Sample records for computerized radiation treatment

  1. Treatment of Test Anxiety: A Computerized Approach (United States)

    Pless, Anica


    Test anxiety creates problems for many students, and can have a negative impact on the academic performance of many who suffer from it (Jones & Petruzzi, 1995). Typical treatment components for test anxiety involve psychoeducation, relaxation training, gradual exposure, cognitive restructuring, study skills training, and relapse prevention.…


    Directory of Open Access Journals (Sweden)

    M. Collier


    Full Text Available In the context of Zimbabwe's current economic problems, parts of the manufacturing industry are turning their attention to the possibility of utilising local design talent in upgrading their manufacturing plants. This paper describes a project undertaken by the National University of Science and Technology to convert the heat-treatment process in a major manufacturing plant from semi -manual to a computerized one. The system comprises microcontroller connection to the furnaces and sensors, and communicates with a central computer on which software for a windowed user-interface is hosted. Experimental results for the system are presented, and a strategy for other companies in the same predicament is proposed.

  3. Internet-Based and other computerized psychological treatments for adults depression: A meta-analysis

    NARCIS (Netherlands)

    Andersson, G.; Cuijpers, P.


    Computerized and, more recently, Internet-based treatments for depression have been developed and tested in controlled trials. The aim of this meta-analysis was to summarize the effects of these treatments and investigate characteristics of studies that may be related to the effects. In particular,

  4. Establishment of computerized support system for the assessment of radiation exposure in a nuclear emergency

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    Han, Moon Hui; Lee, Yeong Bok; Kim, Eun Han; Seo, Kyeong Seok; Hwang, Won Tae [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of); Kim, Byeong Woo [Sungkyunkwan Univ., Seoul (Korea, Republic of)


    For the development of a real-time dose assessment, the knowledge over several fields is necessary. For the establishment of the computerized support system for radiation dose assessment, the followings activities have been carried out in this first year. The first test operation of FADAS on HP workstation has been done by editing the basic modules which had been developed as a nuclear long-term project of Korea Atomic Energy Research Institute. The environmental information around the Kori site have been investigated and the information related to the emergency planning such as population density, road network, and socio-environmental data have been displayed on the computer screen. For the automatic control of the basic modules of FADAS, a first-step control program has been organized.

  5. Radiation Therapy: Additional Treatment Options (United States)

    ... Cancer Upper GI Cancers Search x FIND A RADIATION ONCOLOGIST CLOSE SNIPEND TREATMENT TYPES SNIPSTART Home / Treatment ... novel targeted therapies can act as radiosensitizers. Systemic Radiation Therapy Certain cancers may be treated with radioactive ...

  6. Computerized acoustic assessment of treatment efficacy of nebulized epinephrine and albuterol in RSV bronchiolitis

    Directory of Open Access Journals (Sweden)

    Talmon Gil


    Full Text Available Abstract Aim We evaluated the use of computerized quantification of wheezing and crackles compared to a clinical score in assessing the effect of inhaled albuterol or inhaled epinephrine in infants with RSV bronchiolitis. Methods Computerized lung sounds analysis with quantification of wheezing and crackles and a clinical score were used during a double blind, randomized, controlled nebulized treatment pilot study. Infants were randomized to receive a single dose of 1 mgr nebulized l-epinephrine or 2.5 mgr nebulized albuterol. Computerized quantification of wheezing and crackles (PulmoTrack® and a clinical score were performed prior to, 10 minutes post and 30 minutes post treatment. Results were analyzed with Student's t-test for independent samples, Mann-Whitney U test and Wilcoxon test. Results 15 children received albuterol, 12 received epinephrine. The groups were identical at baseline. Satisfactory lung sounds recording and analysis was achieved in all subjects. There was no significant change in objective quantification of wheezes and crackles or in the total clinical scores either within the groups or between the groups. There was also no difference in oxygen saturation and respiratory distress. Conclusion Computerized lung sound analysis is feasible in young infants with RSV bronchiolitis and provides a non-invasive, quantitative measure of wheezing and crackles in these infants. Trial registration number: NCT00361452

  7. The development and role of megavoltage cone beam computerized tomography in radiation oncology (United States)

    Morin, Olivier

    External beam radiation therapy has now the ability to deliver doses that conform tightly to a tumor volume. The steep dose gradients planned in these treatments make it increasingly important to reproduce the patient position and anatomy at each treatment fraction. For this reason, considerable research now focuses on in-room three-dimensional imaging. This thesis describes the first clinical megavoltage cone beam computed tomography (MVCBCT) system, which utilizes a conventional linear accelerator equipped with an amorphous silicon flat panel detector. The document covers the system development and investigation of its clinical applications over the last 4-5 years. The physical performance of the system was evaluated and optimized for soft-tissue contrast resolution leading to recommendations of imaging protocols to use for specific clinical applications and body sites. MVCBCT images can resolve differences of 5% in electron density for a mean dose of 9 cGy. Hence, the image quality of this system is sufficient to differentiate some soft-tissue structures. The absolute positioning accuracy with MVCBCT is better than 1 mm. The accuracy of isodose lines calculated using MVCBCT images of head and neck patients is within 3% and 3 mm. The system shows excellent stability in image quality, CT# calibration, radiation exposure and absolute positioning over a period of 8 months. A procedure for MVCBCT quality assurance was developed. In our clinic, MVCBCT has been used to detect non rigid spinal cord distortions, to position a patient with a paraspinous tumor close to metallic hardware, to position prostate cancer patients using gold markers or soft-tissue landmarks, to monitor head and neck anatomical changes and their dosimetric consequences, and to complement the convention CT for treatment planning in presence of metallic implants. MVCBCT imaging is changing the clinical practice of our department by increasingly revealing patient-specific errors. New verification

  8. Current treatments for radiation retinopathy

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    Giuliari, Gian Paolo; Simpson, E. Rand (Princess Margaret Hospital, Univ. of Toronto, Dept. of Ophthalmology and Vision Sciences, Toronto (Canada)), e-mail:; Sadaka, Ama (Schepens Eye Research Inst., Boston, MA (United States)); Hinkle, David M. (Massachusetts Eye Research and Surgery Institution, Cambridge, MA (United States))


    Background. To review the currently available therapeutic modalities for radiation retinopathy (RR), including newer investigational interventions directed towards specific aspects of the pathophysiology of this refractory complication. Methods. A review of the literature encompassing the pathogenesis of RR and the current therapeutic modalities available was performed. Results. RR is a chronic and progressive condition that results from exposure to any source of radiation. It might be secondary to radiation treatment of intraocular tumors such as choroidal melanomas, retinoblastomas, and choroidal metastasis, or from unavoidable exposure to excessive radiation from the treatment of extraocular tumors like cephalic, nasopharyngeal, orbital, and paranasal malignancies. After the results of the Collaborative Ocular Melanoma Study, most of the choroidal melanomas are being treated with plaque brachytherapy increasing by that the incidence of this radiation complication. RR has been reported to occur in as many as 60% of eyes treated with plaque radiation, with higher rates associated with larger tumors. Initially, the condition manifests as a radiation vasculopathy clinically seen as microaneurysms and telangiectasis, with posterior development of retinal hard exudates and hemorrhages, macular edema, neovascularization and tractional retinal detachment. Regrettably, the management of these eyes remains limited. Photodynamic therapy, laser photocoagulation, oral pentoxyphylline and hyperbaric oxygen have been attempted as treatment modalities with inconclusive results. Intravitreal injections of anti-vascular endothelial growth factor such as bevacizumab, ranibizumab and pegaptanib sodium have been recently used, also with variable results. Discussion. RR is a common vision threatening complication following radiation therapy. The available therapeutic options are limited and show unsatisfactory results. Further large investigative studies are required for developing

  9. Radiation treatment of molasses (United States)

    Rodríguez, A. S.; Serrano G., J.; Lara R., O.; Reyes L., J.

    Molasses are a by-product of the sugar industry. Their annual production in México in around 1 million tons and are mainly used as a complement for animal feeding and for the production of alcohols. Their value is relatively low compared with another chemicals. When molasses are irradiated with gamma radiation or accelerated electrons, in presence of nitric acid and oxygen, it is obtained oxalic acid and several polymeric compounds. In both cases, the same products are obtained, but the yield is greater with electrons. It has been studied the effect of dose and dose rate in the yields. As example, when mixtures of molasses-nitric acid, with an initial concentration of 26% of total sugar reductors, are irradiated with 1.0 MeV electrons, in a continuous flow reactor, at 0.11 {Gy}/{sec} to a total dose of 30 KGy, the oxalic acid yield is around 44% of the total chemical reductors used. The separations of the radiolytic products was made by successive decantations and concentrations, and purified by recristallizations. From the analytical information, the minimal formula were calculated for the acid product and the polymeric compounds.

  10. Radiation conditions for computerized tomography: determination and comparison; Condicoes de radiacao para tomografia computadorizada: determinacao e comparacoes

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    Andrade, Lucio das Chagas de


    Radiology is the practice in which radiation beams, usually radiation X are used to produce an image of the human body in order to obtain a diagnosis, for example, to evaluate a pathological condition by computerized tomography (CT). Although the computerized tomography diagnostic potential is unquestionable, caution must be taken because the doses are almost always higher than the observed in conventional radiology procedures. The ionization chamber used for dosimetry in CT is a unsealed cylindrical chamber with 10 cm and 15 cm of sensitive length. A typical characteristics of this camera is its uniform response to radiation incident at all angles around its axis. The revised edition of IEC 61267 (2005) brought as an innovation the radiation conditions for computed tomography, RQT, that simulate non-attenuated beam and are used in special CT applications. This study aims to establish the necessary conditions to obtain radiation pattern beam computed tomography, RQT, and a calibration laboratory implementation for pencil ionization chambers used in the beam dosimetry produced by these scanners in the Metrology National Laboratory of Ionizing Radiation (LNMRI). In the implementation of RQT conditions we were found that the ratio of kerma rates in the air, with or without additional filtration equivalent to the first HVL (half-value layer), are in accordance with IEC 61267 (2005), which provides a range between 48.5% and 51.5% for each quality. The LNMRI characterized the radiation conditions of RQT series (IEC, 2005), obtaining a percentage of 49.6% for the RQT 8, 50% for the RQT 9 and 50,4% for the RQT 10. With the substitution of the total additional filtration RQT qualities, composed by Al + Cu and by a total filtration composed by copper (Cu) only, it can be seen the emergence of a similar RQT quality named Quality Copper Tomography - QCT. The results of the calibration, the RQT and QCT qualities, had expanded uncertainties with a confidence level 95.45%, less

  11. Neuroplasticity-based computerized cognitive remediation for treatment-resistant geriatric depression. (United States)

    Morimoto, Sarah Shizuko; Wexler, Bruce E; Liu, Jiacheng; Hu, Willie; Seirup, Joanna; Alexopoulos, George S


    Executive dysfunction (ED) in geriatric depression (GD) is common, predicts poor clinical outcomes and often persists despite remission of symptoms. Here we develop a neuroplasticity-based computerized cognitive remediation-geriatric depression treatment (nCCR-GD) to target ED in GD. Our assumption is that remediation of these deficits may modulate the underlying brain network abnormalities shared by ED and depression. We compare nCCR-GD to a gold-standard treatment (escitalopram: 20 mg per 12 weeks) in 11 treatment-resistant older adults with major depression; and 33 matched historical controls. We find that 91% of participants complete nCCR-GD. nCCR-GD is equally as effective at reducing depressive symptoms as escitalopram but does so in 4 weeks instead of 12. In addition, nCCR-GD improves measures of executive function more than the escitalopram. We conclude that nCCR-GD may be equally effective as escitalopram in treating GD. In addition, nCCR-GD participants showed greater improvement in executive functions than historical controls treated with escitalopram.


    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring; David I. Gertman


    Computerized procedures (CPs) are an emerging technology within nuclear power plant control rooms. While CPs have been implemented internationally in advanced control rooms, to date no US nuclear power plant has implemented CPs in its main control room. Yet, CPs are a reality of new plant builds and are an area of considerable interest to existing plants, which see advantages in terms of easier records management by omitting the need for updating hardcopy procedures. The overall intent of this paper is to provide a characterization of human reliability analysis (HRA) issues for computerized procedures. It is beyond the scope of this document to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper serves as a review of current HRA as it may be used for the analysis and review of computerized procedures.

  13. Impact of repeat computerized tomography replans in the radiation therapy of head and neck cancers

    Directory of Open Access Journals (Sweden)

    Virendra Bhandari


    Full Text Available Anatomical changes can occur during course of head-and-neck (H and N radiotherapy like tumor shrinkage, decreased edema and/or weight loss. This can lead to discrepancies in planned and delivered dose increasing the dose to organs at risk. A study was conducted to determine the volumetric and dosimetric changes with the help of repeat computed tomography (CT and replanning for selected H and N cancer patients treated with IMRT plans to see for these effects. In 15 patients with primary H and N cancer, a repeat CT scan after 3 rd week of radiotherapy was done when it was clinically indicated and then two plans were generated on repeat CT scan, actual plan (AP planned on repeat CT scan, and hybrid plan (HP, which was generated by applying the first intensity-modulated radiation therapy (IMRT plan (including monitoring units to the images of second CT scan. Both plans (AP and HP on repeat CT scan were compared for volumetric and dosimetric parameter. The mean variation in volumes between CT and repeat CT were 44.32 cc, 82.2 cc, and 149.83 cc for gross tumor volume (GTV, clinical target volumes (CTV, and planning target volume (PTV, respectively. Mean conformity index and homogeneity index was 0.68 and 1.07, respectively for AP and 0.5 and 1.16, respectively for HP. Mean D 95 and D 99 of PTV was 97.92% (standard deviation, SD 2.32 and 93.4% (SD 3.75, respectively for AP and 92.8% (SD 3.83 and 82.8% (SD 8.0, respectively for HP. Increase in mean doses to right parotid, left parotid, spine, and brainstem were 5.56 Gy (D mean , 3.28 Gy (D mean , 1.25 Gy (D max , and 3.88 Gy (D max , respectively in HP compared to AP. Repeat CT and replanning reduces the chance of discrepancies in delivered dose due to volume changes and also improves coverage to target volume and further reduces dose to organ at risk.

  14. Radiation treatment and radiation reactions in dermatology. 2. ed.

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    Panizzon, Renato G. [Univ. Hospital CHUV, Lausanne (Switzerland). Dept. of Dermatology; Seegenschmiedt, M. Heinrich (ed.) [Strahlenzentrum Hamburg (Germany)


    Explains the use of radiation treatment in the full range of skin cancers and precancerous lesions. Covers physical and radiobiological principles, dose definitions, radiation reactions, and risk assessments. Revised and updated edition that includes new chapters and numerous additional figures. In this book, leading experts in the dermatological and oncological field describe the use of radiation therapy for the treatment of the full range of dermatological malignancies - including basal cell carcinoma, squamous cell carcinoma, cutaneous lymphomas, Kaposi's sarcoma, melanoma, and Merkel cell tumor - as well as those precancerous lesions and non-malignant dermatological disorders which are amenable to radiation therapy. In each case the specific indications for the use of radiotherapy and its application are clearly explained with the aid of numerous high-quality illustrations. In addition, the book provides a concise introduction to physical and radiobiological principles, selection of radiation factors, dose definitions, radiation reactions, and risk assessments. The new edition has been thoroughly revised and updated to reflect advances in practical knowledge and clinical practice. It will be an invaluable source of information on the management of skin tumors and related non-malignant disorders for both dermatologists, oncologists and radiation oncologists.

  15. Cellulose destruction under successive thermal and radiation treatment. [Gamma radiation

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    Ershov, B.G.; Komarov, V.B.


    The influence of successive thermal and radiation effect on cellulose is investigated. The samples were ..gamma.. irradiated (/sup 60/Co) with a dose rate of 20 kGy/h (the absorbed doses ranged from 0 to 80 kGy) and heated up to 190 deg C. It is shown that the attainment of the same destruction depth for the heated-up cellulose occurs at noticeably lower absorbed doses than for the cellulose which has not been subjected to thermal treatment. For successive thermal and radiation treatment of cellulose the ratio S=S therm.+Ssub(rad) where S is a number of broken bonds in a macromolecule is correct. The radiation-chemical yield of cellulose destruction is determined to be: G=7.3 +- 0.1 mol/100 eV.

  16. Evaluation method of reference levels of radiation diagnostic in computerized tomography; Metodo de evaluacion de niveles de referencia de radiodiagnostico en tomografia computarizada

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    Flores, Walter; Borges, Jose C. [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia. Programa de Engenharia Nuclear; Mota, Helvecio C. [Instituto de Radioprotecao e Dosimetria (IRD), Rio de Janeiro, RJ (Brazil). Dept. de Fisica Medica


    The computerized tomography (CT) is a complex technique, with many parameters to be selected and protocols of quality control not standardized, connected with high doses in the patients. In this work a simple methodology is developed, to evaluate levels of reference of diagnosis in computerized tomography using the concept of Multiple Scan Average Dose (MSAD), recently adopted by the Ministry of Health of Brazil. This methodology, can be used in the routine of inspection of evaluation of radiological safety in medical radiation diagnostics, executed by the Department of Medical Physics of the Institute of Radiation Protection and Dosimetry and by the sanitary authorities in Brazil. In order to evaluate this dosimeter magnitude the distribution of dose it was studied the dose distribution obtained trough a profile of dose measured in the axial axis of a simulator(phantom) of water with thermoluminescent dosimeters, TLD-100, for three techniques of examination by CT. The magnitude MSAD was evaluated by means of two different methods. In first, it was evaluated for an only cut, and in the second for multiple cuts. This last method presents/displays to be more practical and adapted to be applied in the routine of evaluation of reference levels, with TLDs.

  17. The use of computerized tomography in pediatrics: risk of radiation; Actualizacion de temas relacionados con elriesgo de radiacion y la obtencion de imagenes pediatricas por tomografia computerizada

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    Lane, F.; Donnelly, M. D.


    The use of computerized tomography in paediatrics is rapidly increasing and with that the dose received by the patients. Recent publications show that the new technique is overused and therefore the cancer risk is increasing in paediatric patients. The article discusses the strategies in use ro reduce the radiation doses without losing the advantages of the new technique. Paediatric doses can be reduced adjusting the photon beam to the density and dimensions of the paediatric patient, in new equipment modulating automatically the current and the tension in the cathodic tube to the optimum values without impairing the quality of the image. Dose can also be reduce increasing the rotation velocity and the pitch of the gantry, limiting the exploration to the region of interest and using shielding to protect the most sensitive tissues. Nevertheless, the article defends the prudent use of computerised tomography and recommends, whenever possible, the use of complementary non ionizing radiation techniques. (Author) 26 refs.

  18. Pelvic radiation disease: Updates on treatment options (United States)

    Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo


    Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

  19. Radiation treatment of ovarian cancer

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    Morita, S.; Arai, T.; Kurisu, A. (National Inst. of Radiological Sciences, Chiba (Japan))


    We evaluated the clinical results obtained in 129 primary malignant ovarian cancer patients who had been treated by 4 modes of postoperative irradiation between 1961 and 1980 at NIRS. The 3- and 5-year survival rates were 52% (45/86) and 43% (32/75) in total and 71% (20/28) and 59% (10/17) in whole abdominal irradiation cases, respectively. Leucopenia (>2,000) occurred in 48%, ileus in 5.2% of the latter cases. The necessity of combining radiation therapy with surgery and chemotherapy was emphasized.

  20. Molecular targeted treatment and radiation therapy for rectal cancer

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    Marquardt, Friederike; Roedel, Franz; Capalbo, Gianni; Weiss, Christian; Roedel, Claus [Dept. of Radiation Therapy, Univ. of Frankfurt/Main (Germany)


    Background: EGFR (epidermal growth factor receptor) and VEGF (vascular endothelial growth factor) inhibitors confer clinical benefit in metastatic colorectal cancer when combined with chemotherapy. An emerging strategy to improve outcomes in rectal cancer is to integrate biologically active, targeted agents as triple therapy into chemoradiation protocols. Material and methods: cetuximab and bevacizumab have now been incorporated into phase I-II studies of preoperative chemoradiation therapy (CRT) for rectal cancer. The rationale of these combinations, early efficacy and toxicity data, and possible molecular predictors for tumor response are reviewed. Computerized bibliographic searches of Pubmed were supplemented with hand searches of reference lists and abstracts of ASCO and ASTRO meetings. Results: the combination of cetuximab and CRT can be safely applied without dose compromises of the respective treatment components. Disappointingly low rates of pathologic complete remission have been noted in several phase II studies. The K-ras mutation status and the gene copy number of EGFR may predict tumor response. The toxicity pattern (radiation-induced enteritis, perforations) and surgical complications (wound healing, fistula, bleeding) observed in at least some of the clinical studies with bevacizumab and CRT warrant further investigations. Conclusion: longer follow-up (and, finally, randomized trials) is needed to draw any firm conclusions with respect to local and distant failure rates, and toxicity associated with these novel treatment approaches. (orig.)

  1. Hyperbaric oxygen treatment for haemorrhagic radiation cystitis

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    Bevers, R.F.M.; Kurth, K.H. [Amsterdam Univ. (Netherlands). Academic Medical Center; Bakker, D.J. [Amsterdam Univ. (Netherlands). Depts. of Urology and Surgery


    Radiation-induced severe haemorrhagic cystitis is difficult to treat. Conventional treatments may decrease haematuria but do not affect the radiocystitis itself. Hyperbaric oxygen treatment has been reported to do both. We report the results of a prospective study of hyperbaric oxygen (20 sessions of 100% oxygen inhalation at 3 bar for 90 min in a multiplace hyperbaric chamber) to 40 patients with biopsy-proven radiation cystitis and severe haematuria. Haematuria disappeared completely or improved in 37 patients after treatment. Mean follow-up was 23.1 months (range 1-74); and the recurrence rate was 0.12/year. There were no adverse effects. Hyperbaric oxygen treatment should be considered for patients with severe radiation-induced haematuria. (author).

  2. Banking on Fatherhood: Pilot Studies of a Computerized Educational Tool on Sperm Banking before Cancer Treatment (United States)

    Huyghe, Eric; Martinetti, Paul; Sui, Dawen; Schover, Leslie R.


    OBJECTIVES We conducted pilot studies of the feasibility and efficacy of an interactive, computerized educational tool, Banking on Fatherhood (BOF METHODS Two small randomized trials were conducted, with 20 male cancer patients eligible to bank sperm in Study 1 and 19 oncology fellows or residents in Study 2. In each trial, half of subjects viewed BOF before completing questionnaires, and half viewed it afterwards. Outcome measures included a knowledge test in both trials and a decisional conflict scale in the patient trial. All participants, plus a panel of ten experts, ultimately viewed BOF and completed a form evaluating its usability and value. RESULTS Patients who completed questionnaires after viewing BOF had significantly less decisional conflict about banking sperm than those who had not viewed it(P = 0.0065), but knowledge scores were not significantly different between groups. Physicians who filled out questionnaires after viewing BOF scored significantly higher on the Knowledge Test (P banking. Research with larger groups is needed to validate its effectiveness. PMID:19061198

  3. Radiation treatment of superior sulcus lung carcinoma

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    Millar, J.; Ball, D.; Worotniuk, V.; Smith, J.; Crennan, E.; Bishop, M. [Peter MacCallum Cancer Inst., East Melbourne, VIC (Australia)


    The survival of patients with superior sulcus lung carcinoma and the effects of treatment were reviewed. From a prospective database of 4123 consecutive new patients with lung carcinoma, 131 (3.2%) cases of superior sulcus lung carcinoma were identified. Seventy-four patients were planned to receive radiation with palliative intent, 53 radical radiotherapy and one was observed only. The remaining three patients, with small-cell carcinoma, were treated with chemotherapy with or without radiotherapy. Of the 53 radically treated patients, nine were treated with pre-operative radiation prior to intended radical resection. Analysis was carried out on the effect on survival of performance status, nodal involvement, weight loss, vertebral body or rib involvement, treatment intent and radical combined modality treatment compared with radical radiation alone. The estimated median survival for the whole group was 7.6 months; for those treated radically it was 18.3 months, while for the palliatively treated patients it was 3.7 months. Radically treated patients with no initial nodal involvement had an estimated median survival of 22 months, while radically treated patients with nodal involvement had an estimated median survival of 8.4 months (P = 0.003). There were no statistically significant differences in survival between radically treated patients grouped according to initial weight loss, performance status, or vertebral body and rib involvement. Patients treated with pre-operative radiation did not survive significantly longer than patients treated with radiation alone, although the numbers are small. 33 refs., 2 tabs., 4 figs.

  4. Development of Radiation Technique for Environmental Treatment

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    Lee, Myun Joo; Kuk, Il Hiun; Jin, Joon Ha (and others)


    The purpose of this research is to development of technologies for 1) the removal of toxic organic chemicals in sewage sludges and the volume reduction of the sewage sludge 2) the recycling/reuse of sewage sludge 3) the reconvey of resource from fishery waste by using radiation technologies. This research project focused on the study of treatment, disposal, and recycling/reuse of sewage sludge by radiation technology, and recovery of highly value-added resources from the wastes. As basic studies with a radiation technology, an enhancement of dewaterbilities of sewage sludge, development of dewatering conditioner, reduction of trace toxic organic chemicals, and the toxicities of the byproducts were studied. Based on the basic experimental results, we developed the pilot-scale system with the continuous e-beam and dewatering unit and the advanced treatment system with the use of carbon source recovered from sewage sludge.

  5. Classification and treatment of radiation maculopathy.

    LENUS (Irish Health Repository)

    Horgan, Noel


    PURPOSE OF REVIEW: Radiation maculopathy is a sight-limiting consequence of radiotherapy in the management of uveal melanoma and other intraocular tumors. In this review, we consider clinical, fluorescein angiographic and optical coherence tomographic findings, propose a classification for radiation maculopathy and discuss the management of this condition. RECENT FINDINGS: Radiation macular edema (RME) can be classified by optical coherence tomography into noncystoid or cystoid edema, with foveolar or extrafoveolar involvement. Optical coherence tomographic grading of RME has been found to correlate with visual acuity. Focal argon laser might have some limited benefit in the treatment of RME. Intravitreal triamcinolone and intravitreal antivascular endothelial growth factor agents can be of short-term benefit in the treatment of RME. In a randomized controlled trial, periocular triamcinolone significantly reduced rates of RME and vision loss up to 18 months following plaque radiotherapy for uveal melanoma. SUMMARY: Currently, there is no proven treatment for established RME, though periocular triamcinolone has been shown to have a preventive benefit. An accepted classification system for radiation maculopathy would be of benefit in planning and comparing future treatment trials.

  6. Volume visualization in radiation treatment planning. (United States)

    Pelizzari, C A; Chen, G T


    Radiation treatment planning (RTP), historically an image-intensive discipline and one of the first areas in which 3D information from imaging was clinically applied, has become even more critically dependent on accurate 3D definition of target and non-target structures in recent years with the advent of conformal radiation therapy. In addition to the interactive display of wireframe or shaded surface models of anatomic objects, proposed radiation beams, beam modifying devices, and calculated dose distributions, recently significant use has been made of direct visualization of relevant anatomy from image data. Dedicated systems are commercially available for the purpose of geometrically optimizing beam placement, implementing in virtual reality the functionality of standard radiation therapy simulators. Such "CT simulation" systems rely heavily on 3D visualization and on reprojection of image data to produce simulated radiographs for comparison with either diagnostic-quality radiographs made on a simulator or megavoltage images made using the therapeutic beams themselves. Although calculation and analysis of dose distributions is an important component of radiation treatment design, geometric targeting with optimization based on 3D anatomic information is frequently performed as a separate step independent of dose calculations.

  7. Treatment of radiation enteritis: a comparison study

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    Loiudice, T.A.; Lang, J.A.


    Twenty-four patients with severe radiation injury to the small bowel seen over a 4-year period were randomized to four treatment groups: 1) methylprednisolone 80 mg intravenously plus Vivonex-HN, 2 L/day po, 2) methylprednisolone 80 mg intravenously plus total parenteral nutrition, 2.5 L/day, 3) total parenteral nutrition, 2.5 L/day, and 4) Vivonex-HN, 2 L/day po. Patients received nothing by mouth except water in groups II and III, and only Vivonex-HN in groups I and IV. Patients were treated for 8-wk periods. Improvement was gauged by overall nutritional assessment measurements, nitrogen balance data and by radiological and clinical parameters. No significant difference between groups I, II, III, and IV could be found for age, sex, mean radiation dosage, time of onset after radiation therapy, or initial nutritional assessment data. Differences statistically could be found between groups II and III and I and IV regarding nutritional assessment data, nitrogen balance, radiographic and clinical parameters after therapy, with marked improvement noted in groups II and III. We conclude that a treatment regimen consisting of total parenteral nutrition and bowel rest is beneficial in the treatment of radiation enteritis. Methylprednisolone appears to enhance this effect and indeed, may be responsible for a longer lasting response.

  8. The frequency of missed test results and associated treatment delays in a highly computerized health system



    Abstract Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results") are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA). Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary ca...

  9. Surgical treatment of intestinal radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Maekelae, J.Ne.; Nevasaari, K.; Kairaluoma, M.I.


    A review of 43 consecutive patients requiring operation for serious intestinal radiation injury was undertaken to elucidate the efficacy of surgical treatment. The most common site of radiation injury was the rectum (19 cases), followed by the small bowel (13 cases), the colon (7 cases), and the combination of these (4 cases). The overall operative mortality was 14%; morbidity, 47%; and the postoperative symptom-free period, 18 +/- 30 months. Colostomy (N = 20) carried the lowest risk of mortality, 0%, as compared with resection (N = 17) and bypass procedure (N = 6), which were accompanied by the mortalities of 24% and 33%, respectively. During the follow-up (3-13 years) 12 patients (28%) died of recurrent cancer and 9 patients (21%) of persistent radiation injury, which yielded an overall mortality of 65% after resection and 50% and 65% after bypass and colostomy procedures, respectively. Continuing radiation damage led to 15 late reoperations. Ten of these were performed after colostomy, four after resection, and one after bypass. We conclude that colostomy cannot be regarded as a preferred operative method, because it does not prevent the progression of radiation injury and because it is, for this reason, associated with a higher late-complication rate. A more radical surgery is recommended but with the limitation that the operative method must be adapted to the operative finding.

  10. A computerized treatment of dyslexia: benefits from treating lexico-phonological processing problems. (United States)

    Tijms, Jurgen; Hoeks, Jan


    Two hundred sixty-seven 10- to 14-year-old Dutch children with dyslexia were randomly assigned to one of two samples that received a treatment for reading and spelling difficulties. The treatment was computer-based and focused on learning to recognise and use the phonological and morphological structure of Dutch words. The inferential algorithmic basis of the program ensured that the instruction was highly structured. The present study examined the reliability of the effects of the treatment, and provided an evaluation of the attained levels of reading and spelling by relating them to normal levels. Both samples revealed large, generalized treatment effects on reading accuracy, reading rate, and spelling skills. Following the treatment, participants attained an average level of reading accuracy and spelling. The attained level of reading rate was comparable to the lower bound of the average range.

  11. [A method for the surgical treatment of pericoronitis using a computerized laser apparatus]. (United States)

    Grigor'iants, L A; Belova, E Iu; Badalian, V A


    Use of pulsed exposure to CO2 laser permits operations on soft tissues of the oral cavity with the minimal injury. The choice of optimal parameters of laser exposure depends on the stage of the inflammatory process. The proposed ablation regimen for the treatment of pericoronitis notably accelerates the treatment and decreases the amount of drugs used. The absence of complications after the operation and a shorter rehabilitation period recommend the Lancet computer-aided laser for dissection of the veil.

  12. Computerized EEG as a predictor of drug response in treatment resistant schizophrenics. (United States)

    Itil, T M; Shapiro, D; Schneider, S J; Francis, I B


    Thirteen chronic schizophrenics were identified who failed to improve with physician's choice medication and 1 year of systematic treatment with a long acting phenothiazine. These patients were considered to be treatment resistant. Computer analyzed electroencephalogram (CEEG) or these treatment resistant schizophrenics was characterized by a large amount of alpha activity and less fast activity, in comparison with previous results from therapy responsive schizophrenics. The therapy resistant subjects did not display the typical neuroleptic CEEG profile following test dosages of four neuroleptics, and instead displayed CEEG profiles which more closely resembled the typical profile for psychostimulants. These findings may point to an altered metabolism, neurotransmitter defect, or other problem which alters the physiological and clinical response of therapy resistant schizophrenics to neuroleptic medication.

  13. The frequency of missed test results and associated treatment delays in a highly computerized health system (United States)

    Wahls, Terry L; Cram, Peter M


    Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results") are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA). Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary care providers in VA clinics. Methods: An anonymous on-line survey of primary care providers was conducted as part of the health systems ongoing quality improvement programs. We collected information from providers concerning their clinical effort (e.g., number of clinic sessions, number of patient visits per session), number of patients with missed abnormal test results, and the number and types of treatment delays providers encountered during the two week period prior to administration of our survey. Results: The survey was completed by 106 out of 198 providers (54 percent response rate). Respondents saw and average of 86 patients per 2 week period. Providers encountered 64 patients with missed results during the two week period leading up to the study and 52 patients with treatment delays. The most common missed results included imaging studies (29 percent), clinical laboratory (22 percent), anatomic pathology (9 percent), and other (40 percent). The most common diagnostic delays were cancer (34 percent), endocrine problems (26 percent), cardiac problems (16 percent), and others (24 percent). Conclusion: Missed results leading to clinically important treatment delays are an important and likely underappreciated source of diagnostic error. PMID:17519017

  14. The frequency of missed test results and associated treatment delays in a highly computerized health system

    Directory of Open Access Journals (Sweden)

    Wahls Terry L


    Full Text Available Abstract Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results" are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA. Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary care providers in VA clinics. Methods: An anonymous on-line survey of primary care providers was conducted as part of the health systems ongoing quality improvement programs. We collected information from providers concerning their clinical effort (e.g., number of clinic sessions, number of patient visits per session, number of patients with missed abnormal test results, and the number and types of treatment delays providers encountered during the two week period prior to administration of our survey. Results: The survey was completed by 106 out of 198 providers (54 percent response rate. Respondents saw and average of 86 patients per 2 week period. Providers encountered 64 patients with missed results during the two week period leading up to the study and 52 patients with treatment delays. The most common missed results included imaging studies (29 percent, clinical laboratory (22 percent, anatomic pathology (9 percent, and other (40 percent. The most common diagnostic delays were cancer (34 percent, endocrine problems (26 percent, cardiac problems (16 percent, and others (24 percent. Conclusion: Missed results leading to clinically important treatment delays are an important and likely underappreciated source of diagnostic error.

  15. Computerized implant-dentistry: Advances toward automation (United States)

    Gulati, Minkle; Anand, Vishal; Salaria, Sanjeev Kumar; Jain, Nikil; Gupta, Shilpi


    Advancements in the field of implantology such as three-dimensional imaging, implant-planning software, computer-aided-design/computer-aided-manufacturing (CAD/CAM) technology, computer-guided, and navigated implant surgery have led to the computerization of implant-dentistry. This three-dimensional computer-generated implant-planning and surgery has not only enabled accurate preoperative evaluation of the anatomic limitations but has also facilitated preoperative planning of implant positions along with virtual implant placement and subsequently transferring the virtual treatment plans onto the surgical phase via static (guided) or dynamic (navigated) systems aided by CAD/CAM technology. Computerized-implant-dentistry being highly predictable and minimally invasive in nature has also allowed implant placement in patients with medical comorbidities (e.g. radiation therapy, blood dyscrasias), in patients with complex problems following a significant alteration of the bony anatomy as a result of benign or malignant pathology of the jaws or trauma and in patients with other physical and emotional problems. With significant achievements accomplished in the field of computerized implant-dentistry, attempts are now been made toward complete automation of implant-dentistry. PMID:25810585

  16. Computerized implant-dentistry: Advances toward automation

    Directory of Open Access Journals (Sweden)

    Minkle Gulati


    Full Text Available Advancements in the field of implantology such as three-dimensional imaging, implant-planning software, computer-aided-design/computer-aided-manufacturing (CAD/CAM technology, computer-guided, and navigated implant surgery have led to the computerization of implant-dentistry. This three-dimensional computer-generated implant-planning and surgery has not only enabled accurate preoperative evaluation of the anatomic limitations but has also facilitated preoperative planning of implant positions along with virtual implant placement and subsequently transferring the virtual treatment plans onto the surgical phase via static (guided or dynamic (navigated systems aided by CAD/CAM technology. Computerized-implant-dentistry being highly predictable and minimally invasive in nature has also allowed implant placement in patients with medical comorbidities (e.g. radiation therapy, blood dyscrasias, in patients with complex problems following a significant alteration of the bony anatomy as a result of benign or malignant pathology of the jaws or trauma and in patients with other physical and emotional problems. With significant achievements accomplished in the field of computerized implant-dentistry, attempts are now been made toward complete automation of implant-dentistry.

  17. Computerized evaluation of deambulatory pattern before and after visual rehabilitation treatment performed with biofeedback in visually impaired patients suffering from macular degeneration


    Fernanda Pacella; Raffaele Migliorini; Alessandro Segnalini; Enzo Agostinelli; Sara Di Pillo; Gianpaolo Smaldone; Mauro Salducci; Elena Pacella


    Aims: The aim of this study was double: the primary endpoint was to evaluate the efficacy of visual rehabilitation of visually impaired patients with macular degeneration (AMD). The secondary endpoint was to assess the effect of rehabilitation treatment on the ambulatory pattern using a computerized evaluation of walking, focusing the attention on space-time parameters that are influenced in patients with visual impairment. Methods: 10 patients with AMD were enrolled, 6 males and 4 female...

  18. A meta-analysis of computerized cognitive-behavioral therapy for the treatment of DSM-5 anxiety disorders. (United States)

    Adelman, Caroline B; Panza, Kaitlyn E; Bartley, Christine A; Bontempo, Allyson; Bloch, Michael H


    Access to qualified cognitive-behavioral therapy (CBT) remains a major barrier to improving clinical outcomes in anxiety disorders. The current meta-analysis examined the efficacy of computerized CBT (cCBT) for anxiety disorders and the durability of treatment gains during follow-up. We searched PubMed and references from included trials and previous meta-analyses in the area. We included randomized controlled trials assessing the efficacy of cCBT for non-OCD and non-PTSD anxiety disorders. Forty trials involving 2,648 participants were included in this meta-analysis. We used a fixed-effect model to examine standardized mean difference in posttreatment anxiety levels. cCBT was compared to wait-list, in-person CBT, and Internet control. We also examined moderators of cCBT treatment gains over follow-up. Meta-analysis indicated that cCBT was significantly more effective than wait-list control in the treatment of anxiety disorders (standardized mean difference [SMD] = 0.92 [95% CI, 0.83 to 1.02], k = 31, z = 18.8, P anxiety disorders had greater efficacy than that targeting mixed anxiety symptoms. The efficacy of cCBT was equivalent to in-person CBT in studies that compared them head-to-head, for both children and adults (SMD = 0.05 [95% CI, -0.09 to 0.19], k = 15, z = 0.7, P = .46). Longitudinal studies indicate that individuals undergoing cCBT tended to continue to improve after completion of treatment, with longer follow-up periods associated with greater symptom reduction. cCBT represents an efficacious intervention for the treatment of anxiety disorders and may circumvent barriers to accessing traditional CBT treatments. Further research is needed to examine the effectiveness of cCBT in real-world settings, for individuals with clinical comorbidities, and in comparison with more ecologically valid comparison conditions. © Copyright 2014 Physicians Postgraduate Press, Inc.

  19. Randomized Controlled Trial of a Computerized Interactive Media-Based Problem Solving Treatment for Depression. (United States)

    Sandoval, Luis R; Buckey, Jay C; Ainslie, Ricardo; Tombari, Martin; Stone, William; Hegel, Mark T


    This study evaluated the efficacy of an interactive media-based, computer-delivered depression treatment program (imbPST) compared to a no-treatment control condition (NTC) in a parallel-group, randomized, controlled trial conducted in an outpatient psychiatric research clinic. 45 adult participants with major depressive disorder or dysthymia were randomized to receive either 6 weekly sessions of imbPST or no treatment (No Treatment Control; NTC). The primary outcome measure was the Beck Depression Inventory II (BDI-II). There was a significant Group x Time interaction effect [F (1.73, 43)= 58.78; p<.001; η2=.58, Cohens d=1.94], such that the patients receiving imbPST had a significantly greater reduction in depressive symptoms compared to the patients in the NTC condition. Participants in the imbPST group improved their depression symptoms significantly from moderate (BDI-II=21.9±4.20) to mild levels of depression (BDI-II=17.9±4.0) after receiving 3 weekly sessions of imbPST (p<0.001), and progressed to still milder levels of depression after six weekly sessions (BDI-II=14.5±3.7, p<0.001). NTC participants showed no significant reduction in BDI-II scores (BDI-II=21.8±4.2 pre, BDI-II=21.5±5.2 post, N.S.). Additionally, 40% of the imbPST group showed a clinically significant and reliable change in depression levels while none of the NTC group met this criterion. imbPST participants rated the program highly usable on the system usability scale (SUS) after the first session (SUS Session 1=74.6±7.2) and usability scores increased significantly by the last session (SUS Session 6=85.4±5.6). We conclude that imbPST is an effective, engaging, and easily used depression treatment program that warrants further evaluation with heterogeneous depressed populations in a stand-alone, self-administered fashion. Copyright © 2016. Published by Elsevier Ltd.

  20. Implementation of a quality assurance program for computerized treatment planning systems. (United States)

    Camargo, Priscilla R T L; Rodrigues, Laura N; Furnari, Laura; Rubo, Rodrigo A


    In the present investigation, the necessary tests for implementing a quality assurance program for a commercial treatment planning system (TPS), recently installed at Sao Paulo University School of Medicine Clinicas Hospital-Brazil, was established and performed in accordance with the new IAEA publication TRS 430, and with AAPM Task Group 53. The tests recommended by those documents are classified mainly into acceptance, commissioning (dosimetric and nondosimetric), periodic quality assurance, and patient specific quality assurance tests. The recommendations of both IAEA and AAPM documents are being implemented at the hospital for photon beams produced by two linear accelerators. A Farmer ionization chamber was used in a 30 x 30 x 30 cm3 phantom with a dose rate of 320 monitor unit (MU)/min and 50 MU in the case of the dosimetric tests. The acceptance tests verified hardware, network systems integration, data transfer, and software parameters. The results obtained are in good agreement with the specifications of the manufacturer. For the commissioning dosimetric tests, the absolute dose was measured for simple geometries, such as square and rectangular fields, up to more complex geometries such as off-axis hard wedges and for behavior in the build up region. Results were analysed by the use of confidence limit as proposed by Venselaar et al. [Radio Ther. Oncol. 60, 191-201 (2001)]. Criteria of acceptability had been applied also for the comparison between the values of MU calculated manually and MU generated by TPS. The results of the dosimetric tests show that work can be reduced by choosing to perform only those that are more crucial, such as oblique incidence, shaped fields, hard wedges, and buildup region behavior. Staff experience with the implementation of the quality assurance program for a commercial TPS is extremely useful as part of a training program.

  1. Operative treatment of radiation-induced fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Balslev, I.; Harling, H.


    Out of 136 patients with radiation-induced intestinal complications, 45 had fistulae. Twenty-eight patients had rectovaginal fistulae while the remainder had a total of 13 different types of fistulae. Thirty-seven patients were treated operatively and eight were treated conservatively. Thirty-three patients were submitted to operation for rectal fistulae. Of these, 28 were treated by defunctioning colostomy, three were treated by Hartmann's method and resection and primary anastomosis was carried out in two patients. In the course of the period of observation, 35% of the patients developed new radiation damage. The frequency in the basic material without fistulae was 21% (0.05treatment of rectal fistula is a reasonable form of treatment in elderly patients and in case of recurrence. Younger patients should be assessed in a special department in view of the possibility of a sphincter-preserving procedure following resection of the rectum and restorative anastomosis. 11 refs.

  2. Induced arousal following zolpidem treatment in a vegetative state after brain injury in 7 cases Analysis using visual single photon emission computerized tomography and digitized cerebral state monitor

    Institute of Scientific and Technical Information of China (English)

    Bo Du; Aijun Shan; Di Yang; Wei Xiang


    BACKGROUND: Several studies have reported the use of zolpidem for induced arousal after permanent vegetative states. However, changes in brain function and EMG after zolpidem treatment requires further investigation. OBJECTIVE: To investigate the effect of zolpidem, an unconventional drug, on inducing arousal in patients in a permanent vegetative state after brain injury using visual single photon emission computerized tomography and digitized cerebral state monitor. DESIGN: A self-controlled observation. SETTING: Shenzhen People's Hospital.PARTICIPANTS: Seven patients in a permanent vegetative state were selected from the Department of Neurosurgery, Shenzhen People's Hospital from March 2005 to May 2007. The group included 5 males and 2 females, 24–55 years of age, with a mean age of 38.5 years. All seven patients had been in a permanent vegetative statement for at least six months. The patient group included three comatose patients, who had sustained injuries to the cerebral cortex, basal ganglia, or thalamus in motor vehicle accidents, and four patients, who had suffered primary/secondary brain stem injury. Informed consents were obtained from the patients’ relatives. METHODS: The patients brains were imaged by 99Tcm ECD single photon emission computerized tomography prior to treatment with zolpidem [Sanofi Winthrop Industrie, France, code number approved by the State Food & Drug Administration (SFDA) J20040033, specification 10 mg per tablet. At 8:00 p.m., 10 mg zolpidem was dissolved with distilled water and administered through a nasogastric tube at 1 hour before and after treatment and 1 week following treatment, respectively. Visual analysis of cerebral perfusion changes in the injured brain regions before and after treatment was performed. Simultaneously, three monitoring parameters were obtained though a cerebral state monitor, which included cerebral state index, electromyographic index, and burst suppression index. MAIN OUTCOME MEASURES: Comparison

  3. Methodologies in the modeling of combined chemo-radiation treatments (United States)

    Grassberger, C.; Paganetti, H.


    The variety of treatment options for cancer patients has increased significantly in recent years. Not only do we combine radiation with surgery and chemotherapy, new therapeutic approaches such as immunotherapy and targeted therapies are starting to play a bigger role. Physics has made significant contributions to radiation therapy treatment planning and delivery. In particular, treatment plan optimization using inverse planning techniques has improved dose conformity considerably. Furthermore, medical physics is often the driving force behind tumor control and normal tissue complication modeling. While treatment optimization and outcome modeling does focus mainly on the effects of radiation, treatment modalities such as chemotherapy are treated independently or are even neglected entirely. This review summarizes the published efforts to model combined modality treatments combining radiation and chemotherapy. These models will play an increasing role in optimizing cancer therapy not only from a radiation and drug dosage standpoint, but also in terms of spatial and temporal optimization of treatment schedules.

  4. Radiation treatment for newly diagnosed esophageal cancer with prior radiation to the thoracic cavity

    Energy Technology Data Exchange (ETDEWEB)

    Sponseller, Patricia, E-mail: [University of Wisconsin at La Crosse, La Crosse, WI (United States); Lenards, Nishele [Department of Radiation Oncology, University of Washington, Seattle, WA (United States); Kusano, Aaron; Patel, Shilpen [University of Wisconsin at La Crosse, La Crosse, WI (United States)


    The purpose of this report is to communicate the use of single-positron emission computed tomography scan in planning radiation treatments for patients with a history of radiation to the thoracic cavity. A patient presented with obstructive esophageal cancer, having previously received chemotherapy and radiation therapy to the mediastinum for non-Hodgkin lymphoma 11 years earlier. Owing to a number of comorbidities, the patient was not a surgical candidate and was referred to the University of Washington Medical Center for radiation therapy. Prior dose to the spinal cord and lung were taken into account before designing the radiation treatment plan.

  5. Treatment of cloud radiative effects in general circulation models

    Energy Technology Data Exchange (ETDEWEB)

    Wang, W.C.; Dudek, M.P.; Liang, X.Z.; Ding, M. [State Univ. of New York, Albany, NY (United States)] [and others


    We participate in the Atmospheric Radiation Measurement (ARM) program with two objectives: (1) to improve the general circulation model (GCM) cloud/radiation treatment with a focus on cloud verticle overlapping and layer cloud optical properties, and (2) to study the effects of cloud/radiation-climate interaction on GCM climate simulations. This report summarizes the project progress since the Fourth ARM Science Team meeting February 28-March 4, 1994, in Charleston, South Carolina.

  6. An improved treatment of radiation energy flow in the radiation-hydrodynamics code CHARTD

    Energy Technology Data Exchange (ETDEWEB)

    Rottler, J.S.


    An improved treatment of radiation transport has been added to the energy flow model in CHARTD. The new energy flow model was derived based on the assumption that the directional dependence of the radiation energy density can be represented by the first two terms of a spherical harmonic expansion, and that the photon energy spectrum can be partitioned into energy groups. This treatment of radiation transport is called the multigroup P-1 approximation, and is an effective description of radiation transport for a broad class of radiation-hydrodynamics problems. A synthetic acceleration scheme is used to solve the differenced multigroup P-1 equations. The coupling between the material field and the radiation field is fully explicit. This report describes the new energy flow model and the acceleration scheme used to solve the difference equations. 15 refs.

  7. Medical treatment of radiation injuries-Current US status

    Energy Technology Data Exchange (ETDEWEB)

    Jarrett, D.G. [OSA - CBD and CDP, 3050 Defense Pentagon, Room 3C257, Washington, DC 20301-3050 (United States)], E-mail:; Sedlak, R.G.; Dickerson, W.E. [Uniformed Services University, Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States); Reeves, G.I. [Northrop Grumman IT, 8211 Terminal Road, Lorton, VA 22079-1421 (United States)


    A nuclear incident or major release of radioactive materials likely would result in vast numbers of patients, many of whom would require novel therapy. Fortunately, the numbers of radiation victims in the United States (USA) have been limited to date. If a mass-casualty situation occurs, there will be a need to perform rapid, accurate dose estimates and to provide appropriate medications and other treatment to ameliorate radiation injury. The medical management of radiation injury is complex. Radiation injury may include acute radiation sickness (ARS) from external and/or internal radiation exposure, internal organ damage from incorporated radioactive isotopes, and cutaneous injury. Human and animal data have shown that optimal medical care may nearly double the survivable dose of ionizing radiation. Current treatment strategies for radiation injuries are discussed with concentration on the medical management of the hematopoietic syndrome. In addition, priority areas for continuing and future research into both acute deterministic injuries and also long-term stochastic sequelae of radiation exposure have been identified. There are several near-term novel therapies that appear to offer excellent prognosis for radiation casualties, and these are also described.

  8. Improved treatment of radiation effects on the skin

    Energy Technology Data Exchange (ETDEWEB)

    Wandl, E.O.; Kaercher, K.H.; Wandl-Hainberger, I.


    The treatment concept developed by K.H. Kaercher was extended by a therapy using Elasten S cream. In the course of a highvoltage therapy using fast electrons or cobalt-60, interesting aspects in the treatment and progression of the radiation reactions of the skin were established. The dermato-therapeutic principles layed down by K.H. Kaercher with the treatment palette used hitherto, have without doubt invariably proven their value. The exclusive powder treatment, however, may be made more practical by application of the new treatment cream in accordance with the intervals in radiation treatment or as a basic treatment towards the end of therapy. Furthermore it is ideally suited for the care and after-treatment of skin, strained by radiation. It reduces considerably the remaining visible radiation reactions. The treatment with powder and emulsion has for more than 10 years proven effective. After the excellent results of the new cream during radiation treatment, additional positive effects are expected in a long-term trial which will be reported on separately.

  9. Production of silver nanoparticles in water solution by radiation treatment (United States)

    Mikhailenko, M. A.; Korobeinikov, M. V.; Bryazgin, A. A.; Tolochko, B. P.


    Radiation-chemical synthesis of silver nanoparticles was studied. The silver nanoparticles in arabinogalactan (AG) water solution are stabilized in conglomerates, it is fixed by rise of additional bands in the optical absorption spectra. Pre-radiation treatment of AG causes crosslinking and oxidation. Pretreated AG solution increases the stability of conglomerates containing silver nanoparticles in case of dilution.

  10. Kinetic treatment of radiation reaction effects (United States)

    Noble, Adam; Gratus, Jonathan; Burton, David; Ersfeld, Bernhard; Islam, M. Ranaul; Kravets, Yevgen; Raj, Gaurav; Jaroszynski, Dino


    Modern accelerators and light sources subject bunches of charged particles to quasiperiodic motion in extremely high electric fields, under which they may emit a substantial fraction of their energy. To properly describe the motion of these particle bunches, we require a kinetic theory of radiation reaction. We develop such a theory based on the notorious Lorentz-Dirac equation, and explore how it reduces to the usual Vlasov theory in the appropriate limit. As a simple illustration of the theory, we explore the radiative damping of Langmuir waves.

  11. Statistical Decision Theory Applied to Radiation Therapy Treatment Decisions


    Schultheiss, T. E.; El-Mahdi, Anas M.


    Statistical decision theory has been applied to the treatment planning decision of radiation therapy. The decision involves the choice of parameters which determine the radiation dose distribution. To choose among dose distributions requires a decision rule which reflects the uncertainty of possible outcomes for any specific dose distribution and the various risks associated with each outcome. A relative gravity or morbidity is assigned to each possible complication of treatment. In this stud...

  12. MINERVA - A Multi-Modal Radiation Treatment Planning System

    Energy Technology Data Exchange (ETDEWEB)

    D. E. Wessol; C. A. Wemple; D. W. Nigg; J. J. Cogliati; M. L. Milvich; C. Frederickson; M. Perkins; G. A. Harkin


    Recently, research efforts have begun to examine the combination of BNCT with external beam photon radiotherapy (Barth et al. 2004). In order to properly prepare treatment plans for patients being treated with combinations of radiation modalities, appropriate planning tools must be available. To facilitiate this, researchers at the Idaho National Engineering and Environmental Laboratory (INEEL)and Montana State University (MSU) have undertaken development of a fully multi-modal radiation treatment planning system.

  13. Challenges With the Diagnosis and Treatment of Cerebral Radiation Necrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chao, Samuel T., E-mail: [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Ahluwalia, Manmeet S. [Department of Medical Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Barnett, Gene H. [Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Stevens, Glen H.J. [Department of Neurology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Murphy, Erin S. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Stockham, Abigail L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Shiue, Kevin [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Suh, John H. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States)


    The incidence of radiation necrosis has increased secondary to greater use of combined modality therapy for brain tumors and stereotactic radiosurgery. Given that its characteristics on standard imaging are no different that tumor recurrence, it is difficult to diagnose without use of more sophisticated imaging and nuclear medicine scans, although the accuracy of such scans is controversial. Historically, treatment had been limited to steroids, hyperbaric oxygen, anticoagulants, and surgical resection. A recent prospective randomized study has confirmed the efficacy of bevacizumab in treating radiation necrosis. Novel therapies include using focused interstitial laser thermal therapy. This article will review the diagnosis and treatment of radiation necrosis.

  14. Insights from radiation treatment for benign disease

    Energy Technology Data Exchange (ETDEWEB)

    Bleehen, N.M.


    This note compares mortality figures for patients treated with low dose ionizing radiation for benign conditions between the 1920's and 1950's with figures available from the Japanese A-bomb survivors. X radiation for ringworm, ankylosing spondylitis and post-partum mastitis are considered. Figures for leukemia are roughly comparable between radiotherapy groups and A-bomb survivors. Figures for the increased relative risk of breast cancer in spondylitis patients were in marked contrast to bomb survivors who received comparable doses, but compatible with the increase among women given x-rays for acute post-partum mastitis in the 1940's and 1950's. This study also suggests the possibility of different time patterns of risk between different cancers. (U.K.).

  15. Innovations in Computerized Assessment. (United States)

    Drasgow, Fritz, Ed.; Olson-Buchanan, Julie B., Ed.

    Chapters in this book present the challenges and dilemmas faced by researchers as they created new computerized assessments, focusing on issues addressed in developing, scoring, and administering the assessments. Chapters are: (1) "Beyond Bells and Whistles; An Introduction to Computerized Assessment" (Julie B. Olson-Buchanan and Fritz Drasgow);…

  16. Large area radiation source for water and wastewater treatment (United States)

    Mueller, Michael T.; Lee, Seungwoo; Kloba, Anthony; Hellmer, Ronald; Kumar, Nalin; Eaton, Mark; Rambo, Charlotte; Pillai, Suresh


    There is a strong desire for processes that improve the safety of water supplies and that minimize disinfection byproducts. Stellarray is developing mercury-free next-generation x-ray and UV-C radiation sources in flat-panel and pipe form factors for water and wastewater treatment applications. These new radiation sources are designed to sterilize sludge and effluent, and to enable new treatment approaches to emerging environmental concerns such as the accumulation of estrogenic compounds in water. Our UV-C source, based on cathodoluminescent technology, differs significantly from traditional disinfection approaches using mercury arc lamps or UV LEDs. Our sources accelerate electrons across a vacuum gap, converting their energy into UV-C when striking a phosphor, or x-rays when striking a metallic anode target. Stellarray's large area radiation sources for wastewater treatment allow matching of the radiation source area to the sterilization target area for maximum coverage and improved efficiency.

  17. Rapid and Decentralized Human Waste Treatment by Microwave Radiation. (United States)

    Nguyen, Tu Anh; Babel, Sandhya; Boonyarattanakalin, Siwarutt; Koottatep, Thammarat


    This study evaluates the technical feasibility of using microwave radiation for the rapid treatment of human feces. Human feces of 1000 g were radiated with a commercially available household microwave oven (with rotation) at different exposure time lengths (30, 50, 60, 70, and 75 minutes) and powers (600, 800, and 1000 W). Volume reduction over 90% occurred after 1000 W microwave radiation for 75 minutes. Pathogen eradiation performances of six log units or more at a high range of microwave powers were achieved. Treatments with the same energy input of 1000 Wh, but at lower powers with prolonged exposure times, significantly enhanced moisture removal and volume reduction. Microwave radiation caused carbonization and resulted in a more stable end product. The energy content of the samples after microwave treatment at 1000 W and 75 minutes is 3517 ± 8.85 calories/g of dried sample, and the product can also be used as compost.

  18. Hyperbaric oxygen treatment in radiation reactions; Hyperbar oksygenbehandling ved straalereaksjoner

    Energy Technology Data Exchange (ETDEWEB)

    Aanderud, Leif; Thorsen, Einar; Bratteboe, Guttorm; Forland, Martha; Kristensen, Gunnar


    Background: A national hyperbaric centre was established in 1994 at Haukeland Hospital with responsibility of all hyperbaric oxygen (HBO) treatment in Norway. In hypoxic tissues with symptomatic radiation reactions, hyperbaric oxygen induces the formation of collagen and angiogenesis resulting in permanently improved local microcirculation. Material and method: 234 patients received elective HBO treatment at Haukeland Hospital in 12997 with total of 4048 treatments. All 47 patients treated for radiation reactions in the pelvic area in 1997 received a questionnaire 3-15 months after HBO therapy, 81% reported. Results: Rectal bleeding and haematuria were reported as much improved in 61% and 55% respectively, while bladder incontinence was much improved in 46%. Interpretation: this treatment modality may be an alternative in symptomatic radiation reactions at the urinary bladder and the bowel when conventional treatment has given unsatisfactory results.

  19. Superficial Radiation Therapy for the Treatment of Nonmelanoma Skin Cancers. (United States)

    McGregor, Sean; Minni, John; Herold, David


    Superficial radiation therapy has become more widely available to dermatologists. With the advent of more portable machines, it has become more convenient for dermatology practices to employ in an office-based setting. The goal of this paper is to provide a deeper insight into the role of superficial radiation therapy in dermatology practice and to review the current literature surrounding its use in the treatment of both basal and squamous cell carcinomas.

  20. Hyperbaric oxygen: Primary treatment of radiation-induced hemorrhagic cystitis

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, J.P.; Neville, E.C.


    Of 8 patients with symptoms of advanced cystitis due to pelvic radiation treated with hyperbaric oxygen 7 are persistently improved during followup. All 6 patients treated for gross hematuria requiring hospitalization have been free of symptoms for an average of 24 months (range 6 to 43 months). One patient treated for stress incontinence currently is dry despite little change in bladder capacity, implying salutary effect from hyperbaric oxygen on the sphincter mechanism. One patient with radiation-induced prostatitis failed to respond. This experience suggests that hyperbaric oxygen should be considered the primary treatment for patients with symptomatic radiation-induced hemorrhagic cystitis.

  1. [Importance of sonotomography in radiation therapy (author's transl)]. (United States)

    Heckemann, R; Quast, U; Glaeser, L; Schmitt, G


    Ultrasound tomography provides true scale representation of body contours and organ structures. The image supplies substantial, individual geometrical data, essential for computerized radiation treatment planning. The mehtod is described. Typical planning examples for therapy are demonstrated. The value of follow up sonograms for radiation therapy is described. The limitations of the method are pointed out.

  2. Radiation therapy in the treatment of metastatic renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Onufrey, V.; Mohiuddin, M.


    Adenocarcinoma of the kidney is an unusual tumor, both in its biological behavior and in its response to radiation treatment. Historically, these tumors have been considered to be radioresistant, and the role of radiation therapy remains questionable in the primary management of this disease. However, radiation treatment is routinely used in the palliation of metastatic lesions for relief of symptoms. Therefore, we have undertaken a review of our experience in the treatment of this disease to determine the effectiveness of radiation in its palliation. From 1956 to 1981, 125 patients with metastatic lesions from hypernephroma have been treated in the Department of Radiation Therapy at Thomas Jefferson University Hospital. Most patients were referred for relief of bone pain (86), brain metastasis (12), spinal cord compression (9), and soft tissue masses (18). Total doses varied from 2000 rad to a maximum of 6000 rad. Response to treatment was evaluated on the basis of relief of symptoms, either complete, partial or no change. Our results indicate a significantly higher response rate of 65% for total doses equal to or greater than a TDF of 70, as compared to 25% for doses lower than a TDF of 70. No difference in response was observed either for bone or soft tissue metastasis or visceral disease. This leads us to believe that metastatic lesions from adenocarcinomas of the kidney should be treated to higher doses to obtain maximum response rates. Analysis of these results are presented in detail.

  3. Scintillation detectors in computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Gilar, O.; Pavlicek, Z.; Jursova, L. (Tesla, Premysleni (Czechoslovakia). Vyzkumny Ustav Pristroju Jaderne Techniky)


    A new scintillator, Bi/sub 4/Ge/sub 3/O/sub 12/ (BGO), was tested for use in the detection part of computerized tomographs. In comparison with the NaI(Tl) scintillator it has a three-fold mass stopping power and allows the detection of medium and high energy gamma radiation with a higher detection efficiency, i.e., for the same detection efficiency its size is much smaller. Some other mechanical, physical and optical parameters of the BGO scintillator are given. BGO is prospective for use in high energy spectrometry and may replace NaI(Tl) wherever the following parameters are significant: crystal size, detection efficiency for gamma radiation, and good spatial resolution.

  4. Skin Treatment with Pulsed Monochromatic UVA1 355 Device and Computerized Morphometric Analysis of Histochemically Identified Langerhans Cells

    Directory of Open Access Journals (Sweden)

    Nicola Zerbinati


    Full Text Available Fluorescent or metal halide lamps are widely used in therapeutic applications in dermatological diseases, with broadband or narrow band emission UVA/UVA1 (320–400 nm obtained with suitable passive filters. Recently, it has been possible for us to use a new machine provided with solid state source emitting pulsed monochromatic UVA1 355 nm. In order to evaluate the effects of this emission on immunocells of the skin, human skin samples were irradiated with monochromatic 355 nm UVA1 with different energetic fluences and after irradiation Langerhans cells were labeled with CD1a antibodies. The immunohistochemical identification of these cells permitted evaluating their modifications in terms of density into the skin. Obtained results are promising for therapeutical applications, also considering that a monochromatic radiation minimizes thermic load and DNA damage in the skin tissues.

  5. Radiation treatment of food. A new technology for preservation

    Energy Technology Data Exchange (ETDEWEB)

    Wetzel, K.; Huebner, G.


    The brief survey reports on irradiation of food, especially onions, potatoes, chicken meat, spices, additives, and enzyme solutions used in food industries, demonstrating examples from several countries. Advantages, microbiological aspects of irradiation treatment and chemical radiation effects are described. Technological fundamentals of radiopreservation including irradiation plants and devices are outlined.

  6. Radiation-induced xerostomia: pathophysiology, clinical course and supportive treatment. (United States)

    Guchelaar, H J; Vermes, A; Meerwaldt, J H


    Xerostomia, or oral dryness, is one of the most common complaints experienced by patients who have had radiotherapy of the oral cavity and neck region. The hallmarks of radiation-induced damage are acinar atrophy and chronic inflammation of the salivary glands. The early response, resulting in atrophy of the secretory cells without inflammation might be due to radiation-induced apoptosis. In contrast, the late response with inflammation could be a result of radiation-induced necrosis. The subjective complaint of a dry mouth appears to be poorly correlated with objective findings of salivary gland dysfunction. Xerostomia, with secondary symptoms of increased dental caries, difficulty in chewing, swallowing and speaking, and an increased incidence of oral candidiasis, can have a significant effect on the quality of life. At present there is no causal treatment for radiation-induced xerostomia. Temporary symptomatic relief can be offered by moistening agents and saliva substitutes, and is the only option for patients without residual salivary function. In patients with residual salivary function, oral administration of pilocarpine 5-10 mg three times a day is effective in increasing salivary flow and improving the symptoms of xerostomia, and this therapy should be considered as the treatment of choice. Effectiveness of sialogogue treatment requires residual salivary function, which emphasizes the potential benefit from sparing normal tissue during irradiation. The hypothesis concerning the existence of early apoptotic and late necrotic effects of irradiation on the salivary glands theoretically offers a way of achieving this goal.

  7. Brain radiation necrosis following treatment of an esthesioneuroblastoma (olfactory neurocytoma)

    Energy Technology Data Exchange (ETDEWEB)

    Baron, S.H.


    Esthesioneuroblastoma is an uncommon malignant nasal tumor which may be difficult to diagnose. Once diagnosed, selection of treatment may be a dilemma. Some advocate preoperative radiation and surgery; others, surgery and postoperative radiation if needed. A case that developed brain necrosis from postoperative radation is presented. It is felt that the possibility exists that the patient might still be living with tumor had irradiation not been given. This is a plea for the conservative approach to treatment. The author agrees with John S. Lewis that it is unwise to use all modalities at once as there is no definite evidence that any one method of treatment or a combination of surgery and irradiation will alter the prognosis. The paper stresses the brain hazards of irradiation.

  8. The check-up: in-person, computerized, and telephone adaptations of motivational enhancement treatment to elicit voluntary participation by the contemplator

    Directory of Open Access Journals (Sweden)

    Picciano Joseph F


    Full Text Available Abstract Countless barriers come between people who are struggling with substance abuse and those charged with providing substance abuse treatment. The check-up, a form of motivational enhancement therapy, is a harm reduction intervention that offers a manner of supporting individuals by lowering specific barriers to reaching those who are untreated. The check-up was originally developed to reach problem drinkers who were neither seeking treatment nor self-initiating change. The intervention, marketed as an opportunity to take stock of one's experiences, involves an assessment and personalized feedback delivered with a counseling style termed motivational interviewing. Check-ups can be offered in care settings to individuals who, as a result of screening, manifest risk factors for specific disorders such as alcoholism. They can also be free-standing and publicized widely to the general public. This paper will discuss illustrations of in-person, computerized, in-school, and telephone applications of the free-standing type of check-up with reference to alcohol consumers, adult and adolescent marijuana smokers, and gay/bisexual males at risk for sexual transmission of HIV. The paper's major focus is to highlight how unique features of each application have the potential of reducing barriers to reaching specific at-risk populations. Also considered are key policy issues such as how check-up services can be funded, which venues are appropriate for the delivery of check-up interventions, pertinent competency criteria in evaluating staff who deliver this intervention, how marketing can be designed to reach contemplators in untreated at-risk populations, and how a check-up's success ought to be defined.

