Conceptus radiation dose and risk from chest screen-film radiography.

Science.gov (United States)

Damilakis, John; Perisinakis, Kostas; Prassopoulos, Panos; Dimovasili, Evangelia; Varveris, Haralambos; Gourtsoyiannis, Nicholas

2003-02-01

The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d(a)) was estimated for 51 women of childbearing age from chest CT examinations. The value of d(a) was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10(-3) mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d(a) estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is no need for

Conceptus radiation dose and risk from chest screen-film radiography

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Damilakis, John; Perisinakis, Kostas; Dimovasili, Evangelia [Department of Medical Physics, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece); Prassopoulos, Panos; Gourtsoyiannis, Nicholas [Department of Radiology, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece); Varveris, Haralambos [Department of Radiotherapy, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece)

2003-02-01

The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d{sub a}) was estimated for 51 women of childbearing age from chest CT examinations. The value of d{sub a} was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10{sup -3} mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d{sub a} estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is

Radiation dermatitis and pneumonitis following breast conserving therapy

International Nuclear Information System (INIS)

Yoden, Eisaku; Hiratsuka, Junichi; Imajo, Yoshinari

2000-01-01

We investigated the frequency, degree and risk factors of radiation-induced dermatitis and pneumonitis in 255 patients receiving breast conserving therapy between April 1987 and April 1998. The majority of the patients underwent a wide excision or quadrantectomy with a level I, II axillary dissection, followed by radiotherapy consisting of 50 Gy/25 Fr/5 weeks to the preserved breast with a 4 MV beam by tangentially opposed portals using the half-field technique. Eleven patients received an additional 10 Gy/5 Fr of electron therapy to the tumor bed. Most of the patients developed radiation dermatitis which was limited to reddening or dry desquamation, with the exception of 14 patients with a localized moist reaction. The skin reaction was transient in all patients and improved with conservative treatments. Radiation pneumonitis appeared on chest X-rays in 30 patients, with a slight appearance in 21 and patchy appearance in 9. Three patients presented with persistent symptoms requiring medication. They were treated with steroids, resulting in complete resolution of the symptoms. A large volume of the chest wall within the irradiation field and a large area of irradiated skin were the risk factors of radiation dermatitis. The volume of irradiated lung significantly correlated with the frequency and degree of radiation pneumonitis. It was preferable that the maximum thickness of the involved lung should not exceed 3 cm. Complicated disease, adjuvant therapy and boost irradiation had no impact on the radiation dermatitis or pneumonitis. (author)

Radiation recall dermatitis triggered by sorafenib after radiation therapy for hepatocellular carcinoma

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Kim, Gwi Eon; Song, Hee Sung; Kim, Young Suk [Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of); Ahn, Ki Jung [Dept. of Radiation Oncology, Inje University Busan Paik Hospital, Inje University of Medicine, Busan (Korea, Republic of)

2017-09-15

Sorafenib is widely used for unresectable and metastatic hepatocellular carcinomas. Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin that occurs after the administration of certain drugs. RRD after sorafenib treatment is rare; five cases have been reported thus far. We describe a 44-year-old man irradiated for chest wall bone metastasis from hepatocellular carcinoma. Eight days after radiotherapy completion, systemic therapy for metastatic hepatocellular carcinoma was initiated with sorafenib treatment. Eleven days after starting sorafenib, the patient complained of erythematous rash with pruritus in the chest wall, in a location consistent with the previous radiation field. Sorafenib was continued at the same dose, despite the RRD. The skin reaction subsided over the next 2 weeks without any medical intervention.

A case of radiation ulcer of chest wall with osteomyelitis

International Nuclear Information System (INIS)

Baba, Kyoko; Shibata, Hirotatsu; Mouri, Mari; Uchinuma, Eiju

2005-01-01

We report a case of anterior chest skin ulcer with rib and sternum osteomyelitis following radiation therapy for post operative mammary carcinoma. Operation was performed six times including debridement with sternum and rib resection reconstruction and skin grafting. It took about one and a half years after first operation to heal the ulcer with osteomyelitis. Principle of treatment for radiation ulcer accompanied by osteomyelitis is complete resection of the damaged lesion. However, it is difficult to evaluate the exact area of the damaged lesion. Therefore it is not rare to repeat its recurrence and have trouble with its treatment. In this case, it was considered that the resected area was insufficient on the initial operation. In order to treat for radiation ulcers accompanied by osteomyelitis, enough resection of the damaged lesion in the initial operation is necessary. Ultimately, in our case, the resection of all sternum, part of the right second to fifth rib and part of left second to seventh rib was necessary. It is generally said that reconstructing bone structure is required in the case of wide defect of chest wall. Though, we did not perform reconstruction of the bone structures, there is no problem in the condition of respiratory system. The surrounding soft tissues changed to hard enough to avoid paradoxical breathing. (author)

Specific toxicity after stereotactic body radiation therapy to the central chest. A comprehensive review

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Oskan, Feras; Becker, Gerd; Bleif, Martin [Alb-Fils Kliniken GmbH, Department of Radiation Oncology, Goeppingen (Germany); CyberKnife Suedwest Centre, Radiochirurgicum, Goeppingen (Germany)

2017-03-15

The toxicity of stereotactic body radiation therapy in the central chest remains an unsettled issue. The collected data concerning the observed complications are poorly understood and are limited in their quantity and quality, thus hampering a precise delineation of treatment-specific toxicity. The majority of complications scored as toxicity grade 5, namely respiratory failure and fatal hemoptysis, are most likely related to multiple competing risks and occurred at different dose fractionation schemas, e. g., 10-12 fractions of 4-5 Gy, 5 fractions of 10 Gy, 3 fractions of 20-22 Gy, and 1 fraction of 15-30 Gy. Further investigations with longer follow-up and more details of patients' pretreatment and tumor characteristics are required. Furthermore, satisfactory documentation of complications and details of dosimetric parameters, as well as limitation of the wide range of possible fractionation schemes is also warranted for a better understanding of the risk factors relevant for macroscopic damage to the serially organized anatomic structure within the central chest. (orig.) [German] Das Risiko fuer schwere Nebenwirkungen der stereotaktischen Strahlentherapie bei zentralen Lungentumoren ist bisher schlecht definiert. Nicht nur die begrenzte Zahl der dokumentierten Ereignisse, sondern auch die Vielzahl der verwendeten Fraktionierungsschemata erschwert das Herausarbeiten valider prognostischer Faktoren. Auf Basis dieser Datenlage laesst sich das Risiko fuer Grad-5-Toxizitaeten, insbesondere Atemversagen und toedliche Blutungen, kaum einem bestimmten Dosis- oder Fraktionierungsschema, wie z. B. 10-12 Fraktionen mit 4-5 Gy, 5 Fraktionen mit 10 Gy, 3 Fraktionen mit 20-22 Gy und 1 Fraktion mit 15-30 Gy zuordnen, da multiple patientenspezifische, konkurrierende Risiken dabei einen wesentlichen Einfluss zu haben scheinen. Es wird zukuenftig erforderlich sein, praetherapeutische Patienten- und Tumorcharakteristika genauer zu erfassen, dosimetrische Parameter besser zu

COMPARISON OF HYPOFRACTIONATED RADIATION THERAPY VERSUS CONVENTIONAL RADIATION THERAPY IN POST MASTECTOMY BREAST CANCER

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Abhilash

2016-03-01

Full Text Available INTRODUCTION Breast cancer is the most common cancer in women worldwide and a leading cause of cancer death in females and accounts for 1.8 million new cases and approximately 0.5 million deaths annually. Patients who present with locally advanced breast cancer (LABC require multidisciplinary team approach that incorporates diagnostic imaging, surgery, chemotherapy and histopathological assessment, including molecular-based studies, radiation, and, if indicated, biologic and hormonal therapies. Hypofractionated radiation therapy following mastectomy has been used in many institutions for several decades and have demonstrated equivalent local control, cosmetic and normal tissues between 50 Gy in 25 fractions and various hypofractionated radiotherapy prescriptions employing 13-16 fractions. Evidence suggests that hypofractionated radiotherapy may also be safe and effective for regional nodal disease. AIMS AND OBJECTIVES To compare the local control and side effects of hypofractionated radiation therapy with conventional radiation therapy in post mastectomy carcinoma breast with stage II and III and to compare the tolerability and compliance of both schedules. MATERIALS AND METHODS The study was conducted on 60 histopathologically proven patients of carcinoma of breast, treated surgically with modified radical mastectomy. Group I patients were given external radiation to chest flap and drainage areas, a dose of 39 Gy/13 fractions/3.1 weeks, a daily dose 3 Gy for 13 fractions in 4 days a week schedule and Group II patients were given external radiation to chest flap and drainage areas, a dose of 50 Gy/25 fractions/5 weeks, to receive a daily dose 2 Gy for 25 fractions in a 5 days a week schedule. RESULTS The median age at presentation in Group I and II was 48 and 50 years respectively. Locoregional control after completion of radiotherapy in Group I vs. Group II was 26/30 (86.7% vs. 27/30 (90% respectively. Acute reactions and their grades in Group

Weekly monitoring of the effects of conventional external beam radiation therapy on patients with head and neck, chest, and pelvis cancer by means of blood cells count

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Lundgren, Maria da Salete Fonseca dos Santos [Hospital Universitario Oswaldo Cruz, Recife, PE (Brazil). Radiotherapy Unit]. E-mail: salete@lundgren.med.br; Cavalcanti, Maria do Socorro de Mendonca [Universidade de Pernambuco, Recife, PE (Brazil); Sampaio, Divaldo de Almeida [Centro de Hematologia de Pernambuco (Hemope), Recife, PE (Brazil)

2008-01-15

Objective: To evaluate the necessity of weekly monitoring by means of leukocyte and platelet counts of patients with head and neck, chest, and pelvis cancer submitted to conventional radiotherapy. Materials and methods: A hundred and one adult patients with cancer of head and neck (n = 11), chest (n = 35) and pelvis (n = 55), submitted to radiotherapy were assessed by means of leukocyte and platelet counts on a weekly basis, with a comparison between the results before and during the treatment and in correlation with the area treated, patient's sex and age group. Results: The most significant decrease in leukocytes was observed in the fourth week, when lymphocytes, total leukocytes, neutrophils, monocytes and platelets presented a decrease of 53.5%, 26.8%, 19.4%, 22.2% and 14.6%, respectively, in comparison with the values found before the beginning of the therapy. Geometric means for pelvis during the treatment were lower than those for chest, and head and neck. Lymphocytes demonstrated to be more sensitive to radiation therapy. No alteration was found in leukocyte or platelet counts in correlation with patients' sex or age. Conclusion: Based on the results of the present study, weekly leukocyte and platelet counts do not seem to be useful in the assessment patients submitted to conventional radiotherapy for localized cancer. (author)

[The effectiveness of magnetic therapy of grade I-II radiation pneumofibrosis].

Science.gov (United States)

Grushina, T I

2014-01-01

Radiation therapy of malignant tumours of the chest organs may result in radiation damage of the lungs. To prevent and reduce radiation-induced lung injuries, new types of radiation therapy have been developed, a number of various modifiers investigated, the methods of pharmacotherapy and physiotherapy proposed. The present study involved 37 patients presenting with radiation pneumofibrosis, including 7 ones with lung cancer and 30 patients with breast cancer. Based on the results of clinical, radiographic, and functional investigations, grade 1 and II pneumofibrosis was diagnosed in 20 and 17 patients respectively. After the application of an alternating magnetic field during 15 days, all the patients experience the overall regression of clinical symptoms and disorders of respiratory biomechanics. However, it seems premature to draw a definitive conclusion about the effectiveness of magnetic therapy of grade 1 and II radiation pneumofibrosis before the extensive in-depth investigations are carried out based on a large clinical material including the results of long-term follow-up studies and continuous monitoring.

Radiodiagnostic measurements radiation load of children by chest

International Nuclear Information System (INIS)

Nikodemova, D.; Vladar, M.; Ranogajec, M.; Horvathova, M

1998-01-01

In the district of Slovak Republic we have tried to estimate the radiation load of children to 15 years by chest radiodiagnostic examinations. Our data were collected using measurements with TLD for 100 patients divided in 5 age categories at six radiodiagnostic departments. The analysis of obtained absorbed doses as a function of age for chest radiodiagnostic examinations has shown, that the investigated Slovak radiodiagnostic centres use rather lower voltage techniques and the entrance surface doses are much higher than the proposed value of European Communities. (authors)

Microwave hyperthermia as an adjuvant to radiation therapy. Summary experience of 256 multifraction treatment cases

International Nuclear Information System (INIS)

Bicher, H.I.

1985-01-01

Analysis is presented of a series of 256 human tumors treated under multifraction protocol regimes with standard controlled hyperthermia parameters and increasing doses of radiation therapy. Air cooled microwave applicators intracavitary and interstitial antennae operating at 915 or 300 MHz were used in various sites. Temperatures were measured by micro-thermocouples. Minimum tumor temperatures of 42 0 C were maintained at 1 hour, twice weekly. Treatment included a radiation dose of 1600-1700 rads. Tumor response was 94% with 60% or more total response. Frequency and duration of total responses depended mainly on the radiation dose. Skin tumors, melanomas, chest wall recurrences responded better than head and neck or intrapelvic recurrences. Side effects observed were minor burns; proctitis or oesophagitis with intracavitary devices; ulcerations or fistulae due to rapid tumor regression; 4 cases of pleuritis treating chest wall. Overall toxicity was less than 5%. In conclusion: 1) Combination heat-low dose radiation offers good palliation. 2) Response depends on radiation dose. 3) Combination of full dose radiation therapy plus hyperthermia proves to be well tolerated

Gonad protective effect of radiation protective apron in chest radiography

International Nuclear Information System (INIS)

Hashimoto, Masatoshi; Kato, Hideyuki; Fujibuchi, Toshiou; Ochi, Shigehiro; Morita, Fuminori

2004-01-01

Depending on the facility, a radiation protective apron (protector) is used to protect the gonad from radiation exposure in chest radiography. To determine the necessity of using a protector during chest radiography, we measured the effect of the protector on the gonad in this study. First, using a human body phantom, we measured the absorbed dose of the female gonad with and without the protector, using a thermoluminescence dosimeter (TLD), and confirmed its protective effect. Using the protector, the absorbed dose was reduced to 28±2% and 39±4% for field sizes of 14 x 17 inch and 14 x 14 inch, respectively. Next, we used Monte Carlo simulation and confirmed, not only the validity of the actual measurement values, but also the fact that the influence of radiation on the absorbed dose of the gonad was mostly from scattered radiation from inside the body for the 14 x 17 inch field size, and also from the X-ray tube for the 14 x 14 inch field size. Although a certain protective effect is achieved by using the protector, the radiation dose to the gonad is only a few μGy even without a protector. Thus, the risk of a genetic effect would be as small as 10 -8 . Given that acceptable risk is below 10 -6 , we conclude the use of a radiation protective apron is not necessary for diagnostic chest radiography. (author)

[Gonad protective effect of radiation protective apron in chest radiography].

Science.gov (United States)

Hashimoto, Masatoshi; Kato, Hideyuki; Fujibuchi, Toshiou; Ochi, Shigehiro; Morita, Fuminori

2004-12-01

Depending on the facility, a radiation protective apron (protector) is used to protect the gonad from radiation exposure in chest radiography. To determine the necessity of using a protector during chest radiography, we measured the effect of the protector on the gonad in this study. First, using a human body phantom, we measured the absorbed dose of the female gonad with and without the protector, using a thermoluminescence dosimeter (TLD), and confirmed its protective effect. Using the protector, the absorbed dose was reduced to 28+/-2% and 39+/-4% for field sizes of 14 x 17 inch and 14 x 14 inch, respectively. Next, we used Monte Carlo simulation and confirmed, not only the validity of the actual measurement values, but also the fact that the influence of radiation on the absorbed dose of the gonad was mostly from scattered radiation from inside the body for the 14 x 17 inch field size, and also from the X-ray tube for the 14 x 14 inch field size. Although a certain protective effect is achieved by using the protector, the radiation dose to the gonad is only a few microGy even without a protector. Thus, the risk of a genetic effect would be as small as 10(-8). Given that acceptable risk is below 10(-6), we conclude the use of a radiation protective apron is not necessary for diagnostic chest radiography.

Metastatic Sarcomatoid Squamous Cell Carcinoma of the Cervix Presenting with Chest Mass

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Lilit Karapetyan

2017-01-01

Full Text Available Background. Sarcomatoid squamous cell carcinoma is a rare and aggressive form of cervical cancer. We report a case of metastatic sarcomatoid squamous cell carcinoma (SSCC of cervix that presented with an anterior chest wall mass. Case. A 43-year-old Hispanic female presented with a two-month history of a central chest wall mass. The patient’s only past medical history was SSCC of the cervix, stage IIB, diagnosed two years priorly. She underwent neoadjuvant chemoradiation therapy (CRT with cisplatin followed by radical hysterectomy. Surgical margins were positive which led to adjuvant CRT with carboplatin and paclitaxel. PET scan 4 months after the postoperative treatment was negative for recurrence and metastatic disease. On current presentation, the CT chest revealed anterior mediastinal destructive soft tissue mass involving sternum, and the biopsy showed SSCC. The patient received palliative radiation therapy to her chest with improvement in pain and ability to swallow. After discussing the prognosis she refused further chemotherapy and decided on hospice care. Conclusion. Despite good response to first-line therapy, SSCC tends to recur early and does not respond to second-line therapy. Radiation therapy seems to be the most effective modality for treatment, but randomized controlled trials of therapy are impractical.

Reduction of adult fingers visualized on pediatric intensive care unit (PICU) chest radiographs after radiation technologist and PICU staff radiation safety education

International Nuclear Information System (INIS)

Tynan, J.R.; Duncan, M.D.; Burbridge, B.E.

2009-01-01

A recent publication from our centre revealed a disturbing finding of a significant incidence of adult fingers seen on the pediatric intensive care unit (PICU) chest radiographs. This is inappropriate occupational exposure to diagnostic radiation. We hypothesized that the incidence of adult fingers on PICU chest radiographs would decline after radiation safety educational seminars were given to the medical radiation technologists and PICU staff. The present study's objectives were addressed by using a pretest-posttest design. Two cross-sectional PICU chest radiograph samples, taken before and after the administration of radiation safety education for our medical radiation technologists and PICU staff, were compared by using a χ 2 test. There was a 61.2% and 76.9% reduction in extraneous adult fingers, directly exposed to the x-ray beam and those seen in the coned regions of the film, respectively, on PICU chest radiographs (66.7% reduction overall). This reduction was statistically significant (χ2 = 20.613, P < .001). Limiting unnecessary occupational radiation exposure is a critical issue in radiology. There was a statistically and clinically significant association between radiation safety education and the decreased number of adult fingers seen on PICU chest radiographs. This study provides preliminary evidence in favour of the benefit of radiation safety seminars. (author)

Hypofractionated Whole-Breast Radiation Therapy: Does Breast Size Matter?

International Nuclear Information System (INIS)

Hannan, Raquibul; Thompson, Reid F.; Chen Yu; Bernstein, Karen; Kabarriti, Rafi; Skinner, William; Chen, Chin C.; Landau, Evan; Miller, Ekeni; Spierer, Marnee; Hong, Linda; Kalnicki, Shalom

2012-01-01

Purpose: To evaluate the effects of breast size on dose-volume histogram parameters and clinical toxicity in whole-breast hypofractionated radiation therapy using intensity modulated radiation therapy (IMRT). Materials and Methods: In this retrospective study, all patients undergoing breast-conserving therapy between 2005 and 2009 were screened, and qualifying consecutive patients were included in 1 of 2 cohorts: large-breasted patients (chest wall separation >25 cm or planning target volume [PTV] >1500 cm 3 ) (n=97) and small-breasted patients (chest wall separation 3 ) (n=32). All patients were treated prone or supine with hypofractionated IMRT to the whole breast (42.4 Gy in 16 fractions) followed by a boost dose (9.6 Gy in 4 fractions). Dosimetric and clinical toxicity data were collected and analyzed using the R statistical package (version 2.12). Results: The mean PTV V95 (percentage of volume receiving >= 95% of prescribed dose) was 90.18% and the mean V105 percentage of volume receiving >= 105% of prescribed dose was 3.55% with no dose greater than 107%. PTV dose was independent of breast size, whereas heart dose and maximum point dose to skin correlated with increasing breast size. Lung dose was markedly decreased in prone compared with supine treatments. Radiation Therapy Oncology Group grade 0, 1, and 2 skin toxicities were noted acutely in 6%, 69%, and 25% of patients, respectively, and at later follow-up (>3 months) in 43%, 57%, and 0% of patients, respectively. Large breast size contributed to increased acute grade 2 toxicity (28% vs 12%, P=.008). Conclusions: Adequate PTV coverage with acceptable hot spots and excellent sparing of organs at risk was achieved by use of IMRT regardless of treatment position and breast size. Although increasing breast size leads to increased heart dose and maximum skin dose, heart dose remained within our institutional constraints and the incidence of overall skin toxicity was comparable to that reported in the

Chest Wall tumor: combined management

International Nuclear Information System (INIS)

Rao Bhaskar, N.

1997-01-01

Cancer is relatively rare disease among children and adolescents. The incidence of solid tumors other than CNS is less than 2/100,000. Tumors of the chest wall can arise either from the somatic tissue or ribs. These are rare, so either institutional reviews or multi institutional studies should determine optimal therapeutic management. Of the bony chest wall, Ewing's sarcoma or the family of tumor (peripheral neuro epithelioma, Askin tumor), are the most common. These lesions are lytic and have associated large extra pleural component. This large extra pleural component often necessitates major chest wall resection (3 or more ribs), and when lower ribs are involved, this entails resection of portion of diaphragm. Despite this resection, survival in the early 1970 was 10-20%. Since 1970 multi agent chemotherapy has increased survival rates. of importance, however, is these regimens have caused significant reduction of these extra pleural components so that major chest wall resections have become a rarity. With improved survival and decreased morbidity preoperative chemotherapy followed by surgery is now the accepted modality of treatment. Another major advantage of this regimen is that potential radiation therapy may be obviated. The most common chest wall lesion is rhabdomyosarcoma. In the IRS study of 1620 RMS patients, in 141 (9%) the primary lesion was in the chest wall. these are primarily alveolar histology. when lesions were superficial, wide local excision with supplemental radiation therapy was associated with low morbidity and good overall survival. however, a majority have significant intra- thoracic components. in these circumstances the resectability rate is less than 30% and the survival poor. Other lesions include non rhabdomyosarcomas, eosinophilic granuloma, chondrosarcoma, and osteomyelitis. The management of these lesions varies according to extent, histology, and patient characteristics

CT of the chest in suspected child abuse using submillisievert radiation dose

International Nuclear Information System (INIS)

Sanchez, Thomas R.; Seibert, J.A.; Stein-Wexler, Rebecca; Lee, Justin S.; Coulter, Kevin P.

2015-01-01

The cornerstone of child abuse imaging is the skeletal survey, but initial imaging with radiographs may not demonstrate acute and non-displaced fractures, especially those involving the ribs. Given the high mortality of undiagnosed non-accidental trauma, timely diagnosis is crucial. CT is more sensitive in assessing rib fractures; however the effective radiation dose of a standard chest CT is high. We retrospectively identified four children (three boys, one girl; age range 1-4 months) admitted between January 2013 and February 2014 with high suspicion for non-accidental trauma from unexplained fractures of the long bones; these children all had CT of the chest when no rib fractures were evident on the skeletal survey. The absorbed radiation dose estimates for organs and tissue from the four-view chest radiographs and subsequent CT were determined using Monte Carlo photon transport software, and the effective dose was calculated using published tissue-weighting factors. In two children, CT showed multiple fractures of the ribs, scapula and vertebral body that were not evident on the initial skeletal survey. The average effective dose for a four-view chest radiograph across the four children was 0.29 mSv and the average effective dose for the chest CT was 0.56 mSv. Therefore the effective dose of a chest CT is on average less than twice that of a four-view chest radiograph. Our protocol thus shows that a reduced-dose chest CT may be useful in the evaluation of high specificity fractures of non-accidental trauma when the four-view chest radiographs are negative. (orig.)

CT of the chest in suspected child abuse using submillisievert radiation dose

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Sanchez, Thomas R.; Seibert, J.A.; Stein-Wexler, Rebecca [Medical Center Children' s Hospital, Division of Pediatric Radiology, University of California-Davis, Sacramento, CA (United States); Lee, Justin S. [University of California-Davis, Department of Radiology, Sacramento, CA (United States); Coulter, Kevin P. [Medical Center Children' s Hospital, Department of Pediatrics, University of California-Davis, Sacramento, CA (United States)

2015-07-15

The cornerstone of child abuse imaging is the skeletal survey, but initial imaging with radiographs may not demonstrate acute and non-displaced fractures, especially those involving the ribs. Given the high mortality of undiagnosed non-accidental trauma, timely diagnosis is crucial. CT is more sensitive in assessing rib fractures; however the effective radiation dose of a standard chest CT is high. We retrospectively identified four children (three boys, one girl; age range 1-4 months) admitted between January 2013 and February 2014 with high suspicion for non-accidental trauma from unexplained fractures of the long bones; these children all had CT of the chest when no rib fractures were evident on the skeletal survey. The absorbed radiation dose estimates for organs and tissue from the four-view chest radiographs and subsequent CT were determined using Monte Carlo photon transport software, and the effective dose was calculated using published tissue-weighting factors. In two children, CT showed multiple fractures of the ribs, scapula and vertebral body that were not evident on the initial skeletal survey. The average effective dose for a four-view chest radiograph across the four children was 0.29 mSv and the average effective dose for the chest CT was 0.56 mSv. Therefore the effective dose of a chest CT is on average less than twice that of a four-view chest radiograph. Our protocol thus shows that a reduced-dose chest CT may be useful in the evaluation of high specificity fractures of non-accidental trauma when the four-view chest radiographs are negative. (orig.)

Evaluation of radiation doses delivered in different chest CT protocols

International Nuclear Information System (INIS)

Gorycki, Tomasz; Lasek, Iwona; Kamiński, Kamil; Studniarek, Michał

2014-01-01

There are differences in the reference diagnostic levels for the computed tomography (CT) of the chest as cited in different literature sources. The doses are expressed either in weighted CT dose index (CTDI VOL ) used to express the dose per slice, dose-length product (DLP), and effective dose (E). The purpose of this study was to assess the radiation dose used in Low Dose Computer Tomography (LDCT) of the chest in comparison with routine chest CT examinations as well as to compare doses delivered in low dose chest CT with chest X-ray doses. CTDI VOL and DLP doses were taken to analysis from routine CT chest examinations (64 MDCT TK LIGHT SPEED GE Medical System) performed in 202 adult patients with FBP reconstruction: 51 low dose, 106 helical, 20 angio CT, and 25 high resolution CT protocols, as well as 19 helical protocols with iterative ASIR reconstruction. The analysis of chest X-ray doses was made on the basis of reports from 44 examinations. Mean values of CTDI VOL and DLP were, respectively: 2.1 mGy and 85.1 mGy·cm, for low dose, 9.7 mGy and 392.3 mGy·cm for helical, 18.2 mGy and 813.9 mGy·cm for angio CT, 2.3 mGy and 64.4 mGy·cm for high resolution CT, 8.9 mGy. and 317.6 mGy·cm for helical ASIR protocols. Significantly lower CTDI VOL and DLP values were observed for low dose and high resolution CT versus the remaining CT protocols; doses delivered in CT ASIR protocols were also lower (80–81%). The ratio between medial doses in low dose CT and chest X-ray was 11.56. Radiation dose in extended chest LDCT with parameters allowing for identification of mediastinal structures and adrenal glands is still much lower than that in standard CT protocols. Effective doses predicted for LDCT may exceed those used in chest X-ray examinations by a factor of 4 to 12, depending on LDCT scan parameters. Our results, as well as results from other authors, suggest a possibility of reducing the dose by means of iterative reconstruction. Efforts towards further dose

The combined effects of cold therapy and music therapy on pain following chest tube removal among patients with cardiac bypass surgery.

Science.gov (United States)

Yarahmadi, Sajad; Mohammadi, Nooredin; Ardalan, Arash; Najafizadeh, Hassan; Gholami, Mohammad

2018-05-01

Chest tube removal is an extremely painful procedure and patients may not respond well to palliative therapies. This study aimed to examine the effect of cold and music therapy individually, as well as a combination of these interventions on reducing pain following chest tube removal. A factorial randomized-controlled clinical trial was performed on 180 patients who underwent cardiac surgery. Patients were randomized into four groups of 45. Group A used ice packs for 20 minutes prior to chest tube removal. Group B was assigned to listen to music for a total length of 30 minutes which started 15 minutes prior to chest tube removal. Group C received a combination of both interventions; and Group D received no interventions. Pain intensity was measured in each group every 15 minutes for a total of 3 readings. Analysis of variance, Tukey and Bonferroni post hoc tests, as well as repeated measures ANOVA were employed for data analysis. Cold therapy and combined method intervention effectively reduced the pain caused by chest tube removal (P < 0.001). Additionally, there were no statistically significant difference in pain intensity scores between groups at 15 minutes following chest tube removal (P = 0.07). Cold and music therapy can be used by nursing staff in clinical practice as a combined approach to provide effective pain control following chest tube removal. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adjuvant Hypofractionated Versus Conventional Whole Breast Radiation Therapy for Early-Stage Breast Cancer: Long-Term Hospital-Related Morbidity From Cardiac Causes

International Nuclear Information System (INIS)

Chan, Elisa K.; Woods, Ryan; McBride, Mary L.; Virani, Sean; Nichol, Alan; Speers, Caroline; Wai, Elaine S.; Tyldesley, Scott

2014-01-01

Purpose: The risk of cardiac injury with hypofractionated whole-breast/chest wall radiation therapy (HF-WBI) compared with conventional whole-breast/chest wall radiation therapy (CF-WBI) in women with left-sided breast cancer remains a concern. The purpose of this study was to determine if there is an increase in hospital-related morbidity from cardiac causes with HF-WBI relative to CF-WBI. Methods and Materials: Between 1990 and 1998, 5334 women ≤80 years of age with early-stage breast cancer were treated with postoperative radiation therapy to the breast or chest wall alone. A population-based database recorded baseline patient, tumor, and treatment factors. Hospital administrative records identified baseline cardiac risk factors and other comorbidities. Factors between radiation therapy groups were balanced using a propensity-score model. The first event of a hospital admission for cardiac causes after radiation therapy was determined from hospitalization records. Ten- and 15-year cumulative hospital-related cardiac morbidity after radiation therapy was estimated for left- and right-sided cases using a competing risk approach. Results: The median follow-up was 13.2 years. For left-sided cases, 485 women were treated with CF-WBI, and 2221 women were treated with HF-WBI. Mastectomy was more common in the HF-WBI group, whereas boost was more common in the CF-WBI group. The CF-WBI group had a higher prevalence of diabetes. The 15-year cumulative hospital-related morbidity from cardiac causes (95% confidence interval) was not different between the 2 radiation therapy regimens after propensity-score adjustment: 21% (19-22) with HF-WBI and 21% (17-25) with CF-WBI (P=.93). For right-sided cases, the 15-year cumulative hospital-related morbidity from cardiac causes was also similar between the radiation therapy groups (P=.76). Conclusions: There is no difference in morbidity leading to hospitalization from cardiac causes among women with left-sided early-stage breast

Adjuvant Hypofractionated Versus Conventional Whole Breast Radiation Therapy for Early-Stage Breast Cancer: Long-Term Hospital-Related Morbidity From Cardiac Causes

Energy Technology Data Exchange (ETDEWEB)

Chan, Elisa K. [Department of Oncology, Saint John Regional Hospital, Saint John (Canada); Woods, Ryan; McBride, Mary L. [Cancer Control Research Department, BC Cancer Agency, Vancouver (Canada); Virani, Sean [Division of Cardiology, University of British Columbia, Vancouver (Canada); Nichol, Alan [Radiation Therapy Program, BC Cancer Agency, Vancouver (Canada); Speers, Caroline [Breast Cancer Outcomes Unit, BC Cancer Agency, Vancouver (Canada); Wai, Elaine S. [Radiation Therapy Program, BC Cancer Agency, Vancouver (Canada); Tyldesley, Scott, E-mail: styldesl@bccancer.bc.ca [Radiation Therapy Program, BC Cancer Agency, Vancouver (Canada)

2014-03-15

Purpose: The risk of cardiac injury with hypofractionated whole-breast/chest wall radiation therapy (HF-WBI) compared with conventional whole-breast/chest wall radiation therapy (CF-WBI) in women with left-sided breast cancer remains a concern. The purpose of this study was to determine if there is an increase in hospital-related morbidity from cardiac causes with HF-WBI relative to CF-WBI. Methods and Materials: Between 1990 and 1998, 5334 women ≤80 years of age with early-stage breast cancer were treated with postoperative radiation therapy to the breast or chest wall alone. A population-based database recorded baseline patient, tumor, and treatment factors. Hospital administrative records identified baseline cardiac risk factors and other comorbidities. Factors between radiation therapy groups were balanced using a propensity-score model. The first event of a hospital admission for cardiac causes after radiation therapy was determined from hospitalization records. Ten- and 15-year cumulative hospital-related cardiac morbidity after radiation therapy was estimated for left- and right-sided cases using a competing risk approach. Results: The median follow-up was 13.2 years. For left-sided cases, 485 women were treated with CF-WBI, and 2221 women were treated with HF-WBI. Mastectomy was more common in the HF-WBI group, whereas boost was more common in the CF-WBI group. The CF-WBI group had a higher prevalence of diabetes. The 15-year cumulative hospital-related morbidity from cardiac causes (95% confidence interval) was not different between the 2 radiation therapy regimens after propensity-score adjustment: 21% (19-22) with HF-WBI and 21% (17-25) with CF-WBI (P=.93). For right-sided cases, the 15-year cumulative hospital-related morbidity from cardiac causes was also similar between the radiation therapy groups (P=.76). Conclusions: There is no difference in morbidity leading to hospitalization from cardiac causes among women with left-sided early-stage breast

Estimation of the radiation exposure of a chest pain protocol with ECG-gating in dual-source computed tomography

International Nuclear Information System (INIS)

Ketelsen, Dominik; Luetkhoff, Marie H.; Thomas, Christoph; Werner, Matthias; Tsiflikas, Ilias; Reimann, Anja; Kopp, Andreas F.; Claussen, Claus D.; Heuschmid, Martin; Buchgeister, Markus; Burgstahler, Christof

2009-01-01

The aim of the study was to evaluate radiation exposure of a chest pain protocol with ECG-gated dual-source computed tomography (DSCT). An Alderson Rando phantom equipped with thermoluminescent dosimeters was used for dose measurements. Exposure was performed on a dual-source computed tomography system with a standard protocol for chest pain evaluation (120 kV, 320 mAs/rot) with different simulated heart rates (HRs). The dose of a standard chest CT examination (120 kV, 160 mAs) was also measured. Effective dose of the chest pain protocol was 19.3/21.9 mSv (male/female, HR 60), 17.9/20.4 mSv (male/female, HR 80) and 14.7/16.7 mSv (male/female, HR 100). Effective dose of a standard chest examination was 6.3 mSv (males) and 7.2 mSv (females). Radiation dose of the chest pain protocol increases significantly with a lower heart rate for both males (p = 0.040) and females (p = 0.044). The average radiation dose of a standard chest CT examination is about 36.5% that of a CT examination performed for chest pain. Using DSCT, the evaluated chest pain protocol revealed a higher radiation exposure compared with standard chest CT. Furthermore, HRs markedly influenced the dose exposure when using the ECG-gated chest pain protocol. (orig.)

Reconstruction of the radiation-damaged chest wall

International Nuclear Information System (INIS)

Arnold, P.G.; Pairolero, P.C.

1989-01-01

In the patient with a radiation ulcer of the chest wall, the first question is whether the lesion contains persistent or recurrent cancer. It is also important to determine whether any other local problems such as mediastinal abscess may interfere with the reconstruction. Whether or not cancer is present, all nonviable tissue must be removed. If cancer is not present, and a partial thickness of the chest remains, the authors prefer transposition of the greater omentum for repair. If cancer is present, the physiologic defect resulting from cancer resection and wound debridement is far more severe, and a muscle or musculocutaneous flap usually is appropriate. The pectoralis major, latissimus dorsi, external oblique, rectus abdominis, and trapezius muscles have been utilized; the authors most often use the pectoralis or latissimus muscles. 27 references

Breast Cancer Risk After Radiation Therapy for Hodgkin Lymphoma : Influence of Gonadal Hormone Exposure

NARCIS (Netherlands)

Krul, Inge M; Opstal-van Winden, Annemieke W J; Aleman, Berthe M P; Janus, Cécile P M; van Eggermond, Anna M; De Bruin, Marie L; Hauptmann, Michael; Krol, Augustinus D G; Schaapveld, Michael; Broeks, Annegien; Kooijman, Karen R; Fase, Sandra; Lybeert, Marnix L; Zijlstra, Josée M; van der Maazen, Richard W M; Kesminiene, Ausrele; Diallo, Ibrahima; de Vathaire, Florent; Russell, Nicola S; van Leeuwen, Flora E

2017-01-01

BACKGROUND: Young women treated with chest radiation therapy (RT) for Hodgkin lymphoma (HL) experience a strongly increased risk of breast cancer (BC). It is unknown whether endogenous and exogenous gonadal hormones affect RT-associated BC risk. METHODS: We conducted a nested case-control study

The Impact of Radiation Therapy on the Risk of Lymphedema After Treatment for Breast Cancer: A Prospective Cohort Study

Energy Technology Data Exchange (ETDEWEB)

Warren, Laura E.G.; Miller, Cynthia L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Skolny, Melissa N.; Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean A. [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); MacDonald, Shannon M. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2014-03-01

Purpose/Objective: Lymphedema after breast cancer treatment can be an irreversible condition with a negative impact on quality of life. The goal of this study was to identify radiation therapy-related risk factors for lymphedema. Methods and Materials: From 2005 to 2012, we prospectively performed arm volume measurements on 1476 breast cancer patients at our institution using a Perometer. Treating each breast individually, 1099 of 1501 patients (73%) received radiation therapy. Arm measurements were performed preoperatively and postoperatively. Lymphedema was defined as ≥10% arm volume increase occurring >3 months postoperatively. Univariate and multivariate Cox proportional hazard models were used to evaluate risk factors for lymphedema. Results: At a median follow-up time of 25.4 months (range, 3.4-82.6 months), the 2-year cumulative incidence of lymphedema was 6.8%. Cumulative incidence by radiation therapy type was as follows: 3.0% no radiation therapy, 3.1% breast or chest wall alone, 21.9% supraclavicular (SC), and 21.1% SC and posterior axillary boost (PAB). On multivariate analysis, the hazard ratio for regional lymph node radiation (RLNR) (SC ± PAB) was 1.7 (P=.025) compared with breast/chest wall radiation alone. There was no difference in lymphedema risk between SC and SC + PAB (P=.96). Other independent risk factors included early postoperative swelling (P<.0001), higher body mass index (P<.0001), greater number of lymph nodes dissected (P=.018), and axillary lymph node dissection (P=.0001). Conclusions: In a large cohort of breast cancer patients prospectively screened for lymphedema, RLNR significantly increased the risk of lymphedema compared with breast/chest wall radiation alone. When considering use of RLNR, clinicians should weigh the potential benefit of RLNR for control of disease against the increased risk of lymphedema.

Hypofractionated Whole-Breast Radiation Therapy: Does Breast Size Matter?

Energy Technology Data Exchange (ETDEWEB)

Hannan, Raquibul, E-mail: Raquibul.Hannan@gmail.com [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Thompson, Reid F.; Chen Yu; Bernstein, Karen; Kabarriti, Rafi; Skinner, William [Department of Radiation Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York (United States); Chen, Chin C. [Department of Radiation Oncology, Columbia University Medical Center, New York, New York (United States); Landau, Evan; Miller, Ekeni; Spierer, Marnee; Hong, Linda; Kalnicki, Shalom [Department of Radiation Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York (United States)

2012-11-15

Purpose: To evaluate the effects of breast size on dose-volume histogram parameters and clinical toxicity in whole-breast hypofractionated radiation therapy using intensity modulated radiation therapy (IMRT). Materials and Methods: In this retrospective study, all patients undergoing breast-conserving therapy between 2005 and 2009 were screened, and qualifying consecutive patients were included in 1 of 2 cohorts: large-breasted patients (chest wall separation >25 cm or planning target volume [PTV] >1500 cm{sub 3}) (n=97) and small-breasted patients (chest wall separation <25 cm and PTV <1500 cm{sub 3}) (n=32). All patients were treated prone or supine with hypofractionated IMRT to the whole breast (42.4 Gy in 16 fractions) followed by a boost dose (9.6 Gy in 4 fractions). Dosimetric and clinical toxicity data were collected and analyzed using the R statistical package (version 2.12). Results: The mean PTV V95 (percentage of volume receiving >= 95% of prescribed dose) was 90.18% and the mean V105 percentage of volume receiving >= 105% of prescribed dose was 3.55% with no dose greater than 107%. PTV dose was independent of breast size, whereas heart dose and maximum point dose to skin correlated with increasing breast size. Lung dose was markedly decreased in prone compared with supine treatments. Radiation Therapy Oncology Group grade 0, 1, and 2 skin toxicities were noted acutely in 6%, 69%, and 25% of patients, respectively, and at later follow-up (>3 months) in 43%, 57%, and 0% of patients, respectively. Large breast size contributed to increased acute grade 2 toxicity (28% vs 12%, P=.008). Conclusions: Adequate PTV coverage with acceptable hot spots and excellent sparing of organs at risk was achieved by use of IMRT regardless of treatment position and breast size. Although increasing breast size leads to increased heart dose and maximum skin dose, heart dose remained within our institutional constraints and the incidence of overall skin toxicity was comparable

Radiation Load of Children by Chest Radiodiagnostic Measurements

International Nuclear Information System (INIS)

Nikodemova, D.; Vladar, M.; Ranogajec-Komor, M.; Horvathova, M.

1998-01-01

Radiodiagnostic examinations of children present particular importance from the radiation hygiene point of view. The estimation of the radiation load of pediatric patient is not easy, because of the lack of information about organ weighting factors for various ages of patients, as well as due to the differences in applied X-ray examination parameters. In the district of Slovak Republic, in which also the working Nuclear Power Plant Jaslovske Bohunice is included, efforts were done to estimate the radiation load of children to 15 years by chest radiodiagnostic examinations. The data of entrance surface doses were collected using measurements with TLD for 100 patients divided in 5 age categories at six radiodiagnostic departments. The calculations of the total absorbed dose were performed using the measured ESD values (entrance surface dose in mGy) integrated over the X-ray beam area, the conversion factors between the imparted energy and the dose-area product and the known irradiation parameters (kV, HVL, mass, etc.). The analysis of the obtained absorbed doses (E a ) as a function of age for chest PA radiodiagnostic examinations has shown, that the investigated Slovak radiodiagnostic centres use rather lower voltage techniques and the entrance surface doses are much higher than the proposed value of European Communities. (author)

Computed tomography of the chest with model-based iterative reconstruction using a radiation exposure similar to chest X-ray examination: preliminary observations

Energy Technology Data Exchange (ETDEWEB)

Neroladaki, Angeliki; Botsikas, Diomidis; Boudabbous, Sana; Becker, Christoph D.; Montet, Xavier [Geneva University Hospital, Department of Radiology, Geneva 4 (Switzerland)

2013-02-15

The purpose of this study was to assess the diagnostic image quality of ultra-low-dose chest computed tomography (ULD-CT) obtained with a radiation dose comparable to chest radiography and reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) in comparison with standard dose diagnostic CT (SDD-CT) or low-dose diagnostic CT (LDD-CT) reconstructed with FBP alone. Unenhanced chest CT images of 42 patients acquired with ULD-CT were compared with images obtained with SDD-CT or LDD-CT in the same examination. Noise measurements and image quality, based on conspicuity of chest lesions on all CT data sets were assessed on a five-point scale. The radiation dose of ULD-CT was 0.16 {+-} 0.006 mSv compared with 11.2 {+-} 2.7 mSv for SDD-CT (P < 0.0001) and 2.7 {+-} 0.9 mSv for LDD-CT. Image quality of ULD-CT increased significantly when using MBIR compared with FBP or ASIR (P < 0.001). ULD-CT reconstructed with MBIR enabled to detect as many non-calcified pulmonary nodules as seen on SDD-CT or LDD-CT. However, image quality of ULD-CT was clearly inferior for characterisation of ground glass opacities or emphysema. Model-based iterative reconstruction allows detection of pulmonary nodules with ULD-CT with radiation exposure in the range of a posterior to anterior (PA) and lateral chest X-ray. (orig.)

[Radiation exposure of children in pediatric radiology. Part 5: organ doses in chest radiography].

Science.gov (United States)

Seidenbusch, M C; Schneider, K

2009-05-01

Reconstruction of organ doses of selected organs and tissues from radiographic settings and exposure data collected during chest X-ray examinations of children of various age groups performed in Dr. von Hauner's Kinderspital (children's hospital of the University of Munich, DvHK) between 1976 and 2007. The dosimetric data of all X-ray examinations performed since 1976 at DvHK were stored electronically in a database. After 30 years of data collection, the database now includes 305 107 radiological examinations (radiographs and fluoroscopies), especially 119 150 chest radiographs of all age groups. Reconstruction of organ doses in 40 organs and tissues in X-ray examinations of the chest was performed based on the conversion factor concept. The radiation exposure of organs in projection radiography is determined by the exact site of the organs relative to the edges of the X-ray field and the beam direction of X-rays. Optimal collimation in chest radiography can reduce the exposure of organs located at the periphery of the X-ray field, e. g. thyroid gland, stomach and partially the liver, by a factor of 2 to 3, while organs located in the center of the X-ray-field, e. g. thymus, breasts, lungs, esophagus and red bone marrow, are not affected by exact collimation. The high frequency of the roentgen examination of the chest in early age groups increases the collective radiation burden to radiosensitive organs. Therefore, radiation protection of the patient during chest radiographies remains of great importance.

Concomitant Imaging Dose and Cancer Risk in Image Guided Thoracic Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Zhang, Yibao; Wu, Hao [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing (China); Chen, Zhe [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Knisely, Jonathan P.S. [Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York (United States); Nath, Ravinder [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Feng, Zhongsu [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing (China); Bao, Shanglian [Beijing Key Laboratory of Medical Physics and Engineering, Peking University, Beijing (China); Deng, Jun, E-mail: jun.deng@yale.edu [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States)

2015-11-01

Purpose: Kilovoltage cone beam computed tomography (CT) (kVCBCT) imaging guidance improves the accuracy of radiation therapy but imposes an extra radiation dose to cancer patients. This study aimed to investigate concomitant imaging dose and associated cancer risk in image guided thoracic radiation therapy. Methods and Materials: The planning CT images and structure sets of 72 patients were converted to CT phantoms whose chest circumferences (C{sub chest}) were calculated retrospectively. A low-dose thorax protocol on a Varian kVCBCT scanner was simulated by a validated Monte Carlo code. Computed doses to organs and cardiac substructures (for 5 selected patients of various dimensions) were regressed as empirical functions of C{sub chest}, and associated cancer risk was calculated using the published models. The exposures to nonthoracic organs in children were also investigated. Results: The structural mean doses decreased monotonically with increasing C{sub chest}. For all 72 patients, the median doses to the heart, spinal cord, breasts, lungs, and involved chest were 1.68, 1.33, 1.64, 1.62, and 1.58 cGy/scan, respectively. Nonthoracic organs in children received 0.6 to 2.8 cGy/scan if they were directly irradiated. The mean doses to the descending aorta (1.43 ± 0.68 cGy), left atrium (1.55 ± 0.75 cGy), left ventricle (1.68 ± 0.81 cGy), and right ventricle (1.85 ± 0.84 cGy) were significantly different (P<.05) from the heart mean dose (1.73 ± 0.82 cGy). The blade shielding alleviated the exposure to nonthoracic organs in children by an order of magnitude. Conclusions: As functions of patient size, a series of models for personalized estimation of kVCBCT doses to thoracic organs and cardiac substructures have been proposed. Pediatric patients received much higher doses than did the adults, and some nonthoracic organs could be irradiated unexpectedly by the default scanning protocol. Increased cancer risks and disease adverse events in the

Adjuvant radiation therapy versus surgery alone in operable breast cancer

International Nuclear Information System (INIS)

Rutqvist, L.E.; Pettersson, D.; Johansson, H.

