilities are sufficiently employed. To overcome the above deficiencies, a quality assurance program such as those developed in the technically advanced countries should be developed to exactly assess the doses administered to patients with the radiotherapy practices and develop the necessary procedures to maintain the continuing performance of the machine or equipment for the radiotherapy. The QA program and procedures should induce the fluent calibration of the machine or equipment with quality, and definitely establish the safety of patients in the radiotherapy practices. In this study, a methodology for the verification and evaluation of the radiotherapy doses is developed, and several accurate measurements, evaluations of the doses delivered to patients and verification of the performance of the therapy machine and equipment are

  11. Hypofractionation in radiotherapy. An investigation of injured Swedish women, treated for cancer of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Friberg, Sten; Ruden, Bengt-Inge (Division of Medical Radiation Physics, Karolinska Institute and Stockholm University, Stockholm (Sweden))

    2009-07-15

    Background. The Swedish Insurance Company for Patient Injuries asked the two authors of this report to identify the Swedish women with cancer of the breast who had been injured by radiotherapy with a hypofractionated schedule. The purpose was to provide a basis on which the Company could decide if indemnification could be given. Material and methods. We define hypo-fractionation as any fraction dose exceeding 2.0 gray (Gy) per day. We set the lower limit for the 'late effect' at 53.0 Gy with 2 Gy/fraction. All departments of radiotherapy in Sweden were asked to identify women who had developed brachial plexus neuropathy (BPN). Their medical records were obtained. The clinical picture of their injuries was recorded, and the absorbed dose was calculated or reconstructed. All doses, no matter in what way they were expressed, were recalculated to 'late effect', presented in EQD2Gy (Equalized Total Dose in 2 Gy/fraction). The latency period from therapy to onset of symptoms was also noted. Results. A variety of treatment techniques was used, fractions ranging in size from 2.5 to 6.0 Gy. Absorbed doses up to a Biologically Equivalent Dose (BED) 146 EQD2Gy in late effects were recorded (6 Gyx13). More than 95% of the injured women had a combination of stiff shoulder, paralysis, pain, oedema and atrophy of the muscles to the arm and/or hand. Latency from end of radiotherapy to onset of symptoms could be as long as 30 years. Discussion. Hypofractionated radiotherapy has injured severely numerous patients. The lesions have become a medico-legal issue in some countries. The life of many of these women has been ruined: physically, mentally, socially and economically. Conclusion. Hypofractionated radiotherapy can cause injuries if the target volume is not exact, or the total dose is not adjusted to a tolerable level as compared to conventional treatments employing 2 Gy/day fractions

  12. A proliferation saturation index to predict radiation response and personalize radiotherapy fractionation

    International Nuclear Information System (INIS)

    Although altered protocols that challenge conventional radiation fractionation have been tested in prospective clinical trials, we still have limited understanding of how to select the most appropriate fractionation schedule for individual patients. Currently, the prescription of definitive radiotherapy is based on the primary site and stage, without regard to patient-specific tumor or host factors that may influence outcome. We hypothesize that the proportion of radiosensitive proliferating cells is dependent on the saturation of the tumor carrying capacity. This may serve as a prognostic factor for personalized radiotherapy (RT) fractionation. We introduce a proliferation saturation index (PSI), which is defined as the ratio of tumor volume to the host-influenced tumor carrying capacity. Carrying capacity is as a conceptual measure of the maximum volume that can be supported by the current tumor environment including oxygen and nutrient availability, immune surveillance and acidity. PSI is estimated from two temporally separated routine pre-radiotherapy computed tomography scans and a deterministic logistic tumor growth model. We introduce the patient-specific pre-treatment PSI into a model of tumor growth and radiotherapy response, and fit the model to retrospective data of four non-small cell lung cancer patients treated exclusively with standard fractionation. We then simulate both a clinical trial hyperfractionation protocol and daily fractionations, with equal biologically effective dose, to compare tumor volume reduction as a function of pretreatment PSI. With tumor doubling time and radiosensitivity assumed constant across patients, a patient-specific pretreatment PSI is sufficient to fit individual patient response data (R2 = 0.98). PSI varies greatly between patients (coefficient of variation >128 %) and correlates inversely with radiotherapy response. For this study, our simulations suggest that only patients with intermediate PSI (0.45–0.9) are

  13. The future of breast cancer radiotherapy: From one size fits all to taylor-made treatment; L'avenir de la radiotherapie du cancer du sein: de la taille unique au sur-mesure

    Energy Technology Data Exchange (ETDEWEB)

    Hennequin, C. [Service de cancerologie-radiotherapie, hopital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris (France); Azria, D. [Departement de cancerologie radiotherapie, CRLC Val-d' Aurelle-Paul-Lamarque, rue Croix-Verte, 34298 Montpellier cedex 5 (France); Universite de Montpellier I, 5, boulevard Henri-IV, CS 19044, 34967 Montpellier cedex 2 (France); Inserm U896, institut de recherche en cancerologie de Montpellier, CRLC Val-d' Aurelle-Paul-Lamarque, rue Croix-Verte, 34298 Montpellier cedex 5 (France)

    2011-10-15

    Various subgroups of breast tumours have been identified during the last 10 years according to the risk of local relapse. Prognostic factors for local relapse are age, surgical margins, tumour size, Her2 expression and hormonal receptors status. For tumours with a high risk of local relapse, an increased in boost dose or the addition of new drugs (trastuzumab, anti-angiogenics, PARP inhibitors) could be considered. For low risk tumours, hypo-fractionated, accelerated partial breast and intraoperative radiotherapy are being evaluated. The classical schedule (45-50 Gy to the whole gland followed by a boost dose of 16 Gy) is no longer the universal rule. Treatment individualization, according to clinical and biological characteristics of the tumour and - possibly - to the radiobiological profile of the patient, is likely to be the future of breast cancer radiotherapy. (authors)

  14. The Early Result of Whole Pelvic Radiotherapy and Stereotactic Body Radiotherapy Boost for High Risk Localized Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Yu-Wei eLin

    2014-10-01

    Full Text Available PurposeThe rationale for hypofractionated radiotherapy in the treatment of prostate cancer is based on the modern understanding of radiobiology and advances in stereotactic body radiotherapy (SBRT techniques. Whole-pelvis irradiation combined with SBRT boost for high-risk prostate cancer might escalate biologically effective dose without increasing toxicity. Here, we report our 4-year results of SBRT boost for high-risk localized prostate cancer.Methods and MaterialsFrom October 2009 to August 2012, 41 patients of newly diagnosed, high-risk or very high-risk (NCCN definition localized prostate cancer patients were treated with whole-pelvis irradiation and SBRT boost. The whole pelvis dose was 45Gy (25 fractions of 1.8Gy. The SBRT boost dose was 21 Gy (three fractions of 7 Gy. Ninety percent of these patients received hormone therapy. The toxicities of gastrointestinal (GI and genitourinary (GU tracts were scored by Common Toxicity Criteria Adverse Effect (CTCAE v3.0. Biochemical failure was defined by Phoenix definition.ResultsMedian follow-up was 42 months. Mean PSA before treatment was 44.18 ng/ml. Mean PSA level at 3, 6, 12, 18, and 24 months was 0.94, 0.44, 0.13, 0.12, and 0.05 ng/ml, respectively. The estimated 4-year biochemical failure-free survival was 91.9%. Three biochemical failures were observed. GI and GU tract toxicities were minimal. No grade 3 acute GU or GI toxicity was noted. During radiation therapy, 27% of the patient had grade 2 acute GU toxicity and 12% had grade 2 acute GI toxicity. At 3 months, most toxicity scores had returned to baseline. At the last follow up, there was no grade 3 late GU or GI toxicity.ConclusionsWhole-pelvis irradiation combined with SBRT boost for high-risk localized prostate cancer is feasible with minimal toxicity and encouraging biochemical failure-free survival. Continued accrual and follow-up would be necessary to confirm the biochemical control rate and the toxicity profiles.

  15. Persistence of unstable and stable chromosome aberrations in lymphocytes of cancer patients treated with radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Di Giorgio, M.; Vallerga, M.B.; Taja, M.R. [Autoridad Regulatoria Nuclear, Buenos Aires (Argentina); Sardi, M. [Hospital Italiano - Mevaterapia, Buenos Aires (Argentina)

    2006-07-01

    Background: Radiation-induced DNA damage in human lymphocytes has equal probability of producing both stable or unstable chromosome aberrations (C.A.). Reports of its in vivo persistence show considerable variations. The quantification of unstable C.A. (dicentrics) in peripheral blood lymphocytes (P.B.L.) is the most reliable biological method for estimating whole-body doses of recent overexposures to ionizing radiation. Given that during the division of T cell precursors, proliferative death of cells containing dicentrics reduces the number of such lymphocytes in peripheral blood, dicentric methodology should be modified to account for past exposures. Micronuclei (M.N.) in cytokinesis-blocked human P.B.L. are well established bio markers for assessing radiation damage in vivo. However, persistence of radiation induced M.N. is limited. Unlike dicentrics and M.N., stable C.A. (translocations) identified at present by the FISH technique, seem to be an adequate indicator for the dosimetric evaluation of past exposures, since translocations are not selected against during mitotic division in the haematopoietic stem cells compartment. Nevertheless, for partial -body exposures with high dose there is some evidence that the decline with time of dicentrics causes some reduction in the yield of translocations. Purpose: To assess the persistence along time of dicentrics, M.N. and translocations in lymphocytes of cancer patients after radiotherapy in order to model changes in C.A. frequencies with partial-body exposures. Materials and methods: 22 cancer patients with different tumor sites, treated with radiotherapy, were evaluated through dicentric chromosome, M.N. and FISH techniques with a follow-up time of up to 90 months after the end of radiotherapy. Regression analysis were performed: 1) for dicentric and for M.N. frequencies in relation to time after the end of radiotherapy and total tumor dose; 2) for the percentage of uns table cells in relation to time after the end

  16. Quantum Biology

    CERN Document Server

    Sergi, Alessandro

    2009-01-01

    A critical assessment of the recent developments of molecular biology is presented. The thesis that they do not lead to a conceptual understanding of life and biological systems is defended. Maturana and Varela's concept of autopoiesis is briefly sketched and its logical circularity avoided by postulating the existence of underlying {\\it living processes}, entailing amplification from the microscopic to the macroscopic scale, with increasing complexity in the passage from one scale to the other. Following such a line of thought, the currently accepted model of condensed matter, which is based on electrostatics and short-ranged forces, is criticized. It is suggested that the correct interpretation of quantum dispersion forces (van der Waals, hydrogen bonding, and so on) as quantum coherence effects hints at the necessity of including long-ranged forces (or mechanisms for them) in condensed matter theories of biological processes. Some quantum effects in biology are reviewed and quantum mechanics is acknowledge...