  9. Radiation condition in computerized tomography (CT): determination and calibration of dosemeters; Condicoes de radiacao em tomografia computadorizada (TC): determinacao e calibracao de dosimetros

    Energy Technology Data Exchange (ETDEWEB)

    Adrade, L.C.; Peixoto, J.G.P., E-mail: [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)


    RQT is the standard for radiation conditions in computed tomography . It simulates a beam unrelieved of a CT scanner . The camera pencil ionization dosimeter is used in CT. The LNMRI become known characterization of RQT radiation conditions and the secondary standard calibration for type pencil ionisation chambers in its lab. The obtained beam has the characteristics required by IEC 61267. The results of the calibration presented combined uncertainty expanded to 95.45% from 2.22% . (author)

  10. Development of computer algorithms for radiation treatment planning. (United States)

    Cunningham, J R


    As a result of an analysis of data relating tissue response to radiation absorbed dose the ICRU has recommended a target for accuracy of +/- 5 for dose delivery in radiation therapy. This is a difficult overall objective to achieve because of the many steps that make up a course of radiotherapy. The calculation of absorbed dose is only one of the steps and so to achieve an overall accuracy of better than +/- 5% the accuracy in dose calculation must be better yet. The physics behind the problem is sufficiently complicated so that no exact method of calculation has been found and consequently approximate solutions must be used. The development of computer algorithms for this task involves the search for better and better approximate solutions. To achieve the desired target of accuracy a fairly sophisticated calculation procedure must be used. Only when this is done can we hope to further improve our knowledge of the way in which tissues respond to radiation treatments.

  11. Computerized evaluation of deambulatory pattern before and after visual rehabilitation treatment performed with biofeedback in visually impaired patients suffering from macular degeneration

    Directory of Open Access Journals (Sweden)

    Fernanda Pacella


    Full Text Available Aims: The aim of this study was double: the primary endpoint was to evaluate the efficacy of visual rehabilitation of visually impaired patients with macular degeneration (AMD. The secondary endpoint was to assess the effect of rehabilitation treatment on the ambulatory pattern using a computerized evaluation of walking, focusing the attention on space-time parameters that are influenced in patients with visual impairment. Methods: 10 patients with AMD were enrolled, 6 males and 4 females, and examined 15 eyes, at Department of Sense Organs, Faculty of Medicine and Dentistry Sapienza University of Rome, Italy. Visual rehabilitation was carried out with the use of a microperimeter MP1 using the examination of biofeedback. Patients are asked to move their eyes in coordination with an audible feedback that alerts the patient when he is setting properly the fixation target previously selected. All patients were subjected to 10 sessions lasting 15 minutes each for each eye, 1 time per week. The best corrected visual acuity (BCVA was assessed by far with the ETDRS optotype IN LOG MAR, and by close to 25 cm by adding + 4 ball (addition to near to the BCVA. For each eye the PB ( print body on the distance of 25 cm was measured; It fixation stability for 30 seconds was examined by microperimeter. Gait Analysis was performed with system ELITE BTS SpA (Milan, Italy. Results: At the end of the rehabilitation treatment with biofeedback it was found a marked improvement in BCVA. The BCVA before the rehabilitation treatment was ETDRS 12 LETTERS = 0.86 logMAR. At the end of the visual rehabilitation 16 LETTERS = 0.78 logMAR. The near visual acuity presented a decrease of the printer body measurement (PB and a statistically significant improvement in the fixation stability. Analysis of the spatial and temporal parameters of gait cycle, aimed at assessing the global aspects of gait (speed, rhythm, symmetry, fluidity, dynamic balance showed no significant changes

  12. Acupuncture treatment of patients with radiation-induced xerostomia

    Energy Technology Data Exchange (ETDEWEB)

    Blom, M.; Dawidson, I.; Johnson, G.; Angmar-Maansson, B. [Karolinska Inst., Huddinge (Sweden). Dept. of Cardiology; Fernberg, J.-O. [Karolinska Hospital, Stockholm (Sweden). Dept. of General Oncology


    Xerostomia is a common and usually irreversible side effect in patients receiving radiation therapy (>50 Gy) for head and neck cancer. Of 38 patients with radiation-induced xerostomia, 20 in the experimental group were treated with classical acupuncture and 18 patients in the control group received superficial acupuncture as placebo. Within both groups the patients showed significantly increased salivary flow rates after the acupuncture treatment. In the experimental group 68% and in the control group 50% of the patients had increased salivary flow rates at the end of the observation period. Among those patients who had had all their salivary glands irradiated, 50% in both groups showed increased salivary flow rates (>20%) by the end of the observation period of 1 year. The study indicates that among the patients who had increased salivary flow rates already after the first 12 acupuncture sessions, the majority had high probability of continual improvement after the completion of acupuncture treatment. (Author).

  13. Treatment of radiation- and chemotherapy-induced stomatitis

    Energy Technology Data Exchange (ETDEWEB)

    Carnel, S.B.; Blakeslee, D.B.; Oswald, S.G.; Barnes, M. (Fitzsimons Army Medical Center, Aurora, CO (USA))


    Severe stomatitis is a common problem encountered during either radiation therapy or chemotherapy. Most therapeutic regimens are empirical, with no scientific basis. The purpose of this study is to determine the efficacy of various topical solutions in the treatment of radiation- or chemotherapy-induced stomatitis. Eighteen patients were entered into a prospective double-blinded study to test several topical solutions: (1) viscous lidocaine with 1% cocaine; (2) dyclonine hydrochloride 1.0% (Dyclone); (3) kaolin-pectin solution, diphenhydramine plus saline (KBS); and (4) a placebo solution. Degree of pain relief, duration of relief, side effects, and palatability were evaluated. The results showed that Dyclone provided the most pain relief. Dyclone and viscous lidocaine with 1% cocaine provided the longest pain relief, which averaged 50 minutes This study provides objective data and defines useful guidelines for treatment of stomatitis.

  14. Gamma radiation induced effects on slaughterhouse wastewater treatment (United States)

    Melo, Rita; Cabo Verde, Sandra; Branco, Joaquim; Botelho, M. Luisa


    A preliminary study using gamma radiation on slaughterhouse wastewater samples was carried out. Chemical oxygen demand (COD), biochemical oxygen demand (BOD) and total suspended solids (TSS) results were obtained at a dose rate of 0.9 kGy h -1. A decrease of COD, BOD and colour was observed after irradiation at high absorbed doses. The microbiological results, following irradiation in the same conditions, correlated with the BOD results. The results obtained highlight the potential of this technology for wastewater treatment.

  15. Can radiation therapy treatment planning system accurately predict surface doses in postmastectomy radiation therapy patients?

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Sharon [National University of Singapore, Yong Loo Lin School of Medicine (Singapore); Back, Michael [Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, New South Wales (Australia); Tan, Poh Wee; Lee, Khai Mun; Baggarley, Shaun [National University, Cancer Institute, Department of Radiation Oncology, National University, Hospital, Tower Block (Singapore); Lu, Jaide Jay, E-mail: [National University of Singapore, Yong Loo Lin School of Medicine (Singapore); National University, Cancer Institute, Department of Radiation Oncology, National University, Hospital, Tower Block (Singapore)


    Skin doses have been an important factor in the dose prescription for breast radiotherapy. Recent advances in radiotherapy treatment techniques, such as intensity-modulated radiation therapy (IMRT) and new treatment schemes such as hypofractionated breast therapy have made the precise determination of the surface dose necessary. Detailed information of the dose at various depths of the skin is also critical in designing new treatment strategies. The purpose of this work was to assess the accuracy of surface dose calculation by a clinically used treatment planning system and those measured by thermoluminescence dosimeters (TLDs) in a customized chest wall phantom. This study involved the construction of a chest wall phantom for skin dose assessment. Seven TLDs were distributed throughout each right chest wall phantom to give adequate representation of measured radiation doses. Point doses from the CMS Xio Registered-Sign treatment planning system (TPS) were calculated for each relevant TLD positions and results correlated. There were no significant difference between measured absorbed dose by TLD and calculated doses by the TPS (p > 0.05 (1-tailed). Dose accuracy of up to 2.21% was found. The deviations from the calculated absorbed doses were overall larger (3.4%) when wedges and bolus were used. 3D radiotherapy TPS is a useful and accurate tool to assess the accuracy of surface dose. Our studies have shown that radiation treatment accuracy expressed as a comparison between calculated doses (by TPS) and measured doses (by TLD dosimetry) can be accurately predicted for tangential treatment of the chest wall after mastectomy.

  16. Computerizing the Library. (United States)

    Chan, Jeanie; Whelan, Errol


    Discusses the development of a computerized high school library which uses CD-ROM optical storage systems. Describes hardware and software, setting up the system, preparing the online catalog, teaching information retrieval skills, and project evaluation. Notes prices of CD-ROM disks and equipment purchased. 4 references. (SV)

  17. Computerized Peer Assessment. (United States)

    Davies, Phil


    Describes the introduction of a computerized peer assessment system as part of an undergraduate module in computer studies in the United Kingdom. Analyzes student responses to modification of the tutor-student relationship to a student-student relationship for assessment purposes, discusses plagiarism and the Web, and investigates effects on…

  18. Computerized Drug Information Services (United States)

    And Others; Smith, Daniel R.


    To compare computerized services in chemistry, pharmacology, toxicology, and clinical medicine of pharmaceutical interest, equivalent profiles were run on magnetic tape files of CA-Condensates," CBAC," Excerpta Medica," MEDLARS" and Ringdoc." The results are tabulated for overlap of services, relative speed of citing references, and unique…

  19. Usefulness of radiation treatment planning allpied respiration factor for streotatic body radiation therapy in the lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sung Pil; Kim, Tae Hyung; So, Woon Young; Back, Geum Mun [Dept. of Medical Health Science, Graduate School, Kangwon National University, Chuncheon (Korea, Republic of)


    We are evaluated the usefulness of radiation treatment planning applied respiration factor for stereotactic body radiation therapy in the lung cancer. Four dimensional computed tomography images were obtained in 10 patients with lung cancer. The radiation treatment plans were established total lung volume according to respiration images (new method) and conventional method. We was analyzed in the lung volume, radiation absorbed dose of lung and main organs (ribs, tracheobronchus, esophagus, spinal cord) around the tumor, respectively. We were confirmed that lung volume and radiation absorbed dose of lung and main organs around the tumor deference according to applied respiration. In conclusion, radiation treatment planning applied respiration factor seems to be useful for stereotactic body radiation therapy in the lung cancer.

  20. Radiation optic neuropathy and retinopathy with low dose (20 Gy radiation treatment

    Directory of Open Access Journals (Sweden)

    Crandall E. Peeler


    Conclusions and importance: Though cumulative radiation doses to the anterior visual pathway of less than 50 Gy are traditionally felt to be safe, it is important to consider not just the total exposure but also the size of individual fractions. The single-dose threshold for RON in proton beam treatment has yet to be defined. Our case suggests that fractions of less than 10 Gy should be delivered to minimize the risk of optic nerve injury.

  1. The EORTC emotional functioning computerized adaptive test

    DEFF Research Database (Denmark)

    Gamper, Eva-Maria; Grønvold, Mogens; Petersen, Morten Aa


    The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group is currently developing computerized adaptive testing measures for the Quality of Life Questionnaire Core-30 (QLQ-C30) scales. The work presented here describes the development of an EORTC item bank...

  2. The EORTC emotional functioning computerized adaptive test

    DEFF Research Database (Denmark)

    Gamper, Eva-Maria; Grønvold, Mogens; Petersen, Morten Aa;


    The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group is currently developing computerized adaptive testing measures for the Quality of Life Questionnaire Core-30 (QLQ-C30) scales. The work presented here describes the development of an EORTC item bank...

  3. [Treatment of extensive acute radiation burn and its complications]. (United States)

    Li, Ye-yang; Wang, Jin-lun; Li, Gang; Lin, Wei-hua; Liang, Min; Huang, Jun; Sun, Jing-en


    This article reports the treatment of a patient suffered from acute radiation burn covering 41% TBSA, with deep partial-thickness and full-thickness injury, produced by exposure to a large-scale industrial electron accelerator. An open wound began to appear and enlarged gradually 10 weeks after the exposure. Serious wound infection with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, pneumonia, respiratory failure, systemic inflammatory response syndrome, nephropathy and hypoproteinemia developed successively since 3 weeks after the wound formation. Skin grafts failed to survive, resulting in enlargement of the wound. After being treated with proper measures, including parenteral nutrition, respiratory support with a ventilator, appropriate antibiotics, steroid administration for nephropathy, deep debridement for wounds followed by skin grafting, the patient was cured and discharged after undergoing 15 operations in 500 days. The clinical condition of an extensive acute radiation burn is complicated. We should pay close attention to the changes in functions of organs, and strengthen the therapeutic strategies to support the function of organs to reduce the incidence of systemic complications. The control of the infection and the timely and effective repair of the wound are still the key points of the treatment of an extensive local radiation injury.

  4. Treatment of retinoblastoma by precision megavoltage radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schipper, J.; Peperzeel, H.A. van (Rijksuniversiteit Utrecht (Netherlands). Academisch Ziekenhuis); Tan, K.E.W.P. (Royal Dutch Eye Hospital, Utrecht, Netherlands)


    The principal treatment concept in the Utrecht Retinoblastoma Centre is megavoltage irradiation, followed by light coagulation and/or cryotherapy if there is any doubt as to whether the residual tumour is still active. Radiation therapy is administered by means of a simple but highly accurate temporal beam technique. A standardized dose of 45 Gy is given in 15 fractions of 3 Gy at 3 fractions per week. From 1971 to 1982, 39 children with retinoblastoma have been irradiated in at least one eye. Of the 73 affected eyes, 18 were primarily enucleated, one received light coagulation only, and 54 received radiation therapy. Of the 54 irradiated eyes, 32 were additionally treated by light coagulation and/or cryotherapy for suspicious residual tumour (in 29 eyes), recurrent tumour (in 1 eye), and/or new tumour (in 3 eyes) and 10 were ultimately enucleated. Two eyes also received hyperthermia. The percentages of cure of the irradiated eyes with a minimum follow-up of 2 years were 100% (14/14), 100% (9/9), 83% (10/12), 79% (11/14) and 0% (0/5) in the Reese-Ellsworth groups I to V-A, respectively. Of the saved eyes 95% achieved useful vision. Eighteen eyes developed a clinically detectable radiation cataract; in five of these the lens was aspirated. Cataracts developed exclusively in those lenses of which a posterior portion of more than 1 mm had to be included in the treatment field. The likelihood and the degree of cataract formation was found to be directly related to the dose of radiation to the germinative zone of the lens epithelium. The minimum cataractogenic dose found in this series was 8 Gy.

  5. A computerized TLD system

    Energy Technology Data Exchange (ETDEWEB)

    Pla, C.; Podgorsak, E.B.

    A computerized thermoluminescent (TL) readout technique is presented which considerably improves the precision of dose readout and facilitates the dose information management and storage. The technique is relatively simple and it involves an interface between a commercially available thermoluminescent dosimetry (TLD) analyzer and a minicomputer. Curve fitting, subtraction of unwanted thermogram peaks, background subtraction, studies of TL decay kinetics, and storage of large number of measured TL data are easily performed with the technique.

  6. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... and compliance with CPGs in most areas of clinical practice are deficient. Computerization of CPGs has been brought forward as a method to disseminate and to support application of CPGs. Until now, CPG-computerization has focused on development of formal expressions of CPGs. The developed systems have, however......, not gained any extensive application in clinical practice. The basic assumption in this thesis is that the scanty penetration is due to an inappropriate design process when designing computerized CPGs for clinical work practice. This thesis examines the application of guidance within areas where CPG...

  7. Gamma radiation induced effects on slaughterhouse wastewater treatment

    Energy Technology Data Exchange (ETDEWEB)

    Melo, Rita [Departamento de Fisica, Instituto Tecnologico e Nuclear, Estrada Nacional 10, Apartado 21, 2686-953 Sacavem (Portugal)], E-mail:; Cabo Verde, Sandra [Departamento de Fisica, Instituto Tecnologico e Nuclear, Estrada Nacional 10, Apartado 21, 2686-953 Sacavem (Portugal); Branco, Joaquim [Departamento de Quimica, Instituto Tecnologico e Nuclear, Estrada Nacional 10, Apartado 21, 2686-953 Sacavem (Portugal); Botelho, M. Luisa [Departamento de Fisica, Instituto Tecnologico e Nuclear, Estrada Nacional 10, Apartado 21, 2686-953 Sacavem (Portugal)


    A preliminary study using gamma radiation on slaughterhouse wastewater samples was carried out. Chemical oxygen demand (COD), biochemical oxygen demand (BOD) and total suspended solids (TSS) results were obtained at a dose rate of 0.9 kGy h{sup -1}. A decrease of COD, BOD and colour was observed after irradiation at high absorbed doses. The microbiological results, following irradiation in the same conditions, correlated with the BOD results. The results obtained highlight the potential of this technology for wastewater treatment.

  8. Treatment optimisation using external beam radiation in gynaecological cancers

    Directory of Open Access Journals (Sweden)

    V. Sharma


    Full Text Available The majority of patients with gynaecological cancers present with advanced stages in which external beam radiation forms a major component of the treatment. These patients undergo simulation for treatment planning prior to radiation. Currently the lower extent of the disease is evaluated by vaginal examination and marked using a lead wire on the anterior abdominal wall in the pelvic region. A 2 cm margin inferior to this level is used as the lower border of the treatment field. The suggested modified technique includes the placement of an indigenously designed perspex vaginal obturator with graduations at 1 cm distance from its tip. Following vaginal examination the obturator can be inserted into the vagina and fixed at the predefined length using a fixation device. The radio-opaque markers can be seen even in the lateral films. Twentyfive consecutive patients underwent the procedure and the differences between the two methods of marking the lower border were calculated. The external lead wire was inferior to the internal obturator in 19 patients (76% ranging from 0.5 cm to 3 cm (median 1.5 cm, mean 1.37 cm. It was at the same level in 4 patients (16% and 1 cm superior to the internal obturator in 2 (8%. With the modified technique using the internal obturator application for delineating the lower border of vaginal disease or vault, it was possible to decrease the length of field thereby reducing the chances of treatment-related toxicity, especially groin and vulval reactions, as well as avoiding treatment interruptions.

  9. Detection of radiation treatment of beans using DNA comet assay (United States)

    Khan, Ashfaq A.; Khan, Hasan M.; Delincée, Henry


    A simple technique of microgel electrophoresis of single cells (DNA Comet Assay) enabled a quick detection of radiation treatment of several kinds of leguminous beans (azuki, black, black eye, mung, pinto, red kidney and white beans). Each variety was exposed to radiation doses of 0.5, 1 and 5kGy covering the permissible limits for insect disinfestation. The cells or nuclei from beans were extracted in cold PBS, embedded in agarose on microscope slides, lysed between 15 and 60min in 2.5% SDS and electrophoresis was carried out at a voltage of 2V/cm for 2-2.5min. After silver staining, the slides were evaluated through an ordinary transmission microscope. In irradiated samples, fragmented DNA stretched towards the anode and the damaged cells appeared as a comet. The density of DNA in the tails increased with increasing radiation dose. However, in non-irradiated samples, the large molecules of DNA remained relatively intact and there was only minor or no migration of DNA; the cells were round or had very short tails only. Hence, the DNA comet assay provides an inexpensive, rapid and relatively simple screening method for the detection of irradiated beans.

  10. Photodegradation of etridiazole by UV radiation during drinking water treatment. (United States)

    Liu, Chao; Qiang, Zhimin; Tian, Fang; Zhang, Tao


    The photodegradation of etridiazole (ETZ) in water by UV radiation at 254 nm was investigated. Results indicate that the simulated first-order rate constants decreased with the increase of initial ETZ concentration (i.e., 5, 20 and 30 microM), and did not show any pH dependence within the range from 6.0 to 8.0. The quantum yield was 0.46+/-0.02 molE(-1) at pH 7.0. H(2)O(2) was generated at trace levels in the range from 0 to 1.0 microM during photodegradation of ETZ. Direct photodegradation was responsible for the decomposition of ETZ in distilled water by UV radiation. Three organic byproducts were identified: 5-ethoxy-3-dichloromethyl-1,2,4-thiadiazole, 5-ethoxy-1,2,4-thiadiazole-3-carboxylic acid and 5-ethoxy-3-hydroxyl-1,2,4-thiadiazole. About 90% of chloro mass in the initial ETZ was released as Cl(-) at the end of photodegradation. In contrast, the formation of sulfate and nitrate was insignificant. In general, ETZ decayed more quickly in groundwater than in sand-filtered or surface water. It is reasonably deduced that ETZ may not get removed effectively under a typical UV dose of 40 mJcm(-2) at most water treatment plants that employ UV radiation for disinfection.

  11. Organ doses from computerized tomography examinations

    Energy Technology Data Exchange (ETDEWEB)

    Janeczek, J.


    Estimates of mean organs doses from five typical computerized tomography (CT) examinations were obtained. Measurements were done using Rando-Alderson anthropomorphic phantom and thermoluminescent dosemeters (TLD). Radiation dose distributions within a phantom has been measured for each examination and results were used for organ dose calculation. Doses to organs specified by ICPR 60 Recommendations were measured for five CT scanners (CT/T8800, CT 9800, CT MAX - made by General Electric; CT 1200 SX - made by Picker; SOMATOM 2 - made by Siemens). Dose distributions from scattered radiation were measured and indicate that scattered radiation dose to thyroid and eye lens can be reduced by proper examination limits setting. The lowest mean organ doses were obtained from CT/T8800 scanner. More advanced scanners using high intensity continuous radiation were giving higher organ doses. (author). 23 refs, 6 figs, 13 tabs.

  12. Dianhydrogalactitol and radiation therapy. Treatment of supratentorial glioma. (United States)

    Eagan, R T; Childs, D S; Layton, D D; Laws, E R; Bisel, H F; Holbrook, M A; Fleming, T R


    Dianhydrogalactitol was the most active of 177 agents tested against a mouse ependymoblastoma tumor. We conducted a prospectively randomized trial comparing whole-brain irradiation alone vs identical irradiation plus dianhydrogalactitol in 42 patients with grade 3 and 4 supratentorial astrocytomas. Patients receiving dianhydrogalactitol in addition to irradiation had a significantly longer median survival time (67 vs 35 weeks) than did patients receiving only irradiation. The major toxic effect of dianhydrogalactitol is hematologic suppression of a cumulative nature. Dianhydrogalactitol may play an important role (in conjunction with radiation therapy) in the initial treatment of patients with supratentorial glioma. Our data may indicate that the mouse ependymoblastoma system is a useful screen for agents to be used in the treatment of human glioma.

  13. Decision tools for radiation oncology. Prognosis, treatment response and toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Nieder, Carsten [Tromso Univ., Bodo (Norway). Dept. of Oncology; Gaspar, Laurie E. (ed.) [Colorado Univ., Aurora, CO (United States). Dept. of Radiation Oncology


    Comprehensive overview of prognostic and predictive models for radiation oncology, stratified by disease site. Identification of models' limits and caveats. Excellent aid to decision making in daily clinical practice. A look at the recent oncology literature or a search of one of the common databases reveals a steadily increasing number of nomograms and other prognostic models, some of which are also available in the form of web-based tools. These models may predict the risk of relapse, lymphatic spread of a given malignancy, toxicity, survival, etc. Pathology information, gene signatures, and clinical data may all be used to compute the models. This trend reflects increasingly individualized treatment concepts and also the need for approaches that achieve a favorable balance between effectiveness and side-effects. Moreover, optimal resource utilization requires prognostic knowledge, for example to avoid lengthy and aggressive treatment courses in patients with a short survival expectation. In order to avoid misuse, it is important to understand the limits and caveats of prognostic and predictive models. This book provides a comprehensive overview of such decision tools for radiation oncology, stratified by disease site, which will enable readers to make informed choices in daily clinical practice and to critically follow the future development of new tools in the field.

  14. Current state of methodological and decisions for radiation treatment of blood, its components and products

    Directory of Open Access Journals (Sweden)

    Gordeev A.V.


    Full Text Available This article presents currently used blood transfusion media — components and blood products, therapeutic effects, reactions and complications of blood transfusion, use of radiation treatment for blood transfusion fluids. There had been discussed in detail the practice of radiation processing of blood components and for the prevention of reaction "graft versus host" and studies of plasma radiation treatment for its infectious safety. There was presented the current state of techniques and technical solutions of radiation treatment of transfusion-transmissible environments. There were also considered an alternative to radiation treatment of blood.

  15. Radiation therapy of intracranial germinomas: optimum radiation dose and treatment volume

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Sei Kyung [Eulji Medical College, Taejon (Korea, Republic of); Suh, Chang Ok; Kim, Gwi Eon [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)


    To evaluate the possibility of decreasing the radiation dose and to determine optimum treatment volume in intracranial germinomas. Forty five patients with pathologically-verified or presumed germinomas by a radiosensitivity test who had been treated with radiotherapy (RT) alone between 1971 and 1992 were retrospectively analyzed. The average age was 17.2 years with 68.9% of the patients being between the ages of 10-20. The male and female ratio was 2.2:1. The locations of the primary tumors were at the pineal regions in 14 patients; the suprasellar regions in 12 patients; and multiple sites in 12 patients. Treatment volumes varied from a small local field (1Q) to the whole brain (7) or entire neuroaxis irradiation(28). All the cases after 1982 received craniospinal irradiation (CSI). Radiation .doses were 41-59 Gv (median 48.5 Gy) to the primary tumor site and 19.5-36 Gy (median 24 Gy) to the neuroaxis. The median follow-up period was 82 months with a range of 2-260 months. All the patients showed complete response after AT. Four patients suffered from recurrence 14. 65. 76, and 170 months after AT,. respectively, and two patients died with intercurrent disease. One of four recurrent cases was salvaged by re-irradiation. Therefore, a 5 and 10 year overall survival was 95.3 % and 84.7 % respectively. Five and ten year disease free survival was 97.6 % and 88.8 % respectively. All the recurrences occurred in the patients who received local RT (3/10) or whole brain RT (1/7) with a radiation dose of 48-50 Gy. None of the patients who received CSJ suffered recurrence. There was no recurrence among the 15 patients who received 45 Gy to the primary site and the 18 patients who received 24 Gy (6 patients received 19.5 Gy) to the neuroaxis. CSI is recommended for the treatment of intracranial germinomas. The radiation dose can be safely decreased to {<=}45 Gy on a primary tumor site and 19.5 Gy on the spine.

  16. Computerized procedures system (United States)

    Lipner, Melvin H.; Mundy, Roger A.; Franusich, Michael D.


    An online data driven computerized procedures system that guides an operator through a complex process facility's operating procedures. The system monitors plant data, processes the data and then, based upon this processing, presents the status of the current procedure step and/or substep to the operator. The system supports multiple users and a single procedure definition supports several interface formats that can be tailored to the individual user. Layered security controls access privileges and revisions are version controlled. The procedures run on a server that is platform independent of the user workstations that the server interfaces with and the user interface supports diverse procedural views.

  17. MINERVA - a multi-modal radiation treatment planning system

    Energy Technology Data Exchange (ETDEWEB)

    Wemple, C.A. E-mail:; Wessol, D.E.; Nigg, D.W.; Cogliati, J.J.; Milvich, M.L.; Frederickson, C.; Perkins, M.; Harkin, G.J


    Researchers at the Idaho National Engineering and Environmental Laboratory and Montana State University have undertaken development of MINERVA, a patient-centric, multi-modal, radiation treatment planning system. This system can be used for planning and analyzing several radiotherapy modalities, either singly or combined, using common modality independent image and geometry construction and dose reporting and guiding. It employs an integrated, lightweight plugin architecture to accommodate multi-modal treatment planning using standard interface components. The MINERVA design also facilitates the future integration of improved planning technologies. The code is being developed with the Java Virtual Machine for interoperability. A full computation path has been established for molecular targeted radiotherapy treatment planning, with the associated transport plugin developed by researchers at the Lawrence Livermore National Laboratory. Development of the neutron transport plugin module is proceeding rapidly, with completion expected later this year. Future development efforts will include development of deformable registration methods, improved segmentation methods for patient model definition, and three-dimensional visualization of the patient images, geometry, and dose data. Transport and source plugins will be created for additional treatment modalities, including brachytherapy, external beam proton radiotherapy, and the EGSnrc/BEAMnrc codes for external beam photon and electron radiotherapy.

  18. Radiation treatment parameters for re-irradiation of malignant glioma

    Energy Technology Data Exchange (ETDEWEB)

    Niyazi, M.; Soehn, M.; Schwarz, S.B.; Lang, P.; Belka, C.; Ganswindt, U. [Ludwig-Maximilians-Univ., Muenchen (Germany). Dept. of Radiation Oncology


    Background and purpose: Most patients with malignant glioma ultimately fail locally or loco-regionally after the first treatment, with re-irradiation being a reasonable treatment option. However, only limited data are presently available allowing for a precise selection of patients suitable for re-treatment with regard to safety and efficacy. Material and methods: Using the department database, 39 patients with a second course of radiation were identified. Doses to gross tumor volume (GTV), planning target volume (PTV), and relevant organs at risk (OARs; brainstem, optic chiasm, optic nerves, brain) were retrospectively analyzed and correlated to outcome parameters. Relevant treatment parameters including D{sub max}, D{sub min}, D{sub mean}, and volume (ml) were obtained. Equivalent uniform dose (EUD) values were calculated for the tumor and OARs. To address the issue of radiation necrosis/leukoencephalopathy posttherapeutic MRI images were routinely examined every 3 months. Results: Median follow-up was 147 days. The time interval between first and second irradiation was regularly greater than 6 months. Median EUDs to the OARs were 11.9 Gy (range 0.7-27.4 Gy) to the optic chiasm, 17.6 Gy (range 0.7-43.0 Gy) to the brainstem, 4.9/2.1 Gy (range 0.3-24.5 Gy) to the right/left optic nerve, and 29.4 Gy (range 25.2-32.5 Gy) to the brain. No correlation between treated volume and survival was observed. Cold spots and dose did not correlate with survival. Re-irradiated volumes were treated with on average lower doses if they were larger and vice versa. Conclusion: In general, re-irradiation is a safe and feasible re-treatment option. No relevant toxicity was observed after re-irradiation in our patient cohort during follow-up. In this regard, this analysis provides baseline data for the selection of putative patients. EUD values are derived and may serve as reference for further studies, including intensity-modulated radiotherapy (IMRT) protocols. (orig.)

  19. Immobilization for the radiation therapy treatment of the pelvic region

    Energy Technology Data Exchange (ETDEWEB)

    Van den Heuvel, F.; De Beukeleer, M.; Nys, F.; Bijdekerke, P.; Robberechts, M.; Van Cauwenbergh, R. [Brussels Univ. (Belgium). Dept. of Radiotherapy


    Previous experience with the treatment of the pelvic region has shown that geometric setup errors are considerable in extent and incidence. A proposal to alleviate this problem is the introduction of immobilization devices in analogy with head and neck treatment. The practicality and efficacy of such a technique is investigated and compared with an earlier proposed technique using interactive adjustment and Electronic Portal Imaging (EPI). A group of 13 patients treated in the pelvic region using external radiation therapy was immobilized using an Orfit-like cast. Every fraction for every patients was imaged using an EPID. Immediately after obtaining an image it was compared to a digitized simulation image using the in-house developed OPIDUM system. Patient position was adjusted when an error in one of the main directions (transversal or longitudinal) exceeded 5 mm. Time measurements were carried out in order to asses the impact of the immobilization procedure on the patient throughput. In 68% of the cases a corrective action was necessary. The fraction of total treatment time was 50% for 26% of the fields. The range of errors measured in the longitudinal direction was between 29 and -22 mm. In the transversal direction the range was from -7 to 60 mm. A full analysis 13 patients yielding statistics for more than 200 fields is presented. Special attention has been paid to the determination of the nature of the errors (random or systematic) and the impact on patient throughput.

  20. Chronic radiation proctopathy:A practical review of endoscopic treatment

    Institute of Scientific and Technical Information of China (English)

    Luciano Lenz; Rachel Rohr; Frank Nakao; Ermelindo Libera; Angelo Ferrari


    Chronic radiation proctopathy(CRP) is a troublesome complication of pelvic radiotherapy. The most common presentation is rectal bleeding. CRP symptoms interfere with daily activities and decrease quality of life. Rectal bleeding management in patients with CRP represents a conundrum for practitioners. Medical therapy is ineffective in general and surgical approach has a high morbidmortality. Endoscopy has a role in the diagnosis,staging and treatment of this disease. Currently available endoscopic modalities are formalin,potassium titanyl phosphate laser,neodymium:yttrium-aluminum-garnet laser,argon laser,bipolar electrocoagulation(BiCAP),heater probe,band ligation,cryotherapy,radiofrequency ablation and argon plasma coagulation(APC). Among these options,APC is the most promising.

  1. BNCT-RTPE: BNCT radiation treatment planning environment

    Energy Technology Data Exchange (ETDEWEB)

    Wessol, D.E.; Wheeler, F.J. [Idaho National Engineering Lab., Idaho Fall, ID (United States); Babcock, R.S. [and others


    Several improvements have been developed for the BNCT radiation treatment planning environment (BNCT-Rtpe) during 1994. These improvements have been incorporated into Version 1.0 of BNCT-Rtpe which is currently installed at the INEL, BNL, Japanese Research Center (JRC), and Finland`s Technical Research Center. Platforms supported by this software include Hewlett-Packard (HP), SUN, International Business Machines (IBM), and Silicon Graphics Incorporated (SGI). A draft version of the BNCT-Rtpe user manual is available. Version 1.1 of BNCT-Rtpe is scheduled for release in March 1995. It is anticipated that Version 2.x of BNCT-Rtpe, which includes the nonproprietary NURBS library and data structures, will be released in September 1995.

  2. Surface treatment of CFRP composites using femtosecond laser radiation (United States)

    Oliveira, V.; Sharma, S. P.; de Moura, M. F. S. F.; Moreira, R. D. F.; Vilar, R.


    In the present work, we investigate the surface treatment of carbon fiber-reinforced polymer (CFRP) composites by laser ablation with femtosecond laser radiation. For this purpose, unidirectional carbon fiber-reinforced epoxy matrix composites were treated with femtosecond laser pulses of 1024 nm wavelength and 550 fs duration. Laser tracks were inscribed on the material surface using pulse energies and scanning speeds in the range 0.1-0.5 mJ and 0.1-5 mm/s, respectively. The morphology of the laser treated surfaces was investigated by field emission scanning electron microscopy. We show that, by using the appropriate processing parameters, a selective removal of the epoxy resin can be achieved, leaving the carbon fibers exposed. In addition, sub-micron laser induced periodic surface structures (LIPSS) are created on the carbon fibers surface, which may be potentially beneficial for the improvement of the fiber to matrix adhesion in adhesive bonds between CFRP parts.

  3. Comprehensive computerized medical imaging: interim hypothetical economic evaluation (United States)

    Warburton, Rebecca N.; Fisher, Paul D.; Nosil, Josip


    The 422-bed Victoria General Hospital (VGH) and Siemens Electric Limited have since 1983 been piloting the implementation of comprehensive computerized medical imaging, including digital acquisition of diagnostic images, in British Columbia. Although full PACS is not yet in place at VGH, experience to date habeen used to project annual cost figures (including capital replacement) for a fully-computerized department. The resulting economic evaluation has been labelled hypothetical to emphasize that some key cost components were estimated rather than observed; this paper presents updated cost figures based on recent revisions to proposed departmental equipment configuration which raised the cost of conventional imaging equipment by 0.3 million* and lowered the cost of computerized imaging equipment by 0.8 million. Compared with conventional diagnostic imaging, computerized imaging appears to raise overall annual costs at VGH by nearly 0.7 million, or 11.6%; this is more favourable than the previous results, which indicated extra annual costs of 1 million (16.9%). Sensitivity analysis still indicates that all reasonable changes in the underlying assumptions result in higher costs for computerized imaging than for conventional imaging. Computerized imaging offers lower radiation exposure to patients, shorter waiting times, and other potential advantages, but as yet the price of obtaining these benefits remains substantial.

  4. 21 CFR 579.22 - Ionizing radiation for treatment of animal diets. (United States)


    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Ionizing radiation for treatment of animal diets... for treatment of animal diets. Ionizing radiation for treatment of complete diets for animals may be... Bagged complete diets, packaged feeds, feed ingredients, bulk feeds, animal treats and chews...

  5. Treatment of advanced head and neck cancer: multiple daily dose fractionated radiation therapy and sequential multimodal treatment approach. (United States)

    Nissenbaum, M; Browde, S; Bezwoda, W R; de Moor, N G; Derman, D P


    Fifty-eight patients with advanced head and neck cancer were entered into a randomised trial comparing chemotherapy (DDP + bleomycin) alone, multiple daily fractionated radiation therapy, and multimodality therapy consisting of chemotherapy plus multiple fractionated radiation therapy. Multimodal therapy gave a significantly higher response rate (69%) than either single-treatment modality. The use of a multiple daily dose fractionation allowed radiation therapy to be completed over 10 treatment days, and the addition of chemotherapy to the radiation treatment did not significantly increase toxicity. Patients receiving multimodal therapy also survived significantly longer (median 50 weeks) than those receiving single-modality therapy (median 24 weeks).

  6. Correlation of Computerized Tomography density patterns of lymph nodes with treatment results and outcome in head and neck cancer patients treated by 2 different chemoradiotherapy schedules

    Directory of Open Access Journals (Sweden)

    Sweta Jaju


    Full Text Available Aims/Background: Tumor necrosis is visualized on CT scan as non enhancing hypodense area. Necrotic areas contain less oxygen and results in poor response of chemo-radiotherapy. Literature review (1 has shown that for hypodense lesions in head and neck cancer the complete response rate is lower than the isodense lesions. Locally advanced head and neck cancer require the addition of surgery but after a radical dose of radiation that is, 7000 cGy, surgery become difficult but there is no tool initially that can be used for selection of patients after delivery of 4500 cGy, that is the dose after which surgery can be performed without much difficulty. The hypothesis is that, hypodense lymph nodes even when they are small will show less response to various schedules of chemoradiotherapy so hypodensity of lymph nodes can be used as a tool to select patient, who will go for surgery after initial 4500 cGy of radiotherapy. Surgery is usually performed 2 to 3 weeks after radiotherapy, so primary can be treated to full dose while the skin in region of lymph nodes radiation field will recover from acute radiation reaction. Correlation of C T density patterns of lymph nodes in head and neck cancer patients with treatment results when two different chemoradiotherapy schedules are used is studied. Materials and Methods: Eighty three patients with locally advanced head and neck cancer were treated with two schedules of concurrent chemoradiotherapy prospectively from August 2010 to July 2011. CT Scans of the entire neck region including primary were performed. An iodine based contrast material (150 ml was injected intravenously starting with a bolus of 50ml (3ml/s, followed by a slow (1ml/s infusion of the remaining dose. The total tumor volume of the primary and involved neck nodes was calculated as a cuboid volume using maximum dimension in each plane: Vc= (a x b x c. Nodal density was graded. Results and Conclusion: No statistically significant association

  7. Optimizing global liver function in radiation therapy treatment planning (United States)

    Wu, Victor W.; Epelman, Marina A.; Wang, Hesheng; Romeijn, H. Edwin; Feng, Mary; Cao, Yue; Ten Haken, Randall K.; Matuszak, Martha M.


    Liver stereotactic body radiation therapy (SBRT) patients differ in both pre-treatment liver function (e.g. due to degree of cirrhosis and/or prior treatment) and radiosensitivity, leading to high variability in potential liver toxicity with similar doses. This work investigates three treatment planning optimization models that minimize risk of toxicity: two consider both voxel-based pre-treatment liver function and local-function-based radiosensitivity with dose; one considers only dose. Each model optimizes different objective functions (varying in complexity of capturing the influence of dose on liver function) subject to the same dose constraints and are tested on 2D synthesized and 3D clinical cases. The normal-liver-based objective functions are the linearized equivalent uniform dose (\\ell \\text{EUD} ) (conventional ‘\\ell \\text{EUD} model’), the so-called perfusion-weighted \\ell \\text{EUD} (\\text{fEUD} ) (proposed ‘fEUD model’), and post-treatment global liver function (GLF) (proposed ‘GLF model’), predicted by a new liver-perfusion-based dose-response model. The resulting \\ell \\text{EUD} , fEUD, and GLF plans delivering the same target \\ell \\text{EUD} are compared with respect to their post-treatment function and various dose-based metrics. Voxel-based portal venous liver perfusion, used as a measure of local function, is computed using DCE-MRI. In cases used in our experiments, the GLF plan preserves up to 4.6 % ≤ft(7.5 % \\right) more liver function than the fEUD (\\ell \\text{EUD} ) plan does in 2D cases, and up to 4.5 % ≤ft(5.6 % \\right) in 3D cases. The GLF and fEUD plans worsen in \\ell \\text{EUD} of functional liver on average by 1.0 Gy and 0.5 Gy in 2D and 3D cases, respectively. Liver perfusion information can be used during treatment planning to minimize the risk of toxicity by improving expected GLF; the degree of benefit varies with perfusion pattern. Although fEUD model optimization is computationally inexpensive and

  8. Optimizing global liver function in radiation therapy treatment planning (United States)

    Wu, Victor W; Epelman, Marina A; Wang, Hesheng; Romeijn, H Edwin; Feng, Mary; Cao, Yue; Haken, Randall K Ten; Matuszak, Martha M


    Liver stereotactic body radiation therapy (SBRT) patients differ in both pre-treatment liver function (e.g. due to degree of cirrhosis and/or prior treatment) and radiosensitivity, leading to high variability in potential liver toxicity with similar doses. This work investigates three treatment planning optimization models that minimize risk of toxicity: two consider both voxel-based pre-treatment liver function and local-function-based radiosensitivity with dose; one considers only dose. Each model optimizes different objective functions (varying in complexity of capturing the influence of dose on liver function) subject to the same dose constraints and are tested on 2D synthesized and 3D clinical cases. The normal-liver-based objective functions are the linearized equivalent uniform dose (ℓEUD) (conventional ‘ℓEUD model’), the so-called perfusion-weighted ℓEUD (fEUD) (proposed ‘fEUD model’), and post-treatment global liver function (GLF) (proposed ‘GLF model’), predicted by a new liver-perfusion-based dose-response model. The resulting ℓEUD, fEUD, and GLF plans delivering the same target ℓEUD are compared with respect to their post-treatment function and various dose-based metrics. Voxel-based portal venous liver perfusion, used as a measure of local function, is computed using DCE-MRI. In cases used in our experiments, the GLF plan preserves up to 4.6%(7.5%) more liver function than the fEUD (ℓEUD) plan does in 2D cases, and up to 4.5%(5.6%) in 3D cases. The GLF and fEUD plans worsen in ℓEUD of functional liver on average by 1.0 Gy and 0.5 Gy in 2D and 3D cases, respectively. Liver perfusion information can be used during treatment planning to minimize the risk of toxicity by improving expected GLF; the degree of benefit varies with perfusion pattern. Although fEUD model optimization is computationally inexpensive and often achieves better GLF than ℓEUD model optimization does, the GLF model directly optimizes a more clinically

  9. Computerized voiding diary. (United States)

    Rabin, J M; McNett, J; Badlani, G H


    An electronic, computerized voiding diary, "Compu-Void" (patent pending) was developed in order to simplify, augment, and automate patients' recording of bladder symptomatology. A voiding diary as a tool has the potential to provide essential information for a more complete diagnostic and therefore therapeutic picture for each patient. Two major problems with the standard written voiding diary have been a lack of patient compliance and the limited amount of information it garners. Twenty-five women with various types of voiding dysfunctions were compared to twenty-five age and parity-matched control women in order to determine patient preferences of the Compu-Void when compared to the standard written voiding diary, compliance with each method, and amount and quality of information obtained with each method. Over 90% of subjects and over 70% of control group patients preferred the Compu-Void over the written diary (P Compu-Void exceeded that obtained with the written method.

  10. Computerizing natural history collections. (United States)

    Sunderland, Mary E


    Computers are ubiquitous in the life sciences and are associated with many of the practical and conceptual changes that characterize biology's twentieth-century transformation. Yet comparatively little has been written about how scientists use computers. Despite this relative lack of scholarly attention, the claim that computers revolutionized the life sciences by making the impossible possible is widespread, and relatively unchallenged. How did the introduction of computers into research programs shape scientific practice? The Museum of Vertebrate Zoology (MVZ) at the University of California, Berkeley provides a tractable way into this under-examined question because it is possible to follow the computerization of data in the context of long-term research programs.

  11. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    . The analysis focuses on the emergence of general clinical work practice demands on guidance • An analysis of guidance demands from clinical work practice and business strategy, focusing on implications for the design of computerised CPGs. In my research, I have applied observation studies, interviews...... is comprised by fieldwork in three oncology departments and a case study of advanced life support. Although close to all patients within oncology are treated according to a CPG, I found limited application of physical CPGs and web-based CPG portals. However, I found comprehensive application of activity...... feasible • Designed in a way that provides room for local adaptations of guidance • Designed with focus on specific business strategic aims Further, based on my findings, I will suggest that design of computerized CPGs should be based on: 1) scrutinization of the clinical work practice, 2) articulation...

  12. Primary radiation therapy in the treatment of anal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cantril, S.T. (Children' s Hospital of San Francisco, CA); Green, J.P.; Schall, G.L.; Schaupp, W.C.


    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N/sub 0/ patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease.

  13. Proton Radiation Therapy for the Treatment of Retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Mouw, Kent W. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Sethi, Roshan V.; Yeap, Beow Y.; MacDonald, Shannon M.; Chen, Yen-Lin E.; Tarbell, Nancy J.; Yock, Torunn I.; Munzenrider, John E.; Adams, Judith [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Grabowski, Eric [Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts (United States); Mukai, Shizuo [Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts (United States); Shih, Helen A., E-mail: [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)


    Purpose: To investigate long-term disease and toxicity outcomes for pediatric retinoblastoma patients treated with proton radiation therapy (PRT). Methods and Materials: This is a retrospective analysis of 49 retinoblastoma patients (60 eyes) treated with PRT between 1986 and 2012. Results: The majority (84%) of patients had bilateral disease, and nearly half (45%) had received prior chemotherapy. At a median follow-up of 8 years (range, 1-24 years), no patients died of retinoblastoma or developed metastatic disease. The post-PRT enucleation rate was low (18%), especially in patients with early-stage disease (11% for patients with International Classification for Intraocular Retinoblastoma [ICIR] stage A-B disease vs 23% for patients with ICIR stage C-D disease). Post-PRT ophthalmologic follow-up was available for 61% of the preserved eyes (30 of 49): 14 of 30 eyes (47%) had 20/40 visual acuity or better, 7 of 30 (23%) had moderate visual acuity (20/40-20/600), and 9 of 30 (30%) had little or no useful vision (worse than 20/600). Twelve of 60 treated eyes (20%) experienced a post-PRT event requiring intervention, with cataracts the most common (4 eyes). No patients developed an in-field second malignancy. Conclusions: Long-term follow-up of retinoblastoma patients treated with PRT demonstrates that PRT can achieve high local control rates, even in advanced cases, and many patients retain useful vision in the treated eye. Treatment-related ocular side effects were uncommon, and no radiation-associated malignancies were observed.

  14. Surgical management of vestibular schwannomas after failed radiation treatment. (United States)

    Nonaka, Yoichi; Fukushima, Takanori; Watanabe, Kentaro; Friedman, Allan H; Cunningham, Calhoun D; Zomorodi, Ali R


    Increasing numbers of patients with vestibular schwannoma (VS) have been treated with focused-beam stereotactic radiation treatment (SRT) including Gamma knife, CyberKnife, X-knife, Novalis, or proton beam therapy. The purpose of this study was to document the incidence of tumor regrowth or symptoms that worsened or first developed following SRT and to discuss surgical strategies for patients who have failed SRT for VS. A consecutive series of 39 patients with SRT failed VS were surgically treated. Clinical symptoms, tumor regrowth at follow-up, intraoperative findings, and surgical outcome were evaluated. There were 15 males and 24 females with a mean age of 51.8 years. Thirty-six patients (92.3%) demonstrated steady tumor growth after SRT. Two (5.1%) patients with slight increase of the mass underwent surgical resection because of development of unbearable facial pain. Symptoms that worsened or newly developed following SRT in this series were deafness (41%), dizziness (35.9%), facial numbness (25.6%), tinnitus (20.5%), facial nerve palsy (7.7%), and facial pain (7.7%). Intraoperative findings demonstrated fibrous changes of the tumor mass, cyst formation, and brownish-yellow or purple discoloration of the tumor capsule. Severe adhesions between the tumor capsule and cranial nerves, vessels, and the brainstem were observed in 69.2%. Additionally, the facial nerve was more fragile and irritable in all cases. Gross total resection (GTR) was achieved in 33.3% of patients, near-total resection (NTR) in 35.9%, and subtotal resection (STR) in 30.8% of patients. New facial nerve palsy was seen in seven patients (19.4%) postoperatively. Our findings suggest that patients with VS who fail SRT with either tumor progression or worsening of clinical symptoms will have an increased rate of adhesions to the neurovascular structures and may have radiation-influenced neuromalacia. Salvage surgery of radiation-failed tumors is more difficult and will have a higher risk of

  15. Radiation safety issues in the water treatment plant - Indoor radon and gamma radiation

    Energy Technology Data Exchange (ETDEWEB)

    Jantsikene, A.; Kiisk, M.; Suursoo, S.; Koch, R. [University of Tartu, Institute of Physics (Estonia); Lumiste, L. [Tallinn University of Technology, Department of Chemical Engineering (Estonia)


    In order to reduce the indicative dose from drinking water consumption in Viimsi parish, Estonia, a new water treatment plant was launched in 2012 serving about 15 000 consumers. The promising new technology for groundwater purification consists of air injector, oxidation tank, patented venturi-type centrifugal degassing separation unit GDT and two-stage filtration in open filter columns. In each of the five parallel lines, approximately 95 tons of catalytic (FMH and sand) and 45 tons of non-catalytic (zeolite) filter materials were used. These filter materials proved to be very effective adsorbents of incoming radium isotopes. As a result, the columns emit direct gamma radiation. Moreover, columns' exposure to indoor air makes them radon generators that affect all rooms in the building. During the study period of two years the filter materials were not replaced and their lifespan has not been estimated yet. In order to minimize radiation risks for the workers inside the water treatment plant, a complex study and a long-term monitoring is needed. For the measurements of {sup 226}Ra and {sup 228}Ra concentrations in water and in solid filter materials gamma-ray spectroscopy was used. According to the results, the annual input of {sup 226}Ra and {sup 228}Ra is 325 MBq and 420 MBq, respectively. The average incoming concentration of {sup 226}Ra and {sup 228}Ra isotopes is 0.5 Bq/L and 0.6 Bq/L, respectively, and the radium content in the output water is below the limit of detection (about 10-15 mBq/L). This means strong accumulation of radium isotopes in the filter materials, thus causing an increase of {sup 222}Rn concentrations in the outgoing treated water. External dose rates throughout the length of the filter columns were measured with the portable dosimeter to estimate the {sup 226}Ra and {sup 228}Ra depth distribution. The results showed that distribution of these radionuclides is uneven with the maximum of 0.5 μSv/h for the first stage and 3 μSv/h for

  16. Computerized analysis of the smile in Orthodontics

    Directory of Open Access Journals (Sweden)

    Luiz Vicente de Moura LOPES


    Full Text Available In most cases the search for orthodontic treatment is related withesthetics cause. Nowadays, a beautiful smile is extremely importantfor the society. Establishing elements for diagnosis and planning,looking at a harmonious and well-balanced smile became an obligation at dentistry offices. The esthetics is evaluated by the outline of the bone tissues and its relation with the soft tissues. A good way to get this evaluation is using photographs. The purpose of this research was to analyze computer standard pictures of the maximum smile, as complement to the orthodontic documentation to help not only in the diagnostic and planning but also in the valuation of obtained results. Standard pictures of the maximum smile were obtained in the natural position of the head. Linear,angular and proportional measures were evaluated through the computerized program (CEFX2001 – CDT. The sample consisted of 28 patients, white, male, age between 19 and 25 years old, with Class I occlusion and no previous orthodontic treatment. The values of the descriptive statistics and error analysis were obtained. The results were compared with the values found in the literature, and the values found at a study using the same computerized program CEFX2001 – CDT, but with female patients. The final results were similar to the values found in the literature and the values found in a study using the same computerized program CEFX2001 – CDT,but with female patients.

  17. Advantages obtained in radiation protection when using computerized radiography tests - CR (digital) in processing plants; Vantagens obtidas em radioprotecao quando do uso do ensaio de radiografia computadorizada - RC (digital) em plantas de processo

    Energy Technology Data Exchange (ETDEWEB)

    Jose, Joao Carlos Videira; Milani, Hilton Sergio B.; Paes, Eliseu Almir de Oliveira; Boita, Mario de [ARCtest Servicos Tecnicos de Inspecao e Manutencao Industrial Ltda., Sao Paulo, SP (Brazil)]. E-mail:; Souza, Laercio de; Serra, Flavio Augusto dos Santos [PETROBRAS, Paulinia, SP, RJ (Brazil). Refinaria do Planalto Paulista (REPLAN)]. E-mails:;


    During the year 2000, the ARCtest initiated the development of the research for adapting the Computerized Radiography - CR, originally conceived for medical applications, for the Industry, trying initially to attend the requirements of the processing plants, concerning to the detection of deterioration mechanisms (evaluation of the piping integrity). Due to the obtained excellent results, the possibility of utilization the Computerized Radiography - CR in the radiographic inspection were studied during the shutdown of the Catalytic Cracking Unit of the PETROBRAS-REPLAN, specifically in the replacement of the CO boiler superheater, where a large number of the small diameter welded joints have been predicted.

  18. Reducing the Human Burden of Breast Cancer: Advanced Radiation Therapy Yields Improved Treatment Outcomes. (United States)

    Currey, Adam D; Bergom, Carmen; Kelly, Tracy R; Wilson, J Frank


    Radiation therapy is an important modality in the treatment of patients with breast cancer. While its efficacy in the treatment of breast cancer was known shortly after the discovery of x-rays, significant advances in radiation delivery over the past 20 years have resulted in improved patient outcomes. With the development of improved systemic therapy, optimizing local control has become increasingly important and has been shown to improve survival. Better understanding of the magnitude of treatment benefit, as well as patient and biological factors that confer an increased recurrence risk, have allowed radiation oncologists to better tailor treatment decisions to individual patients. Furthermore, significant technological advances have occurred that have reduced the acute and long-term toxicity of radiation treatment. These advances continue to reduce the human burden of breast cancer. It is important for radiation oncologists and nonradiation oncologists to understand these advances, so that patients are appropriately educated about the risks and benefits of this important treatment modality.

  19. Experimental treatment of radiation pneumonitis with human umbilical cord mesenchymal stem cells

    Institute of Scientific and Technical Information of China (English)

    Rui Wang; Chang-zheng Zhu; Ping Qiao; Jian Liu; Qiang Zhao; Kui-jie Wang; Ting-bao Zhao


    Objective: To evaluate of the curative effect of human umbilical cord mesenchymal stem cells (hUC-MSCs) on rat acute radiation pneumonitis. Methods: Fourty rats were randomly divided into control group, radiation group, stem cell prevention group, stem cell treatment group and prednisone treatment group. All rats except those in the control group were radiated with X ray to establish the acute radiation pneumonitis damage model. The hUC-MSCs cultured in vitro was administrated to the rats of the prevention group via tail vein (1×106 cells/kg BW) 24 h before the radiation, while the same administration was performed in the rats of the treatment group 24 h after the radiation. After 24 h post the radiation, the rats in the radiation group were given 0.4 mL physiological saline, and those in the prednisone group were given 1 mg/kg prednisone. All rats were observed and executed 72 h after the radiation to detect lung histological changes. Results:After the administration of hUC-MSCs, the survival status of the rats in the prevention group and treatment group was obviously better than that in the control group. As shown by the histological staining, the morphology, proliferation activity and bronchial state of lung tissues were better in the prevention group and treatment group than in the control group. Conclusion: The hUC-MSCs have definite therapeutic effects on acute radiation pneumonitis in rats.

  20. Radiation recall dermatitis after docetaxel chemotherapy. Treatment by antioxidant ointment

    Energy Technology Data Exchange (ETDEWEB)

    Duncker-Rohr, Viola; Freund, Ulrich; Momm, Felix [Ortenau-Klinikum Offenburg-Gengenbach Lehrkrankenhaus der Albert-Ludwigs-Universitaet Freiburg i. Br., Radio-Onkologie, Offenburg (Germany)


    Radiation recall dermatitis (RRD) is an acute skin toxicity caused by different anticancer or antibiotic drugs within a former completely healed irradiation field. Predictive factors for RRD are not known and its mechanisms are not completely understood. A case of RRD induced by docetaxel and successfully treated by an antioxidant ointment (Mapisal {sup registered}) is presented here. Such an ointment might be useful not only in RRD therapy, but also in the treatment of high-grade dermatitis induced by radiotherapy and thus may contribute to the improvement of patients' quality of life and to the scheduled completion of cancer therapies. (orig.) [German] Die Strahlen-Recall-Dermatitis (RRD) ist eine akute Hauttoxizitaet, die durch verschiedene Chemotherapeutika oder Antibiotika innerhalb eines frueheren, komplett abgeheilten Bestrahlungsfelds hervorgerufen wird. Praediktive Faktoren fuer die RRD sind nicht bekannt und ihr Mechanismus ist nicht vollstaendig geklaert. Es wird ein Fallbericht einer durch Docetaxel induzierten RRD dargestellt, die erfolgreich mit einer antioxidativen Salbe (Mapisal {sup registered}) behandelt wurde. Solche Salben koennten nicht nur zur Therapie der RRD, sondern auch bei der Behandlung einer akuten Dermatitis waehrend der Strahlentherapie nuetzlich sein und damit zur Verbesserung der Lebensqualitaet der Patienten und zur planmaessigen Durchfuehrung der Tumortherapie beitragen. (orig.)

  1. Computerized molecular modeling of carbohydrates (United States)

    Computerized molecular modleing continues to increase in capability and applicability to carbohydrates. This chapter covers nomenclature and conformational aspects of carbohydrates, perhaps of greater use to carbohydrate-inexperienced computational chemists. Its comments on various methods and studi...

  2. Elimination of Listeria monocytogenes in sausage meat by combination treatment: Radiation and radiation-resistant bacteriocins (United States)

    Turgis, Mélanie; Stotz, Viviane; Dupont, Claude; Salmieri, Stéphane; Khan, Ruhul A.; Lacroix, Monique


    Two new bacteria were isolated from human feces and were designated MT 104 and MT 162. They were able to produce bacteriocins that are active against five strains of Listeria monocytogenes. Bacteriocins produced by these isolated strains had 100% and 82.35% residual activity when they were treated by gamma radiation at doses of 4 and 40 kGy, respectively. A reduction of 1.0, 1.5 and 3 log CFU/g of L. monocytogenes was observed in sausage meat when treated with bacteriocins from MT 104, MT 162, and nisin, respectively. For synergic effect, the D10 value in presence of the bacteriocins produced by MT 104 showed a 1.08 fold increased relative sensitivity of L. monocytogenes as compared to control after 5 days. The highest synergic effect was observed in presence of nisin which led to 1.61 fold increased relative sensitivity. Combined treatments with nisin and γ-irradiation showed a synergic antimicrobial effect in meat after 24 h and 5 days of storage. A synergic effect was observed only after 5 days at 4 °C for the bacteriocin from MT 104, as compared to the bacteriocin produced by MT 162 that had only an additive antimicrobial effect in all conditions.

  3. Volumetric Spectroscopic Imaging of Glioblastoma Multiforme Radiation Treatment Volumes

    Energy Technology Data Exchange (ETDEWEB)

    Parra, N. Andres [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Maudsley, Andrew A. [Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida (United States); Gupta, Rakesh K. [Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana (India); Ishkanian, Fazilat; Huang, Kris [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Walker, Gail R. [Biostatistics and Bioinformatics Core Resource, Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Padgett, Kyle [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida (United States); Roy, Bhaswati [Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana (India); Panoff, Joseph; Markoe, Arnold [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Stoyanova, Radka, E-mail: [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States)


    Purpose: Magnetic resonance (MR) imaging and computed tomography (CT) are used almost exclusively in radiation therapy planning of glioblastoma multiforme (GBM), despite their well-recognized limitations. MR spectroscopic imaging (MRSI) can identify biochemical patterns associated with normal brain and tumor, predominantly by observation of choline (Cho) and N-acetylaspartate (NAA) distributions. In this study, volumetric 3-dimensional MRSI was used to map these compounds over a wide region of the brain and to evaluate metabolite-defined treatment targets (metabolic tumor volumes [MTV]). Methods and Materials: Volumetric MRSI with effective voxel size of ∼1.0 mL and standard clinical MR images were obtained from 19 GBM patients. Gross tumor volumes and edema were manually outlined, and clinical target volumes (CTVs) receiving 46 and 60 Gy were defined (CTV{sub 46} and CTV{sub 60}, respectively). MTV{sub Cho} and MTV{sub NAA} were constructed based on volumes with high Cho and low NAA relative to values estimated from normal-appearing tissue. Results: The MRSI coverage of the brain was between 70% and 76%. The MTV{sub NAA} were almost entirely contained within the edema, and the correlation between the 2 volumes was significant (r=0.68, P=.001). In contrast, a considerable fraction of MTV{sub Cho} was outside of the edema (median, 33%) and for some patients it was also outside of the CTV{sub 46} and CTV{sub 60}. These untreated volumes were greater than 10% for 7 patients (37%) in the study, and on average more than one-third (34.3%) of the MTV{sub Cho} for these patients were outside of CTV{sub 60}. Conclusions: This study demonstrates the potential usefulness of whole-brain MRSI for radiation therapy planning of GBM and revealed that areas of metabolically active tumor are not covered by standard RT volumes. The described integration of MTV into the RT system will pave the way to future clinical trials investigating outcomes in patients treated based on

  4. Radiation therapy in the multimodal treatment approach of pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Becker, G. [Klinik am Eichert, Goeppingen (Germany). Dept. of Radiooncology and Radiation Therapy; Radiooncologic Univ. Clinic, Tuebingen (Germany); Kocher, M.; Mueller, R.P. [Koeln Univ. (Germany). Clinic of Radiation Therapy; Kortmann, R.D.; Paulsen, F.; Jeremic, B.; Bamberg, M. [Radiooncologic Univ. Clinic, Tuebingen (Germany)


    In this paper, literature will be reviewed to assess the role of modern radiotherapy and radiosurgery in the management of pituitary adenomas. Material and Methods: Nowadays, magnetic resonance imaging for the definition of the target volume and a real three-dimensional (3-D) treatment planning with field conformation and the possibility for non-coplanar irradiation has to be recommended. Most groups irradiate these benign tumors with single doses of 1.8-2.0 Gy up to a total dose of 45 Gy or 50.4 Gy in extensive parasellar adenomas. Adenomas are mostly small, well circumscribed lesions, and have, therefore, attracted the use of stereotactically guided high-precision irradiation techniques which allow extreme focussing and provide steep dose gradients with selective treatment of the target and optimal protection of the surrounding brain tissue. Results: Radiation therapy controls tumor growth in 80-98% of patients with non-secreting adenomas and 67-89% for endocrine active tumors. Reviewing the recent literature including endocrine active and non-secreting adenomas, irradiated postoperatively or in case of recurrence the 5-, 10- and 15-year local control rates amount 92%, 89% and 79%. In cases of microprolactinoma primary therapy consists of dopamine agonists. Irradiation should be preferred in patients with macroprolactinomas, when drug therapy and/or surgery failed or for patients medically unsuitable for surgery. Reduction and control of prolactin secretion can be achieved in 44-70% of patients. After radiotherapy in acromegaly patients somatomedin-C and growth hormone concentrations decrease to normal levels in 70-90%, with a decrease rate of 10-30% per year. Hypercortisolism is controlled in 50-83% of adults and 80% of children with Cushing's disease, generally in less than 9 months. Hypopituitarism is the most common side effect of pituitary irradiation with an incidence of 13-56%. Long-term overall risk for brain necrosis in a total of 1,388 analyzed

  5. Radiation treatment of materials - elaboration bases of radiation technology; Obrobka radiacyjna materialow - zasady opracowywania technologii

    Energy Technology Data Exchange (ETDEWEB)

    Panta, P.P. [Institute of Nuclear Chemistry and Technology, Warsaw (Poland)


    The basic rules in design of radiation technologies have been presented and discussed. The recommendations for achieving of assigned goal in respect of obliged regulations have been done and explained on the example of radiation technology of adhesive materials and glue production.

  6. Changing Attitude Toward Radiation Carcinogenesis and Prospects for Novel Low-Dose Radiation Treatments. (United States)

    Socol, Yehoshua; Welsh, James S


    All procedures involving ionizing radiation, whether diagnostic or therapeutic, are subject to strict regulation, and public concerns have been raised about even the low levels of radiation exposures involved in diagnostic imaging. During the last 2 decades, there are signs of more balanced attitude to ionizing radiation hazards, as opposed to the historical "radiophobia." The linear no-threshold hypothesis, based on the assumption that every radiation dose increment constitutes increased cancer risk for humans, is increasingly debated. In particular, the recent memorandum of the International Commission on Radiological Protection admits that the linear no-threshold hypothesis predictions at low doses (that International Commission on Radiological Protection itself has used and continues to use) are "speculative, unproven, undetectable, and 'phantom'." Moreover, numerous experimental, ecological, and epidemiological studies suggest that low doses of ionizing radiation may actually be beneficial to human health. Although these advances in scientific understanding have not yet yielded significant changes in radiation regulation and policy, we are hopeful such changes may happen in the relatively near future. This article reviews the present status of the low-dose radiation hazard debate and outlines potential opportunities in the field of low-dose radiation therapy. © The Author(s) 2015.

  7. Measurement of the Radiation Dose Rates of Patients Receiving Treatment with I-131 Using Telescopic Radiation Survey Meter

    Directory of Open Access Journals (Sweden)

    Yehia Lahfi


    Full Text Available Introduction In order to discharge the patients receiving treatment with large radiation doses of 131I for thyroid cancer, it is necessary to measure and evaluate the external dose rates of these patients. The aim of the study was to assess a new method of external dose rate measurement, and to analyze the obtained results as a function of time. Materials and Methods In this study, a telescopic radiation survey meter was utilized to measure the external dose rates of a sample population of 192 patients receiving treatment with high-dose 131I at one, 24, and 48 hours after dose administration. Results The proposed technique could reduce the occupational radiation exposure of the physicist by a factor of 1/16. Moreover, the external dose rates of both genders rapidly decreased with time according to bi-exponential equations, which could be attributed to the additional factors associated with iodine excretion, as well as the physiology of the body in terms of 131I uptake. Conclusion According to the results of this study, telescopic radiation survey meter could be used to measure the external dose rates of patients receiving treatment with 131I. Furthermore, the average difference in the radiation exposure between female and male patients was calculated to be less than 17%.

  8. A method for the quantitative analysis of Intensity-Modulated Radiation Therapy (IMRT) treatment plan verification with radiographic film and polymer gel dosimeters (United States)

    Witten, Matthew Roy

    The clinical implementation of intensity-modulated radiotherapy has necessitated the development of sophisticated quality assurance techniques to ensure that the radiation dose distribution calculated by the computerized radiotherapy treatment planning system is reproduced with an acceptable degree of fidelity during treatment delivery. The index of agreement is introduced as a quantitative quality assurance tool capable of comparing the planned dose distribution with the dose distribution measured with a radiation dosimeter. The index of agreement method begins with solving a constrained optimization problem for each pixel (or voxel) of the planned dose distribution. Each pixel (or voxel) of the planned distribution is then assigned a score based upon the solution of the constrained optimization problem. The index of agreement is then calculated by dividing the number of pixels (or voxels) that are clinically relevant and for which the score function is equal to zero by the total number of clinically relevant pixels (or voxels). Data acquired with radiographic film and polymer gel indicate that the index of agreement is a stable quality assurance parameter.

  9. A semi-classical treatment of channeling radiation reaction (United States)

    Huang, Zhirong; Chen, Pisin; Ruth, Ronald D.