1993-01-01

This paper presents long-term results from a randomized trial of pre- or postoperative megavoltage radiation therapy versus surgery alone in pre- and postmenopausal women with operable breast cancer. Treatment outcome after relapse among patients who developed loco-regional recurrences was also analyzed. A total of 960 patients were included in the trial. The mean follow-up was 16 years (range: 13-19 years). The radiation therapy was individually planned. It included the chest wall (and the breast in the preoperative cases) and the regional lymph nodes. The tumor dose was 45 Gy/5 weeks. No adjuvant systemic therapy was used. The results showed a significant benefit with radiation therapy in terms of recurrence-free survival during the entire follow-up period. There was also an overall survival difference - corresponding to 16% reduction of deaths - in favour of the irradiated patients which, however, was not statistically significant (p=0.09). Among those 169 patients who developed loco-regional recurrences long-term control was only achieved in about one-third of the cases. This figure was similar among those who had received adjuvant radiation therapy (34%) compared to those initially treated with surgery alone (32%). This implied that the overall proportion of patients who eventually developed uncontrolled local disease was significantly higher among those initially allocated to surgery alone (16%) compared to those allocated to pre- or postoperative radiation therapy (6%, p<0.01). These results suggest that local undertreatment may be deleterious in subgroups of patients. (author) 5 tabs

Current perspectives of radiation therapy. History of radiation therapy

International Nuclear Information System (INIS)

Itami, Jun

2011-01-01

More than 100 years have passed since the discovery of X-Strahlen by Roentgen. The history of radiation therapy has evolved under mutual stimulating relationships of the external beam radiation therapy by X-ray tubes and accelerators, and the internal radiation therapy employing radium and other radionuclides. The currently employed technologies in radiation therapy have its origin already till nineteen sixties and the development of physics and engineering have realized the original concept. (author)

Radiation induced skin cancer the chest wall 30 years later from breast cancer operation

Energy Technology Data Exchange (ETDEWEB)

Miyamoto, Kouji; Togawa, Tamotsu; Hasegawa, Takeshi; Matsunami, Hidetoshi; Ikeda, Tsuneko [Matsunami General Hospital, Kasamatsu, Gifu (Japan); Matsuo, Youichi

1998-10-01

This paper describes the skin cancer on the frontal chest wall induced by postoperative irradiation 30 years later from mastectomy. The patients was a 62-year-old woman, who received mastectomy of the right breast cancer (invasive ductal carcinoma, comedo type) at 31 years old, and received the postoperative radiotherapy of total 11,628 rad over 38 times. On the first medical examination in author`s hospital, the patient had an ulcer of about 10 cm diameter and was diagnosed the radiation induced skin cancer (well differentiated squamous cell carcinoma) in the biopsy. Because of the general condition of the patient was extremely bad and the skin cancer had highly developed, the excision was thought to be impossible. The radiotherapy (16 Gy) and combined local chemotherapy by OK 432 and Bleomycin were performed. In spite of the short term treatment, these therapies were effective on the reduction of the tumor size and the hemostasis, and brought the patient the improvement of QOL. The general condition of the patient improved to be stable and she recovered enough to go out from the hospital for 6 months. After 10 months, she showed anorexia and dyspnea and died after about 1 year from the admission. The present case is extremely rare, and it is required the radical therapy like the excision of chest wall at early stage. (K.H.)

Radiation dose reduction in chest CT—Review of available options

International Nuclear Information System (INIS)

Kubo, Takeshi; Ohno, Yoshiharu; Kauczor, Hans Ulrich; Hatabu, Hiroto

2014-01-01

Highlights: • The present status of proliferating CT examinations was presented. • Technical improvements of CT scanners for radiation dose reduction were reviewed. • Advantage and disadvantage of methods for CT radiation dose reduction were discussed. • Evidences for safety of CT radiation dose reduction were reviewed. - Abstract: Computed tomography currently accounts for the majority of radiation exposure related to medical imaging. Although technological improvement of CT scanners has reduced the radiation dose of individual examinations, the benefit was overshadowed by the rapid increase in the number of CT examinations. Radiation exposure from CT examination should be kept as low as reasonably possible for patient safety. Measures to avoid inappropriate CT examinations are needed. Principles and information on radiation dose reduction in chest CT are reviewed in this article. The reduction of tube current and tube potential are the mainstays of dose reduction methods. Study results indicate that routine protocols with reduced tube current are feasible with diagnostic results comparable to conventional standard dose protocols. Tube current adjustment is facilitated by the advent of automatic tube current modulation systems by setting the appropriate image quality level for the purpose of the examination. Tube potential reduction is an effective method for CT pulmonary angiography. Tube potential reduction often requires higher tube current for satisfactory image quality, but may still contribute to significant radiation dose reduction. Use of lower tube potential also has considerable advantage for smaller patients. Improvement in image production, especially the introduction of iterative reconstruction methods, is expected to lower radiation dose significantly. Radiation dose reduction in CT is a multifaceted issue. Understanding these aspects leads to an optimal solution for various indications of chest CT

Radiation dose reduction in chest CT—Review of available options

Energy Technology Data Exchange (ETDEWEB)

Kubo, Takeshi, E-mail: tkubo@kuhpkyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 (Japan); Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan); Kauczor, Hans Ulrich, E-mail: hu.kauczor@med.uni-heidelberg.de [Diagnostic and Interventional Radiology, University Clinic Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg (Germany); Hatabu, Hiroto, E-mail: hhatabu@partners.org [Department of Radiology, Brigham and Women' s Hospital, 75 Francis Street, Boston, MA 02115 (United States)

2014-10-15

Highlights: • The present status of proliferating CT examinations was presented. • Technical improvements of CT scanners for radiation dose reduction were reviewed. • Advantage and disadvantage of methods for CT radiation dose reduction were discussed. • Evidences for safety of CT radiation dose reduction were reviewed. - Abstract: Computed tomography currently accounts for the majority of radiation exposure related to medical imaging. Although technological improvement of CT scanners has reduced the radiation dose of individual examinations, the benefit was overshadowed by the rapid increase in the number of CT examinations. Radiation exposure from CT examination should be kept as low as reasonably possible for patient safety. Measures to avoid inappropriate CT examinations are needed. Principles and information on radiation dose reduction in chest CT are reviewed in this article. The reduction of tube current and tube potential are the mainstays of dose reduction methods. Study results indicate that routine protocols with reduced tube current are feasible with diagnostic results comparable to conventional standard dose protocols. Tube current adjustment is facilitated by the advent of automatic tube current modulation systems by setting the appropriate image quality level for the purpose of the examination. Tube potential reduction is an effective method for CT pulmonary angiography. Tube potential reduction often requires higher tube current for satisfactory image quality, but may still contribute to significant radiation dose reduction. Use of lower tube potential also has considerable advantage for smaller patients. Improvement in image production, especially the introduction of iterative reconstruction methods, is expected to lower radiation dose significantly. Radiation dose reduction in CT is a multifaceted issue. Understanding these aspects leads to an optimal solution for various indications of chest CT.

Proton radiotherapy for chest wall and regional lymphatic radiation; dose comparisons and treatment delivery

International Nuclear Information System (INIS)

MacDonald, Shannon M; Jimenez, Rachel; Paetzold, Peter; Adams, Judith; Beatty, Jonathan; DeLaney, Thomas F; Kooy, Hanne; Taghian, Alphonse G; Lu, Hsiao-Ming

2013-01-01

The delivery of post-mastectomy radiation therapy (PMRT) can be challenging for patients with left sided breast cancer that have undergone mastectomy. This study investigates the use of protons for PMRT in selected patients with unfavorable cardiac anatomy. We also report the first clinical application of protons for these patients. Eleven patients were planned with protons, partially wide tangent photon fields (PWTF), and photon/electron (P/E) fields. Plans were generated with the goal of achieving 95% coverage of target volumes while maximally sparing cardiac and pulmonary structures. In addition, we report on two patients with unfavorable cardiac anatomy and IMN involvement that were treated with a mix of proton and standard radiation. PWTF, P/E, and proton plans were generated and compared. Reasonable target volume coverage was achieved with PWTF and P/E fields, but proton therapy achieved superior coverage with a more homogeneous plan. Substantial cardiac and pulmonary sparing was achieved with proton therapy as compared to PWTF and P/E. In the two clinical cases, the delivery of proton radiation with a 7.2 to 9 Gy photon and electron component was feasible and well tolerated. Akimbo positioning was necessary for gantry clearance for one patient; the other was treated on a breast board with standard positioning (arms above her head). LAO field arrangement was used for both patients. Erythema and fatigue were the only noted side effects. Proton RT enables delivery of radiation to the chest wall and regional lymphatics, including the IMN, without compromise of coverage and with improved sparing of surrounding normal structures. This treatment is feasible, however, optimal patient set up may vary and field size is limited without multiple fields/matching

Radiation therapy in the management of patients with breast cancer: why, where, and when

International Nuclear Information System (INIS)

Webber, B.M.; Giicksman, A.S.

1974-01-01

The applications of radiaition therapy in the management of all stages of breast cancer has been reviewed. It is obvious that, as the disease progresses through its spectrum from early subclinical cancer to far-advanced incurable disease, the uses of radiation vary. In the very early case irradiation is a valuable primary therapeutic method and when properly administered, offers the probability of long-term local control which is equivalent to that offered by radical surgery. It is advised that radiation treatment be reserved for those who ultimately manifest evidences of local tumor recurrence on the chest wall or in the regional node-bearing areas. When such manifestations occur, intensive radiation to the appropriate areas is indicated and has a high probability of eradicating the local tumor. In patients in whom the disease is moderately advanced so that they are essentially inoperable by reasonable standards, radiation therapy can play an important role in preparing the local field for surgical intervention. A combination of preoperative irradiation and mastectomy in these patients offers the highest probability of permanent local control of tumor. It is postulated that the addition of prolonged chemotherapeutic management in such patients may be of value in reducing the tumor burden within the inevitable metastatic deposits which are present. Whether or not treatment of this sort can completely eliminate these metastases remains to be seen. In the patient with far-advanced metastatic disease, radiation therapy is a valuable local method of palliation, offering an excellent therapy controlling symptoms in such areas as the eye and the central nervous system. Tumor which recurs on the chest wall following prior treatment with supervoltage irradiation can often be well managed by re-irradiation with the electron beam. (U.S.)

A case of postirradiation cutaneous angiosarcoma on the chest after radical mastectomy without any therapies

International Nuclear Information System (INIS)

Hirai, Nobuyuki; Suzuki, Yutaka

2009-01-01

The patient was a 78-year-old woman who had undergone radical mastectomy for left breast cancer, followed by irradiation to the chest wall about 40 years earlier. In the fall of 2006, small purpura appeared around the surgical scar in the left chest. Because it had spread on the chest gradually, she was seen at this hospital on August 28, 2007, when a purple red brownish induration 7.5 x 3.5 cm in diameter was noted on the left chest. A biopsy gave the histopathological diagnosis of angiosarcoma. According to her clear intention, no therapies have done and thus the tumor has spread over the entire left chest. But she is doing well over two years since she had noticed the purpura without any therapies. Postirradiation cutaneous angiosarcoma is rare, but carries very poor prognosis. In Japan, the number of patients with breast cancer is increasing rapidly, and the number of patients with postirradiation cutaneous angiosarcoma after breast cancer treatment will increase. Surgeons must inform the patients about the possibility that irradiation can cause cutaneous angiosarcoma, and must strictly follow the post-irradiation patients. (author)

{sup 99m}Tc-MIBI scintigraphy for early detection of locally recurrent non-small cell lung cancer treated with definitive radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Furuta, Masaya; Nozaki, Miwako; Kawashima, Miho; Iimuro, Mamoru; Kitazumi, Yoshinori; Okayama, Aya; Natsui, Satoshi [Department of Radiology, Koshigaya Hospital, Dokkyo University School of Medicine, 2-1-50 Minami-Koshigaya, 343-8555, Koshigaya (Japan); Hamashima, Yoshio; Nagao, Koushuu [Department of Respiratory Internal Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya (Japan)

2003-07-01

After radiation therapy of lung cancer, a dense fibrotic shadow develops in the irradiated lung. Owing to this fibrosis, early detection of local recurrence after treatment is sometimes difficult even when using computed tomography (CT) and magnetic resonance imaging. We investigated the diagnostic accuracy of technetium-99m hexakis 2-methoxyisobutylisonitrile ({sup 99m}Tc-MIBI) scintigraphy for the detection of recurrent lung cancer following definitive radiation therapy. Eighteen patients with primary non-small cell lung cancer treated with radiation therapy 1 year previously were studied with {sup 99m}Tc-MIBI scintigraphy. They showed no evidence of local recurrence on serial chest radiographs. All single-photon emission tomography (SPET) images acquired 2 h after intravenous administration of the radiopharmaceutical were visually interpreted with knowledge of the pretreatment chest radiograph, CT and the details of radiation therapy (radiation portals and administered doses). A region of interest (ROI) analysis was also performed. In addition to the ROI ratio of tumour uptake to accumulation in contralateral normal lung (tumour/lung ratio), another semiquantitative analysis, the ratio of tumour uptake to accumulation in radiation fibrosis (tumour/fibrosis ratio), was performed to differentiate between accumulation in radiation fibrosis and the tumour uptake. The scintigraphic diagnoses were correlated with clinical outcome. The sensitivity, specificity and negative predictive value of {sup 99m}Tc-MIBI scintigraphy for the detection of recurrent lung cancer were all 88.9% (8/9). The tumour/lung ratios (mean{+-}SEM) of the nine patients with local recurrence and the other eight without local failure were 2.00{+-}0.11 and 1.40{+-}0.09, respectively (P<0.01). The tumour/fibrosis ratios of the patients with and those without recurrence were 1.47{+-}0.08 and 0.93{+-}0.05, respectively (P<0.01). These results suggest that {sup 99m}Tc-MIBI scintigraphy might be of

Squamous cell carcinoma of the trachea in a non-smoking woman after radiation therapy for breast cancer

Energy Technology Data Exchange (ETDEWEB)

Ishiwa, Naoki; Yamada, Kouzou; Nakayama, Haruhiko; Noda, Kazumasa [Kanagawa Cancer Center, Yokohama (Japan); Kameda, Youichi; Maehara, Takamitsu

2000-04-01

Few cases of squamous cell carcinoma of the trachea have been reported in non-smoking women. We report one case which was probably due to radiation therapy. A 50-year-old non-smoking woman was referred to our hospital because wheezing and dyspnea had been aggravated for 3 months. She had received radiation therapy ({sup 60}Cobalt) after standard radical mastectomy for right breast cancer 13 years previously. Bronchoscopic findings and chest CT scan showed tracheal stenosis due to the tumor. Sleeve resection of the trachea was performed, and the tumor was histologically diagnosed as poorly differentiated squamous cell carcinoma. We may consider this case to be radiation-induced cancer compatible with the most strict criteria of radiation induced malignancy. (author)

Patient-specific radiation dose and cancer risk for pediatric chest CT.

Science.gov (United States)

Li, Xiang; Samei, Ehsan; Segars, W Paul; Sturgeon, Gregory M; Colsher, James G; Frush, Donald P

2011-06-01

To estimate patient-specific radiation dose and cancer risk for pediatric chest computed tomography (CT) and to evaluate factors affecting dose and risk, including patient size, patient age, and scanning parameters. The institutional review board approved this study and waived informed consent. This study was HIPAA compliant. The study included 30 patients (0-16 years old), for whom full-body computer models were recently created from clinical CT data. A validated Monte Carlo program was used to estimate organ dose from eight chest protocols, representing clinically relevant combinations of bow tie filter, collimation, pitch, and tube potential. Organ dose was used to calculate effective dose and risk index (an index of total cancer incidence risk). The dose and risk estimates before and after normalization by volume-weighted CT dose index (CTDI(vol)) or dose-length product (DLP) were correlated with patient size and age. The effect of each scanning parameter was studied. Organ dose normalized by tube current-time product or CTDI(vol) decreased exponentially with increasing average chest diameter. Effective dose normalized by tube current-time product or DLP decreased exponentially with increasing chest diameter. Chest diameter was a stronger predictor of dose than weight and total scan length. Risk index normalized by tube current-time product or DLP decreased exponentially with both chest diameter and age. When normalized by DLP, effective dose and risk index were independent of collimation, pitch, and tube potential (chest CT protocols. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101900/-/DC1. RSNA, 2011

Estimated risk of radiation-induced cancer from paediatric chest CT: two-year cohort study

Energy Technology Data Exchange (ETDEWEB)

Niemann, Tilo [Cantonal Hospital Baden, Department of Radiology, Baden (Switzerland); University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Colas, Lucie; Santangelo, Teresa; Faivre, Jean Baptiste; Remy, Jacques; Remy-Jardin, Martine [University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Roser, Hans W.; Bremerich, Jens [University of Basel Hospital, Clinic of Radiology and Nuclear Medicine, Medical Physics, Basel (Switzerland)

2015-03-01

The increasing absolute number of paediatric CT scans raises concern about the safety and efficacy and the effects of consecutive diagnostic ionising radiation. To demonstrate a method to evaluate the lifetime attributable risk of cancer incidence/mortality due to a single low-dose helical chest CT in a two-year patient cohort. A two-year cohort of 522 paediatric helical chest CT scans acquired using a dedicated low-dose protocol were analysed retrospectively. Patient-specific estimations of radiation doses were modelled using three different mathematical phantoms. Per-organ attributable cancer risk was then estimated using epidemiological models. Additional comparison was provided for naturally occurring risks. Total lifetime attributable risk of cancer incidence remains low for all age and sex categories, being highest in female neonates (0.34%). Summation of all cancer sites analysed raised the relative lifetime attributable risk of organ cancer incidence up to 3.6% in female neonates and 2.1% in male neonates. Using dedicated scan protocols, total lifetime attributable risk of cancer incidence and mortality for chest CT is estimated low for paediatric chest CT, being highest for female neonates. (orig.)

Chest CT using spectral filtration: radiation dose, image quality, and spectrum of clinical utility

Energy Technology Data Exchange (ETDEWEB)

Braun, Franziska M.; Johnson, Thorsten R.C.; Sommer, Wieland H.; Thierfelder, Kolja M.; Meinel, Felix G. [University Hospital Munich, Institute for Clinical Radiology, Munich (Germany)

2015-06-01

To determine the radiation dose, image quality, and clinical utility of non-enhanced chest CT with spectral filtration. We retrospectively analysed 25 non-contrast chest CT examinations acquired with spectral filtration (tin-filtered Sn100 kVp spectrum) compared to 25 examinations acquired without spectral filtration (120 kV). Radiation metrics were compared. Image noise was measured. Contrast-to-noise-ratio (CNR) and figure-of-merit (FOM) were calculated. Diagnostic confidence for the assessment of various thoracic pathologies was rated by two independent readers. Effective chest diameters were comparable between groups (P = 0.613). In spectral filtration CT, median CTDI{sub vol}, DLP, and size-specific dose estimate (SSDE) were reduced (0.46 vs. 4.3 mGy, 16 vs. 141 mGy*cm, and 0.65 vs. 5.9 mGy, all P < 0.001). Spectral filtration CT had higher image noise (21.3 vs. 13.2 HU, P < 0.001) and lower CNR (47.2 vs. 75.3, P < 0.001), but was more dose-efficient (FOM 10,659 vs. 2,231/mSv, P < 0.001). Diagnostic confidence for parenchymal lung disease and osseous pathologies was lower with spectral filtration CT, but no significant difference was found for pleural pathologies, pulmonary nodules, or pneumonia. Non-contrast chest CT using spectral filtration appears to be sufficient for the assessment of a considerable spectrum of thoracic pathologies, while providing superior dose efficiency, allowing for substantial radiation dose reduction. (orig.)

Radiation therapy for Kasabach-Merritt syndrome. Analysis of unfavorable factors in 5 children

International Nuclear Information System (INIS)

Kawamori, Jiro; Saito, Tsutomu; Tanaka, Yoshiaki; Sato, Katsuhiko.

1996-01-01

During the past 10 years, five infants with Kasabach-Merritt syndrome (K-M) receiving radiation therapy were reported. We investigated whether radiation therapy for K-M was useful and what the unfavorable factors of K-M were. During the past 10 years, we have treated five infants with K-M. The syndrome occurred at ages ranging from birth to 4 months. The incidence of female to male ratio was 3:2. Among 5 cases, the site of hemangioma was as follows; shoulder, anterior chest wall, lower abdominal wall, face and neck and inguinal site. All 5 cases received medication to control the coagulopathy including prednisone and blood transfusion at first. Because the platelet count and the bleeding tendency did not improve in any case, these cases received radiation therapy. Total dose ranged from 5 to 10 Gy and fraction-size ranged from 0.5 to 1.75 Gy. Irradiation session was 2 or 3 times per week. In 5 cases, 4 cases showed cure of bleeding tendency and disappearance of tumor, and survived. In these 4 cases, normalization of platelet count was obtained at the early phase of dose ranging from 3 to 5 Gy by radiation therapy. In the remaining case, bleeding tendency was improved at the late phase by initial radiation therapy, however, after that immediately relapsed. In this case, the salvage radiation therapy was not effective and she died from airway obstruction. This case was of neonatal age and had bulky neck tumor. We recognized that radiation therapy was effective for K-M. A serious case was of neonatal age and had bulky neck tumor. It was estimated that the unfavorable factors of K-M were neonatal case and bulky neck tumor case. (author)

Radiation safety education reduces the incidence of adult fingers on neonatal chest radiographs

International Nuclear Information System (INIS)

Sahota, N; Burbridge, B E; Duncan, M D

2014-01-01

A previous audit revealed a high frequency of adult fingers visualised on neonatal intensive care unit (NICU) chest radiographs—representing an example of inappropriate occupational radiation exposure. Radiation safety education was provided to staff and we hypothesised that the education would reduce the frequency of adult fingers visualised on NICU chest radiographs. Two cross-sectional samples taken before and after the administration of the education were compared. We examined fingers visualised directly in the beam, fingers in the direct beam but eliminated by technologists editing the image, and fingers under the cones of the portable x-ray machine. There was a 46.2% reduction in fingers directly in the beam, 50.0% reduction in fingers directly in the beam but cropped out, and 68.4% reduction in fingers in the coned area. There was a 57.1% overall reduction in adult fingers visualised, which was statistically significant (Z value − 7.48, P < 0.0001). This study supports radiation safety education in minimising inappropriate occupational radiation exposure. (paper)

Hendee's radiation therapy physics

CERN Document Server

Pawlicki, Todd; Starkschall, George

2016-01-01

The publication of this fourth edition, more than ten years on from the publication of Radiation Therapy Physics third edition, provides a comprehensive and valuable update to the educational offerings in this field. Led by a new team of highly esteemed authors, building on Dr Hendee’s tradition, Hendee’s Radiation Therapy Physics offers a succinctly written, fully modernised update. Radiation physics has undergone many changes in the past ten years: intensity-modulated radiation therapy (IMRT) has become a routine method of radiation treatment delivery, digital imaging has replaced film-screen imaging for localization and verification, image-guided radiation therapy (IGRT) is frequently used, in many centers proton therapy has become a viable mode of radiation therapy, new approaches have been introduced to radiation therapy quality assurance and safety that focus more on process analysis rather than specific performance testing, and the explosion in patient-and machine-related data has necessitated an ...

Occult constrictive pericardial disease emerging 40 years after chest radiation therapy: a case report.

Science.gov (United States)

Goten, Chiaki; Murai, Hisayoshi; Takashima, Shin-Ichiro; Kato, Takeshi; Usui, Soichiro; Furusho, Hiroshi; Saeki, Takahiro; Sakagami, Satoru; Takemura, Hirofumi; Kaneko, Shuichi; Takamura, Masayuki

2018-05-31

The main etiology of constrictive pericarditis (CP) has changed from tuberculosis to therapeutic mediastinal radiation and cardiac surgery. Occult constrictive pericardial disease (OCPD) is a covert disease in which CP is manifested in a condition of volume overload. A 60-year-old patient with a history of thoracic radiation therapy for non-Hodgkin's lymphoma (40 years earlier) was transferred to our hospital for treatment of repeated congestive heart failure. For a preoperative hemodynamic study, pre-hydration with intravenous normal saline (50 mL/hour) was used to manifest the pericardial disease and prevent contrast-induced nephropathy. The hemodynamic study showed a right ventricular dip-plateau pattern and discordance of right and left ventricular systolic pressures during inspiration, which was not seen in the volume-controlled state. These responses were concordant with OCPD. A pericardiectomy, aortic valve replacement, and mitral and tricuspid valve repair were performed. Postoperatively, the heart failure was controlled with standard medication. This case revealed a volume-induced change in hemodynamics in OCPD with severe combined valvular heart disease, which suggests the importance of considering OCPD in patients who had undergone radiation therapy 40 years before.

On the problem of radiation damage due to diagnostic radiology of the chest

International Nuclear Information System (INIS)

Angerstein, W.

1979-01-01

The factors of risk for radiation-induced cancer given by UNSCEAR and ICRP are discussed. Under the uncertain assumption of the validity of these factors for diagnostic radiology the number of lung and breast cancers as well as of leukemias induced by mass chest radiography was estimated. It was found that for 30 chest X-rays per capita in the course of life there would be 180 lung cancers, 5 breast cancers and 27 leukemias in the GDR each year. These figures have been compared with the number of cases of lung tuberculosis and lung cancer detected annually ley mass chest radiography. However, no correlation could be found between diagnostic irradiations and detected cases of cancer. (author)

Changes of intrathoracic extrapulmonary organs after radiation therapy for lung and esophageal cancer:CT findings

International Nuclear Information System (INIS)

Song, Kyeong Seop; Kim, Sung Jin; Park, Woo Yoon; Hun, Bae Il; Han, Gi Seok; Cha, Sang Hun; Park, Kil Sun

2001-01-01

To evaluate the CT findings and incidence of complications occurring in intrathoracic extrapulmonary organs due to radiation therapy. Among 82 patients who underwent chest CT before and after radiation therapy, 23, in whom the procedure provided no evidence of pericardial invasion or pleural effusion before radiation therapy, nor of significant improvement in the tumor after this therapy, were evaulated. Changes in the pericardium, pleura and mediastinal fat were retrospectively assessed. In comparing the CT findings obtained before radiation therapy with those obtained afterwards, changes in the pericardium and pleura were classified as effusion where low density fluid was present and as thickening where there was no fluid. If an increased abundance of soft tissue strands was seen within mediastinal fat, changes in this fat were deemed to have occurred. Among the 23 patients evaluated, changes in the pericardium [thickening (n=3 ; 13.0%) ; effusion (n=8 ; 34.8%)] were found in 11 patients (47.8%), and changes in the pleura [thickening (n=3 ; 13.1%); effusion (n=9 ; 39.1%)] in 12 (52.2%). In no patient with pericardial or pleural effusion was thickening or contrast enhancement of the pericardium or pleura evident. In seven cases(30.4%), soft tissue strands within mediastinal fat had become more abundant. The CT findings which demonstrated complications resulting from radiation therapy were pericardial or pleural thickening or effusion and an increased abundance of soft tissue strands within mediastinal fat. In contrast to previous reports, pericardial and pleural change after radiation therapy was a common finding in our study, occurring in 69.6% of cases

Effect of radiation dose level on the detectability of pulmonary nodules in chest tomosynthesis.

Science.gov (United States)

Asplund, Sara A; Johnsson, Åse A; Vikgren, Jenny; Svalkvist, Angelica; Flinck, Agneta; Boijsen, Marianne; Fisichella, Valeria A; Månsson, Lars Gunnar; Båth, Magnus

2014-07-01

To investigate the detectability of pulmonary nodules in chest tomosynthesis at reduced radiation dose levels. Eighty-six patients were included in the study and were examined with tomosynthesis and computed tomography (CT). Artificial noise was added to simulate that the tomosynthesis images were acquired at dose levels corresponding to 12, 32, and 70% of the default setting effective dose (0.12 mSv). Three observers (with >20, >20 and three years of experience) read the tomosynthesis cases for presence of nodules in a free-response receiver operating characteristics (FROC) study. CT served as reference. Differences between dose levels were calculated using the jack-knife alternative FROC (JAFROC) figure of merit (FOM). The JAFROC FOM was 0.45, 0.54, 0.55, and 0.54 for the 12, 32, 70, and 100% dose levels, respectively. The differences in FOM between the 12% dose level and the 32, 70, and 100% dose levels were 0.087 (p = 0.006), 0.099 (p = 0.003), and 0.093 (p = 0.004), respectively. Between higher dose levels, no significant differences were found. A substantial reduction from the default setting dose in chest tomosynthesis may be possible. In the present study, no statistically significant difference in detectability of pulmonary nodules was found when reducing the radiation dose to 32%. • A substantial radiation dose reduction in chest tomosynthesis may be possible. • Pulmonary nodule detectability remained unchanged at 32% of the effective dose. • Tomosynthesis might be performed at the dose of a lateral chest radiograph.

Risk management of radiation therapy. Survey by north Japan radiation therapy oncology group

International Nuclear Information System (INIS)

Aoki, Masahiko; Abe, Yoshinao; Yamada, Shogo; Hareyama, Masato; Nakamura, Ryuji; Sugita, Tadashi; Miyano, Takashi

2004-01-01

A North Japan Radiation Oncology Group (NJRTOG) survey was carried out to disclose the risk management of radiation therapy. During April 2002, we sent questionnaires to radiation therapy facilities in northern Japan. There were 31 replies from 27 facilities. Many incidents and accidents were reported, including old cases. Although 60% of facilities had a risk management manual and/or risk manager, only 20% had risk management manuals for radiation therapy. Eighty five percent of radiation oncologists thought that incidents may be due to a lack of manpower. Ninety percent of radiation oncologists want to know the type of cases happened in other facilities. The risk management system is still insufficient for radiation therapy. We hope that our data will be a great help to develop risk management strategies for radiation therapy for all radiation oncologists in Japan. (author)

Complication of radiation therapy

International Nuclear Information System (INIS)

Imajo, Yoshinari; Suematsu, Toru; Narabayashi, Isamu; Gose, Kyuhei; Takimoto, Saeko

1984-01-01

The radiation pneumonitis is a major complication for patients recieving thoracic irradiation. This report describe the radiographic recognition, pathological change and imapired pulmonary functions of radiation pneumonitis. The 57 patients with lung cancer treated with radiation are analyzed on the pneumonitis by chest X-P. Among these, 50 patients (88%) develop radiation pneumonitis. Repeated CT scans give more detailed information than conventional radiograms as to exdative changes. The pathological analysis are made on the 35 patients of which affected lungs are resected after pre-operative irradiation. Three phases are recognized in the evolution of pneumonitis, the ongestive, the degenerative, and the fibrotic. Adding to the morphorogical damage, pulmonary functions also detrieorate both in ventilation and perfusion scans. (author)

The relationship of sick leave benefits, employment patterns, and individual characteristics to radiation therapy-related fatigue.

Science.gov (United States)

Poirier, Patricia

2006-05-03

To examine the relationship among sick leave benefits, employment patterns, individual characteristics, and fatigue in patients receiving radiation therapy. Prospective, longitudinal design. A community hospital radiation oncology department. 77 patients receiving radiation therapy to the breast, chest, head and neck, pelvis, or prostate. All were employed at the time of diagnosis. The Piper Integrated Fatigue Model guided the study. The Revised Piper Fatigue Scale (PFS), Brief Fatigue Inventory, and a single-item scale were used to measure five dimensions of subjective fatigue. Sick leave, employment, individual characteristics, and fatigue were measured at baseline, weekly during treatment, and at one month post-treatment. Employment patterns, availability of sick leave benefits, and fatigue. Mean total fatigue scores on the PFS ranged from 0-4.77 at baseline (mean = 0.46, SD = 0.93), 0-8.77 at the completion of treatment (mean = 2.84, SD = 2.40), and 0-4.82 at one month post-treatment (mean = 0.77, SD = 1.20). Side effects, education, living situation, age, treatment site, and work were associated with fatigue along the trajectory of radiation therapy. Study participants who were working at the end of radiation had lower fatigue scores than those who were not. Availability of sick leave benefits was associated with employment patterns during treatment. Work may have benefits during radiation therapy but may be affected by radiation therapy-related fatigue. Management of treatment side effects, including fatigue, may help patients remain in the workforce during radiation.

Radiation therapy for breast cancer: Literature review

Energy Technology Data Exchange (ETDEWEB)

Balaji, Karunakaran, E-mail: karthik.balaji85@gmail.com [Department of Radiation Oncology, Global Hospitals, Chennai (India); School of Advanced Sciences, VIT University, Vellore (India); Subramanian, Balaji [Department of Radiation Oncology, Global Hospitals, Chennai (India); Yadav, Poonam [Department of Medical Physics and Human Oncology, University of Wisconsin-Madison, WI and Aspirus UW Cancer Center, Wisconsin Rapids, WI (United States); Anu Radha, Chandrasekaran; Ramasubramanian, Velayudham [School of Advanced Sciences, VIT University, Vellore (India)

2016-10-01

Concave shape with variable size target volume makes treatment planning for the breast/chest wall a challenge. Conventional techniques used for the breast/chest wall cancer treatment provided better sparing of organs at risk (OARs), with poor conformity and uniformity to the target volume. Advanced technologies such as intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) improve the target coverage at the cost of higher low dose volumes to OARs. Novel hybrid techniques present promising results in breast/chest wall irradiation in terms of target coverage as well as OARs sparing. Several published data compared these technologies for the benefit of the breast/chest wall with or without nodal volumes. The aim of this article is to review relevant data and identify the scope for further research in developing optimal treatment plan for breast/chest wall cancer treatment.

Radiation therapy for breast cancer: Literature review

International Nuclear Information System (INIS)

Balaji, Karunakaran; Subramanian, Balaji; Yadav, Poonam; Anu Radha, Chandrasekaran; Ramasubramanian, Velayudham

2016-01-01

Concave shape with variable size target volume makes treatment planning for the breast/chest wall a challenge. Conventional techniques used for the breast/chest wall cancer treatment provided better sparing of organs at risk (OARs), with poor conformity and uniformity to the target volume. Advanced technologies such as intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) improve the target coverage at the cost of higher low dose volumes to OARs. Novel hybrid techniques present promising results in breast/chest wall irradiation in terms of target coverage as well as OARs sparing. Several published data compared these technologies for the benefit of the breast/chest wall with or without nodal volumes. The aim of this article is to review relevant data and identify the scope for further research in developing optimal treatment plan for breast/chest wall cancer treatment.

SPECT Analysis of Cardiac Perfusion Changes After Whole-Breast/Chest Wall Radiation Therapy With or Without Active Breathing Coordinator: Results of a Randomized Phase 3 Trial

Energy Technology Data Exchange (ETDEWEB)

Zellars, Richard, E-mail: zellari@jhmi.edu [Johns Hopkins Medical Institution, Baltimore, Maryland (United States); Bravo, Paco E. [University of Washington Medical Center, Seattle, Washington (United States); Tryggestad, Erik [Mayo Clinic, Rochester, Minnesota (United States); Hopfer, Kari [Hahnemann University, Philadelphia, Pennsylvania (United States); Myers, Lee; Tahari, Abdel; Asrari, Fariba; Ziessman, Harvey [Johns Hopkins Medical Institution, Baltimore, Maryland (United States); Garrett-Mayer, Elizabeth [Medical University of South Carolina, Charleston, South Carolina (United States)

2014-03-15

Purpose: Cardiac muscle perfusion, as determined by single-photon emission computed tomography (SPECT), decreases after breast and/or chest wall (BCW) irradiation. The active breathing coordinator (ABC) enables radiation delivery when the BCW is farther from the heart, thereby decreasing cardiac exposure. We hypothesized that ABC would prevent radiation-induced cardiac toxicity and conducted a randomized controlled trial evaluating myocardial perfusion changes after radiation for left-sided breast cancer with or without ABC. Methods and Materials: Stages I to III left breast cancer patients requiring adjuvant radiation therapy (XRT) were randomized to ABC or No-ABC. Myocardial perfusion was evaluated by SPECT scans (before and 6 months after BCW radiation) using 2 methods: (1) fully automated quantitative polar mapping; and (2) semiquantitative visual assessment. The left ventricle was divided into 20 segments for the polar map and 17 segments for the visual method. Segments were grouped by anatomical rings (apical, mid, basal) or by coronary artery distribution. For the visual method, 2 nuclear medicine physicians, blinded to treatment groups, scored each segment's perfusion. Scores were analyzed with nonparametric tests and linear regression. Results: Between 2006 and 2010, 57 patients were enrolled and 43 were available for analysis. The cohorts were well matched. The apical and left anterior descending coronary artery segments had significant decreases in perfusion on SPECT scans in both ABC and No-ABC cohorts. In unadjusted and adjusted analyses, controlling for pretreatment perfusion score, age, and chemotherapy, ABC was not significantly associated with prevention of perfusion deficits. Conclusions: In this randomized controlled trial, ABC does not appear to prevent radiation-induced cardiac perfusion deficits.

SPECT Analysis of Cardiac Perfusion Changes After Whole-Breast/Chest Wall Radiation Therapy With or Without Active Breathing Coordinator: Results of a Randomized Phase 3 Trial

International Nuclear Information System (INIS)

Zellars, Richard; Bravo, Paco E.; Tryggestad, Erik; Hopfer, Kari; Myers, Lee; Tahari, Abdel; Asrari, Fariba; Ziessman, Harvey; Garrett-Mayer, Elizabeth

2014-01-01

Purpose: Cardiac muscle perfusion, as determined by single-photon emission computed tomography (SPECT), decreases after breast and/or chest wall (BCW) irradiation. The active breathing coordinator (ABC) enables radiation delivery when the BCW is farther from the heart, thereby decreasing cardiac exposure. We hypothesized that ABC would prevent radiation-induced cardiac toxicity and conducted a randomized controlled trial evaluating myocardial perfusion changes after radiation for left-sided breast cancer with or without ABC. Methods and Materials: Stages I to III left breast cancer patients requiring adjuvant radiation therapy (XRT) were randomized to ABC or No-ABC. Myocardial perfusion was evaluated by SPECT scans (before and 6 months after BCW radiation) using 2 methods: (1) fully automated quantitative polar mapping; and (2) semiquantitative visual assessment. The left ventricle was divided into 20 segments for the polar map and 17 segments for the visual method. Segments were grouped by anatomical rings (apical, mid, basal) or by coronary artery distribution. For the visual method, 2 nuclear medicine physicians, blinded to treatment groups, scored each segment's perfusion. Scores were analyzed with nonparametric tests and linear regression. Results: Between 2006 and 2010, 57 patients were enrolled and 43 were available for analysis. The cohorts were well matched. The apical and left anterior descending coronary artery segments had significant decreases in perfusion on SPECT scans in both ABC and No-ABC cohorts. In unadjusted and adjusted analyses, controlling for pretreatment perfusion score, age, and chemotherapy, ABC was not significantly associated with prevention of perfusion deficits. Conclusions: In this randomized controlled trial, ABC does not appear to prevent radiation-induced cardiac perfusion deficits

One-stage reconstruction of chest wall defects with greater omentum transplantation

Energy Technology Data Exchange (ETDEWEB)

Harashina, T [Keio Univ., Tokyo (Japan). School of Medicine; Oshiro, T; Sato, K

1976-11-01

Reconstructive operation by greater omentum transplantation in two cases of chest wall ulcer due to radiation therapy following an operation of breast cancer was introduced. The exposed dose of one case was not clarified, but that of another case was 5000 rad. This operation method is an excellent one, because operation is completed at one-stage and reconstruction of tissue is great owing to good blood circulation. It was thought that this method must be used more positively in the treatment of chest wall ulcer due to irradiation which is difficult to be treated.

Radiation therapy for digestive tumors

International Nuclear Information System (INIS)

Piedbois, P.; Levy, E.; Thirion, P.; Martin, L.; Calitchi, E.; Otmezguine, Y.; Le Bourgeois, J.P.

1995-01-01

This brief review of radiation therapy of digestive tumors in 1994 seeks to provide practical answers to the most commonly asked questions: What is the place of radiation therapy versus chemotherapy for the treatment of these patients ? What are the approved indications of radiation therapy and which avenues of research are being explored ? Radiation therapy is used in over two-thirds of patients referred to an oncology department for a gastrointestinal tract tumor. The main indications are reviewed: cancer of the rectum and anal canal and, to a lesser extent, cancer of the esophagus and pancreas. The main focuses of current research include radiation therapy-chemotherapy combinations, intraoperative radiation therapy, and radiation therapy of hepatobiliary tumors. (authors). 23 refs., 1 fig

Assessment of patient radiation doses in chest X-ray examinations

International Nuclear Information System (INIS)

Orsini, S.; Scribano, V.S.; Merluzzi, F.; Tosca, L.

1987-01-01

The paper reports the initial results of a radioprotection programme for diagnostic radiology carried out in a major hospital in Milan. The data cover chest X-ray examinations. The dose values were obtained using different techniques, according to the specific diagnostic requirements in each departement. A wide radiation dose range was observed between the different techniques, with a ratio between maximum and minimum dose > 30 for the skin and the spine. The doses were however lower than those capable of inducing non-stochastic effects by about 10000 and were so low that the probability of a stochastics effect is minimal. Nevertheless, because chest X-rays are performed so frequently, it is recommended that radiologists take greater account of patient dose, as far as compatible with diagnostic requirements. Radiology technicians must strictly observe the regulations for radioprotection of the patient

Electron arc therapy: chest wall irradiation of breast cancer patients

International Nuclear Information System (INIS)

McNeely, L.K.; Jacobson, G.M.; Leavitt, D.D.; Stewart, J.R.

1988-01-01

From 1980 to October 1985 we treated 45 breast cancer patients with electron arc therapy. This technique was used in situations where optimal treatment with fixed photon or electron beams was technically difficult: long scars, recurrent tumor extending across midline or to the posterior thorax, or marked variation in depth of target tissue. Forty-four patients were treated following mastectomy: 35 electively because of high risk of local failure, and 9 following local recurrence. One patient with advanced local regional disease was treated primarily. The target volume boundaries on the chest wall were defined by a foam lined cerrobend cast which rested on the patient during treatment, functioning as a tertiary collimator. A variable width secondary collimator was used to account for changes in the radius of the thorax from superior to inferior border. All patients had computerized tomography performed to determine Internal Mammary Chain depth and chest wall thickness. Electron energies were selected based on these thicknesses and often variable energies over different segments of the arc were used. The chest wall and regional node areas were irradiated to 45 Gy-50 Gy in 5-6 weeks by this technique. The supraclavicular and upper axillary nodes were treated by a direct anterior photon field abutted to the superior edge of the electron arc field. Follow-up is from 10-73 months with a median of 50 months. No major complications were observed. Acute and late effects and local control are comparable to standard chest wall irradiation. The disadvantages of this technique are that the preparation of the tertiary field defining cast and CT treatment planning are labor intensive and expensive. The advantage is that for specific clinical situations large areas of chest wall with marked topographical variation can be optimally, homogeneously irradiated while sparing normal uninvolved tissues

The effect of pre-injury anti-platelet therapy on the development of complications in isolated blunt chest wall trauma: a retrospective study.

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Ceri Battle

Full Text Available INTRODUCTION: The difficulties in the management of the blunt chest wall trauma patient in the Emergency Department due to the development of late complications are well recognised in the literature. Pre-injury anti-platelet therapy has been previously investigated as a risk factor for poor outcomes following traumatic head injury, but not in the blunt chest wall trauma patient cohort. The aim of this study was to investigate pre-injury anti-platelet therapy as a risk factor for the development of complications in the recovery phase following blunt chest wall trauma. METHODS: A retrospective study was completed in which the medical notes were analysed of all blunt chest wall trauma patients presenting to a large trauma centre in Wales in 2012 and 2013. Using univariate and multivariable logistic regression analysis, pre-injury platelet therapy was investigated as a risk factor for the development of complications following blunt chest wall trauma. Previously identified risk factors were included in the analysis to address the influence of confounding. RESULTS: A total of 1303 isolated blunt chest wall trauma patients presented to the ED in Morriston Hospital in 2012 and 2013 with complications recorded in 144 patients (11%. On multi-variable analysis, pre-injury anti-platelet therapy was found to be a significant risk factor for the development of complications following isolated blunt chest wall trauma (odds ratio: 16.9; 95% confidence intervals: 8.2-35.2. As in previous studies patient age, number of rib fractures, chronic lung disease and pre-injury anti-coagulant use were also found to be significant risk factors. CONCLUSIONS: Pre-injury anti-platelet therapy is being increasingly used as a first line treatment for a number of conditions and there is a concurrent increase in trauma in the elderly population. Pre-injury anti-platelet therapy should be considered as a risk factor for the development of complications by clinicians managing

Surgical management of the radiated chest wall

International Nuclear Information System (INIS)

Arnold, P.G.; Pairolero, P.C.

1986-01-01

Fifty consecutive patients with radiation-related problems of the chest wall were treated between 1976 and 1984. There were 40 women and 10 men with an average age of 54 years (range 26 to 78 years). Twenty-three patients had radiation ulcers alone, 20 had recurrent cancer, and 7 had infected median sternotomy wounds. Thirty-six had skeletal resections and 44 had soft-tissue resections. The skeleton was reconstructed with Prolene mesh in 12 patients and with autogenous rib in 3. Sixty-three muscles were transposed in 43 patients. Twelve omental transpositions were performed (8 for primary treatment and 4 for salvage of a failed muscle flap). Hospitalization averaged 20.2 days. There was one operative death (at 29 days). Partial flap necrosis occurred in 10 patients. Mesh was removed in three patients. There were 14 late deaths, most from recurrent tumor. The remaining patients had well-healed wounds and a generally improved quality of life. We conclude that aggressive resection and reliable reconstruction are critical considerations in the surgical management of this perplexing clinical problem

Paediatrician awareness of radiation dose and inherent risks in chest imaging studies--a questionnaire study.

Science.gov (United States)

Heyer, Christoph M; Hansmann, Jan; Peters, Sören A; Lemburg, Stefan P

2010-11-01

To assess paediatricians' knowledge regarding radiation exposure of chest imaging. German paediatricians were surveyed using a questionnaire. Participants were asked to estimate effective dose (ED) of radiographs (CR) and computed tomography (CT). Further questions included dose-saving of paediatric CT-protocols, ALARA principle, and awareness of the link between radiation and cancer development. Length and type of occupation and amount of ordered procedures were evaluated. 137 paediatricians participated with 59% and 39% correctly estimating ED of an adult (0.01-0.1mSv) and newborn CR (0.01-0.1mSv), respectively. ED of an adult chest CT (1-10mSv) was underestimated by 28%, whereas ED of cardiac CT (10-100mSv) was underestimated by 54%. 35% of participants correctly estimated ED of a chest CT in an infant (10-100mSv) which was underestimated by 56%. Neither length nor type of occupation showed significant impact on dose estimations. 14% of paediatricians stated that MRI causes radiation, whereas 4% correctly estimated the potential of paediatric CT-protocols. 15% were familiar with the ALARA principle and 26% were aware of a publication concerning radiation and malignancy. Paediatricians demonstrated an increased level of awareness compared to previous surveys. However, estimation of ED of CT remained difficult. Increased information transfer and education seem pressing in the light of increasing radiological examinations. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of chest physiotherapy in the management of bronchiectasis

International Nuclear Information System (INIS)

Arif, M.; Bashir, M.S.

2014-01-01

Bronchiectasis is a chronic disease in which clearance of sputum is disturbed because bronchi dilated permanently. So for the clearance of sputum we have to use physiotherapy techniques such as postural drainage percussion and vibration (PDPY), active cycle of breathing technique (ACBT), autogenic drainage, positive expiratory pressure, high frequency chest wall oscillation. Objective: To determine the role of Chest Physical therapy intervention in the management of Bronchi ectasis. To compare the prognosis of bronchiectasis with and without chest physiotherapy. Methodology: Data was collected from Gulab Devi Chest Hospital, Lahore. A Randomized Control Trial (RCT) study method was used and 60 patients are studied. In this study, they were divided into 03 groups 1- Antibiotics Therapy 2-Chest Physical therapy 3-Antibiotics and Chest Physical therapy. Each group consistant. (author)

Radiation pneumonitis: a complication resulting from combined radiation and chemotherapy for early breast cancer

International Nuclear Information System (INIS)

Gez, E.; Sulkes, A.; Isacson, R.; Catane, R.; Weshler, Z.

1985-01-01

Described is a patient with early breast carcinoma who developed clinical radiation pneumonitis during primary radiation therapy and concomitant chemotherapy that included prednisone. This syndrome developed three days following abrupt steroid withdrawal. Retrieval of steroids brought complete resolution of the clinical and radiological findings. Although this syndrome is rare, it is recommended that steroid therapy in a patient previously irradiated to the chest be avoided

Radiation protection. Factors influencing compliance to referral guidelines in minor chest trauma

International Nuclear Information System (INIS)

Tack, Denis; Louage, Fabian; Muylem, Alain van; Howarth, Nigel; Gevenois, Pierre Alain

2018-01-01

To test the hypothesis that referral guidelines are not sufficiently known by prescribers and that medico-legal concerns could influence the prescription of radiographs in minor chest trauma. We submitted a questionnaire including a typical clinical history and questions on reasons for prescribing radiographs of the ribs in minor chest trauma to 112 prescriptors (33 residents, 18 surgeons, 7 internists, 24 general practitioners and 30 ER physicians). All accepted to participate. Comparisons were performed by Fisher's exact test followed by a post-hoc analysis and by a McNemar test. Fifty-eight percent of prescriptors proposed rib radiographs, most (89%) being unaware of the guidelines. Only 11% of them changed their intention to order radiographs after information on referral guidelines and radiation dose (P=0.057). The mean dose delivered by rib radiographs was 38 times higher than that of a chest X-ray. Legal and medico-legal concerns (requirements from insurance policies and avoidance of lawsuits) were the main reasons for requesting radiographs. Unsharpness of guidelines in addition to social and medico-legal issues, rather than medical reasons or the lack of knowledge of the guidelines, strongly influence the prescription of radiographs of the ribs in minor chest trauma. (orig.)

Approach to chest pain and acute myocardial infarction.

Science.gov (United States)

Pandie, S; Hellenberg, D; Hellig, F; Ntsekhe, M

2016-03-01

Patient history, physical examination, 12-lead electrocardiogram (ECG) and cardiac biomarkers are key components of an effective chest pain assessment. The first priority is excluding serious chest pain syndromes, namely acute coronary syndromes (ACSs), aortic dissection, pulmonary embolism, cardiac tamponade and tension pneumothorax. On history, the mnemonic SOCRATES (Site Onset Character Radiation Association Time Exacerbating/relieving factor and Severity) helps differentiate cardiac from non-cardiac pain. On examination, evaluation of vital signs, evidence of murmurs, rubs, heart failure, tension pneumothoraces and chest infections are important. A 12-lead ECG should be interpreted within 10 minutes of first medical contact, specifically to identify ST elevation myocardial infarction (STEMI). High-sensitivity troponins improve the rapid rule-out of myocardial infarction (MI) and confirmation of non-ST elevation MI (NSTEMI). ACS (STEMI and NSTEMI/unstable anginapectoris (UAP)) result from acute destabilisation of coronary atheroma with resultant complete (STEMI) or subtotal (NSTEMI/UAP) thrombotic coronary occlusion. The management of STEMI patients includes providing urgent reperfusion: primary percutaneous coronary intervention(PPCI) if available, deliverable within 60 - 120 minutes, and fibrinolysis if PPCI is not available. Essential adjunctive therapies include antiplatelet therapy (aspirin, P2Y12 inhibitors), anticoagulation (heparin or low-molecular-weight heparin) and cardiac monitoring.