  17. The role of radiotherapy in the management of POEMS syndrome

    International Nuclear Information System (INIS)

    POEMS syndrome is a paraneoplastic syndrome caused by an underlying plasma cell proliferative disease. In this study, we examined the treatment outcomes and role of radiotherapy in the management of POEMS syndrome. In total, 33 patients diagnosed with POEMS syndrome were analyzed. These patients presented with osteosclerotic myeloma (OSM, n = 13), Castleman’s disease (CD, n = 4), OSM with CD (n = 10), and vascular endothelial growth factor elevation without gross lesions (VEGFe, n = 6), respectively. The patients were treated by radiotherapy alone (n = 4), chemotherapy alone (n = 16), or a combination thereof (n = 9). The clinical response rates of radiotherapy, chemotherapy, and radiotherapy plus chemotherapy were 75%, 69%, and 89%, respectively. In addition, the hematologic response rates were 50%, 69%, and 71%, respectively. Among the six patients with limited multiple lesions who underwent radiotherapy, the clinical symptoms were improved in five patients after radiotherapy. The median progression-free survival (PFS) was 51 months, and the median overall survival (OS) was 65 months. In univariate analysis, the administration of chemotherapy was significantly associated with better PFS (p = 0.007) and OS (p = 0.020). In contrast, underlying VEGFe was a significant factor worsening PFS (p = 0.035) and OS (p = 0.008). Radiotherapy produces a reliable clinical response and is effective in improving POEMS-associated symptoms that are refractory to chemotherapy in selected patients with clustered or limited multiple lesions that can be covered by single radiation field

  18. Status of Radiotherapy in Kenya: The Milestones and Challenges

    International Nuclear Information System (INIS)

    According to Gobacan 2012, seventy eight (78) Kenyans die daily of cancer related complications. Ratiotherapy is the treatment of cancer using high energy radiation targeting the tumour cells. The three main modalities used in treatment are radiotherapy, chemotherapy and surgery. More than 50% of cases are treated using radiotherapy. Radiotherapy is divided into two brad categoeis, namely external beam radiotherapy (EBRT) or teletherapy and internal radiotherapy (Brachytherapy). In Kenya, the machines available for EBRT are Cobalt-60 and linear accelerators. Co-60 source emits gamma-ray with energy of 1.25 MV while linear accelerators available locally emit photons (x-rays) and electrons ranging between 6 to 8MV. Until 2010, there was only one (public) radiotherapy facility using the co-60. Currently, four private facilities using linear accelerations have joined the fray. Two more public institutions are at different stages of putting up radiotherapy facilities. Owing to the high energy range, a lot of radiation safety considerations are made prior to installation, during acceptance testing and commissioning and during the operation. These include, but not limited to shielding integrity checks, Dosimetry checks, mechanical checks and emergency procedures check. In view of these, a lot of capacity building still needs to be done in term of skilled staff development as well as equipment

  19. Quality assurance protocol for linear accelerators used in radiotherapy

    International Nuclear Information System (INIS)

    Radiotherapy is a modality of choice for treatment of malignant diseases. Linear accelerators are the most common devices for implementing external radiation therapy. Taking into account the fact during the treatment, healthy tissue will inevitably be exposed to ionizing radiation, predicted dose in each radiotherapy case should be delivered with the greatest possible accuracy. Medical requirement for quality treatment achieving means as mach as possible dose into volume of interest and the greatest possible healthy tissue protection. From radiation protection point of view, occupational exposure of the staff involved in radiotherapy process should be minimized. To be able to reach it, consistent adherence to the Quality Assurance Programme is necessary. It should be in accordance with higher national and international protocols, because they give guidelines on the necessary standards, procedures, processes, resources and responsibilities that should be defined in structuring the overall radiotherapy quality management. As a part of this Master thesis, quality management as well as Quality Assurance Programme that is necessary to be applied in each radiotherapy center have been prepared. Mandatory dosimetry measurements included in the internal recommendations are also emphasized. Measurement results and external audit by IAEA indicated high accuracy and quality radiotherapy dose delivering in Macedonia. Based on the measurements and analysis, the aim of this Master thesis is offering a Quality Assurance Protocol for external beam radiotherapy that can be used on the national level in Republic of Macedonia. (Author)

  20. Biology and management of ependymomas.

    Science.gov (United States)

    Wu, Jing; Armstrong, Terri S; Gilbert, Mark R

    2016-07-01

    Ependymomas are rare primary tumors of the central nervous system in children and adults that comprise histologically similar but genetically distinct subgroups. The tumor biology is typically more associated with the site of origin rather than being age-specific. Genetically distinct subgroups have been identified by genomic studies based on locations in classic grade II and III ependymomas. They are supratentorial ependymomas with C11orf95-RELA fusion or YAP1 fusion, infratentorial ependymomas with or without a hypermethylated phenotype (CIMP), and spinal cord ependymomas. Myxopapillary ependymomas and subependymomas have different biology than ependymomas with typical WHO grade II or III histology. Surgery and radiotherapy are the mainstays of treatment, while the role of chemotherapy has not yet been established. An in-depth understanding of tumor biology, developing reliable animal models that accurately reflect tumor molecule features, and high throughput drug screening are essential for developing new therapies. Collaborative efforts between scientists, physicians, and advocacy groups will enhance the translation of laboratory findings into clinical trials. Improvements in disease control underscore the need to incorporate assessment and management of patients' symptoms to ensure that treatment advances translate into improvement in quality of life. PMID:27022130

  1. Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

    International Nuclear Information System (INIS)

    To evaluate the results of conventional radiotherapy for pituitary adenomas assessed with computed tomography (CT) or magnetic resonance imaging (MRI). Endpoints include tumor control, normalization of hormone levels in functioning adenomas, and hypopituitarism after radiotherapy as an adverse effect. Forty-two patients were treated with radiotherapy from 1982 to 1995 at Niigata University Hospital. Forty patients were irradiated after surgery because of residual adenomas in 33 patients and tumor regrowth in 7 patients. One patient was treated with radiotherapy alone, and the remaining 1 patient was treated with preoperative radiotherapy. Tumor size and extension were evaluated using CT or MRI, and all tumors were macroadenomas. They consisted of 18 non-functioning and 24 functioning adenomas (growth hormone (GH)-secreting: 11, prolactinomas: 7, concomitant GH and prolactin (PRL)-secreting: 5, gonadotropin-secreting: 1). Treatment was given in 200 cGy daily fraction size and a total dose of 50 Gy was given to most patients. Sixteen patients with GH- and/or PRL-secreting adenomas received bromocriptine. Tumor progression was determined by increase in tumor size as shown by CT or MRI. Hypopituitarism after radiotherapy was evaluated using the functions of corticotropin (ACTH), thyrotropin (TSH), and gonadotropin. Median follow-up time from the end of radiotherapy was 103 months. Tumor progression occurred in 2 out of 42 patients and 10-year progression-free rate for all patients was 93.7%. Normalization of GH levels was obtained in 12 of 16 GH-secreting adenomas with a mean time of 27 months after radiotherapy, and 9 of 12 PRL-secreting adenomas achieved normalization of PRL levels with a mean time of 34 months. One gonadotropin-secreting adenoma achieved normalization of gonadotropin level at 21 months after radiotherapy. The incidence of hypopituitarism after radiotherapy increased with time, and cumulative risk of deficiencies of ACTH, TSH, and gonadotropin at 10

  2. Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchida, Emiko; Sakai, Kunio; Matsumoto, Yasuo; Sugita, Tadashi; Sasamoto, Ryuta [Niigata Univ. (Japan). School of Medicine

    1999-09-01

    To evaluate the results of conventional radiotherapy for pituitary adenomas assessed with computed tomography (CT) or magnetic resonance imaging (MRI). Endpoints include tumor control, normalization of hormone levels in functioning adenomas, and hypopituitarism after radiotherapy as an adverse effect. Forty-two patients were treated with radiotherapy from 1982 to 1995 at Niigata University Hospital. Forty patients were irradiated after surgery because of residual adenomas in 33 patients and tumor regrowth in 7 patients. One patient was treated with radiotherapy alone, and the remaining 1 patient was treated with preoperative radiotherapy. Tumor size and extension were evaluated using CT or MRI, and all tumors were macroadenomas. They consisted of 18 non-functioning and 24 functioning adenomas (growth hormone (GH)-secreting: 11, prolactinomas: 7, concomitant GH and prolactin (PRL)-secreting: 5, gonadotropin-secreting: 1). Treatment was given in 200 cGy daily fraction size and a total dose of 50 Gy was given to most patients. Sixteen patients with GH- and/or PRL-secreting adenomas received bromocriptine. Tumor progression was determined by increase in tumor size as shown by CT or MRI. Hypopituitarism after radiotherapy was evaluated using the functions of corticotropin (ACTH), thyrotropin (TSH), and gonadotropin. Median follow-up time from the end of radiotherapy was 103 months. Tumor progression occurred in 2 out of 42 patients and 10-year progression-free rate for all patients was 93.7%. Normalization of GH levels was obtained in 12 of 16 GH-secreting adenomas with a mean time of 27 months after radiotherapy, and 9 of 12 PRL-secreting adenomas achieved normalization of PRL levels with a mean time of 34 months. One gonadotropin-secreting adenoma achieved normalization of gonadotropin level at 21 months after radiotherapy. The incidence of hypopituitarism after radiotherapy increased with time, and cumulative risk of deficiencies of ACTH, TSH, and gonadotropin at 10

  3. A New Cancer Radiotherapy System Using Multi Robotic Manipulators

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Ho; Lee, Nam Ho; Lee, Byung Chul; Jeung, Kyung Min; Lee, Seong Uk; Bae, Yeong Geol; Na, Hyun Seok [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-10-15

    The CyberKnife system is state-of-the-art cancer treatment equipment that combines an image tracking technique, artificial intelligence software, robot technology, accelerator technology, and treatment simulation technology. The current CyberKnife System has significant shortcomings. The biggest problem is that it takes a longer time to treat a tumor. A long treatment time gives stress to patients. Furthermore it makes the patients uncomfortable with radiation and thus it is difficult to measure the exact radiation dose rate to the tumor in the processing. Linear accelerators for radiation treatment are dependent on imports, and demand high maintenance cost. This also makes the treatment cost higher and prevents the popularization of radiation. To solve the disadvantages of the existing CyberKnife, a radiation treatment robot system applied to several articulated robots is suggested. Essential element techniques for new radiotherapy robot system are investigated and some problems of similar existing systems are analyzed. This paper presents a general configuration of a new radiation robot treatment system including with a quantitative goal of the requirement techniques. This paper described a new radiotherapy robot system to track the tumor using multiple articulated robots in real time. The existing CyberKnife system using a single robot arm has disadvantages of a long radiotherapy time, high medical fee, and inaccurate measurement of the radiotherapy dose. So a new radiotherapy robot system for tumors has been proposed to solve the above problems of conventional CyberKnife systems. Necessary technologies to configure new the radiotherapy robot system have been identified. Quantitative targets of each technology have been established. Multiple robot arms are adopted to decrease the radiotherapy time. The results of this research are provided as a requisite technology for a domestic radiotherapy system and are expected to be the foundation of new technology. The

  4. A New Cancer Radiotherapy System Using Multi Robotic Manipulators

    International Nuclear Information System (INIS)

    The CyberKnife system is state-of-the-art cancer treatment equipment that combines an image tracking technique, artificial intelligence software, robot technology, accelerator technology, and treatment simulation technology. The current CyberKnife System has significant shortcomings. The biggest problem is that it takes a longer time to treat a tumor. A long treatment time gives stress to patients. Furthermore it makes the patients uncomfortable with radiation and thus it is difficult to measure the exact radiation dose rate to the tumor in the processing. Linear accelerators for radiation treatment are dependent on imports, and demand high maintenance cost. This also makes the treatment cost higher and prevents the popularization of radiation. To solve the disadvantages of the existing CyberKnife, a radiation treatment robot system applied to several articulated robots is suggested. Essential element techniques for new radiotherapy robot system are investigated and some problems of similar existing systems are analyzed. This paper presents a general configuration of a new radiation robot treatment system including with a quantitative goal of the requirement techniques. This paper described a new radiotherapy robot system to track the tumor using multiple articulated robots in real time. The existing CyberKnife system using a single robot arm has disadvantages of a long radiotherapy time, high medical fee, and inaccurate measurement of the radiotherapy dose. So a new radiotherapy robot system for tumors has been proposed to solve the above problems of conventional CyberKnife systems. Necessary technologies to configure new the radiotherapy robot system have been identified. Quantitative targets of each technology have been established. Multiple robot arms are adopted to decrease the radiotherapy time. The results of this research are provided as a requisite technology for a domestic radiotherapy system and are expected to be the foundation of new technology. The

  5. Postoperative radiotherapy in carcinoma of the pyriform sinus; Radiotherapie postoperatoire dans les cancers du sinus piriforme

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, T.D.; Panis, X. [Centre Regional de Lutte Contre le Cancer, 51 - Reims (France); Malissard, L.; Hoffstetter, S. [Centre Regional de Lutte Contre le Cancer, 54 - Nancy (France); Eschwege, F. [Centre de Lutte Contre le Cancer Gustave-Roussy, 94 - Villejuif (France); Jung, G.M. [Centre Paul Strauss, 67 -Strasbourg (France); Bachaud, J.M. [Centre de Lutte Contre le Cancer Claudius-Regaud, 31 - Toulouse (France); Prevost, B. [Centre de Lutte Contre le Cancer Oscar-Lambret, 59 - Lille (France); Quint, R. [Centre Regional de Lutte Contre le Cancer, 14 - Caen (France); Chaplain, G. [Centre de Lutte Contre le Cancer Leon-Berard, 69 - Lyon (France); Rambert, P. [Centre de Lutte Contre le Cancer Rene Huguenin, 92 - Saint-Cloud (France); Fleury-Touzeau, F. [Centre Eugene Marquis, 35 - Rennes (France)

    1995-12-31

    Between January 1980 to December 1985, 248 patients with advanced squamous cell carcinoma of the pyriform sinus were retrospectively analysed. Criteria for inclusion in the study were the following: no previous treatment and treatment combining total pharyngolaryngectomy and postoperative radiotherapy. Mean follow up was 5 years with a minimum of 3 years. Seventy-one patients had a local regional recurrence (27,4%). Clinical staging at presentation and residual tumor at the primary site after surgery were factors significantly associated with higher local failure rates. The 5 year survival rate was 33 % and the median survival time was 32 months (plateau was reached after thee 6th year). The most frequent severe complication observed was pharyngeal stenosis occurring in 6 % of the cases. This study confirms the poor prognosis of squamous cell carcinoma of the pyriform sinus, in spite of the combination of radical surgery and high dose postoperative radiotherapy. (authors). 20 refs., 4 figs., 7 tabs.