    A semi-classical formalism is used to calculate the radiation reaction of a relativistic particle in a straight, continuous focusing system. Due to the absence of quantum excitation in such a focusing system, the radiation damping rate of the transverse action obtained using this formalism agrees exactly with the result from the classical Lorentz-Dirac radiation reaction equation. In the limit where the pitch angle of the particle is much smaller than the radiation opening angle, the transverse action damps exponentially with an energy-independent rate that is much faster than the energy decay rate. In the opposite limit, both the transverse action and the energy damp with power laws and their relative rates are comparable. The general time-dependence of the transverse action damping and the energy decay are obtained analytically from these rate equations.

  10. Argon plasma coagulation for treatment of hemorrhagic radiation gastroduodenitis

    Energy Technology Data Exchange (ETDEWEB)

    Maekawa, Shu-Ji; Aoyama, Nobuo; Shirasaka, Daisuke; Inoue, Takashi; Kuroda, Kohei; Ebara, Shigeyuki; Tamura, Takao; Miyamoto, Masaki; Kasuga, Masato [Kobe Univ. (Japan). Graduate School of Medicine


    A 79-year-old man who had received radiotherapy for portal vein thrombosis due to hepatocellular carcinoma (HCC) 5 months earlier, showed progressive anemia and melena. Endoscopy on admission revealed diffuse bleeding from multiple telangiectasias on the anterior wall of the antrum and bulbus. We treated this patient with a new non-contact hemostatic method: the argon plasma coagulator (APC). The melena stopped after the first session and the hemoglobin level remained stable for 7 months. No delayed complications have been observed. Gastrointestinal bleeding from chronic radiation gastroduodenitis is rarely reported compared with radiation proctitis. This case demonstrates that APC is effective for hemostasis of diffuse bleeding from radiation gastroduodenitis, just as for radiation protitis. (author)

  11. Combined single photon emission computerized tomography and conventional computerized tomography: Clinical value for the shoulder surgeons?

    Directory of Open Access Journals (Sweden)

    Michael T Hirschmann


    Full Text Available With the cases described, we strive to introduce single photon emission computerized tomography in combination with conventional computer tomography (SPECT/CT to shoulder surgeons, illustrate the possible clinical value it may offer as new diagnostic radiologic modality, and discuss its limitations. SPECT/CT may facilitate the establishment of diagnosis, process of decision making, and further treatment for complex shoulder pathologies. Some of these advantages were highlighted in cases that are frequently seen in most shoulder clinics.

  12. Malignant mesothelioma after radiation treatment for Hodgkin lymphoma

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Burgers, Jacobus A; Baas, Paul


    Malignant mesothelioma is a relatively uncommon malignancy. Although the pathogenesis is primarily related to asbestos, the disease may be associated with radiation exposure. Recently, increased risks for second primary mesothelioma after radiation for lymphoma have been reported. Because...... and survival of the mesothelioma cases were comparable with cases from the general population, asbestos exposure and the proportion of males were lower than expected. The evidence for radiotherapy as cause for mesothelioma independent of exposure to asbestos is expanding, and the diagnosis of mesothelioma...

  13. Radiation Therapy (United States)

    ... the area is stitched shut. Another treatment, called proton-beam radiation therapy , focuses the radiation on the ... after radiation treatment ends. Sore mouth and tooth decay. If you received radiation therapy to the head ...

  14. Bevacizumab for the Treatment of Gammaknife Radiosurgery-Induced Brain Radiation Necrosis. (United States)

    Ma, Yifang; Zheng, Chutian; Feng, Yiping; Xu, Qingsheng


    Radiation necrosis is one of the complications of Gammaknife radiosurgery. The traditional treatment of radiation necrosis carries a high risk of failure, Bevacizumab is an antiangiogenic monoclonal antibody against vascular endothelial growth factor, a known mediator of cerebral edema. It can be used to successfully treat brain radiation necrosis. Two patients with a history of small cell lung cancer presented with metastatic disease to the brain. They underwent Gammaknife radiosurgery to brain metastases. Several months later, magnetic resonance imaging showed radiation necrosis with significant surrounding edema. The patients had a poor response to treatment with dexamethasone. They were eventually treated with bevacizumab (5 mg/kg every 2 weeks, 7.5 mg/kg every 3 weeks, respectively), and the treatment resulted in significant clinical and radiographic improvement. Bevacizumab can be successfully used to treat radiation necrosis induced by Gammaknife radiosurgery in patients with cerebral metastases. It is of particular benefit in patients with poor reaction to corticosteroids and other medications.

  15. Hypo-fractionated radiation, magnetic nanoparticle hyperthermia and a viral immunotherapy treatment of spontaneous canine cancer (United States)

    Hoopes, P. Jack; Moodie, Karen L.; Petryk, Alicia A.; Petryk, James D.; Sechrist, Shawntel; Gladstone, David J.; Steinmetz, Nicole F.; Veliz, Frank A.; Bursey, Alicea A.; Wagner, Robert J.; Rajan, Ashish; Dugat, Danielle; Crary-Burney, Margaret; Fiering, Steven N.


    It has recently been shown that cancer treatments such as radiation and hyperthermia, which have conventionally been viewed to have modest immune based anti-cancer effects, may, if used appropriately stimulate a significant and potentially effective local and systemic anti-cancer immune effect (abscopal effect) and improved prognosis. Using eight spontaneous canine cancers (2 oral melanoma, 3 oral amelioblastomas and 1 carcinomas), we have shown that hypofractionated radiation (6 x 6 Gy) and/or magnetic nanoparticle hyperthermia (2 X 43°C / 45 minutes) and/or an immunogenic virus-like nanoparticle (VLP, 2 x 200 μg) are capable of delivering a highly effective cancer treatment that includes an immunogenic component. Two tumors received all three therapeutic modalities, one tumor received radiation and hyperthermia, two tumors received radiation and VLP, and three tumors received only mNP hyperthermia. The treatment regimen is conducted over a 14-day period. All patients tolerated the treatments without complication and have had local and distant tumor responses that significantly exceed responses observed following conventional therapy (surgery and/or radiation). The results suggest that both hypofractionated radiation and hyperthermia have effective immune responses that are enhanced by the intratumoral VLP treatment. Molecular data from these tumors suggest Heat Shock Protein (HSP) 70/90, calreticulin and CD47 are targets that can be exploited to enhance the local and systemic (abscopal effect) immune potential of radiation and hyperthermia cancer treatment.

  16. Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a (60)Co Magnetic Resonance Image Guidance Radiation Therapy System

    DEFF Research Database (Denmark)

    Wooten, H Omar; Green, Olga; Yang, Min


    % prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range doses >20 Gy. The mean doses for all (60)Co plan OARs were within......PURPOSE: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating (60)Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. METHODS AND MATERIALS...... plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The (60)Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses...

  17. Radiation protection in brachytherapic treatment of prostatic carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mannino, G.; Bona, R.; Occhipinti, A. [Catania Univ. Hospital, ' Vittorio Emanuele, Ferrarotto e Santo Bambino' (Italy); Testagrossa, B.; Vermiglio, G.; Tripepi, M.G. [Messina Univ., Dept. of Protezionistica Ambientale, Sanitaria, Sociale ed Industriale (Italy)


    Purpose: To evaluate absorbed doses for medical staff and general public deriving from prostate brachytherapy with I-125 seeds. Methods And Materials: Radiation exposure measurements were made for staff and on a subset of 64 patients of the 100 trans perineal I-125 implanted seeds implants at the Vittorio Emanuele, Ferrarotto e Santo Bambino Universitary Hospital. Results: Absorbed doses for operators are very low when using radiation safety devices. The exposure rate at the anterior skin surface due to I-125 implanted seeds ranged from 32 to 120 {mu}Sv/hour. Conclusions: The evaluation of dose measurements shows that radiation risk associated to this practice is very low, both for staff that for critical group of population, if they follow the specific radioprotection statements supplied by health physicists. (authors)

  18. Radiation processing applications in the Czechoslovak water treatment technologies (United States)

    Vacek, K.; Pastuszek, F.; Sedláček, M.

    The regeneration of biologically clogged water wells by radiation proved to be a successful and economically beneficial process among other promising applications of ionizing radiation in the water supply technology. The application conditions and experience are mentioned. The potential pathogenic Mycobacteria occuring in the warm washing and bathing water are resistant against usual chlorine and ozone concentrations. The radiation sensitivity of Mycobacteria allowed to suggest a device for their destroying by radiation. Some toxic substances in the underground water can be efficiently degraded by gamma radiation directly in the wells drilled as a hydraulic barrier surrounding the contaminated land area. Substantial decrease of CN - concentration and C.O.D. value was observed in water pumped from such well equipped with cobalt sources and charcoal. The removing of pathogenic contamination remains to be the main goal of radiation processing in the water purification technologies. The decrease of liquid sludge specific filter resistance and sedimentation acceleration by irradiation have a minor technological importance. The hygienization of sludge cake from the mechanical belt filter press by electron beam appears to be the optimum application in the Czechoslovak conditions. The potatoes and barley crop yields from experimental plots treated with sludge were higher in comparison with using the manure. Biological sludge from the municipal and food industry water purification plants contains nutritive components. The proper hygienization is a necessary condition for using them as a livestock feed supplement. Feeding experiments with broilers and pigs confirmed the possibility of partial (e.g. 50%) replacement of soya-, bone- or fish flour in feed mixtures by dried sludge hygienized either by heat or by the irradiation.

  19. Ceiling art in a radiation therapy department: its effect on patient treatment experience

    Energy Technology Data Exchange (ETDEWEB)

    Bonett, Jotham [Sunshine Hospital Radiation Therapy Centre, Melbourne, Vic. (Australia)


    A new initiative has been implemented at the Sunshine Hospital Radiation Therapy Centre, to provide a calming and comforting environment for patients attending radiation therapy treatment. As part of this initiative, the department's computed tomography (CT) room and radiation therapy bunkers were designed to incorporate ceiling art that replicates a number of different visual scenes. The study was undertaken to determine if ceiling art in the radiation therapy treatment CT and treatment bunkers had an effect on a patient's experience during treatment at the department. Additionally, the study aimed to identify which of the visuals in the ceiling art were most preferred by patients. Patients were requested to complete a 12-question survey. The survey solicited a patient's opinion/perception on the unit's unique ceiling display with emphasis on aesthetic appeal, patient treatment experience and the patient's engagement due to the ceiling display. The responses were dichotomised to ‘positive’ or ‘negative’. Every sixth patient who completed the survey was invited to have a general face-to-face discussion to provide further information about their thoughts on the displays. The results demonstrate that the ceiling artwork solicited a positive reaction in 89.8% of patients surveyed. This score indicates that ceiling artwork contributed positively to patients’ experiences during radiation therapy treatment. The study suggests that ceiling artwork in the department has a positive effect on patient experience during their radiation therapy treatment at the department.

  20. Mathematical Optimization Techniques for Multi-Phase Radiation Treatment Design


    Sonderman, David


    A mathematical model for optimal external beam radiotherapy treatment design over multiple treatment phases is presented. The solution procedure is discussed and illustrated on a case of boost treatment for lung cancer. The models are integrated with current radiobiological software to produce an optimal design over both phases of treatment displayed by means of computer graphics.

  1. Computerized proof techniques for undergraduates (United States)

    Smith, Christopher J.; Tefera, Akalu; Zeleke, Aklilu


    The use of computer algebra systems such as Maple and Mathematica is becoming increasingly important and widespread in mathematics learning, teaching and research. In this article, we present computerized proof techniques of Gosper, Wilf-Zeilberger and Zeilberger that can be used for enhancing the teaching and learning of topics in discrete mathematics. We demonstrate by examples how one can use these computerized proof techniques to raise students' interests in the discovery and proof of mathematical identities and enhance their problem-solving skills.

  2. Inhibition of trihalomethane formation in city water by radiation-ozone treatment and rapid composting of radiation disinfected sewage sludge (United States)

    Takehisa, M.; Arai, H.; Arai, M.; Miyata, T.; Sakumoto, A.; Hashimoto, S.; Nishimura, K.; Watanabe, H.; Kawakami, W.; Kuriyama, I.

    Humic acid and Fulvic acid in natural water are precursors of carcinogenic THM which is formed during chlorine disinfection in city water processing. The radiation-oxidation process in the presence of ozone is effective to remove the precursors. The THM formation was reduced more than the decrease in TOC by the combination treatment. This is mainly due to a change in the chemical structure of the oxidation products. A composting of radiation disinfected sludge cake for agricultural reuse could be achieved within 3 days primary fermentation in a sewage plant. The rapid fermentation with use of radiation is effective to scale down of a fermentor of composting plant and the process reduces a health risk from the workers as well as final users.

  3. A new on-board imaging treatment technique for palliative and emergency treatments in radiation oncology

    Energy Technology Data Exchange (ETDEWEB)

    Held, Mareike


    This dissertation focuses on the use of on-board imaging systems as the basis for treatment planning, presenting an additional application for on-board images. A clinical workflow is developed to simulate, plan, and deliver a simple radiation oncology treatment rapidly, using 3D patient scans. The work focuses on an on-line dose planning and delivery process based on on-board images entirely performed with the patient set up on the treatment couch of the linear accelerator. This potentially reduces the time between patient simulation and treatment to about 30 minutes. The basis for correct dose calculation is the accurate image gray scale to tissue density calibration. The gray scale, which is defined in CT Numbers, is dependent on the energy spectrum of the beam. Therefore, an understanding of the physics characteristics of each on-board system is required to evaluate the impact on image quality, especially regarding the underlying cause of image noise, contrast, and non-uniformity. Modern on-board imaging systems, including kV and megavoltage (MV) cone beam (CB) CT as well as MV CT, are characterized in terms of image quality and stability. A library of phantom and patient CT images is used to evaluate the dose calculation accuracy for the on-board images. The dose calculation objective is to stay within 5% local dose differences compared to standard kV CT dose planning. The objective is met in many treatment cases. However, dose calculation accuracy depends on the anatomical treatment site. While on-board CT-based treatments of the head and extremities are predictable within 5% on all systems, lung tissue and air cavities may create local dose discrepancies of more than 5%. The image quality varies between the tested units. Consequently, the CT number-to-density calibration is defined independently for each system. In case of some imaging systems, the CT numbers of the images are dependent on the protocol used for on-board imaging, which defines the imaging dose

  4. 21 CFR 179.39 - Ultraviolet radiation for the processing and treatment of food. (United States)


    ... treatment of food. 179.39 Section 179.39 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... processing and treatment of food. Ultraviolet radiation for the processing and treatment of food may be... products Without ozone production: high fat-content food irradiated in vacuum or in an inert...

  5. Intensity modulated radiation therapy for squamous cell carcinoma of the vulva: Treatment technique and outcomes

    Directory of Open Access Journals (Sweden)

    Yuan James Rao, MD


    Conclusions: IMRT for vulvar cancer is associated with high rates of LRC in the postoperative setting and limited radiation-related toxicity. Durable LRC of disease after definitive IMRT remains challenging, and several refinements to our treatment technique are suggested.

  6. Reducing Toxicity of Radiation Treatment of Advanced Prostate Cancer (United States)


    408- mitigated mice showed lineage-balanced, long-term, multilineage potential as determined by serial bone marrow transplantation , indicative of...kappaB inhibitors alleviate and the proteasome inhibitor PS-341 exacerbates radiation toxicity in zebrafish embryos . Molecular Cancer Therapeutics 8

  7. Computerized sociometric assessment for preschool children

    NARCIS (Netherlands)

    Endedijk, H.M.; Cillessen, A.H.N.


    In preschool classes, sociometric peer ratings are used to measure children's peer relationships. The current study examined a computerized version of preschool sociometric ratings. The psychometric properties were compared of computerized sociometric ratings and traditional peer ratings for prescho

  8. Predictors of Psychosocial Adjustment During the Post-Radiation Treatment Transition


    Mazanec, Susan; Daly, Barbara J.; Douglas, Sara; Musil, Carol


    The aim of this study was to examine the role of cognitive appraisal in predicting psychosocial adjustment during the post-radiation treatment transition. A predictive correlational design was used in a convenience sample of 80 patients with breast, lung, and prostate cancer who were receiving radiation therapy. Two weeks prior to completion of treatment, subjects completed instruments to measure symptom distress, uncertainty, cognitive appraisal, social support and self-efficacy for coping. ...

  9. Granulocyte Colony-Stimulating Factor in the Treatment of Acute Radiation Syndrome: A Concise Review

    Directory of Open Access Journals (Sweden)

    Michal Hofer


    Full Text Available This article concisely summarizes data on the action of one of the principal and best known growth factors, the granulocyte colony-stimulating factor (G-CSF, in a mammalian organism exposed to radiation doses inducing acute radiation syndrome. Highlighted are the topics of its real or anticipated use in radiation accident victims, the timing of its administration, the possibilities of combining G-CSF with other drugs, the ability of other agents to stimulate endogenous G-CSF production, as well as of the capability of this growth factor to ameliorate not only the bone marrow radiation syndrome but also the gastrointestinal radiation syndrome. G-CSF is one of the pivotal drugs in the treatment of radiation accident victims and its employment in this indication can be expected to remain or even grow in the future.

  10. Treatment and prevention of acute radiation dermatitis;Traitement et prevention des radiodermites aigues

    Energy Technology Data Exchange (ETDEWEB)

    Benomar, S.; Hassam, B. [Service de dermatologie, CHU Ibn-Sina, universite Mohamed-V, Rabat (Morocco); Boutayeb, S.; Errihani, H. [Service de d' oncologie medicale, Institut national d' oncologie, Universite Mohamed-V, Rabat (Morocco); Lalya, I.; El Gueddari, B.K. [Service de radiotherapie, Institut national d' oncologie, universite Mohamed-V, Rabat (Morocco)


    Acute radiation dermatitis is a common side-effect of radiotherapy which often necessitates interruption of the therapy. Currently, there is no general consensus about its prevention or about the treatment of choice. The goal of this work was to focus on optimal methods to prevent and manage acute skin reactions related to radiation therapy and to determine if there are specific topical or oral agents for the prevention of this acute skin reaction. The prevention and the early treatment are the two focus points of the management of the acute radiation dermatitis. (authors)

  11. Experience of laser radiation for treatment of oral mucous lesions of different etiologies (United States)

    Mosesyants, Elvira N.; Zazulevskaya, Lidiya Y.; Shevtsova, Elena


    Laser irradiation use for treatment of different manifestations of oral mucous diseases during the last 10 years. The aim of this research was study of the results of use He-Ne laser radiation in combination with main therapy for treatment of oral mucous lesions of different aetiology. He-Ne laser irradiation use for radiation of lesions were caused by different aetiology reasons. Under the observation was 116 patients 20 - 64 years old, who had and hadn't background pathology. There were biochemical, immunological controls. Data of research confirmed positive effect of use He-Ne laser radiation.

  12. Effect of high-energy radiation and alkali treatment on the properties of cellulose

    Energy Technology Data Exchange (ETDEWEB)

    Foeldvary, Cs.M. E-mail:; Takacs, E.; Wojnarovits, L


    The effect of the treatment with NaOH or tetramethyl ammonium hydroxide solutions on preirradiated cotton-cellulose was investigated. Both the radiation and the treatment with alkali solutions caused loss of weight in cellulose; however, there was a synergism, a high weight loss was observed during alkali treatment of preirradiated samples. The radiation caused scissions of the cellulose chains and during the treatment with aqueous alkaline solutions some smaller fragments dissolved, resulting in a strong absorbance of the solutions with maximum at around 268 nm. It was attributed to the absorbance of aldehyde/keto groups.

  13. Computerized Systems: Centralized or Decentralized? (United States)

    Seitz, Linda Ludington


    Computerized management information systems have long been used in business, and data integration and sophisticated programing now enable many businesses to decentralize their information operations. This approach has advantages and disadvantages that colleges and universities must weigh and plan for carefully. (MSE)

  14. Hypofractionated radiation therapy for the treatment of feline facial squamous cell carcinoma; Hypofractionated radiation therapy for the treatment of feline facial squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cunha, S.C.S.; Corgozinho, K.B.; Holguin, P.G.; Ferreira, A.M.R., E-mail: [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil); Carvalho, L.A.V. [Coordenacao dos Programas de Pos-Graduacao de Engenharia (COPPE/UFRJ), Rio de Janeiro, RJ (Brazil); Canary, P.C.; Reisner, M. [Hospital Universitario Clementino Fraga Filho (HUCFF/UFRJ), Rio de Janeiro, RJ (Brazil); Pereira, A.N.; Souza, H.J.M. [Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropedica, RJ (Brazil)


    The efficacy of hypofractionated radiation protocol for feline facial squamous cell carcinoma was evaluated. Hypofractionated radiation therapy was applied to five cats showing single or multiple facial squamous cell carcinomas, in a total of ten histologically confirmed neoplastic lesions. Of the lesions, two were staged as T{sub 1}, four as T{sub 2}, two as T{sub 3}, and two as T{sub 4}. The animals were submitted to four radiation fractions from 7.6 to 10 grays each, with one week intervals. The equipment was a linear accelerator with electrons beam. The cats were evaluated weekly during the treatment and 30 and 60 days after the end of the radiation therapy. In this study, 40% of the lesions had complete remission, 40% partial remission, and 20% did not respond to the treatment. Response rates were lower as compared to other protocols previously used. However, hypofractionated radiation protocol was considered safe for feline facial squamous cell carcinoma. (author)

  15. [Clinical evaluation of the effectiveness of radiation treatment for endometrial cancer]. (United States)

    Turkevich, V G


    The study is based on data on 306 patients with endometrial cancer treated as combined (remote + contact) and only the contact exposure with low, medium and high dose rate. For comparative radiobiological evaluation of reactions of irradiated tissues there were used the following radiobiological models: factor time-dose-fractionation, the cumulative radiation effect, linear- quadratic model in the variant of biologically effective dose. Survival of endometrial cancer patients undergone combined or only the contact radiation treatment was determined by the stage of disease. In particular, the survival of patients with Stage IB endometrial cancer (combined radiation treatment) was significantly higher than in Stage IC, while in Stage IB (contact radiation treatment) was significantly higher than in Stages IC and IIB. Long-term results of radiation treatment of patients with all Stages of endometrial cancer were significantly better by 16% when only the contact radiation treatment was performed. The most preferred component of radiotherapy in women suffering from endometrial cancer with severe comorbidities was brachytherapy with high dose rate both in the combined and only contact irradiation.

  16. Development of radiation biological dosimetry and treatment of radiation-induced damaged tissue

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Chul Koo; Kim, Tae Hwan; Lee, Yun Sil [and others


    Util now, only a few methods have been developed for radiation biological dosimetry such as conventional chromosome aberration and micronucleus in peripheral blood cell. However, because these methods not only can be estimated by the expert, but also have a little limitation due to need high technique and many times in the case of radiation accident, it is very difficult to evaluate the absorbed dose of victims. Therefore, we should develop effective, easy, simple and rapid biodosimetry and its guideline(triage) to be able to be treated the victims as fast as possible. We established the apoptotic fragment assay, PCC, comet assay, and micronucleus assay which was the significant relationship between dose and cell damages to evaluate the irradiated dose as correct and rapid as possible using lymphocytes and crypt cells, and compared with chromosome dosimetry and micronucleus assay.

  17. [Use of Cone Beam Computerized Tomography (CBCT) in orthodontic diagnosis and treatment planning in the presence of a palatally-impacted canine]. (United States)

    Waugh, Robert L


    Unerupted permanent canines can present orthodontists with special challenges. Conventional two-dimensional panoramic radiographs identify the presence or absence of unerupted canines and can only help approximate their locations, when used with various classification schemes in attempts to describe their locations and estimate treatment difficulties. This article suggests using three-dimensional cone beam CT imaging as a direct objective method of evaluation and treatment planning, thereby eliminating the need for using a subjective system of classifying palatally-impacted permanent canines.


    Directory of Open Access Journals (Sweden)

    I. V. Podsonnaja


    Full Text Available Aim. To assess cognitive functions in liquidators of Chernobyl accident (LCA consequences suffering from arterial hypertension (HT and to study efficacy of their treatment with cortexin (complex of polypeptide fractions.Material and methods. 60 men (aged of 39-60 y.o., LCA with HT and cognitive disorders were included in the study. Cortexin was used (10 mg intramusculary during 10 days for one or two courses. Efficacy of treatment was estimated by neuropsychological tests (Shulte test , A.R. Lurija test, serial account, test "feeling, activity, mood", headache intensity on VAS scale before and in 10 days of treatment as well as 6 and 12 months after treatment.Results. Cortexin therapy (2 courses increased of mental processes speed and retention of information volume, reduced personal and behavioral disorders.Conclusion. Treatment with cortexin (2 courses improves cognitive functions in LCA with HT.

  19. Dietary flaxseed administered post thoracic radiation treatment improves survival and mitigates radiation-induced pneumonopathy in mice

    Directory of Open Access Journals (Sweden)

    Arguiri Evguenia


    BAL fluid revealed a significant decrease of specific inflammatory cytokines in FS-fed mice. Conclusions Dietary FS given post-XRT mitigates radiation effects by decreasing pulmonary fibrosis, inflammation, cytokine secretion and lung damage while enhancing mouse survival. Dietary supplementation of FS may be a useful adjuvant treatment mitigating adverse effects of radiation in individuals exposed to inhaled radioisotopes or incidental radiation.

  20. Dietary flaxseed administered post thoracic radiation treatment improves survival and mitigates radiation-induced pneumonopathy in mice. (United States)

    Christofidou-Solomidou, Melpo; Tyagi, Sonia; Tan, Kay-See; Hagan, Sarah; Pietrofesa, Ralph; Dukes, Floyd; Arguiri, Evguenia; Heitjan, Daniel F; Solomides, Charalambos C; Cengel, Keith A


    specific inflammatory cytokines in FS-fed mice. Dietary FS given post-XRT mitigates radiation effects by decreasing pulmonary fibrosis, inflammation, cytokine secretion and lung damage while enhancing mouse survival. Dietary supplementation of FS may be a useful adjuvant treatment mitigating adverse effects of radiation in individuals exposed to inhaled radioisotopes or incidental radiation.

  1. Counseling patients about sexual health when considering post-prostatectomy radiation treatment (United States)

    Wittmann, D; Montie, J E; Hamstra, D A; Sandler, H; Wood, D P


    Prostate cancer is the second most frequently diagnosed cancer in men in the United States. Many men with clinically localized prostate cancer survive for 15 years or more. Although early detection and successful definitive treatments are increasingly common, a debate regarding how aggressively to treat prostate cancer is ongoing because of the effect of aggressive treatment on the quality of life, including sexual functioning. We examined current research on the effect of post-prostatectomy radiation treatment on sexual functioning, and suggest a way in which patient desired outcomes might be taken into consideration while making decisions with regard to the timing of radiation therapy after prostatectomy. PMID:19609297

  2. Neutron radiation therapy: application of advanced technology to the treatment of cancer

    CERN Document Server

    Maughan, R L; Kota, C; Burmeister, J; Porter, A T; Forman, J D; Blosser, H G; Blosser, E; Blosser, G


    The design and construction of a unique superconducting cyclotron for use in fast neutron radiation therapy is described. The clinical results obtained in the treatment of adenocarcinoma of the prostate with this accelerator are presented. Future use of the boron neutron capture reaction as a means of enhancing fast neutron therapy in the treatment of patients with brain tumors (glioblastoma multiforme) is also discussed.

  3. Hyperbaric oxygen in the treatment of radiation-induced optic neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Guy, J.; Schatz, N.J.


    Four patients with radiation-induced optic neuropathies were treated with hyperbaric oxygen. They had received radiation therapy for treatment of pituitary tumors, reticulum cell sarcoma, and meningioma. Two presented with amaurosis fugax before the onset of unilateral visual loss and began hyperbaria within 72 hours after development of unilateral optic neuropathy. Both had return of visual function to baseline levels. The others initiated treatment two to six weeks after visual loss occurred in the second eye and had no significant improvement of vision. Treatment consisted of daily administration of 100% oxygen under 2.8 atmospheres of pressure for 14-28 days. There were no medical complications of hyperbaria. While hyperbaric oxygen is effective in the treatment of radiation-induced optic neuropathy, it must be instituted within several days of deterioration in vision for restoration of baseline function.

  4. Helical Electron Avoidance Radiation Therapy (HEART) for Breast Cancer Treatment (United States)


    3. K. Li, and L. Ma, "Selective Source Blocking for Treatment of Trigeminal Neuralgia Based on Analytical Gamma Knife Dose Modeling", Phys. Med. Biol...radiosurgery of trigeminal neuralgia " Appl. Clin. Med. Phy., Vol 1(4) 116-119, 2000. (2) Major Presentations 1. The 4 th Era of Hope Conference...treatment planning", Med. Phys. 31(2004) No. 6,1824. 4. L. Ma, and K. Li, " Selective source blocking for treatment of trigeminal neuralgia based on

  5. Dosimetric comparison of different radiation treatment modalities for acoustic neuromas

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Wook; Chung, Weon Kuu [Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Shin, Dong Oh [Kyung Hee Medical Center, Seoul (Korea, Republic of); Shin, Dongho [National Cancer Center, Goyang (Korea, Republic of)


    The dosimetric differences for intensity-modulatedradiotherapy (IMRT), volumetric modulated arc therapy (VMAT), proton therapy(PROTON) and stereotactic radiosurgery (SRS) in patient with acoustic neuroma (AN) were compared by using the dose-volume histogram (DVH). In the present study, we estimated the dosimetric differences for patient with AN who received different treatment modalities. In this study, we found proton therapy is relatively effective treatment techniques than the other.

  6. Radiation therapy, an important mode of treatment for head and neck chemodectomas

    Energy Technology Data Exchange (ETDEWEB)

    Verniers, D.A. (Dr. Daniel den Hoad Cancer Centre, Rotterdam (Netherlands)); Keus, R.B.; Schouwenburg, P.F.; Bartelink, H. (Nederlands Kanker Inst. ' Antoni van Leeuwenhoekhuis' , Amsterdam (Netherlands))


    Between 1970 and 1990, 22 patients with 44 chemodectomas in the head and neck region were seen at the Netherlands Cancer Institute in Amsterdam. All patients were treated with radiation therapy (17 patients with radiation therapy only and 5 in combination with surgery). One patient was treated two times with an interval of 12 years at each side of the neck. Standard dose was 50 Gy in 25 fractions over 5 weeks. A radiation portal arrangement with oblique fields with paired wedges was used most frequently. The follow-up period ranged from 1 year to 20 years. Two recurrences at 2 and 9 years after treatment were observed. The actuarial local control rate was 88% at 10 years follow-up. Comparison of the results of surgery and radiotherapy demonstrates that radiation therapy is an effective treatment modality without mutilation or severe late morbidity for chemodectomas in the head and neck region. (Author).

  7. Vacuum-UV radiation at 185 nm in water treatment--a review. (United States)

    Zoschke, Kristin; Börnick, Hilmar; Worch, Eckhard


    The vacuum-UV radiation of water results in the in situ generation of hydroxyl radicals. Low-pressure mercury vapor lamps which emit at 185 nm are potential sources of VUV radiation. The scope of this article is to give an overview of the application of VUV radiation at 185 nm for water treatment including the transformation of inorganic and organic water constituents, and the disinfection efficiency. Another focus is on the generation of ozone by VUV radiation from oxygen or air and the application of the produced ozone in combination with VUV irradiation of water in the VUV/O3 process. The advantages and limitation of the VUV process at 185 nm as well as possible applications in water treatment are outlined.

  8. Surgical treatment of radiation injuries of the colon and rectum

    Energy Technology Data Exchange (ETDEWEB)

    Jao, S.W.; Beart, R.W. Jr.; Gunderson, L.L.


    Between 1950 and 1983, radiation-induced proctitis was diagnosed proctoscopically in 720 patients at the Mayo Clinic. Sixty-two patients with severe colorectal symptoms were treated surgically. The interval from cessation of radiotherapy to onset of symptoms ranged from 3 weeks to 24 months (mean 33 months). The 62 patients underwent a total of 143 operations with 8 operative deaths (13 percent), and 40 patients (65 percent) had 61 complications. The morbidity rate was lower after colostomy alone (44 percent in 27 patients) than after more aggressive operations (80 percent in 35 patients). Transverse loop colostomy and descending colostomy were safer than sigmoid colostomy. The dissection adhesions, opening of tissue planes, and careless manipulation of intestine may result in necrosis and perforation of the intestine, bladder, or vaginal wall; these were the main causes of fecal and other internal fistulas in our study.

  9. Contribution of radiation treatment to the breast conserving therapy

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, Sho; Shibuya, Hitoshi; Matsumoto, Satoru; Hoshina, Masao (Tokyo Medical and Dental Univ. (Japan). School of Medicine); Nishi, Tsunehiro; Kawahito, Hirotsugu; Inoue, Yoshihiro; Horiuchi, Junichi


    Breast-conserving surgery followed by irradiation for the early breast cancer has become the alternative therapy to mastectomy in European countries and U.S.A., but not yet commonly employed in our country. Sixty-one breasts in 60 patients treated with the above mentioned therapy from September 1983 to April 1991 were surveyed. Although the distant metastases of bone and pleura were found in one patient about four years after the therapy, neither failure of local control nor death was disclosed among them. Moderate fibrotic change with slight telangiectsia was found in only one patient. Otherwise, late effect of radiation was generally found to be mild and acceptable. (author) 59 refs.

  10. Cerenkov radiation-induced phototherapy for depth-independent cancer treatment (Conference Presentation) (United States)

    Akers, Walter J.; Achilefu, Samuel; Kotagiri, Nalinikanth


    Light emitted as the result of high-energy particle transport through biological tissues (Cerenkov radiation) can be exploited for noninvasive diagnostic imaging using high sensitivity scientific cameras. We have investigated the energy transfer potential of Cerenkov radiation, discovering a new phototherapeutic technique for treatment of localized and disseminated cancers. This technique, Cerenkov radiation-induced phototherapy (CRIT), like photodynamic therapy, requires the presence of both light and photosensitive agent together to induce cytotoxicity and effective cancer treatment. But unlike conventional phototherapy strategies in which tissue ablation or activation of photoactive molecules is limited to superficial structures, radiation-induced phototherapy enables phototherapy delivery to the tumor sites throughout the body. Titanium oxide nanoparticles, which produce cytotoxic reactive oxygen species upon irradiation with UV light, were targeted to tumor tissue by surface decoration with transferrin. Subsequent administration of tumor-avid radiotracer, 18-fluorodeoxyglucose (18FDG) provided localized UV light source via Cerenkov radiation. Treatment of tumor-bearing mice with the combination of Titanium nanoparticles and 18FDG resulted in effective reduction in tumor growth, while individual agents were not therapeutic. This new strategy in cancer therapy extends the reach of phototherapy beyond what was previously possible, with potential for treatment of cancer metastases and rescue from treatment resistance.

  11. Emergency radiation treatment for paraplegia caused by extradural leukemic invasion; Report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Masao; Kuroda, Yasumasa; Sano, Akira (Tenri Hospital, Nara (Japan)) (and others)


    We present 2 cases of emergency radiation therapy for paraplegia caused by extradural leukemic invasion. Tumor regression was noted at 12 Gy, and complete disappearance at 20 Gy. MRI proved useful in early detection and in the follow-up. They were doing well for 14 months after irradiation. Irradiation should be the treatment of first choice for these tumors, and the detail such as radiation field, total dosage should be determined in consideration of other therapeutic measures. (author).

  12. Exploration of computerized image processing in underexposed and overexposed X-rays of bones and joints

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhao-chen; ZHANG You-jun; FENG Cheng-qiang; ZHU Yuan-zhong; YAN Shi-yi; LIU Yu-jin


    Objective: To study the effective computerized image processing of underexposed and overexposed X-rays of bones and joints. Methods: Ninety-nine conventional X-ray images (82 were overexposed and 17 were underexposed),scanned by an UMAX Astra 4000U Scanner, were converted into digital images on the basis of their analog images. A computerized imaging processing program consisting of five functional modules such as Contrast Stretch, Fast Flourier Transform (FFT), Image Smoothing Modules, Inverse Fast Flourier Transform (IFFT) and Nonlinear Transform performed image contrast stretch and smoothing. Three senior doctors from hospital image sections made their evaluation of all the processed images. Results: Of 82 overexposed films, 71 met the clinical requirements after image processing, and 11 were unable to be applied to clinical diagnosis, accounting for 87% and 13% respectively. Of the other 17 underexposed X-ray images, 11 met the clinical requirements while 6 were not, making a percentage of 64 and 35. Conclusion: Image contrast stretch and smoothing processing are significantly effective on conventional X-ray images which were inappropriately exposed, and can avoid more X-ray radiation caused by handling of radiological photograph again. This method can decrease hospital cost and provide acute and effective X-ray examinations for the treatment and cure for critical patients.

  13. Computerized tomography. Yesterday and today

    Energy Technology Data Exchange (ETDEWEB)

    Ethier, R.; Melanson, D. (Montreal Neurological Inst., Quebec (Canada))


    This presentation describes the evolution of computerized tomography over the past decade and its contribution to the radiologic investigation of neurologic disorders. This new technique has not only stimulated development in the diagnosis of cerebral diseases, but the whole body as well. Detailed investigation of the spine, spinal cord, sella turcica, the orbits, as well as the petrous pyramids has been made possible through the development of high resolution scanning.

  14. Pelvic radiation - discharge (United States)

    Radiation of the pelvis - discharge; Cancer treatment - pelvic radiation; Prostate cancer - pelvic radiation; Ovarian cancer - pelvic radiation; Cervical cancer - pelvic radiation; Uterine cancer - pelvic radiation; Rectal cancer - pelvic radiation

  15. Cancer patients with cardiac pacemakers needing radiation treatment: A systematic review

    Directory of Open Access Journals (Sweden)

    Anusheel Munshi


    Full Text Available With improving average life expectancy of individuals in most countries, there has been increase in the incidence of cardiovascular diseases and cancers. Radiation oncologists therefore are likely to encounter an increasing number of cancer patients with in situ cardiac pacemaker devices needing radiation treatments. Pacemaker technology has advanced rapidly in recent years. As a result, the potential interactions of these devices with radiation therapy have changed since American Association of Physicists in Medicine (AAPM issued guidelines in 1994. Current approaches to treatment in patients who have these devices vary among radiation oncology centers. Furthermore, the recommendations given by the devices′ manufacturers differ considerably. Common knowledge about pacemaker in radiation oncology community is vital as radiation management needs to be tailored to individual patients in accordance to the information of available for the device. Some general practical guidelines can be gleaned from the literature. It is felt that more robust information is required using web based database sharing to develop total safe practice guidelines in such patients. This article reviews the information available to help create such guidelines and presents recommendations for treatment in this increasingly common clinical situation.

  16. Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a {sup 60}Co Magnetic Resonance Image Guidance Radiation Therapy System

    Energy Technology Data Exchange (ETDEWEB)

    Wooten, H. Omar, E-mail:; Green, Olga; Yang, Min; DeWees, Todd; Kashani, Rojano; Olsen, Jeff; Michalski, Jeff; Yang, Deshan; Tanderup, Kari; Hu, Yanle; Li, H. Harold; Mutic, Sasa


    Purpose: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating {sup 60}Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. Methods and Materials: The ViewRay treatment planning system (Oakwood Village, OH) was used to create {sup 60}Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The {sup 60}Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. Results: All {sup 60}Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for {sup 60}Co was within <1% and 3% of linac plans for 100% and 95% prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range <20 Gy, but comparable sparing for organs with mean doses >20 Gy. The mean doses for all {sup 60}Co plan OARs were within clinical tolerances. Conclusions: A commercial {sup 60}Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system.

  17. Radation distribution in head & thorax computerized tomography

    Directory of Open Access Journals (Sweden)

    Mohammad Mahdavi


    Full Text Available Background: Determination of the exposure levels in the computerized tomography (CT practices is necessary to define the respected national reference levels, quality control of CT centers and the risk assessment for radiation induced cancers. Material and Methods: On the basis of this necessity, the radiation exposure distribution due to common CT practices has been investigated at Razi Hospital CT center in Rasht using tissue-equivalent phantoms and the thermoluminescent dosimeters (TLD. The Head and Thorax phantoms were used with the standard dimensions incorporating holes at the center and edges for TLD placement. Dosimetry was carried out using LiF Mg, Cu, P small chips due to their relatively tissue equivalence, high sensitivity convenient annealing procedure and the non-complex glow curve. Results: Results showed that CTDI for Head is 52.85 mGy and for Body is 68.15mGy. CTDLW for Head is 13.67 mGy and for Body is 16.94mGy . Conclusion: In comparison with other radiographical procedures, patient absorbed doses in CT imaging are usually very high. Content of dose is increased by increase of mAs.

  18. Computerized history-taking as a tool to manage dyslipidemia. (United States)

    Zakim, David; Fritz, Christine; Braun, Niko; Fritz, Peter; Alscher, M Dominik


    Validated guidelines to manage low-density lipoprotein (LDL)-cholesterol are utilized inconsistently or not at all even though their application lowers the incidence of coronary events. New approaches are needed, therefore, to implement these guidelines in everyday practice. We compared an automated method for applying The National Cholesterol Education Panel (NCEP) guidelines with results from routine care for managing LDL-cholesterol. The automated method comprised computerized history-taking and analysis of historical data without physician input. Results from routine care were determined for 213 unselected patients and compared with results from interviews of the same 213 patients by a computerized history-taking program. Data extracted from hospital charts showed that routine care typically did not collect sufficient information to stratify risk and assign treatment targets for LDL-cholesterol and that there were inconsistencies in identifying patients with normal or elevated levels of LDL-cholesterol in relation to risk. The computerized interview program outperformed routine care in collecting historical data relevant to stratifying risk, assigning treatment targets, and clarifying the presence of hypercholesterolemia relative to risk. Computerized history-taking coupled with automated analysis of the clinical data can outperform routine medical care in applying NCEP guidelines for stratifying risk and identifying patients with hypercholesterolemia in relation to risk.

  19. Formalin treatment of radiation-induced hemorrhagic proctitis

    Energy Technology Data Exchange (ETDEWEB)

    Rubinstein, E.; Ibsen, T.; Rasmussen, R.B.; Reimer, E.; Sorensen, B.L.


    A 71-year-old man developed severe hemorrhagic proctitis 1 year after pelvic irradiation for carcinoma of the urinary bladder. Conservative treatment as well as performance of a colostomy failed to control the rectal bleeding. After irrigation of the rectum with a formalin solution the bleeding stopped, and no recurrence has been observed for the next 14 months.

  20. Imaging-Based Treatment Adaptation in Radiation Oncology

    NARCIS (Netherlands)

    Troost, E.G.; Thorwarth, D.; Oyen, W.J.G.


    In many tumor types, significant effort is being put into patient-tailored adaptation of treatment to improve outcome and preferably reduce toxicity. These opportunities first arose with the introduction of modern irradiation techniques (e.g., intensity-modulated radiotherapy) combined with function

  1. A comparison of the standard and the computerized versions of the Well-being Questionnaire (WBQ) and the Diabetes Treatment Satisfaction Questionnaire (DTSQ)

    DEFF Research Database (Denmark)

    Pouwer, F; Snoek, Frank J; Van Der Ploeg, Henk M


    the computer and the paper and pencil version of the Well-being Questionnaire (WBQ) and the Diabetes Treatment Satisfaction Questionnaire (DTSQ) in a randomized order, with a mean interval of 7 days. The scales showed high test-retest correlations and the means, dispersions, kurtosis and skewness were found...... to be approximately the same in both versions. In both modes of assessment, the depression and the energy scale proved to be sensitive for carry-over effects, resulting in better well-being scores at the second measurement. Almost all subjects reported that using the personal computer in the realization...

  2. Systematic review of hyperbaric oxygen therapy for the treatment of radiation-induced skin necrosis. (United States)

    Borab, Zachary; Mirmanesh, Michael D; Gantz, Madeleine; Cusano, Alessandro; Pu, Lee L Q


    Every year, 1.2 million cancer patients receive radiation therapy in the United States. Late radiation tissue injury occurs in an estimated 5-15% of these patients. Tissue injury can include skin necrosis, which can lead to chronic nonhealing wounds. Despite many treatments available to help heal skin necrosis such as hyperbaric oxygen therapy, no clinical guidelines exist and evidence is lacking. The purpose of this review is to identify and comprehensively summarize studies published to date to evaluate the effectiveness of hyperbaric oxygen therapy for the treatment of radiation-induced skin necrosis. Adhering to PRISMA guidelines, a systematic review of currently published articles was performed, evaluating the use of hyperbaric oxygen to treat skin necrosis. Eight articles were identified, including one observational cohort, five case series, and two case reports. The articles describe changes in symptoms and alteration in wound healing of radiation-induced skin necrosis after treatment with hyperbaric oxygen therapy. Hyperbaric oxygen therapy is a safe intervention with promising outcomes; however, additional evidence is needed to endorse its application as a relevant therapy in the treatment of radiation-induced skin necrosis.

  3. Ionizing radiation treatment to improve postharvest life and maintain quality of fresh guava fruit (United States)

    Singh, S. P.; Pal, R. K.


    We investigated the potential of ionizing radiation for improving physiological responses, quality, and storage time of fresh guava fruit. Ionizing radiation treatment suppressed the respiration and ethylene production rates and thus retarded the process of fruit ripening during storage. Irradiation treatment also retarded the physical and biochemical changes associated with ripening such as firmness, titratable acidity, soluble solids content, and vitamin C during storage, but for doses higher than 0.25 kGy the vitamin C content decreased. The positive effects of ionizing radiation treatment on delayed fruit ripening and other quality attributes diminished during 22 days of storage at 10 °C. Thus, a combination of ionizing radiation with low-temperature storage (10 °C) did not have much synergistic effect on storage life and quality of guava fruit. In conclusion, ionizing radiation treatment of guava fruit with 0.25 kGy dose increased the postharvest life by 3-4 days, maintained fruit quality, and reduced the decay incidence. The optimal dose (0.25 kGy) for postharvest life extension of guava fruit may be exploited to provide phytosanitary security against many insect pests including fruit flies.

  4. Ionizing radiation treatment to improve postharvest life and maintain quality of fresh guava fruit

    Energy Technology Data Exchange (ETDEWEB)

    Singh, S.P. [Handling and Storage Laboratory, Division of Postharvest Technology, Indian Agricultural Research Institute (IARI), Pusa, New Delhi 110 012 (India)], E-mail:; Pal, R.K. [Handling and Storage Laboratory, Division of Postharvest Technology, Indian Agricultural Research Institute (IARI), Pusa, New Delhi 110 012 (India)


    We investigated the potential of ionizing radiation for improving physiological responses, quality, and storage time of fresh guava fruit. Ionizing radiation treatment suppressed the respiration and ethylene production rates and thus retarded the process of fruit ripening during storage. Irradiation treatment also retarded the physical and biochemical changes associated with ripening such as firmness, titratable acidity, soluble solids content, and vitamin C during storage, but for doses higher than 0.25 kGy the vitamin C content decreased. The positive effects of ionizing radiation treatment on delayed fruit ripening and other quality attributes diminished during 22 days of storage at 10 deg. C. Thus, a combination of ionizing radiation with low-temperature storage (10 deg. C) did not have much synergistic effect on storage life and quality of guava fruit. In conclusion, ionizing radiation treatment of guava fruit with 0.25 kGy dose increased the postharvest life by 3-4 days, maintained fruit quality, and reduced the decay incidence. The optimal dose (0.25 kGy) for postharvest life extension of guava fruit may be exploited to provide phytosanitary security against many insect pests including fruit flies.

  5. On radiation damage to normal tissues and its treatment. Pt. 2; Anti-inflammatory drugs

    Energy Technology Data Exchange (ETDEWEB)

    Michalowski, A.S. (MRC Cyclotron Unit, Hammersmith Hospital, London (United Kingdom))


    In addition to transiently inhibiting cell cycle progression and sterilizing those cells capable of proliferation, irradiation disturbs the homeostasis effected by endogenous mediators of intercellular communication (humoral component of tissue response to radiation). Changes in the mediator levels may modulate radiation effects either by a assisting a return to normality (e.g., through a rise in H-type cell lineage-specific growth factors) or by aggravating the damage. The latter mode is illustrated with reports on changes in eicosanoid levels after irradiation and on results of empirical treatment of radiation injuries with anti-inflammatory drugs. Prodromal, acute and chronic effects of radiation are accompanied by excessive production of eicosanoids (prostaglandins, prostacyclin, thromboxanes and leukotrienes). These endogenous mediators of inflammatory reactions may be responsible for the vasodilatation, vasoconstriction, increased microvascular permeability, thrombosis and chemotaxis observed after radiation exposure. Glucocorticoids inhibit eicosanoid synthesis primarily by interfering with phospholipase A[sub 2] whilst non-steroidal anti-inflammatory drugs prevent prostaglandin/thromboxane synthesis by inhibiting cycloxygenase. When administered after irradiation on empirical grounds, drugs belonging to both groups tend to attenuate a range of prodomal, acute and chronic effects of radiation in man and animals. Taken together, these two sets of observations are highly suggestive of a contribution of humoral factors to the adverse responses of normal tissues and organs to radiation. A full account of radiation damage should therefore consist of complementary descriptions of cellular and humoral events. Further studies on anti-inflammatory drug treatment of radiation damage to normal organs are justified and desirable. (orig.).

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  7. Prophylactic treatment with a potent corticosteroid cream ameliorates radiodermatitis, independent of radiation schedule

    DEFF Research Database (Denmark)

    Ulff, Eva; Maroti, Marianne; Serup, Jörgen;


    schedules as well as for anatomical sites, skin type, breast size and BMI. Patients treated the irradiated area during the radiation period and two weeks following cessation of radiation. RESULTS: Patients receiving hypofraction RT developed less skin reactions than those treated with conventional RT...... in patients with breast cancer receiving adjuvant radiotherapy (RT) after surgery. In total, 202 patients were randomized to betamethasone-17-valerate cream or Essex® cream, a moisturizer. Treatment was assessed by RTOG clinical scoring. Patients' symptoms were recorded. The analyses were stratified for RT....... Treatment with a potent steroid resulted in clinically and statistically significantly less skin reactions (p

  8. Pelvic complications after definitive treatment of prostate cancer by interstitial or external beam radiation

    Energy Technology Data Exchange (ETDEWEB)

    Schellhammer, P.F.; El-Mahdi, A.M.


    Radiation complications, after definitive treatment of localized prostatic carcinoma by either external beam or interstitial implantation with Iodine-125 seeds, are reviewed. Late serious complications to immediately adjacent structures of the anterior rectal wall, prostatic urethra, bladder neck, and external sphincter occurred with similar frequency in both treatment groups. However, late serious complications of the remotely adjacent structures of the bladder, urethra, distal ureters, and circumferential rectal wall occurred more frequently in the external beam treatment series, a reflection of the fact that larger tissue volumes were irradiated. Rectal ulceration, while occurring in both treatment groups, was amenable to surgical correction or underwent spontaneous healing only in the 125I group. At this point in our experience, morbidity from late radiation complications has been less among those patients having interstitial implantation for definitive treatment of localized prostatic carcinoma.

  9. Radiation Therapy for the Treatment of Recurrent Glioblastoma: An Overview

    Energy Technology Data Exchange (ETDEWEB)

    Amelio, Dante; Amichetti, Maurizio, E-mail: [ATreP-Agenzia Provinciale per la Protonterapia, Via F.lli Perini 181, Trento 38122 (Italy)


    Despite the therapeutic advances in neuro-oncology, most patients with glioblastoma ultimately experience local progression/relapse. Re-irradiation has been poorly viewed in the past, mainly due to the overestimated risk of side effects using conventional radiotherapy. To date, thanks to the improvement of several delivery techniques, together with improved imaging capabilities, re-irradiation is a viable salvage treatment option to manage such clinical scenario. A literature overview on the feasibility and efficacy of the different irradiation modalities for recurrent glioblastoma along with considerations on areas of improvement are provided.

  10. [Brain metastases: Focal treatment (surgery and radiation therapy) and cognitive consequences]. (United States)

    Reygagne, Emmanuelle; Du Boisgueheneuc, Foucaud; Berger, Antoine


    Brain metastases represent the first cause of malignant brain tumor. Without radiation therapy, prognosis was poor with fast neurological deterioration, and a median overall survival of one month. Nowadays, therapeutic options depend on brain metastases presentation, extra brain disease, performance status and estimated prognostic (DS GPA). Therefore, for oligometastatic brain patients with a better prognosis, this therapeutic modality is controversial. In fact, whole-brain radiation therapy improves neurological outcomes, but it can also induce late neuro-cognitive sequelae for long-term survivors of brain metastases. Thus, in this strategy for preserving good cognitive functions, stereotactic radiation therapy is a promising treatment. Delivering precisely targeted radiation in few high-doses in one to four brain metastases, allows to reduce radiation damage to normal tissues and it should allow to decrease radiation-induced cognitive decline. In this paper, we will discuss about therapeutic strategies (radiation therapy and surgery) with their neuro-cognitive consequences for brain metastases patients and future concerning preservation of cognitive functions. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  11. Extrapleural pneumonectomy, photodynamic therapy and intensity modulated radiation therapy for the treatment of malignant pleural mesothelioma. (United States)

    Du, Kevin L; Both, Stefan; Friedberg, Joseph S; Rengan, Ramesh; Hahn, Stephen M; Cengel, Keith A


    Intensity modulated radiation therapy (IMRT) has recently been proposed for the treatment of malignant pleural mesothelioma (MPM). Here, we describe our experience with a multimodality approach for the treatment of mesothelioma, incorporating extrapleural pneumonectomy, intraoperative photodynamic therapy and postoperative hemithoracic IMRT. From 2004-2007, we treated 11 MPM patients with hemithoracic IMRT, 7 of whom had undergone porfimer sodium-mediated PDT as an intraoperative adjuvant to surgical debulking. The median radiation dose to the planning treatment volume (PTV) ranged from 45.4-54.5 Gy. For the contralateral lung, V20 ranged from 1.4-28.5%, V5 from 42-100% and MLD from 6.8-16.5 Gy. In our series, 1 patient experienced respiratory failure secondary to radiation pneumonitis that did not require mechanical ventilation. Multimodality therapy combining surgery with increased doses of radiation using IMRT, and newer treatment modalities such as PDT , appears safe. Future prospective analysis will be needed to demonstrate efficacy of this approach in the treatment of malignant mesothelioma. Efforts to reduce lung toxicity and improve dose delivery are needed and provide the promise of improved local control and quality of life in a carefully chosen multidisciplinary approach.

  12. Excited atoms in the free-burning Ar arc: treatment of the resonance radiation (United States)

    Golubovskii, Yu; Kalanov, D.; Gortschakow, S.; Baeva, M.; Uhrlandt, D.


    The collisional-radiative model with an emphasis on the accurate treatment of the resonance radiation transport is developed and applied to the free-burning Ar arc plasma. This model allows for analysis of the influence of resonance radiation on the spatial density profiles of the atoms in different excited states. The comparison of the radial density profiles obtained using an effective transition probability approximation with the results of the accurate solution demonstrates the distinct impact of transport on the profiles and absolute densities of the excited atoms, especially in the arc fringes. The departures from the Saha-Boltzmann equilibrium distributions, caused by different radiative transitions, are analyzed. For the case of the DC arc, the local thermodynamic equilibrium (LTE) state holds close to the arc axis, while strong deviations from the equilibrium state on the periphery occur. In the intermediate radial positions the conditions of partial LTE are fulfilled.

  13. Modeling of the radiative field in complex geometries using computerized graphical tools. Application to comfort characterization in environments equipped with important radiative sources; Modelisation du champ radiatif dans des geometries complexes a l`aide d`outils infographiques. Application a la caracterisation du confort dans les ambiances munies de sources radiatives importantes

    Energy Technology Data Exchange (ETDEWEB)

    Manolescu, M.; Sperandio, M.; Allard, F. [La Rochelle Universite, 17 - La Rochelle, LEPTAB (France)


    Bibliographic studies in the domain of radiant heat transfers in complex geometries demonstrate the impossibility of resolving such problems using classical analytical methods. The numerical analysis can theoretically be performed successfully but requires enormous computer means. The contribution of this study consists in using computerized graphical techniques to treat general problems of radiant heat transfers in complex geometries. This paper presents the model used, the calculation technique and the optimizations that allow to greatly reduce the computer memory required and the calculation time. The code developed uses evocative images for the synthetic presentation of results which facilitate the searcher`s and conceiver`s choices. Finally, an application to the characterization of thermal comfort in residential environments is developed to illustrate the potentialities of this method. (J.S.) 19 refs.

  14. Surgical treatment of radiation induced injuries of the intestine

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, E.H.; Symmonds, R.E.


    In the patient who has received high dose irradiation of the pelvis and abdomen, all abdominopelvic operations should be avoided, unless it is absolutely essential. Persisting obstruction, hemorrhage, intestinal perforation with peritonitis and with abscess and fistula formation are valid indications for surgical intervention. Ninety-three patients have been operated upon for these complications after irradiation. Some anastomotic dehiscence occurred in ten patients. Six operative deaths occurred. Of the 93 patients, 65 were managed by means of complete resection of the involved segment of intestine, followed by restoration of intestinal continuity by means of an end-to-end anastomosis. This is the treatment of choice when the involved area can be safely resected. In the absence of actual intestinal necrosis and when segments of strictured small intestine are adherent deep in the pelvis, and intestinal bypass procedure may represent the treatment of choice. This was accomplished in 20 patients, two of whom eventually required a second operation for resection of the bypassed segment of intestine.

  15. Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

    Energy Technology Data Exchange (ETDEWEB)

    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: [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)


    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.

  16. Which place for stem cell therapy in the treatment of acute radiation syndrome?

    Directory of Open Access Journals (Sweden)

    Jean-François Mayol


    Full Text Available Radiation-induced (RI tissue injuries can be caused by radiation therapy, nuclear accidents or radiological terrorism. Notwithstanding the complexity of RI pathophysiology, there are some effective approaches to treatment of both acute and chronic radiation damages. Cytokine therapy is the main strategy capable of preventing or reducing the acute radiation syndrome (ARS, and hematopoietic growth factors (GF are particularly effective in mitigating bone marrow (BM aplasia and stimulating hematopoietic recovery. However, first, as a consequence of RI stem and progenitor cell death, use of cytokines should be restricted to a range of intermediate radiation doses (3 to 7 Gy total body irradiation. Second, ARS is a global illness that requires treatment of damages to other tissues (epithelial, endothelial, glial, etc., which could be achieved using pleiotropic or tissue-specific cytokines. Stem cell therapy (SCT is a promising approach developed in the laboratory that could expand the ability to treat severe radiation injuries. Allogeneic hematopoietic stem cell transplantation (BM, mobilized peripheral blood and cord blood transplantation has been used in radiation casualties with variable success due to limiting toxicity related to the degree of graft histocompatibility and combined injuries. Ex vivo expansion should be used to augment cord blood graft size and/or promote very immature stem cells. Autologous SCT might also be applied to radiation casualties from residual hematopoietic stem and progenitor cells (HSPC. Stem cell plasticity of different tissues such as liver or skeletal muscle, may also be used as a source of hematopoietic stem cells. Finally, other types of stem cells such as mesenchymal, endothelial stem cells or other tissue committed stem cells (TCSC, could be used for treating damages to nonhematopoietic organs.

  17. Role of the Technical Aspects of Hypofractionated Radiation Therapy Treatment of Prostate Cancer: A Review

    Energy Technology Data Exchange (ETDEWEB)

    Clemente, Stefania, E-mail: [Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata Rionero in Vulture, Potenza (Italy); Nigro, Roberta [Azienda Sanitaria Locale Rieti, Roma (Italy); Oliviero, Caterina [Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata Rionero in Vulture, Potenza (Italy); Marchioni, Chiara [Azienda Sanitaria Locale Rieti, Roma (Italy); Esposito, Marco [Azienda Sanitaria, Firenze (Italy); Giglioli, Francesca Romana [Azienda Ospedaliera Città della Salute e della Scienza di Torino, Torino (Italy); Mancosu, Pietro [Humanitas Clinical and Research Hospital, Rozzano, Milano (Italy); Marino, Carmelo [Humanitas Centro Catanese di Oncologia, Catania (Italy); Russo, Serenella [Azienda Sanitaria, Firenze (Italy); Stasi, Michele [Azienda Ospedaliera Ordine Mauriziano di Torino, Torino (Italy); Strigari, Lidia [Istituto Nazionale Tumori Regina Elena, Roma (Italy); Veronese, Ivan [Universita' degli Studi di Milano, Milano (Italy); Landoni, Valeria [Istituto Nazionale Tumori Regina Elena, Roma (Italy)


    The increasing use of moderate (<35 fractions) and extreme (<5 fractions) hypofractionated radiation therapy in prostate cancer is yielding favorable results, both in terms of maintained biochemical response and toxicity. Several hypofractionation (HF) schemes for the treatment of prostate cancer are available, although there is considerable variability in the techniques used to manage intra-/interfraction motion and deliver radiation doses. We performed a review of the published studies on HF regimens as a topic of interest for the Stereotactic Ablative Radiotherapy working group, which is part of the Italian Association of Medical Physics. Aspects of organ motion management (imaging for contouring, target volume definition, and rectum/bladder preparation) and treatment delivery (prostate localization, image guided radiation therapy strategy and frequency) were evaluated and categorized to assess outcome relative to disease control and toxicity. Despite the heterogeneity of the data, some interesting trends that emerged from the review might be useful in identifying an optimum HF strategy.

  18. Assessment of computerized treatment planning system accuracy in calculating wedge factors of physical wedged fields for 6 MV photon beams. (United States)

    Muhammad, Wazir; Maqbool, Muhammad; Shahid, Muhammad; Hussain, Amjad; Tahir, Sajjad; Matiullah; Rooh, Gul; Ahmad, Tanveer; Lee, Sang Hoon


    Wedge filters are commonly used in external beam radiotherapy to achieve a uniform dose distribution within the target volume. The main objective of this study was to investigate the accuracy of the beam modifier algorithm of Theraplan plus (TPP version 3.8) treatment planning system and to confirm that either the beam hardening, beam softening and attenuation coefficients along with wedge geometry and measured wedge factor at single depth and multiple fields sizes can be the replacement of wedged profile and wedged cross-sectional data or not. In this regard the effect of beam hardening and beam softening was studied with physical wedges for 6 MV photons. The Normalized Wedge Factors (NWFs) were measured experimentally as well as calculated with the Theraplan plus, as a function of depth and field size in a water phantom for 15°, 30°, 45°, and 60° wedge filters. The beam hardening and softening was determined experimentally by deriving the required coefficients for all wedge angles. The TPP version 3.8 requires wedge transmission factor at single depth and multiple field sizes. Without incorporating the hardening and softening coefficients the percent difference between measured and calculated NFWs was as high as 7%. After the introduction of these parameters into the algorithm, the agreement between measured and TPP (V 3.8) calculated NWFs were improved to within 2 percent for various depths. Similar improvement was observed in TPP version 3.8 while calculating NWFs for various field sizes when the required coefficients were adjusted. In conclusion, the dose calculation algorithm of TPP version 3.8 showed good accuracy for a 6 MV photon beam provided beam hardening and softening parameters are taken into account. From the results, it is also concluded that, the beam hardening, beam softening and attenuation coefficients along with wedge geometry and measured wedge factor at single depth and multiple fields sizes can be the replacement of wedged profile and

  19. Synergistic effect of ionizing radiation on chemical disinfectant treatments for reduction of natural microflora on seafood (United States)

    Kim, Hyunjoo; Ha, Ji-Hyoung; Lee, Ju-Woon; Jo, Cheorun; Ha, Sang-Do


    The purpose of this study was to determine whether combined treatments would produce synergistic disinfection effects on seafood products such as mussel and squid compared with single treatments. We investigated the bactericidal effects of chlorine and ionizing radiation on the natural microflora of mussel and squid. Total aerobic bacteria initially ranged from 102 to 104 Log CFU/g. More than 100 ppm of chlorine and irradiation at 1 kGy were sufficient to reduce the total aerobic bacteria on mussel and squid to a level lower than detection limit (10 CFU/g). Synergistic effects against natural microflora were observed for all combined treatment. These results suggest that a significant synergistic benefit results from combine chlorine-ionizing radiation treatment against natural microflora on mussel and squid.

  20. Evaluation of stability using Monte Carlo Simulation in 2 people isolation treatment room of radiation iodine

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Dong Gun [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer center, Busan (Korea, Republic of); Ko, Sung Jin; KIm, Chang Soo; Kim, Jung Hoon [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)


    Radioactive iodine treatment that uses the 2 people isolation room is to cause unnecessary radiation exposure between patients. This research is to be tested safety of 2 people Isolation treatment room and dose-rate through conservative perspective except physiology characteristic and biology information on the assumption that patient have iodine without excretion in 2 people isolation treatment room. This research shows that 364 keV gamma rays emitted by the radioiodine was to determine that the air layer about 30 cm or lead shield 3 mm a half-layer. In addition, In addition, patients in the distance, and lead shielding, length of hospital stay (48 hours) for external radiation exposure that is received from the other patients, two of treatment as appears to be lower than the legal isolation standard dose less than 5 mSv isolation room effective analyzed that manageable.

  1. In Vivo Imaging of Microglia Turnover in the Mouse Retina After Ionizing Radiation and Dexamethasone Treatment

    DEFF Research Database (Denmark)

    Alt, C.; Runnels, J. M.; Mortensen, L. J.;


    examine if anti-inflammatory treatment can mitigate the radiation-induced turnover of retinal microglia and the replacement by bone marrow-derived cells (BMDCs). METHODS. Two-color chimeric mice were generated by lethal irradiation of heterozygous CX3CR1-GFP mice that express GFP in microglial cells...... to the microglia loss, resulting in a transient depletion of the total immune cell number in the retina. With dexamethasone treatment, both the loss of the resident microglia and the infiltration of BMDCs were suppressed by at least 50%. CONCLUSIONS. Anti-inflammatory treatment with the corticosteroidal agent......PURPOSE. Gamma irradiation and bone marrow transplantation (BMT) are established clinical procedures for the treatment of hematologic malignancies. The radiation targets cells in the bone marrow, but injury to other tissues, including the central nervous system (CNS), have been reported. Here, we...

  2. A computerized track detector reader

    Energy Technology Data Exchange (ETDEWEB)

    Rosinski, S.W. (Centralne Lab. Ochrony Radiologicznej, Warsaw (Poland))


    The structure and basic operation function of a computerized facility named Track Detection Reader is described. This facility is used for recording, counting and evaluation of defects made by [alpha]-particles in a solid state detector. It consists of a microscope equipped with the movable stage, a TV screen and PC-AT computer. The microscope stage is being controlled by a stepper motor. The TV screen enables surface visualization of the detector analyzed while the PC-AT computer is being used for digital analysis of the detector surface, according to the functions of the program. (author). 4 refs, 3 figs.

  3. Development of a technique for environmental treatment by radiation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myun Joo; Jin, J. H.; Jung, Y. D. and others


    This study was carried out for the development of pilot plant which can produce industrial water from effluent of sewage treatment plant by irradiation. As a basic study, the characteristics on decomposition of organic compounds, decoloration and sterilization of bacteria were evaluated. An additive mainly composed by sponge type of TiO{sub 2} was developed for reduction of irradiation dose and enhancement of removal efficiency of organic compounds. The optimum pilot plant was composed of sysem with gamma irradiation/ozone/additive/ion exchange. The effluent with BOD 20 ppm, COD 25 ppm and color 25 ADMI could be treated to less than 5 ppm and 5 ADMI under the irradiation of 5 kGy. The disinfection of microorganism also could be done perfectively under the same irradiation. A small amount of heavy metal ions and inorganic ions, nitrogen, contained in effluent were removed by ion exchanger. From the operation of pilot plant it could be concluded that irradiation technique can be a good method for the produce of industrial water from effluent.

  4. Radiation oncology--linking technology and biology in the treatment of cancer. (United States)

    Coleman, C Norman


    Technical advances in radiation oncology including CT-simulation, 3D- conformal and intensity-modulated radiation therapy (IMRT) delivery techniques, and brachytherapy have allowed greater treatment precision and dose escalation. The ability to intensify treatment requires the identification of the critical targets within the treatment field, recognizing the unique biology of tumor, stroma and normal tissue. Precision is technology based while accuracy is biologically based. Therefore, the intensity of IMRT will undoubtedly mean an increase in both irradiation dose and the use of biological agents, the latter considered in the broadest sense. Radiation oncology has the potential and the opportunity to provide major contributions to the linkage between molecular and functional imaging, molecular profiling and novel therapeutics for the emerging molecular targets for cancer treatment. This process of 'credentialing' of molecular targets will require multi disciplinary imaging teams, clinicians and basic scientists. Future advances will depend on the appropriate integration of biology into the training of residents, continuing post graduate education, participation in innovative clinical research and commitment to the support of basic research as an essential component of the practice of radiation oncology.