Postmastectomy Electron Beam Chest Wall Irradiation in Women With Breast Cancer: A Clinical Step Toward Conformal Electron Therapy

International Nuclear Information System (INIS)

Kirova, Youlia M.; Campana, Francois; Fournier-Bidoz, Nathalie; Stilhart, Anne; Dendale, Remi; Bollet, Marc A.; Fourquet, Alain

2007-01-01

Purpose: Electron beam radiotherapy of the chest wall with or without lymph node irradiation has been used at the Institut Curie for >20 years. The purpose of this report was to show the latest improvements of our technique developed to avoid hot spots and improve the homogeneity. Methods and Materials: The study was split into two parts. A new electron irradiation technique was designed and compared with the standard one (dosimetric study). The dose distributions were calculated using our treatment planning software ISIS (Technologie Diffusion). The dose calculation was performed using the same calculation parameters for the new and standard techniques. Next, the early skin toxicity of our new technique was evaluated prospectively in the first 25 patients using Radiation Therapy Oncology Group criteria (clinical study). Results: The maximal dose found on the five slices was 53.4 ± 1.1 Gy for the new technique and 59.1 ± 2.3 Gy for the standard technique. The hot spots of the standard technique plans were situated at the overlap between the internal mammary chain and chest wall fields. The use of one unique field that included both chest wall and internal mammary chain volumes solved the problem of junction. To date, 25 patients have been treated with the new technique. Of these patients, 12% developed Grade 0, 48% Grade 1, 32% Grade 2, and 8% Grade 3 toxicity. Conclusions: This report describes an improvement in the standard postmastectomy electron beam technique of the chest wall. This new technique provides improved target homogeneity and conformality compared with the standard technique. This treatment was well tolerated, with a low rate of early toxicity events

Electron arc irradiation of the postmastectomy chest wall: clinical results

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Gaffney, David K; Prows, Janalyn; Leavitt, Dennis; Egger, Marlene J; Morgan, John G; Stewart, J Robert

1995-07-01

, and 12% telangectasia formation. Conclusion: These data demonstrate that local control with electron arc therapy of the postmastectomy chest wall is comparable to photon techniques. Acute radiation reactions are well tolerated and mostly of minor extent. A previous report demonstrated a significant reduction in the dose-volume relationship of the lung using the electron arc compared with two photon techniques. Consequently, with careful attention to treatment planning and dosimetry, electron arc therapy of the postmastectomy chest wall is safe and effective. The radiation dose to heart and lung is minimized without compromise on local control.

The physics of radiation therapy

CERN Document Server

Khan, Faiz M

2009-01-01

Dr. Khan's classic textbook on radiation oncology physics is now in its thoroughly revised and updated Fourth Edition. It provides the entire radiation therapy team—radiation oncologists, medical physicists, dosimetrists, and radiation therapists—with a thorough understanding of the physics and practical clinical applications of advanced radiation therapy technologies, including 3D-CRT, stereotactic radiotherapy, HDR, IMRT, IGRT, and proton beam therapy. These technologies are discussed along with the physical concepts underlying treatment planning, treatment delivery, and dosimetry. This Fourth Edition includes brand-new chapters on image-guided radiation therapy (IGRT) and proton beam therapy. Other chapters have been revised to incorporate the most recent developments in the field. This edition also features more than 100 full-color illustrations throughout.

Radiation therapy for prostate cancer

International Nuclear Information System (INIS)

Nakamura, Katsumasa

2001-01-01

In Japan, where the mortality rate of prostate cancer is lower than in Western countries, radical prostatectomy or hormonal therapy has been applied more frequently than radiation therapy. However, the number of patients with prostate cancer has been increasing recently and the importance of radiation therapy has rapidly been recognized. Although there have been no randomized trials, results from several institutions in Western countries suggest that similar results of cancer control are achieved with either radiation therapy or radical prostatectomy. For higher-risk cases, conformal high-dose therapy or adjuvant hormonal therapy is more appropriate. In this article, the results of radiation therapy for prostate cancer were reviewed, with a view to the appropriate choice of therapy in Japan. (author)

Radiation-induced pneumothorax

International Nuclear Information System (INIS)

Epstein, D.M.; Littman, P.; Gefter, W.B.; Miller, W.T.; Raney, R.B. Jr.

1983-01-01

Pneumothorax is an uncommon complication of radiation therapy to the chest. The proposed pathogenesis is radiation-induced fibrosis promoting subpleural bleb formation that ruptures resulting in pneumothorax. We report on two young patients with primary sarcomas without pulmonary metastases who developed spontaneous pneumothorax after irradiation. Neither patient had antecedent radiographic evidence of pulmonary fibrosis

Chest X-Ray

Medline Plus

Full Text Available ... exams and use a very small dose of ionizing radiation to produce pictures of the inside of the ... chest x-ray use a tiny dose of ionizing radiation, the benefit of an accurate diagnosis far outweighs ...

Radiation therapy

International Nuclear Information System (INIS)

Bader, J.L.; Glatstein, E.

1987-01-01

The radiation oncologist encounters the critically ill immunosuppressed patient in four settings. First, the newly diagnosed cancer patient presents for initial evaluation and treatment, with immunosuppression from the cancer itself, malnutrition, concomitant infectious disease, prior drug or alcohol abuse or other medical problems. Second, the previously treated cancer patient presents with metastatic or recurrent primary cancer causing local symptoms. Immune dysfunction in this setting may be due to prior chemotherapy and/or radiation as well as any of the original factors. Third, the patient previously treated with radiation presents with a life-threatening problem possibly due to complications of prior therapy. In this setting, the radiation oncologist is asked to evaluate the clinical problem and to suggest whether radiation might be causing part or all of the problem and what can be done to treat these sequelae of radiation. Fourth, the patient with a benign diagnosis (not cancer) is seen with a problem potentially emeliorated by radiation (e.g., kidney transplant rejection, preparation for transplant, or intractable rheumatoid arthritis). This chapter reviews these four issues and presents clinical and radiobiologic principles on which recommendations for therapy are based

Single-energy pediatric chest computed tomography with spectral filtration at 100 kVp: effects on radiation parameters and image quality

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Bodelle, Boris; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Kaup, Moritz; Beeres, Martin; Vogl, Thomas J.; Scholtz, Jan-Erik [Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany)

2017-06-15

Most of the applied radiation dose at CT is in the lower photon energy range, which is of limited diagnostic importance. To investigate image quality and effects on radiation parameters of 100-kVp spectral filtration single-energy chest CT using a tin-filter at third-generation dual-source CT in comparison to standard 100-kVp chest CT. Thirty-three children referred for a non-contrast chest CT performed on a third-generation dual-source CT scanner were examined at 100 kVp with a dedicated tin filter with a tube current-time product resulting in standard protocol dose. We compared resulting images with images from children examined using standard single-source chest CT at 100 kVp. We assessed objective and subjective image quality and compared radiation dose parameters. Radiation dose was comparable for children 5 years old and younger, and it was moderately decreased for older children when using spectral filtration (P=0.006). Effective tube current increased significantly (P=0.0001) with spectral filtration, up to a factor of 10. Signal-to-noise ratio and image noise were similar for both examination techniques (P≥0.06). Subjective image quality showed no significant differences (P≥0.2). Using 100-kVp spectral filtration chest CT in children by means of a tube-based tin-filter on a third-generation dual-source CT scanner increases effective tube current up to a factor of 10 to provide similar image quality at equivalent dose compared to standard single-source CT without spectral filtration. (orig.)

Single-energy pediatric chest computed tomography with spectral filtration at 100 kVp: effects on radiation parameters and image quality

International Nuclear Information System (INIS)

Bodelle, Boris; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Kaup, Moritz; Beeres, Martin; Vogl, Thomas J.; Scholtz, Jan-Erik

2017-01-01

Most of the applied radiation dose at CT is in the lower photon energy range, which is of limited diagnostic importance. To investigate image quality and effects on radiation parameters of 100-kVp spectral filtration single-energy chest CT using a tin-filter at third-generation dual-source CT in comparison to standard 100-kVp chest CT. Thirty-three children referred for a non-contrast chest CT performed on a third-generation dual-source CT scanner were examined at 100 kVp with a dedicated tin filter with a tube current-time product resulting in standard protocol dose. We compared resulting images with images from children examined using standard single-source chest CT at 100 kVp. We assessed objective and subjective image quality and compared radiation dose parameters. Radiation dose was comparable for children 5 years old and younger, and it was moderately decreased for older children when using spectral filtration (P=0.006). Effective tube current increased significantly (P=0.0001) with spectral filtration, up to a factor of 10. Signal-to-noise ratio and image noise were similar for both examination techniques (P≥0.06). Subjective image quality showed no significant differences (P≥0.2). Using 100-kVp spectral filtration chest CT in children by means of a tube-based tin-filter on a third-generation dual-source CT scanner increases effective tube current up to a factor of 10 to provide similar image quality at equivalent dose compared to standard single-source CT without spectral filtration. (orig.)

Optimisation of radiation dose and image quality in mobile neonatal chest radiography.

Science.gov (United States)

Hinojos-Armendáriz, V I; Mejía-Rosales, S J; Franco-Cabrera, M C

2018-05-01

To optimise the radiation dose and image quality for chest radiography in the neonatal intensive care unit (NICU) by increasing the mean beam energy. Two techniques for the acquisition of NICU AP chest X-ray images were compared for image quality and radiation dose. 73 images were acquired using a standard technique (56 kV, 3.2 mAs and no additional filtration) and 90 images with a new technique (62 kV, 2 mAs and 2 mm Al filtration). The entrance surface air kerma (ESAK) was measured using a phantom and compared between the techniques and against established diagnostic reference levels (DRL). Images were evaluated using seven image quality criteria independently by three radiologists. Images quality and radiation dose were compared statistically between the standard and new techniques. The maximum ESAK for the new technique was 40.20 μGy, 43.7% of the ESAK of the standard technique. Statistical evaluation demonstrated no significant differences in image quality between the two acquisition techniques. Based on the techniques and acquisition factors investigated within this study, it is possible to lower the radiation dose without any significant effects on image quality by adding filtration (2 mm Al) and increasing the tube potential. Such steps are relatively simple to undertake and as such, other departments should consider testing and implementing this dose reduction strategy within clinical practice where appropriate. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Radiation therapy in old patients. Side effects and results of radiation therapy in old patients

International Nuclear Information System (INIS)

Geinitz, H.; Zimmermann, F.B.; Molls, M.

1999-01-01

Background: Despite a growing number of elderly patients receiving radiation therapy little is known about side effects and outcome of irradiation in this section of the population. Methods: In a review article epidemiologic data, aspects of radiation-biology as well as side effects and outcome of radiation therapy of elderly patients are discussed. Results: Cancer incidence rises with age and is exceeding 3.5% for males older than 85 years. With a life expectancy of more than 4 years, curative therapy is indicated even at this age. Furthermore, several retrospective studies indicate that local control and disease-Specific survival after radiation therapy of elderly patients is comparable with that of younger persons. The exception contains elderly patients with grade-III to IV gliomas or with rectal carcinoma who show a reduced survival which is perhaps caused by less aggressive combined treatment (tumor resection). Although some biological and molecular data indicate a rise in radiation sensitivity with growing age like the reduction of the capacity of some DNA-repair enzymes, there is no convincing evidence in animal studies or in retrospective clinical studies that radiation therapy is generally less well tolerated by older individuals. Some age-depending differences in organ toxicities are described in 3 large studies, which evaluate the data of patients who were enrolled in different EORTC-trials: Older patients suffer more of functional mucositis in case of radiation therapy to the head and neck, they have an increased weight loss and a higher frequency of late esophageal damage when irradiated in the thorax, and they show a higher prevalence of sexual dysfunction when treated with radiation therapy to the pelvis. On the other hand younger patients suffer more from acute toxicity like skin damage, nausea, and deterioration of the performance status during pelvic radiotherapy. When discussing the dose intensity of radiation therapy concomitant disease which

Radiation therapy

International Nuclear Information System (INIS)

Peschel, R.E; Fisher, J.J.

1986-01-01

The new insights and controversies concerning the radiobiological properties of malignant melanoma and how these relate to new clinical approaches are reviewed. The recent clinical experience with large individual fraction sizes is analyzed. The treatment of malignant melanoma in certain specialized sites is also described. An attempt is made to place in perspective the usefulness of radiation therapy in the treatment of this complex disease. Finally, certain new applications for radiation therapy both alone and in combustion with other treatment modalities are proposed that may ultimately prove appropriate for clinical trials

Chemotherapy and molecular target therapy combined with radiation therapy

International Nuclear Information System (INIS)

Akimoto, Tetsuo

2012-01-01

Combined chemotherapy and radiation therapy has been established as standard treatment approach for locally advanced head and neck cancer, esophageal cancer and so on through randomized clinical trials. However, radiation-related morbidity such as acute toxicity also increased as treatment intensity has increased. In underlining mechanism for enhancement of normal tissue reaction in chemo-radiation therapy, chemotherapy enhanced radiosensitivity of normal tissues in addition to cancer cells. Molecular target-based drugs combined with radiation therapy have been expected as promising approach that makes it possible to achieve cancer-specific enhancement of radiosensitivity, and clinical trials using combined modalities have been performed to evaluate the feasibility and efficacy of this approach. In order to obtain maximum radiotherapeutic gain, a detailed understanding of the mechanism underlying the interaction between radiation and Molecular target-based drugs is indispensable. Among molecular target-based drugs, inhibitors targeting epidermal growth factor receptor (EGFR) and its signal transduction pathways have been vigorously investigated, and mechanisms regarding the radiosensitizing effect have been getting clear. In addition, the results of randomized clinical trials demonstrated that radiation therapy combined with cetuximab resulted in improvement of overall and disease-specific survival rate compared with radiation therapy in locally advanced head and neck cancer. In this review, clinical usefulness of chemo-radiation therapy and potential molecular targets for potentiation of radiation-induced cell killing are summarized. (author)

Radiation exposure to chest X-rays in the neonatal nursery

International Nuclear Information System (INIS)

Takeuchi, Toshio; Itabashi, Kazuo; Kawaguchi, Shigeru; Suzuka, Takahisa; Okuyama, Kazuo

1989-01-01

To measure how much very low birth-weight infants are exposed to chest X-rays during nursery, skin doses were calculated using phantoms under the same condition as that used in chest X-rays. Skin doses obtained were multiplied by the number of X-rays performed in 86 very low birth-weight infants (mean birth weight+-SD, 1163.0+-232.8 g; mean gestational age+-SD, 29.3+-3.0 week). Exposure doses per film ranged from 4.9 to 14.4 mR, with a mean dose of 6.1+-2.0 mR. Exposure doses per neonate ranged from 6.3 to 794.3 mR, with a mean dose of 170.4+-151.5 mR. The number of films per neonate ranged from one to 107, with a mean of 28.0+-24.9. Eighty-seven percent of X-rays were performed when the body weight was 1,500 g or less. Fourteen patients received 300 mR or more that may be the potential dose of radiation effects. (Namekawa, K)

Relationship between images of risk and anxiety toward radiation. Comparison of radiation from chest X-rays and nuclear power plants

International Nuclear Information System (INIS)

Matsui, Yuko

2003-01-01

In order to clarify the components of people's images of radiation risk and the determinants for the degree of anxiety about radiation exposure, an investigation was conducted. Two kinds of radiation, from nuclear power plants and during a chest X-ray, which are relatively familiar to people, were focused on. As a result, only a 'dread' factor was common to both radiation types of. Although the degree of anxiety toward both types of radiation showed a positive correlation with the 'dread' image, the anxiety toward X-ray radiation showed a negative correlation with the 'feeling of conquest'. Anxiety toward radiation from nuclear power plants had a negative correlation with 'control by experts'. These results suggest that the words radiation from nuclear power plants' evoke an image of a situation with high radiation exposure, which is beyond the experts' control abilities. (author)

[A Case of Central Diabetes Insipidus That Was Caused by Pituitary Metastasis of Lung Adenocarcinoma and Was Controlled by Radiation Therapy].

Science.gov (United States)

Izumi, Yusuke; Masuda, Takeshi; Nabeshima, Shinji; Horimasu, Yasushi; Nakashima, Taku; Miyamoto, Shintaro; Iwamoto, Hiroshi; Fujitaka, Kazunori; Murakami, Yuji; Hamada, Hironobu; Nagata, Yasushi; Hattori, Noboru

2017-06-01

Pituitary metastasis of lung cancer is rare; however, it often causes diabetes insipidus. Although the majority of such patients are treated with radiation therapy, it remains unclear whether diabetes insipidus can be controlled by radiation therapy. A 72-year-old man was admitted to our hospital for hemosputum, headache, and polyuria. A chest CT scan showed a 3.0 cm mass in the left upper lobe of his lung. Bronchofiberscopy results confirmed the pathological diagnosis of lung adenocarcinoma. Based on the findings from PET-CT, head MRI, and endocrine tests, the diagnosis of lung adenocarcinoma( cT1bN0M1b, stage IV)accompanied with central diabetes insipidus caused by pituitary metastasis was made. Oral administration of desmopressin reduced urine volumes; however, chemotherapy for achieving stable disease in the primary tumor was ineffective in controlling the symptoms of diabetes insipidus. Chemotherapy was discontinued after 4 months because of severe hematological toxicity. During 2 months after the cessation of chemotherapy, polyuria worsened and, therefore, radiation therapy for pituitary metastasis was started. Following the radiation therapy, an apparent reduction in urine volume was observed. Our experience of this case suggests that radiation therapy for pituitary metastasis should be considered at the time when diabetes insipidus becomes clinically overt.

A case of central diabetes insipidus that was caused by pituitary metastasis of lung adenocarcinoma and was controlled by radiation therapy

International Nuclear Information System (INIS)

Izumi, Yusuke; Masuda, Takeshi; Nabeshima, Shinji

2017-01-01

Pituitary metastasis of lung cancer is rare; however, it often causes diabetes insipidus. Although the majority of such patients are treated with radiation therapy, it remains unclear whether diabetes insipidus can be controlled by radiation therapy. A 72-year-old man was admitted to our hospital for hemosputum, headache, and polyuria. A chest CT scan showed a 3.0 cm mass in the left upper lobe of his lung. Bronchofiberscopy results confirmed the pathological diagnosis of lung adenocarcinoma. Based on the findings from PET-CT, head MRI, and endocrine tests, the diagnosis of lung adenocarcinoma (cT1bN0M1b, stage four) accompanied with central diabetes insipidus caused by pituitary metastasis was made. Oral administration of desmopressin reduced urine volumes; however, chemotherapy for achieving stable disease in the primary tumor was ineffective in controlling the symptoms of diabetes insipidus. Chemotherapy was discontinued after 4 months because of severe hematological toxicity. During 2 months after the cessation of chemotherapy, polyuria worsened and, therefore, radiation therapy for pituitary metastasis was started. Following the radiation therapy, an apparent reduction in urine volume was observed. Our experience of this case suggests that radiation therapy for pituitary metastasis should be considered at the time when diabetes insipidus becomes clinically overt. (author)

Indications for chest CT. Retrospective study of cases with normal chest CT

International Nuclear Information System (INIS)

Obata, Shiro

1995-01-01

The usefulness of computed tomography (CT) in thoracic radiology is now well appreciated, and the number of chest CTs has greatly increased. There are, however, many chest CT cases that are completely or almost completely normal. Indications for chest CT should be re-evaluated considering the cost and radiation exposure associated with the examination. Reviewing the reports of 4930 chest CT examinations performed in three hospitals during the period of two years, the author found 620 (12.6%) negative CT examinations. In 312 of the 620, the CT was requested because of 'abnormal shadow' on chest radiograph. When the same chest radiographs were re-evaluated by two radiologists, no abnormality was noted in 257 cases (82.4%). CT examinations were considered justified in only 55 cases (17.6%). There was a significant difference in the frequency of normal chest CT examinations between the university hospital and two other hospitals. The causes of false positive interpretation of chest radiographs were analyzed, and it was felt that fundamental knowledge necessary to interpret chest radiographs was lacking. The importance of close cooperation between clinicians and radiologists should be emphasized. (author)

Adjuvant radiation therapy versus surgery alone in operable breast cancer: long-term follow-up of a randomized clinical trial.

Science.gov (United States)

Rutqvist, L E; Pettersson, D; Johansson, H

1993-02-01

This paper presents long-term results from a randomized trial of pre- or postoperative megavoltage radiation therapy versus surgery alone in pre- and postmenopausal women with operable breast cancer. Treatment outcome after relapse among patients who developed loco-regional recurrences was also analyzed. A total of 960 patients were included in the trial. The mean follow-up was 16 years (range: 13-19 years). The radiation therapy was individually planned. It included the chest wall (and the breast in the preoperative cases) and the regional lymph nodes. The tumor dose was 45 Gy/5 weeks. No adjuvant systemic therapy was used. The results showed a significant benefit with radiation therapy in terms of recurrence-free survival during the entire follow-up period. There was also an overall survival difference-corresponding to a 16% reduction of deaths-in favor of the irradiated patients which, however, was not statistically significant (p = 0.09). Among those 169 patients who developed locoregional recurrences long-term control was only achieved in about one-third of the cases. This figure was similar among those who had received adjuvant radiation therapy (34%) compared to those initially treated with surgery alone (32%). This implied that the overall proportion of patients who eventually developed uncontrolled local disease was significantly higher among those initially allocated to surgery alone (16%) compared to those allocated to pre- or postoperative radiation therapy (6%, p < 0.01). These results suggest that local undertreatment may be deleterious in subgroups of patients.

Radiation dose and image quality in pediatric chest CT: effects of iterative reconstruction in normal weight and overweight children

International Nuclear Information System (INIS)

Yoon, Haesung; Kim, Myung-Joon; Shin, Hyun Joo; Kim, Hyun Gi; Lee, Mi-Jung; Yoon, Choon-Sik; Choi, Jiin

2015-01-01

New CT reconstruction techniques may help reduce the burden of ionizing radiation. To quantify radiation dose reduction when performing pediatric chest CT using a low-dose protocol and 50% adaptive statistical iterative reconstruction (ASIR) compared with age/gender-matched chest CT using a conventional dose protocol and reconstructed with filtered back projection (control group) and to determine its effect on image quality in normal weight and overweight children. We retrospectively reviewed 40 pediatric chest CT (M:F = 21:19; range: 0.1-17 years) in both groups. Radiation dose was compared between the two groups using paired Student's t-test. Image quality including noise, sharpness, artifacts and diagnostic acceptability was subjectively assessed by three pediatric radiologists using a four-point scale (superior, average, suboptimal, unacceptable). Eight children in the ASIR group and seven in the control group were overweight. All radiation dose parameters were significantly lower in the ASIR group (P < 0.01) with a greater than 57% dose reduction in overweight children. Image noise was higher in the ASIR group in both normal weight and overweight children. Only one scan in the ASIR group (1/40, 2.5%) was rated as diagnostically suboptimal and there was no unacceptable study. In both normal weight and overweight children, the ASIR technique is associated with a greater than 57% mean dose reduction, without significantly impacting diagnostic image quality in pediatric chest CT examinations. However, CT scans in overweight children may have a greater noise level, even when using the ASIR technique. (orig.)

Radiation dose and image quality in pediatric chest CT: effects of iterative reconstruction in normal weight and overweight children

Energy Technology Data Exchange (ETDEWEB)

Yoon, Haesung; Kim, Myung-Joon; Shin, Hyun Joo; Kim, Hyun Gi; Lee, Mi-Jung [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Seoul (Korea, Republic of); Yoon, Choon-Sik [Yonsei University College of Medicine, Department of Radiology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Choi, Jiin [Yonsei University College of Medicine, Biostatistics Collaboration Unit, Seoul (Korea, Republic of)

2015-03-01

New CT reconstruction techniques may help reduce the burden of ionizing radiation. To quantify radiation dose reduction when performing pediatric chest CT using a low-dose protocol and 50% adaptive statistical iterative reconstruction (ASIR) compared with age/gender-matched chest CT using a conventional dose protocol and reconstructed with filtered back projection (control group) and to determine its effect on image quality in normal weight and overweight children. We retrospectively reviewed 40 pediatric chest CT (M:F = 21:19; range: 0.1-17 years) in both groups. Radiation dose was compared between the two groups using paired Student's t-test. Image quality including noise, sharpness, artifacts and diagnostic acceptability was subjectively assessed by three pediatric radiologists using a four-point scale (superior, average, suboptimal, unacceptable). Eight children in the ASIR group and seven in the control group were overweight. All radiation dose parameters were significantly lower in the ASIR group (P < 0.01) with a greater than 57% dose reduction in overweight children. Image noise was higher in the ASIR group in both normal weight and overweight children. Only one scan in the ASIR group (1/40, 2.5%) was rated as diagnostically suboptimal and there was no unacceptable study. In both normal weight and overweight children, the ASIR technique is associated with a greater than 57% mean dose reduction, without significantly impacting diagnostic image quality in pediatric chest CT examinations. However, CT scans in overweight children may have a greater noise level, even when using the ASIR technique. (orig.)

Study on external beam radiation therapy

International Nuclear Information System (INIS)

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

1999-04-01

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

Study on external beam radiation therapy

Energy Technology Data Exchange (ETDEWEB)

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

1999-04-01

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

Radiation therapy for operable rectal cancer

International Nuclear Information System (INIS)

Bondar, G.V.; Semikoz, N.G.; Bashejev, V.Kh.; Borota, O.V.; Bondarenko, M.V.; Kiyashko, O.Yu.

2012-01-01

The authors present a review of the literature on modern tendencies of radiation therapy application to treatment of operable rectal cancer. Many randomized control studies compared the efficacy of combination of radiation therapy (pre-operative or post-operative) and surgery versus surgery only demonstrating various results. Meta-analysis of the data on efficacy of combination of radiation therapy and standard surgery revealed 22 randomized control studies (14 with pre-operative radiation therapy and 8 with post-operative radiation therapy) with total number of 8507 patients (Colorectal Cancer Collaborative Group, 2000). The use of combination treatment reduced the number of isolated locoregional relapses both with pre-operative (22.5 - 12.5 %; p < 0.00001) and post-operative radiation therapy (25.8 - 16.7 %; p - 0.00001). The influence on total survival was not significant (62 % vs. 63 %; p - 0.06).

Digital chest radiography

DEFF Research Database (Denmark)

Debess, Jeanne Elisabeth; Vejle-Sørensen, Jens Kristian; Thomsen, Henrik

,3 mAs and SID SID of 180 centimetres using a phantom and lithium fluoride thermo luminescence dosimeter (TLD). Dose to risk organs mamma, thyroid and colon are measured at different collimations with one-centimetre steps. TLD results are used to estimate dose reduction for different collimations...... at the conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

Job satisfaction among radiation therapy educators.

Science.gov (United States)

Swafford, Larry G; Legg, Jeffrey S

2007-01-01

Job satisfaction is one of the most consistent variables related to employee retention and is especially relevant considering the shortage of radiation therapists and radiation therapy educators in the United States. To investigate job satisfaction levels among radiation therapy educators certified by the American Registry of Radiologic Technologists and employed in programs accredited by the Joint Review Committee on Education in Radiologic Technology. The long form of the Minnesota Satisfaction Questionnaire (MSQ) was mailed to 158 radiation therapy educators to measure job satisfaction. Overall job satisfaction and subscales were calculated based on MSQ methodology. A total of 90 usable surveys were returned for a 56.9% response rate. With a "general satisfaction" score of 69.64, radiation therapy educators ranked in the lowest 25th percentile of the nondisabled norm scale for job satisfaction. Respondents reported higher degrees of job satisfaction on the moral values, social service and achievement subscales. Lower job satisfaction levels were associated with the company policies and practices, advancement and compensation subscales. Radiation therapy educators report low job satisfaction. Educational institutions must tailor recruitment and retention efforts to better reflect the positive aspects of being a radiation therapy educator. Furthermore, improving retention and recruitment efforts might help offset the current shortages of radiation therapy educators and, ultimately, clinical radiation therapists.

Radionuclide assessment of the effects of chest physical therapy on ventilation in cystic fibrosis

International Nuclear Information System (INIS)

DeCesare, J.A.; Babchyck, B.M.; Colten, H.R.; Treves, S.

1982-01-01

This study assesses the use of /sup 81m/Kr scintigraphy as a measurement tool in evaluating the effectiveness of bronchial drainage with percussion and vibration on peripheral ventilation in patients with cystic fibrosis. Ten patients with cystic fibrosis participated. Each patient underwent a /sup 81m/Kr ventilation study and traditional pulmonary function tests. Forty-five minutes later, these studies were repeated before and after a chest physical therapy treatment. Each patient acted as his own control. All /sup 81m/Kr scintiscans were recorded and analyzed visually and numerically using a digital computer to assess distribution of ventilation. Visual analysis of the scintiscans indicated individual variation in treatment response: in some patients ventilation improved with therapy; in others, no change was noted; still others had changes independent of treatment. Numerical data derived from the scintiscans and pulmonary function tests showed no important differences among the three studies of each patient. Airway abnormalities characteristic of cystic fibrosis, progression of the disease, sputum production, or a combination of these factors may account for the individual variation in response to treatment. /sup 81m/Kr scintigraphy is a reliable measure of regional ventilation and should be useful for assessing the efficacy of chest physical therapy because of the consistent, high quality visual data retrieved

Proton Arc Reduces Range Uncertainty Effects and Improves Conformality Compared With Photon Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Non-Small Cell Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Seco, Joao, E-mail: jseco@partners.org [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Gu, Guan; Marcelos, Tiago; Kooy, Hanne; Willers, Henning [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2013-09-01

Purpose: To describe, in a setting of non-small cell lung cancer (NSCLC), the theoretical dosimetric advantages of proton arc stereotactic body radiation therapy (SBRT) in which the beam penumbra of a rotating beam is used to reduce the impact of range uncertainties. Methods and Materials: Thirteen patients with early-stage NSCLC treated with proton SBRT underwent repeat planning with photon volumetric modulated arc therapy (Photon-VMAT) and an in-house-developed arc planning approach for both proton passive scattering (Passive-Arc) and intensity modulated proton therapy (IMPT-Arc). An arc was mimicked with a series of beams placed at 10° increments. Tumor and organ at risk doses were compared in the context of high- and low-dose regions, represented by volumes receiving >50% and <50% of the prescription dose, respectively. Results: In the high-dose region, conformality index values are 2.56, 1.91, 1.31, and 1.74, and homogeneity index values are 1.29, 1.22, 1.52, and 1.18, respectively, for 3 proton passive scattered beams, Passive-Arc, IMPT-Arc, and Photon-VMAT. Therefore, proton arc leads to a 30% reduction in the 95% isodose line volume to 3-beam proton plan, sparing surrounding organs, such as lung and chest wall. For chest wall, V30 is reduced from 21 cm{sup 3} (3 proton beams) to 11.5 cm{sup 3}, 12.9 cm{sup 3}, and 8.63 cm{sup 3} (P=.005) for Passive-Arc, IMPT-Arc, and Photon-VMAT, respectively. In the low-dose region, the mean lung dose and V20 of the ipsilateral lung are 5.01 Gy(relative biological effectiveness [RBE]), 4.38 Gy(RBE), 4.91 Gy(RBE), and 5.99 Gy(RBE) and 9.5%, 7.5%, 9.0%, and 10.0%, respectively, for 3-beam, Passive-Arc, IMPT-Arc, and Photon-VMAT, respectively. Conclusions: Stereotactic body radiation therapy with proton arc and Photon-VMAT generate significantly more conformal high-dose volumes than standard proton SBRT, without loss of coverage of the tumor and with significant sparing of nearby organs, such as chest wall. In addition

Bolus electron conformal therapy for the treatment of recurrent inflammatory breast cancer: a case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Michelle M., E-mail: mmkim@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Kudchadker, Rajat J.; Kanke, James E.; Zhang, Sean; Perkins, George H. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

2012-07-01

The treatment of locoregionally recurrent breast cancer in patients who have previously undergone radiation therapy is challenging. Special techniques are often required that both eradicate the disease and minimize the risks of retreatment. We report the case of a patient with an early-stage left breast cancer who developed inflammatory-type recurrence requiring re-irradiation of the chest wall using bolus electron conformal therapy with image-guided treatment delivery. The patient was a 51-year-old woman who had undergone lumpectomy, axillary lymph node dissection, and adjuvant whole-breast radiation therapy for a stage I left breast cancer in June 1998. In March 2009, she presented at our institution with biopsy-proven recurrent inflammatory carcinoma and was aggressively treated with multi-agent chemotherapy followed by mastectomy that left a positive surgical margin. Given the patient's prior irradiation and irregular chest wall anatomy, bolus electron conformal therapy was used to treat her chest wall and draining lymphatics while sparing the underlying soft tissue. The patient still had no evidence of disease 21 months after treatment. Our results indicate that bolus electron conformal therapy is an accessible, effective radiation treatment approach for recurrent breast cancer in patients with irregular chest wall anatomy as a result of surgery. This approach may complement standard techniques used to reduce locoregional recurrence in the postmastectomy setting.

Basal cell carcinoma after radiation therapy

International Nuclear Information System (INIS)

Shimbo, Keisuke; Terashi, Hiroto; Ishida, Yasuhisa; Tahara, Shinya; Osaki, Takeo; Nomura, Tadashi; Ejiri, Hirotaka

2008-01-01

We reported two cases of basal cell carcinoma (BCC) that developed after radiation therapy. A 50-year-old woman, who had received an unknown amount of radiation therapy for the treatment of intracranial germinoma at the age of 22, presented with several tumors around the radiation ulcer. All tumors showed BCC. A 33-year-old woman, who had received an unknown amount of radiation therapy on the head for the treatment of leukemia at the age of 2, presented with a black nodule within the area of irradiation. The tumor showed BCC. We discuss the occurrence of BCC after radiation therapy. (author)

Bilateral implant reconstruction does not affect the quality of postmastectomy radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Ho, Alice Y., E-mail: hoa1234@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Patel, Nisha [Drexel University College of Medicine, Philadelphia, PA (United States); Ohri, Nisha [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Morrow, Monica [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Mehrara, Babak J.; Disa, Joseph J.; Cordeiro, Peter G. [Department of Plastic Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Shi, Weiji; Zhang, Zhigang [Department of Biostatistics and Epidemiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Gelblum, Daphna [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Nerbun, Claire T.; Woch, Katherine M.; Ballangrud, Ase [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); McCormick, Beryl; Powell, Simon N. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

2014-04-01

To determine if the presence of bilateral implants, in addition to other anatomic and treatment-related variables, affects coverage of the target volume and dose to the heart and lung in patients receiving postmastectomy radiation therapy (PMRT). A total of 197 consecutive women with breast cancer underwent mastectomy and immediate tissue expander (TE) placement, with or without exchange for a permanent implant (PI) before radiation therapy at our center. PMRT was delivered with 2 tangential beams + supraclavicular lymph node field (50 Gy). Patients were grouped by implant number: 51% unilateral (100) and 49% bilateral (97). The planning target volume (PTV) (defined as implant + chest wall + nodes), heart, and ipsilateral lung were contoured and the following parameters were abstracted from dose-volume histogram (DVH) data: PTV D{sub 95%} > 98%, Lung V{sub 20}Gy > 30%, and Heart V{sub 25}Gy > 5%. Univariate (UVA) and multivariate analyses (MVA) were performed to determine the association of variables with these parameters. The 2 groups were well balanced for implant type and volume, internal mammary node (IMN) treatment, and laterality. In the entire cohort, 90% had PTV D{sub 95%} > 98%, indicating excellent coverage of the chest wall. Of the patients, 27% had high lung doses (V{sub 20}Gy > 30%) and 16% had high heart doses (V{sub 25}Gy > 5%). No significant factors were associated with suboptimal PTV coverage. On MVA, IMN treatment was found to be highly associated with high lung and heart doses (both p < 0.0001), but implant number was not (p = 0.54). In patients with bilateral implants, IMN treatment was the only predictor of dose to the contralateral implant (p = 0.001). In conclusion, bilateral implants do not compromise coverage of the target volume or increase lung and heart dose in patients receiving PMRT. The most important predictor of high lung and heart doses in patients with implant-based reconstruction, whether unilateral or bilateral, is treatment of

Technical advances in radiation therapy

International Nuclear Information System (INIS)

Sause, W.T.

1986-01-01

Substantial advances have been made in radiation therapy. Many of these advances can be applied in most radiation therapy departments without expensive improvements in equipment. Changes in radiation fractionation, chemotherapeutic sensitization, intraoperative radiation, and interstitial implants can be performed with experience and improved physician training in most medium-sized departments. Advances that require investments in expensive equipment such as particle radiation and hyperthermia will need to be evaluated at designated treatment centers. 106 references

Radiation therapy sources, equipment and installations

International Nuclear Information System (INIS)

2011-03-01

The safety code for Telegamma Therapy Equipment and Installations, (AERB/SC/MED-1) and safety code for Brachytherapy Sources, Equipment and Installations, (AERB/SC/MED-3) were issued by AERB in 1986 and 1988 respectively. These codes specified mandatory requirements for radiation therapy facilities, covering the entire spectrum of operations ranging from the setting up of a facility to its ultimate decommissioning, including procedures to be followed during emergency situations. The codes also stipulated requirements of personnel and their responsibilities. With the advent of new techniques and equipment such as 3D-conformal radiation therapy, intensity modulated radiation therapy, image guided radiation therapy, treatment planning system, stereotactic radiosurgery, stereotactic radiotherapy, portal imaging, integrated brachytherapy and endovascular brachytherapy during the last two decades, AERB desires that these codes be revised and merged into a single code titled Radiation Therapy Sources, Equipment, and Installations

Radiation Therapy Side Effects

Science.gov (United States)

Radiation therapy has side effects because it not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. Many people who get radiation therapy experience fatigue. Other side effects depend on the part of the body that is being treated. Learn more about possible side effects.

Skeletal sequelae of radiation therapy for malignant childhood tumors

International Nuclear Information System (INIS)

Butler, M.S.; Robertson, W.W. Jr.; Rate, W.; D'Angio, G.J.; Drummond, D.S.

1990-01-01

One hundred forty-three patients who received radiation therapy for childhood tumors, and survived to the age of skeletal maturity, were studied by retrospective review of oncology records and roentgenograms. Diagnoses for the patients were the following: Hodgkin's lymphoma (44), Wilms's tumor (30), acute lymphocytic leukemia (26), non-Hodgkin's lymphoma (18), Ewing's sarcoma (nine), rhabdomyosarcoma (six), neuroblastoma (six), and others (four). Age at the follow-up examination averaged 18 years (range, 14-28 years). Average length of follow-up study was 9.9 years (range, two to 18 years). Asymmetry of the chest and ribs was seen in 51 (36%) of these children. Fifty (35%) had scoliosis; 14 had kyphosis. In two children, the scoliosis was treated with a brace, while one developed significant kyphosing scoliosis after laminectomy and had spinal fusion. Twenty-three (16%) patients complained of significant pain at the radiation sites. Twelve of the patients developed leg-length inequality; eight of those were symptomatic. Three patients developed second primary tumors. Currently, the incidence of significant skeletal sequelae is lower and the manifestations are less severe than reported in the years from 1940 to 1970. The reduction in skeletal complications may be attributed to shielding of growth centers, symmetric field selection, decreased total radiation doses, and sequence changes in chemotherapy

Internal Radiation Therapy for Cancer

Science.gov (United States)

When getting internal radiation therapy, a source of radiation is put inside your body, in either liquid or solid form. It can be used treat different kinds of cancer, including thyroid, head and neck, breast, cervix, prostate, and eye. Learn more about how what to expect when getting internal radiation therapy.

Nonsurgical treatment for cancer using radiation therapy

International Nuclear Information System (INIS)

Ogi, Yasuo

2012-01-01

The number of people who are dying from cancer has been increasing in association with population aging. Radiation therapy is now one of the three major cancer treatment methods, along with surgery and chemotherapy. People used to consider radiation therapy only as a ''noninvasive cancer treatment''; however, with the ceaseless effort by medical experts and corporations, different radiation therapy types and techniques including the latest technical advances have come out one after another, and the improvements in radiation therapies have provided treatments that are not only less traumatizing to patients but also as effective and therapeutic as surgery in certain body regions. The importance of radiation therapy has become and will become even greater in the society with more elderly cancer patients who do not have the physical strength to undergo surgery. In this article, the history of radiation therapy, rapidly developed high-precision radiation therapy techniques, and unsolved issues are discussed, and then, ''MHI vero4DRT'', which is the high-precision image-guided radiation therapy equipment developed for solving such issues, is introduced. (author)

Radiation Therapy - Multiple Languages

Science.gov (United States)

... W XYZ List of All Topics All Radiation Therapy - Multiple Languages To use the sharing features on this page, ... Information Translations Vietnamese (Tiếng Việt) Expand Section Radiation Therapy - Tiếng Việt (Vietnamese) ... Health Information Translations Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

Different Approaches in Radiation Therapy

Directory of Open Access Journals (Sweden)

Rolf-Dieter eKortmann

2011-12-01

Full Text Available Radiation therapy is a cornerstone in the therapeutic management of craniopharyngioma. The close proximity to neighbouring eloquent structures pose a particular challenge to radiation therapy. Modern treatment technologies including fractionated 3-d conformal radiotherapy, intensity modulated radiation therapy and recently proton therapy are able to precisely cover the target while preserving surrounding tissue,Tumour controls between 80 and in access of 90 % can be achieved. Alternative treatments consisting of radiosurgery, intracavitary application of isotopes and brachytherapy also offer an acceptable tumour control and might be given in selected cases. More research is needed to establish the role of each treatment modality.

A multicenter investigation of late adverse events in Japanese women treated with breast-conserving surgery plus conventional fractionated whole-breast radiation therapy

International Nuclear Information System (INIS)

Nozaki, Miwako; Kagami, Yoshikazu; Mitsumori, Michihide; Hiraoka, Masahiro

2012-01-01

The objective of this study was to investigate late adverse events in Japanese women treated with breast-conserving surgery plus conventional fractionated radiation therapy in 24 hospitals. This is a prospective investigation into patients who have been followed for 3 years or more after the completion of radiation therapy. The women visited hospitals for routine medical follow-up between 1 March and 31 May 2008. All patients underwent interviews and visual/palpating examinations. Their clinical chart, past chest X-rays and laboratory findings were reviewed. Evaluation criteria for late adverse events and breast cosmetic outcome were based on the Common Terminology Criteria for Adverse Events v.3 and the European Organization for Research and Treatment of Cancer Global Cosmetic Rating System. Seven hundred and three women, including 448 treated with whole-breast irradiation and 255 treated with whole-breast and boost irradiation, were examined by radiation oncologists in 24 hospitals. The frequent adverse events were breast pain (Grade 1, 115; Grade 2, 2), breast fibrosis (Grade 1, 72; Grade 2, 8), chest wall pain (Grade 1, 67; Grade 2, 3), telangiectasia (Grade 1, 29; Grade 2, 5) and pneumonitis (Grade 1, 20; Grade 2, 6; Grade 3, 3). Adverse events of Grade 2 or 3 were found in 27 patients (3.8%); 3 presented with radiation pneumonitis of Grade 3. The percentage of patients with an excellent or good cosmetic outcome was 69.1%. In the first multicenter investigation for Japanese women after breast-conserving therapy, the evaluation of late adverse events and breast cosmetic outcome was similar to several other reports from clinical trials in North America and Europe. (author)

Modern Radiation Therapy for Hodgkin Lymphoma

DEFF Research Database (Denmark)

Specht, Lena; Yahalom, Joachim; Illidge, Tim

2014-01-01

Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced...... on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy......, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom...

Radiation therapy for gastric cancer

International Nuclear Information System (INIS)

Dobelbower, R.R.; Bagne, F.; Ajlouni, M.I.; Milligan, A.J.

1988-01-01

Adenocarcinoma of the stomach is a moderately radioresponsive neoplasm. Attempts to treat patients with unresectable disease with external beam radiation therapy alone have generally failed because of problems with tumor localization and adequate dose delivery as well as the inherent radioresponsiveness of the gastric mucosa and the organs intimately related to the stomach. Combining external beam therapy and chemotherapy (acting as a systemic agent and as a radiosensitizer) seems to be of some (albeit limited) benefit in the management of unresectable adenocarcinoma of the stomach. Optimum combinations of radiation therapy, chemotherapy, and radiation sensitizers in this situation remain to be determined. The authors discuss strides which have been made in the treatment of gastric cancer. They also address the unanswered clinical questions which remain regarding the use of radiation therapy in the treatment of this highly lethal disease

Why do patients drop out during radiation therapy?

International Nuclear Information System (INIS)

Huh, Seung Jae; Ahn, Yong Chan; Kim, Dae Yong; Shin, Kyung Hwan; Lee, Kyu Chan; Chong, Won A; Kim, Hyun Joo; Wu, Hong Gyun

1998-01-01

This study is to see how much proportion of the patients receiving radiation therapy drop out during radiation therapy and to analyze the reason for the incomplete treatment. The base population of this study was 1,100 patients with registration numbers 901 through 2,000 at Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea. Authors investigated the incidence of incomplete radiation therapy, which was defined as less than 95% of initially planned radiation dose, and the reasons for incomplete radiation therapy. One hundred and twenty eight patients (12%) did not complete the planned radiation therapy. The performance status of the incompletely treated patients was generally poorer than that of the base population, and the aim of radiation therapy was more commonly palliative. The most common reason for not completing the planned treatment was the patients' refusal of further radiation therapy because of the distrust of radiation therapy and/or the poor economic status. Careful case selection for radiation therapy with consideration of the socioeconomic status of the patients in addition to the clinical indication would be necessary for the reduction of incomplete treatment, especially in the palliative setting

42 CFR 410.35 - X-ray therapy and other radiation therapy services: Scope.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false X-ray therapy and other radiation therapy services... Other Health Services § 410.35 X-ray therapy and other radiation therapy services: Scope. Medicare Part B pays for X-ray therapy and other radiation therapy services, including radium therapy and...

The effects of topical heat therapy on chest pain in patients with acute coronary syndrome: a randomised double-blind placebo-controlled clinical trial.

Science.gov (United States)

Mohammadpour, Ali; Mohammadian, Batol; Basiri Moghadam, Mehdi; Nematollahi, Mahmoud Reza

2014-12-01

To investigate the effects of local heat therapy on chest pain in patients with acute coronary syndrome. Chest pain is a very common complaint in patients with acute coronary syndrome. It is managed both pharmacologically and nonpharmacologically. Pharmacological pain management is associated with different side effects. This was a randomised double-blind placebo-controlled clinical trial conducted in 2013. A convenience sample of 66 patients with acute coronary syndrome was selected from a coronary care unit of a local teaching hospital affiliated to Gonabad University of Medical Sciences, Gonabad, Iran. Patients were randomly assigned to either the experimental or the placebo group. Patients in the experimental and the placebo groups received local heat therapy using a hot pack warmed to 50 and 37 °C, respectively. We assessed chest pain intensity, duration and frequency as well as the need for opioid analgesic therapy both before and after the study. The study instrument consisted of a demographic questionnaire, the McGill Pain Questionnaire, and a data sheet for documenting pain frequency and duration as well as the need for analgesic therapy. The placebo heat therapy did not significantly decrease the intensity, the duration and the frequency of pain episodes. However, pain intensity, duration and frequency in the experimental group decreased significantly after the study. Moreover, the groups differed significantly in terms of the need for opioid analgesic therapy neither before nor after the intervention. Local heat therapy is an effective intervention for preventing and relieving chest pain in patients with acute coronary syndrome. Effective pain management using local heat therapy could help nurses play an important role in providing effective care to patients with acute coronary syndrome and in minimising adverse effects associated with pain medications. © 2014 John Wiley & Sons Ltd.

Radiation Therapy for Cancer

Science.gov (United States)

Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. Learn about the types of radiation, why side effects happen, which ones you might have, and more.

Calculation of the Cardiothoracic Ratio from Portable Anteroposterior Chest Radiography

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Chon, Sung Bin; Oh, Won Sup; Cho, Jun Hwi; Kim, Sam Soo

2011-01-01

Cardiothoracic ratio (CTR), the ratio of cardiac diameter (CD) to thoracic diameter (TD), is a useful screening method to detect cardiomegaly, but is reliable only on posteroanterior chest radiography (chest PA). We performed this cross-sectional 3-phase study to establish reliable CTR from anteroposterior chest radiography (chest AP). First, CDChest PA/CDChest AP ratios were determined at different radiation distances by manipulating chest computed tomography to simulate chest PA and AP. CDChest PA was inferred from multiplying CDChest AP by this ratio. Incorporating this CD and substituting the most recent TDChest PA, we calculated the 'corrected' CTR and compared it with the conventional one in patients who took both the chest radiographies. Finally, its validity was investigated among the critically ill patients who performed portable chest AP. CDChest PA/CDChest AP ratio was {0.00099 × (radiation distance [cm])} + 0.79 (n = 61, r = 1.00, P chest AP with an available previous chest PA. This might help physicians detect congestive cardiomegaly for patients undergoing portable chest AP. PMID:22065900

Radiation therapy of thoracic and abdominal tumors

International Nuclear Information System (INIS)

LaRue, S.M.; Gillette, S.M.; Poulson, J.M.

1995-01-01

Until recently, radiotherapy of thoracic and abdominal tumors in animals has been limited. However, the availability of computerized tomography and other imaging techniques to aid in determining the extent of tumor, an increase in knowledge of dose tolerance of regional organs, the availability of isocentrically mounted megavoltage machines, and the willingness of patients to pursue more aggressive treatment is making radiation therapy of tumors in these regions far more common. Tumor remission has been reported after radiation therapy of thymomas. Radiation therapy has been used to treat mediastinal lymphoma refractory to chemotherapy, and may be beneficial as part of the initial treatment regimen for this disease. Chemodectomas are responsive to radiation therapy in human patients, and favorable response has also been reported in dogs. Although primary lung tumors in dogs are rare, in some cases radiation therapy could be a useful primary or adjunctive therapy. Lung is the dose-limiting organ in the thorax. Bladder and urethral tumors in dogs have been treated using intraoperative and external-beam radiation therapy combined with chemotherapy. These tumors are difficult to control locally with surgery alone, although the optimal method of combining treatment modalities has not been established. Local control of malignant perianal tumors is also difficult to achieve with surgery alone, and radiation therapy should be used. Intraoperative radiation therapy combined with external-beam radiation therapy has been used for the management of metastatic carcinoma to the sublumbar lymph nodes. Tolerance of retroperitoneal tissues may be decreased by disease or surgical manipulation

Dichotomy between theory and practice in chest radiography and its impact on students.