  6. Comparison of intensity modulated radiotherapy with conformal radiotherapy in cancer on anal canal

    International Nuclear Information System (INIS)

    Full text: Introduction: The aim of the Intensity-Modulated Radiation Therapy (IMRT) use is homogeneous irradiation of volume for radiotherapy and preservation of critical organs and normal healthy tissues. The aim of the study is to develop a protocol for radiotherapy of cancer of the anal canal with IMRT, evaluation of dosimetric plans by comparison with analogous obtained with conformal radiotherapy (CRT). Materials and Methods: The protocol was developed using data of 10 patients with carcinoma of the anal canal in clinical stage T3 -4N1-3M0, as 5 patients were treated with CRT, and 5 of them were treated on this protocol. Planned target volumes are: PTV A - perineum with anal opening and anal canal, rectum and all lymph chains in the pelvis (pre-sacral, perirectal, internal iliac, external iliac and obturator) and PTV B - inguinal lymph nodes. Planned total therapeutic dose is 50 Gy, fractionated 2 Gy per day. Critical organs are small intestinal loops, bladder, and hips. Through the dose- volume histograms analysis of the results in the two groups are compared. Results: The results of the analysis of the dose - volume histograms show the following advantages of IMRT over CRT: Better homogeneity of the dose distribution, particularly for PTV B, where for the IMRT plan only 2% of the volume receive a dose > 52 Gy, while on CRT 15% receive a dose > 60Gy; average dose in IMRT plan for intestinal loops, bladder and femoral is with 7 Gy lower and the maximum dose for the critical organs is low and substantially less volume from the critical organs receive it . Conclusion: IMRT protocol offers better homogeneity in the planned target volumes and lower doses to critical organs. Time for planning, verification and simulation of plan for radiotherapy is doubled compared to CRT. The time for irradiation of a patient is similar to this for CRT - about 10 minutes

  7. Practices of Radiotherapy Equipment Quality Control in Radiotherapy Centres in Croatia

    OpenAIRE

    Švabić, Manda; Jurković, Slaven; Faj, Dario; Kasabašić, Mladen; Smilović Radojčić, Djeni; Ivković, Ana

    2008-01-01

    From the prescription to the delivery of a radiotherapy treatment, a team of professionals from a number of disciplines is involved. In this way significant potential for errors leading to an accidental exposure becomes apparent. Comprehensive quality assurance/quality control (QA/QC) program to minimize such errors is, therefore, required. One aspect of QA/QC program is quality control of the equipment. In this paper we present experiences in establishing QC procedures in our cen...

  8. Conformal Radiotherapy: Physics, Treatment Planning and Verification. Proceedings book

    Energy Technology Data Exchange (ETDEWEB)

    De Wagter, C. [ed.

    1995-12-01

    The goal of conformal radiotherapy is to establish radiation dose distributions that conform tightly to the target volume in view of limiting radiation to normal tissues. Conformal radiotherapy significantly improves both local control and palliation and thus contributes to increase survival and to improve the quality of life. The subjects covered by the symposium include : (1) conformal radiotherapy and multi-leaf collimation; (2) three dimensional imaging; (3) treatment simulation, planning and optimization; (4) quality assurance; and (5) dosimetry. The book of proceedings contains the abstracts of the invited lectures, papers and poster presentations as well as the full papers of these contributions.

  9. Current status and potential perspectives in classical radiotherapy technology

    Directory of Open Access Journals (Sweden)

    Dabić-Stanković Kata M.

    2004-01-01

    Full Text Available Introduction and potentials of classical radiotherapy After purchase of radiotherapy equipment in 2003, classic radiation therapy in Serbia will reach the highest world level. In order to define the highest standards in radiation technology, we analyzed the current status and potential perspectives of radiation therapy. Technological levels of radiotherapy in developed countries An analysis of present situation in the USA, assumed as the most developed in the world, was done. Available data, collected in the last 3 years (equipment assortment, therapy modalities, workload and manpower for 284 radiotherapy centers, out of potential 2050, were analyzed. Results were presented as crude percentage and mached to point current status. Results of analysis and discussion The analysis showed that CLINAC accelerators are the most popular (82.7%, as well as, ADAC (43.7% and Focus (CMS (27.4% systems for therapy planning. Movement towards virtual simulation is evident (59.3%, although classic ”simulation” is not fully eliminated from the radiotherapy chain. The most popular brachytherapy afterloader is Microselectron HDR (71%. About 64.4% centers use IMPAC communication/verification/record system that seems more open than Varis. All centers practice modern radiotherapy modalities and techniques (CFRT, IMRT, SRS/SRT, TBI, IORT, IVBHRT, HDR BHRT, etc.. CT and MRI availability is out of question, but PET is available in 3% of centers, however this percentage is rapidly growing. Up to 350 new patients per year are treated by one accelerator (about 35 pts. a day. Centers are relatively small and utilize 2-3 accelerators on average. Average FTE staffing norm is 4 radiation oncologists, 2-3 medical radiotherapy physicists, about 3 certified medical dosimetrists and about 6 radiotherapy technologists. Technological aspects and conclusion In the past 5 years relative stagnation in classic radiotherapy has been observed. In spite of substantial investments in

  10. Heavy-ion radiography applied to charged particle radiotherapy

    International Nuclear Information System (INIS)

    The objectives of the heavy-ion radiography research program applied to the clinical cancer research program of charged particle radiotherapy have a twofold purpose: (1) to explore the manner in which heavy-ion radiography and CT reconstruction can provide improved tumor localization, treatment planning, and beam delivery for radiotherapy with accelerated heavy charged particles; and (2) to explore the usefulness of heavy-ion radiography in detecting, localizing, and sizing soft tissue cancers in the human body. The techniques and procedures developed for heavy-ion radiography should prove successful in support of charged particle radiotherapy

  11. Metallic stent and stereotactic conformal radiotherapy for hilar cholangiocarcinoma

    International Nuclear Information System (INIS)

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

  12. The cost effectiveness of CT-assisted radiotherapy planning

    International Nuclear Information System (INIS)

    The cross-sections displayed by computer tomography are an ideal basis for radiotherapy planning because the bodycontour, tumour target and adjacent normal tissues are accurately visualized. Using this format, dose distribution plans can be computed using an integrated radiotherapy planning system and these techniques make an important contribution to the management of many tumours. With an estimated improvement in cure rate of 4.5% and cost-effective factors of 5.0 (Netherlands) and 3.3 (United Kingdom), CT-assisted radiotherapy planning appears to be a worthwhile procedure. (orig.)

  13. Radiotherapy cost-calculation and its impact on capacity planning.

    Science.gov (United States)

    Lievens, Yolande; Slotman, Berend Jan

    2003-08-01

    The rapid rise in health care expenses has resulted in an increased interest in the cost of treatments from a cost-effectiveness point of view for management purposes and in a reimbursement setting. The economics of radiotherapy within the global context of health care, and more specifically of cancer therapy, are discussed in this review. Furthermore, the calculation of radiotherapy costs from an institutional perspective using activity-based costing and on capacity planning in radiotherapy - at the departmental as well as at the national level - by integrating cost, epidemiological and scientifico-technological data are focused on. PMID:19807460

  14. Optimisation in radiotherapy. II: Programmed and inversion optimisation algorithms.

    Science.gov (United States)

    Ebert, M

    1997-12-01

    This is the second article in a three part examination of optimisation in radiotherapy. The previous article established the bases of optimisation in radiotherapy, and the formulation of the optimisation problem. This paper outlines several algorithms that have been used in radiotherapy, for searching for the best irradiation strategy within the full set of possible strategies. Two principle classes of algorithm are considered--those associated with mathematical programming which employ specific search techniques, linear programming-type searches or artificial intelligence--and those which seek to perform a numerical inversion of the optimisation problem, finishing with deterministic iterative inversion. PMID:9503694

  15. Synergistic Effects of Gold Nanocages in Hyperthermia and Radiotherapy Treatment.

    Science.gov (United States)

    Zhang, Ai-Wei; Guo, Wei-Hua; Qi, Ya-Fei; Wang, Jian-Zhen; Ma, Xiang-Xing; Yu, De-Xin

    2016-12-01

    Gold nanocages (GNCs) are a promising material that not only converts near infrared (NIR) light to heat for the ablation of tumors but also acts as a radiosensitizer. The combination of hyperthermia and radiotherapy has a synergistic effect that can lead to significant tumor cell necrosis. In the current study, we synthesized GNCs that offered the combined effects of hyperthermia and radiotherapy. This combination strategy resulted in increased tumor cell apoptosis and significant tumor tissue necrosis. We propose that GNCs can be used for clinical treatment and to potentially overcome resistance to radiotherapy by clearly increasing the antitumor effect. PMID:27255899

  16. Synergistic Effects of Gold Nanocages in Hyperthermia and Radiotherapy Treatment

    Science.gov (United States)

    Zhang, Ai-wei; Guo, Wei-hua; Qi, Ya-fei; Wang, Jian-zhen; Ma, Xiang-xing; Yu, De-xin

    2016-06-01

    Gold nanocages (GNCs) are a promising material that not only converts near infrared (NIR) light to heat for the ablation of tumors but also acts as a radiosensitizer. The combination of hyperthermia and radiotherapy has a synergistic effect that can lead to significant tumor cell necrosis. In the current study, we synthesized GNCs that offered the combined effects of hyperthermia and radiotherapy. This combination strategy resulted in increased tumor cell apoptosis and significant tumor tissue necrosis. We propose that GNCs can be used for clinical treatment and to potentially overcome resistance to radiotherapy by clearly increasing the antitumor effect.

  17. Supportive care for head and neck cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Recently (chemo-)radiotherapy has been widely used in head and neck cancer with definite evidence. As long survivor has increased, social problems associated with late toxicity have become more. Late toxicities induced by radiotherapy for head and neck lesion are often severe. Xerostomia is one of the severe late toxicities conventionally and dysphagia after chemoradiotherapy is a new topic. Some industrial development (ex. Intensity Modulated Radiotherapy: IMRT) play a great role in toxicity management. Multidisciplinary approach (cooperation between not only physicians but also nurses and dentists) is necessary to control toxicities. The research of supportive care will be needed same as definitive treatment in the future. (author)

  18. Acquired lymphangiectasis following surgery and radiotherapy of breast cancer

    Directory of Open Access Journals (Sweden)

    Angoori Gnaneshwar Rao

    2015-01-01

    Full Text Available Acquired lymphangiectasia (AL is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

  19. Conformal Radiotherapy: Physics, Treatment Planning and Verification. Proceedings book

    International Nuclear Information System (INIS)

    The goal of conformal radiotherapy is to establish radiation dose distributions that conform tightly to the target volume in view of limiting radiation to normal tissues. Conformal radiotherapy significantly improves both local control and palliation and thus contributes to increase survival and to improve the quality of life. The subjects covered by the symposium include : (1) conformal radiotherapy and multi-leaf collimation; (2) three dimensional imaging; (3) treatment simulation, planning and optimization; (4) quality assurance; and (5) dosimetry. The book of proceedings contains the abstracts of the invited lectures, papers and poster presentations as well as the full papers of these contributions

  20. Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell Gamma Knife Society 2000 debate.

