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Sample records for entire radiotherapy courses

  1. Interfractional changes in tumour volume and position during entire radiotherapy courses for lung cancer with respiratory gating and image guidance

    Energy Technology Data Exchange (ETDEWEB)

    Juhler-Noettrup, Trine; Korreman, Stine S.; Pedersen, Anders N.; Persson, Gitte F.; Aarup, Lasse R.; Nystroem, Haakan; Olsen, Mikael; Tarnavski, Nikolai; Specht, Lena (Dept. of Radiation Oncology, The Finsen Centre, Copenhagen (Denmark))

    2008-08-15

    Introduction. With the purpose of implementing gated radiotherapy for lung cancer patients, this study investigated the interfraction variations in tumour size and internal displacement over entire treatment courses. To explore the potential of image guided radiotherapy (IGRT) the variations were measured using a set-up strategy based on imaging of bony landmarks and compared to a strategy using in room lasers, skin tattoos and cupper landmarks. Materials and methods. During their six week treatment course of 60Gy in 2Gy fractions, ten patients underwent 3 respiratory gated CT scans. The tumours were contoured on each CT scan to evaluate the variations in volumes and position. The lung tumours and the mediastinal tumours were contoured separately. The positional variations were measured as 3D mobility vectors and correlated to matching of the scans using the two different strategies. Results. The tumour size was significantly reduced from the first to the last CT scan. For the lung tumours the reduction was 19%, p=0.03, and for the mediastinal tumours the reduction was 34%, p=0.0007. The mean 3D mobility vector and the SD for the lung tumours was 0.51cm (+-0.21) for matching using bony landmarks and 0.85cm (+-0.54) for matching using skin tattoos. For the mediastinal tumours the corresponding vectors and SD's were 0.55cm (+-0.19) and 0.72cm (+-0.43). The differences between the vectors were significant for the lung tumours p=0.004. The interfractional overlap of lung tumours was 80-87% when matched using bony landmarks and 70-76% when matched using skin tattoos. The overlap of the mediastinal tumours were 60-65% and 41-47%, respectively. Conclusions. Despite the use of gating the tumours varied considerably, regarding both position and volume. The variations in position were dependent on the set-up strategy. Set-up using IGRT was superior to set-up using skin tattoos.

  2. Interfractional changes in tumour volume and position during entire radiotherapy courses for lung cancer with respiratory gating and image guidance

    International Nuclear Information System (INIS)

    Juhler-Noettrup, Trine; Korreman, Stine S.; Pedersen, Anders N.; Persson, Gi tte F.; Aarup, Lasse R.; Nystroem, Haakan; Olsen, Mikael; Tarnavski, Nikolai; Sp echt, Lena

    2008-01-01

    Introduction. With the purpose of implementing gated radiotherapy for lung cancer patients, this study investigated the interfraction variations in tumour size and internal displacement over entire treatment courses. To explore the potential of image guided radiotherapy (IGRT) the variations were measured using a set-up strategy based on imaging of bony landmarks and compared to a strategy using in room lasers, skin tattoos and cupper landmarks. Materials and methods. During their six week treatment course of 60Gy in 2Gy fractions, ten patients underwent 3 respiratory gated CT scans. The tumours were contoured on each CT scan to evaluate the variations in volumes and position. The lung tumours and the mediastinal tumours were contoured separately. The positional variations were measured as 3D mobility vectors and correlated to matching of the scans using the two different strategies. Results. The tumour size was significantly reduced from the first to the last CT scan. For the lung tumours the reduction was 19%, p=0.03, and for the mediastinal tumours the reduction was 34%, p=0.0007. The mean 3D mobility vector and the SD for the lung tumours was 0.51cm (±0.21) for matching using bony landmarks and 0.85cm (±0.54) for matching using skin tattoos. For the mediastinal tumours the corresponding vectors and SD's were 0.55cm (±0.19) and 0.72cm (±0.43). The differences between the vectors were significant for the lung tumours p=0.004. The interfractional overlap of lung tumours was 80-87% when matched using bony landmarks and 70-76% when matched using skin tattoos. The overlap of the mediastinal tumours were 60-65% and 41-47%, respectively. Conclusions. Despite the use of gating the tumours varied considerably, regarding both position and volume. The variations in position were dependent on the set-up strategy. Set-up using IGRT was superior to set-up using skin tattoos

  3. UOP HRM 531 Entire Course NEW

    OpenAIRE

    ADMIN

    2018-01-01

    UOP HRM 531 Entire Course NEW Check this A+ tutorial guideline at http://www.hrm531assignment.com/hrm-531-uop/hrm-531-entire-course -latest For more classes visit http://www.hrm531assignment.com HRM 531 Week 1 Employment Law Report (2 Papers) HRM 531 Week 2 Change Management Impact (2 Papers) HRM 531 Week 3 Individual Compensation and Benefits Strategy (2 Papers) HRM 531 Week 3 Team Salary Inequities Case Study AstraZeneca (2 Papers) HRM 531 W...

  4. Radiotherapy Learning in Medical Undergraduate Courses.

    Science.gov (United States)

    de la Peña, L; Garcia-Linares, A

    2016-12-01

    Approximately 60 % of all cancer patients receive radiotherapy as a component of their treatment. Radiation Oncology concepts, specifically, are not formally introduced to students in most traditional school curricula until their clinical rotations or may only be included as an optional elective during the core clinical clerkships. The aim of this study is to determine whether the teaching of Radiation Oncology by radiation oncologists, in the third year, in block diagnostic and therapeutic procedures, is helpful for student training and changes their attitude towards the specialty. We administered a pre-test and post-test examination of the concepts in general radiation oncology, radiation physics, radiobiology, breast cancer and their opinion to the third year medical students. The 10-question, multiple choice tests were administered before starting the lessons and when they finished the course. Of the 130 third year students, 95 (73.07 %) participated in the pre-test and post-test analysis. For the entire cohort, improvement was seen in all questions except one regarding physics. A statistically significant improvement (p < 0.005) was seen in the question regarding the aspects of general radiotherapy, radiobiology, acute and after-effects of radiation and the management of early-stage breast cancer. With an adequate methodology, third year students can learn aspects of Radiation Oncology.

  5. Classical tandem-source dwelling covering the entire uterus. Essential in modern intracavitary radiotherapy for cervical cancer?

    International Nuclear Information System (INIS)

    Ohara, Kiyoshi; Nemoto, Keiko; Ohnishi, Kayoko; Hashimoto, Takayuki; Fukumitsu, Nobuyoshi; Hata, Masaharu; Sugahara, Shinji; Tokuuye, Koichi; Akine, Yasuyuki

    2007-01-01

    We investigated whether conventional tandem-source dwelling to cover the entire uterus, classically regarded as the target volume, is necessary in modem intracavitary radiotherapy (ICRT) for cervical cancer. The study included 95 cervical squamous cell carcinoma patients treated by high-dose-rate ICRT (point A dose was 6.0 Gy, with three to five insertions per patient) after external beam radiotherapy (EBRT), with central pelvic doses of 12-50 Gy. The tandem-source dwell length was adjusted to the target volume specified by magnetic resonance (MR) imaging. A tandem applicator was inserted as far as the uterine fundus in accordance with the post-EBRT MR-assessed cavity length. The pre-EBRT MR-specified target volume was used for the dwell-length adjustment. The safety of the dwell-length adjustment was assessed in terms of treatment failure. The dwell-length adjustment was made in 248 of 366 total insertions with a dwell-length reduction of 5-55 mm (median 15 mm) at the corpus. Pelvic failure was identified in 22 patients with a 2-year pelvic disease-free survival rate of 75.6% but without evidence of failure at dwelling-skipped corpuses. Given after pelvic EBRT and ICRT of full-length dwelling in part, which may have eradicated possible subclinical extension, adjustment of the tandem-source dwell length to the MR-specified target volume appeared to be safe. (author)

  6. Repeated CT studies of a patient with herpes simplex encephalitis during his entire clinical course

    International Nuclear Information System (INIS)

    Shiraishi, Masahiro; Fukui, Keiji; Takeda, Sadanori; Sadamoto, Kazuhiko; Kimura, Hideki; Sakaki, Saburo.

    1985-01-01

    We encountered a patient with herpes simplex encephalitis whose cerebral lesions were studied by repeated CT scannings during his entire clinical course. The purpose of this paper is to report the earliest lesions of the brain as revealed by CT scans. A 63-year-old man was admitted to our clinic complaining of headache, nausea, fever, and disorientation. On admission, a physical examination showed a high fever, while a neurological examination revealed a stiff neck, a positive Kernig's sign, and disorientation. Laboratory examinations revealed a pleocytosis of the cerebrospinal fluid. Electroencephalograms showed the so-called ''periodic sharp-and-slow-waves complex''. The complement fixation titer for herpes simplex virus was x32 in the serum and x128 in the cerebrospinal fluid, suggesting the diagnosis of herpes simplex encephalitis. We treated him with adenine arabinoside and gamma-globulin, but the patient did not recover; rather, he died of pneumonia and gastrointestinal bleeding three months later. Plain CT scans taken on the 12th day after the onset revealed a low-density area with signs of a slight mass in the region from the right island of Reil to the right uncus. Contrast-enhanced CT scans revealed an irregular enhancement in the low-density area. CT scans taken on the 19th day after the onset showed an extensive low-density area with a streak-like enhancement in the right temporal lobe, which is in aggreement with the findings reported by others as characteristic CT findings for herpes simplex encephalitis. In order to make an early diagnosis of a patient, we should pay attention to a low-density area with an irregular contrast enhancement in the region from the island of Reil to the uncus on a CT scan. (author)

  7. A Game-Based Approach to an Entire Physical Chemistry Course

    Science.gov (United States)

    Daubenfeld, Thorsten; Zenker, Dietmar

    2015-01-01

    We designed, implemented, and evaluated a game-based learning approach to increase student motivation and achievement for an undergraduate physical chemistry course. By focusing only on the most important game aspects, the implementation was realized with a production ratio of 1:8 (study load in hours divided by production effort in hours).…

  8. Late course accelerated fractionation in radiotherapy of esophageal carcinoma

    International Nuclear Information System (INIS)

    Shi, X.-H.; Yao, W.; Liu, T.

    1999-01-01

    Purpose: To evaluate the efficacy of adding accelerated fractionation after completing two thirds of routine fractionated radiotherapy in esophageal carcinoma.Methods and materials: From April 1988 to April 1990, 85 patients with histologically confirmed carcinoma of the esophagus were randomized into two groups. (1) The conventional fractionation (CF) group, received 1.8 Gy per day five times a week to a total dose of 68.4 Gy in 7-8 weeks, and (2) the late course accelerated hyperfractionated (LCAF) group which received the same schedule as the CF group during the first two thirds of the course of radiotherapy to a dose of 41.4 Gy/23 fx/4 to 5 weeks. This was then followed by accelerated hyperfractionation using reduced fields. In the LCAF portion of the radiotherapeutic course, the irradiation schedule was changed to 1.5 Gy twice a day, with an interval of 4 h between fractions, to a dose of 27 Gy/18 fx. Thus the total dose was also 68.4 Gy, the same as the CF group, but the course of radiotherapy was shorter, being only 6.4 weeks. The same Cobalt 60 teletherapy unit was used to treat all the cases.Results: The 5 year actuarial survival and disease-free survival rates in the LCAF group were 34% and 42%, as compared to 15% and 15% respectively in the CF group, all statistically significant. Better local control was seen in the LCAF group than in the CF group, the 5 year control rates being 55% versus 21% (P=0.003). The acute reactions were increased but acceptable in the LCAF patients, the radiation treatments could be completed without any breaks. The late reactions as observed after 5 years were not increased in comparison with the CF patients.Conclusions: The results from this study show that the late course accelerated hyperfractionated radiotherapy regime can improve results in esophageal carcinoma, with acceptable acute reactions as compared to conventional radiotherapy. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  9. Prediction of clinical course of glioblastomas by MRI during radiotherapy

    International Nuclear Information System (INIS)

    Leitzen, Christina; Schild, Hans H.; Bungart, Birgitta; Luetter, Christiana; Muedder, Thomas; Wilhelm-Buchstab, Timo; Schueller, Heinrich; Herrlinger, Ulrich

    2010-01-01

    Purpose: Determine the value of MR studies in patients undergoing radiotherapy for glioblastomas pre and during radiotherapy to predict the clinical course. Patients and Methods: MR follow-up studies were performed in 33 patients with glioblastomas before radiotherapy, after 30 Gy, after 60 Gy, and in the treatment follow-up. Findings on MR were categorized into: definite progress, questionable progress, status idem. Patients were followed clinically (median for 11 months). Results: After 30 Gy 23/33 (70%) of the MR examination showed status idem. 10/33 (30%) demonstrated definite (n = 6) or questionable (n = 4) progress. Further tumor progress was faster in these patients and patients succumb to their disease earlier (9 vs. 22 months). The 60 Gy study showed definite (n = 8) and questionable (n = 6) progress in 14/33 (42%) cases. All these tumors were progressing faster and were associated with a comparatively reduced life expectancy. Conclusion: MR follow-up studies after 30 Gy in patients undergoing radiotherapy for glioblastomas allow for prognostic appraisal, and potentially early modification of treatment. (orig.)

  10. Short-course palliative radiotherapy for uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won [Dept. of Radiation Oncology, Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of); Nam, Ji Ho; Jeon, Sang Ho [Dept. of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2013-12-15

    The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

  11. Short-course palliative radiotherapy for uterine cervical cancer

    International Nuclear Information System (INIS)

    Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won; Nam, Ji Ho; Jeon, Sang Ho

    2013-01-01

    The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

  12. Quality controls in radiotherapy. From experiences of the first course-debate

    International Nuclear Information System (INIS)

    Rosi, A.; Viti, V.

    2000-01-01

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

  13. SU-F-T-251: The Quality Assurance for the Heavy Patient Load Department in the Developing Country: The Primary Experience of An Entire Workflow QA Process Management in Radiotherapy

    International Nuclear Information System (INIS)

    Xie, J; Wang, J; Peng, J; Chen, J; Hu, W

    2016-01-01

    Purpose: To implement an entire workflow quality assurance (QA) process in the radiotherapy department and to reduce the error rates of radiotherapy based on the entire workflow management in the developing country. Methods: The entire workflow QA process management starts from patient registration to the end of last treatment including all steps through the entire radiotherapy process. Error rate of chartcheck is used to evaluate the the entire workflow QA process. Two to three qualified senior medical physicists checked the documents before the first treatment fraction of every patient. Random check of the treatment history during treatment was also performed. A total of around 6000 patients treatment data before and after implementing the entire workflow QA process were compared from May, 2014 to December, 2015. Results: A systemic checklist was established. It mainly includes patient’s registration, treatment plan QA, information exporting to OIS(Oncology Information System), documents of treatment QAand QA of the treatment history. The error rate derived from the chart check decreases from 1.7% to 0.9% after our the entire workflow QA process. All checked errors before the first treatment fraction were corrected as soon as oncologist re-confirmed them and reinforce staff training was accordingly followed to prevent those errors. Conclusion: The entire workflow QA process improved the safety, quality of radiotherapy in our department and we consider that our QA experience can be applicable for the heavily-loaded radiotherapy departments in developing country.

  14. SU-F-T-251: The Quality Assurance for the Heavy Patient Load Department in the Developing Country: The Primary Experience of An Entire Workflow QA Process Management in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Xie, J; Wang, J; Peng, J; Chen, J; Hu, W [Fudan University Shanghai Cancer Center, Shanghai, Shanghai (China)

    2016-06-15

    Purpose: To implement an entire workflow quality assurance (QA) process in the radiotherapy department and to reduce the error rates of radiotherapy based on the entire workflow management in the developing country. Methods: The entire workflow QA process management starts from patient registration to the end of last treatment including all steps through the entire radiotherapy process. Error rate of chartcheck is used to evaluate the the entire workflow QA process. Two to three qualified senior medical physicists checked the documents before the first treatment fraction of every patient. Random check of the treatment history during treatment was also performed. A total of around 6000 patients treatment data before and after implementing the entire workflow QA process were compared from May, 2014 to December, 2015. Results: A systemic checklist was established. It mainly includes patient’s registration, treatment plan QA, information exporting to OIS(Oncology Information System), documents of treatment QAand QA of the treatment history. The error rate derived from the chart check decreases from 1.7% to 0.9% after our the entire workflow QA process. All checked errors before the first treatment fraction were corrected as soon as oncologist re-confirmed them and reinforce staff training was accordingly followed to prevent those errors. Conclusion: The entire workflow QA process improved the safety, quality of radiotherapy in our department and we consider that our QA experience can be applicable for the heavily-loaded radiotherapy departments in developing country.

  15. Late course accelerated hyperfractionated radiotherapy of nasopharyngeal carcinoma (LCAF)

    International Nuclear Information System (INIS)

    He Xiayun; Liu Taifu; He Shaoqin; Huan Sulan; Pan Ziqiang

    2007-01-01

    Background and purpose: To study the efficacy of late course accelerated fractionated (LCAF) radiotherapy in the treatment of nasopharyngeal carcinoma (NPC). The end-points were local control, radiation-induced complications, and factors influencing survival. Patients and methods: Between December 1995 and April 1998, 178 consecutive NPC patients were admitted for radiation treatment. The radiation beam used was 60 Co γ or 6 MV X rays. For the first two-thirds of the treatment, two daily fractions of 1.2 Gy were given to the primary lesion, with an interval of ≥6 h, 5 days per week to a total dose of 48 Gy/40 fractions, over a period of 4 weeks. For the last third of the treatment, i.e., beginning the 5th week of treatment, an accelerated hyperfractionated schedule was carried out. The dose per fraction was increased to 1.5 Gy, 2 fractions per day with an interval of ≥6 h, the total dose for this part of the protocol was 30 Gy/20 fractions over 2 weeks. Thus the total dose was 78 Gy in 60 fractions in 6 weeks. Results: All patients completed the treatment. Acute mucositis: none in 2 cases, Grade 1 in 43 cases, Grade 2 in 78 cases, Grade 3 in 52 cases, and Grade 4 in 3 cases. Local control rate: the 5 year nasopharyngeal local control rate was 87.7%, and the cervical lymph nodes local control rate was 85.7%. The 5-year distant metastasis rate was 26.1%, and 5 year survivals were 67.9%, 16 (9%) patients had radiation-induced cranial nerve palsy, 7(4%) patients had temporal lobe or brainstem damage. Conclusions: With this treatment schedule, patients' tolerance was good, local control and 5 year survivals were better than conventional fractionation schedules, and radiation-related late complications did not increase, as 5-year survival rates of conventional fractionation radiotherapy were only 58%. Randomized clinical trials are being carried out to further confirm the efficacy of LCAF for nasopharyngeal carcinoma

  16. All in: expansion of the acquisition of data for outcomes and procedure transfer (ADOPT) program to an entire SAGES annual meeting hands-on hernia course.