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Botwe, Benard O; Arthur, Lawrence; Tenkorang, Michael K K; Anim-Sampong, Samuel

2017-06-01

It is important that theory is synchronous with clinical practices that students engage in. Lack of congruence between theory and practice presents serious problems to students. This study was therefore conducted to determine if there was a theory-practice gap in chest radiography during clinical rotations, and any associated causes and effects on radiography students. A descriptive survey design was used to conduct this study from 2 February to 27 July 2014. A semi-structured questionnaire consisting of open- and close-ended questions was used to purposively collect data from 26 radiography students in Ghana who had completed theory lessons in chest radiography and had either completed or were undertaking clinical rotations in chest radiography. Twenty-five (96%) respondents indicated the presence of theory-practice gap in chest radiography during clinical rotations, where differences between theory and clinical practice were observed. Lack of working materials 16 (62%), heavy workload 14 (54%), equipment breakdowns 14 (54%) and supervisory factors 11 (43%) were identified as the causes. Many students (81%) experienced diverse adverse effects such as confusion 10 (38%), poor performance during clinical examinations 6 (23%) and entire loss of interest in the professional training 1 (4%) of this dichotomy. Dichotomy between theory and practice found in chest radiography has diverse adverse effects on students. Regular feedback on the quality of clinical practice received by students should be encouraged to determine the existence of any gaps between theory and practice in order to promote effective clinical rotation programmes in radiography. © 2016 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans.

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Wojcieszynski, Andrzej P; Hill, Patrick M; Rosenberg, Stephen A; Hullett, Craig R; Labby, Zacariah E; Paliwal, Bhudatt; Geurts, Mark W; Bayliss, R Adam; Bayouth, John E; Harari, Paul M; Bassetti, Michael F; Baschnagel, Andrew M

2017-06-01

Magnetic resonance imaging-guided radiation therapy has entered clinical practice at several major treatment centers. Treatment of early-stage non-small cell lung cancer with stereotactic body radiation therapy is one potential application of this modality, as some form of respiratory motion management is important to address. We hypothesize that magnetic resonance imaging-guided tri-cobalt-60 radiation therapy can be used to generate clinically acceptable stereotactic body radiation therapy treatment plans. Here, we report on a dosimetric comparison between magnetic resonance imaging-guided radiation therapy plans and internal target volume-based plans utilizing volumetric-modulated arc therapy. Ten patients with early-stage non-small cell lung cancer who underwent radiation therapy planning and treatment were studied. Following 4-dimensional computed tomography, patient images were used to generate clinically deliverable plans. For volumetric-modulated arc therapy plans, the planning tumor volume was defined as an internal target volume + 0.5 cm. For magnetic resonance imaging-guided plans, a single mid-inspiratory cycle was used to define a gross tumor volume, then expanded 0.3 cm to the planning tumor volume. Treatment plan parameters were compared. Planning tumor volumes trended larger for volumetric-modulated arc therapy-based plans, with a mean planning tumor volume of 47.4 mL versus 24.8 mL for magnetic resonance imaging-guided plans ( P = .08). Clinically acceptable plans were achievable via both methods, with bilateral lung V20, 3.9% versus 4.8% ( P = .62). The volume of chest wall receiving greater than 30 Gy was also similar, 22.1 versus 19.8 mL ( P = .78), as were all other parameters commonly used for lung stereotactic body radiation therapy. The ratio of the 50% isodose volume to planning tumor volume was lower in volumetric-modulated arc therapy plans, 4.19 versus 10.0 ( P guided tri-cobalt-60 radiation therapy is capable of delivering lung high

Risk analysis of external radiation therapy

International Nuclear Information System (INIS)

Arvidsson, Marcus

2011-09-01

External radiation therapy is carried out via a complex treatment process in which many different groups of staff work together. Much of the work is dependent on and in collaboration with advanced technical equipment. The purpose of the research task has been to identify a process for external radiation therapy and to identify, test and analyze a suitable method for performing risk analysis of external radiation therapy

Gene expression profiles in cervical cancer with radiation therapy alone and chemo-radiation therapy

International Nuclear Information System (INIS)

Lee, Kyu Chan; Kim, Joo Young; Hwang, You Jin; Kim, Meyoung Kon; Choi, Myung Sun; Kim, Chul Young

2003-01-01

To analyze the gene expression profiles of uterine cervical cancer, and its variation after radiation therapy, with or without concurrent chemotherapy, using a cDNA microarray. Sixteen patients, 8 with squamous cell carcinomas of the uterine cervix, who were treated with radiation alone, and the other 8 treated with concurrent chemo-radiation, were included in the study. Before the starting of the treatment, tumor biopsies were carried out, and the second time biopsies were performed after a radiation dose of 16.2-27 Gy. Three normal cervix tissues were used as a control group. The microarray experiments were performed with 5 groups of the total RNAs extracted individually and then admixed as control, pre-radiation therapy alone, during-radiation therapy alone, pre-chemoradiation therapy, and during chemoradiation therapy. The 33P-labeled cDNAs were synthesized from the total RNAs of each group, by reverse transcription, and then they were hybridized to the cDNA microarray membrane. The gene expression of each microarrays was captured by the intensity of each spot produced by the radioactive isotopes. The pixels per spot were counted with an Arrayguage, and were exported to Microsoft Excel. The data were normalized by the Z transformation, and the comparisons were performed on the Z-ratio values calculated. The expressions of 15 genes, including integrin linked kinase (ILK), CDC28 protein kinase 2, Spry 2, and ERK 3, were increased with the Z-ratio values of over 2.0 for the cervix cancer tissues compared to those for the normal controls. Those genes were involved in cell growth and proliferation, cell cycle control, or signal transduction. The expressions of the other 6 genes, including G protein coupled receptor kinase 6, were decreased with the Z-ratio values of below -2.0. After the radiation therapy, most of the genes, with a previously increase expressions, represented the decreased expression profiles, and the genes, with the Z-ratio values of over 2.0, were

Three-dimensional conformal radiation therapy: the tomo-therapy approach

International Nuclear Information System (INIS)

Linthout, N.; Verellen, D.; Coninck, P. de; Bel, A.; Storme, G.

2000-01-01

Conformal radiation therapy allows the possibility of delivering high doses at the tumor volume whilst limiting the dose to the surrounding tissues and diminishing the secondary effects. With the example of the conformal radiation therapy used at the AZ VU8 (3DCRT and tomo-therapy), two treatment plans of a left ethmoid carcinoma will be evaluated and discussed in detail. The treatment of ethmoid cancer is technically difficult for both radiation therapy and surgery because of the anatomic constraints and patterns of local spread. A radiation therapy is scheduled to be delivered after surgical resection of the tumor. The treatment plan for the radiation therapy was calculated on a three-dimensional (3D) treatment planning system based on virtual simulation with a beam's eye view: George Sherouse's Gratis. An effort was made to make the plan as conformal and as homogeneous as possible to deliver a dose of 66 Gy in 33 fractions at the tumor bed with a maximum dose of 56 Gy to the right optic nerve and the chiasma. To establish the clinical utility and potential advantages of tomo-therapy over 3DCRT for ethmoid carcinoma, the treatment of this patient was also planned with Peacock Plant. For both treatment plans the isodose distributions and cumulative dose volume histograms (CDVH) were computed. Superimposing the CDVHs yielded similar curves for the target and an obvious improvement for organs at risk such as the chiasma, brainstem and the left eye when applying tomo-therapy. These results have also been reflected in the tumor control probabilities (equal for both plans) and the normal tissue complication probabilities (NTCP), yielding significant reductions in NTCP for tomo-therapy. The probability of uncomplicated tumor control was 52.7% for tomo-therapy against 38.3% for 3DCRT. (authors)

Radiation-hygienic assessment of theroid exposure in children resulted from X-ray examination of chest organs

International Nuclear Information System (INIS)

Kostenetskij, M.I.

1983-01-01

Radiation doses for thyroid in children in the case of X-ray examination of chest organs with the aim of optimization of investigation regimes are studied. Dosimetric measurements are performed in aqueous plexiglass phantoms imitating children of different age. It is shown that the maximum radiation dose for thyroid is registered in breast-fed children and constitutes, about 50% of the annual radiation background; in the older age it constiturotes 8-10% of the natural annual radiation backgund. The increase of intensity at the X-ray tube with the simultaneous decrease of explosure in the case of constant filtration of radiation gives the increase of radiation dose of thyroid in breast-fed children are inconsiderable; in older children, approximately in 1.7 times

Protection of the patient in radiation therapy

International Nuclear Information System (INIS)

1991-01-01

In the ICRP report (ICRP-Pub-44) a broad picture of radiotheraphy is presented useful to all involved in the care of cancer patients, for instance to physicians, including medical oncologists, and to medical physicists, radiographers, dosimetrists, and administrators. Information is given on the general principles of radiation therapy including external beam therapy and brachytherapy; the accuracy of radiation delivery and quality assurance; the biological radiation response; the expected risk to specific organs or tissues from therapeutic irradiation; the absorbed dose to tissues inside and outside the useful radiation beams; the organization and planning of radiation oncology services; radiation therapy staff education, training and duties; and finally medical research involving the use of radiation therapy. (orig./HP) [de

Management and Prevention of Breast Cancer After Radiation to the Chest for Childhood, Adolescent, and Young Adulthood Malignancy.

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Koo, Eva; Henderson, Michael A; Dwyer, Mary; Skandarajah, Anita R

2015-12-01

Women treated with chest irradiation for childhood, adolescent, and young adulthood (CAYA) malignancies, in particular Hodgkin's lymphoma, have an increased risk of developing second cancers of the breast (SCB). However, there are few uniform guidelines regarding surveillance and prevention for this high-risk group. A systematic search using PUBMED and OVID MEDLINE was performed. Publications listed under the terms "breast neoplasm", "neoplasm, radiation-induced", "therapeutic radiation-induced breast cancer", "screening", "surveillance", "prevention", and "prophylaxis" between January 1992 and January 2015 were assessed. A total of 138 publications were reviewed. Factors associated with increased SCB risk include young age at irradiation, prolong duration since irradiation (peak relative risk 13.87 at 15-19 years postradiation), and increased radiation dose and field. Early menopause reduces SCB risk. Annual screening mammography and breast MRI is recommended from age 25 or 8 years posttreatment for women treated with ≥20 Gy chest radiation before age 30 years. Compared with sporadic primary breast cancers (PBC), SCB more often are bilateral (6-34 %), managed with mastectomy (56-100 %), hormone receptor-negative (27-49 %), and high-grade (35 %). Women with SCB have a similar breast cancer event-free survival and breast cancer-specific survival compared to women with PBC. However, their overall survival is worse due to comorbid conditions. There is paucity of information regarding secondary prevention of SCB. Survivors of CAYA malignancy are at risk of many late effects, including iatrogenic breast cancer from chest irradiation. They are best managed in a multidisciplinary late-effects setting where tailored risk management can be provided.

Radiation biology and radiation therapy

International Nuclear Information System (INIS)

Wideroee, R.

1975-01-01

Radiation biology and radiation therapy can be compared with investigations in different layers of earth. Radiation biology works upwards from the elementary foundations, therapy works downwards with roots to secure and improve the clinical 'surface work'. The Ellis formula (Strandquist), which is a collection of clinical experience, is suited to form connections with radiobiology in the middle layers, and cooperation can give impulses for research. The structure and conditions of tumours and the complicated problems met with are discussed, based on the Carmel symposium of 1969. The oxygen problem in anoxic tumours is not yet solved. Experimental investigations of the effect itself give partly contradictory results. From a clinical viewpoint reoxygenation is of the utmost significance for obtaining control over the primary tumour, and advanced irradiation programmes will here give better results than the traditional ones. New chemicals, e.g. R 0 -07-0582, appear to reduce the OER value to 1.5, thereby making neutron therapy superfluous. Finally a problem from fundamental research is dealt with, wherein two hypotheses explaining the β-effect are described. The repair hypothesis gives a simple explanation but leaves many questions unanswered. The other hypothesis explains the β-effect as two neighbouring single breaks of the DNA molecule. It still presents difficulties, and is scarcely the correct explanation. (JIW)

Aspects of radiation protection during chest X-radiography; Strahlenhygienische Aspekte bei der Roentgenuntersuchung des Thorax

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Seidenbusch, M.C.; Schneider, K. [Dr. von Haunersches Kinderspital, Klinikum der Universitaet Muenchen, Institut fuer Klinische Radiologie - Kinderradiologie, Muenchen (Germany)

2015-07-15

Radiation safety in conventional X-ray diagnostics is based on the concepts of justification, optimization of an X-ray examination and limitation of the radiation exposure achieved during the examination. Optimization of an X-ray examination has to be considered as a multimodal process in which all technical components of the X-ray equipment have to be adapted to each other and also have to be adapted to the anthropometric characteristics of patients and the clinical indications. In this article the technical components of a conventional pediatric chest X-radiograph are presented, and recommendations for optimizing chest X-rays in children are provided. The following measures are of prime importance: correct x-ray beam limitation, using the posteroanterior projection when possible and not using anti-scatter grids in children under approximately 8 years old. In pediatric radiology chest x-rays that are taken not at the peak of inspiration can also be of some diagnostic significance. Optimization of an X-ray examination inevitably results in the limitation of radiation exposure. (orig.) [German] Die Strahlenhygiene in der konventionellen radiologischen Diagnostik basiert auf der Trias Rechtfertigung, Optimierung bzw. Limitierung der Roentgenuntersuchung bzw. Strahlenexposition. Die Optimierung einer Roentgenuntersuchung ist als multimodaler Prozess aufzufassen, in welchem saemtliche technische Komponenten der Roentgeneinrichtung sowohl miteinander als auch mit den anthropometrischen Eigenschaften des Patienten und der klinischen Fragestellung abzustimmen sind. Im vorliegenden Beitrag werden die technischen Komponenten bei der konventionellen Roentgenuntersuchung des paediatrischen Thorax in ihrer Beziehung zueinander dargestellt und Empfehlungen fuer eine Optimierung der konventionellen Thoraxaufnahme bei Kindern ausgesprochen. Die wichtigsten Massnahmen bestehen in einer korrekten Einblendung, in der Anfertigung der Aufnahmen im posteroanterioren Strahlengang und im

External Beam Radiation Therapy for Cancer

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External beam radiation therapy is used to treat many types of cancer. it is a local treatment, where a machine aims radiation at your cancer. Learn more about different types of external beam radiation therapy, and what to expect if you're receiving treatment.

CT of blunt chest trauma in children

International Nuclear Information System (INIS)

Manson, D.; Babyn, P.S.; Palder, S.; Bergmann, K.

1993-01-01

While trauma is still the leading cause of death in the pediatric age range, it is surprising how little the CT appearances of pediatric chest injury have been investigated in the literature. We have reviewed the CT findings of blunt chest trauma in 44 children for whom chest CT examinations were requested to investigate the extent of intrathoracic injury. We noted a propensity for pulmonary contusions to be located posteriorly or posteromedially, and for them to be anatomically nonsegmental and crescentic in shape. This is possibly attributable to the relatively compliant anterior chest wall in children. The CT appearances of other major thoracic injuries are described, including pulmonary lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas, aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with paraspinal fluid collections. Children demonstrating findings incidental to the actual injury yet important to the subsequent therapy are also presented. We conclude that, in the event of clinically significant blunt chest trauma, the single supine chest examination in the trauma room is insufficient to adequately identify the extent of intrathoracic injury. With the exception of concern for aortic injury for which aortography is indicated, a dynamically enhanced CT scan of the thorax should be performed as clinically significant findings may result in altered therapy. (orig.)

Chest X-Ray

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Full Text Available ... evaluate shortness of breath, persistent cough, fever, chest pain or injury. It may also be useful to ... of ionizing radiation, the benefit of an accurate diagnosis far outweighs any risk. For more information about ...

Comparison of dose-volume histograms for Tomo therapy, linear accelerator-based 3D conformal radiation therapy, and intensity-modulated radiation therapy

International Nuclear Information System (INIS)

Ji, Youn-Sang; Dong, Kyung-Rae; Kim, Chang-Bok; Choi, Seong-Kwan; Chung, Woon-Kwan; Lee, Jong-Woong

2011-01-01

Highlights: → Evaluation of DVH from 3D CRT, IMRT and Tomo therapy was conducted for tumor therapy. → The doses of GTV and CTV were compared using DVHs from 3D CRT, IMRT and Tomo therapy. → The GTV was higher when Tomo therapy was used, while the doses of critical organ were low. → They said that Tomo therapy satisfied the goal of radiation therapy more than the others. - Abstract: Evaluation of dose-volume histograms from three-dimensional conformal radiation therapy (3D CRT), intensity-modulated radiation therapy (IMRT), and Tomo therapy was conducted. These three modalities are among the diverse treatment systems available for tumor therapy. Three patients who received tumor therapy for a malignant oligodendroglioma in the cranium, nasopharyngeal carcinoma in the cervical neck, and prostate cancer in the pelvis were selected as study subjects. Therapy plans were made for the three patients before dose-volume histograms were obtained. The doses of the gross tumor volume (GTV) and the clinical target volume (CTV) were compared using the dose-volume histograms obtained from the LINAC-based 3D CRT, IMRT planning station (Varian Eclipse-Varian, version 8.1), and Tomo therapy planning station. In addition, the doses of critical organs in the cranium, cervix, and pelvis that should be protected were compared. The GTV was higher when Tomo therapy was used compared to 3D CRT and the LINAC-based IMRT, while the doses of critical organ tissues that required protection were low. These results demonstrated that Tomo therapy satisfied the ultimate goal of radiation therapy more than the other therapies.

Chest X-Ray

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Full Text Available ... However, it’s important to consider the likelihood of benefit to your health. While a chest x-ray use a tiny dose of ionizing radiation, the benefit of an accurate diagnosis far outweighs any risk. ...

Radiation therapy for metastatic spinal tumors

International Nuclear Information System (INIS)

Kida, Akio; Fukuda, Haruyuki; Taniguchi, Shuji; Sakai, Kazuaki

2000-01-01

The results of radiation therapy for metastatic spinal tumors were evaluated in terms of pain relief, improvement of neurological impairment, and survival. Between 1986 and 1995, 52 symptomatic patients with metastatic spinal tumors treated with radiation therapy were evaluated. The patients all received irradiation of megavoltage energy. Therapeutic efficacy was evaluated in terms of pain relief and improvement of neurological impairment. Pain relief was observed in 29 (61.7%) of 47 patients with pain. Therapy was effective for 17 (70.8%) of 24 patients without neurological impairment, and efficacy was detected in 12 (52.2%) of 23 patients with neurological impairment. Improvement of neurological symptoms was obtained in seven (25.0%) of 28 patients with neurological impairment. Radiation therapy was effective for pain relief in patients with metastatic spinal tumors. In patients with neurological impairment, less pain relief was observed than in those without impairment. Improvement of neurological impairment was restricted, but radiation therapy was thought to be effective in some cases in the early stage of neurological deterioration. Radiation therapy for metastatic spinal tumors contraindicated for surgery was considered effective for improvement of patients' activities of daily living. (author)

Radiation therapy in the treatment of hilar cholangiocarcinoma

International Nuclear Information System (INIS)

Jing Jin; Zhai Renyou

2007-01-01

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

Should the lateral chest radiograph be routinely performed?

International Nuclear Information System (INIS)

Osman, Fatuma; Williams, Imelda

2014-01-01

Background: The chest x-ray is one of the most common plain film radiographic examinations performed. Inclusion of the lateral chest radiograph varies internationally and nationally across radiology departments and states in Australia. Search strategy: A search strategy of the databases Cochrane Library, Ovid Medline/Medline, PubMed, Scopus and Science Direct was conducted. The results were restricted to those published between 1985 and 2013 and those published in English. The following search terms were used: ‘lateral chest’, ‘radiograph’, ‘digital radiography’, ‘chest x-ray’, ‘plain film radiography’, ‘ionising radiation’. The results were restricted to publications with these terms in the title, abstract and/or keywords. Main findings: There are few national or international guidelines pertaining to the inclusion of the lateral chest x-ray as routine. Primary concerns are the increased radiation dose associated with the additional chest view and reduction of medical imaging services cost. Modern digital imaging systems result in a lower radiation dose. The diagnostic yield of the lateral chest x-ray is highly dependent on the clinical indications of the patient. Further research into the routine inclusion of the lateral chest x-ray is recommended. Conclusion: Review of the literature suggests that the lateral chest radiograph should not be performed routinely unless clinically indicated

Effect of radiation dose level on accuracy and precision of manual size measurements in chest tomosynthesis evaluated using simulated pulmonary nodules

International Nuclear Information System (INIS)

Soederman, Christina; Allansdotter Johnsson, Aase; Vikgren, Jenny; Rossi Norrlund, Rauni; Molnar, David; Svalkvist, Angelica; Maansson, Lars Gunnar; Baath, Magnus

2016-01-01

The aim of the present study was to investigate the dependency of the accuracy and precision of nodule diameter measurements on the radiation dose level in chest tomosynthesis. Artificial ellipsoid-shaped nodules with known dimensions were inserted in clinical chest tomosynthesis images. Noise was added to the images in order to simulate radiation dose levels corresponding to effective doses for a standard-sized patient of 0.06 and 0.04 mSv. These levels were compared with the original dose level, corresponding to an effective dose of 0.12 mSv for a standard-sized patient. Four thoracic radiologists measured the longest diameter of the nodules. The study was restricted to nodules located in high-dose areas of the tomosynthesis projection radiographs. A significant decrease of the measurement accuracy and intra-observer variability was seen for the lowest dose level for a subset of the observers. No significant effect of dose level on the interobserver variability was found. The number of non-measurable small nodules (≤5 mm) was higher for the two lowest dose levels compared with the original dose level. In conclusion, for pulmonary nodules at positions in the lung corresponding to locations in high-dose areas of the projection radiographs, using a radiation dose level resulting in an effective dose of 0.06 mSv to a standard-sized patient may be possible in chest tomosynthesis without affecting the accuracy and precision of nodule diameter measurements to any large extent. However, an increasing number of non-measurable small nodules (≤5 mm) with decreasing radiation dose may raise some concerns regarding an applied general dose reduction for chest tomosynthesis examinations in the clinical praxis. (authors)

Postmastectomy intensity modulated radiation therapy following immediate expander-implant reconstruction

International Nuclear Information System (INIS)

Koutcher, Lawrence; Ballangrud, Ase; Cordeiro, Peter G.; McCormick, Beryl; Hunt, Margie; Zee, Kimberly J. Van; Hudis, Clifford; Beal, Kathryn

2010-01-01

Background/purpose: To evaluate radiation plans of patients undergoing mastectomy with immediate expander-implant reconstruction followed by postmastectomy radiation therapy (PMRT). Materials/methods: We identified 41 patients from June 2004 to May 2007 who underwent mastectomy, immediate expander-implant reconstruction, and PMRT with intensity-modulated radiation therapy. We assessed chest wall (CW) coverage and volume of heart and lung irradiated. Results: In 73% of patients, all CW borders were adequately covered, and in 22%, all but 1 border were adequately covered. The total lung V 20 was 20 was 13% (range, 3-23%), and the mean heart D mean was 2.81 Gy (range, 0.53-9.60 Gy). In patients with left-sided lesions without internal mammary nodes (IMNs) treatment (n = 22), the mean lung V 20 was 12.6% and the mean heart D mean was 3.90 Gy, and in the patient with IMN treatment, the lung V 20 was 18% and heart D mean was 8.04 Gy. For right-sided lesions without IMN treatment (n = 12), the mean lung V 20 was 12.4% and the mean heart D mean was 0.90 Gy, and in patients with IMN treatment (n = 6), these numbers were 17.8% and 1.76 Gy. At a median follow-up of 29 months, the 30-month actuarial local control was 97%. Conclusions: In women undergoing immediate expander-implant reconstruction, PMRT can achieve excellent local control with acceptable heart and lung doses. These results can be achieved even when the IMN are being treated, although doses to the heart and lungs will be higher.

Radiation therapy for primary orbital lymphoma

International Nuclear Information System (INIS)

Chao, Cliff K.S.; Lin Hsiusan; Rao Devineni, V.; Smith, Morton

1995-01-01

Purpose: The influence of tumor size, grade, thoroughness of staging workup, and radiation dose on disease control, radiation-related complications, and incidence of systemic progression of primary orbital lymphoma is analyzed. Methods and Materials: Twenty patients with Stage I primary orbital lymphoma were treated from August 1976 through August 1991 at Mallinckrodt Institute of Radiology. Staging workups included physical examination, chest x-ray, complete blood count (CBC), liver function test, and computerized tomography (CT) scan of the orbit, abdomen, and pelvis. Nineteen patients had bone marrow biopsy. The histological types based on the National Cancer Institute working formulation were 9 low-grade and 11 intermediate-grade, including five lymphocytic lymphomas of intermediate differentiation. The extension of disease and the volume of tumor were evaluated by CT scan of the orbit. The most commonly used radiation therapy technique was single anterior direct field with 4 MV or 6 MV photons. Lens was shielded or not treated in eight patients. Dose ranged from 20 to 43.2 Gy. Thirteen of 20 patients received 30 Gy. Minimum follow-up was 24 months (median, 4 years). Results: Local control was achieved in all 20 patients. One patient with lymphocytic lymphoma with intermediate differentiation developed disseminated disease. Actuarial disease-free survival (DFS) was 100% and 90% at 2 and 5 years, respectively. No retinopathy was observed. Cataracts were noted in seven patients at 1 to 10 years following irradiation (median, 2 years). Three patients developed lacrimal function disorder, however, no corneal ulceration occurred. Conclusions: Thirty Gy in 15 fractions appears to be a sufficient dose for local control with acceptable morbidity, especially for low-grade, as well as certain types of intermediate-grade lymphomas, such as diffuse small cleaved cell and lymphocytic lymphoma of intermediate differentiation. Systemic dissemination is minimal, provided local

Radiation therapy for primary orbital lymphoma

Energy Technology Data Exchange (ETDEWEB)

Chao, Cliff K.S.; Hsiusan, Lin; Rao Devineni, V; Smith, Morton

1995-02-15

Purpose: The influence of tumor size, grade, thoroughness of staging workup, and radiation dose on disease control, radiation-related complications, and incidence of systemic progression of primary orbital lymphoma is analyzed. Methods and Materials: Twenty patients with Stage I primary orbital lymphoma were treated from August 1976 through August 1991 at Mallinckrodt Institute of Radiology. Staging workups included physical examination, chest x-ray, complete blood count (CBC), liver function test, and computerized tomography (CT) scan of the orbit, abdomen, and pelvis. Nineteen patients had bone marrow biopsy. The histological types based on the National Cancer Institute working formulation were 9 low-grade and 11 intermediate-grade, including five lymphocytic lymphomas of intermediate differentiation. The extension of disease and the volume of tumor were evaluated by CT scan of the orbit. The most commonly used radiation therapy technique was single anterior direct field with 4 MV or 6 MV photons. Lens was shielded or not treated in eight patients. Dose ranged from 20 to 43.2 Gy. Thirteen of 20 patients received 30 Gy. Minimum follow-up was 24 months (median, 4 years). Results: Local control was achieved in all 20 patients. One patient with lymphocytic lymphoma with intermediate differentiation developed disseminated disease. Actuarial disease-free survival (DFS) was 100% and 90% at 2 and 5 years, respectively. No retinopathy was observed. Cataracts were noted in seven patients at 1 to 10 years following irradiation (median, 2 years). Three patients developed lacrimal function disorder, however, no corneal ulceration occurred. Conclusions: Thirty Gy in 15 fractions appears to be a sufficient dose for local control with acceptable morbidity, especially for low-grade, as well as certain types of intermediate-grade lymphomas, such as diffuse small cleaved cell and lymphocytic lymphoma of intermediate differentiation. Systemic dissemination is minimal, provided local

Multiple-beam equalization radiography in chest radiology

International Nuclear Information System (INIS)

Axelsson, B.; Forsberg, H.; Hansson, B.; Haverling, M.

1991-01-01

The large difference in transmission between the mediastinum and the part of the chest mainly containing lungs causes major problems in chest radiography. A system for advanced multiple beam equalization radiography has been evaluated. Evaluation of image quality has been performed both using standard phantoms and from clinical radiographs. Measurements of radiation dose burden to the patient have been made both in clinical examinations and using an anthropomorphic phantom. The image quality, in areas with low transmission, is substantially increased using the equalization system. In parts of the chest mainly containing lung tissue, conventional systems show an equal or slightly better image quality. The radiation dose burden to the patient is increased by 25 percent using the equation system, as compared to a low-dose air-gap system. In our opinion, the slight increase in radiation dose burden is well motivated by the high quality of the radiographs produced. (orig.)

Clinical experience of radiation therapy for Graves` ophthalmopathy

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo [Gunma Univ., Maebashi (Japan). School of Medicine

1996-11-01

The effect of radiation therapy for Graves` ophthalmopathy was evaluated. Ten patients with Graves` ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves` ophthalmopathy. (author)

Clinical experience of radiation therapy for Graves' ophthalmopathy

International Nuclear Information System (INIS)

Takahashi, Takeo; Mitsuhashi, Norio; Nagashima, Hisako; Sakurai, Hideyuki; Murata, Osamu; Ishizeki, Kei; Shimaya, Sanae; Hayakawa, Kazushige; Niibe, Hideo

1996-01-01

The effect of radiation therapy for Graves' ophthalmopathy was evaluated. Ten patients with Graves' ophthalmopathy were treated with radiation therapy between 1992 and 1993 in Gunma University Hospital. All patients had a past history of hyperthyroidism and received 2,000 cGy to the retrobulbar tissues in 20 fractions. Nine of ten patients were treated with radiation therapy after the failure of corticosteroids. Six patients (60%) showed good or excellent responses. The exophthalmos type was more responsive to radiation therapy than the double vision type in this series. Two of five patients with the exophthalmos type demonstrated excellent responses, and their symptoms disappeared almost completely. The improvement of symptoms appeared within 3-6 months, and obvious clinical effects were demonstrated after 6 months of radiotherapy. Radiation therapy was well tolerated, and we have not observed any side effects of radiation therapy. In conclusion, radiation therapy is effective treatment for Graves' ophthalmopathy. (author)

Radiation therapy for carcinoma of the endometrium

International Nuclear Information System (INIS)

Potish, R.A.

1987-01-01

Carcinoma of the endometrium is the most common malignant tumor in the female genital tract. Radiation therapy continues to play a major role in the management of endometrial carcinoma, both as primary therapy and as adjuvant treatment. The utility of pelvic external beam therapy and intracavitary therapy is long established. However, the modern era of surgical staging has lead to an appreciation of the role of radiation therapy beyond the pelvis. Radiation therapy has been shown to be of particular benefit in peritoneal and nodal spread. The classic management of endometrial cancer is reviewed and relatively new and somewhat controversial topics, such as preoperative intracavitary therapy followed by external beam therapy are discussed

The cost-effectiveness of carbon-fibre cassettes in mobile chest radiography

International Nuclear Information System (INIS)

Brennan, P.C.; Hourihan, S.P.

1998-01-01

Employment of carbon fibre materials is an effective method of reducing radiation dose, yet the increased associated costs have led to a reluctance in implementation. This study investigates the level of dose reduction achievable, while maintaining image quality, in mobile chest radiography using carbon-fibre cassettes, compared with plastic cassettes, and balances this against increased expense of the cassettes. Dose measurements using thermoluminescent dosimeters were carried out on intensive therapy unit (ITU) patients undergoing an anteroposterior chest X-ray examination. Resultant image quality was assessed using objective Commission of European Communities (CEC) criteria. A retrospective audit recorded number of ITU patients currently having chest X-rays to determine total dose savings over the life of the cassettes. The results show significant reductions (p < 0.0001) of 32 % for entrance surface and effective dose with carbon-fibre cassettes. No deterioration in total image quality was noted. The added expense of ≤ 2260 per personSievert (calculated from the effective dose reduction) for employing carbon-fibre cassettes is minimal compared with the estimated cost of manSievert exposures reported by other workers. (orig.)

DNA repair related to radiation therapy

International Nuclear Information System (INIS)

Klein, W.

1979-01-01

The DNA excision repair capacity of peripheral human lymphocytes after radiation therapy has been analyzed. Different forms of application of the radiation during the therapy have been taken into account. No inhibition of repair was found if cells were allowed a certain amount of accomodation to radiation, either by using lower doses or longer application times. (G.G.)

Radiation therapy facilities in the United States

International Nuclear Information System (INIS)

Ballas, Leslie K.; Elkin, Elena B.; Schrag, Deborah; Minsky, Bruce D.; Bach, Peter B.

2006-01-01

Purpose: About half of all cancer patients in the United States receive radiation therapy as a part of their cancer treatment. Little is known, however, about the facilities that currently deliver external beam radiation. Our goal was to construct a comprehensive database of all radiation therapy facilities in the United States that can be used for future health services research in radiation oncology. Methods and Materials: From each state's health department we obtained a list of all facilities that have a linear accelerator or provide radiation therapy. We merged these state lists with information from the American Hospital Association (AHA), as well as 2 organizations that audit the accuracy of radiation machines: the Radiologic Physics Center (RPC) and Radiation Dosimetry Services (RDS). The comprehensive database included all unique facilities listed in 1 or more of the 4 sources. Results: We identified 2,246 radiation therapy facilities operating in the United States as of 2004-2005. Of these, 448 (20%) facilities were identified through state health department records alone and were not listed in any other data source. Conclusions: Determining the location of the 2,246 radiation facilities in the United States is a first step in providing important information to radiation oncologists and policymakers concerned with access to radiation therapy services, the distribution of health care resources, and the quality of cancer care

Effect of radiation dose level on the detectability of pulmonary nodules in chest tomosynthesis

International Nuclear Information System (INIS)

Asplund, Sara A.; Svalkvist, Angelica; Maansson, Lars Gunnar; Baath, Magnus; Johnsson, Aase A.; Vikgren, Jenny; Flinck, Agneta; Boijsen, Marianne; Fisichella, Valeria A.

2014-01-01

To investigate the detectability of pulmonary nodules in chest tomosynthesis at reduced radiation dose levels. Eighty-six patients were included in the study and were examined with tomosynthesis and computed tomography (CT). Artificial noise was added to simulate that the tomosynthesis images were acquired at dose levels corresponding to 12, 32, and 70 % of the default setting effective dose (0.12 mSv). Three observers (with >20, >20 and three years of experience) read the tomosynthesis cases for presence of nodules in a free-response receiver operating characteristics (FROC) study. CT served as reference. Differences between dose levels were calculated using the jack-knife alternative FROC (JAFROC) figure of merit (FOM). The JAFROC FOM was 0.45, 0.54, 0.55, and 0.54 for the 12, 32, 70, and 100 % dose levels, respectively. The differences in FOM between the 12 % dose level and the 32, 70, and 100 % dose levels were 0.087 (p = 0.006), 0.099 (p = 0.003), and 0.093 (p = 0.004), respectively. Between higher dose levels, no significant differences were found. A substantial reduction from the default setting dose in chest tomosynthesis may be possible. In the present study, no statistically significant difference in detectability of pulmonary nodules was found when reducing the radiation dose to 32 %. (orig.)

Effect of radiation dose level on the detectability of pulmonary nodules in chest tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Asplund, Sara A.; Svalkvist, Angelica; Maansson, Lars Gunnar; Baath, Magnus [University of Gothenburg, Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Medical Physics and Biomedical Engineering, Gothenburg (Sweden); Johnsson, Aase A.; Vikgren, Jenny; Flinck, Agneta; Boijsen, Marianne; Fisichella, Valeria A. [University of Gothenburg, Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Radiology, Gothenburg (Sweden)

2014-07-15

To investigate the detectability of pulmonary nodules in chest tomosynthesis at reduced radiation dose levels. Eighty-six patients were included in the study and were examined with tomosynthesis and computed tomography (CT). Artificial noise was added to simulate that the tomosynthesis images were acquired at dose levels corresponding to 12, 32, and 70 % of the default setting effective dose (0.12 mSv). Three observers (with >20, >20 and three years of experience) read the tomosynthesis cases for presence of nodules in a free-response receiver operating characteristics (FROC) study. CT served as reference. Differences between dose levels were calculated using the jack-knife alternative FROC (JAFROC) figure of merit (FOM). The JAFROC FOM was 0.45, 0.54, 0.55, and 0.54 for the 12, 32, 70, and 100 % dose levels, respectively. The differences in FOM between the 12 % dose level and the 32, 70, and 100 % dose levels were 0.087 (p = 0.006), 0.099 (p = 0.003), and 0.093 (p = 0.004), respectively. Between higher dose levels, no significant differences were found. A substantial reduction from the default setting dose in chest tomosynthesis may be possible. In the present study, no statistically significant difference in detectability of pulmonary nodules was found when reducing the radiation dose to 32 %. (orig.)

[Investigation of non-ionizing radiation hazards from physiotherapy equipment in 16 medical institutions].

Science.gov (United States)

He, Jia-xi; Zhou, Wei; Qiu, Hai-li; Yang, Guang-tao

2013-12-01

To investigate the non-ionizing radiation hazards from physiotherapy equipment in medical institutions and to explore feasible control measures for occupational diseases. On-site measurement and assessment of ultra-high-frequency radiation, high-frequency electromagnetic field, microwave radiation, and laser radiation were carried out in 16 medical institutions using the methods in the Measurement of Physical Agents in Workplace (GBZ/T189-2007). All the investigated medical institutions failed to take effective protective measures against non-ionizing radiation. Of the 17 ultra-short wave therapy apparatus, 70.6%, 47.1%, and 17.64% had a safe intensity of ultra-high-frequency radiation on the head, chest, and abdomen, respectively. Of the 4 external high-frequency thermotherapy apparatus, 100%, 75%, and 75%had a safe intensity of high-frequency electromagnetic field on the head, chest, and abdomen, respectively. In addition, the intensities of microwave radiation and laser radiation produced by the 18 microwave therapy apparatus and 12 laser therapeutic apparatus met national health standards. There are non-ionizing radiation hazards from physiotherapy equipment in medical institutions, and effective prevention and control measures are necessary.

Radiation doses to paediatric patients and comforters undergoing chest x rays

International Nuclear Information System (INIS)

Sulieman, A.; Vlychou, M.; Tsougos, I.; Theodorou, K.

2011-01-01

Pneumonia is an important cause of hospital admission among children in the developed world and it is estimated to be responsible for 3-18 % of all paediatric admissions. Chest X ray is an important examination for pneumonia diagnosis and for evaluation of complications. This study aims to determine the entrance surface dose (ESD), organ, effective doses and propose a local diagnostic reference level. The study was carried out at the university hospital of Larissa (Greece). Patients were divided into three groups: organ and effective doses were estimated using National Radiological Protection Board software. The ESD was determined by thermoluminescent dosemeters for 132 children and 76 comforters. The average ESD value was 55±8 μGy. The effective dose for patients was 11.2±5 μSv. The mean radiation dose for comforter is 22±3 mGy. The radiation dose to the patients is well within dose constraint, in the light of the current practice. (authors)

Involved Node Radiation Therapy

DEFF Research Database (Denmark)

Maraldo, Maja V; Aznar, Marianne C; Vogelius, Ivan R

2012-01-01

PURPOSE: The involved node radiation therapy (INRT) strategy was introduced for patients with Hodgkin lymphoma (HL) to reduce the risk of late effects. With INRT, only the originally involved lymph nodes are irradiated. We present treatment outcome in a retrospective analysis using this strategy...... to 36 Gy). Patients attended regular follow-up visits until 5 years after therapy. RESULTS: The 4-year freedom from disease progression was 96.4% (95% confidence interval: 92.4%-100.4%), median follow-up of 50 months (range: 4-71 months). Three relapses occurred: 2 within the previous radiation field......, and 1 in a previously uninvolved region. The 4-year overall survival was 94% (95% confidence interval: 88.8%-99.1%), median follow-up of 58 months (range: 4-91 months). Early radiation therapy toxicity was limited to grade 1 (23.4%) and grade 2 (13.8%). During follow-up, 8 patients died, none from HL, 7...

Whole-brain hippocampal sparing radiation therapy: Volume-modulated arc therapy vs intensity-modulated radiation therapy case study

Energy Technology Data Exchange (ETDEWEB)

Lee, Katrina, E-mail: Trinabena23@gmail.com; Lenards, Nishele; Holson, Janice

2016-04-01

The hippocampus is responsible for memory and cognitive function. An ongoing phase II clinical trial suggests that sparing dose to the hippocampus during whole-brain radiation therapy can help preserve a patient's neurocognitive function. Progressive research and advancements in treatment techniques have made treatment planning more sophisticated but beneficial for patients undergoing treatment. The aim of this study is to evaluate and compare hippocampal sparing whole-brain (HS-WB) radiation therapy treatment planning techniques using volume-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). We randomly selected 3 patients to compare different treatment techniques that could be used for reducing dose to the hippocampal region. We created 2 treatment plans, a VMAT and an IMRT, from each patient's data set and planned on the Eclipse 11.0 treatment planning system (TPS). A total of 6 plans (3 IMRT and 3 VMAT) were created and evaluated for this case study. The physician contoured the hippocampus as per the Radiation Therapy Oncology Group (RTOG) 0933 protocol atlas. The organs at risk (OR) were contoured and evaluated for the plan comparison, which included the spinal cord, optic chiasm, the right and left eyes, lenses, and optic nerves. Both treatment plans produced adequate coverage on the planning target volume (PTV) while significantly reducing dose to the hippocampal region. The VMAT treatment plans produced a more homogenous dose distribution throughout the PTV while decreasing the maximum point dose to the target. However, both treatment techniques demonstrated hippocampal sparing when irradiating the whole brain.

Whole-brain hippocampal sparing radiation therapy: Volume-modulated arc therapy vs intensity-modulated radiation therapy case study

International Nuclear Information System (INIS)

Lee, Katrina; Lenards, Nishele; Holson, Janice

2016-01-01

The hippocampus is responsible for memory and cognitive function. An ongoing phase II clinical trial suggests that sparing dose to the hippocampus during whole-brain radiation therapy can help preserve a patient's neurocognitive function. Progressive research and advancements in treatment techniques have made treatment planning more sophisticated but beneficial for patients undergoing treatment. The aim of this study is to evaluate and compare hippocampal sparing whole-brain (HS-WB) radiation therapy treatment planning techniques using volume-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). We randomly selected 3 patients to compare different treatment techniques that could be used for reducing dose to the hippocampal region. We created 2 treatment plans, a VMAT and an IMRT, from each patient's data set and planned on the Eclipse 11.0 treatment planning system (TPS). A total of 6 plans (3 IMRT and 3 VMAT) were created and evaluated for this case study. The physician contoured the hippocampus as per the Radiation Therapy Oncology Group (RTOG) 0933 protocol atlas. The organs at risk (OR) were contoured and evaluated for the plan comparison, which included the spinal cord, optic chiasm, the right and left eyes, lenses, and optic nerves. Both treatment plans produced adequate coverage on the planning target volume (PTV) while significantly reducing dose to the hippocampal region. The VMAT treatment plans produced a more homogenous dose distribution throughout the PTV while decreasing the maximum point dose to the target. However, both treatment techniques demonstrated hippocampal sparing when irradiating the whole brain.

External radiation therapy of prostatic carcinoma and its relationship to hormonal therapy

International Nuclear Information System (INIS)

Takada, Chitose; Ito, Koushiro; Nishi, Junko; Yamamoto, Toshihiro; Hatanaka, Yoshimi; Baba, Yuji; Takahashi, Mutsumasa.

1995-01-01

From 1980 to 1990, a total of 54 patients with prostatic carcinoma were treated with external radiation therapy at the Kumamoto National Hospital. Ten patients were classified as Stage B, 22 as Stage C, and another 22 as Stage D according to the American Urological Association Clinical Staging System. The 5-year survival for all 54 patients was 30%. The 5-year disease-specific survival was 67% for Stage B, 47% for Stage C, and 26% for Stage D. The 5-year survival was 43% for patients in whom radiation therapy was initiated immediately after the first diagnosis or with less than one year of hormonal therapy, while it was 0% for patients in whom radiation therapy was initiated after more than one year of hormonal therapy (p=0.01). The cause of intercurrent death was acute myocardial infarction in four patients and acute cardiac failure in one. Four of these patients received hormonal therapy for more than one year. The incidence of radiation-induced proctitis was not severe. This study suggests that long-term hormonal therapy prior to radiation therapy worsens the prognosis of patients with prostatic carcinoma. (author)

Radiation doses during chest examinations using dose modulation techniques in multislice CT scanner

OpenAIRE

Livingstone Roshan; Pradip Joe; Dinakran Paul; Srikanth B

2010-01-01

Objective: To evaluate the radiation dose and image quality using a manual protocol and dose modulation techniques in a 6-slice CT scanner. Materials and Methods: Two hundred and twenty-one patients who underwent contrast-enhanced CT of the chest were included in the study. For the manual protocol settings, constant tube potential (kV) and tube current-time product (mAs) of 140 kV and 120 mAs, respectively, were used. The angular and z-axis dose modulation techniques utilized a constant tu...

Communication skills training for radiation therapists: preparing patients for radiation therapy.

Science.gov (United States)

Halkett, Georgia; O'Connor, Moira; Aranda, Sanchia; Jefford, Michael; Merchant, Susan; York, Debra; Miller, Lisa; Schofield, Penelope

2016-12-01

Patients sometimes present for radiation therapy with high levels of anxiety. Communication skills training may assist radiation therapists to conduct more effective consultations with patients prior to treatment planning and treatment commencement. The overall aim of our research is to examine the effectiveness of a preparatory programme 'RT Prepare' delivered by radiation therapists to reduce patient psychological distress. The purpose of this manuscript was to describe the communication skills workshops developed for radiation therapists and evaluate participants' feedback. Radiation therapists were invited to participate in two communication skills workshops run on the same day: (1) Consultation skills in radiation therapy and (2) Eliciting and responding to patients' emotional cues. Evaluation forms were completed. Radiation therapists' consultations with patients were then audio-recorded and evaluated prior to providing a follow-up workshop with participants. Nine full day workshops were held. Sixty radiation therapists participated. Positive feedback was received for both workshops with 88% or more participants agreeing or strongly agreeing with all the statements about the different components of the two workshops. Radiation therapists highlighted participating in role play with an actor, discussing issues; receiving feedback; acquiring new skills and knowledge; watching others role play and practicing with checklist were their favourite aspects of the initial workshop. The follow-up workshops provided radiation therapists with feedback on how they identified and addressed patients' psychological concerns; time spent with patients during consultations and the importance of finding private space for consultations. Communication skills training consisting of preparing patients for radiation therapy and eliciting and responding to emotional cues with follow-up workshops has the potential to improve radiation therapists' interactions with patients undergoing

New modalities in radiation therapy for treatment of cancer

International Nuclear Information System (INIS)

Kumar, Deepak

2013-01-01

Cancer is a generic term for a large group of diseases characterized by rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. Cancer mortality is the second and most common cause of death in the USA and in most European countries. In India, it is the fourth leading disease and the major cause of death. Cancer remains one of the most dreadful disease and approximately ten million cases of cancer occur in the world every year. The course of cancer treatment depends on the type of cancer, its location, and its state of advancement. Cancer is treated with surgery, chemotherapy, radiation therapy, hormone therapy, biological therapy and targeted therapy. Radiation therapy is an important an affordable modality for cancer treatment with minimal side effects. Radiation kills cancer cells with high-energy rays targeted directly to the tumor. Radiation therapy works by damaging the DNA and preventing its replication: therefore, it preferentially kills cancer cells, which rapidly divides. Radiation therapy is used for cure, control, and palliation of cancers in more than 60% of cancer patients. The goal of radiotherapy is to treat the cancer and spare the normal tissue as much as possible. Advances have been made in radiotherapy that allow delivery of higher doses of radiation to the tumor while sparing a greater amount of surrounding tissue, thus achieving more cures and fewer acute and long-term side effects. Technological advances and research are being continued to result in improvements in the field. Several new devices and techniques are used these days in radiotherapy for accurate treatment of cancer. Teletherapy (external radiation therapy) used focused radiation beams targeting well defined tumor through extremely detailed imaging scans. Conventional external beam radiation therapy (2DXRT) is delivered via two-dimensional beams using linear accelerator machines (X

Music therapy CD creation for initial pediatric radiation therapy: a mixed methods analysis.

Science.gov (United States)

Barry, Philippa; O'Callaghan, Clare; Wheeler, Greg; Grocke, Denise

2010-01-01

A mixed methods research design was used to investigate the effects of a music therapy CD (MTCD) creation intervention on pediatric oncology patients' distress and coping during their first radiation therapy treatment. The music therapy method involved children creating a music CD using interactive computer-based music software, which was "remixed" by the music therapist-researcher to extend the musical material. Eleven pediatric radiation therapy outpatients aged 6 to 13 years were randomly assigned to either an experimental group, in which they could create a music CD prior to their initial treatment to listen to during radiation therapy, or to a standard care group. Quantitative and qualitative analyses generated multiple perceptions from the pediatric patients, parents, radiation therapy staff, and music therapist-researcher. Ratings of distress during initial radiation therapy treatment were low for all children. The comparison between the two groups found that 67% of the children in the standard care group used social withdrawal as a coping strategy, compared to 0% of the children in the music therapy group; this trend approached significance (p = 0.076). MTCD creation was a fun, engaging, and developmentally appropriate intervention for pediatric patients, which offered a positive experience and aided their use of effective coping strategies to meet the demands of their initial radiation therapy treatment.