    Science.gov (United States)

    Linskey, Mark E

    2013-12-01

    By definition, the term "radiosurgery" refers to the delivery of a therapeutic radiation dose in a single fraction, not simply the use of stereotaxy. Multiple-fraction delivery is better termed "stereotactic radiotherapy." There are compelling radiobiological principles supporting the biological superiority of single-fraction radiation for achieving an optimal therapeutic response for the slowly proliferating, late-responding, tissue of a schwannoma. It is axiomatic that complication avoidance requires precise three-dimensional conformality between treatment and tumor volumes. This degree of conformality can only be achieved through complex multiisocenter planning. Alternative radiosurgery devices are generally limited to delivering one to four isocenters in a single treatment session. Although they can reproduce dose plans similar in conformality to early gamma knife dose plans by using a similar number of isocenters, they cannot reproduce the conformality of modern gamma knife plans based on magnetic resonance image--targeted localization and five to 30 isocenters. A disturbing trend is developing in which institutions without nongamma knife radiosurgery (GKS) centers are championing and/or shifting to hypofractionated stereotactic radiotherapy for vestibular schwannomas. This trend appears to be driven by a desire to reduce complication rates to compete with modern GKS results by using complex multiisocenter planning. Aggressive advertising and marketing from some of these centers even paradoxically suggests biological superiority of hypofractionation approaches over single-dose radiosurgery for vestibular schwannomas. At the same time these centers continue to use the term radiosurgery to describe their hypofractionated radiotherapy approach in an apparent effort to benefit from a GKS "halo effect." It must be reemphasized that as neurosurgeons our primary duty is to achieve permanent tumor control for our patients and not to eliminate complications at the

  1. Optimum radiotherapy schedule for uterine cervical cancer based-on the detailed information of dose fractionation and radiotherapy technique

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jae Ho; Kim, Hyun Chang; Suh, Chang Ok [Yonsei University Medical School, Seoul (Korea, Republic of)] (and others)

    2005-09-15

    The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of 23.4 {approx} 59.4 Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-ICBT) was also performed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of 14.4{approx} 43.2 Gy (Median 36.0) of EBRT in 495 patients, while in the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder and rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ({alpha} / {beta} = 10) and late-responding tissues ({alpha} /{beta} = 3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED Gy{sub 3} and the risk of complication was assessed using serial multiple logistic regressions models. The associations between R

  2. [Time factors factors in radiotherapy. Introduction (author's transl)].

    Science.gov (United States)

    Dutreix, J

    1976-11-01

    The role of time factors, the fractioning and spread of irradiation, continue to occupy an important place in conference, symposia and meeting of radiotherapists and our own Society has followed this tradition by devoting to the subject this session of the Journées de Radiologie 1975. The problem is a constant feature of everyday clinical practise. Whilst the majority of radiotherapists are prudently attached to the traditional method of 5 sessions per week, they are frequently forced to change this rhythm for pathological reasons, the personal convenience of the patient or problems with apparatus. The association of transcutaneous and curietherapeutic irradiation adds new parameters : the rate of the curie-therapy, the relative contribution of the 2 methods of irradiation, their sequence and the interval which separates them. Poor results of radiotherapy in certain situations indicates the possible value of determining whether other methods of the distribution per session and in time might lead to an improvement. Under these numerous circumstances, one is led to compare different forms of irradiation and to assess their possible biological differences. Objective description of the type of irradiation may be limited to the contents of the treatment sheet. However this does not easily express the biological quantity of the irradiation. As soon as the differences between two types of irradiation involves two parameters, they can no longer be effectively compared. The usefulness of a single figure to express the biological value of irradiation is obvious. With this aim, Cohen proposes calculation of levels of cell survival resulting from irradiation and extracts the parameters of this calculation from clinical results published in the literature. By similar analysis, Ellis has deduced the overall role of time factors which is expressed by the simple relation of the N.S.D., which has itself been at the origin of other expressions seeking to be more convenient and

  3. Dosimetry comparison of irradiation with conformal radiotherapy, intensity modulated radiotherapy, conformal radiotherapy in stereotactic conditions and robotic stereotactic radiotherapy for benign brain tumours; Comparaison dosimetrique de la radiotherapie conformationnelle, la radiotherapie conformationnelle avec modulation d'intensite, la radiotherapie conformationnelle en conditions stereotaxiques et la radiotherapie en conditions stereotaxiques robotisee des tumeurs cerebrales benignes

    Energy Technology Data Exchange (ETDEWEB)

    Spasic, E.; Noel, A. [Departement de radiophysique, centre Alexis-Vautrin, avenue de Bourgogne, 54511 Vandoeuvre-les-Nancy cedex (France); UMR 7039 CNRS, centre de recherche en automatique de Nancy (Cran), BP 239, 54506 Vandoeuvre-les-Nancy cedex (France); Cran UMR 7039, faculte des sciences et techniques, universite Henri-Poincare Nancy 1, BP 239, 54506 Vandoeuvre-les-Nancy cedex (France); Cran UMR 7039, institut national polytechnique de Lorraine, BP 239, 54506 Vandoeuvre-les-Nancy cedex (France); Buchheit, I.; Bernier, V. [Departement de radiophysique, centre Alexis-Vautrin, avenue de Bourgogne, 54511 Vandoeuvre-les-Nancy cedex (France)

    2011-07-15

    Purpose. - To compare several techniques in order to determine the best treatment for benign brain tumours. Methods and patients. - A retrospective study was performed for five patients who received 3D-conformal radiotherapy, intensity modulated radiotherapy or CyberKnife{sup R}. These patients had a meningioma, a pituitary tumour, a cranio-pharyngioma or a neurinoma. In each case, these treatment plans were optimised and compared with the three other dosimetries. Radiobiological or positioning parameters were evaluated, as well as dosimetric parameters, in order to compare treatments with different characteristics. Results. - The dosimetric parameters showed that the choice of treatment seemed to be determined mostly by tumour size, shape and proximity with organs at risk (not tumour localisation). Whereas the results showed no significant deviations with regards to the radiobiological parameters. Therefore, with these parameters, it was difficult to give priority to a treatment. Conclusions. - With regards to benign brain tumours of medium or large size, intensity modulated radiotherapy seemed the recommended treatment. It enabled to obtain a good ratio between efficacy and toxicity for tumours that are really close to organs at risk. Concerning small benign brain tumours, the CyberKnife{sup R} was probably the best treatment. (authors)

  4. The use of multimodality imaging in radiotherapy; Utilisation de l'imagerie multimodalite en radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Boisserie, G.; Hasboun, D. [Hopital Pitie-Salpetriere, 75 - Paris (France)

    2001-11-01

    The quality of treatment that one can realize today in conformal radiotherapy, can be reached only if one has access to 3-D imaging allowing a precise determination of the volume of the organs at risk and of the CTV. For this reason, one has access to anatomical imaging, CT or MRI, and functional and metabolic imaging, PET or SPECT imaging. CT gives the electronic density of the tissues, which is essential to ensure a very precise calculation of dose distribution. Its insufficiency in the visualization of the tumor and some anatomical structures makes necessary the registration of these images with MRI of which distortions are sufficiently weak to be usable in radiotherapy. The registration will be usable only if images of each modality are realized with the patient in treatment position, except for brain, where only CT, on which is based the registration, must be done in treatment position. At least, if one wants to visualize the active parts of a tumor or to make the difference between fibrosis and tumor left or recurrence after radiotherapy or chemotherapy, it is necessary to use PET or SPECT. To define correctly the CTV using these images, one must realize the anatomical localization of the metabolic abnormalities, which they highlight with a registration based on CT or MRI. The difficulties to obtain the registration of these images led the manufacturer to propose mixed machines allowing to realize, at the same time, a CT imaging and a PET or a SPECT imaging with the patient in treatment position. (authors)

  5. Unstable chromosome aberrations on peripheral blood lymphocytes from patients with cervical uterine cancer following radiotherapy; Aberracoes cromossomicas instaveis em linfocitos de pacientes com cancer de colo de utero

    Energy Technology Data Exchange (ETDEWEB)

    Magnata, Simey de Souza Leao Pereira

    2002-09-01

    Absorbed dose determination is an important step for risk assessment related to an exposure to ionizing radiation. However, physical dosimetry cannot be always performed, principally in the case of retrospective estimates. In this context, the use of bioindicators (biological effects) has been proposed, which defines the so-called biological dosimetry. In particular, scoring of unstable chromosomes aberrations (dicentrics, centric rings and fragments) of peripheral blood lymphocytes, while is the most reliable biological method for estimating individual exposure to ionizing radiation. In this work, blood samples from 5 patients, with cervical uterine cancer, were evaluated after partial-body radiotherapy with a source of {sup 69} Co. For this, conventional cytogenetic method was employed, based on Giemsa coloration and fluorescence in situ hybridization, in order to correlate the frequency of unstable chromosome aberrations of blood lymphocytes with absorbed dose, as a result of the radiotherapy. A good agreement was observed between the frequency of chromosome aberrations scored and the values of dose previously calculated by physical dosimetry during patient's radiotherapy. The results presented in this work point out the importance of concerning analyses of unstable chromosome aberrations as biological dosimeter in the investigation of partial-body exposure to ionizing radiation. (author)

  6. Applying radiation safety standards in radiotherapy

    International Nuclear Information System (INIS)

    The International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS) cover the application of ionizing radiation for all practices and interventions and are, therefore, basic and general in nature. Users of radiation sources have to apply these basic requirements to their own particular practices. This requires a degree of 'interpretation' by the user, which can result in varying levels of regulatory compliance and inconsistencies between applications of the BSS to similar practices. In this context, the preamble of the BSS states that: The [regulatory body] may need to provide guidance on how certain regulatory requirements are to be fulfilled for various practices, for example in regulatory guideline documents. In order to guide the user to achieve a good standard of protection and to achieve a consistent national approach to licensing and inspection, some countries have developed practice specific regulatory guidance, while others have practice specific regulations. For obvious reasons, national regulatory guidance is tailored to a country's own legislation and regulations. This can lead to problems if the guidance is used in other States without appropriate modification to take local requirements into account. There would therefore appear to be scope for producing internationally harmonized guidance, while bearing in mind that the ultimate responsibility for the regulatory documents rests with the State. Some regions have taken the initiative of preparing guidance to facilitate the regional harmonization of regulatory control of certain common practices (e.g. radiotherapy). A number of draft regulatory guidance documents for the main practices involving the use of ionizing radiation have already been prepared. This initiative indicates that there is a global demand for such documents. In particular, it is felt that countries participating in the IAEA's technical cooperation model project on Upgrading

  7. Radiotherapy and Antiangiogenic TM in Lung Cancer

    Directory of Open Access Journals (Sweden)

    Mohamed K. Khan

    2002-01-01

    Full Text Available Tetrathiomolybdate (TM is a potent nontoxic orally delivered copper complexing agent under development for the last several years for the treatment of Wilson's disease. It has been shown to block angiogenesis in primary and metastatic tumors. Therefore, the combination of cytotoxic radiotherapy (RT and antiangiogenic TM could target both the existing tumor and the tumor microvasculature in a comprehensive strategy. Using a Lewis lung high metastatic (LLHM carcinoma mouse tumor model, we demonstrate that the combination of TM and RT is more effective than either used as monotherapy. We also show that their therapeutic effects are additive, with no additional toxicity. We show that TM has no significant cytotoxicity in vitro against LLHM tumor cells, further supporting the antiangiogenic mechanism for its action.

  8. Atomic and molecular data for radiotherapy

    International Nuclear Information System (INIS)

    An Advisory Group Meeting devoted solely to review the atomic and molecular data needed for radiotherapy was held in Vienna from 13 to 16 June 1988. The following items as related to the atoms and molecules of human tissues were reviewed: Cross sections differential in energy loss for electrons and other charged particles. Secondary electron spectra, or differential ionization cross sections. Total cross sections for ionization and excitation. Subexcitation electrons. Cross sections for charged-particle collisions in condensed matter. Stopping power for low-energy electrons and ions. Initial yields of atomic and molecular ions and their excited states and electron degradation spectra. Rapid conversion of these initial ions and their excited states through thermal collisions with other atoms and molecules. Track-structure quantities. Other relevant data. Refs, figs and tabs

  9. Quadrantectomy and adjuvant radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    The conservative treatment of early breast cancer always requires irradiation of residual mammary tissue. The preliminary results obtained in 45 early breast cancer patients, who received quadrantectomy plus axillary dissection, followed by radiation of residual breast are reported. Radiation was performed by the two opposed field technique. In some cases the residual breast tissue was compressed using a special accessory provided with the Theratron 780. In addition to the tumor dose of 50 GY, 10 GY boots was added to the surgical scar using 7 MeV electrons. The 6 patients with positive axillary nodes received 6 courses of adjuvant chemotherapy (CMF) after radiotherapy. All patients are currently alive and free of disease. The 64% (29 patients) were followed up for at least 5 years, and 36% (16 patients) for at least 3 years. Only 2 cases of local recurrence were encountered (4,4%). The esthetic result was satisfactory in all cases. No side effects due to treatment were noted

  10. Radiotherapy of acne - a literature survey

    International Nuclear Information System (INIS)

    This review is part of a feasibility study on a follow-up survey of patients having undergone dermatologic X-ray therapy. Its main purpose is to bring up to date the knowledge on the long-term effects of the radiotherapy of seborrheic diseases and to collect any historical data contributing to the interpretation of the results of a future survey in this field. The older and modern physiopathogenic ideas on acne are first stated, and both the radiological protocols and the therapeutic associations set forth by roentgenologists in the years 1930-1960 are then described. A dosimetric and health assessment is made and the modalities of an epidemiological survey are considered

  11. Stereotactic body radiotherapy for solitary spine metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young [Dept. of Radiation Oncology, Sun Medical Center, Daejeon (Korea, Republic of); Chun, Mison [Dept. of Radiation Oncology, Ajou University School of Medicine, Suwon (Korea, Republic of); Lee, Mi Jo [Dept. of Radiation Oncology, Eulji Universtiy School of Medicine, Daejeon (Korea, Republic of)

    2013-12-15

    A clear consensus has not been established regarding the best treatment for solitary bone metastasis. Here, we reviewed the medical records of patients with a controlled primary malignancy who had only solitary spine metastasis without metastasis to the extraspinal bone or viscera and underwent treatment between April 2007 and December 2012 with stereotactic body radiosurgery using CyberKnife, with a total dose of 24 Gy in three to four fractions. During that time, there were only four cases. This was effective in each case, and all the four patients had no local failure and remained alive at a median follow-up of 68 months (range, 64 to 80 months). Although our experience is limited, this study suggests that stereotactic body radiotherapy could be a feasible, safe, effective, and noninvasive alternative treatment for solitary spine metastasis in patients who are medically inoperable or unsuitable for surgery.