    Science.gov (United States)

    Dort, Jonathan; Trickey, Amber; Paige, John; Schwarz, Erin; Cecil, Tom; Coleman, Mark; Dunkin, Brian

    2018-05-01

    Continuing professional development (CPD) for the surgeon has been challenging because of a lack of standardized approaches of hands-on courses, resulting in poor post-course outcomes. To remedy this situation, SAGES has introduced the ADOPT program, implementing a standardized, long-term mentoring program as part of its hernia hands-on course. Previous work evaluating the pilot program showed increased adoption of learned procedures as well as increased confidence of the mentored surgeons. This manuscript describes the impact of such a program when it is instituted across an entire hands-on course. Following collection of pre-course benchmark data, all participants in the 2016 SAGES hands-on hernia course underwent structured, learner-focused instruction during the cadaveric lab. All faculty had completed a standardized teaching course in the Lapco TT format. Subsequently, course participants were enrolled in a year-long program involving longitudinal mentorship, webinars, conference calls, and coaching. Information about participant demographics, training, experience, self-reported case volumes, and confidence levels related to procedures were collected via survey 3 months prior to 9 months after the course. Twenty surgeons participated in the SAGES ADOPT 2016 hands-on hernia program. Of these, seventeen completed pre-course questionnaires (85%), ten completed the 3-month questionnaire (50%), and four completed the 9-month questionnaire (20%). Nine of ten respondents of the 3-month survey (90%) reported changes in their practice. In the 9-month survey, significant increases in the annualized procedural volumes were reported for open primary ventral hernia repair, open components separation, and mesh insertion for ventral hernia repair (p ADOPT program to an entire hands-on hernia course is both feasible and beneficial, with evidence of Kirkpatrick Levels 1-4a training effectiveness. This expanded success suggests that it is a useful blueprint for the CPD of

  17. Do patients' information needs decrease over the course of radiotherapy?

    NARCIS (Netherlands)

    Douma, Kirsten F. L.; Koning, Caro C. E.; Zandbelt, Linda C.; de Haes, Hanneke C. J. M.; Smets, Ellen M. A.

    2012-01-01

    We aimed to investigate if cancer patients' information needs decrease during radiotherapy and if so, which patient, consultation and radiation oncologist characteristics are associated with a decrease in information needs over time. In this longitudinal study, patients (n = 104) completed a

  18. Survey of potential improvements during the course of the radiotherapy treatment. A patient questionnaire

    International Nuclear Information System (INIS)

    Momm, Felix; Jooss, David; Adebahr, Sonja; Duncker-Rohr, Viola; Heinemann, Felix; Kirste, Simon; Messmer, Marc-Benjamin; Grosu, Anca-Ligia; Xander, Carola J.; Becker, Gerhild

    2011-01-01

    In the context of quality assurance, increasing demands are placed on the whole radiotherapy treatment process. The patients directly concerned generally do not realize most aspects of the quality assurance program (e.g., additional safety checks) during their daily therapy. It was the aim of this study to systematically ask patients about potential improvements during the course of radiotherapy treatment from their own perspective. In the defined time span (1 month), 624 radiotherapy patients (600 questionnaires were returned, 96.2%) were interviewed using a questionnaire newly developed to inquire about several aspects of their treatment. Furthermore, they were asked for their specific needs and suggestions for improvements that could be made during the course of radiotherapy treatment. Overall, the patients were satisfied with the course of their radiotherapy treatment and with patient care. As an example, about 90% agreed with the statement: ''My first contact with the radiation oncology unit proceeded with kindness and competence so that I was given the impression that I will be well cared for in this clinic.'' Considering the organization of the course of radiotherapy, a large majority of patients attached great value to set appointments for the therapy fractions. A main point of criticism was waiting times or delays caused by servicing or machine failures. Small, low cost improvements as music in the therapy room were considered as important as expensive measures (e.g., daylight in the therapy room). The patients emphasized the importance of staff friendliness. The situation of radiotherapy patients was, in general, satisfactory. Future improvements can be mainly expected from smooth organisation of both planning and treatment which can be achieved by electronic scheduling systems. Many results of the survey could be easily implemented in daily practice. In matters of organization radiation oncology with its complex procedures can be used as a model for

  19. A Bile Duct Cancer Patient Whose Stent Shifted Significantly Over the Course of External Beam Radiotherapy

    International Nuclear Information System (INIS)

    Yun, Hyong Geun

    2011-01-01

    The author reports a bile duct cancer patient whose stent shifted significantly from right to left over the course of radiotherapy. The 80-year-old female patient had a short stature with thoracic kyphosis and mutiple spinal compression fractures. She was also emaciated and very lean. By comparing the weekly scanned computed tomography images, the author found her stent to have shifted by more than 4 cm from right to left over the course of external beam radiotherapy. The results of this case study suggest that for a very lean and emaciated kyphotic bile duct cancer patient, the possibility of large interfractional movement of the bile duct or stent during radiotherapy should be considered.

  20. Anxiety and its time courses during radiotherapy for non-metastatic breast cancer: A longitudinal study

    OpenAIRE

    Lewis, Florence; Merckaert, Isabelle; Liénard, Aurore; Libert, Yves; Etienne, Anne-Marie; Reynaert, Christine; Slachmuylder, Jean-Louis; Scalliet, Pierre; Van Houtte, Paul; COUCKE, Philippe; Salamon, Emile; Razavi, Darius

    2014-01-01

    Purpose: To our knowledge, no study has specifically assessed the time course of anxiety during radiotherapy (RT). The objective of this study was to assess anxiety time courses in patients with nonmetastatic breast cancer. Material and methods: This multicenter, descriptive longitudinal study included 213 consecutive patients with breast cancer who completed visual analog scales (VASs) assessing state anxiety before and after the RT simulation and the first and last five RT se...

  1. Interfractional changes in tumour volume and position during entire radiotherapy courses for lung cancer with respiratory gating and image guidance

    DEFF Research Database (Denmark)

    Juhler-Nøttrup, Trine; Korreman, Stine Sofia; Pedersen, Anders N

    2008-01-01

    were contoured on each CT scan to evaluate the variations in volumes and position. The lung tumours and the mediastinal tumours were contoured separately. The positional variations were measured as 3D mobility vectors and correlated to matching of the scans using the two different strategies. RESULTS......-87% when matched using bony landmarks and 70-76% when matched using skin tattoos. The overlap of the mediastinal tumours were 60-65% and 41-47%, respectively. CONCLUSIONS: Despite the use of gating the tumours varied considerably, regarding both position and volume. The variations in position were...

  2. Ultrashort courses of adjuvant breast radiotherapy: wave of the future or a fool's errand?

    Science.gov (United States)

    Khan, Atif J; Dale, Roger G; Arthur, Douglas W; Haffty, Bruce G; Todor, Dorin A; Vicini, Frank A

    2012-04-15

    In accelerated partial breast irradiation (APBI), the most commonly used fractionation schemes include 340 or 385 centigrays delivered in a twice daily administration. A further progression of the APBI literature has been the recent interest in extremely short courses of adjuvant radiotherapy, usually delivered by intraoperative radiotherapy techniques. This newer area of single-fraction radiotherapy approaches remains highly contentious. In particular, the recently reported TARGIT trial has been the subject of both praise and scorn, and a critical examination of the trial data and the underlying hypotheses is warranted. Short-term outcomes of the related Italian ELIOT approach have also been reported. Although the assumptions of linear quadratic formalism are likely to hold true in the range of 2 to 8 grays, equating different schedules beyond this range is problematic. A major problem of current single-fraction approaches is that the treatment doses are chosen empirically, or are based on tolerability, or on the physical dose delivery characteristics of the chosen technology rather than radiobiological rationale. This review article summarizes the current data on ultrashort courses of adjuvant breast radiotherapy and highlights both the promise and the potential pitfalls of the abbreviated treatment. Copyright © 2011 American Cancer Society.

  3. Radiotherapy

    International Nuclear Information System (INIS)

    Prosnitz, L.R.; Kapp, D.S.; Weissberg, J.B.

    1983-01-01

    This review highlights developments over the past decade in radiotherapy and attempts to summarize the state of the art in the management of the major diseases in which radiotherapy has a meaningful role. The equipment, radiobiology of radiotherapy and carcinoma of the lung, breast and intestines are highlighted

  4. A national cohort study of long-course preoperative radiotherapy in primary fixed rectal cancer in Denmark

    DEFF Research Database (Denmark)

    Bulow, S.; Jensen, L.H.; Altaf, R.

    2010-01-01

    OBJECTIVE: Preoperative radiotherapy has been shown to enable a fixed rectal cancer to become resectable which in turn may result in long-time survival. In this study, we analysed the outcome of long-course preoperative radiotherapy in fixed rectal cancer in a national cohort including all Danish...... patients registered with primary inoperable rectal cancer and treated in the period May 2001 to December 2005. METHOD: The study was based on surgical and demographic data from a continuously updated and validated national database. In addition, retrospective data were retrieved from all departments...... of radiotherapy concerning technique of radiotherapy, dose and fractionation and use of concomitant chemotherapy. Outcome was determined by actuarial analysis of local control, disease-free survival and overall survival. RESULTS: A total of 258 patients with fixed rectal cancer received long-course radiotherapy...

  5. Clinical outcome in 520 consecutive Danish rectal cancer patients treated with short course preoperative radiotherapy

    DEFF Research Database (Denmark)

    Jensen, L H; Altaf, R; Harling, H

    2010-01-01

    AIM: The purpose of this study was to analyse the results of preoperative short course radiotherapy in a consecutive, national cohort of patients with rectal cancer. METHODS: Through a validated, prospective national database we identified 520 Danish patients who presented with high-risk mobile...... tumours in the lower two thirds of the rectum and were referred for preoperative radiotherapy with 5 x 5 Gy. The inclusion period was 56 months. Radiotherapy data was retrospectively collected. RESULTS: Of the 520 patients, 514 completed radiotherapy and 506 had surgery. Surgery was considered curative...... in 439 patients. The 3-year local recurrence rate was 4.0% (95% CI 2.5-6.5%) and the distant recurrence rate at 3 years was 18.7% (95% CI 15.4-22.5%). The 5-year disease free survival rate was 40.2% (95% CI 27.0-53.1%) and overall survival 50.4% (95% CI 36.1-63.1%). Most tumours (61%) were classified...

  6. TH-E-BRF-01: Exploiting Tumor Shrinkage in Split-Course Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Unkelbach, J; Craft, D; Hong, T; Papp, D; Wolfgang, J; Bortfeld, T [Massachusetts General Hospital, Boston, MA (United States); Ramakrishnan, J [University of Wisconsin, Madison, Wisconsin (United States); Salari, E [Wichita State University, Wichita, KS (United States)

    2014-06-15

    Purpose: In split-course radiotherapy, a patient is treated in several stages separated by weeks or months. This regimen has been motivated by radiobiological considerations. However, using modern image-guidance, it also provides an approach to reduce normal tissue dose by exploiting tumor shrinkage. In this work, we consider the optimal design of split-course treatments, motivated by the clinical management of large liver tumors for which normal liver dose constraints prohibit the administration of an ablative radiation dose in a single treatment. Methods: We introduce a dynamic tumor model that incorporates three factors: radiation induced cell kill, tumor shrinkage, and tumor cell repopulation. The design of splitcourse radiotherapy is formulated as a mathematical optimization problem in which the total dose to the liver is minimized, subject to delivering the prescribed dose to the tumor. Based on the model, we gain insight into the optimal administration of radiation over time, i.e. the optimal treatment gaps and dose levels. Results: We analyze treatments consisting of two stages in detail. The analysis confirms the intuition that the second stage should be delivered just before the tumor size reaches a minimum and repopulation overcompensates shrinking. Furthermore, it was found that, for a large range of model parameters, approximately one third of the dose should be delivered in the first stage. The projected benefit of split-course treatments in terms of liver sparing depends on model assumptions. However, the model predicts large liver dose reductions by more than a factor of two for plausible model parameters. Conclusion: The analysis of the tumor model suggests that substantial reduction in normal tissue dose can be achieved by exploiting tumor shrinkage via an optimal design of multi-stage treatments. This suggests taking a fresh look at split-course radiotherapy for selected disease sites where substantial tumor regression translates into reduced

  7. TH-E-BRF-01: Exploiting Tumor Shrinkage in Split-Course Radiotherapy

    International Nuclear Information System (INIS)

    Unkelbach, J; Craft, D; Hong, T; Papp, D; Wolfgang, J; Bortfeld, T; Ramakrishnan, J; Salari, E

    2014-01-01

    Purpose: In split-course radiotherapy, a patient is treated in several stages separated by weeks or months. This regimen has been motivated by radiobiological considerations. However, using modern image-guidance, it also provides an approach to reduce normal tissue dose by exploiting tumor shrinkage. In this work, we consider the optimal design of split-course treatments, motivated by the clinical management of large liver tumors for which normal liver dose constraints prohibit the administration of an ablative radiation dose in a single treatment. Methods: We introduce a dynamic tumor model that incorporates three factors: radiation induced cell kill, tumor shrinkage, and tumor cell repopulation. The design of splitcourse radiotherapy is formulated as a mathematical optimization problem in which the total dose to the liver is minimized, subject to delivering the prescribed dose to the tumor. Based on the model, we gain insight into the optimal administration of radiation over time, i.e. the optimal treatment gaps and dose levels. Results: We analyze treatments consisting of two stages in detail. The analysis confirms the intuition that the second stage should be delivered just before the tumor size reaches a minimum and repopulation overcompensates shrinking. Furthermore, it was found that, for a large range of model parameters, approximately one third of the dose should be delivered in the first stage. The projected benefit of split-course treatments in terms of liver sparing depends on model assumptions. However, the model predicts large liver dose reductions by more than a factor of two for plausible model parameters. Conclusion: The analysis of the tumor model suggests that substantial reduction in normal tissue dose can be achieved by exploiting tumor shrinkage via an optimal design of multi-stage treatments. This suggests taking a fresh look at split-course radiotherapy for selected disease sites where substantial tumor regression translates into reduced

  8. Radiotherapy

    Directory of Open Access Journals (Sweden)

    Rema Jyothirmayi

    1999-01-01

    Full Text Available Purpose. Conservative treatment in the form of limited surgery and post-operative radiotherapy is controversial in hand and foot sarcomas, both due to poor radiation tolerance of the palm and sole, and due to technical difficulties in achieving adequate margins.This paper describes the local control and survival of 41 patients with soft tissue sarcoma of the hand or foot treated with conservative surgery and radiotherapy. The acute and late toxicity of megavoltage radiotherapy to the hand and foot are described. The technical issues and details of treatment delivery are discussed. The factors influencing local control after radiotherapy are analysed.

  9. Prospective randomized trail on chrono-chemotherapy + late course three dimensional conformal radio-therapy and conventional chemotherapy plus radiotherapy for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Jin Feng; Ouyang Jinling; Dong Hongmin; Wu Weili; Chen Haixia; He Zhihui

    2005-01-01

    Objective: To compare the therapeutic effects, toxic side effects of late-course three dimensional conformal radiotherapy plus chrono-chemotherapy (DDP + 5-FU/CF) and conventional radiotherapy plus chemotherapy for nasopharyngeal carcinoma (NPC). Methods: Eighty -six NPC patients admitted from Feb. 2001 to Jan. 2002 were divided randomly into two groups: 1. Chrono-chemotherapy + late course three dimensional conformal radiotherapy(CCR) group-44 patients were treated by late course three dimensional conformal radio-therapy plus chrono-chemotherapy, and 2. Routine-chemotherapy-radiotherapy (RCR) group-42 patients were treated by routine chemotherapy plus radiotherapy. The patients in CCR and RCR group were comparable in age, KPS, stage and pathology. All patients were treated by combined chemotherapy and radiotherapy, with chemotherapy stared 2 weeks ahead of radiotherapy. Chemotherapy: Braun pump was used in all drug infusions; 1. CCR group-DDP 80 mg/ m 2 starting from 10:00 until 22:00, 5-Fu 750 mg/d/m 2 starting from 22:00 until 10:00 next day, CF 200 mg/d/m 2 starting from 10:00 every day, infused at normal speed. These drugs were given for 3 days, 14 days as one cycle, totally 2 cycle, and 2. RCR group-with the same drugs at the same total dose, only with the difference being DDP and CF given QD, starting from 10:00 but at the normal speed. 5-Fu was given through-out the day and continuously for 3 days, totally for 2 cycles. Radiotherapy: linear accelerator irradiation was given to either group. Composite facio-cervical field + anterior cervical tangential field to D T 40 Gy/4w, followed by the coned down per-auricular field plus anterior tangential field or β beam irradiation. In CCR group, after D T 40gy/4w, late course 3-dimensional conformal radiotherapy (3DCRT) was used to add D T 30Gy/3w. In RCR group, routine radiotherapy of 40 Gy/w was supplemented with 30 Gy/3w. The total dose in either group was 70 Gy/7w at the nasopharynx, D T 60-70 Gy/6-7w at the

  10. Radiotherapy

    International Nuclear Information System (INIS)

    Zedgenidze, G.A.; Kulikov, V.A.; Mardynskij, Yu.S.

    1984-01-01

    The technique for roentgenotopometric and medicamentous preparation of patients for radiotherapy has been reported in detail. The features of planning and performing of remote, intracavitary and combined therapy in urinary bladder cancer are considered. The more effective methods of radiotherapy have been proposed taking into account own experience as well as literature data. The comparative evaluation of treatment results and prognosis are given. Radiation pathomorphism of tumors and tissues of urinary bladder is considered in detail. The problems of diagnosis, prophylaxis and treatment of complications following radiodiagnosis and radiotherapy in patients with urinary bladder cancer are illustrated widely

  11. Short-course radiotherapy in elderly patients with glioblastoma. Feasibility and efficacy of results from a single centre

    Energy Technology Data Exchange (ETDEWEB)

    Fariselli, L.; Pinzi, V.; Milanesi, I.; Marchetti, M. [Neurological Carlo Besta Institute Foundation, Milan (Italy). Dept. of Neurosurgery; Silvani, A.; Salmaggi, A. [Neurological Carlo Besta Institute Foundation, Milan (Italy). Div. of Neurooncology; Farinotti, M. [Neurological Carlo Besta Institute Foundation, Milan (Italy). Epidemiology Unit

    2013-06-15

    Background: The incidence of glioblastoma (GBM) in the elderly population is currently increasing, with a peak seen between 65 and 84 years. The optimal treatment in terms of both efficacy and quality of life still remains a relevant and debated issue today. The purpose of our study was to evaluate the feasibility of short-course hypofractionated accelerated radiotherapy (HART) in GBM patients aged over 70 years and with a good Karnofsky performance score (KPS). Methods: A review of medical records at the 'Istituto Neurologico C. Besta' was undertaken; patients aged {>=} 70 years who had undergone adjuvant HART for GBM between January 2000 and January 2004 were included in the study. HART was administered to a total dose of 45 Gy, 2.5 Gy/fraction, in three daily fractions for three consecutive days/cycle fractions each, delivered in two cycles (split 15 days). Results: A total of 33 patients were evaluable for the current analysis. Median follow-up was 10 months. According to CTCAE (version 3.0) criteria, none of the patients developed radiation-induced neurological status deterioration or necrosis. KPS evaluation after HART was found to be stable in 73 % of patients, improved in 24 %, and worse in 3 %. The median overall survival time of the entire study population was 8 months (range 2-24). Conclusions: Our findings suggest that a hypofractionated accelerated schedule can be a safe and effective option in the treatment of GBM in the elderly. (orig.)