Chemo-thermotherapy for radiation-induced squamous cell carcinoma in anterior chest wall

Energy Technology Data Exchange (ETDEWEB)

Kodama, Ken; Doi, Osamu; Higashiyama, Masahiko; Yokouchi, Hideki; Noguchi, Shinzaburo; Koyama, Hiroki (Osaka Prefectural Center for Adult Diseases (Japan))

1992-09-01

A 62 years-old woman had visited our hospital with the large and deep ulcer formation on the left anterior chest wall. A biopsy of the ulcerous lesion established the diagnosis of a squamous cell carcinoma which might be induced by the irradiation after mastectomy. Although a wide resection of the chest wall including left arm was performed, it was impossible to resect completely. After then, she had operations for local recurrence three times in three years. However, cure was not obtained, and residual lesions gradually enlarged and all layers of the anterior chest wall were replaced with tumor tissues. Conventional chemotherapy using futraful and mytomycin C was not effective. Therefore, we tried combined therapy with intravenous administration of cisplatin (CDDP) and vindesine (VDS), and local hyperthermia using radiofrequency (RF) wave. A total number of 11 courses of this treatment modality was carried out at once a week intervals. The tumor-temperature was maintained at the range of 40-43degC for 40 min in each treatment session. Chemotherapeutic agents were administered simultaneously with hyperthermia. After these treatment, the recurrent tumor was markedly reduced, and epithelization of the ulcer was recognized from the surrounding normal skin. The residual tumor was then resected completely. The operative wound was successfully closed by surrounding normal tissue mobilization. She is in good postoperative condition. We concluded that the chemo-thermotherapy is safe and promising therapeutic modality for such invasive squamous cell carcinoma, and the normal tissues are not affected. Furthermore, this approach will expand the scope of radical resection for such an uncontrollable tumor. (author).

Chemo-thermotherapy for radiation-induced squamous cell carcinoma in anterior chest wall

International Nuclear Information System (INIS)

Kodama, Ken; Doi, Osamu; Higashiyama, Masahiko; Yokouchi, Hideki; Noguchi, Shinzaburo; Koyama, Hiroki

1992-01-01

A 62 years-old woman had visited our hospital with the large and deep ulcer formation on the left anterior chest wall. A biopsy of the ulcerous lesion established the diagnosis of a squamous cell carcinoma which might be induced by the irradiation after mastectomy. Although a wide resection of the chest wall including left arm was performed, it was impossible to resect completely. After then, she had operations for local recurrence three times in three years. However, cure was not obtained, and residual lesions gradually enlarged and all layers of the anterior chest wall were replaced with tumor tissues. Conventional chemotherapy using futraful and mytomycin C was not effective. Therefore, we tried combined therapy with intravenous administration of cisplatin (CDDP) and vindesine (VDS), and local hyperthermia using radiofrequency (RF) wave. A total number of 11 courses of this treatment modality was carried out at once a week intervals. The tumor-temperature was maintained at the range of 40-43degC for 40 min in each treatment session. Chemotherapeutic agents were administered simultaneously with hyperthermia. After these treatment, the recurrent tumor was markedly reduced, and epithelization of the ulcer was recognized from the surrounding normal skin. The residual tumor was then resected completely. The operative wound was successfully closed by surrounding normal tissue mobilization. She is in good postoperative condition. We concluded that the chemo-thermotherapy is safe and promising therapeutic modality for such invasive squamous cell carcinoma, and the normal tissues are not affected. Furthermore, this approach will expand the scope of radical resection for such an uncontrollable tumor. (author)

Chest X ray examination of workers exposed to pneumoconiosis risk

International Nuclear Information System (INIS)

Indovina, P.L.; Reggiani, A.; Calicchia, A.; Nicolosi, A.

1986-01-01

Chest X-ray examination of workers exposed to pneumoconiosis risk: critical analysis of legal and radiation protection aspects. Chest X-ray examination is one of the most common radiological examinations practised in Italy. According to Presidential Decree 1124/65, workers exposed to risk of asbestosis and silicosis must undergo a chest radiography once a year, on occasion of the periodic medical examination. Basic requirements aimed at the radiation protection of the patient must therefore be complied with, and optimization of the chest radiography execution procedures is required. This paper illustrates the results obtained with the implementation of the NEXT programme in Italy for this kind of X-ray examination. The main objective of the NEXT programme is the optimization of radiological techniques. On the basis of the most recent publications in the field of radiation protection, a critical analysis is made of the laws in force in Italy

Pediatric radiation therapy. A Japanese nationwide survey

International Nuclear Information System (INIS)

Nemoto, Kenji; Nagata, Yasushi; Hirokawa, Yutaka

2006-01-01

A national survey on the current status of pediatric radiation therapy was performed in October 2004. We sent questionnaires to 638 radiotherapy facilities in Japan (except for Kansai area) and 245 responses were analyzed. According to the database of committee of Japanese Society of Therapeutic Radiology and Oncology (JASTRO), the number of pediatric patients who received radiation therapy during 2003 in Japan was 1,101. The most frequent pediatric malignancy was brain tumor, followed by leukemia and lymphoma. The total effort of radiation therapy for children was two to six times larger than that for adult patients. An additional fee seems to be necessary for the highly technical and laborious radiation therapy required for children. (author)

Whole-brain hippocampal sparing radiation therapy: Volume-modulated arc therapy vs intensity-modulated radiation therapy case study.

Science.gov (United States)

Lee, Katrina; Lenards, Nishele; Holson, Janice

2016-01-01

The hippocampus is responsible for memory and cognitive function. An ongoing phase II clinical trial suggests that sparing dose to the hippocampus during whole-brain radiation therapy can help preserve a patient׳s neurocognitive function. Progressive research and advancements in treatment techniques have made treatment planning more sophisticated but beneficial for patients undergoing treatment. The aim of this study is to evaluate and compare hippocampal sparing whole-brain (HS-WB) radiation therapy treatment planning techniques using volume-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). We randomly selected 3 patients to compare different treatment techniques that could be used for reducing dose to the hippocampal region. We created 2 treatment plans, a VMAT and an IMRT, from each patient׳s data set and planned on the Eclipse 11.0 treatment planning system (TPS). A total of 6 plans (3 IMRT and 3 VMAT) were created and evaluated for this case study. The physician contoured the hippocampus as per the Radiation Therapy Oncology Group (RTOG) 0933 protocol atlas. The organs at risk (OR) were contoured and evaluated for the plan comparison, which included the spinal cord, optic chiasm, the right and left eyes, lenses, and optic nerves. Both treatment plans produced adequate coverage on the planning target volume (PTV) while significantly reducing dose to the hippocampal region. The VMAT treatment plans produced a more homogenous dose distribution throughout the PTV while decreasing the maximum point dose to the target. However, both treatment techniques demonstrated hippocampal sparing when irradiating the whole brain. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Better Efficacy of Synchrotron Spatially Microfractionated Radiation Therapy Than Uniform Radiation Therapy on Glioma

International Nuclear Information System (INIS)

Bouchet, Audrey; Bräuer-Krisch, Elke; Prezado, Yolanda; El Atifi, Michèle; Rogalev, Léonid; Le Clec'h, Céline; Laissue, Jean Albert; Pelletier, Laurent; Le Duc, Géraldine

2016-01-01

Purpose: Synchrotron microbeam radiation therapy (MRT) is based on the spatial fractionation of the incident, highly focused synchrotron beam into arrays of parallel microbeams, typically a few tens of microns wide and depositing several hundred grays. This irradiation modality was shown to have a high therapeutic impact on tumors, especially in intracranial locations. However, mechanisms responsible for such a property are not fully understood. Methods and Materials: Thanks to recent progress in dosimetry, we compared the effect of MRT and synchrotron broad beam (BB) radiation therapy delivered at comparable doses (equivalent to MRT valley dose) on tumor growth control and on classical radiobiological functions by histologic evaluation and/or transcriptomic analysis. Results: MRT significantly improved survival of rats bearing 9L intracranial glioma compared with BB radiation therapy delivered at a comparable dose (P<.001); the efficacy of MRT and BB radiation therapy was similar when the MRT dose was half that of BB. The greater efficacy of MRT was not correlated with a difference in cell proliferation (Mki67 and proliferating cell nuclear antigen) or in transcriptomic stimulation of angiogenesis (vascular endothelial growth factor A or tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 2) but was correlated with a higher cell death rate (factor for apoptosis signals) and higher recruitment of macrophages (tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 1 and CD68 transcripts) a few days after MRT. Conclusions: These results show the superiority of MRT over BB radiation therapy when applied at comparable doses, suggesting that spatial fractionation is responsible for a specific and particularly efficient tissue response. The higher induction of cell death and immune cell activation in brain tumors treated by MRT may be involved in such responses.

Better Efficacy of Synchrotron Spatially Microfractionated Radiation Therapy Than Uniform Radiation Therapy on Glioma

Energy Technology Data Exchange (ETDEWEB)

Bouchet, Audrey, E-mail: audrey.m.bouchet@gmail.com [Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble (France); Biomedical Beamline, European Synchrotron Radiation Facility, Grenoble (France); Bräuer-Krisch, Elke; Prezado, Yolanda [Biomedical Beamline, European Synchrotron Radiation Facility, Grenoble (France); El Atifi, Michèle [Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble (France); Grenoble University Hospital, Grenoble (France); Rogalev, Léonid; Le Clec' h, Céline [Biomedical Beamline, European Synchrotron Radiation Facility, Grenoble (France); Laissue, Jean Albert [University of Bern, Bern (Switzerland); Pelletier, Laurent, E-mail: laurent.pelletier@ujf-grenoble.fr [Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble (France); Grenoble University Hospital, Grenoble (France); Le Duc, Géraldine [Biomedical Beamline, European Synchrotron Radiation Facility, Grenoble (France)

2016-08-01

Purpose: Synchrotron microbeam radiation therapy (MRT) is based on the spatial fractionation of the incident, highly focused synchrotron beam into arrays of parallel microbeams, typically a few tens of microns wide and depositing several hundred grays. This irradiation modality was shown to have a high therapeutic impact on tumors, especially in intracranial locations. However, mechanisms responsible for such a property are not fully understood. Methods and Materials: Thanks to recent progress in dosimetry, we compared the effect of MRT and synchrotron broad beam (BB) radiation therapy delivered at comparable doses (equivalent to MRT valley dose) on tumor growth control and on classical radiobiological functions by histologic evaluation and/or transcriptomic analysis. Results: MRT significantly improved survival of rats bearing 9L intracranial glioma compared with BB radiation therapy delivered at a comparable dose (P<.001); the efficacy of MRT and BB radiation therapy was similar when the MRT dose was half that of BB. The greater efficacy of MRT was not correlated with a difference in cell proliferation (Mki67 and proliferating cell nuclear antigen) or in transcriptomic stimulation of angiogenesis (vascular endothelial growth factor A or tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 2) but was correlated with a higher cell death rate (factor for apoptosis signals) and higher recruitment of macrophages (tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 1 and CD68 transcripts) a few days after MRT. Conclusions: These results show the superiority of MRT over BB radiation therapy when applied at comparable doses, suggesting that spatial fractionation is responsible for a specific and particularly efficient tissue response. The higher induction of cell death and immune cell activation in brain tumors treated by MRT may be involved in such responses.

Influence of radiation therapy on T-lymphocyte subpopulations

International Nuclear Information System (INIS)

Job, G.

1984-01-01

The author claims this to be the first time where monoclonal antibodies are used in a long-term study in order to determine the influence of radiation therapy on T-lymphozyte-subpopulations in patients suffering from malignant growths. The influence of radiation therapy on B-cells, T-cells and macrophages was also checked. Two groups of patients were given two different radiation doses, and examined separately in order to discover possible effects of the dosage. Radiation therapy reduced B- and T-lymphocytes to the same degree as the total lymphozyte population so that their shares in percent remained unchanged. The same was also found for macrophages. Determination of clones and suppressor T-lymphozytes before, during and after radiation showed T-lymphozytes to have a higher resistance against the influence of radiation than clones. Suppressor cells also regenerated more quickly than clones after the end of the therapy. While radiation therapy was applied the clone/suppressor cell ratio dropped to values lower than those of the healthy reference group. After the end of the therapy this quotient dropped even further in some cases while in others it began to rise slowly, but even 6 months after the end of the therapy it was still lower than normal. As a number of diseases show an increased 'immunoregulatory quotient' it would be conceivable to influence this quotient with radiation therapy in order to achieve a therapeutic effect. (orig./MG) [de

External and internal radiation therapy: Past and future directions

Directory of Open Access Journals (Sweden)

Sadeghi Mahdi

2010-01-01

Full Text Available Cancer is a leading cause of morbidity and mortality in the modern world. Treatment modalities comprise radiation therapy, surgery, chemotherapy and hormonal therapy. Radiation therapy can be performed by using external or internal radiation therapy. However, each method has its unique properties which undertakes special role in cancer treatment, this question is brought up that: For cancer treatment, whether external radiation therapy is more efficient or internal radiation therapy one? To answer this question, we need to consider principles and structure of individual methods. In this review, principles and application of each method are considered and finally these two methods are compared with each other.

Effect of radiation and combined chemoradiation therapy on cardiac activity in patients with esophagus cancer. [Combined effects of /sup 60/Co. gamma. rays and methylglyoxal-bis(guanylhydrazone) an antineoplastic drug

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Neklyudova, V I; Shkhvatsabaya, L V; Ivanova, E M

1978-12-01

The results of a comparative study of the effect of radiation and combined chemoradiation therapy with methyl-GAG in 51 patients with cancer of the chest region of the esophagus indicate an adverse effect of these methods of treatment on cardiac activity. Against the background of chemoradiation therapy, these changes were more marked due perhaps to some cardiotoxic effect of methyl-GAG. However, the changes induced did not lead to considerable disorders of hemodynamics during treatment.

Chest X-Ray (Chest Radiography)

Science.gov (United States)

... Resources Professions Site Index A-Z X-ray (Radiography) - Chest Chest x-ray uses a very small dose ... Radiography? What is a Chest X-ray (Chest Radiography)? The chest x-ray is the most commonly performed diagnostic ...

Modern radiation therapy for extranodal lymphomas

DEFF Research Database (Denmark)

Yahalom, Joachim; Illidge, Tim; Specht, Lena

2015-01-01

Extranodal lymphomas (ENLs) comprise about a third of all non-Hodgkin lymphomas (NHL). Radiation therapy (RT) is frequently used as either primary therapy (particularly for indolent ENL), consolidation after systemic therapy, salvage treatment, or palliation. The wide range of presentations of ENL...... and treatment planning for the most frequently involved organs. Specifically, detailed recommendations for RT volumes are provided. We have applied the same modern principles of involved site radiation therapy as previously developed and published as guidelines for Hodgkin lymphoma and nodal NHL. We have...... there is a lack of guidelines for the use of RT in the management of ENL. This report presents an effort by the International Lymphoma Radiation Oncology Group (ILROG) to harmonize and standardize the principles of treatment of ENL, and to address the technical challenges of simulation, volume definition...

MRI of the Chest

Medline Plus

Full Text Available ... body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various ... seen by other imaging modalities, such as chest x-ray or CT. A special form of MRI called ...

Radiation Therapy for Cancer

Science.gov (United States)

... can cause pain. Radiation given to shrink a tumor near the esophagus , which can interfere with a patient’s ability to eat and drink. How is radiation therapy planned for an individual ... show the location of a patient’s tumor and the normal areas around it. These scans ...

Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy

International Nuclear Information System (INIS)

Liu Hui; Zhang Xu; Vinogradskiy, Yevgeniy Y.; Swisher, Stephen G.; Komaki, Ritsuko; Chang, Joe Y.

2012-01-01

Purpose: To determine the incidence of and risk factors for radiation pneumonitis (RP) after stereotactic ablative radiation therapy (SABR) to the lung in patients who had previously undergone conventional thoracic radiation therapy. Methods and Materials: Seventy-two patients who had previously received conventionally fractionated radiation therapy to the thorax were treated with SABR (50 Gy in 4 fractions) for recurrent disease or secondary parenchymal lung cancer (T 10 and mean lung dose (MLD) of the previous plan and the V 10 -V 40 and MLD of the composite plan were also related to RP. Multivariate analysis revealed that ECOG PS scores of 2-3 before SABR (P=.009), FEV1 ≤65% before SABR (P=.012), V 20 ≥30% of the composite plan (P=.021), and an initial PTV in the bilateral mediastinum (P=.025) were all associated with RP. Conclusions: We found that severe RP was relatively common, occurring in 20.8% of patients, and could be predicted by an ECOG PS score of 2-3, an FEV1 ≤65%, a previous PTV spanning the bilateral mediastinum, and V 20 ≥30% on composite (previous RT+SABR) plans. Prospective studies are needed to validate these predictors and the scoring system on which they are based.

TH-F-202-00: MRI for Radiation Therapy

International Nuclear Information System (INIS)

2016-01-01

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai

TH-F-202-00: MRI for Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai.

Adaptive Stereotactic Body Radiation Therapy Planning for Lung Cancer

International Nuclear Information System (INIS)

Qin, Yujiao; Zhang, Fan; Yoo, David S.; Kelsey, Chris R.; Yin, Fang-Fang; Cai, Jing

2013-01-01

Purpose: To investigate the dosimetric effects of adaptive planning on lung stereotactic body radiation therapy (SBRT). Methods and Materials: Forty of 66 consecutive lung SBRT patients were selected for a retrospective adaptive planning study. CBCT images acquired at each fraction were used for treatment planning. Adaptive plans were created using the same planning parameters as the original CT-based plan, with the goal to achieve comparable comformality index (CI). For each patient, 2 cumulative plans, nonadaptive plan (P NON ) and adaptive plan (P ADP ), were generated and compared for the following organs-at-risks (OARs): cord, esophagus, chest wall, and the lungs. Dosimetric comparison was performed between P NON and P ADP for all 40 patients. Correlations were evaluated between changes in dosimetric metrics induced by adaptive planning and potential impacting factors, including tumor-to-OAR distances (d T-OAR ), initial internal target volume (ITV 1 ), ITV change (ΔITV), and effective ITV diameter change (Δd ITV ). Results: 34 (85%) patients showed ITV decrease and 6 (15%) patients showed ITV increase throughout the course of lung SBRT. Percentage ITV change ranged from −59.6% to 13.0%, with a mean (±SD) of −21.0% (±21.4%). On average of all patients, P ADP resulted in significantly (P=0 to .045) lower values for all dosimetric metrics. Δd ITV /d T-OAR was found to correlate with changes in dose to 5 cc (ΔD5cc) of esophagus (r=0.61) and dose to 30 cc (ΔD30cc) of chest wall (r=0.81). Stronger correlations between Δd ITV /d T-OAR and ΔD30cc of chest wall were discovered for peripheral (r=0.81) and central (r=0.84) tumors, respectively. Conclusions: Dosimetric effects of adaptive lung SBRT planning depend upon target volume changes and tumor-to-OAR distances. Adaptive lung SBRT can potentially reduce dose to adjacent OARs if patients present large tumor volume shrinkage during the treatment

Adaptive Stereotactic Body Radiation Therapy Planning for Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Qin, Yujiao [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Zhang, Fan [Occupational and Environmental Safety Office, Duke University Medical Center, Durham, North Carolina (United States); Yoo, David S.; Kelsey, Chris R. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yin, Fang-Fang [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Cai, Jing, E-mail: jing.cai@duke.edu [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

2013-09-01

Purpose: To investigate the dosimetric effects of adaptive planning on lung stereotactic body radiation therapy (SBRT). Methods and Materials: Forty of 66 consecutive lung SBRT patients were selected for a retrospective adaptive planning study. CBCT images acquired at each fraction were used for treatment planning. Adaptive plans were created using the same planning parameters as the original CT-based plan, with the goal to achieve comparable comformality index (CI). For each patient, 2 cumulative plans, nonadaptive plan (P{sub NON}) and adaptive plan (P{sub ADP}), were generated and compared for the following organs-at-risks (OARs): cord, esophagus, chest wall, and the lungs. Dosimetric comparison was performed between P{sub NON} and P{sub ADP} for all 40 patients. Correlations were evaluated between changes in dosimetric metrics induced by adaptive planning and potential impacting factors, including tumor-to-OAR distances (d{sub T-OAR}), initial internal target volume (ITV{sub 1}), ITV change (ΔITV), and effective ITV diameter change (Δd{sub ITV}). Results: 34 (85%) patients showed ITV decrease and 6 (15%) patients showed ITV increase throughout the course of lung SBRT. Percentage ITV change ranged from −59.6% to 13.0%, with a mean (±SD) of −21.0% (±21.4%). On average of all patients, P{sub ADP} resulted in significantly (P=0 to .045) lower values for all dosimetric metrics. Δd{sub ITV}/d{sub T-OAR} was found to correlate with changes in dose to 5 cc (ΔD5cc) of esophagus (r=0.61) and dose to 30 cc (ΔD30cc) of chest wall (r=0.81). Stronger correlations between Δd{sub ITV}/d{sub T-OAR} and ΔD30cc of chest wall were discovered for peripheral (r=0.81) and central (r=0.84) tumors, respectively. Conclusions: Dosimetric effects of adaptive lung SBRT planning depend upon target volume changes and tumor-to-OAR distances. Adaptive lung SBRT can potentially reduce dose to adjacent OARs if patients present large tumor volume shrinkage during the treatment.

Chest tomosynthesis: technical and clinical perspectives.

Science.gov (United States)

Johnsson, Ase Allansdotter; Vikgren, Jenny; Bath, Magnus

2014-02-01

The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reporting of coronary artery calcification on chest CT studies in breast cancer patients at high risk of cancer therapy related cardiac events

Directory of Open Access Journals (Sweden)

William J. Phillips

2018-03-01

Full Text Available Background: The identification of coronary artery calcification (CAC detected coincidentally on chest CT exams could assist in cardiovascular risk assessment but may not be reported consistently on clinical studies. Cardiovascular risk factor stratification is important to predict short term cardiac events during cancer therapy and long term cardiac event free survival in cancer patients. We sought to determine the prevalence of CAC and clinical reporting rates in a cohort of cancer patients at high risk of cancer therapy related cardiac events. Methods: 408 Breast cancer patients who were referred to a cardiac oncology clinic were screened. Inclusion criteria included having had a CT chest and the absence of known coronary disease. Among those screened 263 patients were included in the study. Results: CAC was identified in 70 patients (26%. CAC was reported in 18% of studies. The reporting rates of CAC increased with the extent of coronary calcification (p < 0.01 and increased during the period of the study (p < 0.05. Conclusions: CAC was commonly detected on chest CT studies in this observational study of breast cancer patients at high risk of cardiac oncology events. The presence of CAC was often not reported clinically but reporting rates have increased over time. Recent SCCT/STR guidelines recommend reporting the presence of CAC on routine chest CT scans in recognition of the importance of CAC as a predictor of cardiovascular events. Reporting of CAC on chest CTs may help to further risk stratify breast cancer patients and improve cardiovascular outcomes in this vulnerable population. Keywords: Cardiac oncology, Coronary calcification and chest CT

Care of the patient receiving radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Yasko, J.M.

1982-12-01

External radiation therapy, or teletherapy, is the use of ionizing radiation to destroy cancer cells. Clinical use of ionizing radiation as treatment for cancer began with the discovery of x-rays in 1895, the identification of natural radioactivity (radium) in 1896, and the first reported cure of cancer, a basal cell epithelioma, induced by radiation in 1899. Initially, radiation was administered as a single large dose and produced severe, life-threatening side effects. The basis for the use of ionizing radiation in daily increments for a period of weeks was provided by Regaud in 1922; ten years later, Coutard clinically developed the method of dose fractionation, which remains in use today. Although the use of ionizing radiation as a treatment is over eighty years old, only in recent years have advancements in its clinical application been based on research related to the biologic effect of radiation on human cells. To effectively care for the patient prior to, during, and at the completion of external radiation therapy, the nurse must know the physical and biologic basis of external radiation therapy and its clinical application.

Care of the patient receiving radiation therapy

International Nuclear Information System (INIS)

Yasko, J.M.

1982-01-01

External radiation therapy, or teletherapy, is the use of ionizing radiation to destroy cancer cells. Clinical use of ionizing radiation as treatment for cancer began with the discovery of x-rays in 1895, the identification of natural radioactivity (radium) in 1896, and the first reported cure of cancer, a basal cell epithelioma, induced by radiation in 1899. Initially, radiation was administered as a single large dose and produced severe, life-threatening side effects. The basis for the use of ionizing radiation in daily increments for a period of weeks was provided by Regaud in 1922; ten years later, Coutard clinically developed the method of dose fractionation, which remains in use today. Although the use of ionizing radiation as a treatment is over eighty years old, only in recent years have advancements in its clinical application been based on research related to the biologic effect of radiation on human cells. To effectively care for the patient prior to, during, and at the completion of external radiation therapy, the nurse must know the physical and biologic basis of external radiation therapy and its clinical application

MRI of the Chest

Medline Plus

Full Text Available ... internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various ... seen by other imaging modalities, such as chest x-ray or CT. A special form of MRI called ...

Gallium-67 citrate imaging for the assessment of radiation pneumonitis

International Nuclear Information System (INIS)

Kataoka, Masaaki

1989-01-01

In order to evaluate its usefulness in the assessment of radiation pneumotinis, gallium-67 citrate ( 67 Ga) imaging was performed before and after radiation therapy (RT) on 103 patients with lung cancer. In 23 patients with radiation pneumonitis detected radiographically, abnormal 67 Ga uptake in sites other than tumors was found in all post-RT 67 Ga lung images. Three patterns of uptake were found: (A) focal uptake corresponding to the RT field (n=10); (B) diffuse uptake including the RT field (n=4); and (C) diffuse uptake outside the RT field (n=9). The area of 67 Ga uptake was consistent with that of interstitial pneumonitis as revealed histopathologically in 7 cases. 67 Ga uptake in pattern (C) was an indicator of poor prognosis for the patients with radiation pneumonitis. 67 Ga uptake in the patients with reversible pneumonitis disappeared with steroid therapy. Sixteen (20%) of 80 asymptomatic patients, in whose chest radiographs there was no finding of radiation pneumonitis, showed transient 67 Ga uptake. These were considered to occur in the subclinical radiation pneumonitis. These data suggest that 67 Ga imaging is more sensitive than chest radiography in the detection of radiation pneumonitis and is useful in the assessment of the extent and clinical course of radiation pneumonitis. (author)

RADIATION THERAPY COMMUNICATION-REIRRADIATION OF A NASAL TUMOR IN A BRACHYCEPHALIC DOG USING INTENSITY MODULATED RADIATION THERAPY.

Science.gov (United States)

Rancilio, Nicholas J; Custead, Michelle R; Poulson, Jean M

2016-09-01

A 5-year-old spayed female Shih Tzu was referred for evaluation of a nasal transitional carcinoma. A total lifetime dose of 117 Gy was delivered to the intranasal mass in three courses over nearly 2 years using fractionated intensity modulated radiation therapy (IMRT) to spare normal tissues. Clinically significant late normal tissue side effects were limited to bilaterally diminished tear production. The patient died of metastatic disease progression 694 days after completion of radiation therapy course 1. This case demonstrates that retreatment with radiation therapy to high lifetime doses for recurrent local disease may be well tolerated with IMRT. © 2016 American College of Veterinary Radiology.

Clinical applications of continuous infusion chemotherapy ahd concomitant radiation therapy

International Nuclear Information System (INIS)

Rosenthal, C.J.; Rotman, M.

1986-01-01

This book presents information on the following topics: theoretical basis and clinical applications of 5-FU as a radiosensitizer; treatment of hepatic metastases from gastro intestingal primaries with split course radiation therapy; combined modality therapy with 5-FU, Mitomycin-C and radiation therapy for sqamous cell cancers; treatment of bladder carcinoma with concomitant infusion chemotherapy and irradiation; a treatment of invasiv bladder cancer by the XRT/5FU protocol; concomitant radiation therapy and doxorubicin by continuous infusion in advanced malignancies; cis platin by continuous infusion with concurrent radiation therapy in malignant tumors; combination of radiation with concomitant continuous adriamycin infusion in a patient with partially excised pleomorphic soft tissue sarcoma of the lower extremeity; treatment of recurrent carcinoma of the paranasal sinuses using concomitant infusion cis-platinum and radiation therapy; hepatic artery infusion for hepatic metastases in combination with hepatic resection and hepatic radiation; study of simultaneous radiation therapy, continuous infusion, 5FU and bolus mitomycin-C; cancer of the esophagus; continuous infusion VP-16, bolus cis-platinum and simultaneous radiation therapy as salvage therapy in small cell bronchogenic carcinoma; and concomitant radiation, mitomycin-C and 5-FU infusion in gastro intestinal cancer

Effect of radiation therapy against intracranial hemangiopericytoma

Energy Technology Data Exchange (ETDEWEB)

Uemura, Shozaburo; Kuratsu, Jun-ichi; Hamada, Jun-ichiro; Yoshioka, Susumu; Kochi, Masato; Ushio, Yukitaka [Kumamoto Univ. (Japan). School of Medicine; Nakahara, Tadashi; Kishida, Katsuaki

1992-06-01

Seven cases of intracranial hemangiopericytoma were studied retrospectively to investigate the efficacy of radiation therapy. Tumor response evaluated by computed tomography and magnetic resonance imaging was obvious after 20-30 Gy irradiation. The total reduction rate was 80-90% and continued as long as 5-7 months after treatment. In five patients receiving radiation therapy before radical removal, the tumors were easily removed without massive hemorrhage. Histological inspection of specimens after irradiation showed a significant disappearance of tumor cells. Pyknosis frequently occurred in endothelial cells, and proliferating vessels with hyalinoid degeneration were also seen. Reticulin fibers between tumor cells were fewer, split, or absent. Preoperative radiation therapy is useful in the treatment of hemangiopericytoma involving considerable surgical risk. Postoperative radiation therapy should be given even if removal is complete. (author).

Effect of radiation therapy against intracranial hemangiopericytoma

International Nuclear Information System (INIS)

Uemura, Shozaburo; Kuratsu, Jun-ichi; Hamada, Jun-ichiro; Yoshioka, Susumu; Kochi, Masato; Ushio, Yukitaka; Nakahara, Tadashi; Kishida, Katsuaki.

1992-01-01

Seven cases of intracranial hemangiopericytoma were studied retrospectively to investigate the efficacy of radiation therapy. Tumor response evaluated by computed tomography and magnetic resonance imaging was obvious after 20-30 Gy irradiation. The total reduction rate was 80-90% and continued as long as 5-7 months after treatment. In five patients receiving radiation therapy before radical removal, the tumors were easily removed without massive hemorrhage. Histological inspection of specimens after irradiation showed a significant disappearance of tumor cells. Pyknosis frequently occurred in endothelial cells, and proliferating vessels with hyalinoid degeneration were also seen. Reticulin fibers between tumor cells were fewer, split, or absent. Preoperative radiation therapy is useful in the treatment of hemangiopericytoma involving considerable surgical risk. Postoperative radiation therapy should be given even if removal is complete. (author)

Radiation therapy physics

CERN Document Server

1995-01-01

The aim of this book is to provide a uniquely comprehensive source of information on the entire field of radiation therapy physics. The very significant advances in imaging, computational, and accelerator technologies receive full consideration, as do such topics as the dosimetry of radiolabeled antibodies and dose calculation models. The scope of the book and the expertise of the authors make it essential reading for interested physicians and physicists and for radiation dosimetrists.

Modern radiation therapy for primary cutaneous lymphomas

DEFF Research Database (Denmark)

Specht, Lena; Dabaja, Bouthaina; Illidge, Tim

2015-01-01

Primary cutaneous lymphomas are a heterogeneous group of diseases. They often remain localized, and they generally have a more indolent course and a better prognosis than lymphomas in other locations. They are highly radiosensitive, and radiation therapy is an important part of the treatment......, either as the sole treatment or as part of a multimodality approach. Radiation therapy of primary cutaneous lymphomas requires the use of special techniques that form the focus of these guidelines. The International Lymphoma Radiation Oncology Group has developed these guidelines after multinational...... meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the International Lymphoma Radiation Oncology Group steering committee on the use of radiation therapy in primary cutaneous lymphomas in the modern era....

Radiation dose reduction with the adaptive statistical iterative reconstruction (ASIR) technique for chest CT in children: an intra-individual comparison.

Science.gov (United States)

Lee, Seung Hyun; Kim, Myung-Joon; Yoon, Choon-Sik; Lee, Mi-Jung

2012-09-01

To retrospectively compare radiation dose and image quality of pediatric chest CT using a routine dose protocol reconstructed with filtered back projection (FBP) (the Routine study) and a low-dose protocol with 50% adaptive statistical iterative reconstruction (ASIR) (the ASIR study). We retrospectively reviewed chest CT performed in pediatric patients who underwent both the Routine study and the ASIR study on different days between January 2010 and August 2011. Volume CT dose indices (CTDIvol), dose length products (DLP), and effective doses were obtained to estimate radiation dose. The image quality was evaluated objectively as noise measured in the descending aorta and paraspinal muscle, and subjectively by three radiologists for noise, sharpness, artifacts, and diagnostic acceptability using a four-point scale. The paired Student's t-test and the Wilcoxon signed-rank test were used for statistical analysis. Twenty-six patients (M:F=13:13, mean age 11.7) were enrolled. The ASIR studies showed 60.3%, 56.2%, and 55.2% reductions in CTDIvol (from 18.73 to 7.43 mGy, PASIR studies (20.81 vs. 16.67, P=0.004), but was not different in the aorta (18.23 vs. 18.72, P=0.726). The subjective image quality demonstrated no difference between the two studies. A low-dose protocol with 50% ASIR allows radiation dose reduction in pediatric chest CT by more than 55% while maintaining image quality. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Physics fundamentals and biological effects of synchrotron radiation therapy

International Nuclear Information System (INIS)

Prezado, Y.

2010-01-01

The main goal of radiation therapy is to deposit a curative dose in the tumor without exceeding the tolerances in the nearby healthy tissues. For some radioresistant tumors, like gliomas, requiring high doses for complete sterilization, the major obstacle for curative treatment with ionizing radiation remains the limited tolerance of the surrounding healthy tissue. This limitation is particularly severe for brain tumors and, especially important in children, due to the high risk of complications in the development of the central nervous system. In addition, the treatment of tumors close to an organ at risk, like the spinal cord, is also restricted. One possible solution is the development of new radiation therapy techniques exploiting radically different irradiation modes and modifying, in this way, the biological equivalent doses. This is the case of synchrotron radiation therapy (SRT). In this work the three new radiation therapy techniques under development at the European Synchrotron Radiation Facility (ESRF), in Grenoble (France) will be described, namely: synchrotron stereotactic radiation therapy (SSRT), microbeam radiation therapy (MRT) and minibeam radiation therapy. The promising results in the treatment of the high grade brain tumors obtained in preclinical studies have paved the way to the clinical trials. The first patients are expected in the fall of 2010. (Author).

Radiation therapy and late reactions in normal tissues

International Nuclear Information System (INIS)

Aoyama, Takashi; Kuroda, Yasumasa

1998-01-01

Recent developments in cancer therapy have made us increasingly aware that the quality of life of a patient is as valuable as other benefits received from therapy. This awareness leads to an emphasis on organ and/or function preservation in the course of therapy. In line with this new thinking, greater consideration is placed on radiation therapy as an appropriate modality of cancer therapy. Possible complications in normal tissues, especially those of late reaction type after the therapy must be overcome. This review, therefore, focuses on recent progress of studies on mechanisms of the complications of the late reaction type. An observation of a clinical case concerning a late reaction of spinal cord (radiation myelopathy) and surveys of experimental studies on the mechanisms of late reactions (including radiation pneumonitis and lung fibrosis, and radiation response of vascular endothelial cells) provide a hypothesis that apoptosis through the pathway starting with radiation-induced sphingomyelin hydrolysis may play an important role in causing a variety of late reactions. This insight is based on the fact that radiation also activates protein kinase C which appears to block apoptosis. The mechanisms of late reactions, therefore, may involve a balance between radiation-induced apoptotic death and its down regulation by suppressor mechanisms through protein kinase C. (author)

Selective use of adjuvant radiation therapy in resectable colorectal adenocarcinoma

International Nuclear Information System (INIS)

Cohen, A.M.; Gunderson, L.L.; Welch, C.E.

1981-01-01

Colorectal cancer recurs within the operative field in 10-20 per cent of patients undergoing potentially curative surgery. In certain subgroups, the recurrence rate is 20-50 per cent. There are some data to suggest either preoperative or postoperative radiation therapy as an adjuvant to potentially curative surgery can reduce the local operative failure rate. However, since radiation therapy has significant side effects, patient selection to maximize the therapeutic ratio is important. This report defines the criteria at the Massachusetts General Hospital for selection of patients with colorectal cancer for adjuvant radiation therapy, defines radiation therapy-surgery sequencing alternatives used, and describes techniques to reduce radiation side effects. Over a period of three and a half years, 196 patients received adjuvant radiation therapy: 51 patients received either moderate or low dose preoperative radiation therapy to rectal or rectosigmoid cancers, and 161 patients received postoperative radiation therapy to the pelvis or extrapelvic colonic tumor-lymph node beds. Some patients who received low-dose preoperative radiation therapy also received moderate-dose postoperative radiation therapy. We prefer moderate-dose postoperative radiation therapy as the approach most likely to decrease the local recurrence rate with minimal interference with surgical procedures and late small-bowel complications. Patients who received postoperative radiation therapy were those without distant metastases, whose primary tumor pathology revealed macroscopic or extensive microscopic transmural tumor penetration into extraperitoneal tissues. Careful case selection, multiple field techniques, the use of reperitonealization, omental flaps, and retroversion of the uterus into the pelvis were combined with postoperative small-bowel x-rays, bladder distention, and lateral portals to minimize radiation damage to normal structures

Extramammary Paget's disease: role of radiation therapy

International Nuclear Information System (INIS)

Guerrieri, M.; Back, M.F.

2002-01-01

Extra mammary Paget's disease (EMPD) is an uncommon premalignant skin condition that has been traditionally managed with surgery. A report of long-standing Paget's disease with transformation to invasive adenocarcinoma definitively managed with radiation therapy is presented. A review of cases of extramammary Paget's disease treated with radiation therapy is discussed. The use of radiation therapy should be considered in selected cases, as these studies demonstrate acceptable rates of local control when used as an adjunct to surgery, or as a definitive treatment modality. Copyright (2002) Blackwell Science Pty Ltd

Prediction of Chest Wall Toxicity From Lung Stereotactic Body Radiotherapy (SBRT)

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Stephans, Kevin L., E-mail: stephak@ccf.org [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH (United States); Djemil, Toufik; Tendulkar, Rahul D. [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH (United States); Robinson, Cliff G. [Department of Radiation Oncology, Siteman Cancer Center, Washington University, St Louis, MO (United States); Reddy, Chandana A.; Videtic, Gregory M.M. [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH (United States)

2012-02-01

Purpose: To determine patient, tumor, and treatment factors related to the development of late chest wall toxicity after lung stereotactic body radiotherapy (SBRT). Methods and Materials: We reviewed a registry of 134 patients treated with lung SBRT to 60 Gy in 3 fractions who had greater than 1 year of clinical follow-up and no history of multiple treatments to the same lobe (n = 48). Patients were treated as per Radiation Therapy Oncology Group Protocol 0236 without specific chest wall avoidance criteria. The chest wall was retrospectively contoured. Thirty-two lesions measured less than 3 cm, and sixteen measured 3 to 5 cm. The median planning target volume was 29 cm{sup 3}. Results: With a median follow-up of 18.8 months, 10 patients had late symptomatic chest wall toxicity (4 Grade 1 and 6 Grade 2) at a median of 8.8 months after SBRT. No patient characteristics (age, diabetes, hypertension, peripheral vascular disease, or body mass index) were predictive for toxicity, whereas there was a trend for continued smoking (p = 0.066; odds ratio [OR], 4.4). Greatest single tumor dimension (p = 0.047; OR, 2.63) and planning target volume (p = 0.040; OR, 1.04) were correlated with toxicity, whereas distance from tumor edge to chest wall and gross tumor volume did not reach statistical significance. Volumes of chest wall receiving 30 Gy (V30) through 70 Gy (V70) were all highly significant, although this correlation weakened for V65 and V70 and maximum chest wall point dose only trended to significance (p = 0.06). On multivariate analysis, tumor volume was no longer correlated with toxicity and only V30 through V60 remained statistically significant. Conclusions: Tumor size and chest wall dosimetry are correlated to late chest wall toxicity. Only chest wall V30 through V60 remained significant on multivariate analysis. Restricting V30 to 30 cm{sup 3} or less and V60 to 3 cm{sup 3} or less should result in a 10% to 15% risk of late chest wall toxicity or lower.

Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study

Science.gov (United States)

Makri, T.; Yakoumakis, E.; Papadopoulou, D.; Gialousis, G.; Theodoropoulos, V.; Sandilos, P.; Georgiou, E.

2006-10-01

Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 ± 16 µGy and 43 ± 19 µGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 ± 3.7 µSv, regardless of sex, and an imparted energy of 18.5 ± 6.7 µJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 ± 7.6 µSv (males)/17.2 ± 7.6 µSv (females) and 29.7 ± 13.2 µJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods.

Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study

International Nuclear Information System (INIS)

Makri, T; Yakoumakis, E; Papadopoulou, D; Gialousis, G; Theodoropoulos, V; Sandilos, P; Georgiou, E

2006-01-01

Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 ± 16 μGy and 43 ± 19 μGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 ± 3.7 μSv, regardless of sex, and an imparted energy of 18.5 ± 6.7 μJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 ± 7.6 μSv (males)/17.2 ± 7.6 μSv (females) and 29.7 ± 13.2 μJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods

A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged fifty or younger

International Nuclear Information System (INIS)

Freedman, G.M.; Fowble, B.L.; Hanlon, A.L.; Myint, M.A.; Hoffman, J.P.; Sigurdson, E.R.; Eisenberg, B.L.; Goldstein, L.J.; Fein, D.A.

1997-01-01

Purpose: Indications for postmastectomy radiation include primary tumor size > 5 cm and ≥ 4 positive axillary nodes. In clinical practice, patients with a close or positive margin after mastectomy are also often treated with postmastectomy radiation. However, there is little data regarding the risk of a chest wall recurrence in patients with this pathologic feature who otherwise would be considered low risk (tumor size 25% at 8 years: Age ≤ 50 years was 28% vs. 0% for age > 50 (p=0.08). There was no correlation with chest wall failure and number of nodes, ER status, lymphovascular invasion, location of primary, grade, family history or type of tumor close to the margin. All four chest wall failures were in patients who had received adjuvant systemic chemotherapy ± Tamoxifen. Chest wall failures occurred in patients with margins within 1-2 mm in three patients and 5 mm in one patient. The cumulative chest wall recurrence at 8 years by margin proximity was 24% ≤ 2mm vs. 7% 2.1-6 mm (p=0.44), and by clinical size 24% for T2 tumors vs. 7% for T1 (p=0.55). Conclusions: A close or positive margin is uncommon (< 5%) after mastectomy in patients with tumor size < 5 cm and 0-3 positive axillary nodes, but when present it appears to be in a younger patient population. The subgroup of patients aged 50 or younger with clinical T1-T2 tumor size and 0-3 positive nodes who have a close (≤ 5 mm) or positive mastectomy margin are at high risk (28% at 8 years) for chest wall recurrence regardless of adjuvant systemic therapy, and therefore we recommend they be considered for postmastectomy radiation. This high risk of local failure was not observed in patients over age 50, suggesting this subgroup may not require adjuvant chest wall irradiation

Peripheral primitive neuroendocrine tumor of the chest wall—A case report with pathological correlation

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Jidi Gao, MD

2018-04-01

Full Text Available Primitive neuroectodermal tumor is a high-grade malignant tumor originating from the neural crest and neuroectoderm, which can be subdivided into central and peripheral categories. Peripheral primitive neuroectodermal tumor is thought to be identical to Ewing's sarcoma, and falls under a broader category of Ewing's sarcoma family of tumors. Very rarely, it may present without osseous involvement, known as extraosseous Ewing's sarcoma. Here we present a case of a 38-year-old woman, who presented with several-month history of a slow-growing chest wall mass, initially thought to be a breast mass. The mass was diagnosed as extraosseous Ewing's sarcoma upon tissue biopsy. The patient was started on a dose-intensified neoadjuvant therapy, based on protocol from pediatric population given rarity of this tumor in the adult population. While the patient was initially planned for surgical resection, the tumor showed excellent response to chemotherapy on follow-up imaging, and radiation therapy was elected in lieu of resection. Keywords: Chest wall tumors, Peripheral PNET, Ewing's sarcoma

Scalp Dose Evaluation According Radiation Therapy Technique of Whole Brain Radiation Therapy

International Nuclear Information System (INIS)

Jang, Joon Yung; Park, Soo Yun; Kim, Jong Sik; Choi, Byeong Gi; Song, Gi Won

2011-01-01

Opposing portal irradiation with helmet field shape that has been given to a patient with brain metastasis can cause excess dose in patient's scalp, resulting in hair loss. For this reason, this study is to quantitatively analyze scalp dose for effective prevention of hair loss by comparing opposing portal irradiation with scalp-shielding shape and tomotherapy designed to protect patient's scalp with conventional radiation therapy. Scalp dose was measured by using three therapies (HELMET, MLC, TOMO) after five thermo-luminescence dosimeters were positioned along center line of frontal lobe by using RANDO Phantom. Scalp dose and change in dose distribution were compared and analyzed with DVH after radiation therapy plan was made by using Radiation Treatment Planning System (Pinnacle3, Philips Medical System, USA) and 6 MV X-ray (Clinac 6EX, VARIAN, USA). When surface dose of scalp by using thermo-luminescence dosimeters was measured, it was revealed that scalp dose decreased by average 87.44% at each point in MLC technique and that scalp dose decreased by average 88.03% at each point in TOMO compared with HELMET field therapy. In addition, when percentage of volume (V95%, V100%, V105% of prescribed dose) was calculated by using Dose Volume Histogram (DVH) in order to evaluate the existence or nonexistence of hotspot in scalp as to three therapies (HELMET, MLC, TOMO), it was revealed that MLC technique and TOMO plan had good dose coverage and did not have hot spot. Reducing hair loss of a patient who receives whole brain radiotherapy treatment can make a contribution to improve life quality of the patient. It is expected that making good use of opposing portal irradiation with scalp-shielding shape and tomotherapy to protect scalp of a patient based on this study will reduce hair loss of a patient.

Scalp Dose Evaluation According Radiation Therapy Technique of Whole Brain Radiation Therapy

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Jang, Joon Yung; Park, Soo Yun; Kim, Jong Sik; Choi, Byeong Gi; Song, Gi Won [Dept. of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of)

2011-09-15

Opposing portal irradiation with helmet field shape that has been given to a patient with brain metastasis can cause excess dose in patient's scalp, resulting in hair loss. For this reason, this study is to quantitatively analyze scalp dose for effective prevention of hair loss by comparing opposing portal irradiation with scalp-shielding shape and tomotherapy designed to protect patient's scalp with conventional radiation therapy. Scalp dose was measured by using three therapies (HELMET, MLC, TOMO) after five thermo-luminescence dosimeters were positioned along center line of frontal lobe by using RANDO Phantom. Scalp dose and change in dose distribution were compared and analyzed with DVH after radiation therapy plan was made by using Radiation Treatment Planning System (Pinnacle3, Philips Medical System, USA) and 6 MV X-ray (Clinac 6EX, VARIAN, USA). When surface dose of scalp by using thermo-luminescence dosimeters was measured, it was revealed that scalp dose decreased by average 87.44% at each point in MLC technique and that scalp dose decreased by average 88.03% at each point in TOMO compared with HELMET field therapy. In addition, when percentage of volume (V95%, V100%, V105% of prescribed dose) was calculated by using Dose Volume Histogram (DVH) in order to evaluate the existence or nonexistence of hotspot in scalp as to three therapies (HELMET, MLC, TOMO), it was revealed that MLC technique and TOMO plan had good dose coverage and did not have hot spot. Reducing hair loss of a patient who receives whole brain radiotherapy treatment can make a contribution to improve life quality of the patient. It is expected that making good use of opposing portal irradiation with scalp-shielding shape and tomotherapy to protect scalp of a patient based on this study will reduce hair loss of a patient.

Cancer of the larynx: radiation therapy. III

International Nuclear Information System (INIS)

Wang, C.C.

1976-01-01

Radiation therapy is the treatment of choice for a T1 and T2 tumor with normal cord mobility and/or an exophytic lesion. It not only provides excellent control of the disease, but also preserves a good, useful voice in approximately 90 percent of the irradiated patients. For a T2 lesion with impaired cord mobility and/or moderate ulceration, a trial course of radiotherapy is initially given. If the tumor shows good regression and/or a return of normal cord mobility after a dose of 4000 rads, radiation therapy may be continued to a curative dose level, about 6500 rads. Surgery is reserved for treating residual disease six to eight weeks after radiation therapy or for recurrence. A T3 lesion with complete cord fixation and/or deep ulceration with nodes does not respond favorably to radiation therapy, and a planned combination of irradiation and laryngectomy is advised. Disease that extends beyond the larynx, T4, is rarely curable by radiation therapy alone. If the lesion is still operable, a combined approach of radiation and surgery is preferred; if not, palliative radiation therapy is given. Lymph node metastases from laryngeal carcinoma indicate advanced disease and is managed by preoperative irradiation and radical neck dissection. Under a program of therapeutic individualization, two-thirds to three-quarters of patients with cancer of the larynx can be cured by irradiation with preservation of a good, useful voice. In the remainder, the larynx must be sacrificed to save the patient's life. The ultimate control of laryngeal cancer lies in eradicating the extensive primary lesion and metastatic nodes, a common problem in the management of squamous cell carcinoma elsewhere in the body

Dosimetric analysis of imaging changes following pulmonary stereotactic body radiation therapy.