  5. Application of Hydrocyclone and UV Radiation as a Ballast Water Treatment Method

    Directory of Open Access Journals (Sweden)

    Željko Kurtela


    Full Text Available The ballast water exchange methods in open sea are, for the time being, the prevailing procedures accepted by shipowners. However, such methods do not guarantee full efficacy in elimination of allochthonous organisms. Besides, in some navigation zones, in particular in the closed seas, not even the criteria prescribed by international regulations can be fulfilled, i.e. the position of a ship exchanging ballast must be farther than 200Nm from the shore (alternatively 50Nm at the sea depth exceeding 200m. Numerous research attempts on various treatment methods lead to the conclusion that there is still no scientific opinion on the final choice of methods for wide application on board. The treatment methods, such as hydrocyclone separation in the first stage and UV radiation in the second stage, stand a good chance for application on board. Advantages of such a combined method are in the very application of treatment that can be performed during all stages of ballast water treatment, i.e. loading ballast, voyage in ballast and discharging ballast. In closed seas and on shorter routes the operational advantages of hydrocyclone and UV radiation could be the prevailing factor for application. Within the research on the possible application of ballast water treatment by hydrocyclone and UV radiation, a pilot plant with hydrocyclone cluster and UV device was constructed. The research carried out on the pilot plant installed on board the m/v ‘’Naše more’’ proved the effectiveness of such ballast water treatment method and offered a new approach in using hydrocyclone for the inactivation of organisms by hydrodynamic forces. This approach has largely increased the efficacy of the device and a new method for utilization of hydrocyclone in ballast water treatment on board has been discovered. KEY WORDS: ballast water treatment, hydrocyclone, UV radiation, application of method, pilot plant, hydrodynamic forces

  6. Successful radiation treatment of chylous ascites following pancreaticoduodenectomy

    Energy Technology Data Exchange (ETDEWEB)

    Corradini, Stefanie; Niemoeller, Olivier M. [University of Munich, Department of Radiation Oncology, Munich (Germany); Liebig, Sylke [Gemeinschaftspraxis Prof. Zwicker and Partner, Konstanz (Germany); Zwicker, Felix [Gemeinschaftspraxis Prof. Zwicker and Partner, Konstanz (Germany); German Cancer Research Center (DKFZ), Clinical Cooperation Unit Molecular and Radiation Oncology, Heidelberg (Germany); Lamade, Wolfram [Helios Privatklinik, Allgemein- and Viszeralchirurgie, Ueberlingen (Germany)


    Chylous ascites is a rare complication following pancreaticoduodenectomy. We report on a case of chylous ascites following pancreaticoduodenectomy in a 76-year-old patient diagnosed with pancreatic cancer. There are various known conservative management strategies, including dietary measures or total parenteral nutrition. Unfortunately, conservative treatment - with total parenteral nutrition and fasting over a period of 4 weeks - was not successful in the present case. The daily output volume of chylous ascites was up to 2500 ml/day. Based on clinical experiences with successfully treated lymphocutaneous fistulas, low-dose radiotherapy was initiated. External beam radiotherapy comprising a total dose of 8.0 Gy to the paraaortic lymph node region was administered in daily single fractions of 1.0 Gy (five fractions/week). Throughout the course of external beam radiotherapy, the secretion of abdominal ascites rapidly decreased, resulting in complete resolution after 2 weeks. There was no clinical evidence of chylous ascites on follow-up. As a result of this experience, we believe that external beam radiotherapy should be considered as an alternative therapy in refractory cases of chylous ascites. (orig.) [German] Das Chyloperitoneum ist eine seltene Komplikation nach Pankreatikoduodenektomie. Wir berichten ueber einen 76-jaehrigen Patienten mit Chyloperitoneum nach Resektion eines Pankreaskarzinoms. Die konservativen Therapiestrategien, wie beispielsweise diaetetische Massnahmen oder totale parenterale Ernaehrung, waren im vorliegenden Fall ueber einen Zeitraum von 4 Wochen nicht erfolgreich. Es bestand eine persistierende Sekretion von Chylaszites von bis zu 2500 ml/Tag. Basierend auf den klinischen Erfahrungen bei erfolgreich behandelten lymphokutanen Fisteln, wurde eine perkutane Radiotherapie eingeleitet. Die Bestrahlung des paraaortalen Lymphabflusses ueber ventrodorsale Gegenfelder wurde bis zu einer Gesamtdosis von 8,0 Gy in 1,0 Gy Einzeldosis (5 Fraktionen

  7. Treatment Guidelines for Preoperative Radiation Therapy for Retroperitoneal Sarcoma: Preliminary Consensus of an International Expert Panel

    Energy Technology Data Exchange (ETDEWEB)

    Baldini, Elizabeth H., E-mail: [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Haas, Rick L.M. [Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Kirsch, David G. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montreal, Montreal, Quebec (Canada); Salerno, Kilian [Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, New York (United States); Deville, Curtiland [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Sidney Kimmel Cancer Center, Washington, DC (United States); Guadagnolo, B. Ashleigh [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); O' Sullivan, Brian [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Le Pechoux, Cecile [Department of Radiotherapy, Institut Gustave-Roussy, Villejuif (France); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)


    Purpose: Evidence for external beam radiation therapy (RT) as part of treatment for retroperitoneal sarcoma (RPS) is limited. Preoperative RT is the subject of a current randomized trial, but the results will not be available for many years. In the meantime, many practitioners use preoperative RT for RPS, and although this approach is used in practice, there are no radiation treatment guidelines. An international expert panel was convened to develop consensus treatment guidelines for preoperative RT for RPS. Methods and Materials: An expert panel of 15 academic radiation oncologists who specialize in the treatment of sarcoma was assembled. A systematic review of reports related to RT for RPS, RT for extremity sarcoma, and RT-related toxicities for organs at risk was performed. Due to the paucity of high-quality published data on the subject of RT for RPS, consensus recommendations were based largely on expert opinion derived from clinical experience and extrapolation of relevant published reports. It is intended that these clinical practice guidelines be updated as pertinent data become available. Results: Treatment guidelines for preoperative RT for RPS are presented. Conclusions: An international panel of radiation oncologists who specialize in sarcoma reached consensus guidelines for preoperative RT for RPS. Many of the recommendations are based on expert opinion because of the absence of higher level evidence and, thus, are best regarded as preliminary. We emphasize that the role of preoperative RT for RPS has not been proven, and we await data from the European Organization for Research and Treatment of Cancer (EORTC) study of preoperative radiotherapy plus surgery versus surgery alone for patients with RPS. Further data are also anticipated pertaining to normal tissue dose constraints, particularly for bowel tolerance. Nonetheless, as we await these data, the guidelines herein can be used to establish treatment uniformity to aid future assessments of efficacy

  8. Computerized classification testing with the Rasch model

    NARCIS (Netherlands)

    Eggen, Theo J.H.M.


    If classification in a limited number of categories is the purpose of testing, computerized adaptive tests (CATs) with algorithms based on sequential statistical testing perform better than estimation-based CATs (e.g., Eggen & Straetmans, 2000). In these computerized classification tests (CCTs), the

  9. A First Life with Computerized Business Simulations (United States)

    Thavikulwat, Precha


    The author discusses the theoretical lens, origins, and environment of his work on computerized business simulations. Key ideas that inform his work include the two dimensions (control and interaction) of computerized simulation, the two ways of representing a natural process (phenotypical and genotypical) in a simulation, which he defines as a…

  10. Computerizing primary schools in rural kenya

    DEFF Research Database (Denmark)

    Ogembo, J.G.; Ngugi, B.; Pelowski, Matthew John


    This paper investigates the outstanding challenges facing primary schools' computerization in rural Kenya. Computerization of schools is often envisaged as a 'magic', or at least a particularly efficient, solution to many of the problems that developing countries face in improving primary school...

  11. Resources for Improving Computerized Learning Environments. (United States)

    Yeaman, Andrew R. J.


    Presents an annotated review of human factors literature that discusses computerized environments. Topics discussed include the application of office automation practices to educational environments; video display terminal (VDT) workstations; health and safety hazards; planning educational facilities; ergonomics in computerized offices; and…

  12. The Evaluation of SISMAKOM (Computerized SDI Project). (United States)

    University of Science, Penang (Malaysia).

    A survey of 88 users of SISMAKOM, a computerized selective dissemination of information (SDI) and document delivery service provided by the Universiti Sains Malaysia and four other Malaysian universities, was conducted in August 1982 in order to collect data about SISMAKOM and to assess the value of a computerized SDI service in a developing…

  13. Computerized Sociometric Assessment for Preschool Children (United States)

    Endedijk, Hinke M.; Cillessen, Antonius H. N.


    In preschool classes, sociometric peer ratings are used to measure children's peer relationships. The current study examined a computerized version of preschool sociometric ratings. The psychometric properties were compared of computerized sociometric ratings and traditional peer ratings for preschoolers. The distributions, inter-item…

  14. 21 CFR 579.40 - Ionizing radiation for the treatment of poultry feed and poultry feed ingredients. (United States)


    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Ionizing radiation for the treatment of poultry feed and poultry feed ingredients. 579.40 Section 579.40 Food and Drugs FOOD AND DRUG ADMINISTRATION... § 579.40 Ionizing radiation for the treatment of poultry feed and poultry feed ingredients....

  15. Radiation retinopathy secondary to treatment of maxillary sinus carcinoma: a dramatic case. (United States)

    Galindo-Bocero, J; Macías-Franco, S; Sánchez-García, S; Fonollá-Gil, M; García-Alonso, A


    A 53-year old male presented with visual impairment in right eye after irradiation of right maxillary sinus carcinoma. Funduscopy shows radiation retinopathy: haemorrhages, exudates, macular oedema, and peripheral retinal ischaemia. A poor outcome was achieved despite laser treatment and intravitreal injections of bevacizumab, resulting in evisceration of the affected eye. Radiation retinopathy must be considered in any loss of vision after head and neck irradiation. Ophthalmological long-term follow-up of these patients is essential for an early diagnosis. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Advances in 4D radiation therapy for managing respiration: part II - 4D treatment planning. (United States)

    Rosu, Mihaela; Hugo, Geoffrey D


    The development of 4D CT imaging technology made possible the creation of patient models that are reflective of respiration-induced anatomical changes by adding a temporal dimension to the conventional 3D, spatial-only, patient description. This had opened a new venue for treatment planning and radiation delivery, aimed at creating a comprehensive 4D radiation therapy process for moving targets. Unlike other breathing motion compensation strategies (e.g. breath-hold and gating techniques), 4D radiotherapy assumes treatment delivery over the entire respiratory cycle - an added bonus for both patient comfort and treatment time efficiency. The time-dependent positional and volumetric information holds the promise for optimal, highly conformal, radiotherapy for targets experiencing movements caused by respiration, with potentially elevated dose prescriptions and therefore higher cure rates, while avoiding the uninvolved nearby structures. In this paper, the current state of the 4D treatment planning is reviewed, from theory to the established practical routine. While the fundamental principles of 4D radiotherapy are well defined, the development of a complete, robust and clinically feasible process still remains a challenge, imposed by limitations in the available treatment planning and radiation delivery systems. Copyright © 2012. Published by Elsevier GmbH.

  17. Advances in 4D Radiation Therapy for Managing Respiration: Part II – 4D Treatment Planning (United States)

    Rosu, Mihaela; Hugo, Geoffrey D.


    The development of 4D CT imaging technology made possible the creation of patient models that are reflective of respiration-induced anatomical changes by adding a temporal dimension to the conventional 3D, spatial-only, patient description. This had opened a new venue for treatment planning and radiation delivery, aimed at creating a comprehensive 4D radiation therapy process for moving targets. Unlike other breathing motion compensation strategies (e.g. breath-hold and gating techniques), 4D radiotherapy assumes treatment delivery over the entire respiratory cycle – an added bonus for both patient comfort and treatment time efficiency. The time-dependent positional and volumetric information holds the promise for optimal, highly conformal, radiotherapy for targets experiencing movements caused by respiration, with potentially elevated dose prescriptions and therefore higher cure rates, while avoiding the uninvolved nearby structures. In this paper, the current state of the 4D treatment planning is reviewed, from theory to the established practical routine. While the fundamental principles of 4D radiotherapy are well defined, the development of a complete, robust and clinically feasible process still remains a challenge, imposed by limitations in the available treatment planning and radiation delivery systems. PMID:22796324

  18. Effect of gamma radiation and endodontic treatment on mechanical properties of human and bovine root dentin

    Energy Technology Data Exchange (ETDEWEB)

    Novais, Veridiana Resende; Soares, Priscilla Barbosa Ferreira; Guimaraes, Carlla Martins; Schliebe, Lais Rani Sales Oliveira; Braga, Stella Sueli Lourenco; Soares, Carlos Jose, E-mail: [Universidade Federal de Uberlandia (UFU), MG (Brazil)


    This study evaluated the effect of gamma radiation and endodontic treatment on the microhardness and flexural strength of human and bovine root dentin. Forty single rooted human teeth and forty bovine incisor teeth were collected, cleaned and stored in distilled water at 4 °C. The human and bovine teeth were divided into 4 groups (n=10) resulting from the combination of two study factors: first, regarding the endodontic treatment in 2 levels: with or without endodontic treatment; and second, radiotherapy in two levels: with or without radiotherapy by 60 Gy of Co-60 gamma radiation fractioned into 2 Gy daily doses five days per week. Each tooth was longitudinally sectioned in two parts; one-half was used for the three-point bending test and the other for the Knoop hardness test (KHN). Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). No significant difference was found for flexural strength values. The human dentin had significantly higher KHN than the bovine. The endodontic treatment and radiotherapy resulted in significantly lower KHN irrespective of tooth origin. The results indicated that the radiotherapy had deleterious effects on the microhardness of human and bovine dentin and this effect is increased by the interaction with endodontic therapy. The endodontic treatment adds additional negative effect on the mechanical properties of radiated tooth dentin; the restorative protocols should be designed taking into account this effect. (author)

  19. Emerging Role of MRI for Radiation Treatment Planning in Lung Cancer. (United States)

    Cobben, David C P; de Boer, Hans C J; Tijssen, Rob H; Rutten, Emma G G M; van Vulpen, Marco; Peerlings, Jurgen; Troost, Esther G C; Hoffmann, Aswin L; van Lier, Astrid L H M W


    Magnetic resonance imaging (MRI) provides excellent soft-tissue contrast and allows for specific scanning sequences to optimize differentiation between various tissue types and properties. Moreover, it offers the potential for real-time motion imaging. This makes magnetic resonance imaging an ideal candidate imaging modality for radiation treatment planning in lung cancer. Although the number of clinical research protocols for the application of magnetic resonance imaging for lung cancer treatment is increasing ( and the magnetic resonance imaging sequences are becoming faster, there are still some technical challenges. This review describes the opportunities and challenges of magnetic resonance imaging for radiation treatment planning in lung cancer. © The Author(s) 2015.

  20. Photonuclear processes in the treatment room and patient during radiation therapy with 50 MV photons

    Energy Technology Data Exchange (ETDEWEB)

    Gudowska, Irena [Karolinska Inst., Stockholm (Sweden). Dept. of Radiation Physics


    The objectives of this project were to determine the level of photoneutron radiation around the MM50 Racetrack Microtron at Karolinska Hospital, operating in different modes and to evaluate the photonuclear absorbed dose to the treated volume during therapy with a 50 MV photon beam. The photoneutron radiation has been studied both using a {sup 235}U fission chamber and by computer simulation. The estimated neutron equivalent dose due to accelerator produced neutrons delivered to the tissues inside and outside the treatment volume do not exceed the recommended values. However, there is a potential risk that the sensitive tissues (lens of the eye and gonads), outside the treatment volume, can receive a dose of about 300-500 mSv per photon treatment course of 60 Gy with a slight increase for secondary malignancies. 47 refs, 15 figs, 6 tabs.

  1. Abdominal radiation - discharge (United States)

    Radiation - abdomen - discharge; Cancer - abdominal radiation; Lymphoma - abdominal radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after radiation treatment starts, you might notice changes ...

  2. Stereotactic Radiosurgery and Fractionated Stereotactic Radiation Therapy for the Treatment of Uveal Melanoma. (United States)

    Yazici, Gozde; Kiratli, Hayyam; Ozyigit, Gokhan; Sari, Sezin Yuce; Cengiz, Mustafa; Tarlan, Bercin; Mocan, Burce Ozgen; Zorlu, Faruk


    To evaluate treatment results of stereotactic radiosurgery or fractionated stereotactic radiation therapy (SRS/FSRT) for uveal melanoma. We retrospectively evaluated 181 patients with 182 uveal melanomas receiving SRS/FSRT between 2007 and 2013. Treatment was administered with CyberKnife. According to Collaborative Ocular Melanoma Study criteria, tumor size was small in 1%, medium in 49.5%, and large in 49.5% of the patients. Seventy-one tumors received treatment outcome was achieved using ≥45 Gy in 3 fractions. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Orthovoltage radiation therapy treatment planning using Monte Carlo simulation: treatment of neuroendocrine carcinoma of the maxillary sinus (United States)

    Gao, Wanbao; Raeside, David E.


    Dose distributions that result from treating a patient with orthovoltage beams are best determined with a treatment planning system that uses the Monte Carlo method, and such systems are not readily available. In the present work, the Monte Carlo method was used to develop a computer code for determining absorbed dose distributions in orthovoltage radiation therapy. The code was used in planning treatment of a patient with a neuroendocrine carcinoma of the maxillary sinus. Two lateral high-energy photon beams supplemented by an anterior orthovoltage photon beam were utilized in the treatment plan. For the clinical case and radiation beams considered, a reasonably uniform dose distribution TOP"/> is achieved within the target volume, while the dose to the lens of each eye is 4 - 8% of the prescribed dose. Therefore, an orthovoltage photon beam, when properly filtered and optimally combined with megavoltage beams, can be effective in the treatment of cancers below the skin, providing that accurate treatment planning is carried out to establish with accuracy and precision the doses to critical structures.

  4. Treatment of radiation-induced hemorrhagic gastritis with prednisolone: A case report

    Institute of Scientific and Technical Information of China (English)

    Lan Zhang; Xiao-Ying Xie; Yan Wang; Yan-Hong Wang; Yi Chen; Zheng-Gang Ren


    Radiation-induced gastritis is an infrequent cause of gastrointestinal bleeding.It is a serious complication arising from radiation therapy,and the standard treatment method has not been established.The initial injury is characteristically acute inflammation of gastric mucosa.We presented a 46-year-old male patient with hemorrhagic gastritis induced by external radiotherapy for metastatic retroperitoneal lymph node of hepatocellular carcinoma.The endoscopic examination showed diffuse edematous hyperemicmucosa with telangiectasias in the whole muscosa of the stomach and duodenal bulb.Mlultiple hemorrhagic patches with active oozing were found over the antrum.Anti-secretary therapy was initiated for hemostasis,but melena still occurred off and on.Finally,he was successfully treated by prednisolone therapy.We therefore strongly argue in favor of perdnisolone therapy to effectively treat patients with radiation-induced hemorrhagic gastritis.

  5. Determinants of success for computerized cognitive behavior therapy: examination of an insomnia program. (United States)

    Vincent, Norah; Walsh, Kate; Lewycky, Samantha


    This study evaluated plausible moderators of outcome in a 6-week computerized treatment for insomnia. Using secondary data from two randomized controlled trials, participants were 228 adults with chronic insomnia. Participants received computerized treatment from their homes. Outcomes were assessed using a sleep diary, as well as several standardized self-report scales. Using linear mixed models with SPSS, treatment was largely robust to comorbid conditions, education, age, and gender. Results showed that psychiatric comorbidity and education moderated the impact of treatment on fatigue and that sleep symptom comorbidity moderated the impact of treatment on maladaptive attitudes about sleep. Implications of these findings are that more widespread use of computerized treatment for insomnia may be warranted.

  6. Risk of second bone sarcoma following childhood cancer: role of radiation therapy treatment. (United States)

    Schwartz, Boris; Benadjaoud, Mohamed Amine; Cléro, Enora; Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine; Teinturier, Cécile; Oberlin, Odile; Veres, Cristina; Pacquement, Hélène; Munzer, Martine; N'guyen, Tan Dat; Bondiau, Pierre-Yves; Berchery, Delphine; Laprie, Anne; Hawkins, Mike; Winter, David; Lefkopoulos, Dimitri; Chavaudra, Jean; Rubino, Carole; Diallo, Ibrahima; Bénichou, Jacques; de Vathaire, Florent


    Bone sarcoma as a second malignancy is rare but highly fatal. The present knowledge about radiation-absorbed organ dose-response is insufficient to predict the risks induced by radiation therapy techniques. The objective of the present study was to assess the treatment-induced risk for bone sarcoma following a childhood cancer and particularly the related risk of radiotherapy. Therefore, a retrospective cohort of 4,171 survivors of a solid childhood cancer treated between 1942 and 1986 in France and Britain has been followed prospectively. We collected detailed information on treatments received during childhood cancer. Additionally, an innovative methodology has been developed to evaluate the dose-response relationship between bone sarcoma and radiation dose throughout this cohort. The median follow-up was 26 years, and 39 patients had developed bone sarcoma. It was found that the overall incidence was 45-fold higher [standardized incidence ratio 44.8, 95 % confidence interval (CI) 31.0-59.8] than expected from the general population, and the absolute excess risk was 35.1 per 100,000 person-years (95 % CI 24.0-47.1). The risk of bone sarcoma increased slowly up to a cumulative radiation organ absorbed dose of 15 Gy [hazard ratio (HR) = 8.2, 95 % CI 1.6-42.9] and then strongly increased for higher radiation doses (HR for 30 Gy or more 117.9, 95 % CI 36.5-380.6), compared with patients not treated with radiotherapy. A linear model with an excess relative risk per Gy of 1.77 (95 % CI 0.6213-5.935) provided a close fit to the data. These findings have important therapeutic implications: Lowering the radiation dose to the bones should reduce the incidence of secondary bone sarcomas. Other therapeutic solutions should be preferred to radiotherapy in bone sarcoma-sensitive areas.

  7. Treatment of small cell lung cancer with TRA-8 in combination with cisplatin and radiation. (United States)

    Bonner, James A; Willey, Christopher D; Yang, Eddy S; Dobelbower, Michael C; Sanford, Leisa L; Bright, Sheila J; Buchsbaum, Donald J; Raisch, Kevin P


    Limited stage small cell lung cancer (SCLC) represents a minority of SCLC. Despite extensive clinical trials, standard treatment remains cisplatin-based chemotherapy and thoracic irradiation (TI). This study focused on the interaction of cisplatin/radiation with the anti-human DR5 monoclonal antibody TRA-8 in SCLC cells. TRA-8 binds specifically to DR5 and has been shown to activate apoptosis. Four human SCLC cell lines were utilized for experimentation (SCLC-41, SCLC-58, SCLC-68, and SCLC-74). Immunoblot analysis was used to determine relative protein levels of DR5, DR4 and pro-caspase 8 for each cell line. Using a tetrazolium-based assay (XTT), the IC(50) values for cisplatin with or without TRA-8 were determined for the SCLC cell lines. Four SCLC lines were assayed with a combination of TRA-8 (10 μg/ml), 2 Gy radiation and various concentrations of cisplatin. Apoptosis was evaluated using Annexin V-FITC and cleaved caspase immunoblotting. Using a SCLC-58 subcutaneous xenograft model, treatment began 21 d after tumor cell injection. Treatment included weekly cisplatin (4 mg/kg) and radiation of 1 Gy (24 h after cisplatin) and TRA-8 (200 μg) was administered i.p. twice weekly for three weeks. Immunoblot analysis showed similar levels of DR5 for all cell lines with variable levels of DR4. Various concentrations of TRA-8 antibody (≤ 10 μg/ml) induced no significant cytotoxicity in the SCLC cell lines. The in vitro combination treatment with TRA-8 (10 μg/ml), 1.25 μg/ml cisplatin and 2 Gy radiation showed increased cytotoxicity when compared to combinations without TRA-8. Furthermore, the triple combination demonstrated the greatest amount of apoptosis as measured by Annexin V staining. The in vivo studies showed the combination of 1G y, cisplatin and TRA-8 extended the tumor doubling time to 44 d as compared to any doublet treatment groups that ranged from 12 to 20 d. Analysis of survival data showed 100% of the combination group (RT+cisplatin+TRA-8) were

  8. Androgen Induces Adaptation to Oxidative Stress in Prostate Cancer: Implications for Treatment with Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Jehonathan H. Pinthus


    Full Text Available Radiation therapy is a standard treatment for prostate cancer (PC. The postulated mechanism of action for radiation therapy is the generation of reactive oxygen species (ROS. Adjuvant androgen deprivation (AD therapy has been shown to confer a survival advantage over radiation alone in high-risk localized PC. However, the mechanism of this interaction is unclear. We hypothesize that androgens modify the radioresponsiveness of PC through the regulation of cellular oxidative homeostasis. Using androgen receptor (AR+ 22rv1 and AR− PC3 human PC cell lines, we demonstrated that testosterone increased basal reactive oxygen species (bROS levels, resulting in dose-dependent activation of phospho-p38 and pAKT, increased expression of clusterin, catalase, manganese superoxide dismutase. Similar data were obtained in three human PC xenografts; WISH-PC14, WISH-PC23, CWR22, growing in testosterone-supplemented or castrated SCID mice. These effects were reversible through AD or through incubation with a reducing agent. Moreover, testosterone increased the activity of catalase, superoxide dismutases, glutathione reductase. Consequently, AD significantly facilitated the response of AR+ cells to oxidative stress challenge. Thus, testosterone induces a preset cellular adaptation to radiation through the generation of elevated bROS, which is modified by AD. These findings provide a rational for combined hormonal and radiation therapy for localized PC.

  9. Exposure to Mobile Phone Radiation Opens New Horizons in Alzheimer’s Disease Treatment (United States)

    Mortazavi, SAR; Shojaei-Fard, MB; Haghani, M; Shokrpour, N; Mortazavi, SMJ


    Alzheimer’s disease, the most common type of dementia and a progressive neurodegenerative disease, occurs when the nerve cells in the brain die. Although there are medications that can help delay the development of Alzheimer’s disease, there is currently no cure for this disease. Exposure to ionizing and non-ionizing radiation may cause adverse health effects such as cancer.  Looking at the other side of the coin, there are reports indicating stimulatory or beneficial effects after exposure to cell phone radiofrequency radiation. Mortazavi et al. have previously reported some beneficial cognitive effects such as decreased reaction time after human short-term exposure to cell phone radiation or occupational exposure to radar microwave radiation. On the other hand, some recent reports have indicated that RF radiation may have a role in protecting against cognitive impairment in Alzheimer’s disease. Although the majority of these data come from animal studies that cannot be easily extrapolated to humans, it can be concluded that this memory enhancing approach may open new horizons in treatment of cognitive impairment in Alzheimer disease. PMID:25505755

  10. Psychometrics behind Computerized Adaptive Testing. (United States)

    Chang, Hua-Hua


    The paper provides a survey of 18 years' progress that my colleagues, students (both former and current) and I made in a prominent research area in Psychometrics-Computerized Adaptive Testing (CAT). We start with a historical review of the establishment of a large sample foundation for CAT. It is worth noting that the asymptotic results were derived under the framework of Martingale Theory, a very theoretical perspective of Probability Theory, which may seem unrelated to educational and psychological testing. In addition, we address a number of issues that emerged from large scale implementation and show that how theoretical works can be helpful to solve the problems. Finally, we propose that CAT technology can be very useful to support individualized instruction on a mass scale. We show that even paper and pencil based tests can be made adaptive to support classroom teaching.

  11. Preoperative, intraoperative, and postoperative radiation in the treatment of primary soft tissue sarcoma. (United States)

    Suit, H D; Mankin, H J; Wood, W C; Proppe, K H


    The rationale for combining radiation with conservative surgery in the treatment of sarcoma of soft tissue is discussed, as well as the advantages for performing the radiation preoperatively on the one hand and postoperatively on the other. The results of treatment of soft tissue sarcoma by radical resectional surgery or amputation in 464 patients at four centers and by conservative surgery, and postoperative radiation in 416 patients at three centers, have been reviewed. The local failure rates were 18.1% and 18.3%, respectively. The results obtained by radiation administered postoperatively (110 patients) or preoperatively (60 patients) at the Massachusetts General Hospital during the period September 1971 to August 1982 are analyzed and discussed with reference to 5-year actuarial local control and survival results as well as causes of failure with respect to AJC stage, histologic type, anatomic site, and size of tumor. The results which have been obtained by the preoperative approach are judged to be superior, particularly for the larger lesions and higher grades that predominated in that group. Of a total of 170 patients, there were 19 local failures; 13 of these were diagnosed at the time when metastatic disease was not evident. Of those 13, 12 have been subjected to salvage surgery and 7 remain with no evidence of disease at 1 to 3.5 years after the salvage procedure. A major problem in the management of these patients remains the occult metastatic disease.

  12. Radiation Therapy (United States)

    Radiation therapy is a cancer treatment. It uses high doses of radiation to kill cancer cells and stop them from ... half of all cancer patients receive it. The radiation may be external, from special machines, or internal, ...

  13. Determination of radiation-induced DNA double-strand breaks for the biological dose monitoring in cardiac computerized tomography; Bestimmung von strahleninduzierten DNA-Doppelstrangbruechen zum Monitoring der biologischen Dosis in der Herz-Computertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Wegener, Jasmin


    Background and aims: X-rays cause relevant DNA damage to cells. DNA double-strand breaks (DSBs) are considered to be the most biologically significant radiation induced DNA-lesions. Recently a sensitive immunofluorescence microscopic method was developed to quantify x-ray induced DSBs as nuclear foci, even after doses as used in computed tomography. The method is based on the phosphorylation of the histone variant H2AX after formation of DSBs and distinct foci representing DSBs can be visualised. The number of foci correlates well with the delivered radiation dose. The importance of cardiac CT has increased during the last years. The radiation exposure of cardiac CT is rather high compared to other radiologic diagnostic procedures and techniques for dose-reduction receive increasing attention. In this context the purpose of this study was to determine to what extent the γ-H2AX-based method is able to measure x-ray induced DSBs in patients undergoing cardiac CT. Furthermore the objective was to evaluate whether CT-induced DSBs correlate with exposure parameters (dose length product, DLP) and to assess the influence of the scan protocols on the biological radiation damage. Materials and methods: 32 patients undergoing coronary CT angiography either using a 64-slice (n = 5: SOMATOM Sensation 64 {sup registered}) or a dual-source CT scanner (n = 27: SOMATOM Definition {sup registered}) were included in the study. Venous blood samples were taken before and 0.5 h, 2.5 h, and 24 h after the CT scan. Additional venous blood samples obtained before CT were irradiated in-vitro at various radiation doses (10 mGy, 50 mGy, 100 mGy) to obtain reference values of foci. Lymphocytes were separated and incubated with a specific γ-H2AX primary and a fluorescent secondary antibody. The number of γ-H2AX-foci was quantified using a fluorescence microscope. Every distinct focus represents one DNA-DSB. The number of radiation-induced DSBs was calculated by subtracting the foci number

  14. The peer review system (PRS) for quality assurance and treatment improvement in radiation therapy (United States)

    Le, Anh H. T.; Kapoor, Rishabh; Palta, Jatinder R.


    Peer reviews are needed across all disciplines of medicine to address complex medical challenges in disease care, medical safety, insurance coverage handling, and public safety. Radiation therapy utilizes technologically advanced imaging for treatment planning, often with excellent efficacy. Since planning data requirements are substantial, patients are at risk for repeat diagnostic procedures or suboptimal therapeutic intervention due to a lack of knowledge regarding previous treatments. The Peer Review System (PRS) will make this critical radiation therapy information readily available on demand via Web technology. The PRS system has been developed with current Web technology, .NET framework, and in-house DICOM library. With the advantages of Web server-client architecture, including IIS web server, SOAP Web Services and Silverlight for the client side, the patient data can be visualized through web browser and distributed across multiple locations by the local area network and Internet. This PRS will significantly improve the quality, safety, and accessibility, of treatment plans in cancer therapy. Furthermore, the secure Web-based PRS with DICOM-RT compliance will provide flexible utilities for organization, sorting, and retrieval of imaging studies and treatment plans to optimize the patient treatment and ultimately improve patient safety and treatment quality.

  15. A suspected case of radiation induced-cancer 13 years after initial treatment for tongue cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nakashima, Mikio; Ozeki, Satoru; Oobu, Kazunari; Ohishi, Masamichi; Matsuo, Kou [Kyushu Univ., Fukuoka (Japan). Faculty of Dentistry


    A suspected case of radiation-induced cancer 13 years after initial treatment for tongue cancer was reported. The patient was a 61-year-old female, treated by 60 Gy radiotherapy for tongue cancer of the right side. Seven years later, recurrent tongue tumor arose and was irradiated up to the total dosage of 82.5 Gy. Thirteen years after the initial treatment, a tumor arose near the flap resembling a mucocele at first, and its growth was rapid. She underwent surgery in 1993. Histopathological examination revealed partial mesenchymal features, but it was difficult to determine its origin. Based on Sakai`s criteria, the points of location, latency, and histopathological observation, the tumor was considered to be radiation-induced cancer. (author)

  16. Application of mass spectrometry based electronic nose and chemometrics for fingerprinting radiation treatment (United States)

    Gupta, Sumit; Variyar, Prasad S.; Sharma, Arun


    Volatile compounds were isolated from apples and grapes employing solid phase micro extraction (SPME) and subsequently analyzed by GC/MS equipped with a transfer line without stationary phase. Single peak obtained was integrated to obtain total mass spectrum of the volatile fraction of samples. A data matrix having relative abundance of all mass-to-charge ratios was subjected to principal component analysis (PCA) and linear discriminant analysis (LDA) to identify radiation treatment. PCA results suggested that there is sufficient variability between control and irradiated samples to build classification models based on supervised techniques. LDA successfully aided in segregating control from irradiated samples at all doses (0.1, 0.25, 0.5, 1.0, 1.5, 2.0 kGy). SPME-MS with chemometrics was successfully demonstrated as simple screening method for radiation treatment.

  17. Stereotactic body radiation therapy for the primary treatment of localized prostate cancer


    Oliai, Caspian; Lanciano, Rachelle; Sprandio, Brian; Yang, Jun; Lamond, John; Arrigo, Steven; Good, Michael; Mooreville, Michael; Garber, Bruce; Brady, Luther W.


    Objective The low alpha/beta ratio of prostate cancer suggests that hypofractionated schemes of dose-escalated radiotherapy should be advantageous. We report our experience using stereotactic body radiation therapy (SBRT) for the primary treatment of prostate cancer to assess efficacy and toxicity. Methods From 2007 to 2010, 70 patients (51 % low risk, 31 % intermediate risk, and 17 % high risk) with localized prostate cancer were treated with SBRT using the CyberKnife system. One-third of pa...

  18. Two Cases of Post-Radiation Sarcoma after Breast Cancer Treatment


    Noh, Jae Myoung; Huh, Seung Jae; Choi, Doo Ho; Park, Won; Nam, Seok Jin


    We describe two cases of post-radiation sarcoma after breast cancer treatment. The first patient was a 61-year-old woman who underwent partial mastectomy of the right breast and adjuvant whole breast irradiation 7 years previously. Subsequently, a rapidly growing mass from the anterior arc of the right fifth rib was incidentally detected on an abdomino-pelvic computed tomography scan. The second patient was a 70-year-old woman who received neoadjuvant chemotherapy and a partial mastectomy of ...

  19. Hodgkin lymphoma: Evolution and dilemma in radiation treatments; Evolution et dilemmes dans les traitements du lymphome de Hodgkin

    Energy Technology Data Exchange (ETDEWEB)

    Girinsky, T.; Ghalibafian, M.; Paumier, A. [Institut Gustave-Roussy, Dept. des Radiations, 94 - Villejuif (France); Ghalibafian, M. [Hopital Marak, Dept. des radiations, Teheran (Iran, Islamic Republic of)


    Multiple new developments in the treatments of patients with Hodgkin lymphoma have occurred in the last 10 years. Radiation treatments have become extremely precise in localized Hodgkin lymphomas, on the other hand, they have almost completely disappeared in advanced stages. For patients with refractory or recurrent disease, it is strongly advocated, whenever feasible, to deliver a mantle field radiation treatment after an autologous stem cell transplant to avoid any further recurrence of the disease. (authors)

  20. Argon beam coagulation for treatment of symptomatic radiation-induced proctitis. (United States)

    Fantin, A C; Binek, J; Suter, W R; Meyenberger, C


    Radiation proctitis is a complication of radiotherapy for malignant pelvic disease. Argon beam coagulation is a new and rapidly evolving technology that permits a "no-touch" electrocoagulation of diseased tissue. We analyzed retrospectively the records of 7 patients with prostatic and endometrial cancers treated with irrradiation (median radiation dose was 6840 cGy, range 2400 to 7200 cGy). The median time to onset of symptoms after the conclusion of radiotherapy was 20 months (range 16 to 48 months); symptoms consisted of rectal bleeding and tenesmus in all patients. The patients underwent argon beam coagulation after colonoscopic evaluation. The usual treatment interval was 3 weeks (range 1 to 3 weeks). A median of 2 treatment sessions (range 2 to 4) was necessary for complete symptom relief. All interventions were well tolerated without complications. During follow-up (median 24 months, range 18 to 24 months), there was no recurrence of symptoms (bleeding, tenesmus). Argon beam coagulation is a safe, well tolerated, and effective treatment option in symptomatic radiation proctitis.

  1. A study of the radiobiological modeling of the conformal radiation therapy in cancer treatment (United States)

    Pyakuryal, Anil Prasad

    Cancer is one of the leading causes of mortalities in the world. The precise diagnosis of the disease helps the patients to select the appropriate modality of the treatments such as surgery, chemotherapy and radiation therapy. The physics of X-radiation and the advanced imaging technologies such as positron emission tomography (PET) and computed tomography (CT) plays an important role in the efficient diagnosis and therapeutic treatments in cancer. However, the accuracy of the measurements of the metabolic target volumes (MTVs) in the PET/CT dual-imaging modality is always limited. Similarly the external beam radiation therapy (XRT) such as 3D conformal radiotherapy (3DCRT) and intensity modulated radiation therapy (IMRT) is the most common modality in the radiotherapy treatment. These treatments are simulated and evaluated using the XRT plans and the standard methodologies in the commercial planning system. However, the normal organs are always susceptible to the radiation toxicity in these treatments due to lack of knowledge of the appropriate radiobiological models to estimate the clinical outcomes. We explored several methodologies to estimate MTVs by reviewing various techniques of the target volume delineation using the static phantoms in the PET scans. The review suggests that the more precise and practical method of delineating PET MTV should be an intermediate volume between the volume coverage for the standardized uptake value (SUV; 2.5) of glucose and the 50% (40%) threshold of the maximum SUV for the smaller (larger) volume delineations in the radiotherapy applications. Similarly various types of optimal XRT plans were designed using the CT and PET/CT scans for the treatment of various types of cancer patients. The qualities of these plans were assessed using the universal plan-indices. The dose-volume criteria were also examined in the targets and organs by analyzing the conventional dose-volume histograms (DVHs). The biological models such as tumor

  2. Radiation-induced bowel injury: the impact of radiotherapy on survivorship after treatment for gynaecological cancers (United States)

    Kuku, S; Fragkos, C; McCormack, M; Forbes, A


    Background: The number of women surviving cancer who live with symptoms of bowel toxicity affecting their quality of life continues to rise. In this retrospective study, we sought to describe and analyse the presenting clinical features in our cohort, and evaluate possible predictors of severity and chronicity in women with radiation-induced bowel injury after treatment for cervical and endometrial cancers. Methods: Review of records of 541 women treated within the North London Gynaecological Cancer Network between 2003 and 2010 with radiotherapy with or without chemotherapy for cervical and endometrial cancer identified 152 women who reported significant new bowel symptoms after pelvic radiation. Results: Factor analysis showed that the 14 most common and important presenting symptoms could be ‘clustered' into 3 groups with predictive significance for chronicity and severity of disease. Median follow-up for all patients was 60 months. Univariate analysis showed increasing age, smoking, extended field radiation, cervical cancer treatment and the need for surgical intervention to be significant predictors for severity of ongoing disease at last follow-up. On multivariate analysis, only age, cancer type (cervix) and symptom combinations/‘cluster' of (bloating, flatulence, urgency, rectal bleeding and per-rectal mucus) were found to be significant predictors of disease severity. Fifteen (19%) women in the cervical cancer group had radiation-induced bowel injury requiring surgical intervention compared with five (6.7%) in the endometrial cancer group. Conclusion: Women with cervical cancer are younger and appear to suffer more severe symptoms of late bowel toxicity, whereas women treated for endometrial cancer suffer milder more chronic disease. The impact of radiation-induced bowel injury and the effect on cancer survivorship warrants further research into investigation of predictors of severe late toxicity. There is a need for prospective trials to aid early

  3. Radiation absorbed dose measurement after I-131 metaiodobenzylguanidine treatment in a patient with pheochromycytoma

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Won Il; Kim, Byeung Il; Lee, Jae Sung; Lee, Jung Rim; Choi, Chang Woon; Lim, Sang Moo; Hong, Sung Woon [Korea Cancer Center, Seoul (Korea, Republic of)


    The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of K-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simulatanously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). Follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our results suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.

  4. MO-B-BRB-03: Systems Engineering Tools for Treatment Planning Process Optimization in Radiation Medicine

    Energy Technology Data Exchange (ETDEWEB)

    Kapur, A. [Long Island Jewish Medical Center (United States)


    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  5. Physics strategies for sparing neural stem cells during whole-brain radiation treatments

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, Neil; Chuang, Cynthia; Pouliot, Jean; Hwang, Andrew; Barani, Igor J. [Department of Radiation Oncology, University of California San Francisco, San Francisco, California 94143-1708 (United States)


    Purpose: Currently, there are no successful long-term treatments or preventive strategies for radiation-induced cognitive impairments, and only a few possibilities have been suggested. One such approach involves reducing the dose to neural stem cell compartments (within and outside of the hippocampus) during whole-brain radiation treatments for brain metastases. This study investigates the fundamental physics issues associated with the sparing of neural stem cells during photon radiotherapy for brain metastases. Methods: Several factors influence the stem cell dose: intracranial scattering, collimator leakage, beam energy, and total number of beams. The relative importance of these factors is investigated through a set of radiation therapy plans, which are all variations of an initial 6 MV intensity-modulated radiation therapy (IMRT) plan designed to simultaneously deliver a whole-brain dose of 30 Gy and maximally reduce stem cell compartment dose. Additionally, an in-house leaf segmentation algorithm was developed that utilizes jaw motion to minimize the collimator leakage. Results: The plans are all normalized such that 50% of the PTV receives 30 Gy. For the initial 6 MV IMRT plan, 50% of the stem cells receive a dose greater than 6.3 Gy. Calculations indicate that 3.6 Gy of this dose originates from intracranial scattering. The jaw-tracking segmentation algorithm, used in conjunction with direct machine parameter optimization, reduces the 50% stem cell dose to 4.3 and 3.7 Gy for 6 and 10 MV treatment beams, respectively. Conclusions: Intracranial scattering alone is responsible for a large dose contribution to the stem cell compartment. It is, therefore, important to minimize other contributing factors, particularly the collimator leakage, to maximally reduce dose to these critical structures. The use of collimator jaw tracking in conjunction with modern collimators can minimize this leakage.

  6. Treatment Effects and Sequelae of Radiation Therapy for Orbital Mucosa-Associated Lymphoid Tissue Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Hata, Masaharu, E-mail: [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan); Omura, Motoko; Koike, Izumi [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan); Tomita, Naoto [Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan); Iijima, Yasuhito [Department of Ophthalmology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan); Tayama, Yoshibumi; Odagiri, Kazumasa; Minagawa, Yumiko [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan); Ogino, Ichiro [Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Kanagawa (Japan); Inoue, Tomio [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa (Japan)


    Purpose: Among extranodal lymphomas, orbital mucosa-associated lymphoid tissue (MALT) lymphoma is a relatively rare presentation. We performed a review to ascertain treatment efficacy and toxicity of radiation therapy for orbital MALT lymphoma. We also evaluated changes in visual acuity after irradiation. Methods and Materials: Thirty patients with orbital MALT lymphoma underwent radiation therapy with curative intent. Clinical stages at diagnosis were stage I{sub E}A in 29 patients and stage II{sub E}A in 1 patient. Total doses of 28.8 to 45.8 Gy (median, 30 Gy) in 15 to 26 fractions (median, 16 fractions) were delivered to the tumors. Results: All irradiated tumors were controlled during the follow-up period of 2 to 157 months (median, 35 months) after treatment. Two patients had relapses that arose in the cervical lymph node and the ipsilateral palpebral conjunctiva outside the radiation field at 15 and 67 months after treatment, respectively. The 5-year local progression-free and relapse-free rates were 100% and 96%, respectively. All 30 patients are presently alive; the overall and relapse-free survival rates at 5 years were 100% and 96%, respectively. Although 5 patients developed cataracts of grade 2 at 8 to 45 months after irradiation, they underwent intraocular lens implantation, and their eyesight recovered. Additionally, there was no marked deterioration in the visual acuity of patients due to irradiation, with the exception of cataracts. No therapy-related toxicity of grade 3 or greater was observed. Conclusions: Radiation therapy was effective and safe for patients with orbital MALT lymphoma. Although some patients developed cataracts after irradiation, visual acuity was well preserved.

  7. PET-guided delineation of radiation therapy treatment volumes: a survey of image segmentation techniques

    Energy Technology Data Exchange (ETDEWEB)

    Zaidi, Habib [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Geneva University, Geneva Neuroscience Center, Geneva (Switzerland); El Naqa, Issam [Washington University School of Medicine, Department of Radiation Oncology, St. Louis, MO (United States)


    Historically, anatomical CT and MR images were used to delineate the gross tumour volumes (GTVs) for radiotherapy treatment planning. The capabilities offered by modern radiation therapy units and the widespread availability of combined PET/CT scanners stimulated the development of biological PET imaging-guided radiation therapy treatment planning with the aim to produce highly conformal radiation dose distribution to the tumour. One of the most difficult issues facing PET-based treatment planning is the accurate delineation of target regions from typical blurred and noisy functional images. The major problems encountered are image segmentation and imperfect system response function. Image segmentation is defined as the process of classifying the voxels of an image into a set of distinct classes. The difficulty in PET image segmentation is compounded by the low spatial resolution and high noise characteristics of PET images. Despite the difficulties and known limitations, several image segmentation approaches have been proposed and used in the clinical setting including thresholding, edge detection, region growing, clustering, stochastic models, deformable models, classifiers and several other approaches. A detailed description of the various approaches proposed in the literature is reviewed. Moreover, we also briefly discuss some important considerations and limitations of the widely used techniques to guide practitioners in the field of radiation oncology. The strategies followed for validation and comparative assessment of various PET segmentation approaches are described. Future opportunities and the current challenges facing the adoption of PET-guided delineation of target volumes and its role in basic and clinical research are also addressed. (orig.)

  8. Correcting radiation survey data to account for increased leakage during intensity modulated radiotherapy treatments

    Energy Technology Data Exchange (ETDEWEB)

    Kairn, T. [Premion Cancer Care, Wesley Medical Centre, Suite 1, 40 Chasely St, Auchenflower Qld 4066, Australia and Science and Engineering Faculty, Queensland University of Technology, G.P.O. Box 2434, Brisbane Qld 4000 (Australia); Crowe, S. B.; Trapp, J. V. [Science and Engineering Faculty, Queensland University of Technology, G.P.O. Box 2434, Brisbane Qld 4000 (Australia)


    Purpose: Intensity modulated radiotherapy (IMRT) treatments require more beam-on time and produce more linac head leakage to deliver similar doses to conventional, unmodulated, radiotherapy treatments. It is necessary to take this increased leakage into account when evaluating the results of radiation surveys around bunkers that are, or will be, used for IMRT. The recommended procedure of applying a monitor-unit based workload correction factor to secondary barrier survey measurements, to account for this increased leakage when evaluating radiation survey measurements around IMRT bunkers, can lead to potentially costly overestimation of the required barrier thickness. This study aims to provide initial guidance on the validity of reducing the value of the correction factor when applied to different radiation barriers (primary barriers, doors, maze walls, and other walls) by evaluating three different bunker designs.Methods: Radiation survey measurements of primary, scattered, and leakage radiation were obtained at each of five survey points around each of three different radiotherapy bunkers and the contribution of leakage to the total measured radiation dose at each point was evaluated. Measurements at each survey point were made with the linac gantry set to 12 equidistant positions from 0° to 330°, to assess the effects of radiation beam direction on the results.Results: For all three bunker designs, less than 0.5% of dose measured at and alongside the primary barriers, less than 25% of the dose measured outside the bunker doors and up to 100% of the dose measured outside other secondary barriers was found to be caused by linac head leakage.Conclusions: Results of this study suggest that IMRT workload corrections are unnecessary, for survey measurements made at and alongside primary barriers. Use of reduced IMRT workload correction factors is recommended when evaluating survey measurements around a bunker door, provided that a subset of the measurements used in

  9. Evaluation of planning dose accuracy in case of radiation treatment on inhomogeneous organ structure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chan Yong; Lee, Jae Hee; Kwak, Yong Kook; Ha, Min Yong [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)


    We are to find out the difference of calculated dose of treatment planning system (TPS) and measured dose in case of inhomogeneous organ structure. Inhomogeneous phantom is made with solid water phantom and cork plate. CT image of inhomogeneous phantom is acquired. Treatment plan is made with TPS (Pinnacle3 9.2. Royal Philips Electronics, Netherlands) and calculated dose of point of interest is acquired. Treatment plan was delivered in the inhomogeneous phantom by ARTISTE (Siemens AG, Germany) measured dose of each point of interest is obtained with Gafchromic EBT2 film (International Specialty Products, US) in the gap between solid water phantom or cork plate. To simulate lung cancer radiation treatment, artificial tumor target of paraffin is inserted in the cork volume of inhomogeneous phantom. Calculated dose and measured dose are acquired as above. In case of inhomogeneous phantom experiment, dose difference of calculated dose and measured dose is about -8.5% at solid water phantom-cork gap and about -7% lower in measured dose at cork-solid water phantom gap. In case of inhomogeneous phantom inserted paraffin target experiment, dose difference is about 5% lower in measured dose at cork-paraffin gap. There is no significant difference at same material gap in both experiments. Radiation dose at the gap between two organs with different electron density is significantly lower than calculated dose with TPS. Therefore, we must be aware of dose calculation error in TPS and great care is suggested in case of radiation treatment planning on inhomogeneous organ structure.

  10. SU-E-J-267: Change in Mean CT Intensity of Lung Tumors During Radiation Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Mahon, R; Tennyson, N; Weiss, E; Hugo, G [Virginia Commonwealth University, Richmond, VA (United States)


    Purpose: To evaluate CT intensity change of lung tumors during radiation therapy. Methods: Repeated 4D CT images were acquired on a CT simulator during the course of therapy for 27 lung cancer patients on IRB approved protocols. All subjects received definitive radiation treatment ± chemotherapy. CT scans were completed prior to treatment, and 2–7 times during the treatment course. Primary tumor was delineated by an experienced Radiation Oncologist. Contours were thresholded between −100 HU and 200 HU to remove airways and bone. Correlations between the change in the mean tumor intensity and initial tumor intensity, SUVmax, and tumor volume change rate were investigated. Reproducibility was assessed by evaluating the variation in mean intensity over all phases in 4DCT, for a subgroup of 19 subjects. Results: Reproducibility of tumor intensity between phases as characterized by the root mean square of standard deviation across 19 subjects was 1.8 HU. Subjects had a mean initial tumor intensity of 16.5 ± 11.6 HU and an overall reduction in HU by 10.3 ± 8.5 HU. Evaluation of the changes in tumor intensity during treatment showed a decrease of 0.3 ± 0.3 HU/day for all subjects, except three. No significant correlation was found between change in HU/day and initial HU intensity (p=0.53), initial PET SUVmax (p=0.69), or initial tumor volume (p=0.70). The rate of tumor volume change was weakly correlated (R{sup 2}=0.05) with HU change (p=0.01). Conclusion: Most lung cancer subjects showed a marked trend of decreasing mean tumor CT intensity throughout radiotherapy, including early in the treatment course. Change in HU/day is not correlated with other potential early predictors for response, such as SUV and tumor volume change. This Result supports future studies to evaluate change in tumor intensity on CT as an early predictor of response.

  11. MO-D-BRB-00: Pediatric Radiation Therapy Planning, Treatment, and Late Effects

    Energy Technology Data Exchange (ETDEWEB)



    Most Medical Physicists working in radiotherapy departments see few pediatric patients. This is because, fortunately, children get cancer at a rate nearly 100 times lower than adults. Children have not smoked, abused alcohol, or been exposed to environmental carcinogens for decades, and of course, have not fallen victim to the aging process. Children get very different cancers than adults. Breast or prostate cancers, typical in adults, are rarely seen in children but instead a variety of tumors occur in children that are rarely seen in adults; examples are germinomas, ependymomas and primitive neuroectodermal tumors, which require treatment of the child’s brain or neuroblastoma, requiring treatment in the abdomen. The treatment of children with cancer using radiation therapy is one of the most challenging planning and delivery problems facing the physicist. This is because bones, brain, breast tissue, and other organs are more sensitive to radiation in children than in adults. Because most therapy departments treat mostly adults, when the rare 8 year-old patient comes to the department for treatment, the physicist may not understand the clinical issues of his disease which drive the planning and delivery decisions. Additionally, children are more prone than adults to developing secondary cancers after radiation. For bilateral retinoblastoma for example, an irradiated child has a 40% chance of developing a second cancer by age 50. The dosimetric tradeoffs made during the planning process are complex and require careful consideration for children treated with radiotherapy. In the first presentation, an overview of childhood cancers and their corresponding treatment techniques will be given. These can be some of the most complex treatments that are delivered in the radiation therapy department. These cancers include leukemia treated with total body irradiation, medulloblastoma, treated with craniospinal irradiation plus a conformal boost to the posterior fossa

  12. Acutely exacerbated hypertension and increased inflammatory signs due to radiation treatment for metastatic pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Teno, Shinichi; Tanabe, Akiyo; Nomura, Kaoru; Demura, Hiroshi [Tokyo Women`s Medical Coll. (Japan)


    Hypertension and norepinephrine hypersecretion in a 59-year-old woman suffering from malignant pheochromocytoma with multiple metastases were appropriately controlled with {alpha}- and {beta}- blockers, and {alpha}-methyltyrosine ({alpha}-MT), a catecholamine-synthesis inhibitor. Metastasized vertebrae were treated with external radiation to relieve pain, but this treatment had to be interrupted at a total dose of 20 Gy because the patient suffered acutely exacerbated hypertension (200/110 mmHg), tachycardia (160 beats/min) and a low-grade fever. Simultaneously her serum levels of LDH, potassium, urea nitrogen, creatinine, white blood cell count, CRP and norepinephrine were significantly increased, suggesting that this episode was due to radiation-induced tissue destruction and the leakage of catecholamines and possibly interleukin-6, a cytokine mediating inflammation which is reportedly present in pheochromocytoma. The marked hypertension was controlled by continuous iv administration of phentolamine and propranolol. Although radiation therapy effectively relieves pain due to neoplasmic metastasis to the bone, physicians should be aware that life-threatening complications such as the above occur in malignant pheochromocytoma. Sufficient pretreatment with adrenergic blocking agents and/or {alpha}-MT and careful monitoring of the patient`s general condition during radiation therapy, even at a low dose, are highly recommended. (author)

  13. SU-E-T-208: Incidence Cancer Risk From the Radiation Treatment for Acoustic Neuroma Patient

    Energy Technology Data Exchange (ETDEWEB)

    Kim, D [Kyung Hee University International Med. Serv., Seoul (Korea, Republic of); Chung, W [Kyung Hee University Hospital at Gangdong, Seoul, Seoul (Korea, Republic of); Shin, D [Kyung Hee University Hospital, Seoul, Seoul (Korea, Republic of); Yoon, M [Korea University, Seoul (Korea, Republic of)


    Purpose: The present study aimed to compare the incidence risk of a secondary cancer from therapeutic doses in patients receiving intensitymodulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic radiosurgery (SRS). Methods: Four acoustic neuroma patients were treated with IMRT, VMAT, or SRS. Their incidnece excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) were estimated using the corresponding therapeutic doses measured at various organs by radio-photoluminescence glass dosimeters (RPLGD) placed inside a humanoid phantom. Results: When a prescription dose was delivered in the planning target volume of the 4 patients, the average organ equivalent doses (OED) at the thyroid, lung, normal liver, colon, bladder, prostate (or ovary), and rectum were measured. The OED decreased as the distance from the primary beam increased. The thyroid received the highest OED compared to other organs. A LAR were estimated that more than 0.03% of AN patients would get radiation-induced cancer. Conclusion: The tyroid was highest radiation-induced cancer risk after radiation treatment for AN. We found that LAR can be increased by the transmitted dose from the primary beam. No modality-specific difference in radiation-induced cancer risk was observed in our study.


    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring; David I. Gertman; Katya Le Blanc


    This paper provides a characterization of human reliability analysis (HRA) issues for computerized procedures in nuclear power plant control rooms. It is beyond the scope of this paper to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper provides a review of HRA as applied to traditional paper-based procedures, followed by a discussion of what specific factors should additionally be considered in HRAs for computerized procedures. Performance shaping factors and failure modes unique to computerized procedures are highlighted. Since there is no definitive guide to HRA for paper-based procedures, this paper also serves to clarify the existing guidance on paper-based procedures before delving into the unique aspects of computerized procedures.

  15. Computerizing marine biota: a rational approach

    Digital Repository Service at National Institute of Oceanography (India)

    Chavan, V.S.; Chandramohan, D.; Parulekar, A.H.

    Data on marine biota while being extensive are also patchy and scattered; thus making retrieval and dissemination of information time consuming. This emphasise the need for computerizing information on marine biota with the objective to collate...

  16. Acquired Tumor Cell Radiation Resistance at the Treatment Site Is Mediated Through Radiation-Orchestrated Intercellular Communication

    Energy Technology Data Exchange (ETDEWEB)

    Aravindan, Natarajan, E-mail: [Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States); Aravindan, Sheeja; Pandian, Vijayabaskar; Khan, Faizan H.; Ramraj, Satish Kumar; Natt, Praveen [Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States); Natarajan, Mohan [Department of Pathology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States)


    Purpose: Radiation resistance induced in cancer cells that survive after radiation therapy (RT) could be associated with increased radiation protection, limiting the therapeutic benefit of radiation. Herein we investigated the sequential mechanistic molecular orchestration involved in radiation-induced radiation protection in tumor cells. Results: Radiation, both in the low-dose irradiation (LDIR) range (10, 50, or 100 cGy) or at a higher, challenge dose IR (CDIR), 4 Gy, induced dose-dependent and sustained NFκB-DNA binding activity. However, a robust and consistent increase was seen in CDIR-induced NFκB activity, decreased DNA fragmentation, apoptosis, and cytotoxicity and attenuation of CDIR-inhibited clonal expansion when the cells were primed with LDIR prior to challenge dose. Furthermore, NFκB manipulation studies with small interfering RNA (siRNA) silencing or p50/p65 overexpression unveiled the influence of LDIR-activated NFκB in regulating CDIR-induced DNA fragmentation and apoptosis. LDIR significantly increased the transactivation/translation of the radiation-responsive factors tumor necrosis factor-α (TNF-α), interleukin-1α (IL-1α), cMYC, and SOD2. Coculture experiments exhibit LDIR-influenced radiation protection and increases in cellular expression, secretion, and activation of radiation-responsive molecules in bystander cells. Individual gene-silencing approach with siRNAs coupled with coculture studies showed the influence of LDIR-modulated TNF-α, IL-1α, cMYC, and SOD2 in induced radiation protection in bystander cells. NFκB inhibition/overexpression studies coupled with coculture experiments demonstrated that TNF-α, IL-1α, cMYC, and SOD2 are selectively regulated by LDIR-induced NFκB. Conclusions: Together, these data strongly suggest that scattered LDIR-induced NFκB-dependent TNF-α, IL-1α, cMYC, and SOD2 mediate radiation protection to the subsequent challenge dose in tumor cells.

  17. Modified Head Shake Computerized Dynamic Posturography (United States)


    form of dizziness (in- cluding complaints of lightheadedness, vertigo , or un- steadiness) lasting longer than 1 hr or recurring for greater than 1...noted limitations. Method: Forty participants ranging in age from 20 to 79 years with no history of dizziness completed Conditions 2 and 5 of the SOT...shake, Sensory Organization Test, computerized dynamic posturography, dizziness Computerized dynamic posturography (CDP) is anassessment of an

  18. Computerized ultrasound risk evaluation system (United States)

    Duric, Nebojsa; Littrup, Peter J.; Holsapple, III, Earle; Barter, Robert Henry; Moore, Thomas L.; Azevedo, Stephen G.; Ferguson, Sidney W.


    A method and system for examining tissue are provided in which the tissue is maintained in a position so that it may be insonified with a plurality of pulsed spherical or cylindrical acoustic waves. The insonifying acoustic waves are scattered by the tissue so that scattered acoustic radiation including a mix of reflected and transmitted acoustic waves is received. A representation of a portion of the tissue is then derived from the received scattered acoustic radiation.

  19. Optimization of Heart Block in the Left-sided Whole Breast Radiation Treatments

    Directory of Open Access Journals (Sweden)

    Ning Jeff Yue


    Full Text Available Purpose: Blocks have been used to protect heart from potential radiation damage in left-sided breast treatments. Since cardiac motion pattern may not be fully captured on conventional 3DCT or 4DCT simulation scans, this study was intended to investigate the optimization of the heart block design taking the cardiac motion into consideration.Materials and Methods: Whole breast treatment plans using two opposed tangential fields were designed based on 4DCT simulation images for 10 left-sided breast cancer patients. Using an OBI system equipped to a Varian Linac, beam-eye viewed fluoroscopy images were acquired for each of the treatment beams after patient treatment setup, and the MLC heart blocks were overlaid onto the fluoroscopy images with an in-house software package. A non-rigid image registration and tracking algorithm was utilized to track the cardiac motion on the fluoroscopy images with minimal manual delineation for initialization, and the tracked cardiac motion information was used to optimize the heart block design to minimize the radiation damage to heart while avoiding the over-shielding that may lead to underdosing certain breast tissues. Results: Twenty-three sets of fluoroscopy images were acquired on 23 different days of treatment for the 10 patients. As expected, heart moved under the influences of both respiratory and cardiac motion. It was observed that for 16 out of the 23 treatments heart moved beyond the planed heart block into treatment fields and MLC had to be adjusted to fully block heart. The adjustment was made for all but one patient. The number of the adjusted MLC leaves ranged from 1 to 16 (mean = 10, and the MLC leaf position adjustment ranged from 2 mm to 10 mm (mean = 6 mm. The added heart block areas ranged from 3 mm2 to 1230 mm2 (mean = 331 mm2. Conclusion: In left-sided whole breast radiation treatments, simulation CT (and 4DCT based heart block design may not provide adequate heart protection for all the

  20. Long-term results and complications of preoperative radiation in the treatment of rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Reed, W.P.; Garb, J.L.; Park, W.C.; Stark, A.J.; Chabot, J.R.; Friedmann, P.


    A retrospective study of 149 patients with rectal cancer diagnosed between 1972 and 1979 was undertaken to compare survival, disease-free survival, recurrence sites, and long-term complications of 40 patients who received 4000 to 4500 rads of preoperative adjuvant radiotherapy (radiation group) with those of 109 patients treated by resection alone (control group). After a mean follow-up of 84 months and 99 months, respectively, survival of the irradiated patients was significantly better than that of controls (68% versus 52%, p less than 0.05). Disease-free survival of those patients rendered free of disease by treatment was also superior for the irradiated group (84% versus 57%, p less than 0.005). Local recurrence without signs of distant metastases developed only one-third as often in irradiated patients (6% versus 18%). Distant metastases, alone or in combination with local recurrence, were also less common after radiation (12% versus 27%). Second primary tumors developed in 15% and 10% of the respective groups, a difference that was not statistically significant. When we consider the survival benefit of preoperative radiation therapy, long-term complications were relatively mild. Delayed healing of the perineum was noted in two irradiated patients. Persistent diarrhea was severe enough to warrant treatment in only one case, and one patient required a colostomy for intestinal obstruction from pelvic fibrosis.

  1. Successful treatment of a case of extensive radiation burns with multiple organ dysfunction syndrome. (United States)

    Li, Yeyang; Wang, Jinlun; Li, Gang; Lin, Weihua; Li, Xiaojian; Tong, Renlian


    A patient sustained acute third-degree radiation burns over 41% of his body surface. The burns were due to occupational injury caused by an electron accelerator. Most of his wounds appeared and spread gradually during the 10th week after the radiation burn. Subsequently, severe wound infection with methicillin-resistant Staphylococcus aureus, severe pneumonia, respiratory failure, systemic inflammatory response syndrome, nephropathy, and hypoproteinemia had developed 3 months after the radiation injury. Most of the skin grafts could neither survive nor spread on the fresh wound after removing the necrotic tissue. This phenomenon resulted in many more wounds after operations, increasing the risk of wound infection. Parenteral nutrition, respiratory support with a ventilator, antibiotics for methicillin-resistant Staphylococcus aureus, steroid therapeutics for nephropathy, deeper debridement for wounds, and skin grafting were applied for treatment of this patient. The patient recovered gradually and was discharged from the hospital in good condition after 18 months. The authors suggest that deeper excision of necrotic tissue and skin grafting as well as appropriate antibiotics are principal measures to counteract systemic inflammatory response syndrome. Sufficient albumen by vein and steroid should be administered for treatment against nephropathy and for control of infection. Functions of organs should be carefully monitored to fine-tune the therapeutic programs and to minimize complications of organs.

  2. [Evaluation of Radiation Dose during Stent-graft Treatment Using a Hybrid Operating Room System]. (United States)

    Haga, Yoshihiro; Chida, Kouichi; Kaga, Yuji; Saitou, Kazuhisa; Arai, Takeshi; Suzuki, Shinichi; Iwaya, Yoshimi; Kumasaka, Eriko; Kataoka, Nozomi; Satou, Naoto; Abe, Mitsuya


    In recent years, aortic aneurysm treatment with stent graft grafting in the X-ray fluoroscopy is increasing. This is an endovascular therapy, because it is a treatment which includes the risk of radiation damage, having to deal with radiation damage, to know in advance is important. In this study, in order to grasp the trend of exposure stent graft implantation in a hybrid operating room (OR) system, focusing on clinical data (entrance skin dose and fluoroscopy time), was to count the total. In TEVAR and EVAR, fluoroscopy time became 13.40 ± 7.27 minutes, 23.67 ± 11.76 minutes, ESD became 0.87 ± 0.41 mGy, 1.11 ± 0.57 mGy. (fluoroscopy time of EVAR was 2.0 times than TEVAR. DAP of EVAR was 1.2 times than TEVAR.) When using the device, adapted lesions and usage are different. This means that care changes in exposure-related factors. In this study, exposure trends of the stent graft implantation was able to grasp. It can be a helpful way to reduce/optimize the radiation dose in a hybrid OR system.

  3. A surrogate-based metaheuristic global search method for beam angle selection in radiation treatment planning (United States)

    Zhang, H. H.; Gao, S.; Chen, W.; Shi, L.; D'Souza, W. D.; Meyer, R. R.