  12. Monte Carlo Treatment Planning for Advanced Radiotherapy

    DEFF Research Database (Denmark)

    Cronholm, Rickard

    for commissioning of a Monte Carlo model of a medical linear accelerator, ensuring agreement with measurements within 1% for a range of situations, is presented. The resulting Monte Carlo model was validated against measurements for a wider range of situations, including small field output factors, and agreement...... modulating the intensity of the field during the irradiation. The workflow described has the potential to fully model the dynamic delivery, including gantry rotation during irradiation, of modern radiotherapy. Three corner stones of Monte Carlo Treatment Planning are identified: Building, commissioning...... and validation of a Monte Carlo model of a medical linear accelerator (i), converting a CT scan of a patient to a Monte Carlo compliant phantom (ii) and translating the treatment plan parameters (including beam energy, angles of incidence, collimator settings etc) to a Monte Carlo input file (iii). A protocol...

  13. Postoperative radiotherapy for parotid gland malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Eom, Keun Yong; Wu, Hong Gyun; Kim, Jae Sung; Park, Charn Il; Kim, Kwang Hyun; Lee, Chae Seo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, In Ah [Bundang Seoul National University Hospital, Seongnam (Korea, Republic of)

    2005-09-15

    The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Between 1980 and 2002, 130 patients with parotid malignancy were registered in the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative irradiation. There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. The overall 5 and 10 year survival rates were 85 and 76%, respectively. The five-year locoregional control rate was 85%, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal involvement and a positive resection margin were associated with poor locoregional control.

  14. Informed consent for radiotherapy: Our responsibility

    Energy Technology Data Exchange (ETDEWEB)

    Colyer, Hazel [Canterbury Christ Church University College, North Holmes Road, Canterbury, Kent CT1 1QU (United Kingdom)]. E-mail: h.m.colyer@canterbury.ac.uk

    2007-08-15

    This article describes and contextualises the findings from an email survey of cancer centres in the United Kingdom (UK) conducted early in 2005. It sought to discover how widely the model consent policy and process, published in 2001 [Department of Health. Good practice in consent. Achieving the NHS Plan commitment to patient-centred consent practice. HSC 2001/023. NHS Executive; November 2001], had been implemented and, more controversially, which professional groups gained the consent of patients to radiotherapy. The survey was sent on the author's behalf by the Society and College of Radiographers (SCoR) to all cancer centres in the UK, including five private sector facilities (n = 63). Forty-eight responses were received (76%). A majority of cancer centres have implemented the new procedures and these are undertaken most commonly by consultant oncologists and trained specialist registrars. In 10 centres, therapeutic radiographers (radiographers) are among the team gaining consent to radiotherapy and other centres have radiographers in training. There is widespread adherence to government guidance for obtaining consent and a growing number of centres are implementing radiographer-led consent. However, this is controversial from both medical and radiographic professional perspectives despite guidance indicating that the person who is actually treating the patients should seek their consent [Department of Health. 12 Key points on consent: the law in England. March 2001]. In the context of creating person-centred services, the significance for the development of the profession of therapeutic radiography is evaluated. In particular, the implications of radiographers both capitalising on and failing to assume this professional responsibility were explored.

  15. Use of Postmastectomy Radiotherapy in Older Women

    International Nuclear Information System (INIS)

    Purpose: Clinical trials and guidelines published between 1997 and 2001 concluded that postmastectomy radiotherapy (PMRT) improves overall survival for women with high-risk breast cancer. However, the effect of these findings on current practice is not known. Using the Surveillance, Epidemiology, and End Results-Medicare cohort, we sought to characterize the adoption of PMRT from 1992 to 2002 and identify risk factors for PMRT omission among high-risk older patients. Methods and Materials: We identified 28,973 women aged ≥66 years who had been treated with mastectomy for invasive breast cancer between 1992 and 2002. Trends in the adoption of PMRT for low- (T1-T2N0), intermediate- (T1-T2N1), and high- (T3-T4 and/or N2-N3) risk patients were characterized using a Monte Carlo permutation algorithm. Multivariate logistic regression identified the risk factors for PMRT omission and calculated the adjusted use rates. Results: Postmastectomy radiotherapy use increased gradually and consistently for low-risk (+2.16%/y) and intermediate-risk (+7.20%/y) patients throughout the study interval. In contrast, PMRT use for high-risk patients increased sharply between 1996 and 1997 (+30.99%/y), but subsequently stabilized. Between 1998 and 2002, only 53% of high-risk patients received PMRT. The risk factors for PMRT omission included advanced age, moderate to severe comorbidity, smaller tumor size, fewer positive lymph nodes, and geographic region, with adjusted use rates ranging from 63.5% in San Francisco to 44.9% in Connecticut. Conclusion: Among the high-risk patients, PMRT use increased sharply in 1997 after the initial clinical trial publication. Despite subsequent guidelines recommending the use of PMRT, no further increase in PMRT use has occurred, and nearly 50% of high-risk patients still do not receive PMRT

  16. Informed consent for radiotherapy: Our responsibility

    International Nuclear Information System (INIS)

    This article describes and contextualises the findings from an email survey of cancer centres in the United Kingdom (UK) conducted early in 2005. It sought to discover how widely the model consent policy and process, published in 2001 [Department of Health. Good practice in consent. Achieving the NHS Plan commitment to patient-centred consent practice. HSC 2001/023. NHS Executive; November 2001], had been implemented and, more controversially, which professional groups gained the consent of patients to radiotherapy. The survey was sent on the author's behalf by the Society and College of Radiographers (SCoR) to all cancer centres in the UK, including five private sector facilities (n = 63). Forty-eight responses were received (76%). A majority of cancer centres have implemented the new procedures and these are undertaken most commonly by consultant oncologists and trained specialist registrars. In 10 centres, therapeutic radiographers (radiographers) are among the team gaining consent to radiotherapy and other centres have radiographers in training. There is widespread adherence to government guidance for obtaining consent and a growing number of centres are implementing radiographer-led consent. However, this is controversial from both medical and radiographic professional perspectives despite guidance indicating that the person who is actually treating the patients should seek their consent [Department of Health. 12 Key points on consent: the law in England. March 2001]. In the context of creating person-centred services, the significance for the development of the profession of therapeutic radiography is evaluated. In particular, the implications of radiographers both capitalising on and failing to assume this professional responsibility were explored

  17. Accidents in radiotherapy: Lack of quality assurance?

    International Nuclear Information System (INIS)

    About 150 radiological accidents, involving more than 3000 patients with adverse effects, 15 patient's fatalities and about 5000 staff and public exposures have been collected and analysed. Out of 67 analysed accidents in external beam therapy 22% has been caused by wrong calculation of the exposure time or monitor units, 13% by inadequate review of patient's chart, 12% by mistakes in the anatomical area to be treated. The remaining 35% can be attributed to 17 different causes. The most common mistakes in brachytherapy were wrong activities of sources used for treatment (20%), inadequate procedures for placement of sources applicators (14%), mistakes in calculating the treatment time (12%), etc. The direct and contributing causes of radiological accidents have been deduced from each event, when it was possible and categorized into 9 categories: mistakes in procedures (30%), professional mistakes (17%), communication mistakes (15%), lack of training (8.5%), interpretation mistakes (7%), lack of supervision (6%), mistakes in judgement (6%), hardware failures (5%), software and other mistakes (5.5%). Three types of direct and contributing causes responsible for almost 62% of all accidents are directly connected to the quality assurance of treatment. The lessons learnt from the accidents are related to frequencies of direct and contributing factors and show that most of the accident are caused by lack, non-application of quality assurance (QA) procedures or by underestimating of QA procedures. The international system for collection of accidents and dissemination of lessons learnt from the different accidents, proposed by IAEA, can contribute to better practice in many radiotherapy departments. Most of the accidents could have been avoided, had a comprehensive QA programme been established and properly applied in all radiotherapy departments, whatever the size. (author)

  18. Targeted Radiotherapy of Estrogen Receptor Positive Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Raghavan Rajagopalan

    2006-08-31

    The overall objectives of the proposal were to develop estrogen receptor (ER) binding small molecule radiopharmaceuticals for targeted radiotherapy of ER positive (ER+) tumors. In particular, this proposal focused on embedding a {sup 186,188}Re or a {sup 32}P radionuclide into an estrogen steroidal framework by isosteric substitution such that the resulting structure is topologically similar to the estrogen (estrogen mimic). The estrogen mimic molecules expected to bind to the ER and exhibit biodistribution akin to that of native estrogen due to structural mimicry. It is anticipated that the {sup 186,188}Re- or a {sup 32}P-containing estrogen mimics will be useful for targeted molecular radiotherapy of ER+ tumors. It is well established that the in vivo target tissue uptake of estrogen like steroidal molecules is related to the binding of the steroids to sex hormone binding globulin (SHBG). SHBG is important in the uptake of estrogens and testosterone in target tissues by SHBG receptors on the cell surface. However, hitherto the design of estrogen like small molecule radiopharmaceuticals was focused on optimizing ER binding characteristics without emphasis on SHBG binding properties. Consequently, even the molecules with good ER affinity in vitro, performed poorly in biodistribution studies. Based on molecular modeling studies the proposal focused on developing estrogen mimics 1-3 which were topologically similar to native estrogens, and form hydrogen bonds in ER and SHBG in the same manner as those of native estrogens. To this end the technical objectives of the proposal focused on synthesizing the rhenium-estrone and estradiol mimics 1 and 2 respectively, and phosphorous estradiol mimic 3 and to assess their stability and in vitro binding characteristics to ER and SHBG.

  19. Magnetic Resonance Imaging in Postprostatectomy Radiotherapy Planning

    International Nuclear Information System (INIS)

    Purpose: To investigate whether the use of magnetic resonance imaging (MRI) in prostate bed treatment planning could influence definition of the clinical target volume (CTV) and organs at risk. Methods and Materials: A total of 21 consecutive patients referred for prostate bed radiotherapy were included in the present retrospective study. The CTV was delineated according to the European Organization for Research and Treatment of Cancer recommendations on computed tomography (CT) and T1-weighted (T1w) and T2-weighted (T2w) MRI. The CTV magnitude, agreement, and spatial differences were evaluated on the planning CT scan after registration with the MRI scans. Results: The CTV was significantly reduced on the T1w and T2w MRI scans (13% and 9%, respectively) compared with the CT scans. The urinary bladder was drawn smaller on the CT scans and the rectum was smaller on the MRI scans. On T1w MRI, the rectum and urinary bladder were delineated larger than on T2w MRI. Minimal agreement was observed between the CT and T2w images. The main spatial differences were measured in the superior and superolateral directions in which the CTV on the MRI scans was 1.8–2.9 mm smaller. In the posterior and inferior border, no difference was seen between the CT and T1w MRI scans. On the T2w MRI scans, the CTV was larger in these directions (by 1.3 and 1.7 mm, respectively). Conclusions: The use of MRI in postprostatectomy radiotherapy planning resulted in a reduction of the CTV. The main differences were found in the superior part of the prostate bed. We believe T2w MRI enables more precise definition of prostate bed CTV than conventional planning CT.