  12. Results of a prospective randomised trial comparing conventional radiotherapy to split course bifractionated radiation therapy in patients with nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Daoud, Jamel; Toumi, Nabil; Siala, Wissem; Ghorbel, Abdelmonem; Drira, Mohamed Mokthar; Frikha, Mounir

    2007-01-01

    Background and purpose: Nasopharyngeal carcinoma (NPC) is generally responsive to radiation therapy. However therapeutic results after conventional radiotherapy remain relatively poor especially for patients with locoregional advanced NPC. The aim of this study was to evaluate the impact of a split course bifractionated radiotherapy regimen in a phase III randomised trial. Patients and methods: From January 1997 to September 2003, 154 patients with M0 histologically proven NPC were treated in our institution. They were staged according to the American Joint Committee on Cancer - International Union Against Cancer (AJCC-UICC) 1986 TNM classification. Patients with locally advanced nodal disease (N2-N3) received induction chemotherapy. All patients were randomised to receive either conventional radiotherapy at 2 Gy/fraction/day, 5 days/week to 70 Gy/7 weeks or split course bifractionated radiotherapy at 1.6 Gy/fraction, twice daily, 5 days/week to 70.4 Gy/6 weeks. Response and toxicity were evaluated according to the WHO and RTOG criteria. Results: Patients were well balanced between the two arms. The complete remission rate was 91% in conventional radiotherapy arm and 93% in bifractionated radiotherapy arm (p = 0.3). There was more grade II-III skin fibrosis in experimental arm with a 5 year actuarial probability of 66% vs 52% (p = 0.04). Locoregional and distant relapses occurred in 34% of cases in conventional arm and 38% in experimental arm (p = 0.28). With a median follow-up of 56 months, the 5 year overall survival and the disease free survival rates were, respectively (71% and 61%), in conventional arm and (62% and 60%) in bifractionated arm, the difference being statistically non significant. Comments: The present trial comparing conventional radiotherapy to a split course bifractionated radiation therapy failed to demonstrate significant improvement in locoregional control and survival in experimental arm which was associated with more grade II-III skin

  13. Radiotherapy

    International Nuclear Information System (INIS)

    Wannenmacher, M.; Debus, J.; Wenz, F.

    2006-01-01

    The book is focussed on the actual knowledge on the clinical radiotherapy and radio-oncology. Besides fundamental and general contributions specific organ systems are treated in detail. The book contains the following contributions: Basic principles, radiobiological fundamentals, physical background, radiation pathology, basics and technique of brachytherapy, methodology and technique of the stereotactic radiosurgery, whole-body irradiation, operative radiotherapy, hadron therapy, hpyerthermia, combined radio-chemo-therapy, biometric clinical studies, intensity modulated radiotherapy, side effects, oncological diagnostics; central nervous system and sense organs, head-neck carcinomas, breast cancer, thorax organs, esophagus carcinoma, stomach carcinoma, pancreas carcinoma, heptabiliary cancer and liver metastases, rectal carcinomas, kidney and urinary tract, prostate carcinoma, testicular carcinoma, female pelvis, lymphatic system carcinomas, soft tissue carcinoma, skin cancer, bone metastases, pediatric tumors, nonmalignant diseases, emergency in radio-oncology, supporting therapy, palliative therapy

  14. Electrocardiographic changes is patients with esophageal carcinoma exposed to radiotherapy by a continuous and split course

    Energy Technology Data Exchange (ETDEWEB)

    Sarkisyan, Yu Kh; Goncharova, I M; Kallistova, L P; Syromyatnikova, E N; Slaviner, S I; Abramchenko, Yu A [Nauchno-Issledovatel' skij Inst. Rentgenologii i Radiologii, Moscow (USSR)

    1980-10-01

    An analysis of clinical, electrocardiographic, roentgenological and biochemical changes was made in 170 patients with esophageal carcinoma before, during and after radiation therapy conducted by a continuous (34 patients) and split course (136 patients). A rise in sinus tachycardia, appearance of extrasystolia and His' bundle right branch block, lowering of the ST-segment, flattening or appearance of negative T wave, an increase in the activity of creatine phosphokinase and aspartate aminotransferase in the blood serum were noted in a number of patients during radiation therapy. The changes were observed more often and were more marked in patients who had received continuous telegammatherapy. Irrespective of the method of radiotherapy in the restoration of the processes of excitation and conduction, improvement of metabolism in the cardiac muscle, a decrease in dysproteinemia, an increase in the content of electrolytes in the blood were noted.

  15. Radiotherapy.

    Science.gov (United States)

    Krause, Sonja; Debus, Jürgen; Neuhof, Dirk

    2011-01-01

    Solitary plasmocytoma occurring in bone (solitary plasmocytoma of the bone, SBP) or in soft tissue (extramedullary plasmocytoma, EP) can be treated effectively and with little toxicity by local radiotherapy. Ten-year local control rates of up to 90% can be achieved. Patients with multiple myeloma often suffer from symptoms such as pain or neurological impairments that are amenable to palliative radiotherapy. In a palliative setting, short treatment schedules and lower radiation doses are used to reduce toxicity and duration of hospitalization. In future, low-dose total body irradiation (TBI) may play a role in a potentially curative regimen with nonmyeloablative conditioning followed by allogenic peripheral blood stem cell transplantation.

  16. Measurement of prostate movement over the course of routine radiotherapy using implanted markers

    International Nuclear Information System (INIS)

    Balter, James M.; Sandler, Howard M.; Lam, Kwok; Bree, Robert L.; Lichter, Allen S.; Haken, Randall K. ten

    1995-01-01

    Purpose: To measure the range and frequency of occurrence of intertreatment movement of the prostate gland over the course of radiotherapy, and to demonstrate that the prostate may move independently of the surrounding bones of the pelvis. Methods and Materials: Ten patients underwent implantation of radiopaque markers around the prostate. Orthogonal portal films were taken at multiple stages during the course of treatment and digitized. An image registration tool was used to solve for film detector placement and, subsequently, to determine positional changes between structures on a reference portal image pair and all subsequent pairs for each patient. Transformations describing prostate movement were measured independently of those describing setup variations of the pelvic girdle. Results: Translation and/or rotation of the prostate was detected in 70% of the treatments for which films were taken. The maximum measured displacement was 7.5 mm along a major axis. Typical translations of the prostate were between 0-4 mm. The translation and rotation had a predominant direction, suggesting a natural axis for prostate movement. Conclusion: Although significant prostate displacement can occur between treatments, the typical range of movement seen along a major axis was less than 5 mm. Proper treatment planning should consider the movement of the target independent of surrounding bony anatomy. Advances in online portal imaging, image registration, and dynamic field shaping may permit shaped fields that encompass the prostate gland in its position at the time of treatment, allowing for the use of smaller fields while ensuring proper target coverage

  17. Anxiety and its time courses during radiotherapy for non-metastatic breast cancer: A longitudinal study

    International Nuclear Information System (INIS)

    Lewis, Florence; Merckaert, Isabelle; Liénard, Aurore; Libert, Yves; Etienne, Anne-Marie; Reynaert, Christine; Slachmuylder, Jean-Louis; Scalliet, Pierre; Paul, Van Houtte; Coucke, Philippe

    2014-01-01

    Purpose: To our knowledge, no study has specifically assessed the time course of anxiety during radiotherapy (RT). The objective of this study was to assess anxiety time courses in patients with non-metastatic breast cancer. Material and methods: This multicenter, descriptive longitudinal study included 213 consecutive patients with breast cancer who completed visual analog scales (VASs) assessing state anxiety before and after the RT simulation and the first and last five RT sessions. Results: Pre- and post-session anxiety mean levels were highest at the RT simulation (respectively, 2.9 ± 2.9 and 1.6 ± 2.5) and first RT session (respectively, 3.4 ± 2.9 and 2.0 ± 2.4), then declined rapidly. Clinically relevant mean differences (⩾1 cm on the VAS) between pre- and post-simulation/session VAS scores were found only for the RT simulation (−1.3 ± 2.7; p < 0.001) and first RT session (−1.4 ± 2.4; p < 0.001). Five percent to 16% of patients presented clinically relevant anxiety (pre- and post-simulation/session VAS scores ⩾ 4 cm) throughout treatment. Conclusions: To optimize care, RT team members should offer all patients appropriate information about treatment at the simulation, check patients’ understanding, and identify patients with clinically relevant anxiety requiring appropriate support throughout RT

  18. Radiotherapy

    International Nuclear Information System (INIS)

    Pistenma, D.A.

    1980-01-01

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

  19. Short-course radiotherapy in elderly patients with glioblastoma: feasibility and efficacy of results from a single centre.

    Science.gov (United States)

    Fariselli, L; Pinzi, V; Milanesi, I; Silvani, A; Marchetti, M; Farinotti, M; Salmaggi, A

    2013-06-01

    The incidence of glioblastoma (GBM) in the elderly population is currently increasing, with a peak seen between 65 and 84 years. The optimal treatment in terms of both efficacy and quality of life still remains a relevant and debated issue today. The purpose of our study was to evaluate the feasibility of short-course hypofractionated accelerated radiotherapy (HART) in GBM patients aged over 70 years and with a good Karnofsky performance score (KPS). A review of medical records at the "Istituto Neurologico C. Besta" was undertaken; patients aged ≥ 70 years who had undergone adjuvant HART for GBM between January 2000 and January 2004 were included in the study. HART was administered to a total dose of 45 Gy, 2.5 Gy/fraction, in three daily fractions for three consecutive days/cycle fractions each, delivered in two cycles (split 15 days). A total of 33 patients were evaluable for the current analysis. Median follow-up was 10 months. According to CTCAE (version 3.0) criteria, none of the patients developed radiation-induced neurological status deterioration or necrosis. KPS evaluation after HART was found to be stable in 73 % of patients, improved in 24 %, and worse in 3 %. The median overall survival time of the entire study population was 8 months (range 2-24). Our findings suggest that a hypofractionated accelerated schedule can be a safe and effective option in the treatment of GBM in the elderly.

  20. Comparison of preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Guckenberger, M.; Saur, G.; Wehner, D.; Sweeney, R.A.; Flentje, M.; Thalheimer, A.; Germer, C.T.

    2012-01-01

    Background: The purpose of this work was to perform a single institution comparison between preoperative short-course radiotherapy (SC-RT) and long-course radiochemotherapy (LC-RCHT) for locally advanced rectal cancer. Methods: A total of 225 patients with clinical stage UICC II-III rectal cancer were treated with SC-RT (29 Gy in 10 twice daily fractions followed by immediate surgery; n = 108) or LC-RCHT (54 Gy in 28 fractions with simultaneous 5-fluorouracil (5-FU) ± oxaliplatin chemotherapy followed by delayed surgery; n = 117). All patients in the LC-RCHT cohort and patients in the SC-RT with pathological UICC stage ≥ II received adjuvant chemotherapy. Before 2004, the standard of care was SC-RT with LC-RCHT reserved for patients where downstaging was considered as required for sphincter preservation or curative resection. In the later period, SC-RT was practiced only for patients unfit for radiochemotherapy. Results: Patients in the LC-RCHT cohort had a significantly higher proportion of cT4 tumors, clinical node positivity, and lower tumor location. The 5-year local control (LC) and overall survival (OS) were 91% and 66% without differences between the SC-RT and LC-RCHT groups. Acute toxicity was increased during LC-RCHT (grade ≥ II 1% vs. 33%) and there were no differences in postoperative complications. Severe late toxicity grade ≥ III was increased after SC-RT (12% vs. 3%). Of patients aged > 80 years, 7 of 7 patients and 4 of 9 patients received curative surgery after SC-RT and LC-RCHT, respectively. Conclusion: Despite the fact that patients with worse prognostic factors were treated with LC-RCHT, there were no significant differences in LC and OS between the SC-RT and LC-RCHT group. Age > 80 years was identified as a significant risk factor for LC-RCHT and these patients could be treated preferably with SC-RT. (orig.)

  1. Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States.

    Science.gov (United States)

    Mowery, Yvonne M; Salama, Joseph K; Zafar, S Yousuf; Moore, Harvey G; Willett, Christopher G; Czito, Brian G; Hopkins, M Benjamin; Palta, Manisha

    2017-04-15

    Short-course radiotherapy (SC-RT) and long-course chemoradiotherapy (LC-CRT) are accepted neoadjuvant treatments of rectal cancer. In the current study, the authors surveyed US radiation oncologists to assess practice patterns and attitudes regarding SC-RT and LC-CRT for patients with rectal cancer. The authors distributed a survey to 1701 radiation oncologists regarding treatment of neoadjuvant rectal cancer. Respondents were asked questions regarding the number of patients with rectal cancer treated, preference for SC-RT versus LC-CRT, and factors influencing regimen choice. Of 1659 contactable physicians, 182 responses (11%) were received. Approximately 83% treated at least 5 patients with rectal cancer annually. The majority of responding radiation oncologists (96%) preferred neoadjuvant LC-CRT for the treatment of patients with locally advanced rectal cancer and 44% never used SC-RT. Among radiation oncologists using SC-RT, respondents indicated they would not recommend this regimen for patients with low (74%) or bulky tumors (70%) and/or concern for a positive circumferential surgical resection margin (69%). The most frequent reasons for not offering SC-RT were insufficient downstaging for sphincter preservation (53%) and a desire for longer follow-up (45%). Many radiation oncologists indicated they would prescribe SC-RT for patients not receiving chemotherapy (62%) or patients with a geographic barrier to receiving LC-CRT (82%). Patient comorbidities appeared to influence regimen preferences for 79% of respondents. Approximately 20% of respondents indicated that altered oncology care reimbursement using capitated payment by diagnosis would impact their consideration of SC-RT. US radiation oncologists rarely use neoadjuvant SC-RT despite 3 randomized controlled trials demonstrating no significant differences in outcome compared with LC-CRT. Further research is necessary to determine whether longer follow-up coupled with the benefits of lower cost, increased

  2. Students' perception of an integrated approach of teaching entire sequence of medicinal chemistry, pharmacology, and pharmacotherapeutics courses in PharmD curriculum.

    Science.gov (United States)

    Islam, Mohammed A; Schweiger, Teresa A

    2015-04-01

    To develop an integrated approach of teaching medicinal chemistry, pharmacology, and pharmacotherapeutics and to evaluate students' perceptions of integration as they progress through the PharmD curriculum. Instructors from each discipline jointly mapped the course contents and sequenced the course delivery based on organ systems/disease states. Medicinal chemistry and pharmacology contents were integrated and aligned with respective pharmacotherapeutics contents to deliver throughout second and third year of the curriculum. In addition to classroom lectures, active learning strategies such as recitation, case studies, online-discussion boards, open book quizzes, and writing patient progress notes were incorporated to enhance student learning. Student learning was assessed by examination scores, patient progress notes, and writing assignments. The impact of course integration was evaluated by a Web-based survey. One hundred and sixty-nine students completed the survey. Students exhibited positive attitude toward the integrated approach of teaching medicinal chemistry, pharmacology, and therapeutics. The P3 and P4 students better appreciated the benefits of integration compared to P2 students (P < .05). Students perceived the course integration as an effective way of learning. This study supports course improvement and the viability of expanding the concept of integration to other courses in the curriculum. © The Author(s) 2014.

  3. Short-Course Accelerated Radiotherapy in Palliative Treatment of Advanced Pelvic Malignancies: A Phase I Study

    Energy Technology Data Exchange (ETDEWEB)

    Caravatta, Luciana [Department of Radiation Oncology, Fondazione di Ricercae Cura ' Giovanni Paolo II,' Universita Cattolica del S. Cuore, Campobasso (Italy); Padula, Gilbert D.A. [Department of Radiation Oncology, Lacks Cancer Center Saint Mary' s Health Care, Grand Rapids, MI (United States); Macchia, Gabriella, E-mail: gmacchia@rm.unicatt.it [Department of Radiation Oncology, Fondazione di Ricercae Cura ' Giovanni Paolo II,' Universita Cattolica del S. Cuore, Campobasso (Italy); Ferrandina, Gabriella [Department of Gynecologic Oncology, Fondazione di Ricercae Cura ' Giovanni Paolo II,' Universita Cattolica del S. Cuore, Campobasso (Italy); Bonomo, Pierluigi; Deodato, Francesco; Massaccesi, Mariangela [Department of Radiation Oncology, Fondazione di Ricercae Cura ' Giovanni Paolo II,' Universita Cattolica del S. Cuore, Campobasso (Italy); Mignogna, Samantha; Tambaro, Rosa [Department of Palliative Therapies, Fondazione di Ricercae Cura ' Giovanni Paolo II,' Universita Cattolica del S. Cuore, Campobasso (Italy); Rossi, Marco [Department of Anaesthesia, Intensive Care, and Pain Medicine, Fondazione di Ricercae Cura ' Giovanni Paolo II,' Universita Cattolica del S. Cuore, Campobasso (Italy); Flocco, Mariano [' Madre Teresa di Calcutta' Hospice, Larino (Italy); Scapati, Andrea [Department of Radiation Oncology, ' San Francesco' Hospital, Nuoro (Italy); and others

    2012-08-01

    Purpose: To define the maximum tolerated dose of a conformal short-course accelerated radiotherapy in patients with symptomatic advanced pelvic cancer. Methods and Materials: A phase I trial in 3 dose-escalation steps was designed: 14 Gy (3.5-Gy fractions), 16 Gy (4-Gy fractions), and 18 Gy (4.5-Gy fractions). The eligibility criteria included locally advanced and/or metastatic pelvic cancer and Eastern Cooperative Oncology Group performance status of {<=}3. Treatment was delivered in 2 days with twice-daily fractionation and at least an 8-hour interval. Patients were treated in cohorts of 6-12 to define the maximum tolerated dose. The dose-limiting toxicity was defined as any acute toxicity of grade 3 or greater, using the Radiation Therapy Oncology Group scale. Pain was recorded using a visual analog scale. The effect on quality of life was evaluated according to Cancer Linear Analog Scale (CLAS). Results: Of the 27 enrolled patients, 11 were male and 16 were female, with a median age of 72 years (range 47-86). The primary tumor sites were gynecologic (48%), colorectal (33.5%), and genitourinary (18.5%). The most frequent baseline symptoms were bleeding (48%) and pain (33%). Only grade 1-2 acute toxicities were recorded. No patients experienced dose-limiting toxicity. With a median follow-up time of 6 months (range 3-28), no late toxicities were observed. The overall (complete plus partial) symptom remission was 88.9% (95% confidence interval 66.0%-97.8%). Five patients (41.7%) had complete pain relief, and six (50%) showed >30% visual analog scale reduction. The overall response rate for pain was 91.67% (95% confidence interval 52.4%-99.9%). Conclusions: Conformal short course radiotherapy in twice-daily fractions for 2 consecutive days was well tolerated up to a total dose of 18 Gy. A phase II study is ongoing to confirm the efficacy on symptom control and quality of life indexes.

  4. Short-Course Accelerated Radiotherapy in Palliative Treatment of Advanced Pelvic Malignancies: A Phase I Study

    International Nuclear Information System (INIS)

    Caravatta, Luciana; Padula, Gilbert D.A.; Macchia, Gabriella; Ferrandina, Gabriella; Bonomo, Pierluigi; Deodato, Francesco; Massaccesi, Mariangela; Mignogna, Samantha; Tambaro, Rosa; Rossi, Marco; Flocco, Mariano; Scapati, Andrea

    2012-01-01

    Purpose: To define the maximum tolerated dose of a conformal short-course accelerated radiotherapy in patients with symptomatic advanced pelvic cancer. Methods and Materials: A phase I trial in 3 dose-escalation steps was designed: 14 Gy (3.5-Gy fractions), 16 Gy (4-Gy fractions), and 18 Gy (4.5-Gy fractions). The eligibility criteria included locally advanced and/or metastatic pelvic cancer and Eastern Cooperative Oncology Group performance status of ≤3. Treatment was delivered in 2 days with twice-daily fractionation and at least an 8-hour interval. Patients were treated in cohorts of 6-12 to define the maximum tolerated dose. The dose-limiting toxicity was defined as any acute toxicity of grade 3 or greater, using the Radiation Therapy Oncology Group scale. Pain was recorded using a visual analog scale. The effect on quality of life was evaluated according to Cancer Linear Analog Scale (CLAS). Results: Of the 27 enrolled patients, 11 were male and 16 were female, with a median age of 72 years (range 47-86). The primary tumor sites were gynecologic (48%), colorectal (33.5%), and genitourinary (18.5%). The most frequent baseline symptoms were bleeding (48%) and pain (33%). Only grade 1-2 acute toxicities were recorded. No patients experienced dose-limiting toxicity. With a median follow-up time of 6 months (range 3-28), no late toxicities were observed. The overall (complete plus partial) symptom remission was 88.9% (95% confidence interval 66.0%-97.8%). Five patients (41.7%) had complete pain relief, and six (50%) showed >30% visual analog scale reduction. The overall response rate for pain was 91.67% (95% confidence interval 52.4%-99.9%). Conclusions: Conformal short course radiotherapy in twice-daily fractions for 2 consecutive days was well tolerated up to a total dose of 18 Gy. A phase II study is ongoing to confirm the efficacy on symptom control and quality of life indexes.