    An important element of radiation treatment planning for cancer therapy is the selection of beam angles (out of all possible coplanar and non-coplanar angles in relation to the patient) in order to maximize the delivery of radiation to the tumor site and minimize radiation damage to nearby organs-at-risk. This category of combinatorial optimization problem is particularly difficult because direct evaluation of the quality of treatment corresponding to any proposed selection of beams requires the solution of a large-scale dose optimization problem involving many thousands of variables that represent doses delivered to volume elements (voxels) in the patient. However, if the quality of angle sets can be accurately estimated without expensive computation, a large number of angle sets can be considered, increasing the likelihood of identifying a very high quality set. Using a computationally efficient surrogate beam set evaluation procedure based on single-beam data extracted from plans employing equally-spaced beams (eplans), we have developed a global search metaheuristic process based on the nested partitions framework for this combinatorial optimization problem. The surrogate scoring mechanism allows us to assess thousands of beam set samples within a clinically acceptable time frame. Tests on difficult clinical cases demonstrate that the beam sets obtained via our method are of superior quality.

  4. Hafnium-doped hydroxyapatite nanoparticles with ionizing radiation for lung cancer treatment. (United States)

    Chen, Min-Hua; Hanagata, Nobutaka; Ikoma, Toshiyuki; Huang, Jian-Yuan; Li, Keng-Yuan; Lin, Chun-Pin; Lin, Feng-Huei


    Recently, photodynamic therapy (PDT) is one of the new clinical options by generating cytotoxic reactive oxygen species (ROS) to kill cancer cells. However, the optical approach of PDT is limited by tissue penetration depth of visible light. In this study, we propose that a ROS-enhanced nanoparticle, hafnium-doped hydroxyapatite (Hf:HAp), which is a material to yield large quantities of ROS inside the cells when the nanoparticles are bombarded with high penetrating power of ionizing radiation. Hf:HAp nanoparticles are generated by wet chemical precipitation with total doping concentration of 15mol% Hf(4+) relative to Ca(2+) in HAp host material. The results show that the HAp particles could be successfully doped with Hf ions, resulted in the formation of nano-sized rod-like shape and with pH-dependent solubility. The impact of ionizing radiation on Hf:HAp nanoparticles is assessed by using in-vitro and in-vivo model using A549 cell line. The 2',7'-dichlorofluorescein diacetate (DCFH-DA) results reveal that after being exposed to gamma rays, Hf:HAp could significantly lead to the formation of ROS in cells. Both cell viability (WST-1) and cytotoxicity (LDH) assay show the consistent results that A549 lung cancer cell lines are damaged with changes in the cells' ROS level. The in-vivo studies further demonstrate that the tumor growth is inhibited owing to the cells apoptosis when Hf:HAp nanoparticles are bombarded with ionizing radiation. This finding offer a new therapeutic method of interacting with ionizing radiation and demonstrate the potential of Hf:HAp nanoparticles in tumor treatment, such as being used in a palliative treatment after lung surgical procedure. Photodynamic therapy (PDT) is one of the new clinical options by generating cytotoxic reactive oxygen species (ROS) to kill cancer cells. Unfortunately, the approach of PDT is usually limited to the treatment of systemic disease and deeper tumor, due to the limited tissue penetration depth of visible

  5. On the importance of prompt oxygen changes for hypofractionated radiation treatments (United States)

    Kissick, Michael; Campos, David; van der Kogel, Albert; Kimple, Randall


    This discussion is motivated by observations of prompt oxygen changes occurring prior to a significant number of cancer cells dying (permanently stopping their metabolic activity) from therapeutic agents like large doses of ionizing radiation. Such changes must be from changes in the vasculature that supplies the tissue or from the metabolic changes in the tissue itself. An adapted linear-quadratic treatment is used to estimate the cell survival variation magnitudes from repair and reoxygenation from a two-fraction treatment in which the second fraction would happen prior to significant cell death from the first fraction, in the large fraction limit. It is clear the effects of oxygen changes are likely to be the most significant factor for hypofractionation because of large radiation doses. It is a larger effect than repair. Optimal dose timing should be determined by the peak oxygen timing. A call is made to prioritize near real time measurements of oxygen dynamics in tumors undergoing hypofractionated treatments in order to make these treatments adaptable and patient-specific.

  6. Efficacy and safety of far infrared radiation in lymphedema treatment: clinical evaluation and laboratory analysis. (United States)

    Li, Ke; Zhang, Zheng; Liu, Ning Fei; Feng, Shao Qing; Tong, Yun; Zhang, Ju Fang; Constantinides, Joannis; Lazzeri, Davide; Grassetti, Luca; Nicoli, Fabio; Zhang, Yi Xin


    Swelling is the most common symptom of extremities lymphedema. Clinical evaluation and laboratory analysis were conducted after far infrared radiation (FIR) treatment on the main four components of lymphedema: fluid, fat, protein, and hyaluronan. Far infrared radiation is a kind of hyperthermia therapy with several and additional benefits as well as promoting microcirculation flow and improving collateral lymph circumfluence. Although FIR therapy has been applied for several years on thousands of lymphedema patients, there are still few studies that have reported the biological effects of FIR on lymphatic tissue. In this research, we investigate the effects of far infrared rays on the major components of lymphatic tissue. Then, we explore the effectiveness and safety of FIR as a promising treatment modality of lymphedema. A total of 32 patients affected by lymphedema in stage II and III were treated between January 2015 and January 2016 at our department. After therapy, a significant decrease of limb circumference measurements was noted and improving of quality of life was registered. Laboratory examination showed the treatment can also decrease the deposition of fluid, fat, hyaluronan, and protein, improving the swelling condition. We believe FIR treatment could be considered as both an alternative monotherapy and a useful adjunctive to the conservative or surgical lymphedema procedures. Furthermore, the real and significant biological effects of FIR represent possible future applications in wide range of the medical field.

  7. Impact of Boost Radiation in the Treatment of Ductal Carcinoma In Situ: A Population-Based Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rakovitch, Eileen, E-mail: [Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario (Canada); Institute for Clinical Evaluative Sciences, Toronto, Ontario (Canada); University of Toronto, Toronto, Ontario (Canada); Narod, Steven A. [University of Toronto, Toronto, Ontario (Canada); Women’s College Research Institute, Toronto, Ontario (Canada); Nofech-Moses, Sharon; Hanna, Wedad [Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario (Canada); University of Toronto, Toronto, Ontario (Canada); Thiruchelvam, Deva; Saskin, Refik; Taylor, Carole [Institute for Clinical Evaluative Sciences, Toronto, Ontario (Canada); Tuck, Alan [London Health Sciences Center, London, Ontario (Canada); Youngson, Bruce; Miller, Naomi; Done, Susan J. [University Health Network, Toronto, Ontario (Canada); Sengupta, Sandip [Kingston General Hospital, Kingston, Ontario (Canada); Elavathil, Leela [University of Toronto, Toronto, Ontario (Canada); Henderson General Hospital, 711 Concession Street, Hamilton, Ontario (Canada); Jani, Prashant A. [University of Toronto, Toronto, Ontario (Canada); Regional Health Sciences Centre, Thunder Bay, Ontario (Canada); Bonin, Michel [Sudbury Regional Hospital, Sudbury, Ontario (Canada); Metcalfe, Stephanie [Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario (Canada); Paszat, Lawrence [Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario (Canada); Institute for Clinical Evaluative Sciences, Toronto, Ontario (Canada); University of Toronto, Toronto, Ontario (Canada)


    Purpose: To report the outcomes of a population of women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery and radiation and to evaluate the independent effect of boost radiation on the development of local recurrence. Methods and Materials: All women diagnosed with DCIS and treated with breast-conserving surgery and radiation therapy in Ontario from 1994 to 2003 were identified. Treatments and outcomes were identified through administrative databases and validated by chart review. The impact of boost radiation on the development of local recurrence was determined using survival analyses. Results: We identified 1895 cases of DCIS that were treated by breast-conserving surgery and radiation therapy; 561 patients received boost radiation. The cumulative 10-year rate of local recurrence was 13% for women who received boost radiation and 12% for those who did not (P=.3). The 10-year local recurrence-free survival (LRFS) rate among women who did and who did not receive boost radiation was 88% and 87%, respectively (P=.27), 94% and 93% for invasive LRFS (P=.58), and was 95% and 93% for DCIS LRFS (P=.31). On multivariable analyses, boost radiation was not associated with a lower risk of local recurrence (hazard ratio = 0.82, 95% confidence interval 0.59-1.15) (P=.25). Conclusions: Among a population of women treated with breast-conserving surgery and radiation for DCIS, additional (boost) radiation was not associated with a lower risk of local or invasive recurrence.

  8. SU-C-19A-05: Treatment Chairs for Modern Radiation Therapy Treatments

    Energy Technology Data Exchange (ETDEWEB)

    Court, L; Fullen, D; Tharp, K; Palmer, J; Ungchusri, G; Reyes, L; Tong, T; Nguyen, S; Phillips, T; Balter, P [UT MD Anderson Cancer Center, Houston, TX (United States)


    Purpose: Treating patients in a seated position has potential advantages including improved comfort, increased lung volume, and reduced respiratory motion. We compared chair designs for head and neck, thoracic and breast patients for use with either IGRT linacs or a proposed low-cost fixed horizontal beam-line machine. Methods: Three treatment chairs were designed and constructed. Two of the chairs are based on a massage-chair, with the patient angled slightly forwards and knee rests used to minimize intra-fraction slouch. The third chair design is more conventional; the patient is angled backwards, with indexed positioning devices and the ability to attach thermoplastic masks. Patient geometries, including PTV location and patient sizes, were extracted from 137 CTs of past patients were used to model the probability of collision between the patient and the linac for various seated positions. All chairs were designed around the weight limits for couches on our linacs. At the time of writing we have just received IRB approval for imaging studies to evaluate comfort, and intra- and interfraction reproducibility. Results: The geometric analysis showed that head and neck patients and thoracic patients could be treated without collision. However, there is very limited space between the patient and the treatment/imaging devices, so careful design of the chair is essential. The position of the treatment target and extended arm positioning means that this is a particular concern for thoracic and breast patients. This was demonstrated for one of the prototype chairs designed for breast treatment where the arm holders would collide with the kV detector. The extra clearance of a dedicated fixed-beam linac would overcome these difficulties. Intra- and inter-fraction reproducibility results will be presented at the meeting. Conclusion: To take advantage of the clinical advantages of seated treatments, appropriate treatment chairs are needed. A dedicate fixed-beam linac may

  9. A pilot study of intensity modulated radiation therapy with hypofractionated stereotactic body radiation therapy (SBRT) boost in the treatment of intermediate- to high-risk prostate cancer. (United States)

    Oermann, Eric K; Slack, Rebecca S; Hanscom, Heather N; Lei, Sue; Suy, Simeng; Park, Hyeon U; Kim, Joy S; Sherer, Benjamin A; Collins, Brian T; Satinsky, Andrew N; Harter, K William; Batipps, Gerald P; Constantinople, Nicholas L; Dejter, Stephen W; Maxted, William C; Regan, James B; Pahira, John J; McGeagh, Kevin G; Jha, Reena C; Dawson, Nancy A; Dritschilo, Anatoly; Lynch, John H; Collins, Sean P


    Clinical data suggest that large radiation fractions are biologically superior to smaller fraction sizes in prostate cancer radiotherapy. The CyberKnife is an appealing delivery system for hypofractionated radiosurgery due to its ability to deliver highly conformal radiation and to track and adjust for prostate motion in real-time. We report our early experience using the CyberKnife to deliver a hypofractionated stereotactic body radiation therapy (SBRT) boost to patients with intermediate- to high-risk prostate cancer. Twenty-four patients were treated with hypofractionated SBRT and supplemental external radiation therapy plus or minus androgen deprivation therapy (ADT). Patients were treated with SBRT to a dose of 19.5 Gy in 3 fractions followed by intensity modulated radiation therapy (IMRT) to a dose of 50.4 Gy in 28 fractions. Quality of life data were collected with American Urological Association (AUA) symptom score and Expanded Prostate Cancer Index Composite (EPIC) questionnaires before and after treatment. PSA responses were monitored; acute urinary and rectal toxicities were assessed using Common Toxicity Criteria (CTC) v3. All 24 patients completed the planned treatment with an average follow-up of 9.3 months. For patients who did not receive ADT, the median pre-treatment PSA was 10.6 ng/ml and decreased in all patients to a median of 1.5 ng/ml by 6 months post-treatment. Acute effects associated with treatment included Grade 2 urinary and gastrointestinal toxicity but no patient experienced acute Grade 3 or greater toxicity. AUA and EPIC scores returned to baseline by six months post-treatment. Hypofractionated SBRT combined with IMRT offers radiobiological benefits of a large fraction boost for dose escalation and is a well tolerated treatment option for men with intermediate- to high-risk prostate cancer. Early results are encouraging with biochemical response and acceptable toxicity. These data provide a basis for the design of a phase II clinical


    Directory of Open Access Journals (Sweden)

    Y. V. Fedosov


    Full Text Available The paper proposes a new approach to the design of the technological equipment used for surface treatment of a free-form object by laser radiation. Design advantages and disadvantages of the similar laser cutting machine with beam focusing control are considered. We propose a new scheme that improves the optical characteristics of the device by reducing the number of reflections in the collimating system. The base for the proposed mechanism is XY table with numerical control. The driven element of the apparatus is the optical head with the ability to adjust the focal distance and the system of beam stabilization based on a modified Stewart platform. Laser radiation of the ultraviolet range is transmitted from the laser source through the optical fiber. A proposed solution is implemented in experimental device for selective polymer curing.

  11. Treatment of folliculitis decalvans using intensity-modulated radiation via tomotherapy. (United States)

    Elsayad, Khaled; Kriz, Jan; Haverkamp, Uwe; Plachouri, Kerasia-Maria; Jeskowiak, Antonia; Sunderkötter, Cord; Eich, Hans Theodor


    Folliculitis decalvans (FD) is a form of primary neutrophilic scarring alopecia that is characterized clinically by chronic suppurative folliculitis and often associated with pruritus or even pain. Treatment of FD is often difficult. Herein, we report a case of recalcitrant and painful folliculitis decalvans refractory to antibiotic and anti-inflammatory therapies, which was successfully treated by intensity-modulated radiotherapy (IMRT) in order to irreversibly eliminate hair follicles that prove to be one etiological trigger. A 45-year-old male patient with a refractory FD presented with a crusting suppurative folliculitis and atrophic scarring patches on the scalp associated with pain and pruritus. We attempted relief of symptoms by reducing scalp inflammation and eliminating hair follicles through radiation. We delivered 11.0 Gy in two radiation series using tomotherapy, 5.0 Gy in 5 equivalent fractions as a first radiation course. The symptoms markedly decreased but did not totally disappear. Therefore, we delivered a second radiation series 4 months later with an additional 6 Gy. This led to almost complete epilation on the scalp and abolished pain and pruritus on the capillitium. The patient was regularly followed up until 26 months after radiotherapy. Draining lesions or exudation did not recur. He only experienced discrete hair regrowth in the occipital region with folliculitis 12 months after radiotherapy. These residual lesions are currently treated with laser epilation therapy. A radical approach to eliminating hair follicles by repeated radiation therapy may induce lasting relief of symptoms in chronic suppurative FD associated with persistent trichodynia.

  12. Moderate salt treatment alleviates ultraviolet-B radiation caused impairment in poplar plants (United States)

    Ma, Xuan; Ou, Yong-Bin; Gao, Yong-Feng; Lutts, Stanley; Li, Tao-Tao; Wang, Yang; Chen, Yong-Fu; Sun, Yu-Fang; Yao, Yin-An


    The effects of moderate salinity on the responses of woody plants to UV-B radiation were investigated using two Populus species (Populus alba and Populus russkii). Under UV-B radiation, moderate salinity reduced the oxidation pressure in both species, as indicated by lower levels of cellular H2O2 and membrane peroxidation, and weakened the inhibition of photochemical efficiency expressed by O-J-I-P changes. UV-B-induced DNA lesions in chloroplast and nucleus were alleviated by salinity, which could be explained by the higher expression levels of DNA repair system genes under UV-B&salt condition, such as the PHR, DDB2, and MutSα genes. The salt-induced increase in organic osmolytes proline and glycine betaine, afforded more efficient protection against UV-B radiation. Therefore moderate salinity induced cross-tolerance to UV-B stress in poplar plants. It is thus suggested that woody plants growing in moderate salted condition would be less affected by enhanced UV-B radiation than plants growing in the absence of salt. Our results also showed that UV-B signal genes in poplar plants PaCOP1, PaSTO and PaSTH2 were quickly responding to UV-B radiation, but not to salt. The transcripts of PaHY5 and its downstream pathway genes (PaCHS1, PaCHS4, PaFLS1 and PaFLS2) were differently up-regulated by these treatments, but the flavonoid compounds were not involved in the cross-tolerance since their concentration increased to the same extent in both UV-B and combined stresses.

  13. Risk of a second cancer from scattered radiation in acoustic neuroma treatment

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Myonggeun; Lee, Hyunho; Sung, Jiwon [Korea University, Seoul (Korea, Republic of); Shin, Dongoh [Kyung Hee University Medical Center, Seoul (Korea, Republic of); Park, Sungho [Ulsan University Hospital, Ulsan (Korea, Republic of); Chung, Weonkuu; Jahng, Geonho; Kim, Dongwook [Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)


    The present study aimed to compare the risk of a secondary cancer from scattered and leakage doses in patients receiving intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic radiosurgery (SRS). Four acoustic neuroma patients were treated with IMRT, VMAT, or SRS. Their excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) of a secondary cancer were estimated using the corresponding secondary doses measured at various organs by using radio-photoluminescence glass dosimeters (RPLGD) placed inside a humanoid phantom. When a prescription dose was delivered in the planning target volume of the 4 patients, the average organ equivalent doses (OED) at the thyroid, lung, liver, bowel, bladder, prostate (or ovary), and rectum were 14.6, 1.7, 0.9, 0.8, 0.6, 0.6, and 0.6 cGy, respectively, for IMRT whereas they were 19.1, 1.8, 2.0, 0.6, 0.4, 0.4, and 0.4 cGy, respectively, for VMAT, and 22.8, 4.6, 1.4, 0.7, 0.5, 0.5, and 0.5 cGy, respectively, for SRS. The OED decreased as the distance from the primary beam increased. The thyroid received the highest OED compared to other organs. A lifetime attributable risk evaluation estimated that more than 0.03% of acoustic neuroma (AN) patients would get radiation-induced cancer within 20 years of receiving radiation therapy. The organ with the highest radiation-induced cancer risk after radiation treatment for AN was the thyroid. We found that the LAR could be increased by the transmitted dose from the primary beam. No modality-specific difference in radiation-induced cancer risk was observed in our study.

  14. Assessing Response to Radiation Therapy Treatment of Bone Metastases: Short-Term Followup of Radiation Therapy Treatment of Bone Metastases with Diffusion-Weighted Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Salvatore Cappabianca


    Full Text Available This study examined the usefulness of diffusion-weighted (DW Magnetic Resonance Imaging (MRI in monitoring bone metastases response to radiation therapy in 15 oligometastatic patients. For each metastasis, both mean apparent diffusion coefficient (ADC changes and high b-value DW metastasis/muscle signal intensity ratio (SIR variations were evaluated at 30 ± 5 days and 60 ± 7 days after the end of treatment. On baseline DW-MRI, all bone metastases were hyperintense and had signal intensities higher than normal bone marrow on calculated ADC maps. At follow-up evaluations, 4 patterns of response were identified: (I decreased high b-value DW SIR associated with increased mean ADC (83.3% of cases; (II increased mean ADC with no change of high b-value DW SIR (10% of cases; (III decreased both high b-value DW SIR and mean ADC (3.3% of cases; (IV a reduction in mean ADC associated with an increase in high b-value DW SIR compared to pretreatment values (3.3% of cases. Patterns (I and (II suggested a good response to therapy; pattern (III was classified as indeterminate, while pattern (IV was suggestive of disease progression. This pattern approach may represent a useful tool in the differentiation between treatment-induced necrosis and highly cellular residual tumor.

  15. Use of radionuclides at small water purification plants and in industrial waste water treatment by radiation adsorption method

    Energy Technology Data Exchange (ETDEWEB)

    Brusentseva, S.A.; Egorov, G.F.; Shubin, V.N. [and others


    An irradiation technique for potable water treatment is described. Use of radionuclides as a source of radiation allows for the automation of the process. The treatment is considered to be effective in waste water treatment to remove phenols, pesticides, and other toxic compounds.

  16. Targeted therapies and radiation for the treatment of head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gwi Eon [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    The purpose of this review is to provide an update on novel radiation treatments for head and neck cancer. Despite the remarkable advances in chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) is an appealing target for novel therapies in head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuximab) and tyrosine kinase inhibitors (ZD1839 and OSI-774) have been assessed and have been most extensively studied in preclinical models and clinical trials. Additional TKIs in clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted in rapid translation into the clinic. Results from initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or in combination with chemotherapy. In this review, we begin with a brief summary of erbB-mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinical and clinical data on the role of EGFR antagonists alone or in combination with radiation in the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR blockade and efforts in the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2

  17. Improving efficiency and safety in external beam radiation therapy treatment delivery using a Kaizen approach. (United States)

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


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

  18. Radiofrequency ablation using BarRx for the endoscopic treatment of radiation proctopathy: a series of three cases

    Directory of Open Access Journals (Sweden)

    Patel A


    Full Text Available Anish Patel, Rahul Pathak, Vrushak Deshpande, Sunil H Patel, Prasanna C Wickremesinghe, Deepak Vadada Department of Gastrointestinal Medicine, Richmond University Medical Center, Staten Island, NY, USA Abstract: Radiation proctopathy is a complication of pelvic radiotherapy, which occurs in patients treated for carcinoma of the prostate, rectum, urinary bladder, cervix, uterus, and testes. If it presents within 6 weeks to 9 months after therapy, it is called acute radiation proctitis/proctopathy (ARP, and if it occurs 9 months to a year after treatment, it is classified as chronic radiation proctitis/proctopathy (CRP. CRP occurs in 5%–20% of patients receiving pelvic radiation, depending on the radiation dose and the presence or absence of chemotherapy. In many cases, CRP resolves spontaneously, but in some, it can lead to persistent rectal bleeding. Other symptoms of CRP include diarrhea, mucoid discharge, urgency, tenesmus, rectal pain, and fecal incontinence. Despite the availability of several therapies, many patients fail to respond, and continue to suffer in their quality of life. Radiofrequency ablation (RFA is a newer endoscopic technique that uses radiofrequency energy to ablate tissue. This is an emerging way to treat radiation proctopathy and other mucosal telangiectasia. We present three cases of radiation proctopathy treated with RFA at our institute and review the literature on treatment modalities for CRP. We were also able to find 16 other cases of CRP that used RFA, and review their literature as well as literature on other treatment modalities. Keywords: radiofrequency ablation, radiation proctopathy, BarRx, Halo catheter

  19. Successful treatment of pituitary carcinoma with concurrent radiation, temozolomide, and bevacizumab after resection. (United States)

    Touma, Waseem; Hoostal, Spencer; Peterson, Richard A; Wiernik, Andres; SantaCruz, Karen S; Lou, Emil


    The optimal treatment of pituitary carcinomas (PC) is unknown. Treatment includes surgical resection, radiation, and more recently, temozolomide (TMZ). Pituitary adenomas have relatively high expression of vascular endothelial growth factor; therefore, bevacizumab, an antiangiogenic agent, has been used in a small number of aggressive or malignant pituitary tumors after recurrence. However, it has not been administered concurrently with other chemotherapeutic agents or combined with radiation therapy in PC. We present a 63-year-old man with an adrenocorticotropic hormone (ACTH)-secreting PC, causing visual loss. It was resected transsphenoidally. There were several notable factors placing the patient at high risk for recurrence including distant metastasis in the form of a pulmonary nodule. Morphologically, his tumor was a pituitary neoplasm with malignant histopathologic features. It had abundant mitotic figures and zones of necrosis. Six weeks post-surgery, the patient started concurrent chemoradiation, using combination therapy with TMZ and bevacizumab. TMZ was continued for 12 cycles in the adjuvant setting. The ACTH was effective as a serum-based tumor marker and normalized during treatment. The patient is alive, five years after diagnosis, with no recurrence to date. This is the first case of pituitary carcinoma treated successfully with concurrent chemoradiation therapy that combined TMZ and bevacizumab with a long-term follow up.

  20. On-line course as tools for radiation protection training in patients. A practical case in computerized tomography; El Aula Virtual como herramienta para la formacion en PR del paciente; caso practico en tomografia computarizada

    Energy Technology Data Exchange (ETDEWEB)

    Medina Campos, J.; Fernandez Tallon, J.; Busca Suau, J.; Baro Casanovas, J.


    The rise in ionizing radiation applications within the field of diagnostics, with the corresponding increase in both number and doses received by patients, requires adequate resources for education and training in radiological protection. In is quite difficult to assemble professionals at a specific place to carry out training. However, the use of Information and Communication Technologies (IT) makes it possible to carry out training. However, the use of Information and Communication Technologies (IT) makes it possible to carry out training through Internet in an effective, easy and amusing way (e-learning). An on-line course of patient radiological protection and quality control in computer tomography has been developed aimed at professionals that use these diagnostic techniques. The course has been run twice in the period 2005-2006. The course is found on an Internet-accessible Virtual Campus, which allows access to multimedia contents, communication between students and instructors and follow-up of students performance. Final evaluation is done on-line and successfully passing the course counts for 8.9 credits in the Continuous Education Programme of Spanish Health Systems. (Author)

  1. Applications of radiation processing in combination with conventional treatments to assure food safety: New development

    Energy Technology Data Exchange (ETDEWEB)

    Lacroix, M. [Canadian Irradiation Center, Research Laboratory in Sciences Applied to Food, INRS-Institut Armand-Frappier, 531 Boulevard des Prairies, Laval, Quebec (Canada)], E-mail:; Turgis, M. [Canadian Irradiation Center, Research Laboratory in Sciences Applied to Food, INRS-Institut Armand-Frappier, 531 Boulevard des Prairies, Laval, Quebec (Canada); Borsa, J. [MDS Nordion, 447 March Road, Kanata, Ontario, K2K 2P7 (Canada); Millette, M.; Salmieri, S.; Caillet, S. [Canadian Irradiation Center, Research Laboratory in Sciences Applied to Food, INRS-Institut Armand-Frappier, 531 Boulevard des Prairies, Laval, Quebec (Canada); Han, J. [Sungkyunkwan University, Department of Food Science and Biotechnology, Suwon 440-746 (Korea, Republic of)


    Spice extracts under the form of essential oils (Eos) were tested for their efficiency to increase the relative bacterial radiosensitivity (RBR) of Listeria monocytogenes, Escherichia coli and Salmonellatyphi in culture media under different atmospheric conditions. The selected Eos were tested for their ability to reduce the dose necessary to eliminate E. coli and S.typhi in medium fat ground beef (23% fat) and Listeria in ready-to-eat carrots when packed under air or under atmosphere rich in oxygen (MAP). Results have demonstrated that depending of the compound added and the combined treatment used, the RBR increased from 2 to 4 times. In order to evaluate the industrial feasibility, EOs were added in ground beef at a concentration which does not affect the taste and treated at a dose of 1.5 kGy. The content of total mesophilic aerobic, E. coli, Salmonella, total coliform, lactic acid bacteria, and Pseudomonas was determined during 28 days. The results showed that the combined treatment (radiation and EOs) can eliminate Salmonella and E. coli when done under air. When done under MAP, Pseudomonas could be eliminated and a shelf life of more than 28 days was observed. An active edible coating containing EOs was also developed and sprayed on ready-to-eat carrots before radiation treatment and Listeria was evaluated. A complete inhibition of Listeria was obtained at a dose of 0.5 kGy when applied under MAP. Our results have shown that the combination of an edible coating, MAP, and radiation can be used to maintain the safety of meat and vegetables.

  2. Applications of radiation processing in combination with conventional treatments to assure food safety: New development (United States)

    Lacroix, M.; Turgis, M.; Borsa, J.; Millette, M.; Salmieri, S.; Caillet, S.; Han, J.


    Spice extracts under the form of essential oils (Eos) were tested for their efficiency to increase the relative bacterial radiosensitivity (RBR) of Listeria monocytogenes, Escherichia coli and Salmonellatyphi in culture media under different atmospheric conditions. The selected Eos were tested for their ability to reduce the dose necessary to eliminate E. coli and S.typhi in medium fat ground beef (23% fat) and Listeria in ready-to-eat carrots when packed under air or under atmosphere rich in oxygen (MAP). Results have demonstrated that depending of the compound added and the combined treatment used, the RBR increased from 2 to 4 times. In order to evaluate the industrial feasibility, EOs were added in ground beef at a concentration which does not affect the taste and treated at a dose of 1.5 kGy. The content of total mesophilic aerobic, E. coli, Salmonella, total coliform, lactic acid bacteria, and Pseudomonas was determined during 28 days. The results showed that the combined treatment (radiation and EOs) can eliminate Salmonella and E. coli when done under air. When done under MAP, Pseudomonas could be eliminated and a shelf life of more than 28 days was observed. An active edible coating containing EOs was also developed and sprayed on ready-to-eat carrots before radiation treatment and Listeria was evaluated. A complete inhibition of Listeria was obtained at a dose of 0.5 kGy when applied under MAP. Our results have shown that the combination of an edible coating, MAP, and radiation can be used to maintain the safety of meat and vegetables.

  3. A System for Continual Quality Improvement of Normal Tissue Delineation for Radiation Therapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States); Roeske, John C., E-mail: [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States)


    Purpose: To implement the 'plan-do-check-act' (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. Methods and Materials: The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues ('gold' contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Results: Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes <8 cc, the average DSC was 0.61 vs organ volumes {>=}8 cc, for which the average DSC was 0.91 (P=.005). Normal tissues that had the lowest scores included the lenses, optic nerves, chiasm, cochlea, and esophagus. Of the 11 organs that were considered for re-testing, 10 showed improvement in the average score, and statistically significant improvement was noted in more than half of these organs after education and re-assessment. Conclusions: The results of this study indicate the feasibility of applying the PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose

  4. Successful Treatment of an Angiosarcoma of the Nose with Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Vatsal B. Patel


    Full Text Available Angiosarcoma is a rare, aggressive malignancy of endothelial cells lining blood vessels. It poses therapeutic challenges since there is no standard established treatment. It is typically treated with resection and wide-field postoperative radiation therapy. Chemotherapy and radiation therapy have also been reported as initial therapies. Regardless of the treatment rendered, the risk of local regional failure and distant relapse remains high for this disease. We present the case of a patient who developed a well-differentiated angiosarcoma of the nose with bilateral malar extension. No commonly associated risk factors such as lymphedema, prior radiotherapy or chronic venous ulceration were present. Given her age, pre-existing renal condition and preference not to receive chemotherapy, systemic therapy was not utilized. Surgery was also refused by the patient due to the projected cosmetic deficit. The patient was ultimately treated with definitive radiotherapy, utilizing electrons to the central face, differential thickness bolus, an intraoral stent, eye shields, an aquaplast mask for immobilization and a wax-coated lead shield over the face in order to limit penumbra of the radiation beam. Right and left anterior 6-MV photons were used to tangentially treat the bilateral malar region in order to extend the field edges. At the time of this report, the patient remains disease free at nearly 2.0 years after radiotherapy. To the best of our knowledge, this represents only the second case in the literature reporting radiotherapy as a single modality treatment that resulted in complete remission of an angiosarcoma of the face.

  5. Computerized Adaptive Personality Testing: A Review and Illustration With the MMPI-2 Computerized Adaptive Version. (United States)

    Forbey, Johnathan D.; Ben-Porath, Yossef S.


    Computerized adaptive testing in personality assessment can improve efficiency by significantly reducing the number of items administered to answer an assessment question. Two approaches have been explored for adaptive testing in computerized personality assessment: item response theory and the countdown method. In this article, the authors…

  6. Chest radiation - discharge (United States)

    Radiation - chest - discharge; Cancer - chest radiation; Lymphoma - chest radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after your first treatment: It may be hard ...

  7. Intensity Modulated Radiation Treatment of Prostate Cancer Guided by High Field MR Spectroscopic Imaging (United States)


    for radiation treatment planning. Med Phys 2003;30:88–97. 9. Vedam SS, Keall PJ, Kini VR, Mostafavi H, Shukla HP, Mohan R. Acquiring a four-dimensional...G.; Shukla , H.; et al. Acquiring 4D thoracic CT scans using a multislice helical method. Phys. Med. Biol. 49:2053–67; 2004. 66. Low. D.A.; Nystrom...Phys 1983;10:410–5. 18. Schultheiss TE, Orton CG. Models in radiotherapy : definition of decision criteria. Med Phys 1985;12:183–7. 19. Martel MK

  8. Timed performance weaknesses on computerized tasks in pediatric brain tumor survivors: A comparison with sibling controls

    NARCIS (Netherlands)

    Ruiter, M.A. de; Grootenhuis, M.A.; Mourik, R. van; Maurice-Stam, H.; Breteler, M.H.M.; Gidding, C.E.M.; Beek, L.R.; Granzen, B.; Vuurden, D.G. van; Schouten-van Meeteren, A.Y.N.; Oosterlaan, J.


    With more children surviving a brain tumor, insight into the late effects of the disease and treatment is of high importance. This study focused on profiling the neurocognitive functions that might be affected after treatment for a pediatric brain tumor, using a broad battery of computerized tests.

  9. Motion management in positron emission tomography/computed tomography for radiation treatment planning. (United States)

    Bettinardi, Valentino; Picchio, Maria; Di Muzio, Nadia; Gilardi, Maria Carla


    Hybrid positron emission tomography (PET)/computed tomography (CT) scanners combine, in a unique gantry, 2 of the most important diagnostic imaging systems, a CT and a PET tomograph, enabling anatomical (CT) and functional (PET) studies to be performed in a single study session. Furthermore, as the 2 scanners use the same spatial coordinate system, the reconstructed CT and PET images are spatially co-registered, allowing an accurate localization of the functional signal over the corresponding anatomical structure. This peculiarity of the hybrid PET/CT system results in improved tumor characterization for oncological applications, and more recently, it was found to be also useful for target volume definition (TVD) and treatment planning in radiotherapy (RT) applications. In fact, the use of combined PET/CT information has been shown to improve the RT treatment plan when compared with that obtained by a CT alone. A limiting factor to the accuracy of TVD by PET/CT is organ and tumor motion, which is mainly due to patient respiration. In fact, respiratory motion has a degrading effect on PET/CT image quality, and this is also critical for TVD, as it can lead to possible tumor missing or undertreatment. Thus, the management of respiratory motion is becoming an increasingly essential component in RT treatment planning; indeed, it has been recognized that the use of personalized motion information can improve TVD and, consequently, permit increased tumor dosage while sparing surrounding healthy tissues and organs at risk. This review describes the methods used for motion management in PET/CT for radiation treatment planning. The article covers the following: (1) problems caused by organ and lesion motion owing to respiration, and the artifacts generated on CT, PET, and PET/CT images; (2) data acquisition and processing techniques used to manage respiratory motion in PET/CT studies; and (3) the use of personalized motion information for TVD and radiation treatment planning.

  10. Amelioration of radiation nephropathy in rats by postirradiation treatment with dexamethasone and/or captopril

    Energy Technology Data Exchange (ETDEWEB)

    Geraci, J.P.; Sun, M.C.; Mariano, M.S. [Univ. of Washington, Seattle, WA (United States)


    Dexamethasone (DEX) and captopril are effective drugs in the treatment of radiation nephropathy in experimental animals. The aim of the present study was to determine the relative effectiveness of the two drugs and to see if their combination is more effective than either drug alone. For this purpose both kidneys of 143 rats were exposed surgically and irradiated with 13-20 Gy {gamma} rays. The surrounding tissues, with the exception of a segment of lumbar cord, were shielded. Each group had free access to acidified drinking water containing either DEX (94 {mu}g/l), captopril (500 mg/l), DEX (94{mu}g/l) + captopril (500 mg/l) or drug-free water. Dexamethasone treatment was stopped after 90 days, but animals continued to receive captopril until death. At approximately monthly intervals the animals were weighed and renal function (PUN, hematocrit, {sup 51}Cr-EDTA retention) was measured. A side effect of treatment with DEX and DEX + captopril was a reduced increase in body weight. Paralysis of the hind limbs developed in nine animals that received captopril and/or DEX treatment. The classical histological lesions associated with radiation myelopathy were not evident in these paretic rats. It is therefore suggested that paralysis may be attributed in part to drug-induced neurotoxicity in animals with impaired renal clearance. Macroscopically and histologically, nearly all the animals that survived more than 400 days had evidence of renal tumor development. dexamethasone and/or captopril appear to selectively ameliorate glomerular compared to tubular damage, based on histological findings. All three experimental treatments delayed but did not stop the progression of lethal renal injury as measured by kidney function tests and survival time. Median survival times for nontreated and captopril-DEX- and DEX + captopril-treated animals exposed to 14.5 to 19.0 Gy kidney irradiation were 175,242,261 and 395 days, respectively. 33 refs., 8 figs., 4 tabs.

  11. Bevacizumab for the Treatment of Radiation-Induced Cerebral Necrosis: A Systematic Review of the Literature (United States)

    Delishaj, Durim; Ursino, Stefano; Pasqualetti, Francesco; Cristaudo, Agostino; Cosottini, Mirco; Fabrini, Maria Grazia; Paiar, Fabiola


    Radiation necrosis (RN) of brain tissue is a serious late complication of brain irradiation and recently bevacizumab has been suggested as treatment option of RN. There is a lack of data in the literature regarding the effectiveness of bevacizumab for the treatment of RN. The purpose of this review was to perform a comprehensive analysis of all reported cases using bevacizumab for the treatment of brain RN. In September 2016, we performed a comprehensive literature search of the following electronic databases: PubMed, Web of Science, Scopus and Cochrane Library. The research for the review was conducted using a combination of the keywords “radiation necrosis”, “radiotherapy” and “bevacizumab” alongside the fields comprising article title, abstract and keywords. Randomized trials, non-randomized trials, prospective studies, retrospective studies and single case reports were included in the review. Our research generated 21 studies and 125 cases where bevacizumab had been used for the treatment of RN. The median follow-up was 8 months and the most frequent bevacizumab dose used was 7.5 mg/kg for 2 weeks with a median of four cycles. Low-dose bevacizumab resulted in effectiveness with improvement in both clinical and radiographic response. The median decrease in T1 contrast enhancement and in T2/FLAIR signal abnormality was 64% and 60%, respectively. A reduction in steroidal therapy was observed in majority of patients treated. Based on the data of our review, bevacizumab appears to be a promising agent for the treatment of brain RN. Future prospective studies are required to evaluate the role of bevacizumab in RN and to define the optimal scheduling, dosage and duration of therapy. PMID:28270886

  12. Combined effect of kinetin and radiation treatment on the cap opening of Agaricus bisporus

    Energy Technology Data Exchange (ETDEWEB)

    Kovacs, E. (Koezponti Elelmiszeripari Kutato Intezet, Budapest (Hungary))


    Cultivated mushrooms (Agaricus bisporus) with a cap diameter of 3-5 cm were incubated at 20 deg C during the experimental period (30-72 h). The degree of cap opening was determined and the data were evaluated. It was found that kinetin solutions in the 0 to 32 mg kg/sup -1/ range stimulated the opening of the mushroom cap. The shorter the time elapsed between picking and treating the mushrooms, the greater was the effect. A kinetin solution with a concentration of 100 mg kg/sup -1/ inhibited the opening of the cap. Cap opening in irradiated mushrooms cannot be induced even with kinetin concentrations that stimulate cap opening. Treatment with 0, 2.5 and 10 kGy doses of radiation the stimulating effect on cap opening decreased as a function of the rising dose. The radiation effects in kinetin solutions and various natural cytokinins (zeatin, 2iP and 2iPA) were studied and it was found that cytokinin solutions lost 50-60% of their activity after a radiation dose of only 1 kGy.

  13. Bevacizumab as a treatment option for radiation-induced cerebral necrosis

    Energy Technology Data Exchange (ETDEWEB)

    Matuschek, Christiane; Boelke, Edwin; Budach, Wilfried [Univ. Hospital Duesseldorf (Germany). Dept. of Radiation Oncology; Nawatny, Jens [Univ. Hospital Duesseldorf (Germany). Dept. of Radiology; Hoffmann, Thomas K. [Duisburg-Essen Univ., Essen (Germany). Dept. of Otorhinolaryngology; Peiper, Matthias; Orth, Klaus [Hospital Essen-Sued, Essen (Germany). Dept. of Surgery; Gerber, Peter Arne [Univ. Hospital Duesseldorf (Germany). Dept. of Dermatology; Rusnak, Ethelyn [State Univ. of New York, Buffalo, NY (United States). Dept. of Anesthesiology; Lammering, Guido [Univ. Hospital Duesseldorf (Germany). Dept. of Radiation Oncology; MAASTRO Clinic, Maastricht (Netherlands). Radiation Oncology


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

  14. Development of sterilized porridge for patients by combined treatment of food technology with radiation technology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jaehun; Choi, Jongil; Song, Beomseok; and others


    This research was conducted to develop patient foods of high quality using a radiation fusion technology with food processing. Radiation technique to increase calorie of porridge was established, and it was investigated that radiation effects on functional materials, which can could be added to increase functionality of patient foods. Moreover, sterilized semi-fluid meal (milk porridge) for patients with higher calorie was developed by a sterilization process by gamma irradiation, combined treatments to improve the sensory qualities, and fortification with various nutrients. Also, sensory survey on irradiated commercial patient foods was performed to find the problems and improvement points of the developed products. Optimal packaging material was selected by evaluation of effect of irradiation in packaging materials and a convenient package for consuming by patients was decided. Safety of the irradiated milk porridge was confirmed by in-vivo genotoxicological test, and its nutritional composition for patients was evaluated by nutritional analysis. Finally, the milk porridge was developed as liquid, dried, powdered, and pellet type products. This research may contribute to improve life quality of patients by supplement of various foods with high quality to immuno-compromised patients. Furthermore, economic profits and technological advances are expected by commercialization of the patient foods.

  15. Extra lethal damage due to residual incompletely repaired sublethal damage in hyperfractionated and continuous radiation treatment

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.; van de Geijn, J.; Goffman, T. (ROB, DCT, NCI, NIH, Bethesda, Maryland 20892 (US))


    In the conventional linear--quadratic model of single-dose response, the {alpha} and {beta} terms reflect lethal damage created {ital during} the delivery of a dose, from two different presumed molecular processes, one linear with dose, the other quadratic. With the conventional one-fraction-per-day (or less) regimens, the sublethal damage (SLD), presumably repairing exponentially over time, is essentially completely fixed by the time of the next dose of radiation. If this assumption is true, the effects of subsequent fractions of radiation should be independent, that is, there should be little, if any, reversible damage left from previous fractions, at the time of the next dose. For multiple daily fractions, or for the limiting case, continuous radiation, this simplification may overlook damaged cells that have had insufficient time for repair. A generalized method is presented for accounting for extra lethal damage (ELD) arising from such residual SLD for hyperfractionation and continuous irradiation schemes. It may help to predict differences in toxicity and tumor control, if any, obtained with unconventional'' treatment regimens. A key element in the present model is the finite size and the dynamic character of the pool of sublethal damage. Besides creating the usual linear and quadratic components of lethal damage, each new fraction converts a certain fraction of the existing SLD into ELD, and creates some new SLD.

  16. SSV3D: Simulador de Sombras Vectoriales por Radiación Solar sobre Objetos Tridimensionales SSV3D: Simulator of Vectorial Shadows by Solar Radiation on 3D Computerized Objects

    Directory of Open Access Journals (Sweden)

    S. Gómez


    Full Text Available Se presenta un simulador de sombras vectoriales por radiación solar sobre objetos tridimensionales, SSV3D, una herramienta de computación gráfica desarrollada sobre la plataforma tridimensional del AUTOCAD 2004. El software simula vectorialmente la radiación solar directa, calculando y trazando los contornos de sombra sobre los planos iluminados del modelo 3D evaluado. En el desarrollo de la herramienta se comprobaron los resultados analíticos mediante su comparación con los obtenidos en las fórmulas de una hoja de cálculo, y de los resultados gráficos mediante comparación con las sombras arrojadas por simulación con un heliodón de tecnología francesa y por el Render de AUTOCAD. El simulador SSV3D respondió satisfactoriamente a las necesidades de estudio de sistemas de protección solar en investigaciones desarrolladas anteriormente.SSV3D is presented as a graphic computer tool developed on the three-dimensional platform of AUTOCAD 2004, which simulates direct solar radiation by measuring and vectorial tracing of shadow outlines on illuminated plans of the 3D model evaluated. The analytical results of this tool were tested during its' development by comparing its' results with those obtained in the formula of a calculus sheet, and graphic results were checked comparing these to the shadows obtained by simulation using physical models in a heliodon (French technology and by the Render of AUTOCAD. The SSV3D simulator responded satisfactorily to the requirements for the study of solar protection systems which had been determined in previous research.

  17. A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Alexandra D., E-mail: [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Nill, Simeon [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Huber, Peter E. [Clinical Co-Operation Unit Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Bendl, Rolf [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Debus, Juergen; Muenter, Marc W. [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)


    Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online

  18. Treatment burden in stage I seminoma: a comparison of surveillance and adjuvant radiation therapy. (United States)

    Leung, Eric; Warde, Padraig; Jewett, Michael; Panzarella, Tony; O'Malley, Martin; Sweet, Joan; Moore, Malcolm; Sturgeon, Jeremy; Gospodarowicz, Mary; Chung, Peter


    To examine the management and outcomes of patients with stage I seminoma and to relate these to overall treatment burden. A total of 764 patients with stage I seminoma underwent surveillance or adjuvant radiation therapy (RT) at a single institution. First relapse on surveillance was managed with RT alone, or with combination chemotherapy (ChT) for more extensive recurrence. Second relapse was managed with ChT. Relapse after adjuvant RT was treated with ChT. The treatment burden was measured, according to the specific treatment undertaken after orchiectomy, by defining treatment episodes as follows: surgery - one episode; one course of RT - one episode; one course of ChT - one episode. In all, 484 patients underwent surveillance and 280 received adjuvant RT. The 5- and 10-year overall survival rates were 98.6 and 97.7% for surveillance, and 97.2 and 91.4% for adjuvant RT. A total of 72 (15%) patients in the surveillance group relapsed; treatment for relapse was RT (n = 56), ChT (n = 15) and surgery (n = 1). Second relapse occurred in six patients; these patients were treated with ChT. Of the patients in the adjuvant RT group, 14 (5%) relapsed: salvage treatment was 10 - ChT (n = 10) surgery (n = 1) and further RT (n = 3). The overall treatment burden represented by number of treatment episodes per patient was 0.16 in the surveillance group and 1.05 in the adjuvant RT group. Surveillance reduces the overall treatment burden in patients with stage I seminoma and is the preferred management option. The selective use of RT at first relapse for patients on surveillance leads to a similar requirement for subsequent ChT to that for patients on adjuvant RT. © 2013 The Authors. BJU International © 2013 BJU International.

  19. Accelerated hypofractionated radiation therapy compared to conventionally fractionated radiation therapy for the treatment of inoperable non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Amini Arya


    Full Text Available Abstract Background While conventionally fractionated radiation therapy alone is an acceptable option for poor prognostic patients with unresectable stage III NSCLC, we hypothesized that accelerated hypofractionated radiotherapy will have similar efficacy without increasing toxicity. Methods This is a retrospective analysis of 300 patients diagnosed with stage III NSCLC treated between 1993 and 2009. Patients included in the study were medically or surgically inoperable, were free of metastatic disease at initial workup and did not receive concurrent chemotherapy. Patients were categorized into three groups. Group 1 received 45 Gy in 15 fractions over 3 weeks (Accelerated Radiotherapy (ACRT while group 2 received 60-63 Gy (Standard Radiation Therapy 1 (STRT1 and group 3 received > 63 Gy (Standard Radiation Therapy (STRT2. Results There were 119 (39.7% patients in the ACRT group, 90 (30.0% in STRT1 and 91 (30.3% in STRT2. More patients in the ACRT group had KPS ≤ 60 (p 5% (p = 0.002, and had stage 3B disease (p Conclusions Despite the limitations of a retrospective analysis, our experience of accelerated hypofractionated radiation therapy with 45 Gy in 15 fractions appears to be an acceptable treatment option for poor performance status patients with stage III inoperable tumors. Such a treatment regimen (or higher doses in 15 fractions should be prospectively evaluated using modern radiation technologies with the addition of sequential high dose chemotherapy in stage III NSCLC.

  20. Benefits of controlled ultraviolet radiation in the treatment of dermatological diseases. (United States)

    Situm, Mirna; Bulat, Vedrana; Majcen, Kristina; Dzapo, Antea; Jezovita, Josip


    Phototherapy is a second-line treatment modality for the most common dermatoses that is safe and effective. Most phototherapy regimens denote the use of ultraviolet (UV) radiation of different wavelengths in the management of several dermatoses. Currently, irradiations with broadband UVB (290-320 nm), narrowband UVB (311-313 nm), 308 nm excimer laser, UVA 1 (340-400 nm), UVA with psoralen (PUVA), and extracorporeal photochemotherapy (photopheresis) are being used. Beneficial effects of UV radiation are far from being completely understood. Dermatoses that may benefit from such approach are numerous, with psoriasis, parapsoriasis, atopic dermatitis, cutaneous T-cell lymphomas, morphea, and vitiligo vulgaris as main indications. UVB radiation primarily acts on cells at the epidermis and the epidermodermal junction, while UVA radiation affects epidermal and dermal components, especially blood vessels. UVradiation has im- mediate and delayed effects. Immediate effects are the formation of DNA photoproducts and DNA damage leading to apoptosis of heratinocytes, Langerhans cells, activated T-lymphocytes, neutrophils, macrophages, NK cells, fibroblasts, endothelial cells, and mast-cells, cell membrane damage by lipid peroxidation, and isomerization of chromophores such as urocanic acid. Delayed effects include synthesis of prostaglandins and cytokines that play important roles in immune suppression. Systemic and local immune suppression, alteration in cytokine expression (induction of interleukin-1 (IL-1) receptor antagonist, decrease in IL-2, increase in IL-IO, IL-15), and cell cycle arrest may all contribute to the suppression of disease activity. PUVA is a form of controlled and repeated induction of phototoxic reactions which uses UVA light to activate chemicals known as psoralens. The conjunction of psoralens with epidermal DNA inhibits DNA synthesis and causes cell apoptosis. PUVA also causes an alteration in the expression of cytokines and cytokine receptors

  1. Advanced treatment planning methods for efficient radiation therapy with laser accelerated proton and ion beams. (United States)

    Schell, Stefan; Wilkens, Jan J


    Laser plasma acceleration can potentially replace large and expensive cyclotrons or synchrotrons for radiotherapy with protons and ions. On the way toward a clinical implementation, various challenges such as the maximum obtainable energy still remain to be solved. In any case, laser accelerated particles exhibit differences compared to particles from conventional accelerators. They typically have a wide energy spread and the beam is extremely pulsed (i.e., quantized) due to the pulsed nature of the employed lasers. The energy spread leads to depth dose curves that do not show a pristine Bragg peak but a wide high dose area, making precise radiotherapy impossible without an additional energy selection system. Problems with the beam quantization include the limited repetition rate and the number of accelerated particles per laser shot. This number might be too low, which requires a high repetition rate, or it might be too high, which requires an additional fluence selection system to reduce the number of particles. Trying to use laser accelerated particles in a conventional way such as spot scanning leads to long treatment times and a high amount of secondary radiation produced when blocking unwanted particles. The authors present methods of beam delivery and treatment planning that are specifically adapted to laser accelerated particles. In general, it is not necessary to fully utilize the energy selection system to create monoenergetic beams for the whole treatment plan. Instead, within wide parts of the target volume, beams with broader energy spectra can be used to simultaneously cover multiple axially adjacent spots of a conventional dose delivery grid as applied in intensity modulated particle therapy. If one laser shot produces too many particles, they can be distributed over a wider area with the help of a scattering foil and a multileaf collimator to cover multiple lateral spot positions at the same time. These methods are called axial and lateral

  2. Higher radiation dose with a shorter treatment duration improves outcome for locally advanced carcinoma of anal canal

    Institute of Scientific and Technical Information of China (English)

    Kim Huang; Daphne Haas-Kogan; Vivian Weinberg; Richard Krieg


    AIM: To assess whether radiation dose and duration of treatment influence local control and survival of patients with locally advanced anal cancer treated with definitive chemoradiation.METHODS: Twenty-eight consecutive patients who were treated with definitive radiation therapy for bulky anal cancers(> 5 cm in size) were reviewed. Nineteen patients had T3 lesions, 8 patients had T4 lesions, and 15 patients had lymph node involvement. The median tumor size was 7.5 cm. All but one patient received concurrent chemoradiation. The median radiation dose was 54 Gy. The median duration of treatment was 58 d.RESULTS: With a median follow-up of 2.5 years in all patients and 7.8 years in living patients, the 2-year local recurrence-free probability was 57% and overall survival rate was 67%. Neither radiation dose nor duration of treatment alone was predictive of either time to local failure or overall survival. However, longer treatment breaks can potentially mask an advantage over higher radiation doses. Therefore, we examined those patients who received ≥ 54 Gy within 60 d, comparing them to the rest of the patients. Of patients who received ≥ 54 Gy within 60 d, local progression-free probability was 89% versus 42% for the rest of the group (P = 0.01).CONCLUSION: Local failure is a significant problem in locally advanced carcinomas of the anal canal. Higher radiation doses with limited treatment breaks may offer an increase in local control and survival.

  3. Human-eye versus computerized color matching. (United States)

    Yap, A U; Sim, C P; Loh, W L; Teo, J H


    This project compared the difference in color matching between human-eye assessment and computerized colorimetry. Fifty dental personnel were asked to color match Vita Lumin shade tabs to seven different randomly arranged test tabs from the Z100 shade guide. All evaluators were blinded to the shades of the test tabs and were asked to match only body shade of the Vita Lumin tab to the middle third or body of each test tab. The results obtained were subsequently computed into L*a*b* values and compared with results obtained by computerized colorimetry. Results indicate that the difference in color matching between human-eye assessment and computerized colorimetry is shade dependent. Discrepancy was significant for b* coordinates for shades A1 and B2 and L* and b* coordinates for shade C4. For all shades evaluated, color difference between human-eye and computerized color matching is perceivable under clinical settings, as delta E values are greater than 3. There is a need for correction factors in the formal specification of the color-matching software due to the discrepancy between human-eye and computerized colorimetric color matching.

  4. Advances in treatment techniques: stereotactic body radiation therapy and the spread of hypofractionation. (United States)

    Kavanagh, Brian D; Miften, Moyed; Rabinovitch, Rachel A


    Radiation therapy (RT) is an essential component of the management of many cancers. Traditionally, a course of external bream RT often involved daily treatments for a duration of 6 weeks or longer in some instances. Now, however, emerging clinical evidence indicates that, for some common cancers, the total length of treatment can be substantially shortened, offering convenience to patients and opportunities for resource utilization efficiencies. This trend toward so-called hypofractionated RT has been supported by hypothesis-driven clinical research guided by a combination of radiobiological and clinical insights and technological enhancements. The present review presents the rationale behind and current status of hypofractionation for prostate, breast, and medically inoperable early stage lung cancer.

  5. Impact of ultraviolet radiation treatments on the quality of freshly prepared tomato (Solanum lycopersicum) juice. (United States)

    Bhat, Rajeev


    Impact of ultraviolet (UV-C) radiation treatments (0, 15, 30 and 60min) on freshly extracted tomato juice quality (physicochemical properties, antioxidant activity and microbial load) was evaluated. On exposure to UV-C, level of water activity, total soluble solids, and titratable acidity exhibited non-significant increase up to 30min of exposure time. Regarding colour analysis, L∗ value significantly increased with subsequent decrease in a∗ and b∗ values post UV-C treatments. Clarity, DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging activity and total phenolics content significantly increased, whereas ascorbic acid level significantly reduced at 60min of UV-C exposure time. So also, lycopene content exhibited a non-significant decrease after UV-C treatment. Microbial studies showed reduction in total plate count and total mould counts post UV-C treatment. Overall, UV-C treatment being a physical, non-thermal method of food preservation holds the ability to improve or preserve vital quality parameters in freshly prepared tomato juices, and henceforth possesses high scope for commercial exploration. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. State-of-the-art of external photon beam radiation treatment planning. Photon Treatment Planning Collaborative Working Group. (United States)


    A virtual revolution in computer capability has occurred in the last few years, largely based on rapidly decreasing costs and increasing reliability of digital memory and mass-storage capability. These developments have now made it possible to consider the application of both computer and display technologies to a much broader range of problems in radiation therapy, including planning of treatment, dose computation, and treatment verification. Several methods of three-dimensional dose computations in heterogeneous media capable of 3% accuracy are likely to be available, but significant work still remains, particularly for high energy x-rays where electron transport, and possibly pair production, need to be considered. Innovative display and planning techniques, as well as plan evaluation schemes, are emerging and show great promise for the future. No doubt these advances will lead to substantially improved treatment planning systems in the next few years. However, it must be emphasized that for many of these applications a tremendous software and hardware development effort is required.

  7. The Effect of High Dose Radioiodine Therapy on Formation of Radiation Retinopathy During Thyroid Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Tülay Kaçar Güvel


    Full Text Available Objective: Non-thyroidal complication of high-dose radioiodine therapy for thyroid carcinoma might cause salivary and lacrimal gland dysfunction, which may be transient or permanent in a dose-dependent manner. However, radiation retinopathy complicating 131I therapy, has not been previously well characterized. The aim of this study was to evaluate the extent of retinal damage among patients who had received high doses of radioiodine treatment. Methods: Forty eyes of 20 patients (3 male, 17 female who received 250-1000 mCi during 131I therapy and on ophthalmological follow up for a year after the last treatment were included in the study. Mean age of the study group was 50 years (range 25-70 years. In ophthalmologic examination, visual acuity was measured in order to determine visual loss. Intraocular pressure was measured in all the patients. Then lens examination was carried out with slit lamp biomicroscopy in order to investigate cataract or partial lens opacities. Fundus observation was carried out through the dilated pupil with slit lamp biomicroscopy using 90 D noncontact lens. Result: The best corrected visual aquity with Snellen chart was found as 1.0 in 36 eyes (90% and between 0.6 and 0.9 (10% in 4 eyes (10%. At the biomicroscopic fundus examination, retinal hemorrhage consistent with radiation retinopathy, microaneurysm, microinfarction, edema or exudation, vitreus hemorrhage, partial or total optical disc pallor indicating papillopathy in the optic disc were not observed in any of the eyes. Conclusion: This result indicates that there is not any significant correlation between repeated high-dose radioiodine therapy and radiation retinopathy in differentiated thyroid carcinomas. Even though there is not a significant restriction in use of higher doses of radioiodine therapy in differentiated thyroid carcinoma, more extensive studies are needed in order to obtain more accurate data on possible occurrence of retinopathy.

  8. Application of adipocyte-derived stem cells in treatment of cutaneous radiation syndrome. (United States)

    Riccobono, Diane; Agay, Diane; Scherthan, Harry; Forcheron, Fabien; Vivier, Mylène; Ballester, Bruno; Meineke, Viktor; Drouet, Michel


    Cutaneous radiation syndrome caused by local high dose irradiation is characterized by delayed outcome and incomplete healing. Recent therapeutic management of accidentally irradiated burn patients has suggested the benefit of local cellular therapy using mesenchymal stem cell grafting. According to the proposed strategy of early treatment, large amounts of stem cells would be necessary in the days following exposure and hospitalization, which would require allogeneic stem cells banking. In this context, the authors compared the benefit of local autologous and allogeneic adipocyte-derived stem cell injection in a large animal model. Minipigs were locally irradiated using a 60Co gamma source at a dose of 50 Gy and divided into three groups. Two groups were grafted with autologous (n = 5) or allogeneic (n = 5) adipocyte-derived stem cells four times after the radiation exposure, whereas the control group received the vehicle without cells (n = 8). A clinical score was elaborated to compare the efficiency of the three treatments. All controls exhibited local inflammatory injuries leading to a persistent painful necrosis, thus mimicking the clinical evolution in human victims. In the autologous adipocyte-derived stem cells group, skin healing without necrosis or uncontrollable pain was observed. In contrast, the clinical outcome was not significantly different in the adipocyte-derived stem cell allogeneic group when compared with controls. This study suggests that autologous adipocyte-derived stem cell grafting improves cutaneous radiation syndrome wound healing, whereas allogeneic adipocyte derived stem cells do not. Further studies will establish whether manipulation of allogeneic stem cells will improve their therapeutic potential.

  9. Advanced Treatment of Wastewater from UASB Reactor by Microfiltration Membrane Associated With Disinfection by Ultraviolet Radiation

    Directory of Open Access Journals (Sweden)

    André Aguiar Battistelli


    Full Text Available The low efficiency of UASB bioreactors, regarding the removal of nutrient, organic matter and pathogens, makes it necessary to carry out a post treatment, in order to improve the quality of the effluent. Accordingly, this research has examined the use of microfiltration associated to the disinfection by the ultraviolet radiation, as an option to this post treatment. For so, were collected samples of UASB reactors’ effluent, in order to carry out some tests on a pilot microfiltration system, using in one of the samples pre-coagulation with vegetable tannin. After, all the microfiltrated samples were inserted in a UV reactor, applying different radiation doses, ranging from 43.8 to 194.9, to simulate the disinfection. The system used showed good results in terms of turbidity removal, apparent color, true color, phosphorus, nitrogen, total solids, total suspended solids and COD, reaching in the best operating condition, the following values: 1.90 uT, 15 uC, 10 uC, 0.94 mg/L, 17.64 mg/L, 123 mg/L, 0 mg/L and 10 mg/L, respectively, which represent the following removal percentages: 91.3%, 93.6%, 82.0%, 55.1%, 26.3%, 35% and 86.1%. The inactivation obtained for E. coli, total coliforms, colifagos and Clostridium perfrigens was satisfactory, achieving a higher inactivation than the detection limit of the method used, when submitted to the highests tested radiation doses. The average permeate flux ranged from 55.2 to 133.6 L.m-2.h-1.

  10. Concomitant treatment of F98 glioma cells with new liposomal platinum compounds and ionizing radiation. (United States)

    Charest, Gabriel; Paquette, Benoit; Fortin, David; Mathieu, David; Sanche, Léon


    Despite significant advances, the radiotherapy and chemotherapy protocols marginally improve the overall survival of patients with glioblastoma. Lipoplatin(TM), and Lipoxal(TM), the liposomal formulations of cisplatin and oxaliplatin respectively, were tested on the F98 glioma cells for their ability to improve the cell uptake and increase the synergic effect when combined with ionizing radiation. The cytotoxicity and synergic effect of platinum compounds were assessed by colony formation assay, while the cellular uptake was measured by Inductively Coupled Plasma Mass Spectrometer (ICP-MS). After 4 h exposure with platinum compounds, cells were irradiated (1.5-6.6 Gy) with a (60)Co source. The liposomal formulations were compared to their liposome-free analogs and to carboplatin. The concomitant treatment of F98 cells with carboplatin and radiation produced the highest radiosensitizing effect (30-fold increase). Among the platinum compounds tested, Lipoplatin(TM) produced the most promising results. This liposomal formulation of cisplatin improved the cell uptake by 3-fold, and its radiosensitizing potential was enhanced by 14-fold. Although Lipoxal(TM) can potentially reduce the adverse effect of oxaliplatin, a synergic effect with radiation was measured only when incubated at a concentration higher than its IC50. Conversely, concomitant treatment with cisplatin did not result in a synergic effect, as in fact a radioprotective effect was measured on the F98 cells. In conclusion, among the five platinum compounds tested, carboplatin and Lipoplatin(TM) showed the best radiosensitizing effect. Lipoplatin(TM) seems the most promising since it led to the best cellular incorporation and has already been reported to be less neurotoxic than other platinum compounds.

  11. Radiation dose delivery verification in the treatment of carcinoma-cervix

    Energy Technology Data Exchange (ETDEWEB)

    Shrotriya, D., E-mail:; Srivastava, R. N. L. [Department of Radiotherapy, J.K. Cancer Institute Kanpur-208019 (India); Kumar, S. [Department of Physics, Christ Church College, Kanpur-208001 (India)


    The accurate dose delivery to the clinical target volume in radiotherapy can be affected by various pelvic tissues heterogeneities. An in-house heterogeneous woman pelvic phantom was designed and used to verify the consistency and computational capability of treatment planning system of radiation dose delivery in the treatment of cancer cervix. Oncentra 3D-TPS with collapsed cone convolution (CCC) dose calculation algorithm was used to generate AP/PA and box field technique plan. the radiation dose was delivered by Primus Linac (Siemens make) employing high energy 15 MV photon beam by isocenter technique. A PTW make, 0.125cc ionization chamber was used for direct measurements at various reference points in cervix, bladder and rectum. The study revealed that maximum variation between computed and measured dose at cervix reference point was 1% in both the techniques and 3% and 4% variation in AP/PA field and 5% and 4.5% in box technique at bladder and rectum points respectively.

  12. Radiation dose delivery verification in the treatment of carcinoma-cervix (United States)

    Shrotriya, D.; Kumar, S.; Srivastava, R. N. L.


    The accurate dose delivery to the clinical target volume in radiotherapy can be affected by various pelvic tissues heterogeneities. An in-house heterogeneous woman pelvic phantom was designed and used to verify the consistency and computational capability of treatment planning system of radiation dose delivery in the treatment of cancer cervix. Oncentra 3D-TPS with collapsed cone convolution (CCC) dose calculation algorithm was used to generate AP/PA and box field technique plan. the radiation dose was delivered by Primus Linac (Siemens make) employing high energy 15 MV photon beam by isocenter technique. A PTW make, 0.125cc ionization chamber was used for direct measurements at various reference points in cervix, bladder and rectum. The study revealed that maximum variation between computed and measured dose at cervix reference point was 1% in both the techniques and 3% and 4% variation in AP/PA field and 5% and 4.5% in box technique at bladder and rectum points respectively.

  13. Specular reflection treatment for the 3D radiative transfer equation solved with the discrete ordinates method

    Energy Technology Data Exchange (ETDEWEB)

    Le Hardy, D. [Université de Nantes, LTN UMR CNRS 6607 (France); Favennec, Y., E-mail: [Université de Nantes, LTN UMR CNRS 6607 (France); Rousseau, B. [Université de Nantes, LTN UMR CNRS 6607 (France); Hecht, F. [Sorbonne Universités, UPMC Université Paris 06, UMR 7598, inria de Paris, Laboratoire Jacques-Louis Lions, F-75005, Paris (France)


    The contribution of this paper relies in the development of numerical algorithms for the mathematical treatment of specular reflection on borders when dealing with the numerical solution of radiative transfer problems. The radiative transfer equation being integro-differential, the discrete ordinates method allows to write down a set of semi-discrete equations in which weights are to be calculated. The calculation of these weights is well known to be based on either a quadrature or on angular discretization, making the use of such method straightforward for the state equation. Also, the diffuse contribution of reflection on borders is usually well taken into account. However, the calculation of accurate partition ratio coefficients is much more tricky for the specular condition applied on arbitrary geometrical borders. This paper presents algorithms that calculate analytically partition ratio coefficients needed in numerical treatments. The developed algorithms, combined with a decentered finite element scheme, are validated with the help of comparisons with analytical solutions before being applied on complex geometries.

  14. Radiation therapy at the end of life: a population-based study examining palliative treatment intensity. (United States)

    Kress, Marie-Adele Sorel; Jensen, Roxanne E; Tsai, Huei-Ting; Lobo, Tania; Satinsky, Andrew; Potosky, Arnold L


    To examine factors associated with the use of radiation therapy (RT) at the end of life in patients with breast, prostate, or colorectal cancer. Using data from the Surveillance, Epidemiology, and End Results (SEER) - Medicare database, patients were over age 65 and diagnosed between January 1, 2004 and December 31, 2011 with any stage of cancer when the cause of death, as defined by SEER, was cancer; or with stage 4 cancer, who died of any cause. We employed multiple logistic regression models to identify patient and health systems factors associated with palliative radiation use. 50% of patients received RT in the last 6 months of life. RT was used less frequently in older patients and in non-Hispanic white patients. Similar patterns were observed in the last 14 days of life. Chemotherapy use in the last 6 months of life was strongly correlated with receiving RT in the last 6 months (OR 2.72, 95% CI: 2.59-2.88) and last 14 days of life (OR 1.55, 95% CI: 1.40-1.66). Patients receiving RT accrued more emergency department visits, radiographic exams and physician visits (all comparisons p End-of-life RT correlated with end-of-life chemotherapy use, including in the last 14 days of life, when treatment may cause increased treatment burden without improved quality of life. Research is needed optimize the role and timing of RT in palliative care.