Science.gov (United States)

Prendergast, Brendan M; Bonner, James A; Popple, Richard A; Spencer, Sharon A; Fiveash, John B; Keene, Kimberly S; Cerfolio, Robert J; Minnich, Douglas J; Dobelbower, Michael C

2011-02-01

The aim of this study was to determine whether late patterns of pulmonary fibrosis are related to specific radiation doses administered during thoracic stereotactic body radiation therapy (SBRT). The records of all patients treated with SBRT for either pulmonary metastases or inoperable primary lung tumours at the University of Alabama at Birmingham from November 2005 to July 2008 were reviewed. Patients selected for analysis had diagnostic chest computed tomography (CT) scans acquired at least 180 days after completion of therapy. CT scans acquired at follow-up were co-registered with the original treatment planning CT scans for 12 eligible patients (17 lesions), and late-occurring pulmonary imaging abnormalities (IAs) were contoured. Dosimetric parameters analysed include D(80) , D(90) , V(18) and V(prescription dose) of the IA and V(14) and V(18) of the lung. Late pulmonary IAs were identified in 11 treated areas from nine patients. Late IAs could not be identified in six treated areas from three patients secondary to emphysema, tumour progression and severe atelectasis, respectively. The mean doses to 80% (D(80) ) and 90% (D(90) ) of the IAs were 18.4 and 14.5 Gy, respectively (ranges: 5.6-27.8 and 3.3-22.4 Gy). On average, 79.4% (range: 45.6-97.5%) of the IA received at least 18 Gy, while an average of 19.3% (range: 0.2-42.2%) received the prescription dose. On average, only 4.2% (range: 1.1-7.8%) of the lungs received 18 Gy. Imaging abnormalities consistent with pulmonary fibrosis are common after SBRT and are well approximated by the 18 Gy isodose distribution. The clinical ramification of these findings should be evaluated in future studies. © 2011 The Authors. Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.

Whole-brain radiation therapy for brain metastases: detrimental or beneficial?

International Nuclear Information System (INIS)

Gemici, Cengiz; Yaprak, Gokhan

2015-01-01

Stereotactic radiosurgery is frequently used, either alone or together with whole-brain radiation therapy to treat brain metastases from solid tumors. Certain experts and radiation oncology groups have proposed replacing whole-brain radiation therapy with stereotactic radiosurgery alone for the management of brain metastases. Although randomized trials have favored adding whole-brain radiation therapy to stereotactic radiosurgery for most end points, a recent meta-analysis demonstrated a survival disadvantage for patients treated with whole-brain radiation therapy and stereotactic radiosurgery compared with patients treated with stereotactic radiosurgery alone. However the apparent detrimental effect of adding whole-brain radiation therapy to stereotactic radiosurgery reported in this meta-analysis may be the result of inhomogeneous distribution of the patients with respect to tumor histologies, molecular histologic subtypes, and extracranial tumor stages between the groups rather than a real effect. Unfortunately, soon after this meta-analysis was published, even as an abstract, use of whole-brain radiation therapy in managing brain metastases has become controversial among radiation oncologists. The American Society of Radiation Oncology recently recommended, in their “Choose Wisely” campaign, against routinely adding whole-brain radiation therapy to stereotactic radiosurgery to treat brain metastases. However, this situation creates conflict for radiation oncologists who believe that there are enough high level of evidence for the effectiveness of whole-brain radiation therapy in the treatment of brain metastases

Radiodiagnostic measurements radiation load of children by chest

International Nuclear Information System (INIS)

Nikodemova, D.; Vladar, M.; Ranogajec, M.; Horvathova, M

1998-01-01

With the aim of optimisation of the radiographic examinations in paediatric radiology the entrance surface doses measured by chest examinations, as the most frequent procedure for children in Slovakia were surveyed. In this paper the results of measurements and calculations of doses obtained by paediatric patients with ages ranging from newborn to 15 years, who undergone chest radiodiagnostic examinations during the year 1996 are presented.. The obtained results are compared with dose assessment procedures based on total absorbed dose calculations using the published conversion factors between energy impaired to the patient and and entrance surface doses integrated over the beam area

Evaluation of Setup Error Correction for Patients Using On Board Imager in Image Guided Radiation Therapy

International Nuclear Information System (INIS)

Kang, Soo Man

2008-01-01

To reduce side effects in image guided radiation therapy (IGRT) and to improve the quality of life of patients, also to meet accurate SETUP condition for patients, the various SETUP correction conditions were compared and evaluated by using on board imager (OBI) during the SETUP. Each 30 cases of the head, the neck, the chest, the belly, and the pelvis in 150 cases of IGRT patients was corrected after confirmation by using OBI at every 2-3 day. Also, the difference of the SETUP through the skin-marker and the anatomic SETUP through the OBI was evaluated. General SETUP errors (Transverse, Coronal, Sagittal) through the OBI at original SETUP position were Head and Neck: 1.3 mm, Brain: 2 mm, Chest: 3 mm, Abdoman: 3.7 mm, Pelvis: 4 mm. The patients with more that 3 mm in the error range were observed in the correction devices and the patient motions by confirming in treatment room. Moreover, in the case of female patients, the result came from the position of hairs during the Head and Neck, Brain tumor. Therefore, after another SETUP in each cases of over 3 mm in the error range, the treatment was carried out. Mean error values of each parts estimated after the correction were 1 mm for the head, 1.2 mm for the neck, 2.5 mm for the chest, 2.5 mm for the belly, and 2.6 mm for the pelvis. The result showed the correction of SETUP for each treatment through OBI is extremely difficult because of the importance of SETUP in radiation treatment. However, by establishing the average standard of the patients from this research result, the better patient satisfaction and treatment results could be obtained.

Evaluation of Setup Error Correction for Patients Using On Board Imager in Image Guided Radiation Therapy

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Kang, Soo Man [Dept. of Radiation Oncology, Kosin University Gospel Hospital, Busan (Korea, Republic of)

2008-09-15

To reduce side effects in image guided radiation therapy (IGRT) and to improve the quality of life of patients, also to meet accurate SETUP condition for patients, the various SETUP correction conditions were compared and evaluated by using on board imager (OBI) during the SETUP. Each 30 cases of the head, the neck, the chest, the belly, and the pelvis in 150 cases of IGRT patients was corrected after confirmation by using OBI at every 2-3 day. Also, the difference of the SETUP through the skin-marker and the anatomic SETUP through the OBI was evaluated. General SETUP errors (Transverse, Coronal, Sagittal) through the OBI at original SETUP position were Head and Neck: 1.3 mm, Brain: 2 mm, Chest: 3 mm, Abdoman: 3.7 mm, Pelvis: 4 mm. The patients with more that 3 mm in the error range were observed in the correction devices and the patient motions by confirming in treatment room. Moreover, in the case of female patients, the result came from the position of hairs during the Head and Neck, Brain tumor. Therefore, after another SETUP in each cases of over 3 mm in the error range, the treatment was carried out. Mean error values of each parts estimated after the correction were 1 mm for the head, 1.2 mm for the neck, 2.5 mm for the chest, 2.5 mm for the belly, and 2.6 mm for the pelvis. The result showed the correction of SETUP for each treatment through OBI is extremely difficult because of the importance of SETUP in radiation treatment. However, by establishing the average standard of the patients from this research result, the better patient satisfaction and treatment results could be obtained.

Insufficiency fractures following radiation therapy for gynecologic malignancies

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Ikushima, Hitoshi; Takegawa, Yoshihiro; Matsuki, Hirokazu; Yasuda, Hiroaki; Kawanaka, Takashi; Shiba, Atsushi; Kishida, Yoshiomi; Iwamoto, Seiji; Nishitani, Hiromu [Tokushima Univ. (Japan). School of Medicine

2002-12-01

The purpose of this study was to investigate the incidence, clinical and radiological findings of insufficiency fractures (IF) of the female pelvis following radiation therapy. We retrospectively reviewed the radiation oncology records of 108 patients with gynecologic malignancies who underwent external beam radiation therapy of the whole pelvis. All patients underwent conventional radiography and computed tomography (CT) scan every 6 months in follow-up after radiation therapy and magnetic resonance imaging (MRI) and radionuclide bone scan were added when the patients complained of pelvic pain. Thirteen of 108 patients (12%) developed IF in the irradiated field with a median interval of 6 months (range 3-51) from the completion of external beam radiation therapy. All patients who developed IF were postmenopausal women. Age of the patients who developed IF was significantly higher than that of the other patients. The parts of IF were sacroiliac joints, pubis, sacral body and 5th lumbar vertebra and six of 14 patients had multiple lesions. Treatment with rest and nonsteroidal anti-inflammatory drugs lead to symptomatic relief in all patients, although symptoms lasted from 3 to 20 months. Radiation-induced pelvic IF following radiation therapy for gynecologic malignancies were frequently observed in the post-menopausal patients within 1 year after external beam radiation therapy. Symmetrical fractures of the bilateral sacroiliac joint and pubis were the characteristic pattern of pelvic IF. All patients healed with conservative treatment, and nobody became non-ambulant. (author)

Intensity-modulated radiation therapy: dynamic MLC (DMLC) therapy, multisegment therapy and tomotherapy. An example of QA in DMLC therapy

International Nuclear Information System (INIS)

Webb, S.

1998-01-01

Intensity-modulated radiation therapy will make a quantum leap in tumor control. It is the new radiation therapy for the new millennium. The major methods to achieve IMRT are: 1. Dynamic multileaf collimator (DMLC) therapy, 2. multisegment therapy, and 3. tomotherapy. The principles of these 3 techniques are briefly reviewed. Each technique presents unique QA issues which are outlined. As an example this paper will present the results of a recent new study of an important QA concern in DMLC therapy. (orig.) [de

Radiation therapy of Graves' ophthalmopathy. 2; Therapy started time

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Kawamura, Toshinori; Koga, Sukehiko (Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine)

1994-04-01

The difference in the improvement of exophthalmos according to the period of starting radiation therapy was investigated for 26 patients of thyroid ophthalmopathy, also taking thyroidism during radiation into consideration. A 4 MV X-ray was used to a total dose of 20 Gy per 2 weeks. The treatment value tended to be better for the patients in whom the period from the appearance of exophthalmos in an euthyroid condition to the start of radiation was less than 12 months; those of a longer period showed poorer improvement. Radiation treatment of a hyperthyroid condition also showed poor results and it was thought it was not an adequately long enough period for the radiation to take effect. As a result, it was considered that the radiation therapy shall be advantageous if started within 12 months after the appearance of exophthalmos in an euthyroid condition. (author).

Radiation therapy for Ewing's sarcoma: Results from Memorial Sloan-Kettering in the modern era

International Nuclear Information System (INIS)

La, Trang H.; Meyers, Paul A.; Wexler, Leonard H.; Alektiar, Kaled M.; Healey, John H.; Laquaglia, Michael P.; Boland, Patrick J.; Wolden, Suzanne L.

2006-01-01

Purpose: To evaluate the outcomes of patients with Ewing's sarcoma family of tumors (ESFT) treated with modern radiotherapy techniques with MRI along with optimal chemotherapy. Methods and Materials: The records of all 60 patients with ESFT who received radiation to the primary site between 1990 and 2004 were reviewed. All patients received chemotherapy, including vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Radiation was used as the sole modality for local control in 31 patients and was given either before (n = 3) or after surgical resection (n = 26) in the remainder. All patients had MRI and CT scan-based treatment planning, and 43% received intensity-modulated radiation therapy. Radiation doses ranged from 30 Gy to 60 Gy (median, 51 Gy), and 35% received hyperfractionated radiotherapy. Results: Median age was 16 years (range, 2-40 years). Because of selection bias for radiotherapy, the majority of primary tumors were centrally located (72%): spine (n = 18), pelvis (n = 15), extremities (n 12), chest wall (n = 5), head and neck (n = 5), and other (n = 5). Thirty-eight percent of patients presented with metastatic disease, and 52% of primary tumors were ≥8 cm. Actuarial 3-year local control was 77%. The presence of metastases at diagnosis was an adverse prognostic factor for local control (84% vs. 61%, p = 0.036). No other predictive factors for local failure were identified. In patients without metastatic disease, 3-year disease-free and overall survival rates were 70% and 86%, respectively, whereas in patients with metastases they were both 21%. Follow-up of surviving patients was 6-178 months (median, 41 months). Conclusion: In this unfavorable cohort of ESFT patients, radiation therapy was an effective modality for local control, especially for patients without metastases. The presence of metastases at diagnosis is a predictive factor not only for death but also for local failure

Postoperative radiation therapy for lung cancer

International Nuclear Information System (INIS)

Teshima, Teruki; Chatani, Masashi; Inoue, Toshihiko; Kurokawa, Eiji; Kodama, Ken; Doi, Osamu

1987-01-01

From January 1978 through December 1982, a total of 241 cases with lung cancer underwent surgery. Twenty-nine cases (operative death: 7, relative non-curative operation: 13, exploratory thoracotomy: 9) were excluded because they did not receive radiation therapy (RT). The remaining 212 cases were available for this analysis. Forty-two of them were treated with RT postoperatively. Three-year survival rates according to curability in the non-RT and RT groups were 83 % and 71 % (NS) in the curative operation group. In the relatively curative operation group, the corresponding figures were 40 % and 33 % (NS), and in the absolutely non-curative operation group, 3 % and 20 % (p < 0.01), respectively. The analysis of background factors revealed that in the curative operation group the rate of combined resection and in the relatively curative operation group pT3 and combined resection were significantly higher in the RT group than non-RT group. In the absolutely non-curative operation group, the rate of pM1 was significantly lower in RT group than the non-RT group. The pattern of failure of the RT group by histology was analysed. Local and regional failure was most common in the squamous cell carcinoma group and distant failure in the adenocarcinoma group. However, in the adenocarcinoma group local and regional or supraclavicular lymph node failure was also frequently noted. The relationship between the radiation field and local and regional or supraclavicular lymph node failure was analysed. In the squamous cell carcinoma group, in-field failure was most common, whereas in the adenocarcinoma group, outside (marginal) failure was common, especially in the supraclavicular lymph nodes. Concerning squamous cell carcinoma, microscopic or macroscopic residual tumor at the surgical margin, which includes the chest wall, stump (BS or VS) and pericardium was well controlled in each operation group with more than 50 Gy of RT. (J.P.N.)

Radiation therapy among atomic bomb survivors, Hiroshima and Nagasaki

International Nuclear Information System (INIS)

Pinkston, J.A.; Antoku, Shigetoshi; Russell, W.J.

1980-10-01

In the continuing evaluations of atomic bomb survivors for late radiation effects, not only doses from the A-bombs but those from other radiation sources must be considered, for the latter may be concomitantly acting factors causing bias among these investigations. In the present study, among 73 Hiroshima and 22 Nagasaki Adult Health Study (AHS) subjects who reported receiving radiation therapy, from 1970 through 1979, the medical records of 72 and 20, respectively, were reviewed, and 41 Hiroshima and 14 Nagasaki subjects were confirmed to have received radiation therapy. The data obtained in the present study were pooled with those of the previous investigation on radiation therapy exposures of AHS subjects prior to 1970. A total of 190 subjects have been documented as receiving radiation therapy and their doses were estimated. Energies used in treatments and diseases treated are discussed. Malignancies developed subsequent to radiation therapy in seven cases; five after treatment for malignancies and two after treatment for benign diseases. Neoplasms of 12 AHS subjects may have been induced by earlier radiation therapy; 5 in the earlier study and 7 in the present one. These investigations underscore the need for continued documentation of exposures to ionizing radiation for medical reasons, especially from sources incurring relatively high doses. Bias in assessments of late radiation effects among A-bomb survivors can thus be avoided. (author)

Chest radiotherapy in limited-stage small cell lung cancer: facts, questions, prospects

International Nuclear Information System (INIS)

De Ruysscher, D.; Vansteenkiste, J.

2000-01-01

Limited-disease small cell lung cancer (LD-SCLC) is initially very sensitive to both radiotherapy and chemotherapy. However, the 5-year survival is generally only 10-15%, with most patients failing with therapy refractory relapses, both locally and in distant sites. The addition of chest irradiation to chemotherapy increases the absolute survival by approximately 5%. We reviewed the many controversies regarding optimal timing and irradiation technique. No strong data support total radiation doses over 50 Gy. According to one phase III trial and several retrospective studies, increasing the volume of the radiation fields to the pre-chemotherapy turnout volume instead of the post-chemotherapy volume does not improve local control. The total time in which the entire combined-modality treatment is delivered may be important. From seven randomized trials, it can be concluded that the timing of the radiotherapy as such is not very important. Some phase III trials support the use of accelerated chest radiation together with cisplatin-etoposide chemotherapy, delivered from the first day of treatment, although no firm conclusions can be drawn from the available data. The best results are reported in studies in which the time from the start of treatment to the end of the radiotherapy was less than 30 days. This has to be taken into consideration when treatment modalities incorporating new chemotherapeutic agents and radiotherapy are considered. (author)

Detoxication and antiproteolytic therapy of radiation complications

International Nuclear Information System (INIS)

Yakhontov, N.E.; Klimov, I.A.; Lavrikova, L.P.; Martynov, A.D.; Provorova, T.P.; Serdyukov, A.S.; Shestakov, A.F.

1984-01-01

49 patients with uterine cervix and ovarian carcinomas were treated with detoxication and antiproteolytic therapy of radiation-induced side-effects. The therapy permits to complete without interruption the remote gamma-therapy course and to reduce patients in-hospital periods by 10+- 1 days. The prescription of hemoder intravenous injection in a dose of 450 ml and contrical intramuscular injection (10000 AtrE) in cases of pronounced manifestations of radiation-induced side-effects (asthenia, leukopenia, enterocolitis) for 3 days should be considered an efficient therapy

Radiation therapy in patients with hematologic diseases

International Nuclear Information System (INIS)

Hennequin, C.; Maylin, C.

1995-01-01

Radiation therapy has a significant place in the treatment of hematologic diseases. Irradiation is a key component of the treatment strategy for Hodgkin's disease and has benefited from clinical studies aimed at improving its therapeutic index. There have been many recent improvements, in particular with regard to accuracy of techniques, imagery, dosimetry, and implementation of quality-control procedures. In localized non-Hodgkin's lymphoma, the gold-standard treatment is radiation therapy coupled with a short course of chemotherapy. In contrast, the place of irradiation in disseminated lymphomas remains to be defined. Prophylactic irradiation of the brain is still used in patients with acute lymphoblastic leukemia. Radiation therapy is of value as palliative treatment of bone lesions of myeloma, in chemo-resistant lymphomas, and in relapses of leukemia. Total body irradiation is a cumbersome but irreplaceable method, which has also benefited from recent clinical and biological studies. Optimal radiation therapy with the best possible therapeutic index requires adequate technological and human resources. (authors). 30 refs., 1 tab

The forgotten view: Chest X-ray - Lateral view

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Abraham M. Ittyachen

2017-01-01

Full Text Available With CT (computed tomography chest gaining more importance as a diagnostic tool, chest X-ray especially the lateral view is taken less commonly nowadays. Besides CT chest is also proven to be superior to chest X-ray in patients with major blunt trauma. We are presenting a 68-year old male who was partially treated from outside for a left sided pneumonia. He came to our hospital because of persisting chest pain. Chest X-ray, frontal view (postero-anterior was almost normal except for a mild opacity in the left lower zone. CT scan of the chest revealed a fluid collection posteriorly enclosed within enhancing pleura. Chest X-ray, left lateral view showed a corresponding posterior pleural based opacity. We are presenting this case to highlight the importance of the lateral view of the chest X-ray. In selected cases there is still a role for the lateral view. With the three dimensional visualization provided by the CT, the lateral view of the chest may be easier to understand. Consequent to the initial diagnosis by CT further follow up can be done with the chest X-ray. In a limited way this mitigates unnecessary expenditure and more importantly prevents the patient from exposure to harmful radiation in the form of repeated CT.

Impact of radiation therapy on sexual life

International Nuclear Information System (INIS)

Leroy, T.; Gabelle Flandin, I.; Habold, D.; Hannoun-Levi, J.M.

2012-01-01

The aim of this study was to evaluate the impact of radiation therapy on sexual life. The analysis was based on a Pubmed literature review. The keywords used for this research were 'sexual, radiation, oncology, and cancer'. After a brief reminder on the anatomy and physiology, we explained the main complications of radiation oncology and their impact on sexual life. Preventive measures and therapeutic possibilities were discussed. Radiation therapy entails local, systematic and psychological after-effects. For women, vaginal stenosis and dyspareunia represent the most frequent side effects. For men, radiation therapy leads to erectile disorders for 25 to 75% of the patients. These complications have an echo often mattering on the patient quality of life of and on their sexual life post-treatment reconstruction. The knowledge of the indications and the various techniques of irradiation allow reducing its potential sexual morbidity. The information and the education of patients are essential, although often neglected. In conclusion, radiation therapy impacts in variable degrees on the sexual life of the patients. Currently, there are not enough preventive and therapeutic means. Patient information and the early screening of the sexual complications are at stake in the support of patients in the reconstruction of their sexual life. (authors)

Revision of orthovoltage chest wall treatment using Monte Carlo simulations.

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Zeinali-Rafsanjani, B; Faghihi, R; Mosleh-Shirazi, M A; Mosalaei, A; Hadad, K

2017-01-01

Given the high local control rates observed in breast cancer patients undergoing chest wall irradiation by kilovoltage x-rays, we aimed to revisit this treatment modality by accurate calculation of dose distributions using Monte Carlo simulation. The machine components were simulated using the MCNPX code. This model was used to assess the dose distribution of chest wall kilovoltage treatment in different chest wall thicknesses and larger contour or fat patients in standard and mid sternum treatment plans. Assessments were performed at 50 and 100 cm focus surface distance (FSD) and different irradiation angles. In order to evaluate different plans, indices like homogeneity index, conformity index, the average dose of heart, lung, left anterior descending artery (LAD) and percentage target coverage (PTC) were used. Finally, the results were compared with the indices provided by electron therapy which is a more routine treatment of chest wall. These indices in a medium chest wall thickness in standard treatment plan at 50 cm FSD and 15 degrees tube angle was as follows: homogeneity index 2.57, conformity index 7.31, average target dose 27.43 Gy, average dose of heart, lung and LAD, 1.03, 2.08 and 1.60 Gy respectively and PTC 11.19%. Assessments revealed that dose homogeneity in planning target volume (PTV) and conformity between the high dose region and PTV was poor. To improve the treatment indices, the reference point was transferred from the chest wall skin surface to the center of PTV. The indices changed as follows: conformity index 7.31, average target dose 60.19 Gy, the average dose of heart, lung and LAD, 3.57, 6.38 and 5.05 Gy respectively and PTC 55.24%. Coverage index of electron therapy was 89% while it was 22.74% in the old orthovoltage method and also the average dose of the target was about 50 Gy but in the given method it was almost 30 Gy. The results of the treatment study show that the optimized standard and mid sternum treatment for different chest

Once-Daily Radiation Therapy for Inflammatory Breast Cancer

International Nuclear Information System (INIS)

Brown, Lindsay; Harmsen, William; Blanchard, Miran; Goetz, Matthew; Jakub, James; Mutter, Robert; Petersen, Ivy; Rooney, Jessica; Stauder, Michael; Yan, Elizabeth; Laack, Nadia

2014-01-01

Purpose: Inflammatory breast cancer (IBC) is a rare and aggressive breast cancer variant treated with multimodality therapy. A variety of approaches intended to escalate the intensity and efficacy of radiation therapy have been reported, including twice-daily radiation therapy, dose escalation, and aggressive use of bolus. Herein, we examine our outcomes for patients treated with once-daily radiation therapy with aggressive bolus utilization, focusing on treatment technique. Methods and Materials: A retrospective review of patients with nonmetastatic IBC treated from January 1, 2000, through December 31, 2010, was performed. Locoregional control (LRC), disease-free survival (DFS), overall survival (OS) and predictors thereof were assessed. Results: Fifty-two women with IBC were identified, 49 (94%) of whom were treated with neoadjuvant chemotherapy. All underwent mastectomy followed by adjuvant radiation therapy. Radiation was delivered in once-daily fractions of 1.8 to 2.25 Gy (median, 2 Gy). Patients were typically treated with daily 1-cm bolus throughout treatment, and 33 (63%) received a subsequent boost to the mastectomy scar. Five-year Kaplan Meier survival estimates for LRC, DFS, and OS were 81%, 56%, and 64%, respectively. Locoregional recurrence was associated with poorer OS (P<.001; hazard ratio [HR], 4.1). Extracapsular extension was associated with worse LRC (P=.02), DFS (P=.007), and OS (P=.002). Age greater than 50 years was associated with better DFS (P=.03). Pathologic complete response was associated with a trend toward improved LRC (P=.06). Conclusions: Once-daily radiation therapy with aggressive use of bolus for IBC results in outcomes consistent with previous reports using various intensified radiation therapy regimens. LRC remains a challenge despite modern systemic therapy. Extracapsular extension, age ≤50 years, and lack of complete response to chemotherapy appear to be associated with worse outcomes. Novel strategies are needed in IBC

Targeted Radiation Therapy for Cancer Initiative

Science.gov (United States)

2017-11-01

AWARD NUMBER: W81XWH-08-2-0174 TITLE: Targeted Radiation Therapy for Cancer Initiative PRINCIPAL INVESTIGATOR: Dusten Macdonald, MD...for Cancer Initiative 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Dusten Macdonald, MD 5d. PROJECT NUMBER...Cancer Initiative Final Report INTRODUCTION: The full potential of radiation therapy has not been realized due to the inability to locate and

Pulmonary disease in cystic fibrosis: assessment with chest CT at chest radiography dose levels.

Science.gov (United States)

Ernst, Caroline W; Basten, Ines A; Ilsen, Bart; Buls, Nico; Van Gompel, Gert; De Wachter, Elke; Nieboer, Koenraad H; Verhelle, Filip; Malfroot, Anne; Coomans, Danny; De Maeseneer, Michel; de Mey, Johan

2014-11-01

To investigate a computed tomographic (CT) protocol with iterative reconstruction at conventional radiography dose levels for the assessment of structural lung abnormalities in patients with cystic fibrosis ( CF cystic fibrosis ). In this institutional review board-approved study, 38 patients with CF cystic fibrosis (age range, 6-58 years; 21 patients 18 years) underwent investigative CT (at minimal exposure settings combined with iterative reconstruction) as a replacement of yearly follow-up posteroanterior chest radiography. Verbal informed consent was obtained from all patients or their parents. CT images were randomized and rated independently by two radiologists with use of the Bhalla scoring system. In addition, mosaic perfusion was evaluated. As reference, the previous available conventional chest CT scan was used. Differences in Bhalla scores were assessed with the χ(2) test and intraclass correlation coefficients ( ICC intraclass correlation coefficient s). Radiation doses for CT and radiography were assessed for adults (>18 years) and children (chest CT protocol can replace the two yearly follow-up chest radiographic examinations without major dose penalty and with similar diagnostic quality compared with conventional CT.

Stereotactic body radiation therapy versus conventional radiation therapy in patients with early stage non-small cell lung cancer

DEFF Research Database (Denmark)

Jeppesen, Stefan Starup; Schytte, Tine; Jensen, Henrik R

2013-01-01

Abstract Introduction. Stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC) is now an accepted and patient friendly treatment, but still controversy exists about its comparability to conventional radiation therapy (RT). The purpose of this single...... and SBRT predicted improved prognosis. However, staging procedure, confirmation procedure of recurrence and technical improvements of radiation treatment is likely to influence outcomes. However, SBRT seems to be as efficient as conventional RT and is a more convenient treatment for the patients....

Effective treatment of the brachial plexus syndrome in breast cancer patients by early detection and control of loco-regional metastases with radiation or systemic therapy

International Nuclear Information System (INIS)

Kamenova, B.; Braverman, A.S.; Schwartz, M.; Sohn, C.; Lange, C.; Efiom-Ekaha, D.; Rotman, M.; Yoon, H.

2009-01-01

In breast cancer (BC) patients the brachial plexus syndrome (BPS) has been reported to be due to loco-regional metastases or radiation plexopathy. Associated arm edema is considered more suggestive of the latter. Radiation therapy is the only effective treatment for BPS reported. The charts of all BC patients who presented to our clinic from 1982 to 2006 with homolateral arm pain and neurological deficits, without humerus, cervical spine, or brain metastases, were reviewed. There were 28 patients fulfilling these criteria for BPS. Supraclavicular, axillary or chest wall metastases developed synchronously with the BPS in 26 patients; in 21 they were recurrences, found 6-94 months (median 34 months) after primary BC treatment, while in 5 others they were progressing inoperable primary tumors and nodes. Arm edema first occurred at the same time as loco-regional metastases in 19 patients. Treatment for the BPS was administered to 22 patients; it was directed at their loco-regional metastases. The BPS was initially treated with radiation (8 patients) or chemo- or endocrine therapy (14 patients); 19 (86%) had partial or complete remission of pain and neurologic deficits, with an 8-month median duration. The BPS in BC patients is due to loco-regional metastases and is often associated with arm edema. Chemo- or endocrine therapy induced the remission of pain and deficits as frequently as radiation therapy. (author)

Intensity-modulated radiation therapy.

Science.gov (United States)

Goffman, Thomas E; Glatstein, Eli

2002-07-01

Intensity-modulated radiation therapy (IMRT) is an increasingly popular technical means of tightly focusing the radiation dose around a cancer. As with stereotactic radiotherapy, IMRT uses multiple fields and angles to converge on the target. The potential for total dose escalation and for escalation of daily fraction size to the gross cancer is exciting. The excitement, however, has greatly overshadowed a range of radiobiological and clinical concerns.

Modern role and issues of radiation therapy for benign diseases

International Nuclear Information System (INIS)

Miyashita, Tsuguhiro; Tateno, Atsushi; Kumazaki, Tatsuo

1999-01-01

Cases of radiation therapy for benign diseases have diminished in number because of recent alternative methods and knowledge about radiation carcinogenesis. In contrast to this tendency, our cases of benign diseases have recently increased. The facts made us reconsider today's radiation therapy of benign diseases. We reviewed 349 patients who were diagnosed as having benign tumors or non-neoplastic conditions and treated by radiation therapy in the past sixteen years. Analyzed items were the annual transition of treatment number, sorts of diseases, patients' age and sex, and the goal of therapy. Of all radiation therapy patients, benign diseases account for 9.26%. The annual percentages were 0.5%, 6.0%, 11.2% and 13.7% at intervals of five years since 1982. The majority was 246 post-operative irradiation for keloids (71%) and 41 pituitary adenomas (12%). Compared with malignant tumors, benign disease patients were statistically younger and female-dominant. Applications of radiation therapy in keloids and pituitary adenomas had definite goals, but were unclear in other rare diseases. Benign diseases should be treated by radiation therapy as the second or third option, provided the patients have serious symptoms and their diseases do not respond to other modalities. It seems to be widely accepted that favorite cases such as keloids and pituitary adenomas are treated by radiation therapy. But, optimal radiation therapies for other rare benign diseases have not been established. Therefore, the building of databases on radiation therapy on benign diseases should be pursued. Since benign disease patients were young and female-dominant and had many remaining years, their carcinogenicity potential should be considered. (author)

Stage IA non-Hodgkin's lymphoma of the Waldeyer's ring; Limited chemotherapy and radiation therapy versus radiation therapy alone

Energy Technology Data Exchange (ETDEWEB)

Uematsu, Minoru (Keio Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology Dept. of Radiology, National Defense Medical College, Saitama (Japan)); Kondo, Makoto (Keio Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology); Hiramatsu, Hideko (Keio Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology); Ikeda, Yasuo (Keio Univ. School of Medicine, Tokyo (Japan). Dept. of Hematology); Mikata, Sumio (Chiba Univ. (Japan). School of Medicine); Katayama, Michiaki (Keio Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology); Ito, Hisao (Keio Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology); Kusano, Shoichi (Dept. of Radiology, National Defense Medical College, Saitama (Japan)); Kubo, Asuchishi (Keio Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology)

1993-01-01

Seventeen patients with stage IA non-Hodgkin's lymphoma of the Waldeyer's ring were treated with radiation therapy with or without chemotherapy. All lesions were judged as having intermediate grade malignancy in the Working Formulation. Eight patients received combined treatment with three cycles of cylcophosphamide, doxorubicin, vincristine and prednison (CHOP) and radiation therapy with 30 to 40 Gy. Another 9 patients were treated with radiation therapy 40 to 60 Gy alone. After a median follow-up of 69 months, all 8 patients, treated with combined modality were alive and relapse-free whereas 4 of the 9 treated with irradiation alone had relapsed. All relapses occurred transdiaphragmatically. Two of the 4 relapsing patients were saved, but the other two died of the disease. The 5-year relapse-free and cause-specific survival rates were 100% and 100% in the combined modality group, and 56% and 76% in the radiation therapy alone group (relapse-free: p=0.04, cause-specific: p=0.16). There were no serious complications related to treatment, although most patients complained of mouth dryness and most patients given CHOP had paresthesia. Our opinion was that the total impact of these two side-effects on quality of life was less pronounced after combined modality than after radiation therapy alone. Limited chemotherapy and radiation therapy seemed to be more beneficial than radiation therapy alone not only in relapse-free survival but also in quality of life after treatment. (orig.).

CT follow-up after radiation therapy for pituitary adenomas

International Nuclear Information System (INIS)

Rush, S.C.; Newall, J.

1988-01-01

Between 1973 and 1985, 105 patients received radiation therapy as all or part of their treatment for pituitary tumor at the New York University Medical Center. Of these, 48 patients underwent computed tomography (CT) at a minimum of 2 years following treatment, with detailed reports available for analysis of tumor regression. There were 28 men with a median age of 46 years (range, 18-71 years) and 20 women with a median age of 53 years (range, 28-80 years). Tumors were classified as secretory in 23 patients, nonsecretory in 21, and undetermined in four. Sixteen patients were treated with radiation therapy alone, 23 patients with surgery and radiation therapy, and the other with bromocriptine and radiation therapy, with or without surgery. With a median follow-up of 5 years (range, 2-14 years), 16 patients developed an empty sella, 25 patients had residual sellar mass, and seven patients had persistent extrasellar components or no change in their intrasellar mass. Among patients who did not have hypopituitarism at the inception of radiation therapy, five of 13 with empty sellas and 12 of 22 with residual mass subsequently required therapy. The authors conclude that residual mass is commonly found in long-term follow-up after radiation therapy, that isolated imaging studies revealing such findings after treatment in no way herald a diagnosis of recurrence, and that hypopituitarism following pituitary radiation therapy does not correlate with the ablation or persistence of tissue within the sella

Digital chest radiography: collimation and dose reduction

DEFF Research Database (Denmark)

Debess, Jeanne; Johnsen, Karen Kirstine; Vejle-Sørensen, Jens Kristian

,3 mAs and SID SID of 180 centimetres using a phantom and lithium fluoride thermo luminescence dosimeter (TLD). Dose to risk organs mamma, thyroid and colon are measured at different collimations with one-centimetre steps. TLD results are used to estimate dose reduction for different collimations...... at the conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

Radiation therapy for hypopharyngeal carcinoma. Impact of fractionation on treatment outcome

International Nuclear Information System (INIS)

Niibe, Yuzuru; Karasawa, Katsuyuki; Igaki, Hiroshi; Miyashita, Hisao; Tanaka, Yoshiaki

2003-01-01

The purpose of the current study was to evaluate the impact of fractionation on the treatment outcome of radiation therapy for hypopharyngeal carcinoma. Thirty-six inoperable or operation-refused hypopharyngeal patients were treated with curative-intended radiation therapy between 1976 and May 2001. Seventeen patients were treated with conventional radiation therapy, 1.8-2.0 Gy per fraction, totaling 64.0 Gy (conventional fractionation (CF) group), and 19 were treated with hyperfractionated radiation therapy, 1.2 Gy per fraction, totaling 74.4 Gy (hyperfractionation (HF) group). The radiation response of the two groups at the end of radiation therapy was almost the same. However, the 2-year local control rates of the HF and CF groups were 59.0% and 26.1% (p=0.012), respectively, a statistically significant differences. Moreover, multivariate analysis showed that HF was an independent prognostic factor for local control. Hyperfractionated radiation therapy was superior to conventional radiation therapy for local control. Local control of hypopharyngeal carcinoma correlated with laryngeal preservation, suggesting that hyperfractionated radiation therapy for hypopharyngeal carcinoma could be beneficial for patient quality of life (QOL). (author)

Investigation of the dosimetry of chest tomosynthesis

Science.gov (United States)

Svalkvist, Angelica; Zachrisson, Sara; Månsson, Lars Gunnar; Båth, Magnus

2009-02-01

Chest tomosynthesis has recently been introduced to healthcare as a low-dose alternative to CT or as a tool for improved diagnostics in chest radiography with only a modest increase in radiation dose to the patient. However, no detailed description of the dosimetry for this type of examination has been presented. The aim of this work was therefore to investigate the dosimetry of chest tomosynthesis. The chest tomosynthesis examination was assumed to be performed using a stationary detector and a vertically moving x-ray tube, exposing the patient from different angles. The Monte Carlo based computer software PCXMC was used to determine the effective dose delivered to a standard-sized patient from various angles using different assumptions of the distribution of the effective dose over the different projections. The obtained conversion factors between input dose measures and effective dose for chest tomosynthesis for different angular intervals were then compared with the horizontal projection. The results indicate that the error introduced by using conversion factors for the PA projection in chest radiography for estimating the effective dose of chest tomosynthesis is small for normally sized patients, especially if a conversion factor between KAP and effective dose is used.

State of the art of radiation therapy for esophageal cancer

International Nuclear Information System (INIS)

Itasaka, Satoshi

2014-01-01

Radiation therapy has a critical role in the treatment of esophageal cancer. To improve the treatment outcome of radiotherapy, not only strengthening the treatment intensity but also decreasing the long term toxicity is needed. To reduce the long term cardiopulmonary toxicity of chemoradiation, JCOG is now running a clinical trial which combines three dimensional conformal radiation therapy (3D-CRT) and mild irradiation dose. New techniques of radiation therapy, such as intensity modulated radiation therapy (IMRT) or particle therapy are also promising in both treatment intensity and decreased toxicity. (author)

Radiation Dose Reduction of Chest CT with Iterative Reconstruction in Image Space - Part I: Studies on Image Quality Using Dual Source CT

International Nuclear Information System (INIS)

Hwang, Hye Jeon; Seo, Joon Beom; Lee, Jin Seong; Song, Jae Woo; Lee, Hyun Joo; Lim, Chae Hun; Kim, Song Soo

2012-01-01

To determine whether the image quality (IQ) is improved with iterative reconstruction in image space (IRIS), and whether IRIS can be used for radiation reduction in chest CT. Standard dose chest CT (SDCT) in 50 patients and low dose chest CT (LDCT) in another 50 patients were performed, using a dual-source CT, with 120 kVp and same reference mAs (50 mAs for SDCT and 25 mAs for LDCT) employed to both tubes by modifying a dual-energy scan mode. Full-dose data were obtained by combining the data from both tubes and half-dose data were separated from a single tube. These were reconstructed by using a filtered back projection (FBP) and IRIS: full-dose FBP (F-FBP); full-dose IRIS (F-IRIS); half-dose FBP (H-FBP) and half-dose IRIS (H-IRIS). Objective noise was measured. The subjective IQ was evaluated by radiologists for the followings: noise, contrast and sharpness of mediastinum and lung. Objective noise was significantly lower in H-IRIS than in F-FBP (p < 0.01). In both SDCT and LDCT, the IQ scores were highest in F-IRIS, followed by F-FBP, H-IRIS and H-FBP, except those for sharpness of mediastinum, which tended to be higher in FBP. When comparing CT images between the same dose and different reconstruction (F-IRIS/F-FBP and H-IRIS/H-FBP) algorithms, scores tended to be higher in IRIS than in FBP, being more distinct in half-dose images. However, despite the use of IRIS, the scores were lower in H-IRIS than in F-FBP. IRIS generally helps improve the IQ, being more distinct at the reduced radiation. However, reduced radiation by half results in IQ decrease even when using IRIS in chest CT.

Nursing care update: Internal radiation therapy

International Nuclear Information System (INIS)

Lowdermilk, D.L.

1990-01-01

Internal radiation therapy has been used in treating gynecological cancers for over 100 years. A variety of radioactive sources are currently used alone and in combination with other cancer treatments. Nurses need to be able to provide safe, comprehensive care to patients receiving internal radiation therapy while using precautions to keep the risks of exposure to a minimum. This article discusses current trends and issues related to such treatment for gynecological cancers.20 references

Approach to chest pain and acute myocardial infarction | Pandie ...

African Journals Online (AJOL)

Approach to chest pain and acute myocardial infarction. ... Patient history, physical examination, 12-lead electrocardiogram (ECG) and cardiac biomarkers ... Essential adjunctive therapies include antiplatelet therapy (aspirin, P2Y12 inhibitors), ...

The role of radiation therapy in the multidisciplinary treatment of patients with malignant tumors. Radiation pathological stand point

International Nuclear Information System (INIS)

Niibe, Hideo

1998-01-01

Estimations suggest that about 60% of all cancer patients will require some form of radiation therapy during their lifetime. Although 40 to 50% of cancer patients in Europe and the United States receive radiation therapy, only about 20% of patients with cancer in Japan undergo such treatment. This is largely due to the lack of understanding of the role of radiation therapy by many medical personnel in Japan, as well as to ''''radiation allergy'''' among many of the general population in Japan, a country that has been undergone atomic bombing. From our perspective as specialists in radiation therapy, the chronic shortage of radiation oncologist also poses a serious problem. Although there are approximately 700 hospitals throughout Japan where radiation therapy is available, no more than half this number of medical facilities have a full-time radiation oncologist. Perhaps the reason for this is that radiation therapy is perceived as unnecessary in Japan. However, it is absolutely essential. In our experience, the 5-year relative survival rate of patients with malignant tumors who have undergone radiation therapy in our clinic is 65 percent. Thus, radiation therapy has proven very useful in the treatment of malignant tumors. Moreover, better estimates of prognosis of cancer patients treated with radiation therapy are becoming possible. This article discusses the role of radiation therapy, from a radiation pathological perspective, in a multidisciplinary approach to treatment of cancer patients. I also emphasize the critical importance of training radiation oncologists who can function as part of multidisciplinary teams that care for patients with malignant tumors. (author). 50 refs

Auger radiation targeted into DNA: a therapy perspective

Energy Technology Data Exchange (ETDEWEB)

Buchegger, Franz [University Hospital of Lausanne CHUV, Service of Nuclear Medicine, Lausanne (Switzerland); University Hospital of Lausanne, Service of Nuclear Medicine, Lausanne (Switzerland); Perillo-Adamer, Florence; Bischof Delaloye, Angelika [University Hospital of Lausanne CHUV, Service of Nuclear Medicine, Lausanne (Switzerland); Dupertuis, Yves M. [University Hospital of Geneva, Service of Nutrition, Geneva (Switzerland)

2006-11-15

Auger electron emitters that can be targeted into DNA of tumour cells represent an attractive systemic radiation therapy goal. In the situation of DNA-associated decay, the high linear energy transfer (LET) of Auger electrons gives a high relative biological efficacy similar to that of {alpha} particles. In contrast to {alpha} radiation, however, Auger radiation is of low toxicity when decaying outside the cell nucleus, as in cytoplasm or outside cells during blood transport. The challenge for such therapies is the requirement to target a high percentage of all cancer cells. An overview of Auger radiation therapy approaches of the past decade shows several research directions and various targeting vehicles. The latter include hormones, peptides, halogenated nucleotides, oligonucleotides and internalising antibodies. Here, we will discuss the basic principles of Auger electron therapy as compared with vector-guided {alpha} and {beta} radiation. We also review some radioprotection issues and briefly present the main advantages and disadvantages of the different targeting modalities that are under investigation. (orig.)

Auger radiation targeted into DNA: a therapy perspective

International Nuclear Information System (INIS)

Buchegger, Franz; Perillo-Adamer, Florence; Bischof Delaloye, Angelika; Dupertuis, Yves M.

2006-01-01

Auger electron emitters that can be targeted into DNA of tumour cells represent an attractive systemic radiation therapy goal. In the situation of DNA-associated decay, the high linear energy transfer (LET) of Auger electrons gives a high relative biological efficacy similar to that of α particles. In contrast to α radiation, however, Auger radiation is of low toxicity when decaying outside the cell nucleus, as in cytoplasm or outside cells during blood transport. The challenge for such therapies is the requirement to target a high percentage of all cancer cells. An overview of Auger radiation therapy approaches of the past decade shows several research directions and various targeting vehicles. The latter include hormones, peptides, halogenated nucleotides, oligonucleotides and internalising antibodies. Here, we will discuss the basic principles of Auger electron therapy as compared with vector-guided α and β radiation. We also review some radioprotection issues and briefly present the main advantages and disadvantages of the different targeting modalities that are under investigation. (orig.)

Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

Science.gov (United States)

Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

2013-01-01

Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged fifty or younger

International Nuclear Information System (INIS)

Freedman, Gary M.; Fowble, Barbara L.; Hanlon, Alexandra L.; Myint, Maung A.; Hoffman, John P.; Sigurdson, Elin R.; Eisenberg, Burton L.; Goldstein, Lori J.; Fein, Douglas A.

1998-01-01

Introduction: Indications for postmastectomy radiation include primary tumor size ≥5 cm and/or ≥4 positive axillary nodes. In clinical practice, patients with a close or positive margin after mastectomy are also often treated with postmastectomy radiation. However, there is little data regarding the risk of a chest wall recurrence in patients with close or positive margins who otherwise would be considered low risk (tumor size 50 (p = 0.04). There was no correlation with chest wall failure and number of positive nodes, ER status, lymphovascular invasion, location of primary, grade, family history, or type of tumor close to the margin. Of 5 chest wall failures, 4 were in patients who had received adjuvant systemic chemotherapy ± tamoxifen. Chest wall failures occurred in 1 patient with a positive deep margin, 3 patients with margins within 2 mm, and 1 patient with a margin of 5 mm. The estimated cumulative incidence probability of chest wall recurrence at 8 years by margin proximity was 24% ≤ 2 mm vs. 7% 2.1-6 mm (p = 0.36), and by clinical size 24% for T2 tumors vs. 7% for T1 (p = 0.98). Conclusions: A close or positive margin is uncommon (≤5%) after mastectomy in patients with tumor size <5 cm and 0-3 positive axillary nodes but, when present, it appears to be in a younger patient population. The subgroup of patients aged 50 or younger with clinical T1-T2 tumor size and 0-3 positive nodes who have a close (≤5 mm) or positive mastectomy margin are at high risk (28% at 8 years) for chest wall recurrence regardless of adjuvant systemic therapy and, therefore, should be considered for postmastectomy radiation

Breast conservation therapy for breast cancer. Radiation oncologist's point of view

International Nuclear Information System (INIS)

Hiraoka, Masahiro; Mitsumori, Michihide; Kokubo, Masaki; Fujishiro, Satsuki

1998-01-01

The roles and problems of radiation therapy in breast conserving therapy for breast cancer were presented. The roles of radiation therapy include decrease in breast recurrence, an alternative to axillary dissection for N0 cases, and neo-adjuvant radiation therapy. On the other hand, problems associated with radiation therapy are question of using radiation therapy for all cases, complications and worsening of cosmetics, and relatively high breast recurrence rates for margin-positive cases. The concept of breast conserving therapy is to improve QOL without decreasing treatment outcomes. It is considered that we should be more concentrated on the aspects of QOL because treatment outcomes of breast conserving therapy in Japan demonstrated sofar appear excellent. (author)

The measurement of organic radiation dose of multi-slice CT scanning by using the Chinese anthropomorphic chest phantom

International Nuclear Information System (INIS)

Peng Gang; Zeng Yongming; Luo Tianyou; Zhao Feng; Zhang Zhiwei; Yu Renqiang; Peng Shengkun

2011-01-01

Objective: Using the Chinese anthropomorphic chest phantom to measure the absorbed dose of various tissues and organs under different noise index, and to assess the radiation dose of MSCT chest scanning with the effective dose (ED). Methods: The equivalence of the Chinese anthropomorphic chest phantom (CDP-1 C) and the adult chest on CT sectional anatomy and X-ray attenuation was demonstrated. The absorbed doses of various tissues and organs under different noise index were measured by laying thermoluminescent dosimeters (TLD) inside the phantom, and the corresponding dose-length products (DLP) were recorded. Both of them were later converted into ED and comparison was conducted to analyze the dose levels of chest CT scanning with automatic tube current modulation (ATCM) under different noise index. Student t-test was applied using SPSS 12.0 statistical software. Results: The Phantom was similar to the human body on CT sectional anatomy. The average CT value of phantom are - 788.04 HU in lung, 45.64 HU in heart, 65.84 HU in liver, 254.32 HU in spine and the deviations are 0.10%, 3.04%, 4.49% and 4.36% respectively compared to humans. The difference of average CT value of liver was statistically significant (t=-8.705, P 0.05). As the noise index increased from 8.5 to 22.5, the DLP decreased from 393.57 mGy · cm to 78.75 mGy · cm and the organs dose declined. For example, the average absorbed dose decreased from 22.38 mGy to 3.66 mGy in lung. Compared to ED calculating by absorbed dose, the ED calculating by DLP was lower. The ED values of the two methods were 6.69 mSv and 8.77 mSv when the noise index was set at 8.5. Conclusions: Application of the Chinese anthropomorphic chest phantom to carry out CT dose assessment is more accurate. The noise index should be set more than 8.5 during the chest CT scanning based on ATCM technique. (authors)

Missed Radiation Therapy and Cancer Recurrence

Science.gov (United States)

Patients who miss radiation therapy sessions during cancer treatment have an increased risk of their disease returning, even if they eventually complete their course of radiation treatment, according to a new study.

21 CFR 892.5050 - Medical charged-particle radiation therapy system.

Science.gov (United States)

2010-04-01

...-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical charged-particle radiation therapy system... equipment, patient and equipment supports, treatment planning computer programs, component parts, and...