  5. Prognostic value of tumor regression evaluated after first course of radiotherapy for anal canal cancer

    International Nuclear Information System (INIS)

    Chapet, Olivier; Gerard, Jean-Pierre; Riche, Benjamin; Alessio, Annunziato; Mornex, Francoise; Romestaing, Pascale

    2005-01-01

    Purpose: To evaluate whether the tumor response after an initial course of irradiation predicts for colostomy-free survival and overall survival in patients with anal canal cancer. Methods and Materials: Between 1980 and 1998, 252 patients were treated by pelvic external-beam radiotherapy (EBRT) followed by a brachytherapy boost in 218 or EBRT in 34. EBRT was combined with chemotherapy in 168 patients. An evaluation of tumor regression, before the boost, was available for 221 patients. They were divided into four groups according to the tumor response: 80% but 80% vs. ≤80%. The group with a T3-T4 lesion and tumor regression ≤80% had the poorest overall (52.8% ± 12.3%), disease-free (19.9% ± 9.9%), and colostomy-free survival (24.8% ± 11.2%) rates. Conclusion: The amount of tumor regression before EBRT or brachytherapy boost is a strong prognostic factor of disease control without colostomy. When regression is ≤80% in patients with an initial T3-T4 lesion, the use of conservative RT should be carefully evaluated because of the very poor disease-free and colostomy-free survival

  6. Safety and adverse events of neoadjuvant short-course hyperfractionated accelerated radiotherapy (SC-HART) for rectal cancer

    International Nuclear Information System (INIS)

    Doi, Hiroshi; Kamikonya, Norihiko; Hirota, Shozo; Beppu, Naohito; Yanagi, Hidenori

    2014-01-01

    We presented good tolerability and short-term outcomes of neoadjuvant short-course hyperfractionated accelerated radiotherapy (SC-HART; 25 Gy in 10 fractions for 5 days) combined with chemotherapy in a total of 73 patients with lower rectal cancer. Age, gender, tumor differentiation, and the type of surgery seemed to have no apparent effects on toxicity of SC-HART. SC-HART appeared to have a good feasibility for use in further clinical trials. (author)

  7. Short-course radiotherapy followed by neo-adjuvant chemotherapy in locally advanced rectal cancer – the RAPIDO trial

    International Nuclear Information System (INIS)

    Nilsson, Per J; Marijnen, Corrie AM; Nagtegaal, Iris D; Wiggers, Theo; Glimelius, Bengt; Etten, Boudewijn van; Hospers, Geke AP; Påhlman, Lars; Velde, Cornelis JH van de; Beets-Tan, Regina GH; Blomqvist, Lennart; Beukema, Jannet C; Kapiteijn, Ellen

    2013-01-01

    Current standard for most of the locally advanced rectal cancers is preoperative chemoradiotherapy, and, variably per institution, postoperative adjuvant chemotherapy. Short-course preoperative radiation with delayed surgery has been shown to induce tumour down-staging in both randomized and observational studies. The concept of neo-adjuvant chemotherapy has been proven successful in gastric cancer, hepatic metastases from colorectal cancer and is currently tested in primary colon cancer. Patients with rectal cancer with high risk features for local or systemic failure on magnetic resonance imaging are randomized to either a standard arm or an experimental arm. The standard arm consists of chemoradiation (1.8 Gy x 25 or 2 Gy x 25 with capecitabine) preoperatively, followed by selective postoperative adjuvant chemotherapy. Postoperative chemotherapy is optional and may be omitted by participating institutions. The experimental arm includes short-course radiotherapy (5 Gy x 5) followed by full-dose chemotherapy (capecitabine and oxaliplatin) in 6 cycles before surgery. In the experimental arm, no postoperative chemotherapy is prescribed. Surgery is performed according to TME principles in both study arms. The hypothesis is that short-course radiotherapy with neo-adjuvant chemotherapy increases disease-free and overall survival without compromising local control. Primary end-point is disease-free survival at 3 years. Secondary endpoints include overall survival, local control, toxicity profile, and treatment completion rate, rate of pathological complete response and microscopically radical resection, and quality of life. Following the advances in rectal cancer management, increased focus on survival rather than only on local control is now justified. In an experimental arm, short-course radiotherapy is combined with full-dose chemotherapy preoperatively, an alternative that offers advantages compared to concomitant chemoradiotherapy with or without postoperative

  8. Survey of potential improvements during the course of the radiotherapy treatment. A patient questionnaire; Erfassung moeglicher Verbesserungen im Ablauf der Strahlentherapie. Eine Patientenbefragung

    Energy Technology Data Exchange (ETDEWEB)

    Momm, Felix; Jooss, David; Adebahr, Sonja; Duncker-Rohr, Viola; Heinemann, Felix; Kirste, Simon; Messmer, Marc-Benjamin; Grosu, Anca-Ligia [Universitaetsklinikum Freiburg, Freiburg im Breisgau (Germany). Klinik fuer Strahlenheilkunde; Xander, Carola J.; Becker, Gerhild [Universitaetsklinikum Freiburg, Freiburg im Breisgau (Germany). Palliativeinheit

    2011-11-15

    In the context of quality assurance, increasing demands are placed on the whole radiotherapy treatment process. The patients directly concerned generally do not realize most aspects of the quality assurance program (e.g., additional safety checks) during their daily therapy. It was the aim of this study to systematically ask patients about potential improvements during the course of radiotherapy treatment from their own perspective. In the defined time span (1 month), 624 radiotherapy patients (600 questionnaires were returned, 96.2%) were interviewed using a questionnaire newly developed to inquire about several aspects of their treatment. Furthermore, they were asked for their specific needs and suggestions for improvements that could be made during the course of radiotherapy treatment. Overall, the patients were satisfied with the course of their radiotherapy treatment and with patient care. As an example, about 90% agreed with the statement: ''My first contact with the radiation oncology unit proceeded with kindness and competence so that I was given the impression that I will be well cared for in this clinic.'' Considering the organization of the course of radiotherapy, a large majority of patients attached great value to set appointments for the therapy fractions. A main point of criticism was waiting times or delays caused by servicing or machine failures. Small, low cost improvements as music in the therapy room were considered as important as expensive measures (e.g., daylight in the therapy room). The patients emphasized the importance of staff friendliness. The situation of radiotherapy patients was, in general, satisfactory. Future improvements can be mainly expected from smooth organisation of both planning and treatment which can be achieved by electronic scheduling systems. Many results of the survey could be easily implemented in daily practice. In matters of organization radiation oncology with its complex procedures can be used

  9. Radiotherapy of malignant growths in the eosophagus with clinical and radiological course control

    International Nuclear Information System (INIS)

    Holzhausen, B.

    1981-01-01

    This paper reports on clinical and radiological symptoms observed before during and after radiotherapy of 172 patients treated under high-voltage conditions at the radiological clinic in Muenster in the time from 1962 to 1977. The 1, 2, and 5 year survival rates are 26.5%, 13%, and 5.9%. The examination carried out retrospectively showed in 52% of the patients (46/90) after radiotherapy an expansion of the tumour stenosis. In 67% of the patients (67/101), the disphagia which had been stated before decreased. Thus the palliative effect of the treatment is the most important issue of the therapy. In the case of polypous and diffusely infiltrating tumours, the average survival rate was 11.2 months and 12.3 months which is significantly better than the results obtained with circular-stenosing tumours (6.4 months). (orig./APR) [de

  10. Split-Course, High-Dose Palliative Pelvic Radiotherapy for Locally Progressive Hormone-Refractory Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gogna, Nirdosh Kumar, E-mail: kumar_gogna@health.qld.gov.au [Radiation Oncology Services, Mater Centre, Brisbane, Queensland (Australia); Baxi, Siddhartha; Hickey, Brigid; Baumann, Kathryn [Radiation Oncology Services, Mater Centre, Brisbane, Queensland (Australia); Burmeister, Elizabeth [Princess Alexandra Hospital, Brisbane, Queensland (Australia); Holt, Tanya [Radiation Oncology Services, Mater Centre, Brisbane, Queensland (Australia)

    2012-06-01

    Purpose: Local progression, in patients with hormone-refractory prostate cancer, often causes significant morbidity. Pelvic radiotherapy (RT) provides effective palliation in this setting, with most published studies supporting the use of high-dose regimens. The aim of the present study was to examine the role of split-course hypofractionated RT used at our institution in treating this group of patients. Methods and Materials: A total of 34 men with locoregionally progressive hormone-refractory prostate cancer, treated with a split course of pelvic RT (45-60 Gy in 18-24 fractions) between 2000 and 2008 were analyzed. The primary endpoints were the response rate and actuarial locoregional progression-free survival. Secondary endpoints included overall survival, compliance, and acute and late toxicity. Results: The median age was 71 years (range, 53-88). Treatment resulted in an overall initial response rate of 91%, a median locoregional progression-free survival of 43 months, and median overall survival of 28 months. Compliance was excellent and no significant late toxicity was reported. Conclusions: The split course pelvic RT described has an acceptable toxicity profile, is effective, and compares well with other high-dose palliative regimens that have been previously reported.

  11. Dynamics of change of both pathological focus and state of body during a radiotherapy course

    International Nuclear Information System (INIS)

    Stavitskij, R.V.; Vasil'ev, R.V.; Lebedenko, V.N.; Burdina, I.M.; Guslistyj, I.I.; Beridze, V.P.; Sergeev, A.D.; Lebedev, I.E.

    1997-01-01

    The ways of an estimation of change of the pathological center and condition of organism during realization of radiotherapy of neoplasms are given. The analysis of the tomography image of the pathological center allows to receive the data about reaction of tumour on the treatment. The research of change of a condition of organism takes possibility to account individual reaction of each patient to realization of a standard method of treatment and to carry out updating of therapy. 11 refs., 2 tabs., 10 figs. in appendix

  12. Adaptive radiotherapy for long course neo-adjuvant treatment of rectal cancer

    International Nuclear Information System (INIS)

    Nijkamp, Jasper; Marijnen, Corrie; Herk, Marcel van; Triest, Baukelien van; Sonke, Jan-Jakob

    2012-01-01

    Purpose: To quantify the potential margin reduction with adaptive radiotherapy (ART) during neo-adjuvant treatment of locally-advanced rectal cancer. Methods and materials: Repeat CT scans were acquired for 28 patients treated with 25 × 2 Gy, daily during the first week, and followed by weekly scans. The CTV was delineated on all scans, and shape variation was estimated. Five ART strategies were tested, consisting of an average CTV over the planning CT and one to five repeat CTs. Required PTV margins were calculated for adapted and non-adapted treatment. The strategy with the least PTV volume over the whole treatment was selected and bowel area dose reduction was estimated. Results: Substantial systematic and random shape variation demanded for a PTV margin up to 2.4 cm at the upper-anterior part of the CTV. Plan adaptation after fraction 4 resulted in a maximum 0.7 cm margin reduction and a significant PTV reduction from 1185 to 1023 cc (p < 0.0001). The bowel area volume receiving 15, 45, and 50 Gy was reduced from 436 to 402 cc, 111 to 81 cc, and 49 to 29 cc, respectively (p < 0.0001). Conclusions: With adaptive radiotherapy, maximum required PTV margins can be reduced from 2.4 to 1.7 cm, resulting in significantly less dose to the bowel area.

  13. Entire Agreement Clauses

    DEFF Research Database (Denmark)

    Mitkidis, Katerina; Neumann, Thomas

    2017-01-01

    , it can then be expected that the contract drafting practice will in turn influence national legal rules and the courts’ approach. This effect can already be seen in Danish legal scholarship and its presumption that the judges will not entirely disregard EA clauses, but take a middle road in interpreting......, but also the contract drafting style typical for common law countries. In this way, common law concepts and rules can be transferred to civil law jurisdictions, however, without certainty about the legal effects. This is especially pertinent to boilerplate provisions. On this background, the article aims...

  14. Acute symptoms during the course of head and neck radiotherapy or chemoradiation are strong predictors of late dysphagia

    International Nuclear Information System (INIS)

    Laan, Hans Paul van der; Bijl, Hendrik P.; Steenbakkers, Roel J.H.M.; Schaaf, Arjen van der; Chouvalova, Olga; Vemer-van den Hoek, Johanna G.M.; Gawryszuk, Agata; Laan, Bernard F.A.M. van der; Oosting, Sjoukje F.; Roodenburg, Jan L.N.; Wopken, Kim; Langendijk, Johannes A.

    2015-01-01

    Purpose: To determine if acute symptoms during definitive radiotherapy (RT) or chemoradiation (CHRT) are prognostic factors for late dysphagia in head and neck cancer (HNC). Material and methods: This prospective cohort study consisted of 260 HNC patients who received definitive RT or CHRT. The primary endpoint was grade 2–4 swallowing dysfunction at 6 months after completing RT (SWALM6). During treatment, acute symptoms, including oral mucositis, xerostomia and dysphagia, were scored, and the scores were accumulated weekly and entered into an existing reference model for SWALM6 that consisted of dose–volume variables only. Results: Both acute xerostomia and dysphagia were strong prognostic factors for SWALM6. When acute scores were added as variables to the reference model, model performance increased as the course of treatment progressed: the AUC rose from 0.78 at the baseline to 0.85 in week 6. New models built for weeks 3–6 were significantly better able to identify patients with and without late dysphagia. Conclusion: Acute xerostomia and dysphagia during the course of RT are strong prognostic factors for late dysphagia. Including accumulated acute symptom scores on a weekly basis in prediction models for late dysphagia significantly improves the identification of high-risk and low-risk patients at an early stage during treatment and might facilitate individualized treatment adaptation

  15. Combined radiotherapy of uterine cervix carcinoma of stage 3 according to a split course

    International Nuclear Information System (INIS)

    Vishnevskaya, E.E.; Danilova, I.A.; Litvinova, T.M.

    1979-01-01

    A comparative evaluation of the results of combined radiation therapy of two groups of patients with neglected forms of uterine cervix carcinoma is given. The groups were nearly identical as to the age, the presence of concomitant diseases, histological structure of the tumour and the extent of its spreading. The first group was treated according to an elaborated split course of radiation therapy, and the second by the conventional method. The analysis of the data obtained allows preference to be given to the split course method since with its use the incidence of radiation complications drops by 3.3 times and the immediate results improve by 1.2 times

  16. Continuous or split-course combined external and intracavitary radiotherapy of locally advanced carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Pedersen, D.; Bentzen, S.M.; Overgaard, J.

    1994-01-01

    From 1974 to 1984, 442 consecutive patients with carcinoma of the uterine cervix (FIGO IIB: 139, IIIA: 10, IIIB: 221, IVA: 72) were referred for combined intracavitary (IRT) and external radiotherapy (ERT). To improve local control and reduce late rectosigmoid morbidity the treatment strategy was changed from continuous (CRT) to split-course radiotherapy (SCRT) in 1978. Stage by stage the 5-year actuarial estimates of survival, local control, and late morbidity did not differ in relation to strategy. In the patients with tumours larger than 8 cm, the SCRT involved an increased dose in point B, a reduced dose in point A from the IRT, a lower total dose in point A, and a 34 day's prolongation of the total treatment time (TTT). The resulting 5-year actuarial local control rates were significantly lower compared with those after CRT. No difference of late severe morbidity was found except in IVA patients. In the patients with tumours between 4 and 8 cm, the SCRT involved a reduced dose in point A from the IRT, an increased total dose in point A and B, and a 50 day's prolongation of the TTT. In patients with stage IIB, the 5-year actuarial central local control rate was lower (p=0.06), and the 5-year estimate of late severe morbidity significantly higher after SCRT compared with CRT. It is concluded that the increase of the dose in point B in the SCRT was insufficient to prevent the deleterious effect on local tumour control of either the lower dose from IRT in point A, or the prolonged TTT. The increase of the total dose in the SCRT may explain why the late morbidity was not reduced, and may suggest that the TTT is of no significant importance for the risk of late normal tissue damage. (orig.)

  17. Phase II Study of Short-Course Radiotherapy Plus Concomitant and Adjuvant Temozolomide in Elderly Patients With Glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Minniti, Giuseppe, E-mail: Giuseppe.Minniti@ospedalesantandrea.it [Department of Radiation Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy); Department of Neurological Sciences, Neuromed Institute, Pozzilli (Italy); Lanzetta, Gaetano [Department of Neurological Sciences, Neuromed Institute, Pozzilli (Italy); Scaringi, Claudia [Department of Radiation Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy); Caporello, Paola [Department of Medical Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy); Salvati, Maurizio [Department of Neurosurgery, Umberto I Hospital, University ' La Sapienza,' Rome (Italy); Arcella, Antonella [Department of Neurological Sciences, Neuromed Institute, Pozzilli (Italy); De Sanctis, Vitaliana [Department of Radiation Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy); Giangaspero, Felice [Department of Neurological Sciences, Neuromed Institute, Pozzilli (Italy); Department of Pathology, Umberto I Hospital, University ' La Sapienza,' Rome (Italy); Enrici, Riccardo Maurizi [Department of Radiation Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy)

    2012-05-01

    Purpose: Radiotherapy (RT) and chemotherapy may prolong survival in older patients (age {>=}70 years) with glioblastoma multiforme (GBM), although the survival benefits remain poor. This Phase II multicenter study was designed to evaluate the efficacy and safety of an abbreviated course of RT plus concomitant and adjuvant temozolomide (TMZ) in older patients with GBM. Patients and Methods: Seventy-one eligible patients 70 years of age or older with newly diagnosed GBM and a Karnofsky performance status {>=}60 were treated with a short course of RT (40 Gy in 15 fractions over 3 weeks) plus TMZ at the dosage of 75 mg/m{sup 2} per day followed by 12 cycles of adjuvant TMZ (150-200 mg/m{sup 2} for 5 days during each 28-day cycle). The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival and toxicity. Results: The Median OS was 12.4 months, and the 1-year and 2-year OS rates were 58% and 20%, respectively. The median and 1-year rates of progression-free survival were 6 months and 20%, respectively. All patients completed the planned programme of RT. Grade 3 or 4 adverse events occurred in 16 patients (22%). Grade 3 and 4 neutropenia and/or thrombocytopenia occurred in 10 patients (15%), leading to the interruption of treatment in 6 patients (8%). Nonhematologic Grade 3 toxicity was rare, and included fatigue in 4 patients and cognitive disability in 1 patient. Conclusions: A combination of an abbreviated course of RT plus concomitant and adjuvant TMZ is well tolerated and may prolong survival in elderly patients with GBM. Future randomized studies need to evaluate the efficacy and toxicity of different schedules of RT in association with chemotherapy.