  15. A Study Of The Potential For Digital Radiographic Data Acquisition For Radiation Therapy Treatment Planning (United States)

    Edwards, M.; Keller, J.; Hobson, G.


    While the quantitative nature of digital fluroscopic and digital radiographic imaging would seem to make possible many radiotherapeutic applications, significant problems must first be solved. The purpose of this study is to examine the potential benefits of digital imaging in radiation therapy, identify what problems must be solved to attain these benefits, and attempt to make some assessment as to the relative merits of developing such technologies. Among the potential benefits are ability to do contrast-subtraction studies for tumor and/or normal structure localization and portal placement, digital simulation of portal placement and treatment delivery, spatial localization and digitization of inhomogeneity boundaries, spatial localization and digitization of brachytherapy sources, and quantitative inhomogeneity acquisition for dosimetry calculations. Significant problems which must be solved include image receptor size limitations, image acquisition geometry related spatial distortion, three dimensional region calculation from limited views, and physical interpretation of digital image grey levels. Maximal benefits of digital imaging in radiation oncology is likely to be obtained by the development of large area image receptors for use in therapy simulators with direct data link to a combined image-analysis/treatment planning computer.

  16. Specular reflection treatment for the 3D radiative transfer equation solved with the discrete ordinates method (United States)

    Le Hardy, D.; Favennec, Y.; Rousseau, B.; Hecht, F.


    The contribution of this paper relies in the development of numerical algorithms for the mathematical treatment of specular reflection on borders when dealing with the numerical solution of radiative transfer problems. The radiative transfer equation being integro-differential, the discrete ordinates method allows to write down a set of semi-discrete equations in which weights are to be calculated. The calculation of these weights is well known to be based on either a quadrature or on angular discretization, making the use of such method straightforward for the state equation. Also, the diffuse contribution of reflection on borders is usually well taken into account. However, the calculation of accurate partition ratio coefficients is much more tricky for the specular condition applied on arbitrary geometrical borders. This paper presents algorithms that calculate analytically partition ratio coefficients needed in numerical treatments. The developed algorithms, combined with a decentered finite element scheme, are validated with the help of comparisons with analytical solutions before being applied on complex geometries.

  17. Computerized occlusal analysis in bruxism

    Directory of Open Access Journals (Sweden)

    Lazić Vojkan


    Full Text Available Introduction. Sleep bruxism as nocturnal parafunction, also known as tooth grinding, is the most common parasomnia (sleep disorder. Most tooth grinding occurs during rapid eye movement - REM sleep. Sleep bruxism is an oral habit characterized by rhythmic activity of the masticatory muscles (m. masseter that causes forced contact between dental surfaces during sleep. Sleep bruxism has been associated with craniomandibular disorders including temporomandibular joint discomfort, pulpalgia, premature loss of teeth due to excessive attrition and mobility, headache, muscle ache, sleep interruption of an individual and problems with removable and fixed denture. Basically, two groups of etiological factors can be distinguished, viz., peripheral (occlusal factors and central (pathophysiological and psychological factors. The role of occlusion (occlusal discrepancies as the causative factor is not enough mentioned in relation to bruxism. Objective. The main objective of this paper was to evaluate the connection between occlusal factors and nocturnal parafunctional activities (occlusal disharmonies and bruxism. Method. Two groups were formed- experimental of 15 persons with signs and symptoms of nocturnal parafunctional activity of mandible (mean age 26.6 years and control of 42 persons with no signs and symptoms of bruxism (mean age 26.3 yrs.. The computerized occlusal analyses were performed using the T-Scan II system (Tekscan, Boston, USA. 2D occlusograms were analyzed showing the occlusal force, the center of the occlusal force with the trajectory and the number of antagonistic tooth contacts. Results. Statistically significant difference of force distribution was found between the left and the right side of the arch (L%-R% (t=2.773; p<0.02 in the group with bruxism. The difference of the centre of occlusal force - COF trajectory between the experimental and control group was not significant, but the trajectory of COF was longer in the group of

  18. Severe coronary artery disease after radiation therapy of the chest and mediastinum: clinical presentation and treatment. (United States)

    Orzan, F; Brusca, A; Conte, M R; Presbitero, P; Figliomeni, M C


    OBJECTIVE--To define the clinical and angiographic features and the therapeutic problems in patients with coronary artery disease after therapeutic irradiation of the chest. DESIGN--An observational retrospective study. SETTING--The cardiac catheterisation laboratory, university medical school. PATIENTS--15 subjects (8 men and 7 women, aged 25-56 years, mean 44) examined in the cardiac catheterisation laboratory, who had significant coronary artery disease years after having radiation treatment to the chest and anterior mediastinum. In the early stages of the study angiography was performed because of typical symptoms of ischaemic heart disease. Later on it was performed because of a high index of suspicion in people with signs of extensive radiation heart damage. MAIN OUTCOME MEASURES--Clinical and electrocardiographic evidence of ischaemic heart disease; echocardiographic signs of pericardial, myocardial or valvar involvement; angiographic evidence of coronary arterial stenosis, with special attention to the ostia; haemodynamic and angiographic signs of pericardial, myocardial, and valvar disease. Survival and symptomatic and functional status were ascertained after medical or surgical treatment. RESULTS--The patients were relatively young and had no risk factors. Seven patients had no signs or symptoms of ischaemic heart disease. Ten patients had ostial stenosis, which was associated with extensive involvement of other cardiac structures in nine of them. Seven required surgical treatment for coronary artery disease. Two died, one at surgery and the other one six months later. Five patients had complications associated with irradiation. CONCLUSIONS--Coronary arterial disease can be reasonably ascribed to the effects of chest irradiation when the patients are young and free from risk factors, especially if the obstructions are ostial and there is important damage to other cardiac structures. In patients with damage to other cardiac structures angina and infarction

  19. Rhinoorbitocerebral mucormycosis. A case study utilizing computerized tomography examination

    Energy Technology Data Exchange (ETDEWEB)

    Prando, D. (Hospital Sirio-Libanes, Sao Paulo (Brazil)); Clemente Filho, A.S.; Secaf, F. (Escola Paulista de Medicina, Sao Paulo (Brazil))

    Rhinoorbitocerebral mucormycosis is a very serious and frequently fatal disease in which accurate analysis will often suggest the diagnosis. The Computerized Tomography (CT) scans are very helpful to establish the early diagnosis of mucormycosis and in the clear demonstration of the typical relationship between the sinus, orbital and cerebral disease. The recognition of the characteristic pattern in the involved areas should be helpful to early diagnosis and surgical treatment. The findings in one patient with craniofacial mucormycosis who underwent five times to CT examination are presented. Special attention is given to the serial CT scans and in the rapid spread to the central nervous system.

  20. Incorporating Cancer Stem Cells in Radiation Therapy Treatment Response Modeling and the Implication in Glioblastoma Multiforme Treatment Resistance

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Victoria Y.; Nguyen, Dan; Pajonk, Frank; Kupelian, Patrick; Kaprealian, Tania; Selch, Michael; Low, Daniel A.; Sheng, Ke, E-mail:


    Purpose: To perform a preliminary exploration with a simplistic mathematical cancer stem cell (CSC) interaction model to determine whether the tumor-intrinsic heterogeneity and dynamic equilibrium between CSCs and differentiated cancer cells (DCCs) can better explain radiation therapy treatment response with a dual-compartment linear-quadratic (DLQ) model. Methods and Materials: The radiosensitivity parameters of CSCs and DCCs for cancer cell lines including glioblastoma multiforme (GBM), non–small cell lung cancer, melanoma, osteosarcoma, and prostate, cervical, and breast cancer were determined by performing robust least-square fitting using the DLQ model on published clonogenic survival data. Fitting performance was compared with the single-compartment LQ (SLQ) and universal survival curve models. The fitting results were then used in an ordinary differential equation describing the kinetics of DCCs and CSCs in response to 2- to 14.3-Gy fractionated treatments. The total dose to achieve tumor control and the fraction size that achieved the least normal biological equivalent dose were calculated. Results: Smaller cell survival fitting errors were observed using DLQ, with the exception of melanoma, which had a low α/β = 0.16 in SLQ. Ordinary differential equation simulation indicated lower normal tissue biological equivalent dose to achieve the same tumor control with a hypofractionated approach for 4 cell lines for the DLQ model, in contrast to SLQ, which favored 2 Gy per fraction for all cells except melanoma. The DLQ model indicated greater tumor radioresistance than SLQ, but the radioresistance was overcome by hypofractionation, other than the GBM cells, which responded poorly to all fractionations. Conclusion: The distinct radiosensitivity and dynamics between CSCs and DCCs in radiation therapy response could perhaps be one possible explanation for the heterogeneous intertumor response to hypofractionation and in some cases superior outcome from

  1. Does the Computer Make a Difference? Computerized versus Face-to-Face versus Self-Report Assessment of Alcohol, Drug and Tobacco Use. (United States)

    Skinner, Harvey A.; Allen, Barbara A.


    Compared histories of alcohol, drug, and tobacco use obtained by computerized interview, face-to-face interview, and self-report in clients (N=150) from an addiction treatment center. Multivariate analyses revealed no important differences. The computerized interview was rated less friendly but faster and more interesting. (Author/JAC)

  2. Strategies for Imaging Androgen Receptor Signaling Pathway in Prostate Cancer: Implications for Hormonal Manipulation and Radiation Treatment

    Directory of Open Access Journals (Sweden)

    Gravina Giovanni Luca


    Full Text Available Prostate cancer (Pca is a heterogeneous disease; its etiology appears to be related to genetic and epigenetic factors. Radiotherapy and hormone manipulation are effective treatments, but many tumors will progress despite these treatments. Molecular imaging provides novel opportunities for image-guided optimization and management of these treatment modalities. Here we reviewed the advances in targeted imaging of key biomarkers of androgen receptor signaling pathways. A computerized search was performed to identify all relevant studies in Medline up to 2013. There are well-known limitations and inaccuracies of current imaging approaches for monitoring biological changes governing tumor progression. The close integration of molecular biology and clinical imaging could ease the development of new molecular imaging agents providing novel tools to monitor a number of biological events that, until a few years ago, were studied by conventional molecular assays. Advances in translational research may represent the next step in improving the oncological outcome of men with Pca who remain at high risk for systemic failure. This aim may be obtained by combining the anatomical properties of conventional imaging modalities with biological information to better predict tumor response to conventional treatments.

  3. Quantification of beam complexity in intensity-modulated radiation therapy treatment plans

    Energy Technology Data Exchange (ETDEWEB)

    Du, Weiliang, E-mail:; Cho, Sang Hyun; Zhang, Xiaodong; Kudchadker, Rajat J. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Hoffman, Karen E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)


    Purpose: Excessive complexity in intensity-modulated radiation therapy (IMRT) plans increases the dose uncertainty, prolongs the treatment time, and increases the susceptibility to changes in patient or target geometry. To date, the tools for quantitative assessment of IMRT beam complexity are still lacking. In this study, The authors have sought to develop metrics to characterize different aspects of beam complexity and investigate the beam complexity for IMRT plans of different disease sites. Methods: The authors evaluated the beam complexity scores for 65 step-and-shoot IMRT plans from three sites (prostate, head and neck, and spine) and 26 volumetric-modulated arc therapy (VMAT) plans for the prostate. On the basis of the beam apertures and monitor unit weights of all segments, the authors calculated the mean aperture area, extent of aperture shape irregularity, and degree of beam modulation for each beam. Then the beam complexity values were averaged to obtain the complexity metrics of the IMRT plans. The authors studied the correlation between the beam complexity metrics and the quality assurance (QA) results. Finally, the effects of treatment planning parameters on beam complexity were studied. Results: The beam complexity scores were not uniform among the prostate IMRT beams from different gantry angles. The lateral beams had larger monitor units and smaller shape irregularity, while the anterior-posterior beams had larger modulation values. On average, the prostate IMRT plans had the smallest aperture irregularity, beam modulation, and normalized monitor units; the head and neck IMRT plans had large beam irregularity and beam modulation; and the spine stereotactic radiation therapy plans often had small beam apertures, which may have been associated with the relatively large discrepancies between planned and QA measured doses. There were weak correlations between the beam complexity scores and the measured dose errors. The prostate VMAT beams showed

  4. Automation and Intensity Modulated Radiation Therapy for Individualized High-Quality Tangent Breast Treatment Plans

    Energy Technology Data Exchange (ETDEWEB)

    Purdie, Thomas G., E-mail: [Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Techna Institute, University Health Network, Toronto, Ontario (Canada); Dinniwell, Robert E.; Fyles, Anthony [Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Sharpe, Michael B. [Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Techna Institute, University Health Network, Toronto, Ontario (Canada)


    Purpose: To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to define and simplify the technical aspects of the treatment planning process. Results: Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Conclusions: Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented

  5. Combination treatment with interleukin-2 and radiation for advanced renal cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ohnishi, Tetsuro; Machida, Toyohei; Saito, Kenichi; Ueda, Masataka; Tashiro, Kazuya; Kanehira, Chihiro; Mochizuki, Sachio (Jikei Univ., Tokyo (Japan). School of Medicine); Sawada, Takuko


    We attempted combination treatment with interleukin-2 (IL-2) and radiation for twelve advanced renal cell carcinoma patients. Treated lesions were lung in 3 (25.0%), bone in 2 (16.7%), retroperitoneal lymph node in 2 (16.7%), lung plus bone in 2 (16.7%), subcutaneous on the sternum in 1 (8.3%), renal bed in 1 (8.3%) and primary kidney in 1 (8.3%). The efficacy of this treatment modality was CR (complete remission) in 1 and PR (partial remission) in 2, with a response rate of 25.0% (3/12). As to the lesion response and response periods, there were CR in recurrence of renal bed (26 months), PR in retroperitoneal lymph node metastasis (16 weeks) and PR in subcutaneous on the sternum (6 weeks). Two of 4 patients with lung metastasis developed severe lung fibrosis, and continued no evidence of progression for 20 to 22 months. On the other hand, both of 2 patients showing PD (progressive disease) had bony metastases. The immunological changes induced by this combination treatment were an observable increase of WBC and peripheral blood lymphocytes (PBL). The subsets of PBL in responding patients revealed an increase of CD3-, CD4-, CD-8, and the ratio of CD4/CD8, CD16-and CD25-positive cells during the treatment session. In terms of complications all patients showed general fatigue and anorexia, and half of them had fever. With regard to the laboratory findings, all patients showed eosinophilia. Side effects were, however, not so serious as to prevent treatment. We concluded that this treatment modality is effective for patients with soft tissue metastasis, i.e., recurrence on the renal bed, and lung. However, it is difficult to cure patients with bony metastasis by this combination treatment. (author).

  6. Bevacizumab treatment in malignant meningioma with additional radiation necrosis. An MRI diffusion and perfusion case study

    Energy Technology Data Exchange (ETDEWEB)

    Bostroem, J.P. [University of Bonn Medical Center, Department of Neurosurgery, Bonn (Germany); MediClin Robert Janker Clinic and MVZ MediClin, Department of Radiosurgery and Stereotactic Radiotherapy, Bonn (Germany); Seifert, M.; Greschus, S. [University of Bonn Medical Center, Department of Radiology, Bonn (Germany); Schaefer, N.; Herrlinger, U. [University of Bonn Medical Center, Division of Clinical Neurooncology, Department of Neurology, Bonn (Germany); Glas, M. [University of Bonn Medical Center, Division of Clinical Neurooncology, Department of Neurology, Bonn (Germany); University of Bonn Medical Center, Stem Cell Pathologies, Institute of Reconstructive Neurobiology, Bonn (Germany); MediClin Robert Janker Clinic, Clinical Cooperation Unit Neurooncology, Bonn (Germany); Lammering, G. [MediClin Robert Janker Clinic and MVZ MediClin, Department of Radiosurgery and Stereotactic Radiotherapy, Bonn (Germany); MediClin Robert Janker Clinic, Clinical Cooperation Unit Neurooncology, Bonn (Germany); Heinrich-Heine-University of Duesseldorf, Department of Radiotherapy and Radiation Oncology, Duesseldorf (Germany)


    Recently two retrospective cohort studies report efficacy of bevacizumab in patients with recurrent atypical and anaplastic meningioma. Another successful therapeutic option of bevacizumab seems to be treatment of cerebral radiation necrosis. However, the antiangiogenic effects in MRI diffusion and perfusion in meningiomas have not been previously described in detail. The objective of this research was to evaluate the clinical and MR imaging effects of bevacizumab in a malignant meningioma patient harboring additional cerebral radiation necrosis. We report the case of an 80-year-old woman who underwent bevacizumab therapy (5 mg/kg every 2 weeks for 2 months) for treatment of a symptomatic radiation necrosis in malignant meningiomatosis of World Health Organization (WHO) grade III. The patient was closely monitored with MRI including diffusion and perfusion studies. Upon bevacizumab therapy, the clinical situation was well stabilized over a period of 4 months until the patient unfortunately died due to pneumonia/septicemia probably unrelated to bevacizumab therapy. Consecutive MRI demonstrated 4 important aspects: (1) considerable decrease of the contrast medium (CM)-enhanced radiation necrosis, (2) mixed response with respect to the meningiomatosis with stable and predominantly growing tumor lesions, (3) a new diffusion-weighted imaging (DWI) lesion in a CM-enhanced tumor as described in gliomas, which we did not interpret as a response to bevacizumab therapy, and (4) new thrombembolic infarcts, which are a known side-effect of bevacizumab treatment. Bevacizumab is effective in the treatment of radiation necrosis. We could not confirm the potential antitumor effect of bevacizumab in this patient. However, we could describe several new radiographic effects of bevacizumab therapy in malignant meningioma. (orig.) [German] In zwei aktuellen retrospektiven Kohortenstudien konnte eine Wirksamkeit von Bevacizumab bei Patienten mit rezidivierenden atypischen und

  7. Autologous bone marrow stromal cell transplantation as a treatment for acute radiation enteritis induced by a moderate dose of radiation in dogs. (United States)

    Xu, Wenda; Chen, Jiang; Liu, Xu; Li, Hongyu; Qi, Xingshun; Guo, Xiaozhong


    Radiation enteritis is one of the most common complications of cancer radiotherapy, and the development of new and effective measures for its prevention and treatment is of great importance. Adult bone marrow stromal stem cells (ABMSCs) are capable of self-renewal and exhibit low immunogenicity. In this study, we investigated ABMSC transplantation as a treatment for acute radiation enteritis. We developed a dog model of acute radiation enteritis using abdominal intensity-modulated radiation therapy in a single X-ray dose of 14 Gy. ABMSCs were cultured in vitro, identified via immunofluorescence and flow cytometry, and double labeled with CM-Dil and superparamagnetic iron oxide (SPIO) before transplantation, which took place 48 hours after abdominal irradiation in a single fraction. The dog model of acute radiation enteritis was transplanted with cultured ABMSCs labeled with CM-Dil and SPIO into the mesenteric artery through the femoral artery. Compared with untreated control groups, dogs treated with ABMSCs exhibited substantially longer survival time and improved relief of clinical symptoms. ABMSC transplantation induced the regeneration of the intestinal epithelium and the recovery of intestinal function. Furthermore, ABMSC transplantation resulted in elevated serum levels of the anti-inflammatory cytokine interleukin-11 (IL10) and intestinal radioprotective factors, such as keratinocyte growth factor, basic fibroblast growth factor-2, and platelet-derived growth factor-B while reducing the serum level of the inflammatory cytokine IL17. ABMSCs induced the regeneration of the intestinal epithelium and regulated the secretion of serum cytokines and the expression of radioprotective proteins and thus could be beneficial in the development of novel and effective mitigators of and protectors against acute radiation enteritis.

  8. Quarantine treatment for Sitophilus zeamais (Coleoptera: Curculionidae) through gamma radiation from Cobalt-60

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, Amanda Cristina Oliveira, E-mail: amandaramos@usp.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Potenza, Marcos Roberto, E-mail: [Instituto Biologico de Sao Paulo, Sao Paulo, SP (Brazil). Centro de Pesquisa e Desenvolvimento de Sanidade Vegetal; Arthur, Valter, E-mail: varthur@cena.usp.b [Centro de Energia Nuclear na Agricultura (CENA/USP), Piracicaba, SP (Brazil)


    Pests like beetles, moths, fungus and mites normally attack stored products such as grains, spices, flours, brans and tobacco in bale. Among these pests the Sitophilus zeamais is one of the most important pests due its elevated potential of reproduction, infesting a great number of products, inducing great damages. This work had as objective to determine the efficacy of gamma radiation from Cobalt-60 as quarantine treatment for S. zeamais. The insects used in this experiment were reared in maize grains, at the Laboratorio de Artropodes of the Instituto Biologico/SP, on climatic room with 27 +- 2 deg C of temperature and relative humidity of 70 +- 5%. Samples containing 25 adult insects were put in acrylic recipients measuring 2.8cm x 2.8cm. Each treatment had four repetitions, in a total of 100 insects for treatment. They were irradiated with growing doses of gamma radiation: 0 (control); 0,25; 0,5; 0,75; 1,0; 1,25; 1,5; 1,75; 2,0; 2,25 2,5; 2,75; 3,0; 3,5 e 4,0 kGy, in a experimental irradiator of Cobalt-60, model Gammacell-220, located at the Centro de Tecnologia da Radiacoes - CTR of the Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN/SP. After irradiation, the samples were transferred to plastic recipients measuring 3,5cm x 10cm, with perforated lids (to allow gaseous exchanges). After the irradiation the samples were kept in climatic room (27 +- 2 deg C and 70 +- 5%). The mortality of insects was evaluated 1 hour after the irradiation and also on the next 7 days. By the results obtained we can conclude that was the dose of 2.75 kGy that induced the immediate mortality for adult insects of the specie S. zeamais. (author)

  9. Study of radiation dose attenuation by skull bone in head during radiotherapy treatment using MCNP

    Energy Technology Data Exchange (ETDEWEB)

    Menezes, Artur F.; Boia, Leonardo S.; Trombetta, Debora M.; Martins, Maximiano C.; Reis Junior, Juraci P.; Silva, Ademir X., E-mail: ademir@con.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Nuclear; Batista, Delano V.S., E-mail: [Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil). Dept. de Fisica Medica


    In this study the MCNPX code was used to investigate possible influences of the attenuation beam by the surface bone during radiotherapy treatments of the skull. The computer simulation was performed on topographic image obtained from the National Cancer Institute, in Rio de Janeiro, database of patients treated with radiotherapy. The image segmentation process were performed using the SAPDI program developed to this purpose. The segmented image conversion for the input file recognized by MCNPX code was performed by SCAN2MCNP Software. The simulation was done using 10MeV Clinac 2300C spectrum considering two opposite parallel beams, with field size 2x2 and 4x4 cm{sup 2}, incident on a slice located above the eyes, containing two row of detectors positioned on the central region with a radius of 0.03 cm and arranged perpendicular to the radiation beams. After analyze the results, the relative error values in the range of 2 at 4% for the high dose region, and 26 at 37% for the low dose area were found, respectively. These differences were attributed to the radiation field attenuation on the bone surface at the entrance of the beam. It was observed that most situations on the high dose region the beam profile, from more realistic scenarios, became smaller than the one obtained when the tomography image was considered consisting of water. However for the low dose area the profile, obtained of the realistic situation, became higher than the one which was obtained when the tomography image was considered consisting of water. The results showed significant differences between both analyzed cases which show the need to use a correction factor by the treatment planning system used in radiotherapy services when the real chemical composition of patient head is unconsidered during the patient treatment planning. (author)

  10. Independent verification of monitor unit calculation for radiation treatment planning system. (United States)

    Chen, Li; Chen, Li-Xin; Huang, Shao-Min; Sun, Wen-Zhao; Sun, Hong-Qiang; Deng, Xiao-Wu


    To ensure the accuracy of dose calculation for radiation treatment plans is an important part of quality assurance (QA) procedures for radiotherapy. This study evaluated the Monitor Units (MU) calculation accuracy of a third-party QA software and a 3-dimensional treatment planning system (3D TPS), to investigate the feasibility and reliability of independent verification for radiation treatment planning. Test plans in a homogenous phantom were designed with 3-D TPS, according to the International Atomic Energy Agency (IAEA) Technical Report No. 430, including open, blocked, wedge, and multileaf collimator (MLC) fields. Test plans were delivered and measured in the phantom. The delivered doses were input to the QA software and the independent calculated MUs were compared with delivery. All test plans were verified with independent calculation and phantom measurements separately, and the differences of the two kinds of verification were then compared. The deviation of the independent calculation to the measurements was (0.1 +/- 0.9)%, the biggest difference fell onto the plans that used block and wedge fields (2.0%). The mean MU difference between the TPS and the QA software was (0.6 +/- 1.0)%, ranging from -0.8% to 2.8%. The deviation in dose of the TPS calculation compared to the measurements was (-0.2 +/- 1.7)%, ranging from -3.9% to 2.9%. MU accuracy of the third-party QA software is clinically acceptable. Similar results were achieved with the independent calculations and the phantom measurements for all test plans. The tested independent calculation software can be used as an efficient tool for TPS plan verification.

  11. High resolution X-ray fluorescence imaging for a microbeam radiation therapy treatment planning system (United States)

    Chtcheprov, Pavel; Inscoe, Christina; Burk, Laurel; Ger, Rachel; Yuan, Hong; Lu, Jianping; Chang, Sha; Zhou, Otto


    Microbeam radiation therapy (MRT) uses an array of high-dose, narrow (~100 μm) beams separated by a fraction of a millimeter to treat various radio-resistant, deep-seated tumors. MRT has been shown to spare normal tissue up to 1000 Gy of entrance dose while still being highly tumoricidal. Current methods of tumor localization for our MRT treatments require MRI and X-ray imaging with subject motion and image registration that contribute to the measurement error. The purpose of this study is to develop a novel form of imaging to quickly and accurately assist in high resolution target positioning for MRT treatments using X-ray fluorescence (XRF). The key to this method is using the microbeam to both treat and image. High Z contrast media is injected into the phantom or blood pool of the subject prior to imaging. Using a collimated spectrum analyzer, the region of interest is scanned through the MRT beam and the fluorescence signal is recorded for each slice. The signal can be processed to show vascular differences in the tissue and isolate tumor regions. Using the radiation therapy source as the imaging source, repositioning and registration errors are eliminated. A phantom study showed that a spatial resolution of a fraction of microbeam width can be achieved by precision translation of the mouse stage. Preliminary results from an animal study showed accurate iodine profusion, confirmed by CT. The proposed image guidance method, using XRF to locate and ablate tumors, can be used as a fast and accurate MRT treatment planning system.

  12. WE-G-16A-01: Evolution of Radiation Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Rothenberg, L [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Mohan, R [UT MD Anderson Cancer Center, Houston, TX (United States); Van Dyk, J [Western University, London, ON (United Kingdom); Fraass, B [Cedars-Sinai Medical Center, Los Angeles, CA (United States); Bortfeld, T [Massachusetts General Hospital, Boston, MA (United States)


    Welcome and Introduction - Lawrence N. Rothenberg This symposium is one a continuing series of presentations at AAPM Annual Meetings on the historical aspects of medical physics, radiology, and radiation oncology that have been organized by the AAPM History Committee. Information on previous presentations including “Early Developments in Teletherapy” (Indianapolis 2013), “Historical Aspects of Cross-Sectional Imaging” (Charlotte 2012), “Historical Aspects of Brachytherapy” (Vancouver 2011), “50 Years of Women in Medical Physics” (Houston 2008), and “Roentgen's Early Investigations” (Minneapolis 2007) can be found in the Education Section of the AAPM Website. The Austin 2014 History Symposium will be on “Evolution of Radiation Treatment Planning.” Overview - Radhe Mohan Treatment planning is one of the most critical components in the chain of radiation therapy of cancers. Treatment plans of today contain a wide variety of sophisticated information conveying the potential clinical effectiveness of the designed treatment to practitioners. Examples of such information include dose distributions superimposed on three- or even four-dimensional anatomic images; dose volume histograms, dose, dose-volume and dose-response indices for anatomic structures of interest; etc. These data are used for evaluating treatment plans and for making treatment decisions. The current state-of-the-art has evolved from the 1940s era when the dose to the tumor and normal tissues was estimated approximately by manual means. However, the symposium will cover the history of the field from the late-1950's, when computers were first introduced for treatment planning, to the present state involving the use of high performance computing and advanced multi-dimensional anatomic, functional and biological imaging, focusing only on external beam treatment planning. The symposium will start with a general overview of the treatment planning process including imaging

  13. The Construction and Uses of CATIA, a Computerized Mathematics Testbank (United States)

    Burton, Charles R.; Marosz, Wanda A.


    Described is the construction of a computerized test bank to generate and score tests in college algebra, trigonometry, and intermediate algebra; including a discussion of uses, advantages and disadvantages of computerized testing. (JLH)

  14. The Construction and Uses of CATIA, a Computerized Mathematics Testbank (United States)

    Burton, Charles R.; Marosz, Wanda A.


    Described is the construction of a computerized test bank to generate and score tests in college algebra, trigonometry, and intermediate algebra; including a discussion of uses, advantages and disadvantages of computerized testing. (JLH)

  15. Vesicoureteral reflux in adults studied by computerized radionuclide cystography

    Energy Technology Data Exchange (ETDEWEB)

    Kinn, A.C.; Jacobsson, H.; Schnell, P.O. (Depts. of Urology Diagnostic Radiology and Hospital Physics, Karolinska Sjukhuset, Stockholm (Sweden))


    Direct radionuclide cystography in a computerized method as described by Willi and Treves was used in adults with recurrent pyelites but without evidence of obstruction. Reflux was observed in 15 out of 38 patients. In patients with neurogenic bladder dysfunction or megaureters, reflux began early during the bladder filling and attained higher volumes than in those with uncomplicated pyelitis, who has minor reflux appearing mainly during voiding. Bladder capacity and detrusor compliance were lower in patients with reflux than in those without reflux. The low radiation exposure in radionuclide cystography permits observation of the urodynamic course of urinary reflux and correlation to the intravesical volume and pressure. The method is sensitive, and minorl refluxed volumes can be detected. Radionuclide cystrography can therefore be recommended for checking or surgical results and for follow-up of patients with neurogenic bladder dysfunction. (au).

  16. Radiation treatment of painful degenerative skeletal conditions; Schmerzbestrahlung bei degenerativ bedingten Skeletterkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, U. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie; Micke, O. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie; Willich, N. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie


    The study reported was intended to present own experience with irradiation for treatment of painful degenerative skeletal conditions and examine the long-term effects of this treatment. A retrospective study was performed covering the period from 1985 until 1991, examining 157 patients suffering from painful degenerative skeletal conditions who entered information on the success of their radiation treatment in a questionnaire. 94 of the questionnaires could be used for evaluation. Pain anamnesis revealed periods of more than one year in 45% of the cases. 74% of the patients had been treated without success with drug or orthopedic therapy. Immediately after termination of the radiotherapy, 38% of the patients said to be free of pain or to feel essentially relieved, while at the time the questionnaire was distributed, the percentage was 76%. Thus in our patient material, radiotherapy for treatment of painful degenerative skeletal lesions was successful in 76% of the cases and for long post-treatment periods, including those cases whith long pain anamnesis and unsuccessful conventional pre-treatment. (orig./MG) [Deutsch] Ziel dieser Untersuchung war es, die eigenen Erfahrungen mit der Schmerzbestrahlung degenerativer Skeletterkrankungen darzustellen und vor allem die Langzeitergebnisse zu untersuchen. Im Zeitraum von 1985 bis 1991 wurden 157 Patienten mit schmerzhaften degenerativen Gelenkerkrankungen retrospektiv untersucht. Der Therapieerfolg wurde mittels Fragebogenaktion ermittelt. Insgesamt waren 94 Frageboegen auswertbar. Die Schmerzanamnese betrug in 45% der Faelle ueber 1 Jahr. Bei 74% der Patienten war eine erfolglose medikamentoese oder orthopaedische Vorbehandlung erfolgt. Sofort nach Beendigung der Radiotherapie gaben insgesamt 38% der Patienten eine Schmerzfreiheit oder wesentliche Besserung der Beschwerden an, zum Zeitpunkt der Fragebogenaktion 76% der Patienten. Die Schmerzbestrahlung degenerativer Skeletterkrankungen erzielte in unserem Patientengut in

  17. Radiation treatment for the right naris in a pediatric anesthesia patient using an adaptive oral airway technique

    Energy Technology Data Exchange (ETDEWEB)

    Sponseller, Patricia, E-mail:; Pelly, Nicole; Trister, Andrew; Ford, Eric; Ermoian, Ralph


    Radiation therapy for pediatric patients often includes the use of intravenous anesthesia with supplemental oxygen delivered via the nasal cannula. Here, we describe the use of an adaptive anesthesia technique for electron irradiation of the right naris in a preschool-aged patient treated under anesthesia. The need for an intranasal bolus plug precluded the use of standard oxygen supplementation. This novel technique required the multidisciplinary expertise of anesthesiologists, radiation therapists, medical dosimetrists, medical physicists, and radiation oncologists to ensure a safe and reproducible treatment course.

  18. Cherenkov imaging during volumetric modulated arc therapy for real-time radiation beam tracking and treatment response monitoring (United States)

    Andreozzi, Jacqueline M.; Zhang, Rongxiao; Glaser, Adam K.; Gladstone, David J.; Jarvis, Lesley A.; Pogue, Brian W.


    External beam radiotherapy utilizes high energy radiation to target cancer with dynamic, patient-specific treatment plans. The otherwise invisible radiation beam can be observed via the optical Cherenkov photons emitted from interaction between the high energy beam and tissue. Using a specialized camera-system, the Cherenkov emission can thus be used to track the radiation beam on the surface of the patient in real-time, even for complex cases such as volumetric modulated arc therapy (VMAT). Two patients undergoing VMAT of the head and neck were imaged and analyzed, and the viability of the system to provide clinical feedback was established.

  19. Sucralfate for the treatment of radiation induced mucositis; Einsatz von Sucralfat in der Radioonkologie

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    Belka, C. [Univ. Tuebingen (Germany). Abt. fuer Strahlentherapie; Hoffmann, W. [Univ. Tuebingen (Germany). Abt. fuer Strahlentherapie; Paulsen, F. [Univ. Tuebingen (Germany). Abt. fuer Strahlentherapie; Bamberg, M. [Univ. Tuebingen (Germany). Abt. fuer Strahlentherapie


    Purpose: Radiotherapy, a cornerstone in the management of head and neck cancer, pelvic cancer, and esophageal cancer is associated with a marked mucosal toxicity. Pain, malnutrition and diarrhea are the most prevalent clinical symptoms of radiation induced mucosal damage. Because there is no known way to obviate radiation mucositis all efforts to prevent aggravation and accelerate healing of mucosal changes are of great importance. Numerous agents including antimicrobials, local and systemic analgesics, antiinflammatory drugs, antidiarrheal drugs, in combination with intensive dietetic care are used to relieve symptoms. Recently coating agents like the polyaluminum-sucrose complex sucralfate were suggested for the prevention and treatment of mucosal reactions. Since sucralfate protects ulcerated epithelium by coating, liberates protective prostaglandins and increases the local availability of protective factors this drug might directly interact with the pathogenesis of mucositis. Patients and Method: The results of available studies are analysed and discussed. Results: The results of several studies indicate that sucralfate treatment especially during radiotherapy for pelvic cancer leads to a significant amelioration of clinical symptoms and morphological changes. An application of sucralfate during radiotherapy of head and neck cancer reveals only limited benefits in most studies performed. Conclusion: Nevertheless sucralfate is a save, cheap and active drug for the prevention and treatment of radiation mucositis especially in patients with pelvic irradiation. (orig.) [Deutsch] Hintergrund: Schleimhautreaktionen stellen eine wesentliche akute und chronische Nebenwirkung radioonkologischer Therapieverfahren dar. Klinisch im Vordergrund stehen Schmerzen, Ernaeherungsprobleme und Durchfaelle. Da bislang keine kausalen Therapie- oder Prophylaxemassnahmen bekannt sind, erfolgt die Behandlung symptomorientiert. Hierbei kommen insbesondere lokale und systemische

  20. Influence of different treatment techniques on radiation dose to the LAD coronary artery

    Directory of Open Access Journals (Sweden)

    Molls Michael


    Full Text Available Abstract Background The purpose of this proof-of-principle study was to test the ability of an intensity-modulated radiotherapy (IMRT technique to reduce the radiation dose to the heart plus the left ventricle and a coronary artery. Radiation-induced heart disease might be a serious complication in long-term cancer survivors. Methods Planning CT scans from 6 female patients were available. They were part of a previous study of mediastinal IMRT for target volumes used in lymphoma treatment that included 8 patients and represent all cases where the left anterior descending coronary artery (LAD could be contoured. We compared 6 MV AP/PA opposed fields to a 3D conformal 4-field technique and an optimised 7-field step-and-shoot IMRT technique and evaluated DVH's for several structures. The planning system was BrainSCAN 5.21 (BrainLAB, Heimstetten, Germany. Results IMRT maintained target volume coverage but resulted in better dose reduction to the heart, left ventricle and LAD than the other techniques. Selective dose reduction could be accomplished, although not to the degree initially attempted. The median LAD dose was approximately 50% lower with IMRT. In 5 out of 6 patients, IMRT was the best technique with regard to heart sparing. Conclusion IMRT techniques are able to reduce the radiation dose to the heart. In addition to dose reduction to whole heart, individualised dose distributions can be created, which spare, e.g., one ventricle plus one of the coronary arteries. Certain patients with well-defined vessel pathology might profit from an approach of general heart sparing with further selective dose reduction, accounting for the individual aspects of pre-existing damage.

  1. Treatment outcome of thymic epithelial tumor: prognostic factors and optimal postoperative radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Dong Ryul; Ahn, Yong Chan; Kim, Kwan Min; Kim, Jhin Gook; Shim, Young Mog; Han, Jung Ho [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    This study was conducted to analyze treatment outcome and prognostic significance of World Health Organization (WHO)-defined thymic epithelial tumor (TET) subtype and to assess optimal radiation target volume in patients receiving surgery and adjuvant radiation therapy with TET. The record of 160 patients with TET, who received surgical resection at the Samsung medical Center, from December 1994 to June 2004, were reviewed. 99 patients were treated with postoperative radiation therapy (PORT). PORT was recommended when patients had more than one findings among suspicious incomplete resection or positive resection margin or Masaoka stage II {approx} IV or WHO tumor type B2 {approx} C. PORT performed to primary tumor bed only with a mean dose of 54 Gy. The prognostic factor and pattern of failure were analyzed retrospectively. The overall survival rate at 5 years was 87.3%. Age (more than 60 years 77.8%, less than 60 years 91.1%; {rho} = 0.03), Masaoka stage (I 92.2%, II 95.4%, III 82.1%, IV 67.5%; {rho} = 0.001), WHO tumor type (A-B1 96.0%, B2-C 82.3%; {rho} = 0.001), Extent of resection (R0 resection 92.3%, R1 or 2 resection 72.6%; {rho} = 0.001) were the prognostic factors according to univariate analysis. But WHO tumor type was the only significant prognostic factor according to multivariate analysis. Recurrence was observed in 5 patients of 71 Masoka stage I-III patients who received grossly complete tumor removal (R0, R1 resection ) and PORT to primary tumor bed. Mediastinal recurrence was observed in only one patients. There were no recurrence within irradiation field. WHO tumor type was the important prognostic factor to predict survival of patients with TET. This study suggest that PORT to only primary tumor bed was optimal. To avoid pleura-or pericardium-based recurrence, further study of effective chemotherapy should be investigated.

  2. Tertiary Treatment of Effluent from Holston AAP (Army Ammunition Plant) Industrial Liquid Waste Treatment Facility. 4. Ultraviolet Radiation and Hydrogen Peroxide Studies: TNT, RDX, HMX, TAX, and SEX (United States)


    AAP Technical Report INDUSTRIAL LIQUID WASTE TREATMENT FACILITY Feb 1983 - Aug 1983 IV. ULTRAVIOLET RADIATION AND HYDROGEN PEROXIDE 1. PERPnRUINe ORO ...ultraviolet light. The production of nitrate-nitrogen and loss of total organic carbon was reportedly indicative of the mineralization of TNT. 5...Treatment of Effluent from Holston AAP Industrial Liquid Waste Treatment Facility. II. Corona Oxidation Studies: TNT, RDX, HMX, TAX, and SEX. Technical

  3. Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a ⁶⁰Co Magnetic Resonance Image Guidance Radiation Therapy System. (United States)

    Wooten, H Omar; Green, Olga; Yang, Min; DeWees, Todd; Kashani, Rojano; Olsen, Jeff; Michalski, Jeff; Yang, Deshan; Tanderup, Kari; Hu, Yanle; Li, H Harold; Mutic, Sasa


    This work describes a commercial treatment planning system, its technical features, and its capabilities for creating (60)Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. The ViewRay treatment planning system (Oakwood Village, OH) was used to create (60)Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The (60)Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. All (60)Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for (60)Co was within 20 Gy. The mean doses for all (60)Co plan OARs were within clinical tolerances. A commercial (60)Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Treatment with intensity-modulated radiation therapy (IMRT) for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Marta, G.N.; Hanna, S.A.; Gadia, R.


    Through the development of four relevant clinical questions related with the proposed subject, we tried to present the main evidence for safety, toxicity and effectiveness using different radiotherapy techniques. The study population consisted of female patients of all ages with primary breast cancer treated with radiation therapy to the whole breast, regardless of histological type, staging, context of treatment (radical, adjuvant or palliative) and whether comorbidities were present or not. For this, a systematic review of the literature was performed in primary scientific research databases (Medline - Pubmed; Embase - Elsevier; Lilacs - Bireme; Cochrane Library - Central Register of Controlled Trials). All articles available until July 22, 2013, were included. The search strategy used for Medline research is described in Appendix. Articles were selected based on critical evaluation in search of the best available evidence. Recommendations were prepared based on discussion with the writing group, composed of three members of the Brazilian Society of Radiotherapy. The guideline was reviewed by an independent group specializing in evidence-based clinical guidelines. After completion, the guideline was made available for public consultation for 15 days and the suggestions forwarded to the writers for evaluation and consideration into the final text. Objective: to assess the most appropriate method of radiation therapy for treating patients with primary breast tumors. (author)

  5. The effectiveness of electromagnetic terahertz radiation use in the treatment of patients with rapidly progressive periodontitis

    Directory of Open Access Journals (Sweden)

    Zelenova A.V.


    Full Text Available The aim: to increase the efficiency of treatment of patients with rapidly progressive periodontitis (RPP using electromagnetic radiation at terahertz frequencies of molecular spectrum of radiation and absorption of nitric oxide 150,176-150,664 GHz. Material and methods. The study involved 50 patients with RPP, which according to the method of therapy were divided into 2 groups: group 1 included patients receiving conventional therapy, group 2 consisted of patients who, along with traditional therapy received EHF-therapy device "Orbit" YAKUL.941526.001. The control group consisted of 20 healthy subjects with intact periodontium. For the non-invasive study of tissue blood flow in the periodontal tissue Doppler ultrasound was used MiniMax-Doppler-Phono. The study of the microvasculature of periodontitis has been conducted. To determine the reactivity of microvascular periodontal tissue reflex functional tests on the indirect effect of the cold were performed. Results. Reductions achieved values of periodontal indices, especially important index PMA, a significant increase in the linear blood flow indices, decreased pulse pressure gradient and the index followed appropriate reduction to their cold test. Conclusion. The proposed complex therapy can accelerate the relief of inflammation in the periodontal tissues of the complex, to improve the elastic properties of blood vessels, reduce their tone and restore microcirculation in periodontal tissues.

  6. Evaluation of potent phytomedicine for treatment of psoriasis using UV radiation induced psoriasis in rats. (United States)

    Nagar, Hemant K; Srivastava, Amit K; Srivastava, Rajnish; Ranawat, Mahendra S


    The aim of present study was to determine the effect of newly formulated gels and suspensions of extractive Phytoconstituents of Woodfordia fructicosa flowers and Gardenia gummifera leaves by using UV Radiation induced psoriasis in rats. Both plants are traditionally claimed to be useful in treatment of number of skin diseases. However, there are no established scientific reports for their potential in psoriasis. Formulated Gels and Suspensions of ethanolic extract of both plants were tested for acute dermal and oral toxicity study respectively. The results of acute dermal toxicity at concentration 1% w/w and oral toxicity at dose 1000mg/kg showed that the gels and suspensions were safe. Psoriasis was induced in Wistar rats by espousing 10% area of total body by UV radiations. Anti-psoriatic activity was performed by applying 0.1% gel and orally at a dose 100mg/kg body weight in rats. Severity Index, histological study and biochemical estimation were analyzed. The results of our studies showed that the test formulations (Gels and Suspensions) of both plant extracts exhibited potential effect in anti-psoriatic activity.

  7. Modification of end-loop ileostomy for the treatment of ischemic or radiation enteritis

    Institute of Scientific and Technical Information of China (English)

    Konstantinos Tepetes; Paraskevi Liakou; Ioannis Balogiannis; Maria Kouvaraki; Konstantinos Hatzitheofilou


    AIM: To evaluate a new technique of temporary ileal anastomotic stoma,following small bowel resection,in patients where the anastomosis is anticipated to have borderline margins with dubious viability.METHODS: Five patients underwent enterectomy and partially anastomosed end-loop ileostomy at the University Hospital of Larissa between 2000 and 2006.Enterectomy was performed because of conditions such as mesenteric vascular occlusive disease,radiation entritis and small bowel injury.RESULTS: Postoperatively,none of the patients developed any stoma-related or anastomotic complications.There were no major complications.All patients were discharged between the 8th and 15th day after the procedure,and the stoma was closed 3 wk to 4 wk later.CONCLUSION: We believe that our proposed modification of end-loop ileostomy is a simple,quick and safe technique with minimal stoma-related morbidity,and with simple and safe reversion.This technique can be considered as a useful option in the treatment of ischemic or radiation-induced enteritis,and in the management of severe intestinal trauma.

  8. Patient-reported outcomes after electron radiation treatment for early-stage palmar and plantar fibromatosis. (United States)

    Schuster, Jessica; Saraiya, Siddharth; Tennyson, Nathan; Nedelka, Michele; Mukhopadhyay, Nitai; Weiss, Elisabeth


    Palmar and plantar fibromatosis (PPF) is a progressive connective tissue disorder of the hand/foot that often leads to debilitating functional impairment. In Europe, orthovoltage radiation therapy (RT) has been demonstrated to prevent local disease progression for up to 80% of patients with early-stage PPF. There are limited data reporting outcomes for populations outside of Europe or using electron RT. Between 2008 and 2013, 44 early-stage PPF cases received RT. RT fields involved clinically defined targets encompassing involved areas (skin changes, cords, nodules) with at least 1.5-cm margins. En face electrons (6-12 MeV) and bolus (0.5-1 cm) were selected individually. Outcomes are reported for patients who participated in an institutional review board-approved standardized questionnaire and chart review. Thirty-three patients received 66 treatments (45 hands/15 feet and 6 reirradiations). Most frequent dose schemes were 21 Gy (3 Gy in 7 fractions) and 30 Gy (3 Gy in 10 fractions with 6- to 8-week breaks after 15 Gy). Median time to follow-up survey was 31 months. Disease progression at any location within or outside the RT treatment field occurred in 20 of 33 patients (61%). Fourteen of 60 sites (23%) developed in-field progression, but 4 sites were successfully reirradiated with final local control in 50 of 60 sites (83%). RT improved pretreatment symptoms of pain with strain at 30 of 37 sites (81%) and itch/burn sensations at 17 of 21 sites (81%). There were no reported grade ≥2 late toxicities even with reirradiation. Patient reported overall success with treatment was 31 of 33 patients (94%). PPF is a progressive disease. En face electron RT is an effective therapy that stabilizes or improves symptoms in the majority of patients. Reirradiation can be considered as a treatment option for in-field progression. Patients report minimal toxicity and a high rate of satisfaction with treatment. Copyright © 2015 American Society for Radiation Oncology. Published

  9. Evaluation of the absorbed dose in odontological computerized tomography; Avaliacao da dose absorvida em tomografia computadorizada odontologica

    Energy Technology Data Exchange (ETDEWEB)

    Legnani, Adriano; Schelin, Hugo R.; Rocha, Anna Silvia P.S. da, E-mail:, E-mail: [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Khoury, Helen J., E-mail: khoury@ufpe.b [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil)


    This paper evaluated the absorbed dose at the surface entry known as 'cone beam computed tomography' (CBCT) in odontological computerized tomography. Examination were simulated with CBCT for measurements of dose. A phantom were filled with water, becoming scatter object of radiation. Thermoluminescent dosemeters were positioned on points correspondent to eyes and salivary glands

  10. Computerized management information systems and organizational structures (United States)

    Zannetos, Z. S.; Sertel, M. R.


    The computerized management of information systems and organizational structures is discussed. The subjects presented are: (1) critical factors favoring centralization and decentralization of organizations, (2) classification of organizations by relative structure, (3) attempts to measure change in organization structure, and (4) impact of information technology developments on organizational structure changes.

  11. Computerized management support for swine breeding farms.

    NARCIS (Netherlands)

    Huirne, R.B.M.


    1. INTRODUCTIONThe investigations described in this thesis have been directed towards computerized management support for swine breeding farms, focused on sow productivity and profitability. The study is composed of three basic parts: (1) basic description and definition of farm man

  12. An Introduction to the Computerized Adaptive Testing (United States)

    Tian, Jian-quan; Miao, Dan-min; Zhu, Xia; Gong, Jing-jing


    Computerized adaptive testing (CAT) has unsurpassable advantages over traditional testing. It has become the mainstream in large scale examinations in modern society. This paper gives a brief introduction to CAT including differences between traditional testing and CAT, the principles of CAT, psychometric theory and computer algorithms of CAT, the…

  13. Graphical Models and Computerized Adaptive Testing. (United States)

    Mislevy, Robert J.; Almond, Russell G.

    This paper synthesizes ideas from the fields of graphical modeling and education testing, particularly item response theory (IRT) applied to computerized adaptive testing (CAT). Graphical modeling can offer IRT a language for describing multifaceted skills and knowledge, and disentangling evidence from complex performances. IRT-CAT can offer…

  14. [Computerization of hospital blood banks in France]. (United States)

    Daurat, G; Py, J-Y


    In France, most blood products are delivered by the établissement francais du sang, directly to the recipients, and hospital blood banks deliver a minor part, but are independent from it. However that may be, hospital blood banks are hazardous activities regarding to recipients, blood products, blood supply of the hospital and regional blood supply. Because of the high risk level, a computerized information system is compulsory for all hospital blood banks, except for those only devoted to vital emergency transfusion. On the field, the integration of computerization in the different processes is very heterogeneous. So, it has been decided to publish guidelines for computerizing hospital blood banks information systems and production management. They have been built according to risk assessment and are intended to minimize those risks. The principle is that all acquisition and processing of data about recipients or blood products and tracking, must be fully computerized and that the result of all manual processes must be checked by computer before proceeding to the next step. The guidelines list the different processes and, for each of them, the functions the software must play. All together, they form the basic level all hospital blood banks should reach. Optional functions are listed. Moreover, the guidelines are also aimed to be a common tool for regional health authorities who supervise hospital blood banks.

  15. Computerized adaptive testing: overview and introduction

    NARCIS (Netherlands)

    Meijer, Rob R.; Nering, Michael L.


    Use of computerized adaptive testing (CAT) has increased substantially since it was first formulated in the 1970s. This paper provides an overview of CAT and introduces the contributions to this Special Issue. The elements of CAT discussed here include item selection procedures, estimation of the la

  16. Computerized Testing: The Hidden Figures Test. (United States)

    Jacobs, Ronald L.; And Others


    This study adapted the Hidden Figures Test for use on PLATO and determined the reliability of the computerized version compared to the paper and pencil version. Results indicate the test was successfully adapted with some modifications, and it was judged reliable although it may be measuring additional constructs. (MBR)

  17. Computerized management support for swine breeding farms

    NARCIS (Netherlands)

    Huirne, R.B.M.



    The investigations described in this thesis have been directed towards computerized management support for swine breeding farms, focused on sow productivity and profitability. The study is composed of three basic parts: (1) basic description and

  18. Computerized Financial Reporting Based on GAAP. (United States)

    Tikkanen, Stan; Liljeberg, Burt


    Describes the statewide computerized system developed in Minnesota following the 1976 enactment of the Uniform Financial Accounting and Reporting Standards (UFARS) law. UFARS includes provisions for an advisory council responsible for recommending accounting and reporting procedures, and seven data processing centers to serve all 560 Minnesota…

  19. Explicit and convex optimization of plan quality measures in intensity-modulated radiation therapy treatment planning

    CERN Document Server

    Engberg, Lovisa; Forsgren, Anders; Hårdemark, Björn


    Given the widespread agreement that doses-at-volume play important roles in quality assessment of radiation therapy treatment plans, planning objectives that correlate well with explicit dose-at-volume optimization are likely to correlate well with plan quality. In this study, planning objectives are formulated to explicitly either minimize or maximize convex approximations of dose-at-volume, namely, mean-tail-doses. This is in contrast to the conventionally used planning objectives, which are used to maximize clinical goal fulfilment by relating to deviations from dose-at-volume thresholds. Advantages of the proposed planning objectives are investigated through juxtaposition with conventional objectives in a computational study of two patient cases, each with three doses-at-volume to be minimized subject to PTV coverage. With proposed planning objectives, this is translated into minimizing three mean-tail-doses. Comparison with conventional objectives is carried out in the dose-at-volume domain and in the no...

  20. Laser radiation in tennis elbow treatment: a new minimally invasive alternative (United States)

    Paganini, Stefan; Thal, Dietmar R.; Werkmann, Klaus


    The epicondylitis humeri radialis (EHR) (tennis elbow), is a common disease in elbow joint pain syndromes. We treated patients with chronic pain for at least one year and no improvement with conservative or operative therapies with a new minimal invasive method, the EHR-Laser radiation (EHR- LR). With this method periepicondylar coagulations were applied to the trigger points of the patients. For this the previously established technique of facet joint coagulation with the Nd:Yag-laser was modified. In a follow-up study of between 6 weeks and 2 years all patients reported either a significant pain reduction or were symptom free. EHR-LR is a new method situated between conservative and surgical treatments for minimal invasive therapy of EHR. Several therapeutic rationales were discussed for the resulting pain reduction.

  1. A Novel Approach for the Treatment of Radiation-Induced Hemorrhagic Cystitis with the GreenLight™ XPS Laser

    Directory of Open Access Journals (Sweden)

    Daniel Roberto Martinez


    Full Text Available ABSTRACTIntroduction:The treatment of pelvic malignancies with radiotherapy can develop severe sequelae, especially radiation-induced hemorrhagic cystitis. It is a progressive disease that can lead to the need for blood transfusion, hospitalizations, and surgical interventions. This tends to affect the quality of life of these patients, and management can at times be difficult. We have evaluated the GreenLight Xcelerated Performance System (XPS with TruCoag, although primarily used for management of benign prostatic hypertrophy (BPH, for the treatment of radiation-induced hemorrhagic cystitis.Materials and Methods:After International Review Board (IRB approval, a retrospective chart review was performed in addition to a literature search. A series of four male patients, mean age of 81 years, with radiation-induced hemorrhagic cystitis secondary to radiotherapy for pelvic malignancies (3 prostate cancer, 1 rectal cancer were successfully treated with the GreenLight laser after unsuccessful treatment with current therapies described in the literature.Results:All four patients treated with the GreenLight laser had resolution of their hematuria after one treatment and were discharge from the hospital with clear urine.Conclusion:The GreenLight XPS laser shows promising results for the treatment of patients with radiation-induced hemorrhagic cystitis, and deserves further evaluation and validation, especially since there is limited data available in the literature regarding the use of this technology for the treatment of this devastating condition.

  2. Fast voxel and polygon ray-tracing algorithms in intensity modulated radiation therapy treatment planning. (United States)

    Fox, Christopher; Romeijn, H Edwin; Dempsey, James F


    We present work on combining three algorithms to improve ray-tracing efficiency in radiation therapy dose computation. The three algorithms include: An improved point-in-polygon algorithm, incremental voxel ray tracing algorithm, and stereographic projection of beamlets for voxel truncation. The point-in-polygon and incremental voxel ray-tracing algorithms have been used in computer graphics and nuclear medicine applications while the stereographic projection algorithm was developed by our group. These algorithms demonstrate significant improvements over the current standard algorithms in peer reviewed literature, i.e., the polygon and voxel ray-tracing algorithms of Siddon for voxel classification (point-in-polygon testing) and dose computation, respectively, and radius testing for voxel truncation. The presented polygon ray-tracing technique was tested on 10 intensity modulated radiation therapy (IMRT) treatment planning cases that required the classification of between 0.58 and 2.0 million voxels on a 2.5 mm isotropic dose grid into 1-4 targets and 5-14 structures represented as extruded polygons (a.k.a. Siddon prisms). Incremental voxel ray tracing and voxel truncation employing virtual stereographic projection was tested on the same IMRT treatment planning cases where voxel dose was required for 230-2400 beamlets using a finite-size pencil-beam algorithm. Between a 100 and 360 fold cpu time improvement over Siddon's method was observed for the polygon ray-tracing algorithm to perform classification of voxels for target and structure membership. Between a 2.6 and 3.1 fold reduction in cpu time over current algorithms was found for the implementation of incremental ray tracing. Additionally, voxel truncation via stereographic projection was observed to be 11-25 times faster than the radial-testing beamlet extent approach and was further improved 1.7-2.0 fold through point-classification using the method of translation over the cross product technique.

  3. Computed tomography imaging parameters for inhomogeneity correction in radiation treatment planning

    Directory of Open Access Journals (Sweden)

    Indra J Das


    Full Text Available Modern treatment planning systems provide accurate dosimetry in heterogeneous media (such as a patient' body with the help of tissue characterization based on computed tomography (CT number. However, CT number depends on the type of scanner, tube voltage, field of view (FOV, reconstruction algorithm including artifact reduction and processing filters. The impact of these parameters on CT to electron density (ED conversion had been subject of investigation for treatment planning in various clinical situations. This is usually performed with a tissue characterization phantom with various density plugs acquired with different tube voltages (kilovoltage peak, FOV reconstruction and different scanners to generate CT number to ED tables. This article provides an overview of inhomogeneity correction in the context of CT scanning and a new evaluation tool, difference volume dose-volume histogram (DVH, dV-DVH. It has been concluded that scanner and CT parameters are important for tissue characterizations, but changes in ED are minimal and only pronounced for higher density materials. For lungs, changes in CT number are minimal among scanners and CT parameters. Dosimetric differences for lung and prostate cases are usually insignificant (<2% in three-dimensional conformal radiation therapy and < 5% for intensity-modulated radiation therapy (IMRT with CT parameters. It could be concluded that CT number variability is dependent on acquisition parameters, but its dosimetric impact is pronounced only in high-density media and possibly in IMRT. In view of such small dosimetric changes in low-density medium, the acquisition of additional CT data for financially difficult clinics and countries may not be warranted.

  4. The combination of novel targeted molecular agents and radiation in the treatment of pediatric gliomas

    Directory of Open Access Journals (Sweden)

    Tina eDasgupta


    Full Text Available Brain tumors are the most common solid pediatric malignancy. For high-grade, recurrent or refractory pediatric brain tumors, radiation therapy (XRT is an integral treatment modality. In the era of personalized cancer therapy, molecularly targeted agents have been designed to inhibit pathways critical to tumorigenesis. Our evolving knowledge of genetic aberrations in low-grade gliomas is being exploited with targeted inhibitors. These agents are also being combined with XRT to increase their efficacy. In this review, we discuss novel agents targeting three different pathways in low-grade gliomas, and their potential combination with XRT. B-Raf is a kinase in the Ras/Raf/MAPK kinase pathway, which is integral to cellular division, survival and metabolism. In low-grade pediatric gliomas, point mutations in BRAF (BRAF V600E or a BRAF fusion mutation (KIAA1549:BRAF causes overactivation of the MEK/MAPK pathway. Pre-clinical data shows cooperation between XRT and tagrgeted inhibitors of BRAF V600E, and MEK and mTOR inhibitors in the gliomas with the BRAF fusion. A second important signaling cascade in pediatric glioma pathogenesis is the PI3 kinase (PI3K/mTOR pathway. Dual PI3K/mTOR inhibitors are poised to enter studies of pediatric tumors. Finally, many brain tumors express potent stimulators of angiogenesis. Several inhibitors of immunomodulators are currently being evaluated in in clinical trials for the treatment of recurrent or refractory pediatric central nervous system (CNS tumors. In summary, combinations of these targeted inhibitors with radiation are currently under investigation in both translational bench research and early clinical trials. We summarize the molecular rationale for, and the pre-clinical data supporting the combinations of these targeted agents with other anti-cancer agents and XRT in pediatric gliomas. Parallels are drawn to adult gliomas, and the molecular mechanisms underlying the efficacy of these agents is discussed

  5. Voice Quality After Treatment of Early Vocal Cord Cancer: A Randomized Trial Comparing Laser Surgery With Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Aaltonen, Leena-Maija, E-mail: [Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Rautiainen, Noora; Sellman, Jaana [Institute of Behavioural Sciences, University of Helsinki, Helsinki (Finland); Saarilahti, Kauko [Department of Oncology, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Mäkitie, Antti; Rihkanen, Heikki [Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Laranne, Jussi; Kleemola, Leenamaija [Department of Otorhinolaryngology–Head and Neck Surgery, Tampere University Hospital, and University of Tampere, Tampere (Finland); Wigren, Tuija [Department of Oncology, Tampere University Hospital, and University of Tampere, Tampere (Finland); Sala, Eeva [Department of Otorhinolaryngology–Head and Neck Surgery, Turku University Hospital, and University of Turku, Turku (Finland); Lindholm, Paula [Department of Oncology, Turku University Hospital, and University of Turku, Turku (Finland); Grenman, Reidar [Department of Otorhinolaryngology–Head and Neck Surgery, Turku University Hospital, and University of Turku, Turku (Finland); Joensuu, Heikki [Department of Oncology, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland)


    Objective: Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Methods and Materials: Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO{sub 2} laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality was assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Results: Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Conclusions: Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option.

  6. Treatment and long-term outcome of chronic radiation esophagitis after radiation therapy for head and neck tumors: A report of 13 cases

    Energy Technology Data Exchange (ETDEWEB)

    Silvain, C.; Barrioz, T.; Besson, I.; Babin, P.; Fontanel, J.P.; Daban, A.; Matuchansky, C.; Beauchant, M. (CHU J Bernard, Poitiers (France))


    The natural history of chronic radiation esophagitis occurring in previously normal esophagus is still unknown. The authors describe here the long-term outcome of chronic esophagitis arising after neck irradiation for oropharynx and larynx carcinomas in 13 consecutive adult patients. The first clinical signs of radiation esophagitis were dysphagia or impossibility of oral intake, which appeared within 26 months (range 2--120 months) after the end of radiation for pyriform fossae carcinoma (N = 5), tonsil carcinoma (N = 2), larynx carcinoma (N = 2), pharynx carcinoma (N = 2), base of the tongue (N = 1), and thyroid carcinomas (N = 1). During upper endoscopy, an esophageal stenosis was found in 11 cases and was associated with ulceration in three cases. An isolated esophageal ulceration was present in only two cases. Chronic radiation esophagitis diagnosis was confirmed by histology and surgery in seven cases. In the last six cases, diagnosis was supported by the absence of first cancer relapses within a median follow-up of two years (16 months to nine years) and by endoscopic findings. Seven patients received parenteral or enteral nutrition. Ten patients were treated by peroral dilatations. These treatments allowed nearly normal oral diet in 11/13 patients. Only one patient was lost of follow-up after 20 months. Four patients died from chronic radiation esophagitis. One of these patients died from massive hemorrhage after peroral dilatation. Four patients died of a second carcinoma with no first cancer recurrence. Four patients were alive after six months to nine years of follow-up. Moderate dysphagia was still present, allowing nearly normal oral feeding. In conclusion, chronic radiation esophagitis is a severe disease with an underestimated frequency. In this study, peroral dilatations appeared to be necessary and were not associated with an increased morbidity. 21 refs., 1 tab.

  7. Psychometric evaluation of the EORTC computerized adaptive test (CAT) fatigue item pool

    DEFF Research Database (Denmark)

    Petersen, Morten Aa; Giesinger, Johannes M; Holzner, Bernhard


    Fatigue is one of the most common symptoms associated with cancer and its treatment. To obtain a more precise and flexible measure of fatigue, the EORTC Quality of Life Group has developed a computerized adaptive test (CAT) measure of fatigue. This is part of an ongoing project developing a CAT v...

  8. Relevance of computerized tomography in the preoperative evaluation of patients with vulvar cancer

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Zobbe, Vibeke; Thranov, Ingrid Regitze;


    BACKGROUND: The purpose of the study was to determine whether inclusion of computerized tomography (CT) in the prospective evaluation of vulvar cancer changed the surgical treatment strategy in terms of detection of lymph node metastases, tumor spread and comorbidity, and additionally to examine...

  9. TH-A-9A-04: Incorporating Liver Functionality in Radiation Therapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Wu, V; Epelman, M; Feng, M; Cao, Y; Wang, H; Romeijn, E; Matuszak, M [University of Michigan, Ann Arbor, MI (United States)


    Purpose: Liver SBRT patients have both variable pretreatment liver function (e.g., due to degree of cirrhosis and/or prior treatments) and sensitivity to radiation, leading to high variability in potential liver toxicity with similar doses. This work aims to explicitly incorporate liver perfusion into treatment planning to redistribute dose to preserve well-functioning areas without compromising target coverage. Methods: Voxel-based liver perfusion, a measure of functionality, was computed from dynamic contrast-enhanced MRI. Two optimization models with different cost functions subject to the same dose constraints (e.g., minimum target EUD and maximum critical structure EUDs) were compared. The cost functions minimized were EUD (standard model) and functionality-weighted EUD (functional model) to the liver. The resulting treatment plans delivering the same target EUD were compared with respect to their DVHs, their dose wash difference, the average dose delivered to voxels of a particular perfusion level, and change in number of high-/low-functioning voxels receiving a particular dose. Two-dimensional synthetic and three-dimensional clinical examples were studied. Results: The DVHs of all structures of plans from each model were comparable. In contrast, in plans obtained with the functional model, the average dose delivered to high-/low-functioning voxels was lower/higher than in plans obtained with its standard counterpart. The number of high-/low-functioning voxels receiving high/low dose was lower in the plans that considered perfusion in the cost function than in the plans that did not. Redistribution of dose can be observed in the dose wash differences. Conclusion: Liver perfusion can be used during treatment planning potentially to minimize the risk of toxicity during liver SBRT, resulting in better global liver function. The functional model redistributes dose in the standard model from higher to lower functioning voxels, while achieving the same target EUD

  10. Ionizing radiation exposures in treatments of solid neoplasms are not associated with subsequent increased risks of chronic lymphocytic leukemia. (United States)

    Radivoyevitch, Tomas; Sachs, Rainer K; Gale, Robert Peter; Smith, Mitchell R; Hill, Brian T


    Exposure to ionizing radiation is not thought to cause chronic lymphocytic leukemia (CLL). Challenging this notion are recent data suggesting CLL incidence may be increased by radiation exposure from the atomic bombs (after many decades), uranium mining and nuclear power facility accidents. To assess the effects of therapeutic ionizing radiation for the treatment of solid neoplasms we studied CLL risks in data from the Surveillance, Epidemiology, and End Results (SEER) Program. Specifically, we compared the risks of developing CLL in persons with a 1(st) non-hematologic cancer treated with or without ionizing radiation. We controlled for early detection effects on CLL risk induced by surveillance after 1(st) cancer diagnoses by forming all-time cumulative CLL relative risks (RR). We estimate such CLL RR to be 1.20 (95% confidence interval, 1.17, 1.23) for persons whose 1(st) cancer was not treated with ionizing radiation and 1.00 (0.96, 1.05) for persons whose 1(st) cancer was treated with ionizing radiations. These results imply that diagnosis of a solid neoplasm is associated with an increased risk of developing CLL only in persons whose 1(st) cancer was not treated with radiation therapy.