  20. Superselective arterial infusion and concomitant radiotherapy

    International Nuclear Information System (INIS)

    Superselective arterial infusion for patients with advanced head and neck cancer has been increasingly applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Through October 1999 to March 2002, 29 patients, ranging in age between 33 and 71 years (median 52 years), received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m2/week) with simultaneous intravenous infusion of thiosulfate for neutralizing cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). Four patients were diagnosed with stage III and 25 with stage IV. Thirteen patients were considered contraindicated for surgery, and the other 16 patients rejected radical surgery. Primary tumor sites included paranasal sinus (11 patients), hypopharynx (7), oropharynx (6), oral cavity (4), and parotid gland (1). During the median follow-up period of 20 months, there was no apparent recurrence in 14 (48.3%) of 29 patients. Eleven (37.9%) patients died of disease, and three (10.3%) were alive with disease. In twenty-one patients (72.4%) the primary lesions were well-controlled. Acute toxic effects were moderate, and severe toxic events occurred in four cases, namely, methicillin-resistant staphylococcus aureus (MRSA) pneumonia, sepsis, tetraplasia, and osteoradionecrosis. We confirmed the effectiveness and safety of superselective arterial infusion and concomitant radiotherapy. Furthermore, we must establish the optimal procedures and schedule, as well as the indications for this treatment. This treatment protocol may improve the prognosis of patients with unresectable disease and patients rejecting surgical treatment. Further study in this particular area is needed. (author)

  1. Indication for radiotherapy in rectal carcinoma

    International Nuclear Information System (INIS)

    Surgery and radiotherapy complete each other in local control of suffering from rectal carcinoma. A radiotherapeutic effect on tumor is secured often. The adjuvant radiotherapy is the most interesting indication, though the most controversial as present too. Analysing all data and with experiences of an own irradiation study we have not any doubt that the indication is qualified for a combined therapy, if the therapeutic aim with priority is to prevent a local relapse as the most frequent and complaintful form of therapeutic failure. In this problem, radical irradiation forms, as pre- and accumulating irradiation (sandwich-technique) and after-irradiation, render superior to an exclusive preirradiation. In result of this tudy we practise a preirradiation of 25 Gy with immediately following operation and an accumulating irradiation to 50 Gy in proved high-risk-stage (T≥3N0M0.TxN1-3M0). If there is a primary local incurability by tumor invasion into the neighbourhood a pre-irradiation is done with 50Gy and following explorative laparatomy within 4-6 weeks. Nearly 60% of these tumors become operably after thast. Likewise we practise in unirradiated patients with locoregional tumor recurrence. Also here the exstirpation quote of recurred tumor can be doubled approximately. The 5-years-survival is 20-30% in both indication groups. In patients with general or systematic incurability, that a stoma construction is required in, we carry out a transanal tumor reduction and irradiate with 50Gy after that. Especially this therapeutic principle has proved its worth in patients that are past eighty. Here with acceptable living quality and avoiding a stoma construction a survival can be reached that corresponds to the statistical survival of this stage of life. (orig.)

  2. Superselective arterial infusion and concomitant radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Homma, Akihiro; Suzuki, Fumiyuki; Inuyama, Yukio; Fukuda, Satoshi [Hokkaido Univ., Sapporo (Japan). School of Medicine

    2003-05-01

    Superselective arterial infusion for patients with advanced head and neck cancer has been increasingly applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Through October 1999 to March 2002, 29 patients, ranging in age between 33 and 71 years (median 52 years), received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m{sup 2}/week) with simultaneous intravenous infusion of thiosulfate for neutralizing cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). Four patients were diagnosed with stage III and 25 with stage IV. Thirteen patients were considered contraindicated for surgery, and the other 16 patients rejected radical surgery. Primary tumor sites included paranasal sinus (11 patients), hypopharynx (7), oropharynx (6), oral cavity (4), and parotid gland (1). During the median follow-up period of 20 months, there was no apparent recurrence in 14 (48.3%) of 29 patients. Eleven (37.9%) patients died of disease, and three (10.3%) were alive with disease. In twenty-one patients (72.4%) the primary lesions were well-controlled. Acute toxic effects were moderate, and severe toxic events occurred in four cases, namely, methicillin-resistant staphylococcus aureus (MRSA) pneumonia, sepsis, tetraplasia, and osteoradionecrosis. We confirmed the effectiveness and safety of superselective arterial infusion and concomitant radiotherapy. Furthermore, we must establish the optimal procedures and schedule, as well as the indications for this treatment. This treatment protocol may improve the prognosis of patients with unresectable disease and patients rejecting surgical treatment. Further study in this particular area is needed. (author)

  3. Biological Oceanography

    Science.gov (United States)

    Abbott, M. R.

    1984-01-01

    Within the framework of global biogeochemical cycles and ocean productivity, there are two areas that will be of particular interest to biological oceanography in the 1990s. The first is the mapping in space time of the biomass and productivity of phytoplankton in the world ocean. The second area is the coupling of biological and physical processes as it affects the distribution and growth rate of phytoplankton biomass. Certainly other areas will be of interest to biological oceanographers, but these two areas are amenable to observations from satellites. Temporal and spatial variability is a regular feature of marine ecosystems. The temporal and spatial variability of phytoplankton biomass and productivity which is ubiquitous at all time and space scales in the ocean must be characterized. Remote sensing from satellites addresses these problems with global observations of mesocale (2 to 20 days, 10 to 200 km) features over a long period of time.

  4. Fractionated stereotactic radiotherapy with vagina carotica protection technique for local residual nasopharyngeal carcinoma after primary radiotherapy

    Institute of Scientific and Technical Information of China (English)

    LIU Feng; HUAN Fu-kui; FANG Hao; WAN Bao; LI Ye-xiong; XIAO Jian-ping; XU Ying-jie; ZHANG Ye; XU Guo-zhen; GAO Li; YI Jun-lin; LUO Jing-wei; HUANG Xiao-dong

    2012-01-01

    Background Local failure of nasopharyngeal carcinoma (NPC) after radiotherapy (RT) remains one of the major treatment failures.This study aimed to evaluate the clinical efficacy and complications of fractionated stereotactic radiotherapy (FSRT) with vagina carotica protection technique for local residual of NPC patients after the primary RT.Methods From August 2006 to August 2010,FSRT with vagina carotica protection technique was applied to 36 patients in our department,the patients aged between 13 and 76 years with a median of 41.3 years,25 of them were male and 11were female.According to 2002 Union for International Cancer Control (UICC) Staging System,the stages before primary radiotherapy were:Ⅱa 2,Ⅱb 5,Ⅲ 18,Ⅳa 7,Ⅳb 4.In the first course of radiotherapy,9 patients received conventional RT,27 patients received intensity modulated radiotherapy (IMRT) and 20 out of the 36 patients received concurrent chemoradiotherapy.The total dose in the first course of RT was 69.96-76.90 Gy (median,72.58 Gy).The intervals between the primary RT and FSRT ranged from 12 to 147 days (median,39.8 days).Target volumes ranged from 1.46 to 32.98 cm3 (median,14.94 cm3).The total FSRT doses were 10.0-24.0 Gy (median,16.5 Gy) with 2.0-5.0Gy per fraction.The most common regimen was 15 Gy in 5 fractions of 3 Gy,the irradiation dose to vagina carotica was less than 2 Gy per fraction.Results The median follow-up time was 34 months (range,12-59 months).The 3-year local control rate was 100%;the 3-year overall survival rate was 94.4%;the 3-year disease-free survival rate was 77.8%.In this study,we had one case of cranial nerve injury,two cases of temporal lobe necrosis,and no nasopharyngeal massive hemorrhage was observed.Conclusion FSRT with vagina carotica protection technique is an effective and safe RT regimen for local residual of NPC with reduction of radiation-related neurovascular lesions.

  5. Fractionated stereotactically guided radiotherapy for pharmacoresistant epilepsy; Fraktionierte, stereotaktisch gefuehrte Radiotherapie der pharmakoresistenten Epilepsie

    Energy Technology Data Exchange (ETDEWEB)

    Grabenbauer, G.G.; Reinhold, C.; Lambrecht, U.; Sauer, R. [Klinik und Poliklinik fuer Strahlentherapie, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Kerling, F.; Pauli, E.; Stefan, H. [Neurologische Klinik, Abt. Epileptologie, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Mueller, R.G. [Inst. fuer Medizinische Physik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany); Ganslandt, O. [Neurochirurgische Klinik, Friedrich-Alexander-Univ. Erlangen-Nuernberg, Erlangen (Germany)

    2003-01-01

    Aim: This prospective study evaluated the efficiency of fractionated stereotactically guided radiotherapy as a treatment of pharmacoresistant temporal lobe epilepsy. Patients and Methods: Inclusion criteria were patients aged between 17 and 65 years with one-sided temporally located focus, without sufficient epilepsy control by, antiepileptic drugs or neurosurgery. Between 1997 and 1999, two groups of six patients each were treated with 21 Gy (7 times 3 Gy) and 30 Gy (15 times 2 Gy). Study end points were seizure frequency, intensity, seizure length and neuropsychological parameters. Results: All patients experienced a marked reduction in seizure frequency. The mean reduction of seizures was 37% (range 9-77%, i.e. seizures reduced from a monthly mean number of 11.75 to 7.52) at 18 months following radiation treatment and 46% (23-94%, i.e. 0.2-23 seizures per month) during the whole follow-up time. Seizure length was reduced in five out of eleven patients and intensity of seizures in seven out of eleven patients. Conclusion: Radiotherapy was identified as safe and effective for pharmacoresistant epilepsy since a very good reduction of seizure frequency was observed. It is no substitute for regular use of antiepileptic drugs, but means an appropriate alternative for patients with contraindication against neurosurgery or insufficient seizure reduction after neurosurgery. (orig.) [German] Ziel: Diese prospektive Studie untersuchte die Effizienz einer fraktionierten stereotaktischen Radiotherapie (RT) bei therapieresistenter Temporallappenepilepsie. Patienten und Methoden: Einschlusskriterien waren Patienten im Alter von 17 bis 65 Jahren, die weder medikamentoes noch epilepsiechirurgisch anfallsfrei wurden und einen einseitigen Fokus aufwiesen. Zwei Patientenkohorten zu je sechs Patienten wurden zwischen 1997 und 1999 einer fraktionierten, stereotaktisch gefuehrten Radiotherapie mit 21 Gy (7 x 3 Gy) bzw. 30 Gy (15 x 2 Gy) unterzogen. Endpunkte der Untersuchung waren

  6. Radiotherapy forgynecologic cancer innonagenarian patients:a framework fornew paradigms

    Institute of Scientific and Technical Information of China (English)

    BenoteMry; AlexisVallard; SophieEspenel; GuillaumeMoriceau; OlivierCollard; ClaireBosacki; JeanPhilippeJacquin; GuydeLaroche; PierreFournel; CyrusChargari; Nicolas Magn; SylvieMengueNdong; JeanBaptisteGuy; AviAssouline; AlexanderTFalk; AnasValeille; JaneChloTrone; RomainRivoirard; PierreAuberdiac

    2016-01-01

    No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenar‑ian patients. We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer (6 endometrial cancers, 6 cervical cancers, 4 vulvar cancers, and 3 vaginal cancers) who were treated with radiotherapy. Radiotherapy was performed mainly in a palliative setting (n=12; 63.2%), with a median dose of 45Gy (range, 6–76Gy). Infrequent major acute or late toxicities were reported. Among 19 patients, 9 (47.4%) experienced tumor progression, 5 (26.3%) experienced complete response, 2 (10.5%) experienced stable disease and/or partial response. At last follow‑up, 12 patients (63.2%) had died; most deaths (n=9) occurred because of the cancer. These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.

  7. Radiotherapy for pituitary adenomas: an endocrinologist`s perspective

    Energy Technology Data Exchange (ETDEWEB)

    O`Halloran, D.J.; Shalet, S.M. [Christie Hospital and Holt Radium Inst., Manchester (United Kingdom)

    1996-10-01

    A brief review is given of the clinical management of patients with pituitary adenomas such as prolactinomas, adenomasin acromegoly and Leushin`s disease, and non-functioning pituitary adenomas. In particular the complications of radiotherapy are explored. (UK).

  8. Acquired Lymphangioma Of Vulva Secondary To Radiotherapy For Carcinoma Cervix

    Directory of Open Access Journals (Sweden)

    Mehta Vandana

    2003-01-01

    Full Text Available Lymphagioma circumscriptum is a rare disorder of lymphatic channels, characterized by occurrence of thin walled frogspawn like vesicles. We report 2 cases of lymphangioma circumscriptum as a late sequel to radiotherapy.

  9. Automated Image-Based Procedures for Adaptive Radiotherapy

    DEFF Research Database (Denmark)

    Bjerre, Troels

    Fractionated radiotherapy for cancer treatment is a field of constant innovation. Developments in dose delivery techniques have made it possible to precisely direct ionizing radiation at complicated targets. In order to further increase tumour control probability (TCP) and decrease normal...... to encourage bone rigidity and local tissue volume change only in the gross tumour volume and the lungs. This is highly relevant in adaptive radiotherapy when modelling significant tumour volume changes. - It is described how cone beam CT reconstruction can be modelled as a deformation of a planning CT scan...... be employed for contour propagation in adaptive radiotherapy. - MRI-radiotherapy devices have the potential to offer near real-time intrafraction imaging without any additional ionising radiation. It is detailed how the use of multiple, orthogonal slices can form the basis for reliable 3D soft tissue tracking....