  18. Patterns of care and course of symptoms in palliative radiotherapy. A multicenter pilot study analysis

    International Nuclear Information System (INIS)

    Oorschot, Birgitt van; Geinitz, Hans

    2011-01-01

    To evaluate patterns of care as well as effectiveness and side effects of palliative treatment in four German radiation oncology departments. All referrals in four German radiation oncology departments (two university hospitals, one academic hospital, one private practice) were prospective documented for 1 month in 2008 (2 months at one of the university hospitals). In palliatively irradiated patients, treatment aims and indications as well as treated sites and fractionation schedules were recorded. In addition, symptoms and side effects were analyzed with standardized questionnaires before and at the end of radiotherapy. During the observation period, 603 patients underwent radiation therapy in the four centers and 153 (24%, study popu-lation) were treated with palliative intent. Within the study, patients were most frequently treated for bone (34%) or brain (27%) metastases. 62 patients reported severe or very severe pain, 12 patients reported severe or very severe dyspnea, 27 patients reported neurological deficits or signs of cranial pressure, and 43 patients reported a poor or very poor sense of well-being. The most frequent goals were symptom relief (53%) or prevention of symptoms (46%). Life prolongation was intended in 37% of cases. A wide range of fractionation schedules was applied with total doses ranging from 3-61.2 Gy. Of the patients, 73% received a slightly hypofractionated treatment schedule with doses of > 2.0 Gy to ? 3.0 Gy per fraction and 12% received moderate to highly hypofractionated therapy with doses of > 3.0 Gy to 8.0 Gy. Radiation therapy led to a significant improvement of well-being (35% of patients) and reduction of symptoms, especially with regard to pain (66%), dyspnea (61%), and neurological deficits (60%). Therapy was very well tolerated with only 4.5% grade I or II acute toxicities being observed. Unscheduled termination was observed in 19 patients (12%). Palliative radiation therapy is effective in reducing symptoms, increases

  19. Patterns of care and course of symptoms in palliative radiotherapy. A multicenter pilot study analysis

    Energy Technology Data Exchange (ETDEWEB)

    Oorschot, Birgitt van [Wuerzburg Univ. (Germany). Dept. of Radiation Oncology; Schuler, Michael [Wuerzburg Univ. (Germany). Inst. of Psychotherapy and Medical Psychology; Simon, Anke [HELIOS Klinikum Erfurt (Germany). Dept. of Radiation Oncology; Schleicher, Ursula [Center for Radiotherapy, Dueren (Germany); Geinitz, Hans [Technische Univ. Muenchen (Germany). Dept. of Radiotherapy and Radiooncology

    2011-08-15

    To evaluate patterns of care as well as effectiveness and side effects of palliative treatment in four German radiation oncology departments. All referrals in four German radiation oncology departments (two university hospitals, one academic hospital, one private practice) were prospective documented for 1 month in 2008 (2 months at one of the university hospitals). In palliatively irradiated patients, treatment aims and indications as well as treated sites and fractionation schedules were recorded. In addition, symptoms and side effects were analyzed with standardized questionnaires before and at the end of radiotherapy. During the observation period, 603 patients underwent radiation therapy in the four centers and 153 (24%, study popu-lation) were treated with palliative intent. Within the study, patients were most frequently treated for bone (34%) or brain (27%) metastases. 62 patients reported severe or very severe pain, 12 patients reported severe or very severe dyspnea, 27 patients reported neurological deficits or signs of cranial pressure, and 43 patients reported a poor or very poor sense of well-being. The most frequent goals were symptom relief (53%) or prevention of symptoms (46%). Life prolongation was intended in 37% of cases. A wide range of fractionation schedules was applied with total doses ranging from 3-61.2 Gy. Of the patients, 73% received a slightly hypofractionated treatment schedule with doses of > 2.0 Gy to ? 3.0 Gy per fraction and 12% received moderate to highly hypofractionated therapy with doses of > 3.0 Gy to 8.0 Gy. Radiation therapy led to a significant improvement of well-being (35% of patients) and reduction of symptoms, especially with regard to pain (66%), dyspnea (61%), and neurological deficits (60%). Therapy was very well tolerated with only 4.5% grade I or II acute toxicities being observed. Unscheduled termination was observed in 19 patients (12%). Palliative radiation therapy is effective in reducing symptoms, increases

  20. Quality controls in radiotherapy. From experiences of the first course-debate; Controlli di qualita' in radioterapia. Dalle esperienze del primo corso-dibattito

    Energy Technology Data Exchange (ETDEWEB)

    Rosi, A.; Viti, V. [Istituto Superiore di Sanita' , Laboratorio di Fisica, Rome (Italy)

    2000-07-01

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

  1. Quality controls in radiotherapy. From experiences of the first course-debate; Controlli di qualita' in radioterapia. Dalle esperienze del primo corso-dibattito

    Energy Technology Data Exchange (ETDEWEB)

    Rosi, A; Viti, V [Istituto Superiore di Sanita' , Laboratorio di Fisica, Rome (Italy)

    2000-07-01

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

  2. Should carbogen and nicotinamide be given throughout the full course of fractionated radiotherapy regimens?

    International Nuclear Information System (INIS)

    Rojas, A.M.; Johns, H.; Fiat, P.R.

    1993-01-01

    Tumor radiosensitization with carbogen and nicotinamide (CON) was compared when both agents were given throughout fractionated radiotherapy with the sensitization observed when administered with only half of the fractions. The effect of overall treatment time on the local control of tumors irradiated in air or with CON was also investigated. Local tumor control of a rodent adenocarcinoma, CaNT, was studied using eight different 20-fraction x-ray regimens. An overall time of either 10 or 20 days was used and CON was given with all, the first half or last half of the treatment. Relative to air, all six sensitizer combinations gave a large and significant increase in sensitization (p much-lt 0.00001). Enhancement ratios were 1.9 and 2.1 when CON was given with all 20 fractions in either 10 or 20 days, respectively. For both overall times, enhancement ratios were reduced by 15-25% when CON was given with only half of the fractions. In air, reducing the treatment time from 20 to 10 days gave a small but significant decrease in the isoeffective doses. When CON was administered with either all or part of a schedule, varying the treatment time had little or no effect on local tumor control. No toxic side-effects were encountered when the sensitizers were administered 10 or 20 times, either once or twice per day. CON is an effective and non-toxic tumor radiosensitizer. In CaNT tumors, a significantly greater effect is seen when CON is given with every fraction of the schedule. The sensitizers reduced or abolished the sparing effect of overall time. 22 refs., 1 fig., 2 tabs

  3. Clinical results and toxicity for short-course preoperative radiotherapy and total mesorectal excision in rectal cancer patients

    International Nuclear Information System (INIS)

    Sterzing, Florian; Jensen, Alexandra; Debus, Jürgen; Hoehle, Frieder; Ulrich, Alexis; Muenter, Marc

    2015-01-01

    Short-course preoperative radiotherapy (SCPRT) is an alternative method to chemoirradiation for patients with Stage II and III rectal cancer when no downsizing is needed, but there is still widespread reluctance to use this method because of fear of side effects from high-fraction doses. This paper reports on a single institution patient cohort of operated rectal cancer patients after SCPRT, evaluated for chronic adverse effects, local control, progression-free survival and overall survival. Altogether, 257 patients were treated with SCPRT and surgery including total mesorectal excision (92% total mesorectal excision = TME) between 2002 and 2009. Local control and survival were analyzed. Chronic adverse effects for 154 patients without local relapse were evaluated according to the NCI–CTCAE version 4.0 classification, with a median follow-up of 48 months. We found a 5-year disease-free survival (DFS) and overall survival (OS) of 71%. The 5-year estimated local control (LC) rate was 94%. A positive resection margin was found in 4% of the patients and was significantly correlated with decreased DFS, OS and LC. Chronic adverse effects were reported by 58% of the patients, of which 10% were Grade 3 toxicities. The most frequent Grade 2 toxicity was stool incontinence (13%). Sexual dysfunction was found in 36% of the patients (31% Grade 1 or 2, and only 5% Grade 3). SCPRT combined with TME produced excellent LC rates together with a low rate of high-grade chronic adverse effects. (author)

  4. Short-course radiotherapy, with elective delay prior to surgery, in patients with unresectable rectal cancer who have poor performance status or significant co-morbidity

    International Nuclear Information System (INIS)

    Hatfield, Paul; Hingorani, Mohan; Radhakrishna, Ganesh; Cooper, Rachel; Melcher, Alan; Crellin, Adrian; Kwok-Williams, Michelle; Sebag-Montefiore, David

    2009-01-01

    Background and purpose: Standard treatment for rectal cancer which threatens the expected plane of resection on MRI imaging is long-course, pre-operative chemoradiotherapy (1.8-2 Gy, 25-28 fractions). Not all patients are suitable for this because of age, poor performance status or co-morbidities. We describe our experience of short-course (5 x 5 Gy) pre-operative radiotherapy with planned, delayed surgery (SCPRT-delay) in this patient group. Materials and methods: Between April 2001 and October 2007, 43 patients were selected for SCPRT-delay. The clinical records were retrospectively evaluated. Results: Median age was 82 (range 58-87). Forty-one patients had radiotherapy of which 26 (61%) were subsequently able to have surgery. Of these, R0, R1 and R2 resections were performed in 22, 2 and 2 patients, respectively. Treatment was well tolerated, although two patients required hospital admission for management of diarrhoea and one developed significant late small bowel toxicity, attributable to radiotherapy. In those undergoing R0 or R1 resection there have been no local recurrences (median follow-up 18 months). Median survival for the whole group was 23 months, although this was 44 months in those undergoing surgery. Conclusions: SCPRT-delay appears to be a useful alternative to long-course pre-operative chemoradiotherapy in this high-risk group of patients.

  5. IBPRO - A Novel Short-Duration Teaching Course in Advanced Physics and Biology Underlying Cancer Radiotherapy.

    Science.gov (United States)

    Joiner, Michael C; Tracey, Monica W; Kacin, Sara E; Burmeister, Jay W

    2017-06-01

    This article provides a summary and status report of the ongoing advanced education program IBPRO - Integrated course in Biology and Physics of Radiation Oncology. IBPRO is a five-year program funded by NCI. It addresses the recognized deficiency in the number of mentors available who have the required knowledge and skill to provide the teaching and training that is required for future radiation oncologists and researchers in radiation sciences. Each year, IBPRO brings together 50 attendees typically at assistant professor level and upwards, who are already qualified/certified radiation oncologists, medical physicists or biologists. These attendees receive keynote lectures and activities based on active learning strategies, merging together the clinical, biological and physics underpinnings of radiation oncology, at the forefront of the field. This experience is aimed at increasing collaborations, raising the level and amount of basic and applied research undertaken in radiation oncology, and enabling attendees to confidently become involved in the future teaching and training of researchers and radiation oncologists.

  6. The results of radiation therapy for intracranial meningiomas. With special reference to the natural course of the tumor size after radiotherapy

    International Nuclear Information System (INIS)

    Kobayashi, Katsuhiro; Murakami, Masao; Kubo, Takeshi; Kono, Koichi; Okamoto, Yoshiaki; Kuroda, Yasumasa

    1998-01-01

    Twenty-four cases with intracranial meningioma received radiation therapy from 1967 to 1995 at Tenri Hospital. Two received preoperative radiotherapy and 22 post operative radiotherapy. Of all, 11 were benign, 9 were malignant and 4 were reported only as meningioma. The extent of surgery consisted of total resection in 4, subtotal resection in 10, partial resection in 6, biopsy in 2, exploration in 1 and unknown in 1. Twelve were initial treatments and another 12 were salvage treatments. In all cases, radiation therapy was given a mean dose of 53.6 Gy with 6 or 10 MV X-rays using conventional fractionation. The mean follow-up interval is 56.7 months. Total cause specific survival at 5 and 10 years were 79% and 69%, respectively. The 10-year recurrence-free survival was 100% in benign and 61% in malignant meningiomas. The clinical course of benign meningiomas suggested the value of postoperative radiation therapy, but that of malignant meningiomas were divided into 2 groups, in which some one had recurrence just after completion of radiotherapy or another had local control. It seemed that there were some radio-resistant varieties in malignant meningiomas. The result of the consecutive follow-up by enhanced CT or MRI revealed benign meningiomas had a tendency to decrease in size in a long interval and some malignant meningiomas changed their size soon after radiotherapy. From analysis of our study we conclude that radiation therapy is a useful post-surgical treatment for intracranial meningiomas. (author)

  7. Assessment of long-term quality of life of esophageal carcinoma patients treated with continuous accelerated hyperfractionated and late-course accelerated hyperfractionated radiotherapy

    International Nuclear Information System (INIS)

    Wang Yang; He Shaoqin; Shi Xuehui; Jiang Kaida; Yao Weiqiang; Wang Ying

    2002-01-01

    Objective: To compare the long-term quality of life in esophageal carcinoma patients treated with continuous accelerated hyperfractionated (CAHF) and late-course accelerated hyperfractionated (LCAF) radiotherapy. Methods: Subjective and Objective Management Analysis (SOMA) scale, Symptom Checklist 90 (SCL-90) and Life Satisfaction Index A (LSIA) questionnaire were mailed to the long survivors in both CAHF and LCAF groups to assess the long-term quality of life including symptoms, psychological status and life satisfaction. Results: There was no significant difference between the two groups in the score of quality of life such as late radiation reaction, SCL-90 and LSI-A. Conclusions: 1. It is reasonable to assess the quality of life with these scales for esophageal carcinoma patients treated with radiotherapy, 2. Preliminary results demonstrate that there is no significant difference in long-term quality of life between the CAHF and LCAF radiotherapy groups, 3. Methods of evaluating the long-term quality of life for esophageal carcinoma patients treated with radiotherapy needs further investigation, preferably involving more patients and setting on control arm

  8. First training course about protection and radiological safety for responsible in radiation protection in nuclear medicine and /or radiotherapy practices

    International Nuclear Information System (INIS)

    2002-08-01

    The Training course provide guidance of the detection and radiation measurement, radioactivity elements and dosimetry, regulatory standards, regulatory organization and practices works and the diary training course

  9. Teaching Discrete Mathematics Entirely from Primary Historical Sources

    Science.gov (United States)

    Barnett, Janet Heine; Bezhanishvili, Guram; Lodder, Jerry; Pengelley, David

    2016-01-01

    We describe teaching an introductory discrete mathematics course entirely from student projects based on primary historical sources. We present case studies of four projects that cover the content of a one-semester course, and mention various other courses that we have taught with primary source projects.

  10. SU-F-J-136: Impact of Audiovisual Biofeedback On Interfraction Motion Over a Course of Liver Cancer Stereotactic Body Radiotherapy

    International Nuclear Information System (INIS)

    Pollock, S; Tse, R; Martin, D; McLean, L; Pham, M; Tait, D; Estoesta, R; Whittington, G; Turley, J; Kearney, C; Cho, G; Pickard, S; Aston, P; Hill, R; Makhija, K; O’Brien, R; Keall, P

    2016-01-01

    Purpose: In abdominal radiotherapy inconsistent interfraction respiratory motion can result in deviations during treatment from what was planned in terms of target position and motion. Audiovisual biofeedback (AVB) is an interactive respiratory guide that produces a guiding interface that the patient follows over a course of radiotherapy to facilitate regular respiratory motion. This study assessed the impact of AVB on interfraction motion consistency over a course of liver cancer SBRT. Methods: Five liver cancer patients have been recruited into this study, 3 followed AVB over their course of SBRT and 2 were free breathing (FB). Respiratory signals from the Varian RPM were obtained during 4DCT and each treatment fraction. Respiratory signals were organized into 10 respiratory bins, and interfraction consistency was quantified by the difference between each treatment fraction respiratory bin and each respiratory bin from 4DCT. Interfraction consistency was considered as both the relative difference (as a percentage) and absolute difference (in centimeters) between treatment respiratory bins and 4DCT respiratory bins. Results: The relative difference between 4DCT and treatment respiratory bins was 22 ± 16% for FB, and 15 ± 10% for AVB, an improvement of 32% (p < 0.001) with AVB. The absolute difference between 4DCT and treatment respiratory bins was 0.15 ± 0.10 cm for FB, and 0.14 ± 0.13 cm for AVB, an improvement of 4% (p = 0.6) with AVB. Conclusion: This was the first study to compare the impact of AVB breathing guidance on interfraction motion consistency over a course of radiotherapy. AVB demonstrated to significantly reduce the relative difference between 4DCT and treatment respiratory motion, but the absolute differences were comparable, largely due to one AVB patient exhibiting a larger amplitude than the other patients. This study demonstrates the potential benefit of AVB in reducing motion variations during treatment from what was planned. Paul Keall

  11. SU-F-J-136: Impact of Audiovisual Biofeedback On Interfraction Motion Over a Course of Liver Cancer Stereotactic Body Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, S [Radiation Physics Laboratory, Sydney (Australia); Tse, R; Martin, D; McLean, L; Pham, M; Tait, D; Estoesta, R; Whittington, G; Turley, J; Kearney, C; Cho, G; Pickard, S; Aston, P [Chris OBrien Lifehouse, Sydney, NSW (Australia); Hill, R [Chris OBrien Lifehouse Camperdown (Australia); Makhija, K [University of Sydney, Camperdown, NSW (Australia); O’Brien, R; Keall, P [University of Sydney, Sydney, NSW (Australia)

    2016-06-15

    Purpose: In abdominal radiotherapy inconsistent interfraction respiratory motion can result in deviations during treatment from what was planned in terms of target position and motion. Audiovisual biofeedback (AVB) is an interactive respiratory guide that produces a guiding interface that the patient follows over a course of radiotherapy to facilitate regular respiratory motion. This study assessed the impact of AVB on interfraction motion consistency over a course of liver cancer SBRT. Methods: Five liver cancer patients have been recruited into this study, 3 followed AVB over their course of SBRT and 2 were free breathing (FB). Respiratory signals from the Varian RPM were obtained during 4DCT and each treatment fraction. Respiratory signals were organized into 10 respiratory bins, and interfraction consistency was quantified by the difference between each treatment fraction respiratory bin and each respiratory bin from 4DCT. Interfraction consistency was considered as both the relative difference (as a percentage) and absolute difference (in centimeters) between treatment respiratory bins and 4DCT respiratory bins. Results: The relative difference between 4DCT and treatment respiratory bins was 22 ± 16% for FB, and 15 ± 10% for AVB, an improvement of 32% (p < 0.001) with AVB. The absolute difference between 4DCT and treatment respiratory bins was 0.15 ± 0.10 cm for FB, and 0.14 ± 0.13 cm for AVB, an improvement of 4% (p = 0.6) with AVB. Conclusion: This was the first study to compare the impact of AVB breathing guidance on interfraction motion consistency over a course of radiotherapy. AVB demonstrated to significantly reduce the relative difference between 4DCT and treatment respiratory motion, but the absolute differences were comparable, largely due to one AVB patient exhibiting a larger amplitude than the other patients. This study demonstrates the potential benefit of AVB in reducing motion variations during treatment from what was planned. Paul Keall

  12. Peripheral myeloid-derived suppressor and T regulatory PD-1 positive cells predict response to neoadjuvant short-course radiotherapy in rectal cancer patients

    Science.gov (United States)

    Napolitano, Maria; D'Alterio, Crescenzo; Cardone, Eleonora; Trotta, Anna Maria; Pecori, Biagio; Rega, Daniela; Pace, Ugo; Scala, Dario; Scognamiglio, Giosuè; Tatangelo, Fabiana; Cacciapuoti, Carmela; Pacelli, Roberto; Delrio, Paolo; Scala, Stefania