  11. Estimated cumulative radiation dose received by diagnostic imaging during staging and treatment of operable Ewing sarcoma 2005-2012

    Energy Technology Data Exchange (ETDEWEB)

    Johnsen, Boel [Haukeland University Hospital, Centre for Nuclear Medicine and PET, Department of Radiology, P.O. Box 1400, Bergen (Norway); Fasmer, Kristine Eldevik [Haukeland University Hospital, Department of Oncology, Medical Physics Section, Bergen (Norway); Boye, Kjetil [Norwegian Radium Hospital, Oslo University Hospital, Department of Oncology, Oslo (Norway); Rosendahl, Karen; Aukland, Stein Magnus [Haukeland University Hospital, Department of Radiology, Paediatric Section, Bergen (Norway); University of Bergen, Department of Clinical Medicine, Bergen (Norway); Trovik, Clement [University of Bergen, Department of Clinical Medicine, Bergen (Norway); Haukeland University Hospital, Department of Surgery, Orthopaedic Section, Bergen (Norway); Biermann, Martin [Haukeland University Hospital, Centre for Nuclear Medicine and PET, Department of Radiology, P.O. Box 1400, Bergen (Norway); University of Bergen, Department of Clinical Medicine, Bergen (Norway)


    Patients with Ewing sarcoma are subject to various diagnostic procedures that incur exposure to ionising radiation. To estimate the radiation doses received from all radiologic and nuclear imaging episodes during diagnosis and treatment, and to determine whether {sup 18}F-fluorodeoxyglucose positron emission tomography - computed tomography ({sup 18}F-FDG PET-CT) is a major contributor of radiation. Twenty Ewing sarcoma patients diagnosed in Norway in 2005-2012 met the inclusion criteria (age <30 years, operable disease, uncomplicated chemotherapy and surgery, no metastasis or residual disease within a year of diagnosis). Radiation doses from all imaging during the first year were calculated for each patient. The mean estimated cumulative radiation dose for all patients was 34 mSv (range: 6-70), radiography accounting for 3 mSv (range: 0.2-12), CT for 13 mSv (range: 2-28) and nuclear medicine for 18 mSv (range: 2-47). For the patients examined with PET-CT, the mean estimated cumulative effective dose was 38 mSv, of which PET-CT accounted for 14 mSv (37%). There was large variation in number and type of examinations performed and also in estimated cumulative radiation dose. The mean radiation dose for patients examined with PET-CT was 23% higher than for patients not examined with PET-CT. (orig.)

  12. Treatment techniques for 3D conformal radiation to breast and chest wall including the internal mammary chain. (United States)

    Sonnik, Deborah; Selvaraj, Raj N; Faul, Clare; Gerszten, Kristina; Heron, Dwight E; King, Gwendolyn C


    Breast, chest wall, and regional nodal irradiation have been associated with an improved outcome in high-risk breast cancer patients. Complex treatment planning is often utilized to ensure complete coverage of the target volume while minimizing the dose to surrounding normal tissues. The 2 techniques evaluated in this report are the partially wide tangent fields (PWTFs) and the 4-field photon/electron combination (the modified "Kuske Technique"). These 2 techniques were evaluated in 10 consecutive breast cancer patients. All patients had computerized tomographic (CT) scans for 3D planning supine on a breast board. The breast was defined clinically by the physician and confirmed radiographically with radiopaque bebes. The resulting dose-volume histograms (DVHs) of normal and target tissues were then compared. The deep tangent field with blocks resulted in optimal coverage of the target and the upper internal mammary chain (IMC) while sparing of critical and nontarget tissues. The wide tangent technique required less treatment planning and delivery time. We compared the 2 techniques and their resultant DVHs and feasibility in a busy clinic.

  13. Application of positron emission tomography/computed tomography in radiation treatment planning for head and neck cancers

    Institute of Scientific and Technical Information of China (English)

    Musaddiq; J; Awan; Farzan; Siddiqui; David; Schwartz; Jiankui; Yuan; Mitchell; Machtay; Min; Yao


    18-fluorodeoxygluocose positron emission tomography/computed tomography(18FDG-PET/CT) provides significant information in multiple settings in the management of head and neck cancers(HNC). This article seeks to define the additional benefit of PET/CT as related to radiation treatment planning for squamous cell carcinomas(SCCs) of the head and neck through a review of relevant literature. By helping further define both primary and nodal volumes, radiation treatment planning can be improved using PET/CT. Special attention is paid to the independent benefit of PET/CT in targeting mucosal primaries as well as in detecting nodal metastases. The utility of PET/CT is also explored for treatment planning in the setting of SCC of unknown primary as PET/CT may help define a mucosal target volume by guiding biopsies for examination under anesthesia thus changing the treatment paradigm and limiting the extent of therapy. Implications of the use of PET/CT for proper target delineation in patients with artifact from dental procedures are discussed and the impact of dental artifact on CT-based PET attenuation correction is assessed. Finally, comment is made upon the role of PET/CT in the high-risk post-operative setting, particularly in the context of radiation dose escalation. Real case examples are used in these settings to elucidate the practical benefits of PET/CT as related to radiation treatment planning in HNCs.

  14. The combination of novel targeted molecular agents and radiation in the treatment of pediatric gliomas. (United States)

    Dasgupta, Tina; Haas-Kogan, Daphne A


    Brain tumors are the most common solid pediatric malignancy. For high-grade, recurrent, or refractory pediatric brain tumors, radiation therapy (XRT) is an integral treatment modality. In the era of personalized cancer therapy, molecularly targeted agents have been designed to inhibit pathways critical to tumorigenesis. Our evolving knowledge of genetic aberrations in pediatric gliomas is being exploited with the use of specific targeted inhibitors. These agents are additionally being combined with XRT to increase the efficacy and duration of local control. In this review, we discuss novel agents targeting three different pathways in gliomas, and their potential combination with XRT. BRAF is a serine/threonine kinase in the RAS/RAF/MAPK kinase pathway, which is integral to cellular division, survival, and metabolism. Two-thirds of pilocytic astrocytomas, a low-grade pediatric glioma, contain a translocation within the BRAF gene called KIAA1549:BRAF that causes an overactivation of the MEK/MAPK signaling cascade. In vitro and in vivo data support the use of MEK or mammalian target of rapamycin (mTOR) inhibitors in low-grade gliomas expressing this translocation. Additionally, 15-20% of high-grade pediatric gliomas express BRAF V600E, an activating mutation of the BRAF gene. Pre-clinical in vivo and in vitro data in BRAF V600E gliomas demonstrate dramatic cooperation between XRT and small molecule inhibitors of BRAF V600E. Another major signaling cascade that plays a role in pediatric glioma pathogenesis is the PI3-kinase (PI3K)/mTOR pathway, known to be upregulated in the majority of high- and low-grade pediatric gliomas. Dual PI3K/mTOR inhibitors are in clinical trials for adult high-grade gliomas and are poised to enter studies of pediatric tumors. Finally, many brain tumors express potent stimulators of angiogenesis that render them refractory to treatment. An analog of thalidomide, CC-5103 increases the secretion of critical cytokines of the tumor

  15. [The role of external beam radiation therapy in the adjuvant treatment of pigmented villonodular synovitis]. (United States)

    Heyd, R; Seegenschmiedt, M H; Micke, O


    Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder arising from synovial cells of the tendon sheets and joint capsules. The potential value of external beam radiation therapy in the interdisciplinary management of PVNS is demonstrated by a comprehensive literature review on the clinical use of radiotherapy and the results of national patterns of care study (PCS) which was conducted by the German Cooperative Group on Radiotherapy in Benign Diseases (GCG-BD) in 2008-2009. A structured questionnaire was mailed to all 227 RT institutions in Germany to assess all previous treatments, the RT indication and techniques, the rate of local control, the functional outcome and the possible adverse effects related to the use of external beam radiation therapy (RT). For comparison of the clinical outcome data, a systematic literature research in several international electronic databases and a conventional library search were performed to identify publications addressing the use of RT for PVNS. Based on an overall response rate of 83.2%, the PCS was nationally representative. Ten percent of institutions presented clinical experience with the use of RT for PVNS; from this database a total of 41 treated sites from 14 institutions were evaluable for long-term analysis. The primary therapeutic approach was cytoreductive surgery in all cases. In cases of residual tissue or complete resection of extensive local recurrences, RT was applied in 39 cases (95.1%). An excellent or good functional outcome was noted in 34 cases (82.9%). The use of RT was not associated with early or late toxicity larger than RTOG grade II. The literature review identified 19 published studies (1940-2009) which represented a total of 140 cases or patients, respectively. After follow-up periods ranging from 1-250 months and administration of total doses in the range of 16-50 Gy the overall rate of local control was 84.5%. Both the results of the national PCS and the literature review

  16. Treatment of Oral Cavity Squamous Cell Carcinoma With Adjuvant or Definitive Intensity-Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sher, David J., E-mail: [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Thotakura, Vijaya [Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Balboni, Tracy A. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Norris, Charles M.; Haddad, Robert I.; Posner, Marshall R.; Lorch, Jochen [Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Goguen, Laura A.; Annino, Donald J. [Department of Surgery, Division of Otolaryngology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Tishler, Roy B. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States)


    Purpose: The optimal management of oral cavity squamous cell carcinoma (OCSCC) typically involves surgical resection followed by adjuvant radiotherapy or chemoradiotherapy (CRT) in the setting of adverse pathologic features. Intensity-modulated radiation therapy (IMRT) is frequently used to treat oral cavity cancers, but published IMRT outcomes specific to this disease site are sparse. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for OCSCC. Methods and Materials: Retrospective study of all patients treated at Dana-Farber Cancer Institute for OCSCC with adjuvant or definitive IMRT between August 2004 and December 2009. The American Joint Committee on Cancer disease stage criteria distribution of this cohort included 5 patients (12%) with stage I; 10 patients (24%) with stage II (n = 10, 24%),; 14 patients (33%) with stage III (n = 14, 33%),; and 13 patients (31%) with stage IV. The primary endpoint was overall survival (OS); secondary endpoints were locoregional control (LRC) and acute and chronic toxicity. Results: Forty-two patients with OCSCC were included, 30 of whom were initially treated with surgical resection. Twenty-three (77%) of 30 surgical patients treated with adjuvant IMRT also received concurrent chemotherapy, and 9 of 12 (75%) patients treated definitively without surgery were treated with CRT or induction chemotherapy and CRT. With a median follow-up of 2.1 years (interquartile range, 1.1-3.1 years) for all patients, the 2-year actuarial rates of OS and LRC following adjuvant IMRT were 85% and 91%, respectively, and the comparable results for definitive IMRT were 63% and 64% for OS and LRC, respectively. Only 1 patient developed symptomatic osteoradionecrosis, and among patients without evidence of disease, 35% experienced grade 2 to 3 late dysphagia, with only 1 patient who was continuously gastrostomy-dependent. Conclusions: In this single-institution series, postoperative IMRT was associated with promising LRC

  17. Distributed approximation of Pareto surfaces in multicriteria radiation therapy treatment planning. (United States)

    Bokrantz, Rasmus


    We consider multicriteria radiation therapy treatment planning by navigation over the Pareto surface, implemented by interpolation between discrete treatment plans. Current state of the art for calculation of a discrete representation of the Pareto surface is to sandwich this set between inner and outer approximations that are updated one point at a time. In this paper, we generalize this sequential method to an algorithm that permits parallelization. The principle of the generalization is to apply the sequential method to an approximation of an inexpensive model of the Pareto surface. The information gathered from the model is sub-sequently used for the calculation of points from the exact Pareto surface, which are processed in parallel. The model is constructed according to the current inner and outer approximations, and given a shape that is difficult to approximate, in order to avoid that parts of the Pareto surface are incorrectly disregarded. Approximations of comparable quality to those generated by the sequential method are demonstrated when the degree of parallelization is up to twice the number of dimensions of the objective space. For practical applications, the number of dimensions is typically at least five, so that a speed-up of one order of magnitude is obtained.

  18. Is cardiac toxicity a relevant issue in the radiation treatment of esophageal cancer?

    NARCIS (Netherlands)

    Beukema, Jannet C; van Luijk, Peter; Widder, Joachim; Langendijk, Johannes A; Muijs, Christina T


    Purpose: In recent years several papers have been published on radiation-induced cardiac toxicity, especially in breast cancer patients. However, in esophageal cancer patients the radiation dose to the heart is usually markedly higher. To determine whether radiation-induced cardiac toxicity is also

  19. Treatment of folliculitis decalvans using intensity-modulated radiation via tomotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Elsayad, Khaled; Kriz, Jan; Haverkamp, Uwe; Eich, Hans Theodor [University Hospital of Muenster, Department of Radiation Oncology, Muenster (Germany); Plachouri, Kerasia-Maria; Jeskowiak, Antonia [University Hospital of Muenster, Department of Dermatology, Muenster (Germany); Sunderkoetter, Cord [University Hospital of Muenster, Department of Dermatology, Muenster (Germany); University Hospital of Muenster, Department of Translational Dermatoninfectiology, Muenster (Germany)


    Folliculitis decalvans (FD) is a form of primary neutrophilic scarring alopecia that is characterized clinically by chronic suppurative folliculitis and often associated with pruritus or even pain. Treatment of FD is often difficult. Herein, we report a case of recalcitrant and painful folliculitis decalvans refractory to antibiotic and anti-inflammatory therapies, which was successfully treated by intensity-modulated radiotherapy (IMRT) in order to irreversibly eliminate hair follicles that prove to be one etiological trigger. A 45-year-old male patient with a refractory FD presented with a crusting suppurative folliculitis and atrophic scarring patches on the scalp associated with pain and pruritus. We attempted relief of symptoms by reducing scalp inflammation and eliminating hair follicles through radiation. We delivered 11.0 Gy in two radiation series using tomotherapy, 5.0 Gy in 5 equivalent fractions as a first radiation course. The symptoms markedly decreased but did not totally disappear. Therefore, we delivered a second radiation series 4 months later with an additional 6 Gy. This led to almost complete epilation on the scalp and abolished pain and pruritus on the capillitium. The patient was regularly followed up until 26 months after radiotherapy. Draining lesions or exudation did not recur. He only experienced discrete hair regrowth in the occipital region with folliculitis 12 months after radiotherapy. These residual lesions are currently treated with laser epilation therapy. A radical approach to eliminating hair follicles by repeated radiation therapy may induce lasting relief of symptoms in chronic suppurative FD associated with persistent trichodynia. (orig.) [German] Die Folliculitis decalvans (FD) ist eine Form der primaer neutrophilen Alopezie, welche klinisch durch Schmerzen und eitrige Follikel gekennzeichnet ist. Da es bisher kein einheitliches Behandlungskonzept gibt, wird hier ueber eine FD berichtet, welche trotz mehrfacher antibiotischer

  20. Multibeam tomotherapy: a new treatment unit devised for multileaf collimation, intensity-modulated radiation therapy. (United States)

    Achterberg, Nils; Müller, Reinhold G


    A fully integrated system for treatment planning, application, and verification for automated multileaf collimator (MLC) based, intensity-modulated, image-guided, and adaptive radiation therapy (IMRT, IGRT and ART, respectively) is proposed. Patient comfort, which was the major development goal, will be achieved through a new unit design and short treatment times. Our device for photon beam therapy will consist of a new dual energy linac with five fixed treatment heads positioned evenly along one plane but one electron beam generator only. A minimum of moving parts increases technical reliability and reduces motion times to a minimum. Motion is allowed solely for the MLCs, the robotic patient table, and the small angle gantry rotation of +/- 36 degrees. Besides sophisticated electron beam guidance, this compact setup can be built using existing modules. The flattening-filter-free treatment heads are characterized by reduced beam-on time and contain apertures restricted in one dimension to the area of maximum primary fluence output. In the case of longer targets, this leads to a topographic intensity modulation, thanks to the combination of "step and shoot" MLC delivery and discrete patient couch motion. Owing to the limited number of beam directions, this multislice cone beam serial tomotherapy is referred to as "multibeam tomotherapy." Every patient slice is irradiated by one treatment head at any given moment but for one subfield only. The electron beam is then guided to the next head ready for delivery, while the other heads are preparing their leaves for the next segment. The "Multifocal MLC-positioning" algorithm was programmed to enable treatment planning and optimize treatment time. We developed an overlap strategy for the longitudinally adjacent fields of every beam direction, in doing so minimizing the field match problem and the effects of possible table step errors. Clinical case studies show for the same or better planning target volume coverage, better

  1. [Hypofractionated radiation therapy for the treatment of malignant melanoma and squamous cell carcinoma in dogs and cats]. (United States)

    Kinzel, Sylvia; Hein, Sven; Stopinski, Thaddeus; Koch, Johannes; Buecker, Arno; Treusacher, Hans-Peter; Schmachtenberg, Axel; Jansen, Thomas; Eble, Michael; Küpper, Wernen


    This study describes the experience with hypofractionated radiation therapy of squamous cell carcinoma and melanoma in dogs and cats. A total dose of 32-48 Gray (Gy) was delivered once a week in 8 Gy fractions. 34 animals in which a complete surgical excision was impossible were treated. There was no tumor detectable macroscopically in 14 patients at the beginning of radiation therapy. In 20 animals the median volume of the tumor was 9.9 cm3. The median survival times and the local tumor control of squamous cell carcinoma of the oral and nasal cavities and of the body are comparable to results which were reached with a Monday-Wednesday-Friday scheme. For the treatment of Melanoma the hypofractionated radiation therapy is first choice. There are no significant side effects. Late side effects did not occur. 88% of the owners are satisfied with this kind of treatment and would choose it again.

  2. Radiation dose to contra lateral breast during treatment of breast malignancy by radiotherapy

    Directory of Open Access Journals (Sweden)

    Chougule Arun


    Full Text Available Aims: External beam radiotherapy is being used regularly to treat the breast malignancy postoperatively. The contribution of collimator leakage and scatter radiation dose to contralateral breast is of concern because of high radio sensitivity of breast tissue for carcinogenesis. This becomes more important when the treated cancer breast patient is younger than 45 years and therefore the contralateral breast must be treated as organ at risk. Quantification of contralateral dose during primary breast irradiation is helpful to estimate the risk of radiation induced secondary breast malignancy. Materials and Methods: In present study contralateral breast dose was measured in 30 cancer breast patients undergoing external beam therapy by Co-60 teletherapy machine. Postoperative radiotherapy was delivered by medial and lateral tangential fields on alternate days in addition to supraclavicle field daily with 200 cGy/F to a total dose of 5000 cGy in 25 fractions. CaSO4: Dy themoluminescence dosimeter discs were employed for these measurements. Three TLD discs were put on the surface of skin of contra lateral breast, one at the level of nipple and two at 3 cms away from nipple on both side along the midline for each field. At the end treatment of each filed, TLD discs were removed and measured for dose after 24h on Thelmador - 6000 TLD reader. Results: The dose at the contra lateral breast nipple was to be 152.5 to 254.75 cGy for total primary breast dose of 5000 cGy in 25 equal fractions which amounted to 3.05-6.05% of total dose to diseased breast. Further it was observed that the maximum contribution of contralateral breast dose was due to medical tangential half blocked field. Conclusion: CaSO4; Dy thermoluminescence dosimetry is quite easy, accurate and convenient method to measure the contra lateral breast dose.

  3. A survey of radiation treatment planning peer-review activities in a provincial radiation oncology programme: current practice and future directions (United States)

    Brundage, Michael; Foxcroft, Sophie; McGowan, Tom; Gutierrez, Eric; Sharpe, Michael; Warde, Padraig


    Objectives To describe current patterns of practice of radiation oncology peer review within a provincial cancer system, identifying barriers and facilitators to its use with the ultimate aim of process improvement. Design A survey of radiation oncology programmes at provincial cancer centres. Setting All cancer centres within the province of Ontario, Canada (n=14). These are community-based outpatient facilities overseen by Cancer Care Ontario, the provincial cancer agency. Participants A delegate from each radiation oncology programme filled out a single survey based on input from their multidisciplinary team. Outcome measures Rated importance of peer review; current utilisation; format of the peer-review process; organisation and timing; case attributes; outcomes of the peer-review process and perceived barriers and facilitators to expanding peer-review processes. Results 14 (100%) centres responded. All rated the importance of peer review as at least 8/10 (10=extremely important). Detection of medical error and improvement of planning processes were the highest rated perceived benefits of peer review (each median 9/10). Six centres (43%) reviewed at least 50% of curative cases; four of these centres (29%) conducted peer review in more than 80% of cases treated with curative intent. Fewer than 20% of cases treated with palliative intent were reviewed in most centres. Five centres (36%) reported usually conducting peer review prior to the initiation of treatment. Five centres (36%) recorded the outcomes of peer review on the medical record. Thirteen centres (93%) planned to expand peer-review activities; a critical mass of radiation oncologists was the most important limiting factor (median 6/10). Conclusions Radiation oncology peer-review practices can vary even within a cancer system with provincial oversight. The application of guidelines and standards for peer-review processes, and monitoring of implementation and outcomes, will require effective knowledge

  4. Intensity-modulated radiation therapy for T4 nasopharyngeal carcinoma. Treatment results and locoregional

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.L.Y.; Tsai, C.L.; Chen, W.Y.; Wang, C.W. [National Taiwan Univ. Hospital, Taipei (China). Div. of Radiation Oncology; Huang, Y.S.; Chen, Y.F. [National Taiwan Univ. Hospital, Taipei (China). Dept. of Medical Imaging; Kuo, S.H. [National Taiwan Univ. Hospital, Taipei (China). Div. of Radiation Oncology; National Taiwan Univ. College of Medicine, Taipei (China). Graduate Inst. of Clinical Medicine; Hong, R.L. [National Taiwan Univ. Hospital, Taipei (China). Div. of Medical Oncology; Ko, J.Y.; Lou, P.J. [National Taiwan Univ. Hospital, Taipei (China). Dept. of Otolaryngology


    Purpose: The purpose of this work was to examine outcomes in patients with T4 nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Methods and materials: Between 2007 and 2010, 154 patients with nonmetastatic T4 NPC were treated with IMRT to a total dose of 70 Gy in 33-35 fractions. In addition, 97 % of patients received concurrent platinum-based chemotherapy. The median follow-up time was 52.8 months. Results: The rates of 5-year actuarial locoregional control, distant metastasis-free survival, progression free-survival, and overall survival (OS) were 81.2, 72.2, 61.9, and 78.1 %, respectively. A total of 27 patients had locoregional recurrence: 85.2 % in-field failures, 11.1 % marginal failures, and 3.7 % out-of-field failures. Fourteen patients with locoregional recurrence received aggressive treatments, including nasopharyngectomy, neck dissection, or re-irradiation, and the 5-year OS rate tended to be better (61.9 %) compared to those receiving conservative treatment (32.0 %, p = 0.051). In patients treated with 1 course of radiotherapy, grade {>=} 3 toxicities of ototoxicity, neck fibrosis, xerostomia, epistaxis, and radiographic temporal lobe necrosis occurred in 18.2, 9.8, 6.3, 2.1, and 5.6 % of patients, respectively. Increased ototoxicity, osteonecrosis, severe nasal bleeding, and temporal necrosis were observed in patients treated by re-irradiation. Conclusion: IMRT offers good locoregional control in patients with T4 NPC. For patients with locoregional recurrence after definitive radiotherapy, aggressive local treatment may be considered for a better outcome. (orig.)

  5. Trust, but verify - Accuracy of clinical commercial radiation Treatment Planning Systems (United States)

    Lehmann, J.; Kenny, J.; Lye, J.; Dunn, L.; Williams, I.


    Computer based Treatment Planning Systems (TPS) are used worldwide to design and calculate treatment plans for treating radiation therapy patients. TPS are generally well designed and thoroughly tested by their developers and local physicists prior to clinical use. However, the wide-reaching impact of their accuracy warrants ongoing vigilance. This work reviews the findings of the Australian national audit system and provides recommendations for checks of TPS. The Australian Clinical Dosimetry Service (ACDS) has designed and implemented a national system of audits, currently in a three year test phase. The Level III audits verify the accuracy of a beam model of a facility's TPS through a comparison of measurements with calculation at selected points in an anthropomorphic phantom. The plans are prescribed by the ACDS and all measurement equipment is brought in for independent onsite measurements. In this first version of audits, plans are comparatively simple, involving asymmetric fields, wedges and inhomogeneities. The ACDS has performed 14 Level III audits to-date. Six audits returned at least one measurement at Action Level, indicating that the measured dose differed more than 3.3% (but less than 5%) from the planned dose. Two audits failed (difference >5%). One fail was caused by a data transmission error coupled with quality assurance (QA) not being performed. The second fail was investigated and reduced to Action Level with the onsite audit team finding phantom setup at treatment a contributing factor. The Action Level results are attributed to small dose calculation deviations within the TPS, which are investigated and corrected by the facilities. Small deviations exist in clinical TPS which can add up and can combine with output variations to result in unacceptable variations. Ongoing checks and independent audits are recommended.

  6. Selective internal radiation therapy with SIR-spheres for the treatment of unresectable colorectal hepatic metastases. (United States)

    Cianni, Roberto; Urigo, Carlo; Notarianni, Ermanno; Saltarelli, Adelchi; Salvatori, Rita; Pasqualini, Valerio; Dornbusch, Tracie; Cortesi, Enrico


    The purpose of this study was to evaluate the effectiveness of colorectal cancer (CRC) liver metastasis radioembolization with yttrium-90 (Y90), assessing toxicity and survival rates in patients with no response to chemotherapy through our 3-year experience. From February 2005 to January 2008, we treated 41 patients affected by CRC from a cohort of selective internal radiation therapy patients treated at our institution. All patients examined showed disease progression and arrived for our observation with an abdominal CT, a body PET, and a hepatic angiography followed by gastroduodenal artery coiling previously performed by us. We excluded patients with a bilirubin level>1.8 mg/dl and pulmonary shunt>20% but not patients with minor extrahepatic metastases. On treatment day, under fluoroscopic guidance, we implanted a dose of Y90 microspheres calculated on the basis of liver tumoral involvement and the body surface area formula. All patients were discharged the day after treatment. We obtained, according to Response Evaluation Criteria on Solid Tumors, a complete response in 2 patients, a partial response in 17 patients, stable disease in 14 patients, and progressive disease in 8 patients. In all cases, we obtained a carcinoembryonic antigen level decrease, especially in the week 8 evaluation. Technical success rate was 98% and technical effectiveness estimated at 3 months after treatment was 80.5%. Side effects graded by Common Terminology Criteria on Adverse Events were represented by one grade 4 hepatic failure, two grade 2 gastritis, and one grade 2 cholecystitis. The median survival and the progression-free survival calculated by Kaplan-Meier analysis were 354 and 279 days, respectively. In conclusion, according to our 3-year experience, Y90 SIR-Spheres radioembolization is a feasible and safe method to treat CRC liver metastases, with an acceptable level of complications and a good response rate.

  7. A dosimetry evaluation of 90y-stent implantation in intracoronary radiation treatment

    Directory of Open Access Journals (Sweden)

    Karimian Alireza


    Full Text Available Ionizing particles have been used for the treatment of atherosclerosis. Internal irradiation is commonly carried out by means of several methods (catheter-based systems, radioactive stents or balloons to reduce the probability of restenosis. 90Y, due to some of its characteristics, is an appropriate radioisotope for intravascular brachytherapy. However, since there are some critical tissues in the vicinity of the heart like the breast and lymph nodes, it is necessary to perform a dosimetry calculation around the artery under radiotherapy to justify the treatment method. In this study, a 3-D dose distribution was obtained for the coronary vessel and its surrounding tissues for a standard 90Y stent in a MCNPX program. The results were compared with other investigations on restenosis prevention using 90Y-coated stents. The calculations represented a 28-day cumulative dose between 1230 cGy and 2400 cGy at 0.1 mm from the stent surface, while this quantity was about 23.8 cGy at 8.5 mm from the stent surface. An assessment of the dose equivalent and effective dose was also performed at r = 8.5 mm for the mentioned surrounding tissues which may be located in the area, based on the latest changes in ICRP recommendations. Additionally, the dose equivalent calculated within the treatment period for these organs was compared with published dosimetry data for 90Sr/90Y seed sources in order to evaluate radiation protection concerns about these two radiotherapy methods. It has been found that, depending on stent parameters, 90Y stent implantation might increase the unfavorable side effects for the patient, but to a much lesser degree than the other methods.

  8. [Solcoseryl--dental adherent paste in the treatment of acute radiation-induced inflammation of oral mucosa, gingivae and tongue]. (United States)

    Kryst, L; Kowalik, S; Bartkowski, S; Henning, G


    On the basis of a study carried out in three teaching departments of maxillofacial surgery the effect was analysed of Solcoseryl dental adherent paste and Linomag in the treatment of acute radiation-induced stomatitis. Both drugs were effective but Solcoseryl was superior to the other drug since it accelerated healing by about 50% and formed a protecting dressing on the inflamed mucosa.

  9. ACR Appropriateness Criteria for external beam radiation therapy treatment planning for clinically localized prostate cancer, part II of II

    Directory of Open Access Journals (Sweden)

    Nicholas G. Zaorsky, MD


    Conclusions: External beam radiation is a key component of the curative management of T1 and T2 prostate cancer. By combining the most recent medical literature, these Appropriateness Criteria can aid clinicians in determining the appropriate treatment delivery and personalized approaches for individual patients.

  10. Scintimammography and single-photon emission computed tomography for postoperative image guidance for radiation treatment planning in breast cancer patients. (United States)

    Piperkova, E; Chavdarova, L; Garanina, Z; Gocheva, L; Parvanova, V; Tzonevska, A; Dimitrova, M


    To evaluate post-surgical tumor-metabolic regions outside of the computed tomography (CT)-defined volume for radiation therapy (RT) planning using functional imaging of scintimammography (SMG) ± single photon emission computerized tomography (SPECT) in breast cancer (BC) patients. 62 operated high-risk BC females, mean age 50.45 years, underwent SMG±SPECT before RT planning. Twenty-one and twelve patients with stage I and IIa respectively had lumpectomy (LT) with axillary lymph node dissection (ALND), and modified radical mastectomy (Patay) + ALND was realized in 29 stage IIb-III patients. All SMG images, positive for viable tumor tissue (VTT) or metastatically involved lymph nodes (LNs) were verified cytologically/ histologically. Three early planar and delayed images were acquired after i.v. administration of 550-740 MBq 99mTc- MIBI or 99mTc-TF. Uptake values (UV) > 1.65 revealed VTT. Data in 49 (79%) of 62 patients were characterized as true-negative (TN; UVVTT in scars, 1 newly defined BC in the contralateral breast and 18 regional LN metastases (6 axillary, 6 parasternal, 1 sub- and 5 supraclavicular). All 22 TP VTT lesions were imaged by scintigraphy using different tumor-seeking radiopharmaceuticals: 99mTc-MIBI - 17 (77%) and 99mTc- TF - 5 (23%) of the TP lesions. One false-positive (FP) (inflammation: UV>1.65) and one false-negative (FN) (UVVTT, LN metastases or altered biological activity in the scars after BC surgery and could modify the irradiated volume, optimizing the therapeutic effect and minimizing RT side effects.

  11. The Efficacy of Radiation Therapy in the Treatment of Graves' Orbitopathy

    Energy Technology Data Exchange (ETDEWEB)

    Matthiesen, Chance, E-mail: [Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States); Thompson, J. Spencer [Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States); Thompson, David [Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States); Farris, Bradley; Wilkes, Byron [Dean A. McGee Eye Institute, Oklahoma City, OK (United States); Ahmad, Salahuddin; Herman, Terence; Bogardus, Carl [Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)


    Purpose: To review our institutional outcomes of patients treated with radiation therapy (RT) for Graves' orbitopathy (GO), assess the role of orbital reirradiation, and identify prognostic factors of complete response (CR). Methods and Materials: This is a retrospective review of 211 patients who presented with a diagnosis of GO and received RT between January 2000-2010. RT dose was 20 Gy in 10 fractions. Patient median age was 51 years (range, 15-84 years), median follow-up was 11 months (range, 1-88 months). Patient symptoms included any combination of proptosis (90.9%), extraocular muscle dysfunction (78.9%), soft tissue signs (68.4%), and diplopia (58.4%). Corticosteroids were used as first-line therapy in 20.6% of patients. Among those who achieved either CR or partial response (PR), prognostic factors were evaluated. Results: Stabilization of disease without recurrence was clinically achieved overall in 202 patients (96.7%). At the completion of RT, 176 patients (84.2%) reported a symptomatic improvement of pretreatment symptoms. CR of GO symptoms was achieved using multiple treatment modalities, including RT by 93 patients (44.5%), of which 32 patients received RT only. Corticosteroids were discontinued in 97.8% of patients who received them as initial therapy. Surgical intervention following radiotherapy was required for 144 (68.9%) of all patients. Fourteen patients received orbital reirradiation for persistent or recurrent symptoms. Five of these achieved a CR, and the other nine achieved disease stabilization but retained persistent ocular symptoms. Long-term side effects of RT included dry eyes (12%). Of the prognostic factors we investigated, only gender predicted CR, which was less common in men (33.9%) than in women (49.7%) p = 0.0471. Conclusions: Orbital radiation for GO is an established treatment modality for patients. Orbital reirradiation is beneficial for patients who do not respond to initial RT or experience symptom recurrence without

  12. Neuroplasticity-based computerized cognitive remediation for geriatric depression. (United States)

    Morimoto, Sarah Shizuko; Wexler, Bruce E; Alexopoulos, George S


    This article describes a novel treatment model designed to target specific neurocognitive deficits in geriatric depression with neuroplasticity-based computerized cognitive remediation (NBCCR). The recent National Institute of Mental Health (NIMH) report "From Discovery to Cure" calls for studies focusing on mechanisms of treatment response with the goal of arriving at new interventions for those who do not respond to existing treatments. We describe the process that led to the identification of specific executive deficits and their underlying neurobiology, as well as the rationale for targeting these symptoms as a part of a strategy intended to improve both executive dysfunction and depression. We then propose a strategy for further research in this emerging area. Despite significant developments, conventional antidepressant treatments leave many older adults still depressed and suffering. Psychotherapy may be effective in some depressed elders, although a recent review concluded that none of the available treatment studies meets stringent criteria for efficacy in the acute treatment of geriatric depression. Appropriately developed and targeted NBCCR, has the potential to serve as a novel treatment intervention for geriatric depression. Pathophysiological changes associated with executive dysfunction may be an appropriate target for NBCCR. Examining both behavioral changes and indices of structural integrity and functional change of networks related to cognitive and emotional regulation may lead to a novel treatment and elucidate the role of specific cerebral networks in geriatric depression. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Computerized Interactive Gaming via Supporting Vector Machines


    Jiang, Yang; Jiang, Jianmin; Palmer, Ian


    Computerized interactive gaming requires automatic processing of large volume of random data produced by players on spot, such as shooting, football kicking, and boxing. This paper describes a supporting vector machine-based artificial intelligence algorithm as one of the possible solutions to the problem of random data processing and the provision of interactive indication for further actions. In comparison with existing techniques, such as rule-based and neural networks, and so forth, our S...

  14. Computerized tomography in evaluation of hepatic neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Luna, R.F.; Resende, C.; Tishler, J.M.A.; Aldrete, J.S.; Shin, M.S.; Rubin, E.; Rahn, N.H.


    The authors reviewed their experience with computerized tomography (CT) of the abdomen in 212 patients with histologically documented liver neoplasms seen during a 30-month period. The CT findings in cavernous hemangioma and focal nodular hyperplasia were specific, and permitted accurate diagnosis of this lesion before biopsy. The CT appearance of all other lesions was variable. CT is useful in providing an accurate evaluation of the intrahepatic and extrahepatic extent of the neoplasm.

  15. Computerized flow monitors detect small kicks

    Energy Technology Data Exchange (ETDEWEB)

    McCann, D.; White, D. (Sedco Forex, Paris (FR))


    This paper reports on a smart alarm system installed on a number of offshore rigs and one land rig which can detect kicks more quickly than conventional systems. This rapid kick detection improves rig safety because the smaller the detected influx, the easier it is to control the well. The extensive computerized monitoring system helps drilling personnel detect fluid influxes and fluid losses before the changes in flow would normally be apparent.

  16. The Future of Computerized Decision Making (United States)


    available in digital form -- data such as newspaper articles, video, and books -- and can be searched according to topics and keywords , or sounds and...away from using observational or model- driven data to inform their decisions. At the same time, enhancements to methods for rapidly creating, merging...themselves---and that we need automated ways of reoptimizing as these metamodels evolve over time. Causal computerized decision making: As I discuss

  17. Errors associated with outpatient computerized prescribing systems (United States)

    Rothschild, Jeffrey M; Salzberg, Claudia; Keohane, Carol A; Zigmont, Katherine; Devita, Jim; Gandhi, Tejal K; Dalal, Anuj K; Bates, David W; Poon, Eric G


    Objective To report the frequency, types, and causes of errors associated with outpatient computer-generated prescriptions, and to develop a framework to classify these errors to determine which strategies have greatest potential for preventing them. Materials and methods This is a retrospective cohort study of 3850 computer-generated prescriptions received by a commercial outpatient pharmacy chain across three states over 4 weeks in 2008. A clinician panel reviewed the prescriptions using a previously described method to identify and classify medication errors. Primary outcomes were the incidence of medication errors; potential adverse drug events, defined as errors with potential for harm; and rate of prescribing errors by error type and by prescribing system. Results Of 3850 prescriptions, 452 (11.7%) contained 466 total errors, of which 163 (35.0%) were considered potential adverse drug events. Error rates varied by computerized prescribing system, from 5.1% to 37.5%. The most common error was omitted information (60.7% of all errors). Discussion About one in 10 computer-generated prescriptions included at least one error, of which a third had potential for harm. This is consistent with the literature on manual handwritten prescription error rates. The number, type, and severity of errors varied by computerized prescribing system, suggesting that some systems may be better at preventing errors than others. Conclusions Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors. The authors offer targeted recommendations on improving computerized prescribing systems to prevent errors. PMID:21715428

  18. Changing to computerized documentation--plus! (United States)

    Town, J


    A recent change to a computerized documentation system has had a positive influence on productivity, reliability of documentation, quality assurance, nurse satisfaction and professional practice. This software system combines the care plan and nurses' notes and is standard-based. Each patient's care plan is compiled from Units of Care, which provide a menu covering nursing diagnosis, medical diagnosis, chief complaints and special procedures and events.

  19. Therapeutic effect of topical application of curcumin during treatment of radiation burns in a mini-pig model. (United States)

    Kim, Joongsun; Park, Sunhoo; Jeon, Byung-Suk; Jang, Won-Seok; Lee, Sun-Joo; Son, Yeonghoon; Rhim, Kyung-Jin; Lee, Soong In; Lee, Seung-Sook


    Curcumin protects the skin against radiation-induced epidermal damage and prevents morphological changes induced by irradiation skin, thereby maintaining the epidermal thickness and cell density of basal layers. In this study, the effects of topical curcumin treatment on radiation burns were evaluated in a mini-pig model. Histological and clinical changes were observed five weeks after radiation exposure to the back (⁶⁰Co gamma-radiation, 50 Gy). Curcumin was applied topically to irradiated skin (200 mg/cm²) twice a day for 35 days. Curcumin application decreased the epithelial desquamation after irradiation. Additionally, when compared to the vehicle-treated group, the curcumin-treated group showed reduced expression of cyclooxygenase-2 and nuclear factor-kappaB. Furthermore, irradiation prolonged healing of biopsy wounds in the exposed area, whereas curcumin treatment stimulated wound healing. These results suggest that curcumin can improve epithelial cell survival and recovery in the skin and therefore be used to treat radiation burns.

  20. LUNGx Challenge for computerized lung nodule classification. (United States)

    Armato, Samuel G; Drukker, Karen; Li, Feng; Hadjiiski, Lubomir; Tourassi, Georgia D; Engelmann, Roger M; Giger, Maryellen L; Redmond, George; Farahani, Keyvan; Kirby, Justin S; Clarke, Laurence P


    The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants' computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. Ten groups applied their own methods to 73 lung nodules (37 benign and 36 malignant) that were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists' AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. The continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community.

  1. Hyperthermia with radiation in the treatment of locally advanced head and neck cancer: A report of randomized trial

    Directory of Open Access Journals (Sweden)

    Huilgol Nagraj


    Full Text Available Background: Head and neck cancer is the leading cause of male mortality due to cancer in India. Surgery, radiation alone or in combination has been the backbone of treatment strategies. Chemo-radiation has emerged as the standard of care in most types of head and neck cancer. This strategy has the advantage of maintaining both structure and functions, albeit with increased acute and delayed side effects. Radiation with hyperthermia can achieve the same objective without additional toxicities. Materials and Methods: A total of 56 patients were randomized to radiation therapy (RT alone or RT-hyperthermia (RT-HT arm. Twenty-six patients were included in RT alone arm and 28 patients in the RT-HT arm. Both groups were evenly matched for age, sex, and stage. Patients in both the arms received radiation to a dose of 66-70 Gy in 6.5-7 weeks. Patients in the study group received weekly HT. HT was started after impedance matching to last for 30 minutes. Results: Complete response was seen in 42.4% of RT alone group compare to 78.6% in the HT group. The difference was statistically significant ( < 0.05. Kaplan-Meir analysis of survival also showed a significant improvement in favor of RT-HT. No dose limiting thermal burns and excessive mucosal or thermal toxicity were recorded. Conclusion: Radiofrequency (RF based heating and radical radiation of head and neck cancers is better than in RT alone group. HT should be considered as a valid option wherever the facility for HT is available. This report should infuse greater confidence in radiation Oncologists to practice HT as an adjuvant treatment modality.

  2. Development of an autonomous treatment planning strategy for radiation therapy with effective use of population-based prior data. (United States)

    Wang, Huan; Dong, Peng; Liu, Hongcheng; Xing, Lei


    Current treatment planning remains a costly and labor intensive procedure and requires multiple trial-and-error adjustments of system parameters such as the weighting factors and prescriptions. The purpose of this work is to develop an autonomous treatment planning strategy with effective use of prior knowledge and in a clinically realistic treatment planning platform to facilitate radiation therapy workflow. Our technique consists of three major components: (i) a clinical treatment planning system (TPS); (ii) a formulation of decision-function constructed using an assemble of prior treatment plans; (iii) a plan evaluator or decision-function and an outer-loop optimization independent of the clinical TPS to assess the TPS-generated plan and to drive the search toward a solution optimizing the decision-function. Microsoft (MS) Visual Studio Coded UI is applied to record some common planner-TPS interactions as subroutines for querying and interacting with the TPS. These subroutines are called back in the outer-loop optimization program to navigate the plan selection process through the solution space iteratively. The utility of the approach is demonstrated by using clinical prostate and head-and-neck cases. An autonomous treatment planning technique with effective use of an assemble of prior treatment plans is developed to automatically maneuver the clinical treatment planning process in the platform of a commercial TPS. The process mimics the decision-making process of a human planner and provides a clinically sensible treatment plan automatically, thus reducing/eliminating the tedious manual trial-and-errors of treatment planning. It is found that the prostate and head-and-neck treatment plans generated using the approach compare favorably with that used for the patients' actual treatments. Clinical inverse treatment planning process can be automated effectively with the guidance of an assemble of prior treatment plans. The approach has the potential to

  3. Prospective Randomized Comparison of the Effectiveness of Radiation Therapy and Local Steroid Injection for the Treatment of Plantar Fasciitis

    Energy Technology Data Exchange (ETDEWEB)

    Canyilmaz, Emine, E-mail: [Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon (Turkey); Canyilmaz, Fatih [Department of Orthopaedics and Traumatology, Yavuz Selim Bone Disease and Rehabilitation Hospital, Trabzon (Turkey); Aynaci, Ozlem; Colak, Fatma; Serdar, Lasif [Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon (Turkey); Uslu, Gonca Hanedan [Department of Radiation Oncology, Kanuni Research and Education Hospital, Trabzon (Turkey); Aynaci, Osman [Department of Orthopaedics and Traumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon (Turkey); Yoney, Adnan [Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon (Turkey)


    Purpose: The purpose of this study was to conduct a randomized trial of radiation therapy for plantar fasciitis and to compare radiation therapy with local steroid injections. Methods and Materials: Between March 2013 and April 2014, 128 patients with plantar fasciitis were randomized to receive radiation therapy (total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy three times a week) or local corticosteroid injections a 1 ml injection of 40 mg methylprednisolone and 0.5 ml 1% lidocaine under the guidance of palpation. The results were measured using a visual analog scale, a modified von Pannewitz scale, and a 5-level function score. The fundamental phase of the study was 3 months, with a follow-up period of up to 6 months. Results: The median follow-up period for all patients was 12.5 months (range, 6.5-18.6 months). For the radiation therapy patients, the median follow-up period was 13 months (range, 6.5-18.5 months), whereas in the palpation-guided (PG) steroid injection arm, it was 12.1 months (range, 6.5-18.6 months). After 3 months, results in the radiation therapy arm were significantly superior to those in the PG steroid injection arm (visual analog scale, P<.001; modified von Pannewitz scale, P<.001; 5-level function score, P<.001). Requirements for a second treatment did not significantly differ between the 2 groups, but the time interval for the second treatment was significantly shorter in the PG steroid injection group (P=.045). Conclusion: This study confirms the superior analgesic effect of radiation therapy compared to mean PG steroid injection on plantar fasciitis for at least 6 months after treatment.

  4. Numerical Treatment of Anisotropic Radiation Field Coupling with the Relativistic Resistive Magnetofluids

    CERN Document Server

    Takahashi, Hiroyuki R


    We develop a numerical scheme for solving a fully special relativistic resistive radiation magnetohydrodynamics. Our code guarantees conservations of total mass, momentum and energy. Radiation energy density and radiation flux are consistently updated using the M-1 closure method, which can resolve an anisotropic radiation fields in contrast to the Eddington approximation as well as the flux-limited diffusion approximation. For the resistive part, we adopt a simple form of the Ohm's law. The advection terms are explicitly solved with an approximate Riemann solver, mainly HLL scheme, and HLLC and HLLD schemes for some tests. The source terms, which describe the gas-radiation interaction and the magnetic energy dissipation, are implicitly integrated, relaxing the Courant-Friedrichs-Lewy condition even in optically thick regime or a large magnetic Reynolds number regime. Although we need to invert $4\\times 4$ (for gas-radiation interaction) and $3\\times 3$ (for magnetic energy dissipation) matrices at each grid ...

  5. Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Sang Min Yoon

    Full Text Available BACKGROUND: Even with early stage hepatocellular carcinoma (HCC, patients are often ineligible for surgical resection, transplantation, or local ablation due to advanced cirrhosis, donor shortage, or difficult location. Stereotactic body radiation therapy (SBRT has been established as a standard treatment option for patients with stage I lung cancer, who are not eligible for surgery, and may be a promising alternative treatment for patients with small HCC who are not eligible for curative treatment. MATERIALS AND METHODS: A registry database of 93 patients who were treated with SBRT for HCC between 2007 and 2009 was analyzed. A dose of 10-20 Gy per fraction was given over 3-4 consecutive days, resulting in a total dose of 30-60 Gy. The tumor response was determined using dynamic computed tomography or magnetic resonance imaging, which was performed 3 months after completion of SBRT. RESULTS: The median follow-up period was 25.6 months. Median size of tumors was 2 cm (range: 1-6 cm. Overall patients' survival rates at 1 and 3 years were 86.0% and 53.8%, respectively. Complete and partial tumor response were achieved in 15.5% and 45.7% of patients, respectively. Local recurrence-free survival rate was 92.1% at 3 years. Most local failures were found in patients with HCCs > 3 cm, and local control rate at 3 years was 76.3% in patients with HCC > 3 cm, 93.3% in patients with tumors between 2.1-3 cm, and 100% in patients with tumors ≤ 2 cm, respectively. Out-of-field intrahepatic recurrence-free survival rates at 1 and 3 years were 51.9% and 32.4%, respectively. Grade ≥ 3 hepatic toxicity was observed in 6 (6.5%. CONCLUSIONS: SBRT was effective in local control of small HCC. SBRT may be a promising alternative treatment for patients with small HCC which is unsuitable for other curative therapy.

  6. An investigation of PRESAGE® 3D dosimetry for IMRT and VMAT radiation therapy treatment verification (United States)

    Jackson, Jake; Juang, Titania; Adamovics, John; Oldham, Mark


    The purpose of this work was to characterize three formulations of PRESAGE® dosimeters (DEA-1, DEA-2, and DX) and to identify optimal readout timing and procedures for accurate in-house 3D dosimetry. The optimal formulation and procedure was then applied for the verification of an intensity modulated radiation therapy (IMRT) and a volumetric modulated arc therapy (VMAT) treatment technique. PRESAGE® formulations were studied for their temporal stability post-irradiation, sensitivity, and linearity of dose response. Dosimeters were read out using a high-resolution optical-CT scanner. Small volumes of PRESAGE® were irradiated to investigate possible differences in sensitivity for large and small volumes (‘volume effect’). The optimal formulation and read-out technique was applied to the verification of two patient treatments: an IMRT plan and a VMAT plan. A gradual decrease in post-irradiation optical-density was observed in all formulations with DEA-1 exhibiting the best temporal stability with less than 4% variation between 2-22 h post-irradiation. A linear dose response at the 4 h time point was observed for all formulations with an R2 value >0.99. A large volume effect was observed for DEA-1 with sensitivity of the large dosimeter being ~63% less than the sensitivity of the cuvettes. For the IMRT and VMAT treatments, the 3D gamma passing rates for 3%/3 mm criteria using absolute measured dose were 99.6 and 94.5% for the IMRT and VMAT treatments, respectively. In summary, this work shows that accurate 3D dosimetry is possible with all three PRESAGE® formulations. The optimal imaging windows post-irradiation were 3-24 h, 2-6 h, and immediately for the DEA-1, DEA-2, and DX formulations, respectively. Because of the large volume effect, small volume cuvettes are not yet a reliable method for calibration of larger dosimeters to absolute dose. Finally, PRESAGE® is observed to be a useful method of 3D verification when careful consideration is given

  7. Radiation-induced skin toxicity: prevention and treatments; Lesions cutanees induites par la radiotherapie: prevention, traitements

    Energy Technology Data Exchange (ETDEWEB)

    Lorette, G.; Machet, L. [Centre Hospitalier Universitaire Trousseau, 37 - Tours (France)


    Acute and long term effects are frequent after radiotherapy. They may alter the general status and quality of life of the patients. Chronic radiodermatitis may result in ulceration and in transformation into a squamous cell carcinoma. There is a correlation of the frequency of acute dermatitis with the total dose. Chronic radiodermatitis may develop after repeated small doses of ionizing radiation for cardiac catheterization and coronary angio-plasties. The other prognostic factors for the level of acute and late skin reactions are volume of tissue treated, total daily dose, fractionations schemes... but there are some variation in the degree of reaction in patients treated with identical radiotherapy schedules. There is a patient - to- patient variability. Several diseases as systemic sclerosis, some genetic diseases, perhaps some drugs may increase the cutaneous reactions. So both acute and chronic irradiation injury is a complex process with many regulations. Chronic fibrosis may be caused by mechanism of cell activation (and particularly fibroblasts). Cytokines e.g transforming growth factor {beta} (TGF-{beta}) might be involved in the induction of fibrosis. Treatment use emollients. Superoxide dismutase was used as an ointment for radio-fibrosis therapy and obtains a reduction of the fibrosis. In late phases plastic surgery or sometimes cryo-surgery can be used. (authors)

  8. Use of Positron Emission Tomography/Computed Tomography in Radiation Treatment Planning for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Kezban Berberoğlu


    Full Text Available Radiotherapy (RT plays an important role in the treatment of lung cancer. Accurate diagnosis and staging are crucial in the delivery of RT with curative intent. Target miss can be prevented by accurate determination of tumor contours during RT planning. Currently, tumor contours are determined manually by computed tomography (CT during RT planning. This method leads to differences in delineation of tumor volume between users. Given the change in RT tools and methods due to rapidly developing technology, it is now more significant to accurately delineate the tumor tissue. F18 fluorodeoxyglucose positron emission tomography/CT (F18 FDG PET/CT has been established as an accurate method in correctly staging and detecting tumor dissemination in lung cancer. Since it provides both anatomic and biologic information, F18 FDG PET decreases interuser variability in tumor delineation. For instance, tumor volumes may be decreased as atelectasis and malignant tissue can be more accurately differentiated, as well as better evaluation of benign and malignant lymph nodes given the difference in FDG uptake. Using F18 FDG PET/CT, the radiation dose can be escalated without serious adverse effects in lung cancer. In this study, we evaluated the contribution of F18 FDG PET/CT for RT planning in lung cancer.

  9. Enhancing the biological degradability of sulfamethoxazole by ionizing radiation treatment in aqueous solution (United States)

    Sági, Gyuri; Kovács, Krisztina; Bezsenyi, Anikó; Csay, Tamás; Takács, Erzsébet; Wojnárovits, László


    Changes of biodegradability and toxicity were followed up on aqueous solutions of sulfamethoxazole (SMX), during ionizing radiation treatment. The biodegradability of SMX (0.1 mmol dm-3) was specified by five-day biological oxygen demand (BOD5), using municipal activated sludge, and the results showed an improvement with applying only 0.4 kGy dose. BOD5 further increased with prolonged irradiation, indicating a conversion of SMX, a non-biodegradable compound, to biologically treatable substances. At 2.5 kGy dose, the BOD5/COD ratio increased from 0 to 0.16. The total organic carbon (TOC) content showed a decrease of only 15% at this point, thus high degree of mineralization is not necessary to make SMX digestible for the low concentrations of microorganisms used during BOD5 measurements. Increment in respiration inhibition of municipal activated sludge was observed with increasing the dose. The EC50 values showed a decrease of one order of magnitude when changing the dose from 0.4 kGy to 2.5 kGy. The increase of inhibition and formation of H2O2 showed a strong correlation.

  10. Geogagnetic Activity and Effectiveness of Millimeter Electromagnetic Radiation in Unstable Angina Treatment (United States)

    Parshina, S. S.; Samsonov, S. N.; Afanasiyeva, T. N.; Tokayeva, L. K.; Petrova, V. D.; Dolgova, E. M.; Manykina, V. I.; Vodolagina, E. S.

    There had been performed a research of an effectiveness of millimeter electromagnetic radiation (MM EMR) use in patients with an unstable angina (UA) at periods of a lower (daily value of Kp-index 16,19±0,18) and a higher (daily value of Kp-index 17,25±0,21, ptreatment of the patients with an UA, enhances an antianginal effect of a drug therapy independently on the period of GA. The MM EMR at the period of a lower geomagnetic activity (LGA) enhances the decrease of diastolic blood pressure (BP), and at the period of a higher geomagnetic activity (HGA) - the decrease of systolic BP. At a HGA there were noted: a quick and more serious antianginal effect, maximal antihypertensive effect was achieved quicker, but (as opposed to the period of a LGA) there was no a pulse slowing effect of a MM EMR. Including the MM EMR into the treatment accelerates stabilization of the patients' condition only at a LGA. Positive effect on blood rheological properties is an independent effect of MM EMR, and it is in blood viscosity reduce in microcirculatory at both of the periods of GA. Normalization of blood viscosity under the MM EMR is only at the period of a LGA. So, the effect of MM EMR on a clinical condition of the patients is more evident at the period of a HGA, blood viscosity - at the period of a LGA.

  11. Treatment outcome of ductal carcinoma in situ patients treated with postoperative radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Yu Jin; Kim, Kyu Bo; Choi, Eui Kyu; Han, Won Shik; Noh, Dong Young; Ha, Sung W. [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or ≥1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.

  12. HemoHIM enhances the therapeutic efficacy of ionizing radiation treatment in tumor-bearing mice. (United States)

    Park, Hae-Ran; Ju, Eun-Jin; Jo, Sung-Kee; Jung, Uhee; Kim, Sung-Ho


    Although radiotherapy is commonly used for a variety of cancers, radiotherapy alone does not achieve a satisfactory therapeutic outcome. In this study, we examined the possibility that HemoHIM can enhance the anticancer effects of ionizing radiation (IR) in melanoma-bearing mice. The HemoHIM was prepared by adding the ethanol-insoluble fraction to the total water extract of a mixture of three edible herbs-Angelica Radix, Cnidium Rhizoma, and Paeonia Radix. Anticancer effects of HemoHIM were evaluated in melanoma-bearing mice exposed to IR. IR treatment (5 Gy at 7 days after melanoma cell injection) reduced the weight of the solid tumors, and HemoHIM supplementation with IR enhanced the decreases in tumor weight (P HemoHIM administration also increased the activity of natural killer cells and cytotoxic T cells, although the proportions of these cells in spleen were not different. In addition, HemoHIM administration increased the interleukin-2 and tumor necrosis factor-alpha secretion from lymphocytes stimulated with concanavalin A, which seemed to contribute to the enhanced efficacy of HemoHIM in tumor-bearing mice treated with IR. In conclusion, HemoHIM may be a beneficial supplement during radiotherapy for enhancing the antitumor efficacy.

  13. Fully radiative relaxation of silicon nanocrystals in colloidal ensemble revealed by advanced treatment of decay kinetics (United States)

    Greben, Michael; Khoroshyy, Petro; Liu, Xiangkai; Pi, Xiaodong; Valenta, Jan


    A comprehensive study of the spectrally resolved photoluminescence (PL) decay kinetics of dodecyl-passivated colloidal silicon nanocrystals (Si NCs) is presented. The correct treatment of average decay lifetime is demonstrated. We report on importance to distinguish the external quantum efficiency (QE) from the internal QE. The external QE of the ensemble of Si NCs is measured to be ˜60%, while the internal QE of Si NCs emitting around ˜1.5 eV is evaluated to be near unity. This difference between internal and external QE is attributed to a fraction of "dark" (absorbing but non-emitting) Si NCs in the ensemble. This conclusion is based on the analysis of deconvoluted size-selected decay curves retrieved by the presented mathematical procedure. The homogeneous line-broadening is estimated to be around 180 meV by experimentally challenging single-NC PL measurements. In addition, radiative lifetimes are calculated by the envelope function approximation and confirm the observed exponential increase of lifetime with decreasing emission photon energy.

  14. Biomechanical-based image registration for head and neck radiation treatment

    Energy Technology Data Exchange (ETDEWEB)

    Al-Mayah, Adil; Moseley, Joanne; Hunter, Shannon; Velec, Mike; Chau, Lily; Breen, Stephen; Brock, Kristy, E-mail: [Radiation Medicine Program, Princess Margaret Hospital, 610 University Ave. Toronto, Ontario, M5G 2M9 (Canada)


    Deformable image registration of four head and neck cancer patients has been conducted using a biomechanical-based model. Patient-specific 3D finite element models have been developed using CT and cone-beam CT image data of the planning and a radiation treatment session. The model consists of seven vertebrae (C1 to C7), mandible, larynx, left and right parotid glands, tumor and body. Different combinations of boundary conditions are applied in the model in order to find the configuration with a minimum registration error. Each vertebra in the planning session is individually aligned with its correspondence in the treatment session. Rigid alignment is used for each individual vertebra and the mandible since no deformation is expected in the bones. In addition, the effect of morphological differences in the external body between the two image sessions is investigated. The accuracy of the registration is evaluated using the tumor and both parotid glands by comparing the calculated Dice similarity index of these structures following deformation in relation to their true surface defined in the image of the second session. The registration is improved when the vertebrae and mandible are aligned in the two sessions with the highest average Dice index of 0.86 {+-} 0.08, 0.84 {+-} 0.11 and 0.89 {+-} 0.04 for the tumor, left and right parotid glands, respectively. The accuracy of the center of mass location of tumor and parotid glands is also improved by deformable image registration where the errors in the tumor and parotid glands decrease from 4.0 {+-} 1.1, 3.4 {+-} 1.5 and 3.8 {+-} 0.9 mm using rigid registration to 2.3 {+-} 1.0, 2.5 {+-} 0.8 and 2.0 {+-} 0.9 mm in the deformable image registration when alignment of vertebrae and mandible is conducted in addition to the surface projection of the body.

  15. Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy. (United States)

    Planas, J; Celma, A; Placer, J; Maldonado, X; Trilla, E; Salvador, C; Lorente, D; Regis, L; Cuadras, M; Carles, J; Morote, J


    To determine the influence of radical prostatectomy (RP) and external beam radiation therapy (EBRT) on the hypothalamic pituitary axis of 120 men with clinically localized prostate cancer treated with RP or EBRT exclusively. 120 patients with localized prostate cancer were enrolled. Ninety two patients underwent RP and 28 patients EBRT exclusively. We measured serum levels of luteinizing hormone, follicle stimulating hormone (FSH), total testosterone (T), free testosterone, and estradiol at baseline and at 3 and 12 months after treatment completion. Patients undergoing RP were younger and presented a higher prostate volume (64.3 vs. 71.1 years, p<0.0001 and 55.1 vs. 36.5 g, p<0.0001; respectively). No differences regarding serum hormonal levels were found at baseline. Luteinizing hormone and FSH levels were significantly higher in those patients treated with EBRT at three months (luteinizing hormone 8,54 vs. 4,76 U/l, FSH 22,96 vs. 8,18 U/l, p<0,0001) while T and free testosterone levels were significantly lower (T 360,3 vs. 414,83ng/dl, p 0,039; free testosterone 5,94 vs. 7,5pg/ml, p 0,018). At 12 months FSH levels remained significantly higher in patients treated with EBRT compared to patients treated with RP (21,01 vs. 8,51 U/l, p<0,001) while T levels remained significantly lower (339,89 vs. 402,39ng/dl, p 0,03). Prostate cancer treatment influences the hypothalamic pituitary axis. This influence seems to be more important when patients with prostate cancer are treated with EBRT rather than RP. More studies are needed to elucidate the role that prostate may play as an endocrine organ. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Low-intensity laser radiation in complex treatment of inflammatory diseases of parodontium (United States)

    Sokolova, Irina A.; Erina, Stanislava V.


    The problem of complex treatment of inflammatory disease of parodontium has become very acute and actual at the moment. The diseases of inflammatory nature are considered to be the most vital issues of the day. The state of the local immune system of oral cavity plays the most important role in the complicated mechanism of inflammatory process development in the tissues of parodontium. Recently physical factors have become predominant in the system of complex therapy of parodontitis. The application of low-intense laser radiation (LLR) is considered to be the most important and up-to-date method in the preventive dentistry. There were 60 patients of average damage rate suffering from chronic generalizing parodontitis at the age of 25 up to 55 under observation. The major goal of examination was to get the objective results of the following methods' application: parodontium index (Russel, 1956), hygiene index (Fyodorov, Volodkina, 1971), Bacterioscopy of dental-gingival pockets content, simple and broadened stomatoscopy (Kunin, 1970), SIgA level determination in mixed saliva (Manchini et all, 1965) and R-protein level in gingival blood (Kulberg, 1990). All the patients were split into 2 groups. The first group (30 patients) has undergone the laser therapy course while the second group of 30 patients couldn't get it (LLR). Despite the kind of therapy they have undergone, all the patients have got the local anti-inflammatory medicamental therapy. The results of clinical observations have proved the fact that laser therapy application makes it possible to shorten the course of treatment in 1.5 times. The shifts of oral cavity local resistance take place in case of chronic generalizing parodontitis. The direct immunostimulating effect could be observed as a result of LLR- therapy application. The close connection of both anti-inflammatory medicamental and LLR-therapy has proved the possibility of purposeful local immune status correction in case of parodontitis.

  17. Simulated versus realistic intra operative radiation therapy (I.O.R.T.) treatment in operating room: from knowledge of stray radiation to action

    Energy Technology Data Exchange (ETDEWEB)

    Andreoli, S.; Moretti, R. [USC Fisica Sanitaria - Ospedali Riuniti di Bergamo (Italy); Catalano, M.; Locatelli, F. [Degli Studi di Milano Univ., Scuola di Specializzazione in Fisica Sanitaria (Italy)


    Intra-Operative Radiation Therapy (I.O.R.T.) is carried out with electron beams produced by a Linac (Linear Accelerator) generally used for conventional radiotherapy with external beam, or by dedicated accelerators that can be employed directly into an operating room. I.O.R.T. refers to the application of radiation during a surgical intervention, after the removal of a neoplastic mass. I.O.R.T. uses on the tumour area a direct irradiation, for the possible localisation of sub-clinic illness or macroscopic residue in the case of non-radical resection. Intra-Operative Radiotherapy foresees a single session only, generally preceded or followed by radiotherapy with external beam. It allows the achievement of a selective radiation boost on the tumour volume. In some cases, it can also be used as a one-time/stand alone treatment in initial cancer of small volume, or in unresectable malignancies for palliative purpose. The technical advantages of I.O.R.T. consist in the direct visual control of the target volume, and in the possibility to protect the healthy tissues by moving them away from the path of the radiation beam. The use of electron beams allows the administration of a homogeneous dose to a selected layer of tissues surrounding the tumour. The following professional staff forms the Operative Group: radiation oncologist, surgeon, anaesthetist, medical physicist, radiation technologist, nurse.The choice of a simulation geometry very similar to the clinical situation allows to evaluate radioprotection data very close to the real situation. For a fixed layout, an anthropomorphic phantom was positioned on the operating bed and a breast I.O.R.T. treatment was simulated positioning all the accessories of the operating room in their typical positions. A detailed dose mapping was performed with a Victoreen 450P ionisation chamber and with environment film-dosimeter on the walls of the operating room during the simulation of the clinical treatment. The simulation appears

  18. Shaping and resizing of multifed slot radiators used in conformal microwave antenna arrays for hyperthermia treatment of large superficial diseases. (United States)

    Maccarini, Paolo F; Arunachalam, Kavitha; Juang, Titania; De Luca, Valeria; Rangarao, Sneha; Neumann, Daniel; Martins, Carlos Daniel; Craciunescu, Oana; Stauffer, Paul R


    It has been recently shown that chestwall recurrence of breast cancer and many other superficial diseases can be successfully treated with the combination of radiation, chemotherapy and hyperthermia. Conformal microwave antenna array for hyperthermia treatment of large area superficial diseases can significantly increase patient comfort while at the same time facilitate treatment of larger and more irregularly shaped disease. A large number of small efficient antennas is preferable for improved control of heating, as the disease can be more accurately contoured and the lower power requirement correlates with system reliability, linearity and reduced cost. Thus, starting from the initially proposed square slot antennas, we investigated new designs for multi-fed slot antennas of several shapes that maximize slot perimeter while reducing radiating area, thus increasing antenna efficiency. Simulations were performed with commercial electromagnetic simulation software packages (Ansoft HFSS) to demonstrate that the antenna size reduction method is effective for several dual concentric conductor (DCC) aperture shapes and operating frequencies. The theoretical simulations allowed the development of a set of design rules for multi-fed DCC slot antennas that facilitate conformal heat treatments of irregular size and shape disease with large multi-element arrays. Independently on the shape, it is shown that the perimeter of 10cm at 915 MHz delivers optimal radiation pattern and efficiency. While the maximum radiation is obtained for a circular pattern the rectangular shape is the one that feels more efficiently the array space.

  19. [The application of helium-neon laser radiation for the combined treatment of the patients with atrophic rhinitis]. (United States)

    Sharipov, R A; Sharipova, E R


    The objective of the present study was to improve the efficacy of the treatment of the patients presenting with atrophic rhinitis (ozena) of the upper respiratory tract by the application of helium-neon laser radiation. A total of 120 patients aged from 15 to 53 years were treated based at the Department of Otorhinolaryngology, G.G. Kuvatov Republican Clinical Hospital, Ufa. All these patients underwent routine clinical, roentgenological, microbiological, and rheographic examination. The method for the treatment of atrophic rhinitis is described; it includes the application of helium-neon laser radiation in combination with the administration of the purified preparation of liquid polyvalent Klebsiella bacteriophage. The positive results of the treatment by the proposed method were documented in 90% of the patients.