  10. [Clinical to planning target volume margins in prostate cancer radiotherapy].

    Science.gov (United States)

    Ramiandrisoa, F; Duvergé, L; Castelli, J; Nguyen, T D; Servagi-Vernat, S; de Crevoisier, R

    2016-10-01

    The knowledge of inter- and intrafraction motion and deformations of the intrapelvic target volumes (prostate, seminal vesicles, prostatectomy bed and lymph nodes) as well as the main organs at risk (bladder and rectum) allow to define rational clinical to planning target volume margins, depending on the different radiotherapy techniques and their uncertainties. In case of image-guided radiotherapy, prostate margins and seminal vesicles margins can be between 5 and 10mm. The margins around the prostatectomy bed vary from 10 to 15mm and those around the lymph node clinical target volume between 7 and 10mm. Stereotactic body radiotherapy allows lower margins, which are 3 to 5mm around the prostate. Image-guided and stereotactic body radiotherapy with adequate margins allow finally moderate or extreme hypofractionation. PMID:27614515

  11. Adverse effects and treatment on palliative radiotherapy for bone metastases

    International Nuclear Information System (INIS)

    Adverse effects on palliative radiotherapy for bone metastases are generally mild. Acute and late adverse effects are similar between 8 Gy single fraction and multi-fraction radiotherapy (e.g. 30 Gy in 10 fractions). Both external beam radiotherapy and radiopharmaceutical therapy with strontium-89 may cause pain flare. A randomized controlled trial is currently performed to confirm the effectiveness of dexamethasone for the prevention of pain flare. Reirradiation for the same site is widely used. However, its safeness has not been confirmed enough. Radiation myelitis is an unrecoverable severe adverse effect. However, the tolerated accumulated dose for the spinal cord is not fully understood. Stereotactic body radiotherapy may be considered to deliver reirradiation for spinal metastases without exposing too much dose for the spinal cord. Another solution to prevent radiation myelitis after reirradiation may use dose fractionations of 8 Gy single or 20 Gy in 5 fractions instead of 30 Gy in 10 fractions. (author)

  12. Protection of patients in the first radiotherapy standard in Peru

    International Nuclear Information System (INIS)

    The evolution of control measures on radiotherapy activities between 1980 and 2000 are reviewed. An increasing in the scope toward the patient protection was observed along these years. After approving the last main regulation on radiation safety the issuing of a specific rule for protection and radiation safety in radiotherapy with emphasis on the patient protection was needed. The proposed specific rules on radiotherapy were reviewed and discussed jointly with the radiotherapy users before approving, and modifications were made in order to reach consistency with the national situation. A summary comparison is made between some requisites as proposed at the beginning and as modified after discussions. Modifications were made because of the current social and economic conditions in the country and taking into consideration another reasons related to the medicine practice. It is suggested to make a revision to the rules and their results after a period of application. (author)

  13. Evolution of radiotherapy and chemotherapy practice in malignant gliomas

    Directory of Open Access Journals (Sweden)

    Anusheel Munshi

    2013-01-01

    Full Text Available Malignant astrocytomas of the brain carry a poor prognosis. This article traces the evolution of radiotherapy and chemotherapy practice including the development of concurrent chemo-radiation schedules in the context of these tumors.

  14. National Program of Quality Assurance in Radiotherapy in Cuba

    International Nuclear Information System (INIS)

    It tries on the establishment of a Quality Assurance Nacional System, a Quality Assurance Committee implemented in Cuba, and a Quality Auditory National Program implemented in Cuba to control and assure radiotherapy quality

  15. Dosimetry on the radiological risks prevention in radiotherapy

    International Nuclear Information System (INIS)

    Dosimetry in its various forms plays a determining role on the radiological risks prevention in radiotherapy. To prove this in this paper is shown an analysis based on the risk matrix method, how the dosimetry can influence in each stages of a radiotherapy service; installation and acceptance, operation, maintenance and calibration. For each one of these stages the role that can play is analyzed as either the initiating event of a radiological accident or limiting barrier of these events of the dosimetric processes used for the individual dosimetry, the area monitoring, fixed or portable, for radiation beam dosimetry and of the patients for a radiotherapy service with cobalt-therapy equipment. The result of the study shows that the application of a prospective approach in the role evaluation of dosimetry in the prevention and mitigation of the consequences of a radiological accident in radiotherapy is crucial and should be subject to permanent evaluation at each development stage of these services. (author)

  16. Rotational total skin and total nodal radiotherapy in mycosis fungoides

    Energy Technology Data Exchange (ETDEWEB)

    Bamberg, M.; Molls, M.; Langrock, J.; Muskalla, K.; Quast, U.

    1987-04-01

    The following report describes our technique of rotational total skin radiotherapy with electrons (TSER). We present stage related treatment results. Furthermore our first experiences with the combination of TSER and total nodal irradiation (TNI) are communicated.

  17. Normal tissue protection for improving radiotherapy: Where are the Gaps?

    Science.gov (United States)

    Prasanna, Pataje G S; Stone, Helen B; Wong, Rosemary S; Capala, Jacek; Bernhard, Eric J; Vikram, Bhadrasain; Coleman, C N

    2012-06-01

    Any tumor could be controlled by radiation therapy if sufficient dose were delivered to all tumor cells. Although technological advances in physical treatment delivery have been developed to allow more radiation dose conformity, normal tissues are invariably included in any radiation field within the tumor volume and also as part of the exit and entrance doses relevant for particle therapy. Mechanisms of normal tissue injury and related biomarkers are now being investigated, facilitating the discovery and development of a next generation of radiation protectors and mitigators. Bringing recent research advances stimulated by development of radiation countermeasures for mass casualties, to clinical cancer care requires understanding the impact of protectors and mitigators on tumor response. These may include treatments that modify cellular damage and death processes, inflammation, alteration of normal flora, wound healing, tissue regeneration and others, specifically to counter cancer site-specific adverse effects to improve outcome of radiation therapy. Such advances in knowledge of tissue and organ biology, mechanisms of injury, development of predictive biomarkers and mechanisms of radioprotection have re-energized the field of normal tissue protection and mitigation. Since various factors, including organ sensitivity to radiation, cellular turnover rate, and differences in mechanisms of injury manifestation and damage response vary among tissues, successful development of radioprotectors/mitigators/treatments may require multiple approaches to address cancer site specific needs. In this review, we discuss examples of important adverse effects of radiotherapy (acute and intermediate to late occurring, when it is delivered either alone or in conjunction with chemotherapy, and important limitations in the current approaches of using radioprotectors and/or mitigators for improving radiation therapy. Also, we are providing general concepts for drug development for

  18. Optimising the management of gastrointestinal symptoms following pelvic radiotherapy.

    OpenAIRE

    Henson, Caroline Claire

    2014-01-01

    BackgroundPelvic radiotherapy is a well-established treatment for pelvic malignancies, with 30,000 patients per year in the UK receiving radical pelvic radiotherapy either alone or in combination with other oncological treatments. 80% develop acute gastrointestinal (GI) symptoms and 50% develop chronic GI symptoms and in parallel to improvements in survival, increasing numbers of patients are living to develop the long term consequences of treatment. Despite this, less than 20% of patients wh...

  19. Radiotherapy of human sarcoma promotes an intratumoral immune effector signature

    OpenAIRE

    Sharma, Anu; Bode, Beata; Moch, Holger; Okoniewski, Michal; Knuth, Alexander; von Boehmer, Lotta; van den Broek, Maries

    2013-01-01

    PURPOSE: The tumor immune microenvironment plays a crucial role in the development and progression of cancer. Sarcomas are a group of heterogeneous soft tissue malignancies that are often treated with radiotherapy as a part of the treatment concept. There is increasing evidence that radiotherapy leads to alterations in the tumor microenvironment, particularly with respect to the immune infiltrate. The present study has been carried out to develop a better understanding of such changes followi...

  20. Factors associated with refusal of radiotherapy among oral cancer patients

    Directory of Open Access Journals (Sweden)

    Agaku IT

    2013-04-01

    Full Text Available Background: Surgery is commonly favored in the management of oral cancer but radiotherapy may be essential because of the size or location of the tumor. Refusal of radiotherapy by patients is an important issue, which must be taken into consideration during treatment planning. This study assessed prevalence and correlates of radiotherapy refusal among oral cancer patients. Methods: Data was analyzed for 47, 174 oral cancer cases in the Surveillance, Epidemiology and End Results (SEER database during 1988–2008. Point estimates were calculated overall and by selected socio-demographic and clinical characteristics. A multivariate logistic regression model was fitted to determine predictors of radiotherapy refusal. Results: The overall prevalence of refusal of radiotherapy was 2.31%. Factors associated with increased likelihood of refusal of radiotherapy included age ± 45 years (adjusted odds ratio, aOR=2.48; P=0.031; gingival/floor of mouth tumors (aOR=1.32; P=0.010; receipt of surgery (aOR=1.21; P=0.04. Conversely, protective factors included being married (aOR=0.59; P<0.001; non-Hispanic blacks (aOR=0.53; P=0.001; involvement of paired structures (aOR=0.61; P<0.001 as well as multiple tumors (aOR=0.75; P=0.021. Sex was not a significant predictor on multivariate analysis. Conclusion: Prevalence of refusal of radiotherapy among oral cancer patients is relatively low and is significantly associated with age, marital status, as well as location, extent and severity of disease. Clinicians may anticipate patients likely to refuse radiotherapy and develop patient-tailored counseling considering the benefits and risks of proposed treatment. Final treatment decision must however take into consideration the wishes of the fully informed patient.

  1. Radiotherapy for pituitary adenomas: long-term outcome and complications

    OpenAIRE

    Rim, Chai Hong; Yang, Dae Sik; Park, Young Je; Yoon, Won Sup; Lee, Jung Ae; Kim, Chul Yong

    2011-01-01

    Purpose To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. Materials and Methods We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-five patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had receiv...

  2. Role of radiotherapy in the treatment of oral cancer

    International Nuclear Information System (INIS)

    Before radiotherapy can be initiated, the patient must be examined thoroughly according to specific protocol to determine the extent of the tumor. Surgical resection accompanied by radiotherapy may be necessary in instances of persistent carcinoma. The radiation response of the tumor must be evaluated, and the optimal tumor dose must be determined to ensure maximum destruction of the tumor and minimum damage to normal tissues. Follow-up examinations should emphasize good oral hygiene to prevent further disease. (U.S.)