    2015-01-01

    Short-course preoperative radiotherapy (SC-RT) followed by total mesorectal excision (TME) is one therapeutic option for locally advanced rectal cancer (LARC) patients. Since radio-induced DNA damage may affect tumor immunogenicity, Myeloid-derived suppressor cells (MDSCs) and T regulatory cells (Tregs) were evaluated in 13 patients undergoing SC-RT and TME for LARC. Peripheral Granulocytic-MDSCs (G-MDSC) [LIN−/HLA-DR−/CD11b+/CD14−/CD15+/CD33+], Monocytic (M-MDSC) [CD14+/HLA-DR−/lowCD11b+/CD33+] and Tregs [CD4+/CD25hi+/FOXP3+- CTLA-4/PD1] basal value was significantly higher in LARC patients compared to healthy donors (HD). Peripheral MDSC and Tregs were evaluated at time 0 (T0), after 2 and 5 weeks (T2-T5) from radiotherapy; before surgery (T8) and 6–12 months after surgery (T9, T10). G-MDSC decreased at T5 and further at T8 while M-MDSC cells decreased at T5; Tregs reached the lowest value at T5. LARC poor responder patients displayed a major decrease in M-MDSC after SC-RT and an increase of Treg-PD-1. In this pilot study MDSCs and Tregs decrease during the SC-RT treatment could represent a biomarker of response in LARC patients. Further studies are needed to confirm that the deepest M-MDSC reduction and increase in Treg-PD1 cells within 5–8 weeks from the beginning of treatment could discriminate LARC patients poor responding to SC-RT. PMID:25823653

  13. SU-E-QI-21: Iodinated Contrast Agent Time Course In Human Brain Metastasis: A Study For Stereotactic Synchrotron Radiotherapy Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Obeid, L; Esteve, F; Adam, J [Grenoble Institut des Neurosciences, La Tronche, Isere (France); Tessier, A; Balosso, J [Centre Hospitalier Universitaire, La Tronche, Isere (France)

    2014-06-15

    Purpose: Synchrotron stereotactic radiotherapy (SSRT) is an innovative treatment combining the selective accumulation of heavy elements in tumors with stereotactic irradiations using monochromatic medium energy x-rays from a synchrotron source. Phase I/II clinical trials on brain metastasis are underway using venous infusion of iodinated contrast agents. The radiation dose enhancement depends on the amount of iodine in the tumor and its time course. In the present study, the reproducibility of iodine concentrations between the CT planning scan day (Day 0) and the treatment day (Day 10) was assessed in order to predict dose errors. Methods: For each of days 0 and 10, three patients received a biphasic intravenous injection of iodinated contrast agent (40 ml, 4 ml/s, followed by 160 ml, 0.5 ml/s) in order to ensure stable intra-tumoral amounts of iodine during the treatment. Two volumetric CT scans (before and after iodine injection) and a multi-slice dynamic CT of the brain were performed using conventional radiotherapy CT (Day 0) or quantitative synchrotron radiation CT (Day 10). A 3D rigid registration was processed between images. The absolute and relative differences of absolute iodine concentrations and their corresponding dose errors were evaluated in the GTV and PTV used for treatment planning. Results: The differences in iodine concentrations remained within the standard deviation limits. The 3D absolute differences followed a normal distribution centered at zero mg/ml with a variance (∼1 mg/ml) which is related to the image noise. Conclusion: The results suggest that dose errors depend only on the image noise. This study shows that stable amounts of iodine are achievable in brain metastasis for SSRT treatment in a 10 days interval.

  14. SU-F-J-81: Evaluation of Automated Deformable Registration Between Planning Computed Tomography (CT) and Daily Cone Beam CT Images Over the Course of Prostate Cancer Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Matney, J; Hammers, J; Kaidar-Person, O; Wang, A; Chen, R; Das, S; Marks, L; Mavroidis, P [University North Carolina, Chapel Hill, NC (United States)

    2016-06-15

    Purpose: To compute daily dose delivered during radiotherapy, deformable registration needs to be relatively fast, automated, and accurate. The aim of this study was to evaluate the performance of commercial deformable registration software for deforming between two modalities: planning computed tomography (pCT) images acquired for treatment planning and cone beam (CB) CT images acquired prior to each fraction of prostate cancer radiotherapy. Methods: A workflow was designed using MIM Software™ that aligned and deformed pCT into daily CBCT images in two steps: (1) rigid shifts applied after daily CBCT imaging to align patient anatomy to the pCT and (2) normalized intensity-based deformable registration to account for interfractional anatomical variations. The physician-approved CTV and organ and risk (OAR) contours were deformed from the pCT to daily CBCT over the course of treatment. The same structures were delineated on each daily CBCT by a radiation oncologist. Dice similarity coefficient (DSC) mean and standard deviations were calculated to quantify the deformable registration quality for prostate, bladder, rectum and femoral heads. Results: To date, contour comparisons have been analyzed for 31 daily fractions of 2 of 10 of the cohort. Interim analysis shows that right and left femoral head contours demonstrate the highest agreement (DSC: 0.96±0.02) with physician contours. Additionally, deformed bladder (DSC: 0.81±0.09) and prostate (DSC: 0.80±0.07) have good agreement with physician-defined daily contours. Rectum contours have the highest variations (DSC: 0.66±0.10) between the deformed and physician-defined contours on daily CBCT imaging. Conclusion: For structures with relatively high contrast boundaries on CBCT, the MIM automated deformable registration provided accurate representations of the daily contours during treatment delivery. These findings will permit subsequent investigations to automate daily dose computation from CBCT. However

  15. Time course of anti-inflammatory effect of low-dose radiotherapy: Correlation with TGF-β1 expression

    International Nuclear Information System (INIS)

    Arenas, Meritxell; Gil, Felix; Gironella, Meritxell; Hernandez, Victor; Biete, Albert; Pique, Josep M.; Panes, Julian

    2008-01-01

    Background and Purpose: Low-dose radiotherapy (LD-RT) has a potent anti-inflammatory effect, and transforming growth factor (TGF)-β 1 is a potential mediator of this effect. The objectives of this study were to characterize the in vivo effects of LD-RT on leukocyte recruitment over time, and its relationship with TGF-β 1 production. Materials and methods: Mice were submitted to abdominal irradiation with a dose of 0.3 Gy, or to sham radiation and studied 5, 24, 48 or 72 h after irradiation. Four hours before the study a proinflammatory stimulus consisting of LPS or placebo was administered. Leukocyte-endothelial cell interactions in intestinal venules were assessed using intravital microscopy. Circulating levels and intestinal tissue production of TGF-β 1 were determined. Results: Compared to non-irradiated LPS-challenged group, the number of adherent leukocytes was significantly reduced 5, 24 and 48 h, but not 72 h after irradiation in LPS-challenged mice. Rolling leukocytes were significantly decreased at all time points analyzed. Plasma TGF-β 1 levels were increased 5 and 24 h after irradiation. Increased intestinal production during this period was corroborated by in vitro culture experiments. Conclusions: LD-RT has a sustained inhibitory effect on leukocyte recruitment for 48 h, which is initially associated with an increase in TGF-β 1 intestinal production

  16. Thoracic re-irradiation using stereotactic body radiotherapy (SBRT) techniques as first or second course of treatment

    International Nuclear Information System (INIS)

    Kilburn, Jeremy M.; Kuremsky, Jeffrey G.; Blackstock, A. William; Munley, Michael T.; Kearns, William T.; Hinson, William H.; Lovato, James F.; Miller, Antonius A.; Petty, William J.; Urbanic, James J.

    2014-01-01

    Background and purpose: Management for in-field failures after thoracic radiation is poorly defined. We evaluated SBRT as an initial or second course of treatment re-irradiating in a prior high dose region. Materials and methods: Thirty-three patients were treated with re-irradiation defined by the prior 30 Gy isodose line. Kaplan–Meier estimates were performed for local (LC), regional (RC), distant control (DC), and overall survival (OS). The plans when available were summed to evaluate doses to critical structures. Patient and treatment variables were analyzed on UVA for the impact on control and survival measures. Results: Median follow-up was 17 months. Treatment for sequential courses was as follows: (course1:course2) EBRT:SBRT (24 patients), SBRT:SBRT (7 patients), and SBRT:EBRT (3 patients). Median re-irradiation dose and fractionation was 50 Gy and 10 fractions (fx), with a median of 18 months (6–61) between treatments. Median OS was 21 months and 2 year LC 67%, yet LC for >1 fraction was 88% (p = 0.006 for single vs. multiple). 10 patients suffered chronic grade 2–3 toxicity (6 chest wall pain, 3 dyspnea, 1 esophagitis) and 1 grade 5 toxicity with aorta-esophageal fistula after 54 Gy in 3 fx for a central tumor with an estimated EQD2 to the aorta of 200 Gy. Conclusion: Tumor control can be established with re-irradiation using SBRT techniques for in-field thoracic failures at the cost of manageable toxicity

  17. vct 251,uop vct 251,vct 251 entire course new

    OpenAIRE

    admin

    2018-01-01

    UOP VCT 251 Week 1 Individual: Graphic Icon NEW Check this A+ tutorial guideline at http://www.assignmentcloud.com/vct-251-uop/vct-251-week-1-individual-graphic-icon-new For more classes visit http://www.assignmentcloud.com/ VCT 251 Week 1 Individual: Graphic Icon NEW Review Lessons 1, 2, and 3 of Adobe® Illustrator® CC™ Digital Classroom and the Lynda.com® video “Introduction to Graphic Design with Justin Seeley”. Create your first Illustrat...

  18. A phase II study of preoperative mFOLFOX6 with short-course radiotherapy in patients with locally advanced rectal cancer and liver-only metastasis.

    Science.gov (United States)

    Kim, Kyung Hwan; Shin, Sang Joon; Cho, Min Soo; Ahn, Joong Bae; Jung, Minkyu; Kim, Tae Il; Park, Young Suk; Kim, Hoguen; Kim, Nam Kyu; Koom, Woong Sub

    2016-02-01

    To evaluate the efficacy and safety of upfront mFOLFOX6 followed by short-course radiotherapy (SCRT) and surgery in patients with locally advanced rectal cancer and liver-only metastases. This single-arm phase II study involved 32 patients. mFOLFOX6 was administered for four cycles followed by SCRT and another four cycles of mFOLFOX6. Surgery was performed 4-6 weeks after the last chemotherapy cycle. The primary endpoint was complete (R0) resection rate. Secondary endpoints were response rate, progression-free survival (PFS), overall survival (OS), and complication rates. Surgical resection of the rectum and liver was performed in 25 patients (78%) and R0 resection was achieved in 20 patients (63%). Local tumor downstaging was observed in 54% of patients. Median OS and PFS were 38 and 9 months, respectively. One patient discontinued treatment due to toxicity and no treatment-related deaths occurred. Patients who progressed after 4 cycles of mFOLFOX6 were less likely to receive resection. This regimen was safe and effective in inducing local tumor response and achieving R0 resection in this patient population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Short course radiotherapy with simultaneous integrated boost for stage I-II breast cancer, early toxicities of a randomized clinical trial

    Science.gov (United States)

    2012-01-01

    Background TomoBreast is a unicenter, non-blinded randomized trial comparing conventional radiotherapy (CR) vs. hypofractionated Tomotherapy (TT) for post-operative treatment of breast cancer. The purpose of the trial is to compare whether TT can reduce heart and pulmonary toxicity. We evaluate early toxicities. Methods The trial started inclusion in May 2007 and reached its recruitment in August 2011. Women with stage T1-3N0M0 or T1-2N1M0 breast cancer completely resected by tumorectomy (BCS) or by mastectomy (MA) who consented to participate were randomized, according to a prescribed computer-generated randomization schedule, between control arm of CR 25x2 Gy/5 weeks by tangential fields on breast/chest wall, plus supraclavicular-axillary field if node-positive, and sequential boost 8x2 Gy/2 weeks if BCS (cumulative dose 66 Gy/7 weeks), versus experimental TT arm of 15x2.8 Gy/3 weeks, including nodal areas if node-positive and simultaneous integrated boost of 0.6 Gy if BCS (cumulative dose 51 Gy/3 weeks). Outcomes evaluated were the pulmonary and heart function. Comparison of proportions used one-sided Fisher's exact test. Results By May 2010, 70 patients were randomized and had more than 1 year of follow-up. Out of 69 evaluable cases, 32 were assigned to CR (21 BCS, 11 MA), 37 to TT (20 BCS, 17 MA). Skin toxicity of grade ≥1 at 2 years was 60% in CR, vs. 30% in TT arm. Heart function showed no significant difference for left ventricular ejection fraction at 2 years, CR 4.8% vs. TT 4.6%. Pulmonary function tests at 2 years showed grade ≥1 decline of FEV1 in 21% of CR, vs. 15% of TT and decline of DLco in 29% of CR, vs. 7% of TT (P = 0.05). Conclusions There were no unexpected severe toxicities. Short course radiotherapy of the breast with simultaneous integrated boost over 3 weeks proved feasible without excess toxicities. Pulmonary tests showed a slight trend in favor of Tomotherapy, which will need confirmation with longer

  20. Double blind randomized trial of sucralfate vs. placebo during a course of radical radiotherapy for head and neck squamous carcinoma

    International Nuclear Information System (INIS)

    Carter, D.L.; Hebert, M.E.; Leopold, K.L.; Brizel, D.M.

    1997-01-01

    Purpose: To determine if sucralfate prophylaxis during a course of high dose radiation therapy (RT) for head and neck cancer decreases acute side effects including mucositis and weight loss. Methods: Ninety-eight patients receiving curative intent RT for advanced head and neck cancers participated in a single institution double blind randomized trial comparing sucralfate to placebo. Patients were stratified according to fractionation (QD or BID), use of concurrent chemotherapy (yes or no), Karnofsky performance status (KPS 5 % or > 10 % occurred more frequently in patients receiving chemotherapy (p<0.01 and p=0.05 respectively). Grade 3 mucositis was more common in patients receiving BID fractionation (p=0.04) or having a poor KPS status (continuous variable: p=0.01). Pain uncontrolled by narcotics was more common in patients who drank alcohol during therapy (p<0.01). No subset appeared to benefit from the use of sucralfate. Conclusions: Prophylactic treatment with sucralfate during high dose head and neck RT does not decrease acute treatment side effects. Other modalities should be investigated

  1. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    International Nuclear Information System (INIS)

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di; Ionascu, Dan

    2012-01-01

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non–small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non–small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T L N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T L N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 ± 0.7 cm and 0.8 ± 0.3 cm, respectively, for B and T L N. Primary and involved LN expansions were 0.7 ± 0.5 cm and 1.1 ± 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T L N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  2. Comparison of IGRT Registration Strategies for Optimal Coverage of Primary Lung Tumors and Involved Nodes Based on Multiple Four-Dimensional CT Scans Obtained Throughout the Radiotherapy Course

    Energy Technology Data Exchange (ETDEWEB)

    Mohammed, Nasiruddin; Kestin, Larry; Grills, Inga; Shah, Chirag; Glide-Hurst, Carri; Yan, Di [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ionascu, Dan, E-mail: Dan.ionascu@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-03-15

    Purpose: To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non-small cell lung cancer using weekly four-dimensional computed tomography (4DCT). Methods and Materials: Eleven patients with advanced non-small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T{sub L}N). Results: The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T{sub L}N: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 {+-} 0.7 cm and 0.8 {+-} 0.3 cm, respectively, for B and T{sub L}N. Primary and involved LN expansions were 0.7 {+-} 0.5 cm and 1.1 {+-} 0.5 cm for T. Conclusion: T is best for solitary targets. When treatments include primary tumor and LNs, B and T{sub L}N provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.

  3. Entire hemithorax irradiation for Masaoka stage IVa thymomas

    Science.gov (United States)

    Soares, André; Louro, Luís Vasco; Almeida, Marta; Sousa, Olga

    2012-01-01

    Thymomas are rare neoplasms that have an indolent growth with a preferentially intra-thoracic dissemination pattern. Surgery is currently the standard treatment of thymomas; however radiotherapy is often used in an adjuvant setting due to a high sensitivity of these tumors to such treatment. Postoperative entire hemithoracic irradiation has been used in selected Masaoka stage IVa cases after complete surgical excision of metastatic lesions. In the present article, the authors report three cases of Masaoka stage IVa thymoma that underwent entire hemithorax irradiation after surgical excision of metastatic lesions. The first two patients presented as stage IVa thymomas. The third case consisted of a pleural recurrence of a thymoma. Hemithoracic irradiation with low doses has been used by different authors; the available data shows that it is a well-tolerated treatment that could potentially lead to better loco-regional control and increased overall survival. PMID:24377042

  4. Continuous and split-course radiotherapy in locally advanced carcinoma of the uterine cervix. Analyses of local control, distant metastases, crude survival, early and late morbidity and prognostic factors

    International Nuclear Information System (INIS)

    Pedersen, D.E.

    1994-01-01

    From 1974 to 1984, 442 consecutive patients with carcinoma of the uterine cervix were referred for combined intracavitary (IRT) and external radiotherapy (ERT). Dose prescriptions were performed based on the points A and B of the Manchester system. From 1978 the treatment strategy was changed from continuous (CRT) to split course radiotherapy (SCRT) with a higher total dose to point B, a lower dose to point A from the IRT, and a longer total treatment time (TTT). The purpose of the present thesis is: To evaluate local tumour control, distant metastases, survival and complications in the rectosigmoid and bladder in relation to treatment strategy (continuous and split course radiotherapy). To evaluate prognostic factors and importance of treatment strategy for local control, distant metastases, and survival by uni- and multivariate analyses. To develop a classification system (AADK, Aarhus, Denmark) for the recording of early and late radiation complications allowing and estimation of the importance of latency when reporting late radiotherapeutic morbidity and a rescoring of complication grade, and to compare results from AADK with those from the French-Italian glossary recording the maximal damage. To evaluate early and late radiotherapeutic morbidity and the importance of latency by comparing frequencies and actuarial estimates of late complications, to estimate the combined late organ morbidity and the probability of being alive, cured and without serious complications. (EG) (61 refs.)

  5. Radiotherapy physics

    International Nuclear Information System (INIS)

    Chen, G.T.Y.; Collier, J.M.; Lyman, J.T.; Pitluck, S.

    1982-01-01

    The Radiotherapy Physics Group works on the physical and biophysical aspects of charged particle radiotherapy. Our activities include the development of isosurvival beams (beams of uniform biological effect), computerized treatment planning development for charged particle radiotherapy, design of compensation to shape dose distributions, and development of dosimetry techniques to verify planned irradiations in both phantoms and patients

  6. Schroedinger--Dirac spaces of entire functions

    International Nuclear Information System (INIS)

    De Branges, L.

    1977-01-01

    A study is made of some Hilbert spaces of entire function which appear in the quantum mechanical theory of the hydrogen atoms. These spaces are examples in the theory of Hilbert spaces whose elements are entire functions and which have certain given properties. 1 reference

  7. Education in physics of radiotherapy

    International Nuclear Information System (INIS)

    Kessler, Judith; Feld, Diana B.; Portillo, Perla A.; Casal, Mariana R.; Menendez, Pablo R.

    2008-01-01

    Radiotherapy is the clinical application which requires the highest precision in dose delivery because of the very high doses administrated to patients, taking into account that new diagnostic methods and new modalities and treatment machines give greater possibilities of dose escalation. These higher doses may also produce serious side effects if not accurately administered. High qualified personnel is therefore needed for dealing with these new complex modalities, assuring that dose prescribed is correctly administered and providing adequate radiation protection to patients, public and staff. Education in Physics of Radiotherapy aims to provide students with solid theoretical and practical basis in order to be able to work with great responsibility and understanding in a Radiotherapy Department and assure that appropriate radiation protection to patients, public and staff. Since 1964 the National Atomic Energy Commission (CNEA) gives course related to Radiotherapy and since 2002, due to a collaborative project, these courses are given at the Oncology Institute 'Angel H. Roffo' (IOAR) which belongs to the University of Buenos Aires (UBA). The IOAR is well equipped in Radiotherapy and new techniques are continuously introduced. That is why, being a University Institution and having highly specialized staff, it is the ideal hospital for teaching Radiotherapy in Buenos Aires, not only for regular courses but also for implementing workshops, seminars and updating courses as well. Continuous education helps to create and increase awareness of the importance of radiation protection in patients as well as in public and staff. (author)

  8. Translational and rotational intra- and inter-fractional errors in patient and target position during a short course of frameless stereotactic body radiotherapy

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, Gitte Fredberg; Logadottir, Ashildur

    2012-01-01

    Implementation of cone beam computed tomography (CBCT) in frameless stereotactic body radiotherapy (SBRT) of lung tumours enables setup correction based on tumour position. The aim of this study was to compare setup accuracy with daily soft tissue matching to bony anatomy matching and evaluate...