Chest X ray effective doses estimation in computed radiography

International Nuclear Information System (INIS)

Abdalla, Esra Abdalrhman Dfaalla

2013-06-01

Conventional chest radiography is technically difficult because of wide in tissue attenuations in the chest and limitations of screen-film systems. Computed radiography (CR) offers a different approach utilizing a photostimulable phosphor. photostimulable phosphors overcome some image quality limitations of chest imaging. The objective of this study was to estimate the effective dose in computed radiography at three hospitals in Khartoum. This study has been conducted in radiography departments in three centres Advanced Diagnostic Center, Nilain Diagnostic Center, Modern Diagnostic Center. The entrance surface dose (ESD) measurement was conducted for quality control of x-ray machines and survey of operators experimental techniques. The ESDs were measured by UNFORS dosimeter and mathematical equations to estimate patient doses during chest X rays. A total of 120 patients were examined in three centres, among them 62 were males and 58 were females. The overall mean and range of patient dosed was 0.073±0.037 (0.014-0.16) mGy per procedure while the effective dose was 3.4±01.7 (0.6-7.0) mSv per procedure. This study compared radiation doses to patients radiographic examinations of chest using computed radiology. The radiation dose was measured in three centres in Khartoum- Sudan. The results of the measured effective dose showed that the dose in chest radiography was lower in computed radiography compared to previous studies.(Author)

Adjuvant and Salvage Radiation Therapy After Prostatectomy: American Society for Radiation Oncology/American Urological Association Guidelines

Energy Technology Data Exchange (ETDEWEB)

Valicenti, Richard K., E-mail: Richard.valicenti@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California, Davis School of Medicine, Davis, California (United States); Thompson, Ian [Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States); Albertsen, Peter [Division of Urology, University of Connecticut Health Center, Farmington, Connecticut (United States); Davis, Brian J. [Department of Radiation Oncology, Mayo Medical School, Rochester, Minnesota (United States); Goldenberg, S. Larry [Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia (Canada); Wolf, J. Stuart [Department of Urology, University of Michigan, Ann Arbor, Michigan (United States); Sartor, Oliver [Department of Medicine and Urology, Tulane Medical School, New Orleans, Louisiana (United States); Klein, Eric [Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio (United States); Hahn, Carol [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Roach, Mack [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Faraday, Martha M. [Four Oaks, Inc (United States)

2013-08-01

Purpose: The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy. Methods and Materials: A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation. Conclusions: Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review.

Adjuvant and Salvage Radiation Therapy After Prostatectomy: American Society for Radiation Oncology/American Urological Association Guidelines

International Nuclear Information System (INIS)

Valicenti, Richard K.; Thompson, Ian; Albertsen, Peter; Davis, Brian J.; Goldenberg, S. Larry; Wolf, J. Stuart; Sartor, Oliver; Klein, Eric; Hahn, Carol; Michalski, Jeff; Roach, Mack; Faraday, Martha M.

2013-01-01

Purpose: The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy. Methods and Materials: A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation. Conclusions: Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review

Thyroid dysfunction after radiation therapy to the neck

International Nuclear Information System (INIS)

Soejima, Toshinori; Hirota, Saeko; Obayashi, Kayoko; Takada, Yoshiki; Kimura, Shuji; Yoshida, Shoji.

1993-01-01

The effects of radiation on the thyroid were investigated in 102 patients treated by radiation therapy to the neck. All patients had radiation ports which included the thyroid gland. Serum thyroid stimulating hormone (TSH) levels were elevated in 41 cases and the cumulative elevation rate was 52.1% in 5 years. The high frequency of elevated serum TSH levels observed in patients whose thyroid glands were included within the radiation fields (74.1%) was statistically significant compared to those whose thyroid glands were only partially included (23.4%). Among the patients whose entire thyroid glands were included within the radiation field, combination with chemotherapy increased the frequency of elevated serum TSH levels, but the increase was not statistically significant. Among 36 laryngeal cancer patients treated by only radiation therapy through a portal encompassing part of the thyroid, 4 (14%) were found to have elevated serum TSH levels. We advocate routine monitoring of thyroid functions after radiation therapy to the neck. (author)

Impaired skin integrity related to radiation therapy

International Nuclear Information System (INIS)

Ratliff, C.

1990-01-01

Skin reactions associated with radiation therapy require frequent nursing assessment and intervention. Preventive interventions and early management can minimize the severity of the skin reaction. With the understanding of the pathogenesis of radiation skin reactions, the ET nurse can determine who is at risk and then implement preventive measures. Because radiation treatment is fractionated, skin reactions do not usually occur until midway through the course of therapy and will subside within a few weeks after completion of radiation. Many patients and their families still fear that radiation causes severe burns. Teaching and anticipatory guidance by the ET nurse is needed to assist patients and their families to overcome this fear, and to educate them on preventive skin care regimens

Technological progress in radiation therapy for brain tumors

LENUS (Irish Health Repository)

Vernimmen, Frederik Jozef

2014-01-01

To achieve a good therapeutic ratio the radiation dose to the tumor should be as high as possible with the lowest possible dose to the surrounding normal tissue. This is especially the case for brain tumors. Technological ad- vancements in diagnostic imaging, dose calculations, and radiation delivery systems, combined with a better un- derstanding of the pathophysiology of brain tumors have led to improvements in the therapeutic results. The widely used technology of delivering 3-D conformal therapy with photon beams (gamma rays) produced by Li-near Accelerators has progressed into the use of Intensity modulated radiation therapy (IMRT). Particle beams have been used for several decades for radiotherapy because of their favorable depth dose characteristics. The introduction of clinically dedicated proton beam therapy facilities has improved the access for cancer patients to this treatment. Proton therapy is of particular interest for pediatric malignancies. These technical improvements are further enhanced by the evolution in tumor physiology imaging which allows for improved delineation of the tumor. This in turn opens the potential to adjust the radiation dose to maximize the radiobiological effects. The advances in both imaging and radiation therapy delivery will be discussed.

Prostate Cancer (Radiation Therapy)

Science.gov (United States)

... be considered carefully, balancing the advantages against the disadvantages as they relate to the individual man's age, ... therapy with photon or x-rays: Uses advanced technology to tailor the x-ray or photon radiation ...

Selective chest imaging for blunt trauma patients: The national emergency X-ray utilization studies (NEXUS-chest algorithm).

Science.gov (United States)

Rodriguez, Robert M; Hendey, Gregory W; Mower, William R

2017-01-01

Chest imaging plays a prominent role in blunt trauma patient evaluation, but indiscriminate imaging is expensive, may delay care, and unnecessarily exposes patients to potentially harmful ionizing radiation. To improve diagnostic chest imaging utilization, we conducted 3 prospective multicenter studies over 12years to derive and validate decision instruments (DIs) to guide the use of chest x-ray (CXR) and chest computed tomography (CT). The first DI, NEXUS Chest x-ray, consists of seven criteria (Age >60years; rapid deceleration mechanism; chest pain; intoxication; altered mental status; distracting painful injury; and chest wall tenderness) and exhibits a sensitivity of 99.0% (95% confidence interval [CI] 98.2-99.4%) and a specificity of 13.3% (95% CI, 12.6%-14.0%) for detecting clinically significant injuries. We developed two NEXUS Chest CT DIs, which are both highly reliable in detecting clinically major injuries (sensitivity of 99.2%; 95% CI 95.4-100%). Designed primarily to focus on detecting major injuries, the NEXUS Chest CT-Major DI consists of six criteria (abnormal CXR; distracting injury; chest wall tenderness; sternal tenderness; thoracic spine tenderness; and scapular tenderness) and exhibits higher specificity (37.9%; 95% CI 35.8-40.1%). Designed to reliability detect both major and minor injuries (sensitivity 95.4%; 95% CI 93.6-96.9%) with resulting lower specificity (25.5%; 95% CI 23.5-27.5%), the NEXUS CT-All rule consists of seven elements (the six NEXUS CT-Major criteria plus rapid deceleration mechanism). The purpose of this review is to synthesize the three DIs into a novel, cohesive summary algorithm with practical implementation recommendations to guide selective chest imaging in adult blunt trauma patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Radiation therapy among A-bomb survivors, Hiroshima and Nagasaki

Energy Technology Data Exchange (ETDEWEB)

Russell, W J; Antoku, S

1971-01-01

The hospitals and clinics responsible for radiation therapy reported by ABCC-JNIH Adult Health Study subjects were surveyed to confirm treatment and estimate doses they received. Of 426 cases, 137 were documented by hospital records. Their ABCC medical records were also reviewed for pertinent clinical information. Excluding the cases not verified because of unavailability of records, confirmation rates were 0.46 in Hiroshima and 0.67 in Nagasaki. Radiation therapy doses according to date of treatment, diagnosis, body site, and source of exposure are included. These data are recorded routinely for future reference, along with doses from diagnostic roentgenology for evaluating overall ionizing radiation exposure of A-bomb survivors and their comparison subjects. Radiation therapy by source and by lesion treated is included. There were three cases with malignancies possibly related to their earlier radiation therapy. One was an A-bomb survivor with lung cancer previously reported as due to ionizing radiation from the A-bomb. Radiation therapy she received for breast cancer 11 years earlier was more likely the cause of the lung lesion than was her relatively small A-bomb dose. The importance of recording all diagnostic and therapeutic radiation, especially that received by those under continuing surveillance for late A-bomb effects, is stressed. (auth)

Planning guide for radiologic installations. fascicle 1 -- radiation therapy installations

International Nuclear Information System (INIS)

Tuddenham, W.J.

1976-01-01

Five articles dealing with the development and operation of radiation therapy facilities present recommendations for the design of various types of radiation therapy facilities, including the university center, the free-standing private oncology center, and the community hospital radiation therapy department. Different concepts of department design are represented. In one article, the planning room is conceived to be the central feature of a facility; in another article, radiation therapy is designed around examination rooms. Shielding requirements are also discussed, as are the advantages and space and licensing requirements of various types of equipment. There is a need for planning appropriate computer facilities in conjunction with other equipment plans, and a critique of one radiation therapy unit is provided. The concept of a regional network for the delivery of radiation therapy services is then explored. The volume contains extensive illustrations in the form of floor plans, drawings, figures, and tables. Many of the articles include a bibliography. This is the first in a series of publications on radiation department design which will be useful to architects, engineers, and hospital planners

Molecular image guided radiation therapy-MIGRT in radiobioluminescence and nanoradioguidance

International Nuclear Information System (INIS)

Rao, V.L. Papineni

2014-01-01

Accurate dose delivery to malignant tissue in radiotherapy is essential for enhancing the treatment efficacy while minimizing morbidity of surrounding normal tissues. Advances in therapeutic strategies and diagnosis technologies along with our understanding of the biology of tumor response to radiation therapy have paved way to allow nearly 60% of current cancer patients to be treated with Radiation Therapy. The confluence of molecular imaging and nanotechnology fields are bridging physics and medicine and are quickly making strides in opening new avenues and therapeutic strategies that complement radiation therapy - with a distinct footprint in immunotherapy, adoptive cell therapy, and targeted chemotherapy. Incorporating optical imaging in radiation therapy in my laboratory, endogenous bioluminescence resulting from whole body irradiation in different organs, and in different animals, which is distinct from the Cherenkov radiation. The endogenous bioluminescence in response to irradiation is coined recently as radiobioluminescence. Thus with the necessity, the design, construction, and validation of Molecular Image Guided Radiation Therapy (MIGRT) instrumentation for preclinical theragnostics is carried out

Advanced Small Animal Conformal Radiation Therapy Device.

Science.gov (United States)

Sharma, Sunil; Narayanasamy, Ganesh; Przybyla, Beata; Webber, Jessica; Boerma, Marjan; Clarkson, Richard; Moros, Eduardo G; Corry, Peter M; Griffin, Robert J

2017-02-01

We have developed a small animal conformal radiation therapy device that provides a degree of geometrical/anatomical targeting comparable to what is achievable in a commercial animal irradiator. small animal conformal radiation therapy device is capable of producing precise and accurate conformal delivery of radiation to target as well as for imaging small animals. The small animal conformal radiation therapy device uses an X-ray tube, a robotic animal position system, and a digital imager. The system is in a steel enclosure with adequate lead shielding following National Council on Radiation Protection and Measurements 49 guidelines and verified with Geiger-Mueller survey meter. The X-ray source is calibrated following AAPM TG-61 specifications and mounted at 101.6 cm from the floor, which is a primary barrier. The X-ray tube is mounted on a custom-made "gantry" and has a special collimating assembly system that allows field size between 0.5 mm and 20 cm at isocenter. Three-dimensional imaging can be performed to aid target localization using the same X-ray source at custom settings and an in-house reconstruction software. The small animal conformal radiation therapy device thus provides an excellent integrated system to promote translational research in radiation oncology in an academic laboratory. The purpose of this article is to review shielding and dosimetric measurement and highlight a few successful studies that have been performed to date with our system. In addition, an example of new data from an in vivo rat model of breast cancer is presented in which spatially fractionated radiation alone and in combination with thermal ablation was applied and the therapeutic benefit examined.

Combined use of Dexa-Scheroson and Primobolan-Depot in radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Nagai, J [Shizuoka Rosai Hospital (Japan)

1976-05-01

Dexa-Scheroson and Primobolan-Depot were used together with radiation therapy (Linac therapy) required in 13 cases. The following results were obtained. The decrease in white cell counts, which often occurs in radiation therapy, was inhibited by the drugs. There was no case in which radiation therapy should necessarily withdraw because the number of leuckocytes was decreased to less than 3,000. The patients whose liver function was poor should be treated with both drugs at the beginning of radiation therapy. It was found that the combined use of the drugs is effective in the prevention and the treatment of cerebral edema in radiation therapy of intracranial lesion.

Treatment of Recurrent Chordomas by Percutaneous Ethanol Injection Therapy and Radiation Therapy

International Nuclear Information System (INIS)

Nakajo, M.; Ohkubo, K.; Fukukura, Y.; Nandate, T.; Nakajo, M.

2006-01-01

We report a case of recurrent sacral chordomas that have been successfully controlled by the combination therapy of percutaneous ethanol injection therapy (PEIT) and radiation therapy in a 71-year-old man. PEIT may be one of the adjuvant therapies for recurrent chordomas

Prototype demonstration of radiation therapy planning code system

International Nuclear Information System (INIS)

Little, R.C.; Adams, K.J.; Estes, G.P.; Hughes, L.S. III; Waters, L.S.

1996-01-01

This is the final report of a one-year, Laboratory-Directed Research and Development project at the Los Alamos National Laboratory (LANL). Radiation therapy planning is the process by which a radiation oncologist plans a treatment protocol for a patient preparing to undergo radiation therapy. The objective is to develop a protocol that delivers sufficient radiation dose to the entire tumor volume, while minimizing dose to healthy tissue. Radiation therapy planning, as currently practiced in the field, suffers from inaccuracies made in modeling patient anatomy and radiation transport. This project investigated the ability to automatically model patient-specific, three-dimensional (3-D) geometries in advanced Los Alamos radiation transport codes (such as MCNP), and to efficiently generate accurate radiation dose profiles in these geometries via sophisticated physics modeling. Modem scientific visualization techniques were utilized. The long-term goal is that such a system could be used by a non-expert in a distributed computing environment to help plan the treatment protocol for any candidate radiation source. The improved accuracy offered by such a system promises increased efficacy and reduced costs for this important aspect of health care

Influence of radiation therapy on oral Candida albicans colonization: a quantitative assessment

International Nuclear Information System (INIS)

Rossie, K.M.; Taylor, J.; Beck, F.M.; Hodgson, S.E.; Blozis, G.G.

1987-01-01

An increase in quantity of oral Candida albicans was documented in patients receiving head and neck radiation therapy during and after therapy, as assessed by an oral-rinse culturing technique. The amount of the increase was greater in denture wearers and directly related to increasing radiation dose and increasing volume of parotid gland included in the radiation portal. A significant number of patients who did not carry C. albicans prior to radiation therapy developed positive cultures by 1 month after radiation therapy. The percentage of patients receiving head and neck radiation therapy who carried C. albicans prior to radiation therapy did not differ significantly from matched dental patient controls

Late complications of radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Masaki, Norie [Osaka Prefectural Center for Adult Diseases (Japan)

1998-03-01

There are cases in which, although all traces of acute radiation complications seem to have disappeared, late complications may appear months or years to become apparent. Trauma, infection or chemotherapy may sometimes recall radiation damage and irreversible change. There were two cases of breast cancer that received an estimated skin dose in the 6000 cGy range followed by extirpation of the residual tumor. The one (12 y.o.) developed atrophy of the breast and severe teleangiectasis 18 years later radiotherapy. The other one (42 y.o.) developed severe skin necrosis twenty years later radiotherapy after administration of chemotherapy and received skin graft. A case (52 y.o.) of adenoidcystic carcinoma of the trachea received radiation therapy. The field included the thoracic spinal cord which received 6800 cGy. Two years and 8 months after radiation therapy she developed complete paraplegia and died 5 years later. A truly successful therapeutic outcome requires that the patient be alive, cured and free of significant treatment-related morbidity. As such, it is important to assess quality of life in long-term survivors of cancer treatment. (author)

Late complications of radiation therapy

International Nuclear Information System (INIS)

Masaki, Norie

1998-01-01

There are cases in which, although all traces of acute radiation complications seem to have disappeared, late complications may appear months or years to become apparent. Trauma, infection or chemotherapy may sometimes recall radiation damage and irreversible change. There were two cases of breast cancer that received an estimated skin dose in the 6000 cGy range followed by extirpation of the residual tumor. The one (12 y.o.) developed atrophy of the breast and severe teleangiectasis 18 years later radiotherapy. The other one (42 y.o.) developed severe skin necrosis twenty years later radiotherapy after administration of chemotherapy and received skin graft. A case (52 y.o.) of adenoidcystic carcinoma of the trachea received radiation therapy. The field included the thoracic spinal cord which received 6800 cGy. Two years and 8 months after radiation therapy she developed complete paraplegia and died 5 years later. A truly successful therapeutic outcome requires that the patient be alive, cured and free of significant treatment-related morbidity. As such, it is important to assess quality of life in long-term survivors of cancer treatment. (author)

21 CFR 892.5300 - Medical neutron radiation therapy system.

Science.gov (United States)

2010-04-01

... therapy system. (a) Identification. A medical neutron radiation therapy system is a device intended to... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical neutron radiation therapy system. 892.5300... analysis and display equipment, patient and equipment support, treatment planning computer programs...

Development of local radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Lee, Seung Hoon; Lim, Sang Moo; Choi, Chang Woon; Chai, Jong Su; Kim, Eun Hee; Kim, Mi Sook; Yoo, Seong Yul; Cho, Chul Koo; Lee, Yong Sik; Lee, Hyun Moo

1999-04-01

The major limitations of radiation therapy for cancer are the low effectiveness of low LET and inevitable normal tissue damage. Boron Neutron Capture Therapy (BNCT) is a form of potent radiation therapy using Boron-10 having a high propensityof capturing theraml neutrons from nuclear reactor and reacting with a prompt nuclear reaction. Photodynamic therapy is a similiar treatment of modality to BNCT using tumor-seeking photosenistizer and LASER beam. If Boron-10 and photosensitizers are introduced selectively into tumor cells, it is theoretically possible to destroy the tumor and to spare the surrounding normal tissue. Therefore, BNCT and PDT will be new potent treatment modalities in the next century. In this project, we performed PDT in the patients with bladder cancers, oropharyngeal cancer, and skin cancers. Also we developed I-BPA, new porphyrin compounds, methods for estimation of radiobiological effect of neutron beam, and superficial animal brain tumor model. Furthermore, we prepared preclinical procedures for clinical application of BNCT, such as the macro- and microscopic dosimetry, obtaining thermal neutron flux from device used for fast neutron production in KCCH have been performed.

Development of local radiation therapy

International Nuclear Information System (INIS)

Lee, Seung Hoon; Lim, Sang Moo; Choi, Chang Woon; Chai, Jong Su; Kim, Eun Hee; Kim, Mi Sook; Yoo, Seong Yul; Cho, Chul Koo; Lee, Yong Sik; Lee, Hyun Moo

1999-04-01

The major limitations of radiation therapy for cancer are the low effectiveness of low LET and inevitable normal tissue damage. Boron Neutron Capture Therapy (BNCT) is a form of potent radiation therapy using Boron-10 having a high propensityof capturing theraml neutrons from nuclear reactor and reacting with a prompt nuclear reaction. Photodynamic therapy is a similiar treatment of modality to BNCT using tumor-seeking photosenistizer and LASER beam. If Boron-10 and photosensitizers are introduced selectively into tumor cells, it is theoretically possible to destroy the tumor and to spare the surrounding normal tissue. Therefore, BNCT and PDT will be new potent treatment modalities in the next century. In this project, we performed PDT in the patients with bladder cancers, oropharyngeal cancer, and skin cancers. Also we developed I-BPA, new porphyrin compounds, methods for estimation of radiobiological effect of neutron beam, and superficial animal brain tumor model. Furthermore, we prepared preclinical procedures for clinical application of BNCT, such as the macro- and microscopic dosimetry, obtaining thermal neutron flux from device used for fast neutron production in KCCH have been performed

Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma

International Nuclear Information System (INIS)

McHenry, C.; Jarosz, H.; Calandra, D.; McCall, A.; Lawrence, A.M.; Paloyan, E.

1987-01-01

The question of thyroid neoplasia following high-dose radiation treatment to the neck and mediastinum for malignant neoplasms such as Hodgkin's lymphoma in children and young adults has been raised recently. Five patients, 19 to 39 years old, were operated on for thyroid neoplasms that developed following cervical and mediastinal radiation therapy for Hodgkin's lymphoma. Three patients had papillary carcinomas and two had follicular adenomas. The latency period between radiation exposure and the diagnosis of thyroid neoplasm ranged from eight to 16 years. This limited series provided strong support for the recommendation that children and young adults who are to receive high-dose radiation therapy to the head, neck, and mediastinum should receive suppressive doses of thyroxine prior to radiation therapy in order to suppress thyrotropin (thyroid-stimulating hormone) and then be maintained on a regimen of suppression permanently

Computed tomography of the chest in blunt thoracic trauma: results of a prospective study

International Nuclear Information System (INIS)

Blostein, P.; Hodgman, C.

1998-01-01

Blunt thoracic injuries detected by computed tomography of the chest infrequently require immediate therapy. If immediate therapy is needed, findings will be visible on plain roentgenograms or on clinical exam. Routine Computed Tomography of the chest in blunt trauma is not recommended but may be helpful in selected cases. (N.C.)

Chondronecrosis of the cricoid cartilage following radiation therapy

International Nuclear Information System (INIS)

Tanabe, Masahiro; Isshiki, Nobuhiko; Kojima, Hisayoshi

1979-01-01

Chondronecrosis of the laryngeal cartilage following radiation therapy is a rare but serious complication. We report herein a case of post-radiation chondronecrosis and discuss factors predisposing to its development. A 67-year-old man received telecobalt therapy for cancer of the right vocal cord. A year after the radiation therapy given in a dose of 7,000r, the patient developed dysphagia and dyspnea. Following tracheotomy, he underwent total laryngectomy. The surgical specimen showed no cancer but chondronecrosis of the cricoid cartilage was present. After laryngectomy he developed progressive soft tissue necrosis of the neck and died following a carotid hemorrhage. (author)

Radiation therapy quality control in MRCCC radiotherapy units

International Nuclear Information System (INIS)

Fielda Djuita; Rina Taurisia; Andreas Nainggolan

2011-01-01

Increasing cancer patients in Indonesia is not supported with the number of equipment that is able to treat cancer patients, especially in the radiation therapy field. Therefore, several private hospitals have joined to provide radiation therapy services and one of them is MRCCC. As a new hospital providing services in radiotherapy field, the writer tries to present our quality control program that we have done in our hospital. Purpose: As quality control to radiation therapy clinical practice. Methods: Descriptive essay of what we do in our institution. Conclusion: Average output photon and electron lower more than tolerance dose. (author)

Evolution of radiation therapy: technology of today

International Nuclear Information System (INIS)

Shrivastava, S.K.; Mishra, Shagun

2013-01-01

The three well established arms of treatment are surgery, radiation therapy and chemotherapy. The management of cancer is multidisciplinary; Radiation Oncologists along with Surgical Oncologists and Medical Oncologists are responsible for cancer therapeutics. They all work in close collaboration with Pathologists and Radiologists for cancer diagnosis and staging and rely on Oncology Nurses, Physiotherapists, Occupational Therapists, Nutritionists and Social Workers for optimal treatment and rehabilitation of cancer patients. Therefore cancer management is a team work for getting the best results. Radiation therapy is one of the most effective methods of treating cancer

Chest radiography after minor chest trauma

Energy Technology Data Exchange (ETDEWEB)

Rossen, B.; Laursen, N.O.; Just, S.

The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma.

Chest radiography after minor chest trauma

International Nuclear Information System (INIS)

Rossen, B.; Laursen, N.O.; Just, S.

1987-01-01

The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma. (orig.)

Evaluation of image quality and radiation dose by adaptive statistical iterative reconstruction technique level for chest CT examination.

Science.gov (United States)

Hong, Sun Suk; Lee, Jong-Woong; Seo, Jeong Beom; Jung, Jae-Eun; Choi, Jiwon; Kweon, Dae Cheol

2013-12-01

The purpose of this research is to determine the adaptive statistical iterative reconstruction (ASIR) level that enables optimal image quality and dose reduction in the chest computed tomography (CT) protocol with ASIR. A chest phantom with 0-50 % ASIR levels was scanned and then noise power spectrum (NPS), signal and noise and the degree of distortion of peak signal-to-noise ratio (PSNR) and the root-mean-square error (RMSE) were measured. In addition, the objectivity of the experiment was measured using the American College of Radiology (ACR) phantom. Moreover, on a qualitative basis, five lesions' resolution, latitude and distortion degree of chest phantom and their compiled statistics were evaluated. The NPS value decreased as the frequency increased. The lowest noise and deviation were at the 20 % ASIR level, mean 126.15 ± 22.21. As a result of the degree of distortion, signal-to-noise ratio and PSNR at 20 % ASIR level were at the highest value as 31.0 and 41.52. However, maximum absolute error and RMSE showed the lowest deviation value as 11.2 and 16. In the ACR phantom study, all ASIR levels were within acceptable allowance of guidelines. The 20 % ASIR level performed best in qualitative evaluation at five lesions of chest phantom as resolution score 4.3, latitude 3.47 and the degree of distortion 4.25. The 20 % ASIR level was proved to be the best in all experiments, noise, distortion evaluation using ImageJ and qualitative evaluation of five lesions of a chest phantom. Therefore, optimal images as well as reduce radiation dose would be acquired when 20 % ASIR level in thoracic CT is applied.

Is Weight-Based Adjustment of Automatic Exposure Control Necessary for the Reduction of Chest CT Radiation Dose?

Science.gov (United States)

Prakash, Priyanka; Gilman, Matthew D.; Shepard, Jo-Anne O.; Digumarthy, Subba R.

2010-01-01

Objective To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. Materials and Methods With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and non-weight-adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Results Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight-adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 ± 3.1) and weight-adjusted (16.1 ± 5.6) AEC techniques (p > 0.05). Conclusion The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT. PMID:20046494

Is Weight-Based Adjustment of Automatic Exposure Control Necessary for the Reduction of Chest CT Radiation Dose?

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Prakash, Priyanka; Kalra, Mannudeep K.; Gilman, Matthew D.; Shepard, Jo Anne O.; Digumarthy, Subba R. [Massachusetts General Hospital and Harvard Medical School, Boston (United States)

2010-02-15

To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and nonweight- adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; < 60 kg (n = 17), 60-90 kg (n = 52), and > 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p < 0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the < 60, 60-90 and > 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 {+-} 3.1) and weight-adjusted (16.1 {+-} 5.6) AEC techniques (p > 0.05). The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT.

Comparison of radiation doses between newborns and 6-y-old children undergoing head, chest and abdominal CT examinations-A phantom study

International Nuclear Information System (INIS)

Sugimoto, N.; Aoyama, T.; Koyama, S.; Yamauchi-Kawaura, C.; Fujii, K.

2013-01-01

Radiation doses in paediatric computed tomography (CT) were investigated for various types of recent CT scanners with newborn and 6-y-old phantoms in which silicon-photodiode dosemeters were implanted at various organ positions. In the head, chest and abdominal CT for the newborn phantom, doses for organs within the scan region were 21-40, 3-8 and 3-12 mGy, respectively. The corresponding doses for the child phantom were 20-37, 2-11 and 4-17 mGy, respectively. In the head, chest and abdominal CT, the effective doses were respectively 2.1-3.3, 2.0-6.0 and 2.2-10.0 mSv for the newborn, and 1.0-2.0, 1.2-6.6 and 2.9-11.8 mSv for the child. Radiation doses for the newborn were at the same levels as those for the child, excepting effective doses in head CT for the newborn, which were 1.8 times higher than those for the child. (authors)

Guidelines for radiation therapy in clinical research on bladder cancer

International Nuclear Information System (INIS)

Shipley, W.U.; VanderSchueren, E.; Kitagawa, T.; Gospodarowicz, M.K.; Frommhold, H.; Magno, L.; Mochizuki, S.; VanderBogaert, W.; VanderWerf-Messing, B.

1986-01-01

Bladder cancer is a heterogeneous disease and that there are important tumor characteristics that will predict significant differences in radiation responsiveness. These should in all instances be well documented prospectively in any treatment protocol. However, in this chapter the authors stress a number of factors related to the tumor at presentation as well as the administration of the radiation therapy that can importantly affect the efficacy of the radiation on the patient's tumor, as well as on his or her normal tissues. As Radiation Oncologists, they are most interested in the conducting and reporting of prospective clinical investigations in the use of radiation therapy in the treatment of patients with bladder carcinoma who will be treated with planned preservation of their bladder, but whose radiation therapy may be combined with additional planned bladder-sparing surgery, intraoperative radiation therapy, or chemotherapy

TH-F-202-03: Advances in MRI for Radiation Therapy

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Cai, J. [Duke University Medical Center (United States)

2016-06-15

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai.

TH-F-202-03: Advances in MRI for Radiation Therapy

International Nuclear Information System (INIS)

Cai, J.

2016-01-01

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai

Radiation therapy in the management of childhood cancer

International Nuclear Information System (INIS)

Kun, L.E.

1987-01-01

Over the past two decades, multimodality treatment regimens have produced significant improvement in survival rates for most types of childhood cancer. The role of radiation therapy has been critically evaluated in prospective clinical trials that established the importance of irradiation in assuring local and regional control of disease central to ultimate survival. Indications for cranial and craniospinal irradiation in acute lymphoblastic leukemia are reviewed, as is difficult technical factors important for successful management. The role of radiation therapy in neuroblastoma and Wilms tumor is reviewed in the context of tumor biology and increasing data from multi-institutional trials. Interactions of irradiation with surgery and chemotherapy are stressed in childhood rhabdomyosarcoma and Ewing sarcoma. Current results in the more common central nervous tumors of childhood are presented, including the central role of radiation therapy in medulloblastoma, astrocytoma, and craniopharyngioma. Concerns regarding late effects of radiation therapy are balanced with the importance of achieving disease control

Outcome of radiation therapy for patients with Kasabach-Merritt syndrome

International Nuclear Information System (INIS)

Mitsuhashi, Norio; Furuta, Masaya; Sakurai, Hideyuki; Takahashi, Takeo; Kato, Shingo; Nozaki, Miwako; Saito, Yoshihiro; Hayakawa, Kazushige; Niibe, Hideo

1997-01-01

Purpose: The efficacy of radiation therapy for Kasabach-Merritt syndrome, which is characterized by a huge hemangioma with consumption coagulopathy, remains controversial. In this study, we retrospectively investigated the treatment outcome of radiation therapy for seven neonates with Kasabach-Merritt syndrome. Methods and Materials: During the past 25 years we have seen seven children with Kasabach-Merritt syndrome who were treated with radiation therapy. Their ages ranged from 1 day to 5 months, with a median age of 1 month. The hemangioma was located in the extremities in four of seven children. Tumor sizes ranged from 70 cm to more than 150 cm in greatest diameter. Initial platelet counts were all less than 40,000/mm 3 except for one patient. In principle, the total dose applied to the hemangioma was 8-10 Gy, with a daily dose of 1 Gy five times a week. Results: Four of seven hemangiomas responded dramatically, with a concomitant rise of the platelet count to radiation therapy. Although the remaining three hemangiomas, all of which were ill circumscribed by widespread overlying shiny, dusky purple skin, became less tense during radiation therapy. Disseminated intravascular coagulopathy was not improved, but they have responded favorably to two or three courses of radiation therapy with an extended radiation field by 1.5 years of age. As a result, all seven patients are now surviving with no evidence of hemangioma or hematological abnormalities. Shortening of the extremity was observed in three patients who received multiple courses of radiation therapy. Conclusions: Radiation therapy appears to be one of the effective treatment options for Kasabach-Merritt syndrome despite the risk of growth delay and malignancy

Postoperative radiation therapy for adenoid cystic carcinoma

International Nuclear Information System (INIS)

Oguchi, Masahiko; Shikama, Naoto; Gomi, Koutarou; Shinoda, Atsunori; Nishikawa, Atsushi; Arakawa, Kazukiyo; Sasaki, Shigeru; Takei, Kazuyoshi; Sone, Syusuke

2000-01-01

The authors retrospectively assessed the usefulness of postoperative radiation therapy after local resection of adenoid cystic carcinoma, with emphasis on organ-conserving treatment and the cosmetic results. Between 1985 and 1995, 32 patients underwent local resection followed by postoperative radiation therapy with curative and organ-conserving intent. None of patients received any form of chemotherapy as part of their initial treatment. Radiation therapy was carried out by techniques that were appropriate for the site and extension of each tumor. The 5-year local control, disease-free, and overall survival rates of all patients were 76%, 68%, and 86%, respectively. The 5-year local control rate and disease-free survival rate of patients with microscopically positive margins were 89% and 75%, respectively, and higher than in patients with macroscopically residual disease, but no significant difference in 5-year overall survival rate was observed. The postoperative cosmetic results in 29 patients with head and neck lesions were evaluated. No difference was documented between the cosmetic results postoperatively setting and after postoperative radiotherapy, and no significant differences in cosmetic results were observed according to radiation dose. The combination of local resection with organ-conserving intent and postoperative radiation therapy provided good cosmetic results in patients with T1 or T2 lesions. Postoperative radiation therapy with smaller fractions is useful, because good local control can be achieved in patients with adenoid cystic carcinoma having microscopically positive margins without inducing any late adverse reactions. However, the number of patients was too small and the follow-up period was too short to draw any definite conclusion in regard to fraction size. A much longer follow-up study with a larger number patients will be required to accurately determine the optimal treatment intensity and duration of treatment. (K.H.)

Acute toxicity in comprehensive head and neck radiation for nasopharynx and paranasal sinus cancers: cohort comparison of 3D conformal proton therapy and intensity modulated radiation therapy

International Nuclear Information System (INIS)

McDonald, Mark W.; Liu, Yuan; Moore, Michael G.; Johnstone, Peter A. S.

2016-01-01

To evaluate acute toxicity endpoints in a cohort of patients receiving head and neck radiation with proton therapy or intensity modulated radiation therapy (IMRT). Forty patients received comprehensive head and neck radiation including bilateral cervical nodal radiation, given with or without chemotherapy, for tumors of the nasopharynx, nasal cavity or paranasal sinuses, any T stage, N0-2. Fourteen received comprehensive treatment with proton therapy, and 26 were treated with IMRT, either comprehensively or matched to proton therapy delivered to the primary tumor site. Toxicity endpoints assessed included g-tube dependence at the completion of radiation and at 3 months after radiation, opioid pain medication requirement compared to pretreatment normalized as equivalent morphine dose (EMD) at completion of treatment, and at 1 and 3 months after radiation. In a multivariable model including confounding variables of concurrent chemotherapy and involved nodal disease, comprehensive head and neck radiation therapy using proton therapy was associated with a lower opioid pain requirement at the completion of radiation and a lower rate of gastrostomy tube dependence by the completion of radiation therapy and at 3 months after radiation compared to IMRT. Proton therapy was associated with statistically significant lower mean doses to the oral cavity, esophagus, larynx, and parotid glands. In subgroup analysis of 32 patients receiving concurrent chemotherapy, there was a statistically significant correlation with a greater opioid pain medication requirement at the completion of radiation and both increasing mean dose to the oral cavity and to the esophagus. Proton therapy was associated with significantly reduced radiation dose to assessed non-target normal tissues and a reduced rate of gastrostomy tube dependence and opioid pain medication requirements. This warrants further evaluation in larger studies, ideally with patient-reported toxicity outcomes and quality of life

21 CFR 892.5750 - Radionuclide radiation therapy system.

Science.gov (United States)

2010-04-01

... system. (a) Identification. A radionuclide radiation therapy system is a device intended to permit an... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radionuclide radiation therapy system. 892.5750... patient's body. This generic type of device may include signal analysis and display equipment, patient and...

DOE Research Contributions to Radiation and Cancer Therapy

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dropdown arrow Site Map A-Z Index Menu Synopsis DOE Research Contributions to Radiation and Cancer Therapy Possible: DOE Advanced Biomedical Technology Research, page 10 Over the time span of many years, DOE's research has made many contributions to radiation and cancer therapy, including PEREGRINE and Boron Neutron

Radiation therapy for chordomas

International Nuclear Information System (INIS)

Ikeda, Hajime; Takahashi, Takeo; Nakamura, Yuji; Niibe, Hideo

1995-01-01

Chordomas are slow-growing primary malignant bone tumors which originate from remnants of the fetal notochordal system. They are difficult to control by surgery alone. Four patients with chordomas treated with radiation therapy were studied, and the effectiveness of radiotherapy was evaluated. These 4 (3.8%) patients were among 106 patients with primary malignant bone tumors referred to us from 1959 to 1987. Primary sites were the sacrococcygeal region in three patients and the clivus in one. The patients' ages ranged from 51 to 75 years. The male : female ratio was 1 : 1. Patients received 48 to 60 Gy of radiation to the primary sites. Because the radiosensitivity of the tumors was low, the responses were poor. The duration of survival was 6, 33, 68, and 125 months. The cause of death in each case was local recurrence of tumor. As a result, a dose greater than 60 Gy is thought to be necessary for curative radiotherapy. Proton beam therapy seems to be best choice for chordomas in the clivus, and mixed-beam (proton and megavolt age X-ray) therapy or multiportal irradiation, which gives an ideal spatial dose distribution, seems to be most suitable for sacrococcygeal chordomas. (author)

Radiation Therapy and Hearing Loss

International Nuclear Information System (INIS)

Bhandare, Niranjan; Jackson, Andrew; Eisbruch, Avraham; Pan, Charlie C.; Flickinger, John C.; Antonelli, Patrick; Mendenhall, William M.

2010-01-01

A review of literature on the development of sensorineural hearing loss after high-dose radiation therapy for head-and-neck tumors and stereotactic radiosurgery or fractionated stereotactic radiotherapy for the treatment of vestibular schwannoma is presented. Because of the small volume of the cochlea a dose-volume analysis is not feasible. Instead, the current literature on the effect of the mean dose received by the cochlea and other treatment- and patient-related factors on outcome are evaluated. Based on the data, a specific threshold dose to cochlea for sensorineural hearing loss cannot be determined; therefore, dose-prescription limits are suggested. A standard for evaluating radiation therapy-associated ototoxicity as well as a detailed approach for scoring toxicity is presented.

Radiation dose reduction with the adaptive statistical iterative reconstruction (ASIR) technique for chest CT in children: An intra-individual comparison

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Lee, Seung Hyun, E-mail: circle1128@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Myung-Joon, E-mail: mjkim@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Yoon, Choon-Sik, E-mail: yooncs58@yuhs.ac [Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Lee, Mi-Jung, E-mail: mjl1213@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

2012-09-15

Objective: To retrospectively compare radiation dose and image quality of pediatric chest CT using a routine dose protocol reconstructed with filtered back projection (FBP) (the Routine study) and a low-dose protocol with 50% adaptive statistical iterative reconstruction (ASIR) (the ASIR study). Materials and methods: We retrospectively reviewed chest CT performed in pediatric patients who underwent both the Routine study and the ASIR study on different days between January 2010 and August 2011. Volume CT dose indices (CTDIvol), dose length products (DLP), and effective doses were obtained to estimate radiation dose. The image quality was evaluated objectively as noise measured in the descending aorta and paraspinal muscle, and subjectively by three radiologists for noise, sharpness, artifacts, and diagnostic acceptability using a four-point scale. The paired Student's t-test and the Wilcoxon signed-rank test were used for statistical analysis. Results: Twenty-six patients (M:F = 13:13, mean age 11.7) were enrolled. The ASIR studies showed 60.3%, 56.2%, and 55.2% reductions in CTDIvol (from 18.73 to 7.43 mGy, P < 0.001), DLP (from 307.42 to 134.51 mGy × cm, P < 0.001), and effective dose (from 4.12 to 1.84 mSv, P < 0.001), respectively, compared with the Routine studies. The objective noise was higher in the paraspinal muscle of the ASIR studies (20.81 vs. 16.67, P = 0.004), but was not different in the aorta (18.23 vs. 18.72, P = 0.726). The subjective image quality demonstrated no difference between the two studies. Conclusion: A low-dose protocol with 50% ASIR allows radiation dose reduction in pediatric chest CT by more than 55% while maintaining image quality.

Radiation dose reduction with the adaptive statistical iterative reconstruction (ASIR) technique for chest CT in children: An intra-individual comparison

International Nuclear Information System (INIS)

Lee, Seung Hyun; Kim, Myung-Joon; Yoon, Choon-Sik; Lee, Mi-Jung

2012-01-01

Objective: To retrospectively compare radiation dose and image quality of pediatric chest CT using a routine dose protocol reconstructed with filtered back projection (FBP) (the Routine study) and a low-dose protocol with 50% adaptive statistical iterative reconstruction (ASIR) (the ASIR study). Materials and methods: We retrospectively reviewed chest CT performed in pediatric patients who underwent both the Routine study and the ASIR study on different days between January 2010 and August 2011. Volume CT dose indices (CTDIvol), dose length products (DLP), and effective doses were obtained to estimate radiation dose. The image quality was evaluated objectively as noise measured in the descending aorta and paraspinal muscle, and subjectively by three radiologists for noise, sharpness, artifacts, and diagnostic acceptability using a four-point scale. The paired Student's t-test and the Wilcoxon signed-rank test were used for statistical analysis. Results: Twenty-six patients (M:F = 13:13, mean age 11.7) were enrolled. The ASIR studies showed 60.3%, 56.2%, and 55.2% reductions in CTDIvol (from 18.73 to 7.43 mGy, P < 0.001), DLP (from 307.42 to 134.51 mGy × cm, P < 0.001), and effective dose (from 4.12 to 1.84 mSv, P < 0.001), respectively, compared with the Routine studies. The objective noise was higher in the paraspinal muscle of the ASIR studies (20.81 vs. 16.67, P = 0.004), but was not different in the aorta (18.23 vs. 18.72, P = 0.726). The subjective image quality demonstrated no difference between the two studies. Conclusion: A low-dose protocol with 50% ASIR allows radiation dose reduction in pediatric chest CT by more than 55% while maintaining image quality

The physical basis and future of radiation therapy.

Science.gov (United States)

Bortfeld, T; Jeraj, R

2011-06-01

The remarkable progress in radiation therapy over the last century has been largely due to our ability to more effectively focus and deliver radiation to the tumour target volume. Physics discoveries and technology inventions have been an important driving force behind this progress. However, there is still plenty of room left for future improvements through physics, for example image guidance and four-dimensional motion management and particle therapy, as well as increased efficiency of more compact and cheaper technologies. Bigger challenges lie ahead of physicists in radiation therapy beyond the dose localisation problem, for example in the areas of biological target definition, improved modelling for normal tissues and tumours, advanced multicriteria and robust optimisation, and continuous incorporation of advanced technologies such as molecular imaging. The success of physics in radiation therapy has been based on the continued "fuelling" of the field with new discoveries and inventions from physics research. A key to the success has been the application of the rigorous scientific method. In spite of the importance of physics research for radiation therapy, too few physicists are currently involved in cutting-edge research. The increased emphasis on more "professionalism" in medical physics will tip the situation even more off balance. To prevent this from happening, we argue that medical physics needs more research positions, and more and better academic programmes. Only with more emphasis on medical physics research will the future of radiation therapy and other physics-related medical specialties look as bright as the past, and medical physics will maintain a status as one of the most exciting fields of applied physics.

The physical basis and future of radiation therapy

Science.gov (United States)

Bortfeld, T; Jeraj, R

2011-01-01

The remarkable progress in radiation therapy over the last century has been largely due to our ability to more effectively focus and deliver radiation to the tumour target volume. Physics discoveries and technology inventions have been an important driving force behind this progress. However, there is still plenty of room left for future improvements through physics, for example image guidance and four-dimensional motion management and particle therapy, as well as increased efficiency of more compact and cheaper technologies. Bigger challenges lie ahead of physicists in radiation therapy beyond the dose localisation problem, for example in the areas of biological target definition, improved modelling for normal tissues and tumours, advanced multicriteria and robust optimisation, and continuous incorporation of advanced technologies such as molecular imaging. The success of physics in radiation therapy has been based on the continued “fuelling” of the field with new discoveries and inventions from physics research. A key to the success has been the application of the rigorous scientific method. In spite of the importance of physics research for radiation therapy, too few physicists are currently involved in cutting-edge research. The increased emphasis on more “professionalism” in medical physics will tip the situation even more off balance. To prevent this from happening, we argue that medical physics needs more research positions, and more and better academic programmes. Only with more emphasis on medical physics research will the future of radiation therapy and other physics-related medical specialties look as bright as the past, and medical physics will maintain a status as one of the most exciting fields of applied physics. PMID:21606068

Results of radiation therapy in periarthritis humeroscapularis

International Nuclear Information System (INIS)

Schultze, J.; Schlichting, G.; Galalae, R.; Kimmig, B.; Koltze, H.

2004-01-01

Background: radiation therapy is applied in painful degenerative shoulder diseases. Aim of this work was to evaluate the contribution of radiation therapy to symptomatic improvement in periarthritis humeroscapularis. Methods: ninety-four patients with periarthritis humeroscapularis were treated in two institutions. Mean age was 68 years, sex distribution were 32 men and 62 women. In 58 cases the right side was affected, left in 36 cases. At single doses of 0,75 Gy once a week a total dose of 6 Gy was applied The treatment effect was evaluated by the standardized von Pannewitz-score at the end of the treatment up to 6 months thereafter. Results: the treatment results of all the 94 patients were documentated at the end of therapy. Seventy-one patients were followed at least for further 4 months. Radiogenic side-effects were not noticed. The symptoms of 54 patients (57.4%) were improved or vanished, in 40 cases the symptoms were not significantly affected (42.6%). Four months after therapy 42 of 71 patients were improved (59.2%), 29 unchanged (40.8%). The treatment effect occured typically up to 2 months after therapy, there were no age-related differences. Also in recurrent radiation therapies the symptoms improved, in 80 percent after one preceding therapy, however only in 31.2 percent after multiple prior radiotherapies. (orig.)

Image quality in children with low-radiation chest CT using adaptive statistical iterative reconstruction and model-based iterative reconstruction.

Directory of Open Access Journals (Sweden)

Jihang Sun

Full Text Available OBJECTIVE: To evaluate noise reduction and image quality improvement in low-radiation dose chest CT images in children using adaptive statistical iterative reconstruction (ASIR and a full model-based iterative reconstruction (MBIR algorithm. METHODS: Forty-five children (age ranging from 28 days to 6 years, median of 1.8 years who received low-dose chest CT scans were included. Age-dependent noise index (NI was used for acquisition. Images were retrospectively reconstructed using three methods: MBIR, 60% of ASIR and 40% of conventional filtered back-projection (FBP, and FBP. The subjective quality of the images was independently evaluated by two radiologists. Objective noises in the left ventricle (LV, muscle, fat, descending aorta and lung field at the layer with the largest cross-section area of LV were measured, with the region of interest about one fourth to half of the area of descending aorta. Optimized signal-to-noise ratio (SNR was calculated. RESULT: In terms of subjective quality, MBIR images were significantly better than ASIR and FBP in image noise and visibility of tiny structures, but blurred edges were observed. In terms of objective noise, MBIR and ASIR reconstruction decreased the image noise by 55.2% and 31.8%, respectively, for LV compared with FBP. Similarly, MBIR and ASIR reconstruction increased the SNR by 124.0% and 46.2%, respectively, compared with FBP. CONCLUSION: Compared with FBP and ASIR, overall image quality and noise reduction were significantly improved by MBIR. MBIR image could reconstruct eligible chest CT images in children with lower radiation dose.

Pediatric digital chest imaging.

Science.gov (United States)

Tarver, R D; Cohen, M; Broderick, N J; Conces, D J

1990-01-01

The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

Pediatric digital chest imaging

International Nuclear Information System (INIS)

Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr.

1990-01-01

The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology

Two case reports of a cerebrovascular disorder after radiation therapy

International Nuclear Information System (INIS)

Ono, Jiro; Mimaki, Takashi; Tagawa, Tetsuzo

1985-01-01

The use of radiation therapy has significantly improved the prognosis of certain brain tumors. However, a few patients have been reported who developed cerebrovasculopathy accompanying transient ischemic attacks several months to several years after radiation therapy. The present report described cerebrovascular disorders after radiation therapy for brain tumors. The first case was an 8-year-6-month-old boy treated with a total dose of 5,200 rads after partial removal of a right periventricular astrocytoma extending into the thalamus. Two years and 7 months after completion of the radiation therapy, he showed transient ischemic attacks of numbness in the right upper limb and right hemiparesis. Arteriography revealed stenosis or occlusion of the anterior and middle cerebral arteries. Preoperative arteriography did not show occlusion nor narrowing of the cerebral arteries. The second case was a 2-year-8-month-old boy diagnosed as diencephalic syndrome, because of marked emaciation and a huge tumor mass expanding into the diencephalon and frontal lobe on the brain CT scan. He was irradiated with up to 5,000 rads. Seven months after radiation therapy, he developed transient right hemiparesis. Arteriography revealed stenosis or occlusion of the middle sized cerebral arteries. Although radiation therapy is acceptable in children with certain brain tumors, and very few patients develop postradiation vasculopathy, the risk of radiation therapy requires more careful consideration in the treatment of intracranial tumors. (author)

Monte Carlo techniques in radiation therapy

CERN Document Server

Verhaegen, Frank

2013-01-01

Modern cancer treatment relies on Monte Carlo simulations to help radiotherapists and clinical physicists better understand and compute radiation dose from imaging devices as well as exploit four-dimensional imaging data. With Monte Carlo-based treatment planning tools now available from commercial vendors, a complete transition to Monte Carlo-based dose calculation methods in radiotherapy could likely take place in the next decade. Monte Carlo Techniques in Radiation Therapy explores the use of Monte Carlo methods for modeling various features of internal and external radiation sources, including light ion beams. The book-the first of its kind-addresses applications of the Monte Carlo particle transport simulation technique in radiation therapy, mainly focusing on external beam radiotherapy and brachytherapy. It presents the mathematical and technical aspects of the methods in particle transport simulations. The book also discusses the modeling of medical linacs and other irradiation devices; issues specific...