  3. Stereotactic body radiotherapy in lung cancer: an update

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Carlos Eduardo Cintra Vita; Ferreira, Paula Pratti Rodrigues; Moraes, Fabio Ynoe de; Neves Junior, Wellington Furtado Pimenta; Carvalho, Heloisa de Andrade, E-mail: heloisa.carvalho@hc.fm.usp.br [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Departamento de Radioterapia; Gadia, Rafael [Hospital Sirio-Libanes, Brasilia, DF (Brazil). Departamento de Radioterapia; Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Departamento de Radiologia e Oncologia. Servico de Radioterapia

    2015-07-15

    For early-stage lung cancer, the treatment of choice is surgery. In patients who are not surgical candidates or are unwilling to undergo surgery, radiotherapy is the principal treatment option. Here, we review stereotactic body radiotherapy, a technique that has produced quite promising results in such patients and should be the treatment of choice, if available. We also present the major indications, technical aspects, results, and special situations related to the technique. (author)

  4. Radiotherapy for Pigmented Villonodular Synovitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Navin Nayan

    2016-06-01

    Full Text Available This is a case report of a 13 year old boy who has been operated for Pigmented Villonodular Synovitis (PVNS and treated with adjuvant post-operative radiotherapy for incomplete surgical resection. This report mainly highlights the role of radiotherapy in managing this rare benign condition with emphasis on improving local control rates with functional joint preservation and avoiding repeated surgeries. [Natl J Med Res 2016; 6(2.000: 222-223

  5. Atypical acute reaction associated with radiotherapy. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Akamansu, M.; Erel, A. [Gazi Univ., Ankara (Turkey). Faculty of Medicine

    1998-09-01

    Radiation therapy may cause acute and/or chronic skin reactions. In this paper a patient with contact urticaria associated with irradiation is described. We could not determine the agent behind the contact urticaria in our patient in light of the current literature. We are reporting this case because the literature neither mentioned radiotherapy as being among the agents that lead to contact urticaria nor reported contact urticaria as being among the acute reactions to radiotherapy. (author)

  6. The place of radiotherapy in the treatment of vulva cancer

    International Nuclear Information System (INIS)

    The authors discuss the therapeutic aspects of the treatment of vulva cancers. This analytic retrospective study is based on a set of 15 patients who have been treated between 1996 and 2010, for an epidermoid cancer for 14 of them. Eleven of them have been irradiated. This rare cancer has a negative prognosis, mainly because of early ganglionary metastases. Radiotherapy (external or interstitial curie-therapy) is a prevailing therapeutic tool. Chemotherapy is emerging, notably concomitantly with radiotherapy. Short communication

  7. GATE: computation code for medical imagery, radiotherapy and dosimetry

    International Nuclear Information System (INIS)

    The author presents the GATE code, a simulation software based on the Geant4 development environment developed by the CERN (the European organization for nuclear research) which enables Monte-Carlo type simulation to be developed for tomography imagery using ionizing radiation, and radiotherapy examinations (conventional and hadron therapy) to be simulated. The authors concentrate on the use of medical imagery in carcinology. They comment some results obtained in nuclear imagery and in radiotherapy

  8. Patients with hip prosthesis: radiotherapy treatment planning considerations

    International Nuclear Information System (INIS)

    The number of patients with hip prosthesis undergoing radiotherapy for pelvic cancer worldwide is increasing. This might be of importance depending on the materials in the prosthesis and whether any of the treatment fields are involved in the prosthesis. Radiotherapy planning involving the pelvic region of patients having total hip prosthesis has been found to be difficult due to the effect of the prosthesis on the dose distribution. This review is intended to project dosimetric considerations and possible solutions to this uncommon problem

  9. Aggressive clinical course of extramammary Paget disease after radiotherapy

    International Nuclear Information System (INIS)

    Extramammary Paget disease (EMPD) is a rare disease, especially in Asian populations. Surgical resection is considered the primary treatment option. Recently, radiotherapy has been suggested as an EMPD treatment, either as an alternative to surgical resection or in combination with surgical resection. This report reviewed a patient with EMPD who was treated with wide excision of the EMPD site followed by radiotherapy for remaining gross lymph node metastases. The aim of this report was to determine the optimal treatment for advanced EMPD.

  10. Surgical spacer placement and proton radiotherapy for unresectable hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Shohei; Komatsu; Yuichi; Hori; Takumi; Fukumoto; Masao; Murakami; Yoshio; Hishikawa; Yonson; Ku

    2010-01-01

    Few potentially curative treatment options exist apart from hepatic resection for patients with huge hepatocellular carcinoma (HCC). Proton radiotherapy is a promising new modality which has an inherent antitumor effect against HCC. However, the application of proton radiotherapy for tumors adjacent to the gastrointestinal tract is restricted because the tolerance dose of the intestine is extremely low. A novel two-step treatment was developed with surgical spacer placement and subsequent proton radiotherap...

  11. DEGRO practical guidelines: radiotherapy of breast cancer I

    OpenAIRE

    Sedlmayer, F.; Sautter-Bihl, M.-L.; Budach, W.; Dunst, J.; Fastner, G.; Feyer, P.; Fietkau, R; Haase, W.; Harms, W.; Souchon, R; Wenz, F.; Sauer, R.; ,

    2013-01-01

    Background and purpose The aim of the present paper is to update the practical guidelines for postoperative adjuvant radiotherapy of breast cancer published in 2007 by the breast cancer expert panel of the German Society for Radiooncology (Deutsche Gesellschaft für Radioonkologie, DEGRO). The present recommendations are based on a revision of the German interdisciplinary S-3 guidelines published in July 2012. Methods A comprehensive survey of the literature concerning radiotherapy following b...

  12. Irradiation stability and cytotoxicity of gold nanoparticles for radiotherapy

    OpenAIRE

    Zhang, Xiao-Dong; Guo, Mei-Li; Wu, Hong-Ying; Sun, Yuan-Ming; Ding, Yan-Qiu; Feng, Xin; Zhang, Liang-An

    2009-01-01

    Gold nanoparticles are promising as a kind of novel radiosensitizer in radiotherapy. If gold nanoparticles are shown to have good irradiation stability and biocompatibility, they would play an important role in radiotherapy. In this work, we investigated irradiation effects of gold nanoparticles under 2–10 kR gamma irradiation and cytotoxicity of gold nanoparticles with human K562 cells by using Cell Titre-Glo™ luminescent cell viability assay. The results revealed that gamma irradiation had ...

  13. Experimental radiotherapy and clinical radiobiology. Vol. 16

    International Nuclear Information System (INIS)

    The following topics were dealt with: DNA repair as therapeutical target in radiation therapy, biological imaging and tumor microenvironment, molecular factors of radiation therapy, molecular factors and modulation of the radiation reaction of normal tissues, experimental tumor therapy, EGFR inhibition, the endothel cell as primary target of radiation therapy, molecular and cellular foundations of the radiation biology of protons and ions. (HSI)

  14. Biology Notes.

    Science.gov (United States)

    School Science Review, 1981

    1981-01-01

    Outlines a variety of laboratory procedures, techniques, and materials including construction of a survey frame for field biology, a simple tidal system, isolation and applications of plant protoplasts, tropisms, teaching lung structure, and a key to statistical methods for biologists. (DS)

  15. Biology Notes.

    Science.gov (United States)

    School Science Review, 1984

    1984-01-01

    Presents information on the teaching of nutrition (including new information relating to many current O-level syllabi) and part 16 of a reading list for A- and S-level biology. Also includes a note on using earthworms as a source of material for teaching meiosis. (JN)

  16. Nutritional consequences of the radiotherapy of head and neck cancer

    International Nuclear Information System (INIS)

    Nutrition-related complications of radiotherapy were evaluated in 74 head and neck cancer patients. Subjective changes of mouth dryness, taste, dysphagia, appetite, and food preferences were determined by questionnaire before and at weekly intervals during curative radiotherapy. Changes in body weight during therapy were also recorded. In addition, 24-hour dietary histories were taken from eight patients at the beginning and end of treatment. Results of the study indicate that patients were subjectively aware of nutritional problems prior to therapy and that therapy exacerbated these problems. As many as 25% of the patients experienced oral complications such as taste loss and/or dry mouth prior to initiation of radiotherapy. By the end of radiotherapy, over 80% of the patients were aware of oral and nutritional problems. Patients had an average weight loss of 5 kg prior to therapy; this loss of weight did not change during therapy. Diet histories of eight patients indicate significant caloric deficiencies early and late in radiotherapy. The oral and nutritional problems experienced by patients, even prior to therapy, support the idea that nutritional evaluation and maintenance are important not only during therapy, but prior to radiotherapy as well. Nutritional evaluation should be made a routine, integral part of therapy for every cancer patient

  17. Development of dose audits for complex treatment techniques in radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Stefanic, A. M.; Molina, L.; Vallejos, M.; Montano, G.; Zaretzky, A.; Saravi, M., E-mail: stefanic@cae.cnea.gov.ar [Centro Regional de Referencia con Patrones Secundarios para Dosimetria - CNEA, Presbitero Juan Gonzalez y Aragon 15, B1802AYA Ezeiza (Argentina)

    2014-08-15

    This work was performed in the frame of a Coordinated Research Project (CRP) with IAEA whose objective was to extend the scope of activities carried out by national TLD-based networks from dosimetry audit for rectangular radiation fields to irregular and small fields relevant to modern radiotherapy. External audit is a crucial element in QA programmes for clinical dosimetry in radiotherapy, therefore a methodology and procedures were developed and were made available for dose measurement of complex radiotherapy parameters used for cancer treatment. There were three audit steps involved in this CRP: TLD based dosimetry for irregular MLC fields for conformal radiotherapy, dosimetry in the presence of heterogeneities and 2D MLC shaped fields relevant to stereotactic radiotherapy and applicable to dosimetry for IMRT. In addition, a new development of film-based 2D dosimetry for testing dose distributions in small field geometry was included. The plan for each audit step involved a pilot study and a trial audit run with a few local hospitals. The pilot study focused on conducting and evaluation of the audit procedures with all participants. The trial audit run was the running of the audit procedures by the participants to test them with a few local radiotherapy hospitals. This work intends to provide audits which are much nearer clinical practice than previous audits as they involve significant testing of Tps methods, as well as verifications to determinate whether hospitals can correctly calculate dose delivery in radiation treatments. (author)

  18. Development of dose audits for complex treatment techniques in radiotherapy

    International Nuclear Information System (INIS)

    This work was performed in the frame of a Coordinated Research Project (CRP) with IAEA whose objective was to extend the scope of activities carried out by national TLD-based networks from dosimetry audit for rectangular radiation fields to irregular and small fields relevant to modern radiotherapy. External audit is a crucial element in QA programmes for clinical dosimetry in radiotherapy, therefore a methodology and procedures were developed and were made available for dose measurement of complex radiotherapy parameters used for cancer treatment. There were three audit steps involved in this CRP: TLD based dosimetry for irregular MLC fields for conformal radiotherapy, dosimetry in the presence of heterogeneities and 2D MLC shaped fields relevant to stereotactic radiotherapy and applicable to dosimetry for IMRT. In addition, a new development of film-based 2D dosimetry for testing dose distributions in small field geometry was included. The plan for each audit step involved a pilot study and a trial audit run with a few local hospitals. The pilot study focused on conducting and evaluation of the audit procedures with all participants. The trial audit run was the running of the audit procedures by the participants to test them with a few local radiotherapy hospitals. This work intends to provide audits which are much nearer clinical practice than previous audits as they involve significant testing of Tps methods, as well as verifications to determinate whether hospitals can correctly calculate dose delivery in radiation treatments. (author)

  19. Delayed airway stenosis after radiotherapy for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yuta, Atsushi; Tatematsu, Masanori; Ishinaga, Hajime; Harada, Teruhiko; Majima, Yuichi [Mie Univ., Tsu (Japan). School of Medicine

    2002-03-01

    Seven cases of delayed airway stenosis after radiotherapy for early staged head and neck cancers during 1989 and 1999 were evaluated (aged 54-77 yrs, 6 male and a female). The cases included five glottic laryngeal cancers (T1a, T1b, and three T2), a subglottic laryngeal cancer, and an unknown origin, but strongly suspected laryngeal cancer, with neck metastasis. Radio injury was found from 3 months to 47 months after radiotherapy. {sup 60}Co for radiotherapy was used in all seven cases, although {sup 60}Co radionuclide was changed to Liniac in 1997. The total dose was 60 Gy for 3 cases, and 70 Gy for 4 cases. Tracheostomy was performed in 3 cases due to bilateral vocal cord impairment. Background, treatment, and response to radiotherapy were compared to those of 90 patients of a control group with early staged laryngeal cancer who did not fail radiation injury during the same period. As a result, radionuclide ({sup 60}Co), total dose, cervical surgery, antiinflammatory drugs, laryngeal edema during radiotherapy were risk factors. The intensity and the period of mucositis by radiotherapy was important for indicating delayed airway stenosis. (author)

  20. Sexual morbidity following radiotherapy for germ cell of the testis

    Energy Technology Data Exchange (ETDEWEB)

    Tinkler, S.D.; Howard, G.C.W.; Kerr, G.R. (Western General Hospital, Edinburgh (United Kingdom))

    1992-11-01

    An anonymous questionnaire study was designed to assess sexual function after orchidectomy and radiotherapy for testicular cancer. Questionnaires were sent to: (1) 237 patients treated with orchidectomy and abdominal radio-therapy in Edinburgh from 1974 to 1988; (2) 32 patients under 'surveillance' following orchidectomy alone; (3) 402 'normal' age-matched controls. All were asked questions concerning sexual function over the preceding 6 months. All the patients were also asked the same questions with reference to the first 6 months after completion of treatment. Completed questionnaires were returned from 137 (62%) radiotherapy patients, 18 (56%) surveillance patients and 121 (35%) controls. There was a significant difference between the radiotherapy patients and the controls in almost all the parameters looked at including erection, ejaculation and libido with the treated group performing less well. In addition, almost 24% of radiotherapy patients felt disabled or disfigured by the treatment, most commonly because of the presence of only one testicle. A deterioration in sexual function was observed with increasing age. In the radiotherapy group there was no difference in response between the 2 time periods or in any of the treatment variables. The clinical significance of these observations are unclear but together with increasing information on other toxicities emerging following this therapy the role of radiation for early stage seminoma is being brought into question. This study also confirms the morbidity of orchidectomy. It is suggested that testicular implants should be offered more widely. (author). 28 refs., 6 figs.