  9. Skin markings in external radiotherapy by temporary tattooing with henna: Improvement of accuracy and increased patient comfort

    International Nuclear Information System (INIS)

    Wurstbauer, Karl; Sedlmayer, Felix; Kogelnik, H. Dieter

    2001-01-01

    Purpose: To guarantee invariable skin markings in patients undergoing a course of external radiotherapy, especially using conformal techniques. Cutaneous markings with henna also increase patient comfort, because washing and showering are allowed. Methods and Materials: Henna, a completely natural product, is a skin colorant with a history of 5,000 years. It is applied to the skin in the form of a paste. While drying, henna stains the superficial skin layers for several weeks, and the marked area can be exposed to water arbitrarily. In case of fading of the stain before the end of radiotherapy, the marking procedure can be repeated. From November 1998 until March 2000, we performed skin markings with henna in 158 patients with different tumor sites. The majority of patients received conformal radiotherapy techniques. All patients have been evaluated concerning durability of the markings, the required number of marking procedures per treatment course, and possible related side effects. Results: The median durability of henna staining is 23 days (range 12-48 days). On average, two marking procedures (range 1-4) are necessary for a patient treated with curative intent. Although washing and showering are freely permitted, no adverse cutaneous side effects (e.g., erythema, allergic reactions) have been observed. Conclusions: Skin marking by temporary tattooing with henna increases the accuracy of external radiotherapy. It yields stable and invariable markings for the entire course of radiotherapy and also increases the comfort of patients

  10. Motion monitoring during a course of lung radiotherapy with anchored electromagnetic transponders. Quantification of inter- and intrafraction motion and variability of relative transponder positions

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, Daniela [German Cancer Research Center (DKFZ), Division of Medical Physics in Radiation Oncology, Heidelberg (Germany); National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg (Germany); Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg (Germany); Nill, Simeon; Oelfke, Uwe [German Cancer Research Center (DKFZ), Division of Medical Physics in Radiation Oncology, Heidelberg (Germany); National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg (Germany); The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Joint Department of Physics, London (United Kingdom); Roeder, Falk [German Cancer Research Center (DKFZ), Clinical Cooperation Unit Molecular Radiooncology, Heidelberg (Germany); University of Munich (LMU), Department of Radiation Oncology, Munich (Germany); Gompelmann, Daniela; Herth, Felix [University of Heidelberg, Pneumology and Critical Care Medicine, Thoraxklinik, Heidelberg (Germany); German Center for Lung Research, Translational Lung Research Center Heidelberg (TLRC), Heidelberg (Germany)

    2017-10-15

    Anchored electromagnetic transponders for tumor motion monitoring during lung radiotherapy were clinically evaluated. First, intrafractional motion patterns were analyzed as well as their interfractional variations. Second, intra- and interfractional changes of the geometric transponder positions were investigated. Intrafractional motion data from 7 patients with an upper or middle lobe tumor and three implanted transponders each was used to calculate breathing amplitudes, overall motion amount and motion midlines in three mutual perpendicular directions and three-dimensionally (3D) for 162 fractions. For 6 patients intra- and interfractional variations in transponder distances and in the size of the triangle defined by the transponder locations over the treatment course were determined. Mean 3D values of all fractions were up to 4.0, 4.6 and 3.4 mm per patient for amplitude, overall motion amount and midline deviation, respectively. Intrafractional transponder distances varied with standard deviations up to 3.2 mm, while a maximal triangle shrinkage of 36.5% over 39 days was observed. Electromagnetic real-time motion monitoring was feasible for all patients. Detected respiratory motion was on average modest in this small cohort without lower lobe tumors, but changes in motion midline were of the same size as the amplitudes and greater midline motion can be observed in some fractions. Intra- and interfractional variations of the geometric transponder positions can be large, so for reliable motion management correlation between transponder and tumor motion needs to be evaluated per patient. (orig.) [German] Verankerte, elektromagnetische Transponder fuer die Bewegungserkennung des Tumors waehrend der Strahlentherapie der Lunge wurden klinisch evaluiert. Dafuer wurden intrafraktionelle Bewegungsmuster und ihre interfraktionellen Variationen analysiert und intra- und interfraktionelle Veraenderungen der geometrischen Transponderpositionen untersucht. Intrafraktionelle

  11. Effects of radiotherapy on the sense of taste

    Energy Technology Data Exchange (ETDEWEB)

    Umeyama, Masayoshi; Suzaki, Harumi [Showa Univ., Tokyo (Japan). School of Medicine

    2001-07-01

    The adverse effects of radiotherapy for cancer in the head and neck region include impairment of the sense of taste and smell and dry mouth. The present study was conducted to examine the effects of such radiotherapy on the sense of taste, in view of its influence on the quality of life of patients with malignant tumors of the head and neck following treatment. In 18 patients with malignant tumors of the head and neck (mean age, 59.9 years) the sense of taste was tested using the filter-paper disc method, serially before and after radiotherapy with {sup 60}Co {gamma} rays, in order to analyze the changes in gustatory threshold after radiotherapy. The patients were also observed for subjective symptoms, including dry mouth and impairment of the sense of taste, and changes in the lingual surface over the course of radiotherapy. No increase in the gustatory threshold or subjective impairment of the sense of taste was noted after radiotherapy when the field of irradiation did not include the tongue (4 cases of laryngeal cancer). When the field of irradiation included a part of the tongue (3 cases of maxillary cancer, 3 cases of hypopharyngeal cancer, 1 case of epipharyngeal cancer) or the entire tongue (2 cases of lingual cancer, 2 cases of cancer of the floor of the mouth, 3 cases of mesopharyngeal cancer), dry mouth was noted after irradiation at 7.2-39.6 Gy, and the gustatory threshold increased after irradiation at 12-40 Gy. Subjective impairment of the sense of taste was also reported after irradiation at 10-25.2 Gy, which was restored to normal within 2-3 months after the end of radiotherapy. In relation to the quality of taste, the gustatory threshold for sweet tastes increased the slowest, and was restored rapidly. In contrast, the gustatory threshold for sour tastes increased most rapidly, and was restored slowly. The relationship between the serum zinc level and the increase in gustatory threshold was unclear. There was a tendency for the lingual surface to

  12. Effects of radiotherapy on the sense of taste

    International Nuclear Information System (INIS)

    Umeyama, Masayoshi; Suzaki, Harumi

    2001-01-01

    The adverse effects of radiotherapy for cancer in the head and neck region include impairment of the sense of taste and smell and dry mouth. The present study was conducted to examine the effects of such radiotherapy on the sense of taste, in view of its influence on the quality of life of patients with malignant tumors of the head and neck following treatment. In 18 patients with malignant tumors of the head and neck (mean age, 59.9 years) the sense of taste was tested using the filter-paper disc method, serially before and after radiotherapy with 60 Co γ rays, in order to analyze the changes in gustatory threshold after radiotherapy. The patients were also observed for subjective symptoms, including dry mouth and impairment of the sense of taste, and changes in the lingual surface over the course of radiotherapy. No increase in the gustatory threshold or subjective impairment of the sense of taste was noted after radiotherapy when the field of irradiation did not include the tongue (4 cases of laryngeal cancer). When the field of irradiation included a part of the tongue (3 cases of maxillary cancer, 3 cases of hypopharyngeal cancer, 1 case of epipharyngeal cancer) or the entire tongue (2 cases of lingual cancer, 2 cases of cancer of the floor of the mouth, 3 cases of mesopharyngeal cancer), dry mouth was noted after irradiation at 7.2-39.6 Gy, and the gustatory threshold increased after irradiation at 12-40 Gy. Subjective impairment of the sense of taste was also reported after irradiation at 10-25.2 Gy, which was restored to normal within 2-3 months after the end of radiotherapy. In relation to the quality of taste, the gustatory threshold for sweet tastes increased the slowest, and was restored rapidly. In contrast, the gustatory threshold for sour tastes increased most rapidly, and was restored slowly. The relationship between the serum zinc level and the increase in gustatory threshold was unclear. There was a tendency for the lingual surface to become dry

  13. Whither radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ross, W M

    1987-03-01

    The 1986 Glyn Evans Memorial Lecture, given at the Joint Provincial Meeting of the Royal College of Radiologists, Sheffield, September 1986, sketches an outline of the history of radiotherapy and discusses the future development of the art. Topics included are siting of centres, training needs, the relationship of radiotherapy to other medical specialities, and the advantages and disadvantages of radiotherapy practitioners forming a separate medical College. (U.K.)

  14. PET/CT and radiotherapy

    International Nuclear Information System (INIS)

    Messa, C.; CNR, Milano; S. Gerardo Hospital, Monza; Di Muzio, N.; Picchio, M.; Bettinardi, V.; Gilardi, M.C.; CNR, Milano; San Raffaele Scientific Institute, Milano; Fazio, F.; CNR, Milano; San Raffaele Scientific Institute, Milano; San Raffaele Scientific Institute, Milano

    2006-01-01

    This article reviews the state of the art of PET/CT applications in radiotherapy, specifically its use in disease staging, patient selection, treatment planning and treatment evaluation. Diseases for which radiotherapy with radical intent is indicated will be considered, as well as those in which PET/CT may actually change the course of disease. The methodological and technological aspects of PET/CT in radiotherapy are discussed, focusing on the problem of target volume definition with CT and PET functional imaging and the problem of tumor motion with respect to imaging and dose delivery

  15. Entire cyclic cohomology and modular theory

    International Nuclear Information System (INIS)

    Stoytchev, O.Ts.

    1992-04-01

    We display a close relationship between C* and W*-dynamical systems with KMS states on them and entire cyclic cohomology theory. We construct a character form which assigns to each such system (A, α, R) an even entire cyclic cocycle of the subalgebra A of differentiable (with respect to the given automorphism group) elements of A. We argue that the most interesting case is the von Neumann algebra one, where the automorphism group is determined uniquely by the faithful normal state on the algebra (the modular group) and where the character may provide important information about the algebra. (author). 11 refs

  16. The class of n-entire operators

    International Nuclear Information System (INIS)

    Silva, Luis O; Toloza, Julio H

    2013-01-01

    We introduce a classification of simple, regular, closed symmetric operators with deficiency indices (1, 1) according to a geometric criterion that extends the classical notions of entire operators and entire operators in the generalized sense due to M G Krein. We show that these classes of operators have several distinctive properties, some of them related to the spectra of their canonical self-adjoint extensions. In particular, we provide necessary and sufficient conditions on the spectra of two canonical self-adjoint extensions of an operator for it to belong to one of our classes. Our discussion is based on some recent results in the theory of de Branges spaces. (paper)

  17. Demand for radiotherapy in Spain.

    Science.gov (United States)

    Rodríguez, A; Borrás, J M; López-Torrecilla, J; Algara, M; Palacios-Eito, A; Gómez-Caamaño, A; Olay, L; Lara, P C

    2017-02-01

    Assessing the demand for radiotherapy in Spain based on existing evidence to estimate the human resources and equipment needed so that every person in Spain has access to high-quality radiotherapy when they need it. We used data from the European Cancer Observatory on the estimated incidence of cancer in Spain in 2012, along with the evidence-based indications for radiotherapy developed by the Australian CCORE project, to obtain an optimal radiotherapy utilisation proportion (OUP) for each tumour. About 50.5 % of new cancers in Spain require radiotherapy at least once over the course of the disease. Additional demand for these services comes from reradiation therapy and non-melanoma skin cancer. Approximately, 25-30 % of cancer patients with an indication for radiotherapy do not receive it due to factors that include access, patient preference, familiarity with the treatment among physicians, and especially resource shortages, all of which contribute to its underutilisation. Radiotherapy is underused in Spain. The increasing incidence of cancer expected over the next decade and the greater frequency of reradiations necessitate the incorporation of radiotherapy demand into need-based calculations for cancer services planning.

  18. The Teichmuller Space of an Entire Function

    DEFF Research Database (Denmark)

    Fagella, Nuria; Henriksen, Christian

    2008-01-01

    points of any quasiconformal automorphism that commutes with f and which is homotopic to the identity, rel. the ideal boundary of the domain. As a consequence, the general framework of McMullen and Sullivan [McMS98] for rational functions applies also to entire functions and we can apply it to study...

  19. AFM image of an entire polygene chromosome

    International Nuclear Information System (INIS)

    Li Minqian; Takeuchi; Ikai, A.

    1994-01-01

    The author present AFM images of an entire polygene chromosome of Drosophila for the first time. Comparing with conventional optical microscope, the AFM image of the polygene chromosomes provides much higher resolution and 3-D measurement capability which will lead to finer scale gene mapping and identification

  20. hrm 595,uop hrm 595,uop hrm 595 complete course,uop hrm 595 entire course

    OpenAIRE

    admin

    2018-01-01

    UOP HRM 595 All Assignments NEW Check this A+ tutorial guideline at http://www.assignmentcloud.com/hrm-595-uop/hrm-595-all-assignments-new For more classes visit http://www.assignmentcloud.com HRM 595 All Assignments NEW HRM 595 Week 1 Talent Acquisition, Management, & Retention Strategies NEW HRM 595 Week 2 Labor Relations Guide for Management NEW HRM 595 Week 3 Career Development and Succession Planning NEW HRM 595 Week 4 Compensation, Benefits, ...

  1. Estimation of the optimal number of radiotherapy fractions for breast cancer: A review of the evidence.

    Science.gov (United States)

    Wong, Karen; Delaney, Geoff P; Barton, Michael B

    2015-08-01

    There is variation in radiotherapy fractionation practice, however, there is no evidence-based benchmark for appropriate activity. An evidence-based model was constructed to estimate the optimal number of fractions for the first course of radiotherapy for breast cancer to aid in services planning and performance benchmarking. The published breast cancer radiotherapy utilisation model was adapted. Evidence-based number of fractions was added to each radiotherapy indication. The overall optimal number of fractions was calculated based on the frequency of specific clinical conditions where radiotherapy is indicated and the recommended number of fractions for each condition. Sensitivity analysis was performed to assess the impact of uncertainties on the model. For the entire Australian breast cancer patient population, the estimated optimal number of fractions per patient was 16.8, 14.6, 13.7 and 0.8 for ductal carcinoma in situ, early, advanced and metastatic breast cancer respectively. Overall, the optimal number of fractions per patient was 14.4 (range 14.4-18.7). These results allow comparison with actual practices, and workload prediction to aid in services planning. The model can be easily adapted to other countries by inserting population-specific epidemiological data, and to future changes in cancer incidence, stage distribution and fractionation recommendations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Quality assurance in radiotherapy

    International Nuclear Information System (INIS)

    2003-03-01

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

  3. Radiotherapy of lymphogranulomatosis

    International Nuclear Information System (INIS)

    Roettinger, E.M.; Sack, H.

    1976-01-01

    Increased knowledge about the course of lymphogranulomatosis and technological progress in radiotherapy during the past 20 years have brought permanent recovery for a major part of patients from this disease which had been infaust before. The supplementation of the local radiotherapy by the systematic effects of chemotherapy enables us at the same time to control the infiltrations and disseminations which cannot be manifested clinically especially in malignant forms and later stages. The good healing results obtained presuppose careful clinical examination of the patient and attentive care during the therapy with regard to the potential complications of radio- and chemotherapy. As potential complications which may occur according to the method used we may name damage to the kidneys, radiopneumonia or pulmonal fibrosis, myocarditis or pericarditis, oeosophagitis, enteritis, and hepatitis. Relatively seldom we see the permanent depression of the bone marrow, induction of leucaemia, and myxoedema. All these complications can occure more frequently in the case of additional chemotherapy. (orig./MG) [de

  4. Estimates of radiation doses in tissue and organs and risk of excess cancer in the single-course radiotherapy patients treated for ankylosing spondylitis in England and Wales

    International Nuclear Information System (INIS)

    Fabrikant, J.I.; Lyman, J.T.

    1982-02-01

    The estimates of absorbed doses of x rays and excess risk of cancer in bone marrow and heavily irradiated sites are extremely crude and are based on very limited data and on a number of assumptions. Some of these assumptions may later prove to be incorrect, but it is probable that they are correct to within a factor of 2. The excess cancer risk estimates calculated compare well with the most reliable epidemiological surveys thus far studied. This is particularly important for cancers of heavily irradiated sites with long latent periods. The mean followup period for the patients was 16.2 y, and an increase in cancers of heavily irradiated sites may appear in these patients in the 1970s in tissues and organs with long latent periods for the induction of cancer. The accuracy of these estimates is severely limited by the inadequacy of information on doses absorbed by the tissues at risk in the irradiated patients. The information on absorbed dose is essential for an accurate assessment of dose-cancer incidence analysis. Furthermore, in this valuable series of irradiated patients, the information on radiation dosimetry on the radiotherapy charts is central to any reliable determination of somatic risks of radiation with regard to carcinogenesis in man. The work necessary to obtain these data is under way; only when they are available can more precise estimates of risk of cancer induction by radiation in man be obtained

  5. The impact of gap duration on local control in anal canal carcinoma treated by split-course radiotherapy and concomitant chemotherapy

    International Nuclear Information System (INIS)

    Weber, Damien C.; Kurtz, John M.; Allal, Abdelkarim S.

    2001-01-01

    Purpose: To investigate the potential benefit of reducing the intersequence gap in patients with anal cancer treated with split-course chemoradiotherapy. Methods: The study group consisted of 90 patients with anal squamous carcinoma treated between 1981 and 1998, using concomitant chemotherapy (CT) and radiation (RT). Median age was 65 years (range 41-87). RT was delivered in a split course, with a median gap of 37.5 days (range 4-97) between sequences. First (pelvic) sequence delivered a median dose of 40 Gy (range 36-50.4), using AP/PA megavoltage photon beams. Boost treatment (median dose 20 Gy, range 13-26) consisted of either Iridium-192 implantation (49 patients) or external beam RT (41 patients). CT consisted of 1-2 cycles of a 5-day continuous infusion of 5-fluorouracil and bolus mitomycin C, usually administered during the first week of each RT course. Median follow-up was 76.2 months. Univariate and multivariate analyses were performed to determine the factors associated with locoregional control (LRC). Results: Five-year actuarial LRC was 72.5%. Factors associated with poorer LRC (univariate) were: age ≤65, male gender, and gap >37.5 days. Number of CT cycles (1 vs. 2 or more), boost technique (brachytherapy vs. external), and T-stage were not significantly associated with LRC. In multivariate analysis, only age (p=0.01), and gap (p=0.02) retained their significance. In patients older than 65 years, LRC was 92.3% and 75% for shorter and longer gaps, respectively. In younger patients, the corresponding values for LRC were 73.7% and 50%. Conclusion: In anal cancers, split-course RT with >50 Gy dose delivery is difficult to avoid because of acute toxicity. The present analysis suggests that shortening the gap contributes to optimizing LRC. Gaps longer than 5 weeks correlated with poorer LRC, with especially unsatisfactory results observed in younger patients

  6. Radiotherapy; Strahlentherapie

    Energy Technology Data Exchange (ETDEWEB)

    Wannenmacher, M. [Heidelberg Univ., Mannheim (Germany). Abt. fuer Klinische Radiologie; Debus, J. [Univ. Heidelberg (Germany). Abt. Radioonkologie und Strahlentherapie; Wenz, F. (eds.) [Universitaetsklinikum Mannheim (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    2006-07-01

    The book is focussed on the actual knowledge on the clinical radiotherapy and radio-oncology. Besides fundamental and general contributions specific organ systems are treated in detail. The book contains the following contributions: Basic principles, radiobiological fundamentals, physical background, radiation pathology, basics and technique of brachytherapy, methodology and technique of the stereotactic radiosurgery, whole-body irradiation, operative radiotherapy, hadron therapy, hpyerthermia, combined radio-chemo-therapy, biometric clinical studies, intensity modulated radiotherapy, side effects, oncological diagnostics; central nervous system and sense organs, head-neck carcinomas, breast cancer, thorax organs, esophagus carcinoma, stomach carcinoma, pancreas carcinoma, heptabiliary cancer and liver metastases, rectal carcinomas, kidney and urinary tract, prostate carcinoma, testicular carcinoma, female pelvis, lymphatic system carcinomas, soft tissue carcinoma, skin cancer, bone metastases, pediatric tumors, nonmalignant diseases, emergency in radio-oncology, supporting therapy, palliative therapy.