A case showing a blistering disorder in radiation dermatitis during radiation therapy

International Nuclear Information System (INIS)

Nonoshita, Takeshi; Nakamura, Katsumasa; Shioyama, Yoshiyuki

2007-01-01

We experienced a case showing a blistering disorder in radiation dermatitis during radiation therapy for thymic cancer. Application of steroid to the lesion improved blisters. The literature on bullous eruption including radiation-induced bullous pemhigoid was critically reviewed. (author)

Radiation therapy for pleural mesothelioma

International Nuclear Information System (INIS)

Seydel, H.G.

1986-01-01

There is clear evidence that both pleural and peritoneal malignant mesothelioma are increasing in incidence in the United States. There is a recognized long period of latency from asbestos exposure to the emergence and diagnosis of tumor. Considering the levels of asbestos utilization in the mid-20th century, we must expect that the number of cases will continue to increase until the end of this century. Evaluation of treatment options is thus a critical issue in determining treatment approaches for this disease. Recognized only recently, mesothelioma has no effective treatment, and patients are reported only anecdotally as cured. Pleural mesothelioma is the more common presentation, but even here the reports are from small, uncontrolled series. Only one study is available in which a concomitant comparison of treatment methods was carried out. Randomized clinical studies regarding treatment of pleural mesothelioma have only recently been initiated by the clinical cooperative groups. There is thus a paucity of information on treatment in general and radiation therapy specifically for malignant mesothelioma. This chapter reviews the reported experience using radiation therapy alone and combined with other modalities for the treatment of malignant pleural mesothelioma and considers the potential for improvement of the results of current methods of radiation therapy

A More Efficient, Radiation-Free Alternative to Systematic Chest X-Ray for the Detection of Embolized Seeds to the Lung

International Nuclear Information System (INIS)

Morrier, Janelle; Chretien, Mario; Martin, Andre-Guy; Vigneault, Eric; Beaulieu, Luc

2010-01-01

Purpose: To evaluate the efficacy of a seed-migration detector and to compare its performance to fluoroscopy and postoperative chest radiographs. Methods and Materials: A gamma scintillation survey meter was converted to a seed-migration detector by adding a shield on the probe detection window. The detector response to three 125 I seed activities was characterized for different source-to-detector distances in water. The detector was used to perform a chest evaluation on 737 patients at their first postoperative visit. When the detector showed positive activity, seed migration was confirmed by taking a chest radiograph and by looking at the region with fluoroscopy. Results: One hundred and three patients (14.0%) presented at least one embolized seed. This accounts for 123 of the 39,887 seeds. Eighty-seven, 12, and 4 patients had respectively one, two, and three seed embolization. Compared with the seed-migration detector, detection based on fluoroscopy would have led to 13 false-negative detections (of 103, or 12.6%), and the radiograph would have resulted in 31 or 30.1%. More important, standard chest X-ray would have required a survey and extra radiation dose to lung to 100% of the patients, rather than the 14% who required it. Conclusions: The usual recommendation to perform chest radiographs at the first follow-up visit to scan lungs for embolized seeds should be revised because of the high false-negative rate. Scintillator-based gamma counter detector provides superior detection sensitivity and should be adopted as a standard of practice. Chest X-ray could be limited to documenting cases of positive migration.

Optimization of adaptive radiation therapy in cervical cancer: Solutions for photon and proton therapy

NARCIS (Netherlands)

van de Schoot, A.J.A.J.

2016-01-01

In cervical cancer radiation therapy, an adaptive strategy is required to compensate for interfraction anatomical variations in order to achieve adequate dose delivery. In this thesis, we have aimed at optimizing adaptive radiation therapy in cervical cancer to improve treatment efficiency and

Routine chest and abdominal high-pitch CT: An alternative low dose protocol with preserved image quality

International Nuclear Information System (INIS)

Amacker, Nadja A.; Mader, Caecilia; Alkadhi, Hatem; Leschka, Sebastian; Frauenfelder, Thomas

2012-01-01

Objective: To investigate the radiation dose and image quality of the high-pitch dual source computer tomography (DSCT) for routine chest and abdominal scans. Methods: 130 consecutive patients (62 female, 68 male, median age 55 years) were included. All patients underwent 128-slice high-pitch DSCT (chest n = 99; abdomen n = 84) at a pitch of 3.2. Two observers independently rated image quality using a 4-point score (1: excellent to 4: non-diagnostic). Image noise was measured and operational radiation dose quantities were recorded. An additional group of 132 patients (chest, n = 80; abdomen n = 52) scanned with standard-pitch CT matched for age, gender, and body mass index (BMI) served as control group. Results: Interobserver agreement for image quality rating was good (k = 0.74). Subjective image quality of high-pitch CT was diagnostic in all patients (median score chest; 2, median score abdomen: 2). Image noise of high-pitch CT was comparable to standard-pitch for the chest (p = 0.32) but increased in the abdomen (p < 0.0001). For high-pitch CT radiation dose was 4.4 ± 0.9 mSv (chest) and 6.5 ± 1.2 mSv (abdomen). These values were significantly lower compared to standard-pitch CT (chest: 5.5 ± 1.2 mSv; abdomen: 11.3 ± 3.8 mSv). Conclusion: Based on the technical background high-pitch dual source CT may serve as an alternative scan mode for low radiation dose routine chest and abdominal CT.

Chest physiotherapy in mechanically ventilated children: a review.

Science.gov (United States)

Krause, M F; Hoehn, T

2000-05-01

Many physicians, nurses, and respiratory care practitioners consider chest physiotherapy (CP) a standard therapy in mechanically ventilated children beyond the newborn period. CP includes percussion, vibration, postural drainage, assisted coughing, and suctioning via the endotracheal tube. We searched the medical literature by using the key words "chest physiotherapy" and "chest physical therapy" (among others) by means of the MEDLINE and Current Contents databases. Because of the paucity of objective data, we examined all reports dealing with this topic, including studies on adult patients. For data extraction, not enough material existed to perform a meta-analysis. Despite its widespread use, almost no literature dealing with this treatment modality in pediatric patients exists. Studies with mechanically ventilated pediatric and adult patients have shown that CP is the most irritating routine intensive care procedure to patients. An increase in oxygen consumption often occurs when a patient receives CP accompanied by an elevation in heart rate, blood pressure, and intracranial pressure. CP leads to short-term decreases in oxygen, partial pressure in the blood, and major fluctuations in cardiac output. Changes in these vital signs and other variables may be even more pronounced in pediatric patients because the lung of a child is characterized by a higher closing capacity and the chest walls are characterized by a much higher compliance, thus predisposing the child to the development of atelectasis secondary to percussion and vibration. CP in mechanically ventilated children may not be considered a standard therapy. Controlled studies examining the impact of CP on the duration of mechanical ventilatory support, critical illness, and hospital stay are needed.

Oral care of the cancer patient receiving radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Holtzhausen, T [Medical Univ. of Southern Africa, Pretoria (South Africa). Dept. of Community Dentistry

1982-07-01

Radiation therapy is frequently being used for the patient with oral cancer. The survival rate is increasing, due to more effective treatment technique. The question of whether any teeth should be extracted, the mode of therapy and the side effects of radiation like Xerostomia, caries, stomatitis, trismus and osteo-radionecrosis and also post radiation care are discussed.

Radiation therapy: age-related macular degeneration.

Science.gov (United States)

Mendez, Carlos A Medina; Ehlers, Justis P

2013-01-01

Age-related macular degeneration (AMD) is the leading cause of severe irreversible vision loss in patients over the age of 50 years in the developed world. Neovascular AMD (NVAMD) is responsible for 90% of the cases with severe visual loss. In the last decade, the treatment paradigm for NVAMD has been transformed by the advent of anti-vascular endothelial growth factor therapy. Despite the excellent results of anti-vascular endothelial growth factor therapy, frequent injections remain a necessity for most patients. The burden of these frequent visits as well as the cumulative risks of indefinite intravitreal injections demand continued pursuit of more enduring therapy that provides similar functional results. Radiotherapy has been studied for two decades as a potential therapy for NVAMD. Because of its antiangiogenic properties, radiation therapy remains a promising potential adjunctive resource for the treatment of choroidal neovascularization secondary to NVAMD. This review considers the past, present and future of radiation as a treatment or combination treatment of NVAMD. Copyright © 2013 S. Karger AG, Basel.

Computed tomography in radiation therapy planning: Thoracic region

International Nuclear Information System (INIS)

Seydel, H.G.; Zingas, A.; Haghbin, M.; Mondalek, P.; Smereka, R.

1983-01-01

With the explosive spread of computed tomographic (CT) scanning throughout the United States, one of the main applications has been in patients who are treated for cancer by surgery, radiation therapy, or chemotherapy. For the radiation oncologist, the desire to provide local tumor control and avoid geographic misses to achieve an expected prolongation of survival has led to the use of large radiation fields in the treatment of intrathoracic cancer, including bronchogenic carcinoma, cancer of the esophagus, and other malignant tumors. The optimal radiation therapy plan is a balance between local tumor control and the necessity to preserve normal structures by the use of directed and limited fields for bulk disease. CT scanning has been employed to accurately demonstrate the extent of tumor as well as to determine the isodose distribution of radiation, including the spatial distribution of radiation portals in single planar and three-dimensional aspects as well as consideration of tissue inhomogeneities. The accurate planning of the distribution of therapeutic irradiation includes both the tumor-bearing target volume and the critical normal tissues. This chapter provides information regarding these aspects of the application of CT scanning to radiation therapy for bronchogenic carcinoma and carcinoma of the esophagus

Radiation optic neuropathy after external beam radiation therapy for acromegaly: report of two cases

International Nuclear Information System (INIS)

Bergh, Alfons C.M. van den; Hoving, Marjanke A.; Links, Thera P.; Dullaart, Robin P.F.; Ranchor, Adelita V.; Weeme, Cees A. ter; Canrinus, Alof A.; Szabo, Ben G.; Pott, Jan-Willem R.

2003-01-01

For diagnosing radiation optic neuropathy (RON) ophthalmological and imaging data were evaluated from 63 acromegalic patients, irradiated between 1967 and 1998. Two patients developed RON: one patient in one optic nerve 10 years and another patient in both optic nerves 5 months after radiation therapy. RON is a rare complication after external beam radiation therapy for acromegaly, which can occur after a considerable latency period

Modeling Internal Radiation Therapy

NARCIS (Netherlands)

van den Broek, Egon; Schouten, Theo E.; Pellegrini, M.; Fred, A.; Filipe, J.; Gamboa, H.

2011-01-01

A new technique is described to model (internal) radiation therapy. It is founded on morphological processing, in particular distance transforms. Its formal basis is presented as well as its implementation via the Fast Exact Euclidean Distance (FEED) transform. Its use for all variations of internal

Radiation Therapy of Suprasellar Germ Cell Tumors

International Nuclear Information System (INIS)

Park, Woo Yoon; Choi, Doo Ho; Choi, Eun Kyung; Kim, Il Han; Ha, Sung Whan; Park, Charn Il

1988-01-01

A retrospective study was performed on 15 patients with suprasellar germ cell tumors treated by megavoltage external beam irradiation between Feb. 1979 and Dec. 1985. Follow-up period of survivors was 30 to 91 months. Histologic diagnosis was obtained before radiation therapy in 10 patients (9 germinomas and 1 mixed). Five patients were treated without histologic verification. In 9 patients with biopsy-proven germinomas radiation therapy was delivered to the craniospinal axis in 6, to the whole brain in 3. In 5 patients with mixed germ cell tumor or elevated tumor marker, irradiation was delivered to the craniospinal axis in 2, to the whole brain in 2, and to the primary site only in 1. Total doses ranged from 5,000 to 5,500 cGy to the primary site, 3,000 to 4,400 cGy to the whole brain, and 1,300 to 3,000 cGy to the spine. In these 14, local tumor was controlled and primary or spinal failure was not observed. One patient without elevated tumor marker was treated to the whole brain, The tumor was not controlled and he had spinal recurrence. It is proven that radiation therapy is an effective treatment for suprasellar germ cell tumors. The neuroendocrinologic presentation, tumor marker status, early response to radiation measured on CT seem to be useful means for selecting patients for radiation therapy when tissue diagnosis is not available

Nursing-led management of side effects of radiation: evidence-based recommendations for practice

Directory of Open Access Journals (Sweden)

Poirier P

2013-03-01

Full Text Available Patricia PoirierUniversity of Maine School of Nursing, Orono, ME, USAAbstract: It has been estimated that 50%–60% of patients diagnosed with cancer will receive radiation therapy at some point in their treatment. Although radiation therapy can play a significant role in the cure or control of cancer, and the palliation of symptoms, it also has side effects. Side effects of radiation therapy can interfere with patient quality of life and daily functioning. Severe side effects can lead to delays in treatment, potentially affecting the outcome of treatment. All patients receiving radiation therapy are at risk of fatigue and skin reactions in the area of the body being treated. Other side effects of radiation therapy are specific to the part of the body being treated. Radiation therapy to the head and neck area may cause oral mucositis, dryness, and nutritional deficiencies. Radiation therapy to the chest or lung area may lead to difficulty in swallowing and eating. Radiation therapy to the pelvis frequently causes diarrhea. There are many nursing interventions available to manage the side effects of treatment based on best available evidence and expert opinion. Nurses in all settings are essential in helping patients manage the side effects of treatment and maintain their quality of life. The purpose of this review is to provide nurses with evidence-based recommendations and suggestions for managing common acute side effects of radiation therapy.Keywords: evidence-based practice, radiation therapy, side effects, nursing management

The relationship of over density to overexposure each film/screen systems in chest radiography

Energy Technology Data Exchange (ETDEWEB)

Kim, Jung Min; Huo Joon [Korea University, Seoul (Korea, Republic of); Taro, Hayash; Yuji, Ishida; Tatsuya, Sakurai [The Chemotherapeutic Istitute Hospital, Tokyo (Japan)

1999-06-01

This study is to calculate the exposed radiation dose using Bit method, NDD calculation method and monogram method without dosimeter. In addition,we can calculate the radiation dose from x-ray film density as a film badge. The authors examined the entrance skin dose from 2 {approx} 3 intercostal chest x-ray film density. We also studied the relationship between film density and equivalent dose in the each screen film system under the different radiation quality and the poor geometry condition of grid ratio. As results, we established the deductive method to define the entrance skin dose from chest x-ray film density. The error range was found in the range -13 percent {approx} +17 percent for between deductive entrance skin dose and the 2 {approx} 3 inter coastal chest x-ray film density to actual detective radiation dose with dosimeter. (author)

Radiation Therapy for Neovascular Age-related Macular Degeneration

Energy Technology Data Exchange (ETDEWEB)

Kishan, Amar U. [Harvard Medical School, Boston, Massachusetts (United States); Modjtahedi, Bobeck S.; Morse, Lawrence S. [Department of Ophthalmology and Vision Sciences, University of California, Davis, Sacramento, California (United States); Lee, Percy, E-mail: percylee@mednet.ucla.edu [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States)

2013-03-01

In the enormity of the public health burden imposed by age-related macular degeneration (ARMD), much effort has been directed toward identifying effective and efficient treatments. Currently, anti-vascular endothelial growth factor (VEGF) injections have demonstrated considerably efficacy in treating neovascular ARMD, but patients require frequent treatment to fully benefit. Here, we review the rationale and evidence for radiation therapy of ARMD. The results of early photon external beam radiation therapy are included to provide a framework for the sequential discussion of evidence for the usage of stereotactic radiation therapy, proton therapy, and brachytherapy. The evidence suggests that these 3 modern modalities can provide a dose-dependent benefit in the treatment of ARMD. Most importantly, preliminary data suggest that all 3 can be used in conjunction with anti-VEGF therapeutics, thereby reducing the frequency of anti-VEGF injections required to maintain visual acuity.

Radiation Therapy of Pituitary Tumors

Energy Technology Data Exchange (ETDEWEB)

Park, Moon Baik; Hong, Seong Eong [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

1989-12-15

Radiation treatment results were analyzed in a retrospective analysis of 47 patients with pituitary adenoma treated with radiation alone or combined with surgery from 1974 through 1987 at the Department of Therapeutic Radiology of Kyung Hee University. The 5-year overall survival rates for all patients was 80.4%. Radiation therapy was effective for improving visual symptoms and headache, but could not normalize amenorrhea and galactorrhoea. There was no difference of survival rate between radiation alone and combination with surgery. Prognostic factors such as age, sex, disease type, visual field, headache and surgical treatment were statistically no significant in survival rates of these patients.

Radiation Therapy of Pituitary Tumors

International Nuclear Information System (INIS)

Park, Moon Baik; Hong, Seong Eong

1989-01-01

Radiation treatment results were analyzed in a retrospective analysis of 47 patients with pituitary adenoma treated with radiation alone or combined with surgery from 1974 through 1987 at the Department of Therapeutic Radiology of Kyung Hee University. The 5-year overall survival rates for all patients was 80.4%. Radiation therapy was effective for improving visual symptoms and headache, but could not normalize amenorrhea and galactorrhoea. There was no difference of survival rate between radiation alone and combination with surgery. Prognostic factors such as age, sex, disease type, visual field, headache and surgical treatment were statistically no significant in survival rates of these patients

Radiation-induced Pulmonary Damage in Lung Cancer Patients

International Nuclear Information System (INIS)

Chung, Su Mi; Choi, Ihl Bohng; Kang, Mi Mun; Kim, In Ah; Shinn, Kyung Sub

1993-01-01

Purpose: A retrospective analysis was performed to evaluate the incidence of radiation induced lung damage after the radiation therapy for the patients with carcinoma of the lung. Method and Materials: Sixty-six patients with lung cancer (squamous cell carcinoma 27, adenocarcinoma 14, large cell carcinoma 2, small cell carcinoma 13, unknown 10) were treated with definitive, postoperative or palliative radiation therapy with or without chemotherapy between July 1987 and December 1991. There were 50 males and 16 females with median age of 63 years(range: 33-80 years). Total lung doses ranged from 500 to 6,660 cGy (median 3960 cGy) given in 2 to 38 fractions (median 20) over a range of 2 to 150 days (median 40 days) using 6 MV or 15 MV linear accelerator. To represent different fractionation schedules of equivalent biological effect, the estimated single dose(ED) model, ED=D·N-0.377·T-0.058 was used in which D was the lung dose in cGy, N was the number of fractions, and T was the overall treatment time in days. The range of ED was 370 to 1357. The endpoint was a visible increase in lung density within the irradiated volume on chest X-ray as observed independently by three diagnostic radiologists. Patients were grouped according to ED, treatment duration, treatment modality and age, and the percent incidence of pulmonary damage for each group was determined. Result: In 40 of 66 patients, radiation induced change was seen on chest radiographs between 11 days and 314 days after initiation of radiation therapy. The incidence of radiation pneumonitis was increased according to increased ED, which was statistically significant (p=0.001). Roentgenographic charges consistent with radiation pneumonitis were seen in 100% of patients receiving radiotherapy after lobectomy or pneumonectomy, which was not statistically significant. In 32 patients who also received chemotherapy, there was no difference in the incidence of radiation induced charge between the group with radiation

Radiation therapy of brain metastases

Energy Technology Data Exchange (ETDEWEB)

Sauer, R; Huenig, R [Kantonsspital Basel (Switzerland). Universitaetsinstitut fuer Medizinische Radiologie

1975-08-01

Experiences are reported obtained with radiation therapy of brain metastases in 121 patients during the last 15 years. The treatment to a lesser extent aimed at prolongation of survival but much more at the attempt to alleviate troubles and to spare pain. The indication thus involved medical points of view as well as ethical ones. The radiotherapy of cerebral metastases comprises the whole cranial volume and requires a focal dose of minimally 4,000 R within four weeks. In 53% of the patients, the regression of neurological symptoms was considerable, in 18% even complete, partly beginning already after a few days of treatment. The number of recurrences was small. Under conditions of rigorous indication, the radiation therapy of brain metastases offers a rewarding palliative measure.

Some computer graphical user interfaces in radiation therapy.

Science.gov (United States)

Chow, James C L

2016-03-28

In this review, five graphical user interfaces (GUIs) used in radiation therapy practices and researches are introduced. They are: (1) the treatment time calculator, superficial X-ray treatment time calculator (SUPCALC) used in the superficial X-ray radiation therapy; (2) the monitor unit calculator, electron monitor unit calculator (EMUC) used in the electron radiation therapy; (3) the multileaf collimator machine file creator, sliding window intensity modulated radiotherapy (SWIMRT) used in generating fluence map for research and quality assurance in intensity modulated radiation therapy; (4) the treatment planning system, DOSCTP used in the calculation of 3D dose distribution using Monte Carlo simulation; and (5) the monitor unit calculator, photon beam monitor unit calculator (PMUC) used in photon beam radiation therapy. One common issue of these GUIs is that all user-friendly interfaces are linked to complex formulas and algorithms based on various theories, which do not have to be understood and noted by the user. In that case, user only needs to input the required information with help from graphical elements in order to produce desired results. SUPCALC is a superficial radiation treatment time calculator using the GUI technique to provide a convenient way for radiation therapist to calculate the treatment time, and keep a record for the skin cancer patient. EMUC is an electron monitor unit calculator for electron radiation therapy. Instead of doing hand calculation according to pre-determined dosimetric tables, clinical user needs only to input the required drawing of electron field in computer graphical file format, prescription dose, and beam parameters to EMUC to calculate the required monitor unit for the electron beam treatment. EMUC is based on a semi-experimental theory of sector-integration algorithm. SWIMRT is a multileaf collimator machine file creator to generate a fluence map produced by a medical linear accelerator. This machine file controls

Drug delivery system and radiation therapy

International Nuclear Information System (INIS)

Shibata, Tokushi

2005-01-01

This paper describes the review of radiation therapy, neutron capture therapy (NCT) and drug delivery system for the latter. In cancer radiation therapy, there are problems of body movement like breathing, needless irradiation of normal tissues, difficulty to decide the correct irradiation position and tumor morphology. NCT has advantages to overcome these, and since boron has a big cross section for thermal neutron, NPT uses the reaction 10 B(n, α) 7 Li in the target cancer which previously incorporated the boron-containing drug. During the period 1966-1996, 246 patients were treated with this in Japan and the treatment has been continued thereafter. The tasks for NCT are developments of drug delivery system efficient to deliver the drug into the tumor and of convenient neutron source like the accelerator. (S.I.)

Computer models for optimizing radiation therapy

International Nuclear Information System (INIS)

Duechting, W.

1998-01-01

The aim of this contribution is to outline how methods of system analysis, control therapy and modelling can be applied to simulate normal and malignant cell growth and to optimize cancer treatment as for instance radiation therapy. Based on biological observations and cell kinetic data, several types of models have been developed describing the growth of tumor spheroids and the cell renewal of normal tissue. The irradiation model is represented by the so-called linear-quadratic model describing the survival fraction as a function of the dose. Based thereon, numerous simulation runs for different treatment schemes can be performed. Thus, it is possible to study the radiation effect on tumor and normal tissue separately. Finally, this method enables a computer-assisted recommendation for an optimal patient-specific treatment schedule prior to clinical therapy. (orig.) [de

Radiation therapy of Graves' ophthalmopathy

Energy Technology Data Exchange (ETDEWEB)

Kawamura, Toshiki; Koga, Sukehiko; Anno, Hirofumi; Komai, Satoshi (Fujita-Gakuen Health Univ., Toyoake, Aichi (Japan))

1992-01-01

During the decade from 1978 to 1987, 20 patients with Graves' ophthalmopathy were treated with irradiation of 2000 cGy to the orbital tissue. We examined the effects of the therapy on 17 such patients. Exophthalmos tended to decrease. When the degree of deviation of the exophthalmic eye was small, the effect of therapy tended to be better than when it was large. Two cases that showed an increase in retrobulbar fatty tissue without thickening of the extraocular muscles did not respond as well as those that had thickening of the extraocular muscles. Diplopia tended to improve both subjectively and objectively. Ocular movement improved in 11 of the 17 patients. There were no serious radiation injuries after the radiation therapy, except for some transient swelling of the eyelid. (author).

Radiation Therapy in Elderly Skin Cancer

Energy Technology Data Exchange (ETDEWEB)

Kim, Jin Hee [Keimyung University College of Medicine, Daegu (Korea, Republic of)

2008-06-15

To evaluate the long term results (local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma (10 patients), basal cell carcinoma (3 patients), verrucous carcinoma (1 patient) and skin adnexal origin carcinoma (1 patient). The most common tumor location was the head (13 patients). The mean tumor diameter was 4.9 cm (range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from 50{approx}80 Gy (mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. The local control rates were 100% (15/15). In addition, the five year disease free survival rate (5YDFS) was 80% and twelve patients (80%) had no recurrence and skin cancer recurrence occurred in 3 patients (20%). Three patients have lived an average of 90 months (68{approx}120 months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin

Accompanying therapy with melatonin at radiation therapy for uterine body cancer

International Nuclear Information System (INIS)

Prokhach, N.E.; Sorochan, P.P.; Gromakova, Yi.A.; Krugova, M.; Sukhyin, V.S.

2011-01-01

The results of treatment for uterine body cancer using post-operative radiation therapy (RT) accompanied by melatonin administration are analyzed. Accompanying therapy with melatonin limited negative RT influence on hematological and immune indices and prevented aggravation of quality of life.

Cardio-oncology: cardiovascular complications of cancer therapy.

Science.gov (United States)

Henning, Robert J; Harbison, Raymond D

2017-07-01

This paper focuses on three classes of commonly used anticancer drugs, which can cause cardiotoxicity: anthracyclines, monoclonal antibodies exemplified by trastuzumab and tyrosine kinase inhibitors. Anthracyclines can induce cardiomyocyte necrosis and fibrosis. Trastuzumab can cause cardiac stunning. The tyrosine kinase inhibitors can increase systemic arterial pressure and impair myocyte contractility. In addition, radiation therapy to the mediastinum or left chest can exacerbate the cardiotoxicity of these anticancer drugs and can also cause accelerated atherosclerosis, myocardial infarction, heart failure and arrhythmias. Left ventricular ejection fraction measurements are most commonly used to assess cardiac function in patients who receive chemo- or radiation-therapy. However, echocardiographic determinations of global longitudinal strain are more sensitive for detection of early left ventricular systolic dysfunction. Information on patient-risk stratification and monitoring is presented and guidelines for the medical treatment of cardiac dysfunction due to cancer therapies are summarized.

Post mastectomy linac IMRT irradiation of chest wall and regional nodes: dosimetry data and acute toxicities

International Nuclear Information System (INIS)

Ma, Jinli; Li, Jiongyan; Xie, Jiang; Chen, Jian; Zhu, Chuanying; Cai, Gang; Zhang, Zhen; Guo, Xiaomao; Chen, Jiayi

2013-01-01

Conventional post-mastectomy radiation therapy is delivered with tangential fields for chest wall and separate fields for regional nodes. Although chest wall and regional nodes delineation has been discussed with RTOG contouring atlas, CT-based planning to treat chest wall and regional nodes as a whole target has not been widely accepted. We herein discuss the dosimetric characteristics of a linac IMRT technique for treating chest wall and regional nodes as a whole PTV after modified radical mastectomy, and observe acute toxicities following irradiation. Patients indicated for PMRT were eligible. Chest wall and supra/infraclavicular region +/−internal mammary nodes were contoured as a whole PTV on planning CT. A simplified linac IMRT plan was designed using either integrated full beams or two segments of half beams split at caudal edge of clavicle head. DVHs were used to evaluate plans. The acute toxicities were followed up regularly. Totally, 85 patients were enrolled. Of these, 45 had left-sided lesions, and 35 received IMN irradiation. Planning designs yielded 55 integrated and 30 segmented plans, with median number of beams of 8 (6–12). The integrated and segmented plans had similar conformity (1.41±0.14 vs. 1.47±0.15, p=0.053) and homogeneity indexes (0.13±0.01 vs. 0.14±0.02, p=0.069). The percent volume of PTV receiving >110% prescription dose was <5%. As compared to segmented plans, integrated plans typically increased V 5 of ipsilateral lung (p=0.005), and heart (p=0.001) in patients with left-sided lesions. Similarly, integrated plans had higher spinal cord D max (p=0.009), ipsilateral humeral head (p<0.001), and contralateral lung D mean (p=0.019). During follow-up, 36 (42%) were identified to have ≥ grade 2 radiation dermatitis (RD). Of these, 35 developed moist desquamation. The median time to onset of moist desquamation was 6 (4–7) weeks from start of RT. The sites of moist desquamation were most frequently occurred in anterior axillary

Spontaneous pneumothorax after upper mantle radiation therapy for Hodgkin disease

International Nuclear Information System (INIS)

Paszat, L.; Basrur, V.; Tadros, A.

1986-01-01

Between 1967 and 1981, 158 of 256 consecutive adult patients received upper mantle (UM) radiation therapy as part of initial treatment of Hodgkin disease at the Hamilton Regional Cancer Centre. Chemotherapy was also part of the initial treatment in 21 of 158 patients who received UM radiation therapy. Spontaneous pneumothorax was observed in six of 158 patients during remission after UM radiation therapy in this series. Three cases were incidental findings on follow-up radiographs, but three other patients were seen initially with symptoms of spontaneous pneumothorax. The entity occurred in three of 21 patients (14%) treated with UM radiation therapy and chemotherapy, and in three of 137 (2%) treated with UM radiation therapy (P < .05). Within the range of UM doses (3,500-4,000 cGy in 4 weeks), higher dose was not associated with higher risk of spontaneous pneumothorax. Although these cases of spontaneous pneumothorax are clustered in an age range classic for this entity, the incidence of spontaneous pneumothorax in this group of patients is higher than the anticipated lifetime incidence of 1:500 for the general population. This risk of spontaneous pneumothorax after UM radiation therapy may be even higher in patients who also receive chemotherapy

Palliative radiation therapy for overloading radiotherapy centre, especially for developing country

International Nuclear Information System (INIS)

Myo, M.; Susworo; San, T.

2001-01-01

In a developing country, most of the cancer cases are diagnosed in the advanced stages. So, the palliative radiation therapy is the only choice of therapy for these inoperable cases where chemotherapy is not effective or affordable. In conventional radiation therapy, a daily dose of 200 cGy for total 4000 cGy in more than 20 fractions (sometimes, up to 6000 cGy) is used. By using linear-quadratic model theory of cell killing by radiation, it can be calculated early and late effects by using alpha and beta ratio. This theory is still the best for radiation cell killing until the new detail one is discovered. These data are obtained by experimental as well as clinical results. The effective radiation dose can be calculated by using the data to different organs which is involved in the radiation fields. This can change the daily dose to palliative cases in which the late effect is unnecessary. The daily doses can be 300, 400, 500, and sometimes 1000 cGy per single fraction. These modalities are well documented. It is recommend to change the short term high-dose palliative radiation therapy instead of using conventional palliative radiation therapy in overloading radiotherapy centre, especially for developing country. The reasons are mainly radiation protection aspect, not only for the patients and those who involved with the radiation therapy but also to reduce the unnecessary radiation exposure to the environment. (author)

Radiation therapy for children: evolving technologies in the era of ALARA

International Nuclear Information System (INIS)

Kun, Larry E.; Beltran, Chris

2009-01-01

The evolution of ever more sophisticated oncologic imaging and technologies providing far more precise radiation therapy have combined to increase the utilization of sophisticated radiation therapy in childhood cancer. For a majority of children with common central nervous system, soft tissue, bone, and dysontogenic neoplasms, local irradiation is fundamental to successful multi-disciplinary management. Along with more precise target volume definition and radiation delivery, new technologies provide added certainty of patient positioning (electronic portal imaging, cone beam CT) and conformality of dose delivery (3-D conformal irradiation, intensity modulated radiation therapy, proton beam therapy). Each of the major areas of technology development are able to better confine the high-dose region to the intended target, but they are also associated with the potential for larger volumes of uninvolved tissues being exposed to low radiation doses. The latter issue plays a role in documented levels of secondary carcinogenesis, sometimes with greater anticipated incidence than that seen in conventional radiation therapy. Parameters related to carcinogenesis, such as dose-volume relationships and neutron contamination that accompanies high-energy photon irradiation and proton therapy, can be identified, sometimes modulated, and accepted as part of the clinical decision process in fine tuning radiation therapy in this more vulnerable age group. (orig.)

Intensity-Modulated Radiation Therapy (IMRT)

Science.gov (United States)

... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... Accelerator Prostate Cancer Treatment Head and Neck Cancer Treatment Introduction to Cancer Therapy (Radiation Oncology) ...

Radiation therapy technology (radiation therapists) manpower needs 1992 comparison of radiation therapeutic technology education in Europe and the United States 1994

International Nuclear Information System (INIS)

Rominger, C. Jules; Owen, Jean; Thompson, Phyllis; Giordano, Patricia; Buck, Beverly; Hanks, Gerald

1995-01-01

The shortage of radiation therapists (radiation therapy technologists) has existed in the United States for many years. It now appears the supply may be matching the demand. This report analyzes the data from the most recent manpower study from ACR/ASTRO carried out in 1990 using the Patterns of Care Master Facility list. The report is a comparison of these figures with similar figures published in IJROBP in December, 1983. Between 1980 and 1990 the number of radiation therapists rose from 3096 to 5353, an increase of 72%. During this period of time, the number of radiation therapy machines increased 47%, and the number of patients being treated increased 30%. The total number of educational programs in radiation therapy technology increased from 101 in 1989 to 123 in 1993. The total enrollment in these programs grew from 806 in 1989 to 1591 in 1993. The number of first time examinees in radiation therapy technology by ARRT in 1983 was 387 and increased to 943 in 1994. It is apparent that as a result of the increase in the number of radiation therapy educational programs and the more effective recruitment into these program, the supply of graduating radiation therapists has reached the demand. The future needs for entry level radiation therapists should be based on current data as well as new Blue Book standards that are being developed

PROTON RADIATION THERAPY: CLINICAL APPLICATION OPPORTUNITIES AND RESEARCH PROSPECTS

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M. V. Zabelin

2018-01-01

Full Text Available This article is the review of literature concerning use of proton beam therapy in treatment of oncology. The staticized data on comparison of effi ciency of this method at an eye melanoma are lit. Advantages of proton therapy on the level of local control and depression of frequency of development of the radio induced cataract are refl ected in the provided data. In evident material the technology of preparation and carrying out radiation of an eye is shortly covered with a fascicle of protons. The experience of use of proton therapy of tumors of a skull base got for the last several decades, showed good results. Physical properties of a fascicle of protons allow to achieve the maximum dose conformality, having lowered, thereby, a radial load on the next crucial anatomical structures. The presented material on an oncopediatrics shows insuffi cient knowledge of scientists concerning advantage of a fascicle of protons over modern methods of photon radiation. There are only preliminary clinical results concerning generally of treatment of cranyopharyngiomas. At cancer therapy of a mammary gland, proton therapy showed the best local control of postoperative recurrent tumors, and also depression of a dose load on the contralateral party. The available results of the retrospective analysis of clinical data in the University medical center of Lome Linda, testify to advantages of proton therapy of the localized prostate cancer. The lack of a biochemical recurrence and a local tumoral progression within 5 years after radiation was shown. The data obtained from experience of use of proton radiation therapy with passively scattered fascicle for cancer therapy of a prostate at an early stage showed the admixed results in comparison with modern methods of radiation therapy with the modulated intensity. In treatment of non-small cell cancer of mild advantage of proton therapy aren’t absolutely proved yet. There are data on extreme toxicity of a combination

The role of radiation therapy in the management of desmoid tumors

International Nuclear Information System (INIS)

Schulz-Ertner, D.; Zierhut, D.; Mende, U.; Harms, W.; Branitzki, P.; Wannenmacher, M.

2002-01-01

Purpose: To investigate the role of radiation therapy (RT) in the management of desmoid tumors. Patients and Methods: Retrospective analysis was performed on 28 patients with desmoid tumors treated with radiation therapy between March 1989 and March 1999. Tumor site was intraabdominal in three, abdominal wall in three and extraabdominal in 22 patients. Median tumor dose was 48 Gy (range 36-60 Gy). Radiation therapy was delivered postoperatively in 26 of 28 patients, two patients received radiation therapy for unresectable recurrent tumors. Results: Median follow-up was 46 months (range 13-108 months). Actuarial 5-year control rate was 73%. We observed six recurrences, located within the radiation field in one patient, out of field in two and at the field margin in three patients. All patients with intraabdominal tumors have been controlled without severe side effects. Conclusions: Radiation therapy is an effective treatment after incomplete resection of desmoid tumors. We did not observe a benefit for tumor doses exceeding 50 Gy. In some patients with circumscribed intraabdominal desmoid tumors, radiation therapy might be a treatment option with low toxicity, if 3-D treatment planning is utilized. (orig.) [de

START: an advanced radiation therapy information system.

Science.gov (United States)

Cocco, A; Valentini, V; Balducci, M; Mantello, G

1996-01-01

START is an advanced radiation therapy information system (RTIS) which connects direct information technology present in the devices with indirect information technology for clinical, administrative, information management integrated with the hospital information system (HIS). The following objectives are pursued: to support decision making in treatment planning and functional and information integration with the rest of the hospital; to enhance organizational efficiency of a Radiation Therapy Department; to facilitate the statistical evaluation of clinical data and managerial performance assessment; to ensure the safety and confidentiality of used data. For its development a working method based on the involvement of all operators of the Radiation Therapy Department, was applied. Its introduction in the work activity was gradual, trying to reuse and integrate the existing information applications. The START information flow identifies four major phases: admission, visit of admission, planning, therapy. The system main functionalities available to the radiotherapist are: clinical history/medical report linking function; folder function; planning function; tracking function; electronic mail and banner function; statistical function; management function. Functions available to the radiotherapy technician are: the room daily list function; management function: to the nurse the following functions are available: patient directing function; management function. START is a departmental client (pc-windows)-server (unix) developed on an integrated database of all information of interest (clinical, organizational and administrative) coherent with the standard and with a modular architecture which can evolve with additional functionalities in subsequent times. For a more thorough evaluation of its impact on the daily activity of a radiation therapy facility, a prolonged clinical validation is in progress.

Combinations of Radiation Therapy and Immunotherapy for Melanoma: A Review of Clinical Outcomes

International Nuclear Information System (INIS)

Barker, Christopher A.; Postow, Michael A.

2014-01-01

Radiation therapy has long played a role in the management of melanoma. Recent advances have also demonstrated the efficacy of immunotherapy in the treatment of melanoma. Preclinical data suggest a biologic interaction between radiation therapy and immunotherapy. Several clinical studies corroborate these findings. This review will summarize the outcomes of studies reporting on patients with melanoma treated with a combination of radiation therapy and immunotherapy. Vaccine therapies often use irradiated melanoma cells, and may be enhanced by radiation therapy. The cytokines interferon-α and interleukin-2 have been combined with radiation therapy in several small studies, with some evidence suggesting increased toxicity and/or efficacy. Ipilimumab, a monoclonal antibody which blocks cytotoxic T-lymphocyte antigen-4, has been combined with radiation therapy in several notable case studies and series. Finally, pilot studies of adoptive cell transfer have suggested that radiation therapy may improve the efficacy of treatment. The review will demonstrate that the combination of radiation therapy and immunotherapy has been reported in several notable case studies, series and clinical trials. These clinical results suggest interaction and the need for further study

Combinations of Radiation Therapy and Immunotherapy for Melanoma: A Review of Clinical Outcomes

Energy Technology Data Exchange (ETDEWEB)

Barker, Christopher A., E-mail: barkerc@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Postow, Michael A. [Department of Medicine, Melanoma and Sarcoma Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

2014-04-01

Radiation therapy has long played a role in the management of melanoma. Recent advances have also demonstrated the efficacy of immunotherapy in the treatment of melanoma. Preclinical data suggest a biologic interaction between radiation therapy and immunotherapy. Several clinical studies corroborate these findings. This review will summarize the outcomes of studies reporting on patients with melanoma treated with a combination of radiation therapy and immunotherapy. Vaccine therapies often use irradiated melanoma cells, and may be enhanced by radiation therapy. The cytokines interferon-α and interleukin-2 have been combined with radiation therapy in several small studies, with some evidence suggesting increased toxicity and/or efficacy. Ipilimumab, a monoclonal antibody which blocks cytotoxic T-lymphocyte antigen-4, has been combined with radiation therapy in several notable case studies and series. Finally, pilot studies of adoptive cell transfer have suggested that radiation therapy may improve the efficacy of treatment. The review will demonstrate that the combination of radiation therapy and immunotherapy has been reported in several notable case studies, series and clinical trials. These clinical results suggest interaction and the need for further study.

Noncontrast chest computed tomography immediately after transarterial chemoembolization in patients with hepatocellular carcinoma: Clinical benefits and effect of radiation reduction on image quality in low-dose scanning

International Nuclear Information System (INIS)

Choi, Joon-Il; Kim, Hyun Beom; Kim, Min Ju; Lee, Jong Seok; Koh, Young Whan; An, Sang Bu; Ko, Heung-kyu; Park, Joong-Won

2011-01-01

Purpose: To evaluate the clinical benefits of noncontrast chest computed tomography (CT) immediately after transarterial chemoembolization in patients with hepatocellular carcinoma and to assess the effect of radiation reduction on image quality in low-dose scanning. Materials and methods: From June to October 2010, we performed standard-dose, noncontrast chest CTs immediately after transarterial chemoembolization in 160 patients and low-dose CTs in 88 patients. We reviewed the entire noncontrast chest CTs and follow-up CTs to reveal the clinical benefits of CT evaluation immediately after transarterial chemoembolization. Using two independent readers, we also retrospectively evaluated the radiation dose and image quality in terms of the image noise, contrast between the liver parenchyma and iodized oil and diagnostic acceptability for the evaluation of treatment response after transarterial chemoembolization. Results: In 5.2% of the patients, additional treatment was performed immediately after the interpretation of the noncontrast chest CT, and additional pulmonary lesions were found in 8.5% of the patients. The measured mean dose-length product for the low-dose scanning was 18.4% of that of the standard-dose scanning. The image noise was significantly higher with the low-dose scanning (p < 0.001). However, all of the low-dose CT scans were diagnostically acceptable, and the mean scores for the subjective assessments of the contrast and diagnostic acceptability showed no significant differences for either reader. Conclusion: A noncontrast chest CT immediately after transarterial chemoembolization has some clinical benefits for immediate decision making and detecting pulmonary lesions. Low-dose, noncontrast chest CTs immediately after transarterial chemoembolization consistently provide diagnostically acceptable images and information on treatment response in patients who have undergone transarterial chemoembolization.

Temporary corneal stem cell dysfunction after radiation therapy

International Nuclear Information System (INIS)

Hiroshi, Fujishima; Kazuo, Tsubota

1996-01-01

Radiation therapy can cause corneal and conjuctival abnormalities that sometimes require surgical treatment. Corneal stem cell dysfunction is described, which recovered after the cessation of radiation. Methods - A 44-year-old man developed a corneal epithelial abnormality associated with conjuctival and corneal inflammation following radiation therapy for maxillary cancer. Examination of brush cytology samples showed goblet cells in the upper and lower parts of the cornea, which showed increased fluorescein permeability, and intraepithelial lymphocytes. Impression cytology showed goblet cells in the same part of the cornea. Specular microscopy revealed spindle type epithelial cells. Patient follow up included artificial tears and an antibiotic ophthalmic ointment. The corneal abnormalities resolved after 4 months with improved visual acuity without any surgical intervention, but the disappearance of the palisades of Vogt did not recover at 1 year after radiation. Radiation therapy in this patient caused temporary stem cell dysfunction which resulted in conjunctivalisation in a part of the cornea. Although limbal stem cell function did not fully recover, this rare case suggested that medical options should be considered before surgery. (Author)

Radiation therapy

International Nuclear Information System (INIS)

Matsuura, Keiichi; Miyoshi, Makoto; Jinguu, Ken-ichi

1982-01-01

Of the cases of lung cancer in which radiation therapy was given between 1961 and November 1981, 399 cases for which histological type was confirmed, and irradiated as follows were reviewed. The cases of squamous cell carcinoma and adenocarcinoma irradiated with more than 5,000 rad or more, those of undifferentiated carcinoma irradiated with 3,000 rad or more, and those irradiated pre- and post-operatively with 3,000 rad or more. The actual 5 year survival rate for stages I, II, III and IV were 29.6, 9.3, 7.5 and 1.9% respectively, and the survival rate tended to be better for adenocarcinoma than squamous cell carcinoma at stages I, II and III, but not different at stage IV. There was no difference between large cell, small cell and squamous cell carcinomas. Irradiation with 200 rad every other day or 150 rad daily was better than that with 200 rad, and daily irradiation with 150 rad was used since 1976. The therapy of stage III small cell carcinoma at the age of up to 80 years was improved with the combination of anticancer agents, maintenance therapy and immunotherapy, but these combined therapies were not significantly effective for the cancers with other histological types or at other stages. Although there was no significant difference in statistics for resectable cases, clinically, the results were experienced to be better after resection, and surgery was done in combination as much as possible. (Kaihara, S.)

Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

International Nuclear Information System (INIS)

McMillan, Matthew T.; Ojerholm, Eric; Roses, Robert E.; Plastaras, John P.; Metz, James M.; Mamtani, Ronac; Karakousis, Giorgos C.; Fraker, Douglas L.; Drebin, Jeffrey A.; Stripp, Diana; Ben-Josef, Edgar; Datta, Jashodeep

2015-01-01

Purpose: Prolonged radiation therapy treatment time (RTT) is associated with worse survival in several tumor types. This study investigated whether delays during adjuvant radiation therapy impact overall survival (OS) in gastric cancer. Methods and Materials: The National Cancer Data Base was queried for patients with resected gastric cancer who received adjuvant radiation therapy with National Comprehensive Cancer Network–recommended doses (45 or 50.4 Gy) between 1998 and 2006. RTT was classified as standard (45 Gy: 33-36 days, 50.4 Gy: 38-41 days) or prolonged (45 Gy: >36 days, 50.4 Gy: >41 days). Cox proportional hazards models evaluated the association between the following factors and OS: RTT, interval from surgery to radiation therapy initiation, interval from surgery to radiation therapy completion, radiation therapy dose, demographic/pathologic and operative factors, and other elements of adjuvant multimodality therapy. Results: Of 1591 patients, RTT was delayed in 732 (46%). Factors associated with prolonged RTT were non-private health insurance (OR 1.3, P=.005) and treatment at non-academic facilities (OR 1.2, P=.045). Median OS and 5-year actuarial survival were significantly worse in patients with prolonged RTT compared with standard RTT (36 vs 51 months, P=.001; 39 vs 47%, P=.005); OS worsened with each cumulative week of delay (P<.0004). On multivariable analysis, prolonged RTT was associated with inferior OS (hazard ratio 1.2, P=.002); the intervals from surgery to radiation therapy initiation or completion were not. Prolonged RTT was particularly detrimental in patients with node positivity, inadequate nodal staging (<15 nodes examined), and those undergoing a cycle of chemotherapy before chemoradiation therapy. Conclusions: Delays during adjuvant radiation therapy appear to negatively impact survival in gastric cancer. Efforts to minimize cumulative interruptions to <7 days should be considered

Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

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McMillan, Matthew T. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Ojerholm, Eric [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Roses, Robert E., E-mail: Robert.Roses@uphs.upenn.edu [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Plastaras, John P.; Metz, James M. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Mamtani, Ronac [Department of Hematology/Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Karakousis, Giorgos C.; Fraker, Douglas L.; Drebin, Jeffrey A. [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Stripp, Diana; Ben-Josef, Edgar [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Datta, Jashodeep [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States)

2015-10-01

Purpose: Prolonged radiation therapy treatment time (RTT) is associated with worse survival in several tumor types. This study investigated whether delays during adjuvant radiation therapy impact overall survival (OS) in gastric cancer. Methods and Materials: The National Cancer Data Base was queried for patients with resected gastric cancer who received adjuvant radiation therapy with National Comprehensive Cancer Network–recommended doses (45 or 50.4 Gy) between 1998 and 2006. RTT was classified as standard (45 Gy: 33-36 days, 50.4 Gy: 38-41 days) or prolonged (45 Gy: >36 days, 50.4 Gy: >41 days). Cox proportional hazards models evaluated the association between the following factors and OS: RTT, interval from surgery to radiation therapy initiation, interval from surgery to radiation therapy completion, radiation therapy dose, demographic/pathologic and operative factors, and other elements of adjuvant multimodality therapy. Results: Of 1591 patients, RTT was delayed in 732 (46%). Factors associated with prolonged RTT were non-private health insurance (OR 1.3, P=.005) and treatment at non-academic facilities (OR 1.2, P=.045). Median OS and 5-year actuarial survival were significantly worse in patients with prolonged RTT compared with standard RTT (36 vs 51 months, P=.001; 39 vs 47%, P=.005); OS worsened with each cumulative week of delay (P<.0004). On multivariable analysis, prolonged RTT was associated with inferior OS (hazard ratio 1.2, P=.002); the intervals from surgery to radiation therapy initiation or completion were not. Prolonged RTT was particularly detrimental in patients with node positivity, inadequate nodal staging (<15 nodes examined), and those undergoing a cycle of chemotherapy before chemoradiation therapy. Conclusions: Delays during adjuvant radiation therapy appear to negatively impact survival in gastric cancer. Efforts to minimize cumulative interruptions to <7 days should be considered.