  20. Computerized simulation of converter process

    Energy Technology Data Exchange (ETDEWEB)

    Jalkanen, H.; Suomi, M.L.; Wallgren, M. [Helsinki Univ. of Technology, Otaniemi (Finland). Lab. of Metallurgy


    Converter process is essentially an oxidising refining process aiming in addition to (1) the primary refining action, decarburisation of high carbon iron melt, also to (2) maximal elimination of impurity elements, especially silicon, phosphorus and sulphur, (3) melting of substantial amounts of scrap using the extra heat released in oxidation reactions and (4) to exact final steel temperature control, optimal for further treatments. `Quantitative modelling of such a complex non-stationary chemical process as oxygen converting necessitates extensive formulation of chemical and thermal evolution of the process in connection with the technological properties of the reactor and the process control measures. A comprehensive converter simulation program like CONSIM-3. 1 and its preceding versions that is based on the theoretical and practical knowledge on the process can be used for (1) educating specialists and smelter personnel, (2) planning of the blowing programs, (3) developing and testing of process control systems and after some elaboration and restructuring (4) it can be integrated to static or dynamic process control systems. (orig.) SULA 2 Research Programme; 10 refs.

  1. Variability for components of yield induced in soybeans by seed treatment with gamma radiation, fission neutrons, and ethylmethane sulfonate

    Energy Technology Data Exchange (ETDEWEB)

    Conger, B.V.; Skinner, L.W.; Skold, L.N.


    The variability for individual components of yield in soybean (Glycine max (L.) Merr.) induced by seed treatment with fission neutrons, gamma radiation, and ethylmethane sulfonate was studied. Nine M/sub 3/ populations, including three doses of each mutagen, were compared with a control for pods/plant, wt/100 seeds, and total seed wt/plant. The means for individual yield components were not significantly altered by the mutagenic treatments. A comparison of frequency distributions of populations from mutagen-treated seed vs. the control revealed differences for certain treatments. The most effective mutagen for increasing variability of the yield components was ethylmethane sulfonate.

  2. Chemotherapy-Induced and/or Radiation Therapy-Induced Oral Mucositis-Complicating the Treatment of Cancer

    Directory of Open Access Journals (Sweden)

    Maddireddy Umameshwar Rao Naidu


    Full Text Available The term mucositis is coined to describe the adverse effects of radiation and chemotherapy treatments. Mucositis is one of the most common adverse reactions encountered in radiation therapy for head and neck cancers, as well as in chemotherapy, in particular with drugs affecting DNA synthesis (Sphase-specific agents such as fluorouracil, methotrexate, and cytarabine. Mucositis may limit the patient's ability to tolerate chemotherapy or radiation therapy, and nutritional status is compromised. It may drastically affect cancer treatment as well as the patient's quality of life. The incidence and severity of mucositis will vary from patient to patient. It will also vary from treatment to treatment. It is estimated that there is 40% incidence of mucositis in patients treated with standard chemotherapy and this will not only increase with the number of treatment cycles but also with previous episodes. Similarly, patients who undergo bone marrow transplantation and who receive high doses of chemotherapy have a 76% chance of getting mucositis. Patients receiving radiation, in particular to head and neck cancers, have a 30% to 60% chance. The exact pathophysiology of development is not known, but it is thought to be divided into direct and indirect mucositis. Chemotherapy and/or radiation therapy will interfere with the normal turnover of epithelial, cells leading to mucosal injury; subsequently, it can also occur due to indirect invasion of Gram-negative bacteria and fungal species because most of the cancer drugs will cause changes in blood counts. With the advancement in cytology, a more precise mechanism has been established. With this understanding, we can select and target particular mediators responsible for the mucositis. Risk factors such as age, nutritional status, type of malignancy, and oral care during treatment will play important roles in the development of mucositis. Many treatment options are available to prevent and treat this

  3. Does IMRT increase the peripheral radiation dose? A comparison of treatment plans 2000 and 2010

    Energy Technology Data Exchange (ETDEWEB)

    Salz, Henning; Eichner, Regina; Wiezorek, Tilo [Jena Univ. (Germany). Dept. of Radiation Oncology


    It has been reported in several papers and textbooks that IMRT treatments increase the peripheral dose in comparison with non-IMRT fields. But in clinical practice not only open fields have been used in the pre-IMRT era, but also fields with physical wedges or composed fields. The aim of this work is to test the hypothesis of increased peripheral dose when IMRT is used compared to standard conformal radiotherapy. Furthermore, the importance of the measured dose differences in clinical practice is discussed and compared with other new technologies for the cases where an increase of the peripheral dose was observed. For cancers of the head and neck, the cervix, the rectum and for the brain irradiation due to acute leukaemia, one to four plans have been calculated with IMRT or conformal standard technique (non-IMRT). In an anthropomorphic phantom the dose at a distance of 30 cm in cranio-caudal direction from the target edge was measured with TLDs using a linear accelerator Oncor {sup registered} (Siemens) for both techniques. IMRT was performed using step-and-shoot technique (7 to 11 beams), non-IMRT plans with different techniques. The results depended on the site of irradiation. For head and neck cancers IMRT resulted in an increase of 0.05 - 0.09% of the prescribed total dose (Dptv) or 40 - 70 mGy (Dptv = 65 Gy), compared to non-IMRT technique without wedges or a decrease of 0.16% (approx. 100 mGy) of the prescribed total dose compared to non-IMRT techniques with wedges. For the cervical cancer IMRT resulted in an increased dose in the periphery (+ 0.07% - 0.15% of Dptv or 30 - 70 mGy at Dptv = 45 Gy), for the rectal cancer in a dose reduction (0.21 - 0.26% of Dptv or 100 - 130 mGy at Dptv = 50 Gy) and for the brain irradiation in an increase dose (+ 0.05% of Dptv = 18 Gy or 9 mSv). In summary IMRT does not uniformly cause increased radiation dose in the periphery in the model used. It can be stated that these dose values are smaller than reported in earlier

  4. A unifying probabilistic Bayesian approach to derive electron density from MRI for radiation therapy treatment planning (United States)

    Sudhan Reddy Gudur, Madhu; Hara, Wendy; Le, Quynh-Thu; Wang, Lei; Xing, Lei; Li, Ruijiang


    MRI significantly improves the accuracy and reliability of target delineation in radiation therapy for certain tumors due to its superior soft tissue contrast compared to CT. A treatment planning process with MRI as the sole imaging modality will eliminate systematic CT/MRI co-registration errors, reduce cost and radiation exposure, and simplify clinical workflow. However, MRI lacks the key electron density information necessary for accurate dose calculation and generating reference images for patient setup. The purpose of this work is to develop a unifying method to derive electron density from standard T1-weighted MRI. We propose to combine both intensity and geometry information into a unifying probabilistic Bayesian framework for electron density mapping. For each voxel, we compute two conditional probability density functions (PDFs) of electron density given its: (1) T1-weighted MRI intensity, and (2) geometry in a reference anatomy, obtained by deformable image registration between the MRI of the atlas and test patient. The two conditional PDFs containing intensity and geometry information are combined into a unifying posterior PDF, whose mean value corresponds to the optimal electron density value under the mean-square error criterion. We evaluated the algorithm’s accuracy of electron density mapping and its ability to detect bone in the head for eight patients, using an additional patient as the atlas or template. Mean absolute HU error between the estimated and true CT, as well as receiver operating characteristics for bone detection (HU > 200) were calculated. The performance was compared with a global intensity approach based on T1 and no density correction (set whole head to water). The proposed technique significantly reduced the errors in electron density estimation, with a mean absolute HU error of 126, compared with 139 for deformable registration (p = 2  ×  10-4), 283 for the intensity approach (p = 2  ×  10-6) and 282 without density

  5. A unifying probabilistic Bayesian approach to derive electron density from MRI for radiation therapy treatment planning. (United States)

    Gudur, Madhu Sudhan Reddy; Hara, Wendy; Le, Quynh-Thu; Wang, Lei; Xing, Lei; Li, Ruijiang


    MRI significantly improves the accuracy and reliability of target delineation in radiation therapy for certain tumors due to its superior soft tissue contrast compared to CT. A treatment planning process with MRI as the sole imaging modality will eliminate systematic CT/MRI co-registration errors, reduce cost and radiation exposure, and simplify clinical workflow. However, MRI lacks the key electron density information necessary for accurate dose calculation and generating reference images for patient setup. The purpose of this work is to develop a unifying method to derive electron density from standard T1-weighted MRI. We propose to combine both intensity and geometry information into a unifying probabilistic Bayesian framework for electron density mapping. For each voxel, we compute two conditional probability density functions (PDFs) of electron density given its: (1) T1-weighted MRI intensity, and (2) geometry in a reference anatomy, obtained by deformable image registration between the MRI of the atlas and test patient. The two conditional PDFs containing intensity and geometry information are combined into a unifying posterior PDF, whose mean value corresponds to the optimal electron density value under the mean-square error criterion. We evaluated the algorithm's accuracy of electron density mapping and its ability to detect bone in the head for eight patients, using an additional patient as the atlas or template. Mean absolute HU error between the estimated and true CT, as well as receiver operating characteristics for bone detection (HU > 200) were calculated. The performance was compared with a global intensity approach based on T1 and no density correction (set whole head to water). The proposed technique significantly reduced the errors in electron density estimation, with a mean absolute HU error of 126, compared with 139 for deformable registration (p = 2  ×  10(-4)), 283 for the intensity approach (p = 2  ×  10(-6)) and 282 without density

  6. Monte Carlo-based treatment planning system calculation engine for microbeam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Rovira, I.; Sempau, J.; Prezado, Y. [Institut de Tecniques Energetiques, Universitat Politecnica de Catalunya, Diagonal 647, Barcelona E-08028 (Spain) and ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 rue Jules Horowitz B.P. 220, F-38043 Grenoble Cedex (France); Institut de Tecniques Energetiques, Universitat Politecnica de Catalunya, Diagonal 647, Barcelona E-08028 (Spain); Laboratoire Imagerie et modelisation en neurobiologie et cancerologie, UMR8165, Centre National de la Recherche Scientifique (CNRS), Universites Paris 7 et Paris 11, Bat 440., 15 rue Georges Clemenceau, F-91406 Orsay Cedex (France)


    Purpose: Microbeam radiation therapy (MRT) is a synchrotron radiotherapy technique that explores the limits of the dose-volume effect. Preclinical studies have shown that MRT irradiations (arrays of 25-75-{mu}m-wide microbeams spaced by 200-400 {mu}m) are able to eradicate highly aggressive animal tumor models while healthy tissue is preserved. These promising results have provided the basis for the forthcoming clinical trials at the ID17 Biomedical Beamline of the European Synchrotron Radiation Facility (ESRF). The first step includes irradiation of pets (cats and dogs) as a milestone before treatment of human patients. Within this context, accurate dose calculations are required. The distinct features of both beam generation and irradiation geometry in MRT with respect to conventional techniques require the development of a specific MRT treatment planning system (TPS). In particular, a Monte Carlo (MC)-based calculation engine for the MRT TPS has been developed in this work. Experimental verification in heterogeneous phantoms and optimization of the computation time have also been performed. Methods: The penelope/penEasy MC code was used to compute dose distributions from a realistic beam source model. Experimental verification was carried out by means of radiochromic films placed within heterogeneous slab-phantoms. Once validation was completed, dose computations in a virtual model of a patient, reconstructed from computed tomography (CT) images, were performed. To this end, decoupling of the CT image voxel grid (a few cubic millimeter volume) to the dose bin grid, which has micrometer dimensions in the transversal direction of the microbeams, was performed. Optimization of the simulation parameters, the use of variance-reduction (VR) techniques, and other methods, such as the parallelization of the simulations, were applied in order to speed up the dose computation. Results: Good agreement between MC simulations and experimental results was achieved, even at

  7. Camera selection for real-time in vivo radiation treatment verification systems using Cherenkov imaging

    Energy Technology Data Exchange (ETDEWEB)

    Andreozzi, Jacqueline M., E-mail:; Glaser, Adam K. [Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire 03755 (United States); Zhang, Rongxiao [Department of Physics and Astronomy, Dartmouth College, Hanover, New Hampshire 03755 (United States); Jarvis, Lesley A.; Gladstone, David J. [Department of Medicine, Geisel School of Medicine and Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03766 (United States); Pogue, Brian W., E-mail: [Thayer School of Engineering and Department of Physics and Astronomy, Dartmouth College, Hanover, New Hampshire 03755 (United States)


    cost than the EM-ICCD. Conclusions: The ICCD with an intensifier better optimized for red wavelengths was found to provide the best potential for real-time display (at least 8.6 fps) of radiation dose on the skin during treatment at a resolution of 1024 × 1024.

  8. Adding chemo after radiation treatment improves survival for adults with a type of brain tumor (United States)

    Adults with low-grade gliomas, a form of brain tumor, who received chemotherapy following completion of radiation therapy lived longer than patients who received radiation therapy alone, according to long-term follow-up results from a NIH-supported random


    Directory of Open Access Journals (Sweden)

    R. I. Absalyamov


    Full Text Available This article analyzes the current trends in radiation therapy of primary and recurrent, localized and locally advanced head and neck tumors. Address the use of radiation therapy as a stand-alone options, or in combination with surgery. Describe the characteristics and evaluate the use of the most modern methods.

  10. Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment. (United States)

    Hafeez, Shaista; McDonald, Fiona; Lalondrelle, Susan; McNair, Helen; Warren-Oseni, Karole; Jones, Kelly; Harris, Victoria; Taylor, Helen; Khoo, Vincent; Thomas, Karen; Hansen, Vibeke; Dearnaley, David; Horwich, Alan; Huddart, Robert


    We report on the clinical outcomes of a phase 2 study assessing image guided hypofractionated weekly radiation therapy in bladder cancer patients unsuitable for radical treatment. Fifty-five patients with T2-T4aNx-2M0-1 bladder cancer not suitable for cystectomy or daily radiation therapy treatment were recruited. A "plan of the day" radiation therapy approach was used, treating the whole (empty) bladder to 36 Gy in 6 weekly fractions. Acute toxicity was assessed weekly during radiation therapy, at 6 and 12 weeks using the Common Terminology Criteria for Adverse Events version 3.0. Late toxicity was assessed at 6 months and 12 months using Radiation Therapy Oncology Group grading. Cystoscopy was used to assess local control at 3 months. Cumulative incidence function was used to determine local progression at 1 at 2 years. Death without local progression was treated as a competing risk. Overall survival was estimated using the Kaplan-Meier method. Median age was 86 years (range, 68-97 years). Eighty-seven percent of patients completed their prescribed course of radiation therapy. Genitourinary and gastrointestinal grade 3 acute toxicity was seen in 18% (10/55) and 4% (2/55) of patients, respectively. No grade 4 genitourinary or gastrointestinal toxicity was seen. Grade ≥3 late toxicity (any) at 6 and 12 months was seen in 6.5% (2/31) and 4.3% (1/23) of patients, respectively. Local control after radiation therapy was 92% of assessed patients (60% total population). Cumulative incidence of local progression at 1 year and 2 years for all patients was 7% (95% confidence interval [CI] 2%-17%) and 17% (95% CI 8%-29%), respectively. Overall survival at 1 year was 63% (95% CI 48%-74%). Hypofractionated radiation therapy delivered weekly with a plan of the day approach offers good local control with acceptable toxicity in a patient population not suitable for radical bladder treatment. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights

  11. Surgical treatment and radiation therapy of frontal lobe meningiomas in 7 dogs. (United States)

    Uriarte, Ane; Moissonnier, Pierre; Thibaud, Jean-Laurent; Reyes-Gomez, Edouard; Devauchelle, Patrick; Blot, Stéphane


    The cases of 7 adult dogs with generalized seizures managed by surgical excision and radiation therapy for frontal lobe meningiomas were reviewed. The neurological examination was unremarkable in 6 of the 7 dogs. Five dogs were operated on using a bilateral transfrontal sinus approach and 2 using a unilateral sinotemporal approach to the frontal lobe. One dog was euthanized 14 d after surgery; radiation therapy was initiated 3 wk after surgery in the remaining 6 dogs. Long-term follow-up consisted of neurological examination and magnetic resonance imaging (MRI) and/or computed tomography (CT) scan after radiation therapy. The mean survival time for dogs that had surgery and radiation therapy was 18 mo after surgery. Frontal lobe meningiomas have been associated with poor prognosis. However, the surgical approaches used in these cases, combined with radiation therapy, allow a survival rate for frontal lobe meningiomas similar to that for meningiomas located over the cerebral convexities.

  12. Medical Preparedness in Radiation Accidents: a Matter of Logistics and Communication not Treatment!

    Directory of Open Access Journals (Sweden)

    T Leitha


    Full Text Available The currently reactor wreckage in Fukushima raised the following important questions: Is our knowledge of the possible dangers of ionizing radiation sufficient to warrant special action? What is the role of the medical community in technical radiation accidents from Windscale to Fukushima? What is the role of the medical community in terrorist radiation attacks? Are we prepared for those challenges? How can medical services communicate information in the media framework? What have we learned recently? And, what should be improved? In this review of the current literature on ionizing radiation, we try to answer these questions. Our conclusion is that medical services have to improve their communication skills and convince the public that the dangers of ionizing radiation can be quantitated within certain limits to support a qualified discussion about its risks and benefits.

  13. Development of oral mucositis model induced by radiation in hamsters: prevention and treatment with low power laser

    Energy Technology Data Exchange (ETDEWEB)

    Galletta, Vivian C.; Folgosi-Correa, Melissa S.; Zezell, Denise M., E-mail:, E-mail:, E-mail: [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Gouw-Soares, Sheila, E-mail: [Universidade Cruzeiro do Sul (UNICSUL), Sao Paulo, SP (Brazil). Fac. de Odontologia; Correa, Luciana, E-mail: [Universidade de Sao Paulo (FO/USP), SP (Brazil). Fac. de Odontologia


    Despite the benefits for the prognosis of patients treated with radiotherapy for oral cancer treatment, it might cause local side effects such as oral mucositis. The oral mucositis is a pathological condition that may appear in affected oral mucosa by ionizing radiation, and the pain related can alter and even stop the antineoplastic treatment, decreasing tumor control rates. Oral mucositis has several treatment modalities, although it remains as a problem since therapies available are not enough to treat efficiently this inflammatory process. Many pharmacological solutions (anti-inflammatory, antibiotics, antiseptic, lubricant agents) are used to alleviate oral mucositis symptoms. Laser treatment has been used as an option, but there is lack of studies to verify the process of laser therapy in oral mucositis caused by ionizing radiation. This work accomplishes follow-up of oral mucositis evolution, comparing laser and benzydamine therapies in an animal model. Forty-two animals were irradiated at head and neck in a single dose of 30 Grays, by means of a Co{sup 60} source. After irradiation, treatments were applied daily, once a day, for 20 days, in which severity of lesions were clinically classified by two calibrated examiners. Histological evaluation was performed to search for mucosal alterations at treated tissues. Statistical analysis of data showed that laser treatment was more efficient than benzydamine treatment, diminishing severity and duration of oral mucosal lesions caused by ionizing irradiation. (author)

  14. 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: [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)


    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.

  15. Perceptions of Radiation Oncologists and Urologists on Sources and Type of Evidence to Inform Prostate Cancer Treatment Decisions

    Energy Technology Data Exchange (ETDEWEB)

    Han, Leona C. [Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota (United States); Delpe, Sophia [Department of Urology, Yale University, New Haven, Connecticut (United States); Shah, Nilay D. [Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota (United States); Ziegenfuss, Jeanette Y. [HealthPartners, Minneapolis, Minnesota (United States); Tilburt, Jon C. [Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota (United States); Biomedical Ethics Program, Mayo Clinic, Rochester, Minnesota (United States); Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota (United States); Karnes, R. Jeffrey [Department of Urology, Mayo Clinic, Rochester, Minnesota (United States); Nguyen, Paul L. [Division of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Gross, Cary P. [Cancer Outcomes and Public Policy Effectiveness Research Center, Yale University, New Haven, Connecticut (United States); Department of Internal Medicine, Yale University, New Haven, Connecticut (United States); Yu, James B. [Cancer Outcomes and Public Policy Effectiveness Research Center, Yale University, New Haven, Connecticut (United States); Department of Radiation Oncology, Yale University, New Haven, Connecticut (United States); Trinh, Quoc-Dien [Division of Urology, Brigham and Women' s Hospital, Harvard University, Boston, Massachusetts (United States); Sun, Maxine [Cancer Prognostics and Health Outcomes, University of Montreal Health Center, Montreal, QC (Canada); Ranasinghe, Weranja K.B. [Division of Urology, Alfred Hospital, Prahran, Melbourne, Victoria (Australia); Kim, Simon P., E-mail: [Department of Urology, Yale University, New Haven, Connecticut (United States); Cancer Outcomes and Public Policy Effectiveness Research Center, Yale University, New Haven, Connecticut (United States)


    Purpose: To perform a national survey of radiation oncologists and urologists about the type of resources used and the level of evidence needed to change clinical practice in localized prostate cancer. Methods and Materials: From a random sample, 1422 physicians were mailed a survey assessing the types of information used and what level of evidence could alter their clinical practice in prostate cancer. Multivariable logistic regression models were used to identify differences in physician characteristics for each outcome. Results: Survey response rates were similar for radiation oncologists and urologists (44% vs 46%; P=.46). Specialty-specific journals represented the most commonly used resource for informing the clinical practice for radiation oncologists (65%) and urologists (70%). Relative to radiation oncologists, urologists were less likely to report utilizing top-tier medical journals (25% vs 39%; adjusted odds ratio [OR] 0.50; P=.01) or cancer journals (22% vs 51%; adjusted OR 0.50; P<.001) but more likely to rely on clinical guidelines (46% vs 38%; adjusted OR 1.6; P=.006). Both radiation oncologists and urologists most commonly reported large randomized, clinical trials as the level of evidence to change treatment recommendations for localized prostate cancer (85% vs 77%; P=.009). Conclusions: Both specialties rely on their own specialty-specific journals and view randomized, clinical trials as the level of evidence needed to change clinical practice. Our study provides a context on meaningful ways of disseminating evidence for localized prostate cancer.

  16. Ornaments in radiation treatment of cultural heritage: Color and UV-vis spectral changes in irradiated nacres (United States)

    Marušić, Katarina; Pucić, Irina; Desnica, Vladan


    Cultural heritage objects that are radiation treated in order to stop their biodegradation often contain ornamenting materials that cannot be removed. Radiation may produce unwanted changes to such materials. Nacre is a common ornamenting material so this is an attempt to assess the impact of gamma-radiation on its optical properties. Two types of nacre (yellow and white) were obtained from a museum and subjected to different absorbed doses of Co-60 gamma irradiation under the same conditions. The radiation induced changes of nacres color were investigated with fiber optic reflectance spectroscopy (FORS). Colorimetry in CIE Lab space revealed that in both nacres the lightness shifted to darker grey hues at high doses while the color component's (red, green, yellow and blue) behavior depended on the nacre type. Observable changes occurred at doses much above the dose range needed for radiation treatment of cultural heritage objects that are often ornamented with nacre. In UV-vis reflectance spectra of samples irradiated to high doses carbonate radical anion absorption appeared.

  17. Idiopathic Radiation Recall Dermatitis Developing Nine Months after Cessation of Cisplatin Therapy in Treatment of Squamous Cell Carcinoma of the Tonsil

    Directory of Open Access Journals (Sweden)

    Stephen M. Melnyk


    Full Text Available To report on a suspected case of idiopathic radiation recall dermatitis in an individual nine months after radiation and chemotherapy treatment of squamous cell carcinoma of the right tonsil. Radiation recall dermatitis is the development of a reaction in a previously irradiated area of skin after the administration of an aggravating medication. A review of the literature revealed several cases of radiation recall dermatitis that occur following radiation therapy and the institution of chemotherapy. Other medications have also been implicated in radiation recall dermatitis; however, this patient has not started any new medications since completion of his combined therapy. The patient developed this skin reaction in a distribution pattern identical to the area that received the highest radiation dose suggesting a possible link between radiation recall dermatitis and radiation dose. Radiation recall dermatitis is a reaction that is typically seen shortly after the reinstitution of chemotherapy during radiation therapy. This case illustrates that other medical etiologies are possible and suggests a relationship between radiation recall dermatitis and the total radiation dose an area receives.

  18. Microbeam radiation therapy. Physical and biological aspects of a new cancer therapy and development of a treatment planning system

    Energy Technology Data Exchange (ETDEWEB)

    Bartzsch, Stefan


    Microbeam Radiation Therapy (MRT) is a novel treatment strategy against cancer. Highly brilliant synchrotron radiation is collimated to parallel, a few micrometre wide, planar beams and used to irradiate malignant tissues with high doses. The applied peak doses are considerably higher than in conventional radiotherapy, but valley doses between the beams remain underneath the established tissue tolerance. Previous research has shown that these beam geometries spare normal tissue, while being effective in tumour ablation. In this work physical and biological aspects of the therapy were investigated. A therapy planning system was developed for the first clinical treatments at the European Synchrotron Radiation Facility in Grenoble (France) and a dosimetry method based on radiochromic films was created to validate planned doses with measurements on a micrometre scale. Finally, experiments were carried out on a cellular level in order to correlate the physically planned doses with the biological damage caused in the tissue. The differences between Monte Carlo dose and dosimetry are less than 10% in the valley and 5% in the peak regions. Developed alternative faster dose calculation methods deviate from the computational intensive MC simulations by less than 15% and are able to determine the dose within a few minutes. The experiments in cell biology revealed an significant influence of intercellular signalling on the survival of cells close to radiation boundaries. These observations may not only be important for MRT but also for conventional radiotherapy.

  19. Comparison of different breast planning techniques and algorithms for radiation therapy treatment. (United States)

    Borges, C; Cunha, G; Monteiro-Grillo, I; Vaz, P; Teixeira, N


    This work aims at investigating the impact of treating breast cancer using different radiation therapy (RT) techniques--forwardly-planned intensity-modulated, f-IMRT, inversely-planned IMRT and dynamic conformal arc (DCART) RT--and their effects on the whole-breast irradiation and in the undesirable irradiation of the surrounding healthy tissues. Two algorithms of iPlan BrainLAB treatment planning system were compared: Pencil Beam Convolution (PBC) and commercial Monte Carlo (iMC). Seven left-sided breast patients submitted to breast-conserving surgery were enrolled in the study. For each patient, four RT techniques--f-IMRT, IMRT using 2-fields and 5-fields (IMRT2 and IMRT5, respectively) and DCART - were applied. The dose distributions in the planned target volume (PTV) and the dose to the organs at risk (OAR) were compared analyzing dose-volume histograms; further statistical analysis was performed using IBM SPSS v20 software. For PBC, all techniques provided adequate coverage of the PTV. However, statistically significant dose differences were observed between the techniques, in the PTV, OAR and also in the pattern of dose distribution spreading into normal tissues. IMRT5 and DCART spread low doses into greater volumes of normal tissue, right breast, right lung and heart than tangential techniques. However, IMRT5 plans improved distributions for the PTV, exhibiting better conformity and homogeneity in target and reduced high dose percentages in ipsilateral OAR. DCART did not present advantages over any of the techniques investigated. Differences were also found comparing the calculation algorithms: PBC estimated higher doses for the PTV, ipsilateral lung and heart than the iMC algorithm predicted.

  20. Maximizing the probability of satisfying the clinical goals in radiation therapy treatment planning under setup uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Fredriksson, Albin, E-mail:; Hårdemark, Björn [RaySearch Laboratories, Sveavägen 44, Stockholm SE-111 34 (Sweden); Forsgren, Anders [Optimization and Systems Theory, Department of Mathematics, KTH Royal Institute of Technology, Stockholm SE-100 44 (Sweden)


    Purpose: This paper introduces a method that maximizes the probability of satisfying the clinical goals in intensity-modulated radiation therapy treatments subject to setup uncertainty. Methods: The authors perform robust optimization in which the clinical goals are constrained to be satisfied whenever the setup error falls within an uncertainty set. The shape of the uncertainty set is included as a variable in the optimization. The goal of the optimization is to modify the shape of the uncertainty set in order to maximize the probability that the setup error will fall within the modified set. Because the constraints enforce the clinical goals to be satisfied under all setup errors within the uncertainty set, this is equivalent to maximizing the probability of satisfying the clinical goals. This type of robust optimization is studied with respect to photon and proton therapy applied to a prostate case and compared to robust optimization using an a priori defined uncertainty set. Results: Slight reductions of the uncertainty sets resulted in plans that satisfied a larger number of clinical goals than optimization with respect to a priori defined uncertainty sets, both within the reduced uncertainty sets and within the a priori, nonreduced, uncertainty sets. For the prostate case, the plans taking reduced uncertainty sets into account satisfied 1.4 (photons) and 1.5 (protons) times as many clinical goals over the scenarios as the method taking a priori uncertainty sets into account. Conclusions: Reducing the uncertainty sets enabled the optimization to find better solutions with respect to the errors within the reduced as well as the nonreduced uncertainty sets and thereby achieve higher probability of satisfying the clinical goals. This shows that asking for a little less in the optimization sometimes leads to better overall plan quality.

  1. Comparison of outcomes and toxicities among radiation therapy treatment options for prostate cancer. (United States)

    Zaorsky, Nicholas G; Shaikh, Talha; Murphy, Colin T; Hallman, Mark A; Hayes, Shelly B; Sobczak, Mark L; Horwitz, Eric M


    We review radiation therapy (RT) options available for prostate cancer, including external beam (EBRT; with conventional fractionation, hypofractionation, stereotactic body RT [SBRT]) and brachytherapy (BT), with an emphasis on the outcomes, toxicities, and contraindications for therapies. PICOS/PRISMA methods were used to identify published English-language comparative studies on PubMed (from 1980 to 2015) that included men treated on prospective studies with a primary endpoint of patient outcomes, with ⩾70 patients, and ⩾5year median follow up. Twenty-six studies met inclusion criteria; of these, 16 used EBRT, and 10 used BT. Long-term freedom from biochemical failure (FFBF) rates were roughly equivalent between conventional and hypofractionated RT with intensity modulation (evidence level 1B), with 10-year FFBF rates of 45-90%, 40-60%, and 20-50% (for low-, intermediate-, and high-risk groups, respectively). SBRT had promising rates of BF, with shorter follow-up (5-year FFBF of >90% for low-risk patients). Similarly, BT (5-year FFBF for low-, intermediate-, and high-risk patients have generally been >85%, 69-97%, 63-80%, respectively) and BT+EBRT were appropriate in select patients (evidence level 1B). Differences in overall survival, distant metastasis, and cancer specific mortality (5-year rates: 82-97%, 1-14%, 0-8%, respectively) have not been detected in randomized trials of dose escalation or in studies comparing RT modalities. Studies did not use patient-reported outcomes, through Grade 3-4 toxicities were rare (treatment decision for a man is usually based on his risk group, ability to tolerate the procedure, convenience for the patient, and the anticipated impact on quality of life. To further personalize therapy, future trials should report (1) race; (2) medical comorbidities; (3) psychiatric comorbidities; (4) insurance status; (5) education status; (6) marital status; (7) income; (8) sexual orientation; and (9) facility-related characteristics.

  2. Continued Development Of An Inexpensive Simulator Based CT Scanner For Radiation Therapy Treatment Planning (United States)

    Peschmann, K. R.; Parker, D. L.; Smith, V.


    An abundant number of different CT scanner models has been developed in the past ten years, meeting increasing standards of performance. From the beginning they remained a comparatively expensive piece of equipment. This is due not only to their technical complexity but is also due to the difficulties involved in assessing "true" specifications (avoiding "overde-sign"). Our aim has been to provide, for Radiation Therapy Treatment Planning, a low cost CT scanner system featuring large freedom in patient positioning. We have taken advantage of the concurrent tremendously increased amount of knowledge and experience in the technical area of CT1 . By way of extensive computer simulations we gained confidence that an inexpensive C-arm simulator gantry and a simple one phase-two pulse generator in connection with a standard x-ray tube could be used, without sacrificing image quality. These components have been complemented by a commercial high precision shaft encoder, a simple and effective fan beam collimator, a high precision, high efficiency, luminescence crystal-silicon photodiode detector with 256 channels, low noise electronic preamplifier and sampling filter stages, a simplified data aquisition system furnished by Toshiba/ Analogic and an LSI 11/23 microcomputer plus data storage disk as well as various smaller interfaces linking the electrical components. The quality of CT scan pictures of phantoms,performed by the end of last year confirmed that this simple approach is working well. As a next step we intend to upgrade this system with an array processor in order to shorten recon-struction time to one minute per slice. We estimate that the system including this processor could be manufactured for a selling price of $210,000.

  3. The influence of package and gamma radiation in the quarantine treatment of Sitophilus Orizae in rice

    Energy Technology Data Exchange (ETDEWEB)

    Modolo, Debora M.; Oliveira, Ana Claudia S.; Silva, Lucia C.A.S.; Arthur, Valter; Harder, Marcia N.C.; Arthur, Paula B.; Lima, Roberta B., E-mail: arthur@cena.usp.b [Centro de Energia Nuclear na Agricultura (CENA/USP), Piracicaba, SP (Brazil). Dept. de Radiobiologia e Ambiente


    There are a variety of insect and pests that damage stored grains, therefore, the need for better conservation with advanced technology, high efficiency, absence of side effects, irradiation has been used as an alternative method to control these insects, being completely the opposite the chemical treatment, which leaves waste and is not always efficient enough. This study has the objective to use the gamma radiation from Cobalt-60 for the control of Sitophilus oryzae, in plastic package with previously infested rice and artificially reinfested. In this research was used 3 types of samples: 'Prato Fino' rice's package, crystal sugar's package and 'Namorado' rice's package. It were packages (bags) of 10x5cm for each type of sample, containing holes for gases exchange. Each pack contained 20g of wholemeal rice and 10 adult insects of the species S. oryzae. The samples were irradiated with dose of 1 kGy to make disinfestations under a dose rate of 0.560 Gy/hour and more the non-irradiated sample (control). After irradiation the bags were placed in a glass bottle with the volume of 3 liters and it were added 300 adult insects in the same bottle to induce reinfestation. This container was closed and after 60 days was calculated the number of living and dead insects existing in each package. The experiment was developed in a room with temperature 25 +- 5 deg C and relative humidity of 60 +- 5%. With the results obtained, it was concluded that the packages containing holes for gases exchange from inside to outside of the package showed more ease of penetration of insects, while the two packages without holes prevented the reinfestation of insects. The dose of 1 kGy was sufficient to induce disinfestations of rice. (author)

  4. Dosimetric Studies of Mixed Energy Intensity Modulated Radiation Therapy for Prostate Cancer Treatments

    Directory of Open Access Journals (Sweden)

    K. Abdul Haneefa


    Full Text Available Dosimetric studies of mixed field photon beam intensity modulated radiation therapy (IMRT for prostate cancer using pencil beam (PB and collapsed cone convolution (CCC algorithms using Oncentra MasterPlan treatment planning system (v. 4.3 are investigated in this study. Three different plans were generated using 6 MV, 15 MV, and mixed beam (both 6 and 15 MV. Fifteen patients with two sets of plans were generated: one by using PB and the other by using CCC for the same planning parameters and constraints except the beam energy. For each patient’s plan of high energy photons, one set of photoneutron measurements using solid state neutron track detector (SSNTD was taken for this study. Mean percentage of V66 Gy in the rectum is 18.55±2.8, 14.58±2.1, and 16.77±4.7 for 6 MV, 15 MV, and mixed-energy plans, respectively. Mean percentage of V66 Gy in bladder is 16.54±2.1, 17.42±2.1, and 16.94±41.9 for 6 MV, 15 MV, and mixed-energy plans, respectively. Mixed fields neutron contribution at the beam entrance surface is 45.62% less than at 15 MV photon beam. Our result shows that, with negligible neutron contributions, mixed field IMRT has considerable dosimetric advantage.

  5. Comparison of treatment outcome between breast-conservation surgery with radiation and total mastectomy without radiation in patients with one to three positive axillary lymph nodes. (United States)

    Kim, Seung Il; Park, Seho; Park, Hyung Seok; Kim, Yong Bae; Suh, Chang Ok; Park, Byeong-Woo


    To test the difference in treatment outcome between breast-conservation surgery with radiation and total mastectomy without radiation, to evaluate the benefits of adjuvant radiotherapy in patients with one to three positive axillary lymph nodes. Using the Severance Hospital Breast Cancer Registry, we divided the study population of T1, T2 and one to three axillary node-positive patients into two groups: breast-conservation surgery with radiation (BCS/RT) and total mastectomy without radiation (TM/no-RT). Data related to locoregional recurrence, distant recurrence, and death were collected, and survival rates were calculated. The study population consisted of 125 patients treated with BCS/RT and 365 patients treated with TM/no-RT. With a median follow-up of 68.4 months, the 10-year locoregional recurrence-free survival rate with BCS/RT and TM/no-RT was 90.5% and 79.2%, respectively (p = 0.056). The 10-year distant recurrence-free survival rate was 78.8% for patients treated with BCS/RT vs. 68.0% for those treated with TM/no-RT (p = 0.012). The 10-years overall survival rate for patients treated with BCT/RT and TM/no-RT was 87.5% and 73.9%, respectively (p = 0.035). After multivariate analysis, patients treated with BCT/RT had better distant recurrence-free survival (hazard ratio [HR], 0.527; 95% confidence interval [CI], 0.297-0.934; p = 0.028), with improving locoregional recurrence-free survival (HR, 0.491; 95% CI, 0.231-1.041; p = 0.064) and overall survival trend (HR, 0.544; 95% CI, 0.277-1.067; p = 0.076). This study provides additional evidence that adjuvant radiation substantially reduces local recurrence, distant recurrence, and mortality for patients with one to three involved nodes. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Design and development of computerized local and overall country's environmental data analysis network system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Gyu; Kang, Jong Gyu; Han, H.; Han, J. S.; Lee, Y. D.; Lee, S. R.; Kang, D. J.; Cho, Y. G.; Yun, S. H. [Daedeok College, Taejon (Korea, Republic of)


    In this development, we designed a integrated database for efficient data processing of radiation-environment data and developed the CLEAN (Computerized Local and overall country's Environmental data Analysis Network) system. The CLEAN system consists of local radiation-environment network, data analysis system, data open system. We developed the CLEAN system focused on building an integrated database, a data mart, and a CLEAN web site. It is expected that the developed system, which organizes the information related to environmental radiation data systematically, can be utilize for the accurate interpretation, analysis and evaluation.

  7. Points to be noted in using radiation treatment planning system; External photon beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Irifune, Toraji (Tokyo Metropolitan Coll. of Allied Medical Sciences (Japan))


    The accuracy of absorbed dose calculations for external photon beam therapy depends on the computational algorithms being used: the acquisition of basic beam data, the patient's anatomical information, the spacing of the points in the matrices, the interpolation routine, inhomogeneity corrections, etc. At present, the dose calculation algorithms employed in most commercially available treatment planning systems for absorbed dose calculation are two-dimensional methods for photon fluence and do not take electronic equilibrium into account. Therefore, their use for radiation treatment planning is limited. In particular, the problem of inhomogeneity correction for lung is the most significant. The inhomogeneity correction methods most commonly used are ratio of TAR (RTAR), power law TAR (PTAR) and equivalent TAR (ETAR) methods. One Japanese society for therapeutic radiology and oncology (JASTRO) task group has compared the three correction methods mentioned above with measured values using the same JARP level dosimeter and lung model phantom. The photon energies were [sup 60]Co [gamma] rays, 4, 6, 10 and 18 MV x rays, and field sizes were 5 x 5, 10 x 10 and 20 x 20 cm[sup 2] at SSD 100 cm. RTAR lead to errors (%) of 2.5 to 12.6, 1.7 to 10.9, 2.7 to 8.5, 3.1 to 9.9, and 1.0 to 19.1; PTAR errors were -0.7 to 2.3, -2.1 to 1.6, -1.1 to 2.2, -0.3 to 3.9, and -2.0 to 6.6; and ETAR errors were 0.7 to 2.5, 0 to 3.1, -0.1 to 6.8, 3.4 to 9.2, and 1.0 to 18.6 for [sup 60]Co [gamma] rays, 4, 6, 10 and 18 MV x rays, respectively. Survey results showed that about 50% of the institutions used measured data obtained by themselves. Basic beam data acquisition should be self-contained. (author).

  8. Long-Term Outcomes After High-Dose Postprostatectomy Salvage Radiation Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Goenka, Anuj; Magsanoc, Juan Martin; Pei Xin; Schechter, Michael; Kollmeier, Marisa; Cox, Brett [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Scardino, Peter T.; Eastham, James A. [Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Zelefsky, Michael J., E-mail: [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)


    Purpose: To review the impact of high-dose radiotherapy (RT) in the postprostatectomy salvage setting on long-term biochemical control and distant metastases-free survival, and to identify clinical and pathologic predictors of outcomes. Methods and Materials: During 1988-2007, 285 consecutive patients were treated with salvage RT (SRT) after radical prostatectomy. All patients were treated with either three-dimensional conformal RT or intensity-modulated RT. Two hundred seventy patients (95%) were treated to a dose {>=}66 Gy, of whom 205 (72%) received doses {>=}70 Gy. Eighty-seven patients (31%) received androgen-deprivation therapy as a component of their salvage treatment. All clinical and pathologic records were reviewed to identify treatment risk factors and response. Results: The median follow-up time after SRT was 60 months. Seven-year actuarial prostate-specific antigen (PSA) relapse-free survival and distant metastases-free survival were 37% and 77%, respectively. Independent predictors of biochemical recurrence were vascular invasion (p < 0.01), negative surgical margins (p < 0.01), presalvage PSA level >0.4 ng/mL (p < 0.01), androgen-deprivation therapy (p = 0.03), Gleason score {>=}7 (p = 0.02), and seminal vesicle involvement (p = 0.05). Salvage RT dose {>=}70 Gy was not associated with improvement in biochemical control. A doubling time <3 months was the only independent predictor of metastatic disease (p < 0.01). There was a trend suggesting benefit of SRT dose {>=}70 Gy in preventing clinical local failure in patients with radiographically visible local disease at time of SRT (7 years: 90% vs. 79.1%, p = 0.07). Conclusion: Salvage RT provides effective long-term biochemical control and freedom from metastasis in selected patients presenting with detectable PSA after prostatectomy. Androgen-deprivation therapy was associated with improvement in biochemical progression-free survival. Clinical local failures were rare but occurred most commonly in

  9. A case of radiation gastritis required surgical treatment in consequence of radiotherapy for recurrent ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hagino, Daisuke; Arai, Yuko; Komatsu, Atsushi; Inoue, Kumiko; Takechi, Kimihiro [Ibaraki Prefectural Central Hospital, Tomobe (Japan)


    We report a case of radiation gastritis in consequence of radiotherapy for recurrent ovarian cancer. A 61-year-old woman received irradiation of a metastatic lesion of the second lumbar vertebra. Six months later she complained of fatigue and presented with severe anemia, and her diagnosis was hemorrhagic radiation gastritis. She was treated endoscopically, but that failed to control the bleeding, making it necessary to resect surgically. The incidence of radiation gastritis is very low because the stomach is rarely within the treated field, but it is of importance to be aware that the stomach is by no means more radioresistant than other organs. (author)

  10. Computerized Information System for Nursing Educators; The First Step Towards Computerized Instruction or Computer Assisted Instruction. (United States)

    Alvir, Howard P.

    This document outlines the guidelines and procedures for educators interested in using the Computerized Information System for Nursing Educators (CISNE), a project sponsored by Francophone International Learning Module Systems. In the first of the report's four sections are a brief description of CISNE guidelines for entry procedures and forms for…

  11. Computerized acoustical characterization system of medical phantoms (United States)

    Nazihah, M. D.; Kadri, S.; Yaacob, M. I. H.; Rosly, J.


    The development of a computerized acoustical characterization system of medical phantoms is described in this paper. The system employs the insertion technique and it was developed using LabView 2011 where the ultrasound signal was acquired through the interfacing scheme of an oscilloscope to a personal computer. The system performance was validated by comparing measured acoustical properties with values obtained from the previous studies. Other than faster measurement time, the developed system carried percentage difference at less than 1.00% for all of the acoustical properties measurements at 23.0°C to 25.0°C respectively.

  12. Visualization in the age of computerization

    CERN Document Server

    Carusi, Annamaria; Webmoor, Timothy; Woolgar, Steve


    Digitalization and computerization are now pervasive in science. This has deep consequences for our understanding of scientific knowledge and of the scientific process, and challenges longstanding assumptions and traditional frameworks of thinking of scientific knowledge. Digital media and computational processes challenge our conception of the way in which perception and cognition work in science, of the objectivity of science, and the nature of scientific objects. They bring about new relationships between science, art and other visual media, and new ways of practicing science and organizing

  13. Computerized documentation systems: blessings or curse? (United States)

    Vlasses, F R


    This article considers the possibility that computerized documentation systems will negatively impact knowledge development in nursing. Ideas from three vantage points is presented. First, systems are being developed from theoretical frameworks that are not necessarily grounded in nursing, and these systems, in turn, influence the nurses's ability to process and conceptualize information. Second, computer systems may support the retrieval of empirical data to the elimination of other types of data necessary to the development of nursing knowledge. Third, computers may decrease opportunities for collegial dialogue. These factors together create an atmosphere of "technologic determinism" (Robinson & Robinson, 1990), which can inhibit the development of new ideas in nursing.

  14. Continuous-time method and its discretization to inverse problem of intensity-modulated radiation therapy treatment planning (United States)

    Fujimoto, Ken'ichi; Tanaka, Yoshihiro; Abou Al-Ola, Omar M.; Yoshinaga, Tetsuya


    We propose a novel approach for solving box-constrained inverse problems in intensity-modulated radiation therapy (IMRT) treatment planning based on the idea of continuous dynamical methods and split-feasibility algorithms. Our method can compute a feasible solution without the second derivative of an objective function, which is required for gradient-based optimization algorithms. We prove theoretically that a double Kullback-Leibler divergence can be used as the Lyapunov function for the IMRT planning system.

  15. A Phase I Study of the Combination of Sorafenib With Temozolomide and Radiation Therapy for the Treatment of Primary and Recurrent High-Grade Gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Den, Robert B., E-mail: [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Kamrava, Mitchell [Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland (United States); Sheng, Zhi [Howard Hughes Medical Institute, Programs in Gene Function and Expression and Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Werner-Wasik, Maria; Dougherty, Erin; Marinucchi, Michelle [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Lawrence, Yaacov R. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Center for Translational Research in Radiation Oncology, Sheba Medical Center (Israel); Hegarty, Sarah; Hyslop, Terry [Department of Biostatistics, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Andrews, David W.; Glass, Jon [Department of Neurosurgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Friedman, David P. [Department of Radiology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Green, Michael R. [Howard Hughes Medical Institute, Programs in Gene Function and Expression and Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Camphausen, Kevin [Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland (United States); Dicker, Adam P. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States)


    Purpose: Despite recent advances in the management of high-grade and recurrent gliomas, survival remains poor. Antiangiogenic therapy has been shown to be efficacious in the treatment of high-grade gliomas both in preclinical models and in clinical trials. We sought to determine the safety and maximum tolerated dose of sorafenib when combined with both radiation and temozolomide in the primary setting or radiation alone in the recurrent setting. Methods and Materials: This was a preclinical study and an open-label phase I dose escalation trial. Multiple glioma cell lines were analyzed for viability after treatment with radiation, temozolomide, or sorafenib or combinations of them. For patients with primary disease, sorafenib was given concurrently with temozolomide (75 mg/m{sup 2}) and 60 Gy radiation, for 30 days after completion of radiation. For patients with recurrent disease, sorafenib was combined with a hypofractionated course of radiation (35 Gy in 10 fractions). Results: Cell viability was significantly reduced with the combination of radiation, temozolomide, and sorafenib or radiation and sorafenib. Eighteen patients (11 in the primary cohort, 7 in the recurrent cohort) were enrolled onto this trial approved by the institutional review board. All patients completed the planned course of radiation therapy. The most common toxicities were hematologic, fatigue, and rash. There were 18 grade 3 or higher toxicities. The median overall survival was 18 months for the entire population. Conclusions: Sorafenib can be safely combined with radiation and temozolomide in patients with high-grade glioma and with radiation alone in patients with recurrent glioma. The recommended phase II dose of sorafenib is 200 mg twice daily when combined with temozolomide and radiation and 400 mg with radiation alone. To our knowledge, this is the first publication of concurrent sorafenib with radiation monotherapy or combined with radiation and temozolomide.

  16. Factors associated with program utilization of radiation therapy treatment for VHA and medicare dually enrolled patients. (United States)

    French, Dustin D; Bradham, Douglas D; Campbell, Robert R; Haggstrom, David A; Myers, Laura J; Chumbler, Neale R; Hagan, Michael P


    We examine how distance to a Veterans Health Administration (VHA) facility, patient hometown classification (e.g., small rural town), and service-connected disability are associated with veterans' utilization of radiation therapy services across the VHA and Medicare. In 2008, 45,914 dually-enrolled veteran patients received radiation therapy. Over 3-quarters (35,513) of the patients received radiation therapy from the Medicare program. Younger age, male gender, shorter distance to a VHA facility, and VHA priority or disability status increased the odds of utilizing the VHA. However, veterans residing in urban areas were less likely to utilize the VHA. Urban dwelling patients' utilization of Medicare instead of the VHA suggests a complex decision that incorporates geographic access to VHA services, financial implications of veteran priority status, and the potential availability of multiple sources of radiation therapy in competitive urban markets.

  17. Implant-prosthetic rehabilitation after radiation treatment in head and neck cancer patients: a case-series report of outcome (United States)

    Cotic, Jasna; Jamsek, Jure; Kuhar, Milan; Ihan Hren, Natasa; Kansky, Andrej; Özcan, Mutlu


    Abstract Background Slovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy. Patients and methods Twenty irradiated head and neck cancer patients who received a removable implant-supported denture at the University Medical Centre Ljubljana were included in the study. Kaplan-Meier survival analysis, Cox proportional hazard models and logistic regression were used to assess the implant survival and success rate. Results Twenty patients had 100 implants inserted. The estimated implant survival rate was 96% after 1 year and 87% after 5 years. Failures were mostly observed before loading (91.2%). Implants inserted in the transplanted bone were significantly more likely to fail. Out of 89 implants supporting the dentures, 79 implants (88.7%) were successful, meaning that they were functionally loaded and exhibited no pain, radiolucency or progressive bone loss. Prosthetic treatment was significantly less successful in older patients. The attachment system and the number of implants did not have a statistically significant influence on the success rate. Conclusions Implant-supported dentures have been shown to be a reliable treatment modality after head and neck cancer surgery and radiation therapy. Possible early failures should be communicated with the patients.

  18. Breast cancer induced by radiation. Relation to mammography and treatment of acne

    Energy Technology Data Exchange (ETDEWEB)

    Simon, N.


    A report is given of cases of 16 women in whom cancer of the breast developed after radiation therapy for acne or hirsutism, suggesting another group at higher risk than is generally expected for cancer of the breast. It is prudent to regard the carcinogenic effect of radiation on the breast as proportional to dose without a threshold. Mammography in young women should be ordered only selectively, not for screening.

  19. Successful imiquimod treatment of multiple basal cell carcinomas after radiation therapy for Hodgkin's disease. (United States)

    Beyeler, Mirjam; Urosevic, Mirjana; Pestalozzi, Bernhard; Dummer, Reinhard


    We present a case of a 55-year-old male patient who developed five basal cell carcinomas 23 years after radiation therapy of Hodgkin's disease. In 1980 he received radiation therapy twice. Due to relapses, he was treated with aggressive polychemotherapy and underwent autologous stem cell transplantation, which then led to complete remission. Until now he is in complete remission. However, multiple superficial basal cell carcinomas have developed on irradiation fields that have been successfully treated by imiquimod.

  20. Rectum separation in patients with cervical cancer for treatment planning in primary chemo-radiation


    Marnitz Simone; Budach Volker; Weißer Friederike; Burova Elena; Gebauer Bernhard; Vercellino Filiberto; Köhler Christhardt


    Abstract Purpose To proof feasibility of hydrogel application in patients with advanced cervical cancer undergoing chemo-radiation in order to reduce rectal toxicity from external beam radiation as well as brachytherapy. Material and methods Under transrectal sonographic guidance five patients with proven cervical cancer underwent hydro gel (20 cc) instillation into the tip of rectovaginal septum adherent to posterior part of the visible cervical tumor. Five days after this procedure all pati...

  1. A review of segmentation and deformable registration methods applied to adaptive cervical cancer radiation therapy treatment planning. (United States)

    Ghose, Soumya; Holloway, Lois; Lim, Karen; Chan, Philip; Veera, Jacqueline; Vinod, Shalini K; Liney, Gary; Greer, Peter B; Dowling, Jason


    Manual contouring and registration for radiotherapy treatment planning and online adaptation for cervical cancer radiation therapy in computed tomography (CT) and magnetic resonance images (MRI) are often necessary. However manual intervention is time consuming and may suffer from inter or intra-rater variability. In recent years a number of computer-guided automatic or semi-automatic segmentation and registration methods have been proposed. Segmentation and registration in CT and MRI for this purpose is a challenging task due to soft tissue deformation, inter-patient shape and appearance variation and anatomical changes over the course of treatment. The objective of this work is to provide a state-of-the-art review of computer-aided methods developed for adaptive treatment planning and radiation therapy planning for cervical cancer radiation therapy. Segmentation and registration methods published with the goal of cervical cancer treatment planning and adaptation have been identified from the literature (PubMed and Google Scholar). A comprehensive description of each method is provided. Similarities and differences of these methods are highlighted and the strengths and weaknesses of these methods are discussed. A discussion about choice of an appropriate method for a given modality is provided. In the reviewed papers a Dice similarity coefficient of around 0.85 along with mean absolute surface distance of 2-4mm for the clinically treated volume were reported for transfer of contours from planning day to the treatment day. Most segmentation and non-rigid registration methods have been primarily designed for adaptive re-planning for the transfer of contours from planning day to the treatment day. The use of shape priors significantly improved segmentation and registration accuracy compared to other models. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Comparison of conventional and virtual simulation for radiation treatment planning of malignant lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Dinges, S.; Koswig, S.; Buchali, A.; Wurm, R.; Schlenger, L.; Boehmer, D.; Budach, V. [Humboldt-Universitaet Berlin (Germany). Klinik fuer Strahlentherapie


    Purpose: The exact coverage of the lymph nodes and optimal shielding of the organs at risk are necessary for patients with Hodgkin`s disease or malignant lymphoma to guarantee a high cure rate and a low rate of late effects for normal tissue. The purpose of this study was to compare conventional simulation and blocking with virtual simulation in terms of coverage of the target volume and shielding of the organs at risk in this highly curative patient group. Patients and Methods: In 10 patients diagnosed with Hodgkin`s disease and 5 patients with a Non-Hodgkin lymphoma radiation treatment planning for a mantle field or para-aortic field with inclusion of the spleen was performed in a conventional manner and with virtual simulation. With conventional technique, irradiation portals were defined during fluoroscopy and shielding of the organs at risk was drawn onto the simulation films, based on the information from previous X-ray films, CT or MRI scans. For virtual simulation, contouring of the target volumes and organs at risk (e.g. the kidneys) and the definition of the irradiation portals were performed with the AcQSim {sup trademark} software package on a VoxelQ {sup trademark} workstation (Picker Inc.). This was done in a beam`s eye view environment on a currently driven CT scan in the treatment position. Both irradiation portals were compared in terms of coverage of the target volume and shielding of the organs at risk. Results: Planning of a mantle field in the conventional way resulted in an imcomplete coverage of the right hilus in 4/15 cases and of the left in 1/15 cases, respectively. The spleen and the spleen hilus were not covered completely in 5/15 and 6/15 cases, respectively. The left kidney was adequately shielded in only two thirds (10/15) of the conventionally planned fields. The planning time required for virtual simulation was reduced for the patient, but was increased for the physician because of the more time consuming contouring procedure

  3. A study on monitoring of pharmaceuticals and personal care products (PPCPs) in livestock wastewater and treatment by radiation techniques

    Energy Technology Data Exchange (ETDEWEB)

    Myung, Seung Woon [KAERI, Daejeon (Korea, Republic of)


    In this study, and effective monitoring and the investigation of treatment efficiency of pharmaceuticals from the influent and effluent of livestock wastewater treatment plant (WWTPs) and by-product with radiation processing by LC/ESI-MS/MS was performed. Thirteen pharmaceuticals including antibiotics, growth promoters and disinfectants were assayed from twelve WWTPs in South Korea. The established method could be used to determine low concentration levels of pharmaceuticals in environmental samples. From few influents of live-stock WWTPs, chlortetracycline and acetaminophen were detected with the highest concentration among the monitoring pharmaceuticals. And also lincomycin, sufathiazole, sulfamethazine, trimethoprim, acetyl salicylic acid, tylosin, glutaraldehyde and formaldehyde were detected from the influents of WWTPs

  4. Starch gelatinization and physical quality of pea flakes in canine dinners as affected by soaking, steam treatment and infrared radiation. (United States)

    Yang, S C; Zandstra, T; van der Poel, A F B


    Cleaned, whole smooth green peas (Pisum sativum L.) were reconstituted by soaking in tap water of 40 degrees C (15, 20 or 25 min) and subsequently either toasted (100 degrees C during 1.5 min) and infrared (IR) radiated or just IR radiated. For IR radiation, a small-scale, propane-fired IR radiation plant was used with average residence times of 58 and 92 s respectively. After exiting the conveyor belt, peas were held for a pre-determined period (holding: 0, 15 or 30 min respectively) in a well-insulated container. Finally, all radiated peas were flaked (roll distance 0.75 mm) in a flaking mill located posterior to the IR plant and analysed for chemical and physical properties. Initial pea starch gelatinization degree (SGD) was 10.1% at a total starch content of 410.1 g/kg. Infrared processing during 92 s significantly improved the SGD (from 10.1% to 32.8%) of pea flakes compared to treatment during 58 s (SGD of 18.6%). The SGD was further improved with steam treatment of peas, prior to IR. For all determined parameters, no effect of holding time could be observed. Starch gelatinization degree can be improved by soaking, toasting and IR processing. The substantial improvement of SGD, however can be only obtained by a longer IR residence time as well as through toasting, prior to the IR processing. The improvements in SGD, however are paralleled by a lower durability of flakes (range 34.9% to 87.4%).

  5. TP53 disruptive mutations lead to head and neck cancer treatment failure through inhibition of radiation-induced senescence. (United States)

    Skinner, Heath D; Sandulache, Vlad C; Ow, Thomas J; Meyn, Raymond E; Yordy, John S; Beadle, Beth M; Fitzgerald, Alison L; Giri, Uma; Ang, K Kian; Myers, Jeffrey N


    Mortality of patients with head and neck squamous cell carcinoma (HNSCC) is primarily driven by tumor cell radioresistance leading to locoregional recurrence (LRR). In this study, we use a classification of TP53 mutation (disruptive vs. nondisruptive) and examine impact on clinical outcomes and radiation sensitivity. Seventy-four patients with HNSCC treated with surgery and postoperative radiation and 38 HNSCC cell lines were assembled; for each, TP53 was sequenced and the in vitro radioresistance measured using clonogenic assays. p53 protein expression was inhibited using short hairpin RNA (shRNA) and overexpressed using a retrovirus. Radiation-induced apoptosis, mitotic cell death, senescence, and reactive oxygen species (ROS) assays were carried out. The effect of the drug metformin on overcoming mutant p53-associated radiation resistance was examined in vitro as well as in vivo, using an orthotopic xenograft model. Mutant TP53 alone was not predictive of LRR; however, disruptive TP53 mutation strongly predicted LRR (P = 0.03). Cell lines with disruptive mutations were significantly more radioresistant (P disruptive TP53 mutations significantly decreased radiation-induced senescence, as measured by SA-β-gal staining, p21 expression, and release of ROS. The mitochondrial agent metformin potentiated the effects of radiation in the presence of a disruptive TP53 mutation partially via senescence. Examination of our patient cohort showed that LRR was decreased in patients taking metformin. Disruptive TP53 mutations in HNSCC tumors predicts for LRR, because of increased radioresistance via the inhibition of senescence. Metformin can serve as a radiosensitizer for HNSCC with disruptive TP53, presaging the possibility of personalizing HNSCC treatment. © 2011 AACR.

  6. Computerized axial tomography in clinical pediatrics. (United States)

    McCullough, D C; Kufta, C; Axelbaum, S P; Schellinger, D


    Computerized axial tomography (CAT), a noninvasive radiologie method, provides a new dimension in screening and diagnosis of intracranial pathology. Evaluation of 725 scans in infants and children demonstrates that CAT may be performed with negligible risk, although sedation and restraint are essential to the successful performance of studies in children under 6 years of age. CAT is the preferred initial diagnostic method in suspected hydrocephalls and is accurate in the detection and precise localization of brain tumors. The management of hydrocephalus and brain tumors has been significantly altered by the availability of CAT. Few invasive neuroradiologic procedures are required and pneumography is especially curtailed. Serial scanning is the best available method of monitoring ventricular alterations in hydrocephalus, tumor size during radiotherapy or chemotherapy, and postoperative recurrence of benign neoplasms. Complex intracranial anomalies are detectable with computerized tomography, but complete definition of pathology often requires angiography and air studies. Limited clinical experience in detecting neonatal intraventricular hemorrhage suggests that CAT will be a valuable tool for futlre investigations of that problem.

  7. Automatic computerized radiographic identification of cephalometric landmarks. (United States)

    Rudolph, D J; Sinclair, P M; Coggins, J M


    Computerized cephalometric analysis currently requires manual identification of landmark locations. This process is time-consuming and limited in accuracy. The purpose of this study was to develop and test a novel method for automatic computer identification of cephalometric landmarks. Spatial spectroscopy (SS) is a computerized method that identifies image structure on the basis of a convolution of the image with a set of filters followed by a decision method using statistical pattern recognition techniques. By this method, characteristic features are used to recognize anatomic structures. This study compared manual identification on a computer monitor and the SS automatic method for landmark identification on minimum resolution images (0.16 cm2 per pixel). Minimum resolution (defined as the lowest resolution at which a cephalometric structure could be identified) was used to reduce computational time and memory requirements during this development stage of the SS method. Fifteen landmarks were selected on a set of 14 test images. The results showed no statistical difference (p > 0.05) in mean landmark identification errors between manual identification on the computer display and automatic identification using SS. We conclude that SS shows potential for the automatic detection of landmarks, which is an important step in the development of a completely automatic cephalometric analysis.

  8. An open trial in the NHS of Blues Begone: a new home based computerized CBT program. (United States)

    Purves, David G; Bennett, Mary; Wellman, Nigel


    Computer based treatment for depression and anxiety has been available for several years and has demonstrated useful clinical effects. Most existing computerized CBT products in the UK that are designed to treat depression and co-morbid anxiety require patients to visit a clinic and require staff input to manage the process. Such intervention adds to the costs and bottlenecks in delivering a clinically effective treatment with mass availability. Internet treatment options are becoming more readily available, although data to support use are not yet strong, and most still require human assessment and telephone support. Blues Begone is a new computerized CBT program that has been designed to be used at home with minimal human support. This pilot project provides data from an open trial of Blues Begone with both primary and secondary care patients. One hundred patients started Blues Begone, 58 completed the program, 72% (n = 42) of completers achieved reliable change and (n = 36) 62% achieved both reliable and clinically significant change, and may be considered to have recovered by the end of the program. These data provide the first demonstration of the potential viability of Blues Begone as a home based computerized treatment for depression and anxiety.

  9. Mesenchymal stem cells are sensitive to treatment with kinase inhibitors and ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Nicolay, Nils H.; Debus, Juergen; Huber, Peter E. [Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg (Germany); German Cancer Research Center (dkfz), Department of Molecular and Radiation Oncology, Heidelberg (Germany); Sommer, Eva; Lopez Perez, Ramon; Wirkner, Ute [German Cancer Research Center (dkfz), Department of Molecular and Radiation Oncology, Heidelberg (Germany); Bostel, Tilman [Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg (Germany); Ho, Anthony D.; Saffrich, Rainer [Heidelberg University Hospital, Department of Hematology, Oncology and Rheumatology, Heidelberg (Germany); Lahn, Michael [Lilly Research Laboratories, Oncology Early Clinical Investigation, Indianapolis, IN (United States)


    Mesenchymal stem cells (MSCs) can regenerate damaged tissues and may therefore be of importance for normal tissue repair after cancer treatment. Small molecule receptor kinase inhibitors (RKIs) have recently been introduced into cancer treatment. However, the influence of these drugs - particularly in combination with radiotherapy - on the survival of MSCs is largely unknown. The sensitivity of human primary MSCs from healthy volunteers and primary human fibroblast cells to small molecule kinase inhibitors of the vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF) and transforming growth factor β (TGFβ) receptors, as well to inhibitors of c-Kit, was examined in combination with ionizing radiation (IR); cell survival and proliferation were assessed. Expression patterns of different kinase receptors and ligands were investigated using gene arrays. MSCs were highly sensitive to the tyrosine kinase inhibitors SU14816 (imatinib) and SU11657 (sunitinib), but showed only moderate sensitivity to the selective TGFβ receptor 1 inhibitor LY2109761. Primary adult human fibroblasts were comparably resistant to all three inhibitors. The addition of IR had an additive or supra-additive effect in the MSCs, but this was not the case for differentiated fibroblasts. Proliferation was markedly reduced in MSCs following kinase inhibition, both with and without IR. Gene expression analysis revealed high levels of the PDGF α and β receptors, and lower levels of the TGFβ receptor 2 and Abl kinase. IR did not alter the expression of kinase receptors or their respective ligands in either MSCs or adult fibroblasts. These data show that MSCs are highly sensitive to RKIs and combination treatments incorporating IR. Expression analyses suggest that high levels of PDGF receptors may contribute to this effect. (orig.) [German] Mesenchymale Stammzellen (MSCs) koennen die Geweberegeneration unterstuetzen und haben daher moeglicherweise eine Rolle bei der Reparatur

  10. Comparison of intraoperative radiation therapy-containing multimodality treatment with historical treatment modalities for locally recurrent rectal cancer

    NARCIS (Netherlands)

    Mannaerts, GHH; Rutten, HJT; Martijn, H; Hanssens, PEJ; Wiggers, T


    PURPOSE: Treatment protocols for patients with locally recurrent rectal cancer have changed in the last two decades. Subsequently, treatment goals shifted from palliation to possible cure. In this retrospective study, we explored the treatment variables that may have contributed to the improvement i

  11. Radiotherapy after radical prostatectomy: treatment recommendations differ between urologists and radiation oncologists.

    Directory of Open Access Journals (Sweden)

    Luke T Lavallée

    Full Text Available PURPOSE: There is no consensus on optimal use of radiotherapy following radical prostatectomy. The purpose of this study was to describe opinions of urologists and radiation oncologists regarding adjuvant and salvage radiotherapy following radical prostatectomy. METHODS: Urologists and genitourinary radiation oncologists were solicited to participate in an online survey. Respondent characteristics included demographics, training, practice setting, patient volume/experience, and access to radiotherapy. Participant practice patterns and attitudes towards use of adjuvant and salvage radiotherapy in standardized clinical scenarios were assessed. RESULTS: One hundred and forty-six staff physicians participated in the survey (104 urologists and 42 genitourinary radiation oncologists. Overall, high Gleason score (Gleason 7 vs. 6, RR 1.37 95% CI 1.19-1.56, p<0.0001 and Gleason 8-10 vs. 6, RR 1.56 95% CI 1.37-1.78, p<0.0001, positive surgical margin (RR 1.43 95% CI 1.26-1.62, p<0.0001, and extraprostatic tumour extension (RR 1.16 95% CI 1.05-1.28, p<0.002 conferred an increased probability of recommending adjuvant radiotherapy. Radiation oncologists were more likely to recommend adjuvant radiotherapy across all clinical scenarios (RR 1.48, 95% CI 1.39, 1.60, p <0.001. Major differences were found for patients with Gleason 6 and isolated positive surgical margin (radiotherapy selected by 21% of urologists vs. 70% of radiation oncologists, and patients with extraprostatic extension and negative surgical margins (radiotherapy selected by 18% of urologist vs. 57% of radiation oncologists. CONCLUSIONS: Urologists and radiation oncologists frequently disagree about recommendation for post-prostatectomy adjuvant radiotherapy. Since clinical equipoise exists between adjuvant versus early salvage post-operative radiotherapy, support of clinical trials comparing these approaches is strongly encouraged.

  12. A comparison of six different ballast water treatment systems based on UV radiation, electrochlorination and chlorine dioxide. (United States)

    Stehouwer, Peter Paul; Buma, Anita; Peperzak, Louis


    The spr