  7. Radiotherapy apparatus

    International Nuclear Information System (INIS)

    Leung, P.M.; Webb, H.P.J.

    1985-01-01

    This invention relates to apparatus for applying intracavitary radiotherapy. In previously-known systems radioactive material is conveyed to a desired location within a patient by transporting a chain of balls pneumatically to and from an appropriately inserted applicator. According to this invention a ball chain for such a purpose comprises several radioactive balls separated by non-radioactive tracer balls of radiographically transparent material of lower density and surface hardness than the radioactive balls. The invention also extends to radiotherapy treatment apparatus comprising a storage, sorting and assembly system

  8. FZUImageReg: A toolbox for medical image registration and dose fusion in cervical cancer radiotherapy.

    Directory of Open Access Journals (Sweden)

    Qinquan Gao

    Full Text Available The combination external-beam radiotherapy and high-dose-rate brachytherapy is a standard form of treatment for patients with locally advanced uterine cervical cancer. Personalized radiotherapy in cervical cancer requires efficient and accurate dose planning and assessment across these types of treatment. To achieve radiation dose assessment, accurate mapping of the dose distribution from HDR-BT onto EBRT is extremely important. However, few systems can achieve robust dose fusion and determine the accumulated dose distribution during the entire course of treatment. We have therefore developed a toolbox (FZUImageReg, which is a user-friendly dose fusion system based on hybrid image registration for radiation dose assessment in cervical cancer radiotherapy. The main part of the software consists of a collection of medical image registration algorithms and a modular design with a user-friendly interface, which allows users to quickly configure, test, monitor, and compare different registration methods for a specific application. Owing to the large deformation, the direct application of conventional state-of-the-art image registration methods is not sufficient for the accurate alignment of EBRT and HDR-BT images. To solve this problem, a multi-phase non-rigid registration method using local landmark-based free-form deformation is proposed for locally large deformation between EBRT and HDR-BT images, followed by intensity-based free-form deformation. With the transformation, the software also provides a dose mapping function according to the deformation field. The total dose distribution during the entire course of treatment can then be presented. Experimental results clearly show that the proposed system can achieve accurate registration between EBRT and HDR-BT images and provide radiation dose warping and fusion results for dose assessment in cervical cancer radiotherapy in terms of high accuracy and efficiency.

  9. Translational and rotational intra- and inter-fractional errors in patient and target position during a short course of frameless stereotactic body radiotherapy

    International Nuclear Information System (INIS)

    Josipovic, Mirjana; Fredberg Persson, Gitte; Logadottir, Aashildur; Smulders, Bob; Westmann, Gunnar; Bangsgaard, Jens Peter

    2012-01-01

    Background. Implementation of cone beam computed tomography (CBCT) in frameless stereotactic body radiotherapy (SBRT) of lung tumours enables setup correction based on tumour position. The aim of this study was to compare setup accuracy with daily soft tissue matching to bony anatomy matching and evaluate intra- and inter-fractional translational and rotational errors in patient and target positions. Material and methods. Fifteen consecutive SBRT patients were included in the study. Vacuum cushions were used for immobilisation. SBRT plans were based on midventilation phase of four-dimensional (4D)-CT or three-dimensional (3D)-CT from PET/CT. Margins of 5 mm in the transversal plane and 10 mm in the cranio-caudal (CC) direction were applied. SBRT was delivered in three fractions within a week. At each fraction, CBCT was performed before and after the treatment. Setup accuracy comparison between soft tissue matching and bony anatomy matching was evaluated on pretreatment CBCTs. From differences in pre- and post-treatment CBCTs, we evaluated the extent of translational and rotational intra-fractional changes in patient position, tumour position and tumour baseline shift. All image registration was rigid with six degrees of freedom. Results. The median 3D difference between patient position based on bony anatomy matching and soft tissue matching was 3.0 mm (0-8.3 mm). The median 3D intra-fractional change in patient position was 1.4 mm (0-12.2 mm) and 2.2 mm (0-13.2 mm) in tumour position. The median 3D intra-fractional baseline shift was 2.2 mm (0-4.7 mm). With correction of translational errors, the remaining systematic and random errors were approximately 1deg. Conclusion. Soft tissue tumour matching improved precision of treatment delivery in frameless SBRT of lung tumours compared to image guidance using bone matching. The intra-fractional displacement of the target position was affected by both translational and rotational changes in tumour baseline position

  10. Longitudinal diffusion MRI for treatment response assessment: Preliminary experience using an MRI-guided tri-cobalt 60 radiotherapy system.

    Science.gov (United States)

    Yang, Yingli; Cao, Minsong; Sheng, Ke; Gao, Yu; Chen, Allen; Kamrava, Mitch; Lee, Percy; Agazaryan, Nzhde; Lamb, James; Thomas, David; Low, Daniel; Hu, Peng

    2016-03-01

    To demonstrate the preliminary feasibility of a longitudinal diffusion magnetic resonance imaging (MRI) strategy for assessing patient response to radiotherapy at 0.35 T using an MRI-guided radiotherapy system (ViewRay). Six patients (three head and neck cancer, three sarcoma) who underwent fractionated radiotherapy were enrolled in this study. A 2D multislice spin echo single-shot echo planar imaging diffusion pulse sequence was implemented on the ViewRay system and tested in phantom studies. The same pulse sequence was used to acquire longitudinal diffusion data (every 2-5 fractions) on the six patients throughout the entire course of radiotherapy. The reproducibility of the apparent diffusion coefficient (ADC) measurements was assessed using reference regions and the temporal variations of the tumor ADC values were evaluated. In diffusion phantom studies, the ADC values measured on the ViewRay system matched well with reference ADC values with ViewRay MRI. Larger patient cohort studies are warranted to correlate the longitudinal diffusion measurements to patient outcomes. Such an approach may enable response-guided adaptive radiotherapy.

  11. Every second cancer patient receives radiotherapy

    International Nuclear Information System (INIS)

    Ojala, A.

    1996-01-01

    Radiotherapy to treat cancer was given for the first time exactly one hundred years ago. Today, radiotherapy and surgery are the two main modes of treating cancer. One in two cancer patients receives radiotherapy at some point during the course of treatment for the disease. Radiotherapy is applied most commonly in cases where surgery is not possible. Moreover, these two modes of treatment are often used together to supplement each other. About half of new cancer cases detected today can be ordered. The estimate given by the EU for cancers cured is 45 per cent, which is divided between the various treatment modes as follows: surgery 22 %, radiotherapy 12 %, surgery plus radiotherapy 6 %, and drug therapy 6 %. In addition to curative treatment, radiotherapy plays a crucial role in palliative treatment, i.e. treatment that alleviates symptoms. The sensitivity of malignant tumours to radiotherapy varies over a wide range; the same is true for healthy tissues. Radiotherapy can only be used to cure a tumour that is more sensitive to radiation than the surrounding healthy tissue. The tumour must also be sufficiently small in size and limited to a relatively small area. (orig.)

  12. Case study thoracic radiotherapy in an elderly patient with pacemaker: The issue of pacing leads

    Energy Technology Data Exchange (ETDEWEB)

    Kirova, Youlia M., E-mail: youlia.kirova@curie.net [Department of Radiation Oncology, Institut Curie, Paris (France); Menard, Jean; Chargari, Cyrus; Mazal, Alejandro [Department of Radiation Oncology, Institut Curie, Paris (France); Kirov, Krassen [Department of Anesthesiology and Reanimation, Institut Curie, Paris (France)

    2012-07-01

    To assess clinical outcome of patients with pacemaker treated with thoracic radiation therapy for T8-T9 paravertebral chloroma. A 92-year-old male patient with chloroma presenting as paravertebral painful and compressive (T8-T9) mass was referred for radiotherapy in the Department of Radiation Oncology, Institut Curie. The patient presented with cardiac dysfunction and a permanent pacemaker that had been implanted prior. The decision of Multidisciplinary Meeting was to deliver 30 Gy in 10 fractions for reducing the symptoms and controlling the tumor growth. The patient received a total dose of 30 Gy in 10 fractions using 4-field conformal radiotherapy with 20-MV photons. The dose to pacemaker was 0.1 Gy but a part of the pacing leads was in the irradiation fields. The patient was treated the first time in the presence of his radiation oncologist and an intensive care unit doctor. Moreover, the function of his pacemaker was monitored during the entire radiotherapy course. No change in pacemaker function was observed during any of the radiotherapy fractions. The radiotherapy was very well tolerated without any side effects. The function of the pacemaker was checked before and after the radiotherapy treatment by the cardiologist and no pacemaker dysfunction was observed. Although updated guidelines are needed with acceptable dose criteria for implantable cardiac devices, it is possible to treat patients with these devices and parts encroaching on the radiation field. This case report shows we were able to safely treat our patient through a multidisciplinary approach, monitoring the patient during each step of the treatment.

  13. Case study thoracic radiotherapy in an elderly patient with pacemaker: The issue of pacing leads

    International Nuclear Information System (INIS)

    Kirova, Youlia M.; Menard, Jean; Chargari, Cyrus; Mazal, Alejandro; Kirov, Krassen

    2012-01-01

    To assess clinical outcome of patients with pacemaker treated with thoracic radiation therapy for T8-T9 paravertebral chloroma. A 92-year-old male patient with chloroma presenting as paravertebral painful and compressive (T8-T9) mass was referred for radiotherapy in the Department of Radiation Oncology, Institut Curie. The patient presented with cardiac dysfunction and a permanent pacemaker that had been implanted prior. The decision of Multidisciplinary Meeting was to deliver 30 Gy in 10 fractions for reducing the symptoms and controlling the tumor growth. The patient received a total dose of 30 Gy in 10 fractions using 4-field conformal radiotherapy with 20-MV photons. The dose to pacemaker was 0.1 Gy but a part of the pacing leads was in the irradiation fields. The patient was treated the first time in the presence of his radiation oncologist and an intensive care unit doctor. Moreover, the function of his pacemaker was monitored during the entire radiotherapy course. No change in pacemaker function was observed during any of the radiotherapy fractions. The radiotherapy was very well tolerated without any side effects. The function of the pacemaker was checked before and after the radiotherapy treatment by the cardiologist and no pacemaker dysfunction was observed. Although updated guidelines are needed with acceptable dose criteria for implantable cardiac devices, it is possible to treat patients with these devices and parts encroaching on the radiation field. This case report shows we were able to safely treat our patient through a multidisciplinary approach, monitoring the patient during each step of the treatment.

  14. The effect on the radiotherapy for cervical cancer patients quality of life and the related health education

    International Nuclear Information System (INIS)

    Gao Xinli

    2012-01-01

    Radiotherapy is an important means of cervical cancer, due to the specificity of tumor site and side effect of radiotherapy, lack of knowledge of radiotherapy for patients and relatives about the disease, It is particularly important during radiotherapy on health education. By the analysis of radiotherapy for cervical cancer patients quality of life, it is the purpose of patients during the period of radiotherapy of whole course health education. Including before radiotherapy, radiotherapy in health education and the guide of the leaving hospital. In order to improve the compliance of patients, reduce the complications. Further it is improved the clinical treatment effect. (author)

  15. Interstitial radiotherapy

    International Nuclear Information System (INIS)

    Scardino, P.T.; Bretas, F.

    1987-01-01

    The authors now have 20 years of experience with modern techniques of brachytherapy. The large number of patients treated in medical centers around the world and the widespread use of this type of radiotherapy have provided us with substantial information about the indications and contraindications, advantages and disadvantages, pitfalls and complications, as well as the results of these techniques. Although the focus of this review is the experience at Baylor using the combined technique of gold seed implantation plus external beam irradiation, the alternative forms of brachytherapy will be described and compared. The authors' intention is to provide the busy clinician with a succinct and informative review indicating the status of modern interstitial radiotherapy and describing day-to-day approach and results

  16. Palliative Radiotherapy

    International Nuclear Information System (INIS)

    Salinas, J.

    2003-01-01

    Palliative care does not attempt to prolong survival but to the achieve the highest quality of life both for the patient and their family covering their physical, psychological, social and spiritual needs. Radiotherapy (RT), one of the most important therapeutic modalities, has a great significance in palliative medicine for cancer since it attempts to reduce as much as possible the acute reaction associated with the treatment for the patient. (Author)

  17. Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: increased bowel dysfunction in irradiated patients--a Dutch colorectal cancer group study.

    NARCIS (Netherlands)

    Peeters, K.C.; Velde, C.J. van de; Leer, J.W.H.; Martijn, H.; Junggeburt, J.M.; Kranenbarg, E.K.; Steup, W.H.; Wiggers, T.; Rutten, H.J.; Marijnen, C.A.

    2005-01-01

    PURPOSE: Preoperative short-term radiotherapy improves local control in patients treated with total mesorectal excision (TME). This study was performed to assess the presence and magnitude of long-term side effects of preoperative 5 x 5 Gy radiotherapy and TME. Also, hospital treatment was recorded

  18. An energy literacy strategy from the University of Calgary for the entire energy sector

    Energy Technology Data Exchange (ETDEWEB)

    Donev, J.M.K.C.; Heffernan, B.; Jenden, J.; Lloyd, E.R.; Toor, J.; Williams, J.E., E-mail: jason.donev@ucalgary.ca [Univ. of Calgary, Calgary, AB (Canada)

    2014-07-01

    The public at large needs to have a better understanding of the entire energy sector in order to put the benefits and drawbacks of nuclear power into proper perspective.University science departments can and should play a more significant role in educating the public about various aspects of nuclear power, and energy in general. This paper discusses how the University of Calgary is launching initiatives to help teach the public about energy issues. These initiatives include a course for non-technical students on energy, a similar course for people within the energy industry without a technical background, and an extensive online encyclopedia to support these courses. (author)

  19. An energy literacy strategy from the University of Calgary for the entire energy sector

    International Nuclear Information System (INIS)

    Donev, J.M.K.C.; Heffernan, B.; Jenden, J.; Lloyd, E.R.; Toor, J.; Williams, J.E.

    2014-01-01

    The public at large needs to have a better understanding of the entire energy sector in order to put the benefits and drawbacks of nuclear power into proper perspective.University science departments can and should play a more significant role in educating the public about various aspects of nuclear power, and energy in general. This paper discusses how the University of Calgary is launching initiatives to help teach the public about energy issues. These initiatives include a course for non-technical students on energy, a similar course for people within the energy industry without a technical background, and an extensive online encyclopedia to support these courses. (author)

  20. Conformation radiotherapy and conformal radiotherapy

    International Nuclear Information System (INIS)

    Morita, Kozo

    1999-01-01

    In order to coincide the high dose region to the target volume, the 'Conformation Radiotherapy Technique' using the multileaf collimator and the device for 'hollow-out technique' was developed by Prof. S. Takahashi in 1960. This technique can be classified a type of 2D-dynamic conformal RT techniques. By the clinical application of this technique, the late complications of the lens, the intestine and the urinary bladder after radiotherapy for the maxillary cancer and the cervical cancer decreased. Since 1980's the exact position and shape of the tumor and the surrounding normal tissues can be easily obtained by the tremendous development of the CT/MRI imaging technique. As a result, various kinds of new conformal techniques such as the 3D-CRT, the dose intensity modulation, the tomotherapy have been developed since the beginning of 1990'. Several 'dose escalation study with 2D-/3D conformal RT' is now under way to improve the treatment results. (author)

  1. Rehabilitation of patients with laryngeal and lung cancer after radiotherapy

    International Nuclear Information System (INIS)

    Strashinin, A.I.; Gerasimyak, V.G.; Vladimirova, V.A.; Ivanova, L.V.

    1980-01-01

    The ways of medical and social-occupational rehabilitation after a course of radiotherapy in patients with respiratory system cancer have been determined. Medical rehabilitation in patients with lung cancer comprises expedient planning of radiotherapy by means of systematic medicamental treatment. It is shown that it is necessary to place the patients in special rehabilitation departments after radiotherapy of carry out the treatment of pneumonities

  2. Postmastectomy radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-10-01

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

  3. Radiotherapy in free practice

    International Nuclear Information System (INIS)

    Schmelz, H.P.

    1974-01-01

    Relating the X-ray ordinance cases of the fourth quarter 1971 to the whole year a total surface and incident dose of 2,107,656 R was administered in 2,189 cases (1,881 patients) in the course of 16,574 sessions. During the same period, 364 patients were treated in the 14 consultation rooms by radiotherapy because of malignant diseases. The genetically significant dose of 0,6 mrem/a is composed of the GSD of 0,194 in practice and 0,407 mrem in clinics and corresponds in its proportions to the GSD calculated and estimated in recent times. Compared with GSD values from other spheres of the application of ionizing radiation in medical practice, the calculated GSD of 0,6 mrem/a in radiotherapy for benign diseases corresponds to the GSD of approximately 0,5 mrem/a for the nuclear medicine in West-Berlin as stated by Hinz and Weil. It corresponds to 1% of the GSD of approximately/a as estimated recently for X-ray diagnostic applications. (orig./HP) [de

  4. Concurrent radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Fu, K.K.

    1985-01-01

    The principal objective of combining chemotherapy with radiotherapy (XRT) for the treatment of advanced head and neck cancer is to improve the therapeutic ratio through the enhancement of local control and reduction of distant metastases without excessively enhancing normal tissue effects. Improved tumour control can result from sole additivity of either therapy or direct interactions between drug and radiation leading to increased tumour cell kill. Chemotherapy may sensitize the cells to radiation, interfere with repair of sublethal or potentially lethal radiation damage, induce cell synchrony, and reduce tumour mass leading to reoxygenation and decreased fraction of resistant hypoxic cells. Radiation may improve drug accessibility to tumour cells and reduce tumour volume leading to increased cell proliferation and chemosensitivity. If the enhanced effects of combined therapy are purely additive, then the two modalities can be administered either sequentially or concurrently with the same results. However, if the enhanced effects result from the direct interaction between drug and radiation, it is necessary that the two modalities be administered concurrently and in close temporal proximity. This review summarizes the results of clinical studies in which chemotherapy was administered concurrently during the course of radiotherapy for patients with previously untreated advanced squamous cell carcinoma in the head and neck

  5. Radiotherapy in bladder cancer

    International Nuclear Information System (INIS)

    Rozan, R.

    1992-01-01

    In 1992, the problem of the vesical radiotherapy is not resolved. The author presents the situation and the different techniques of radiotherapy in bladder cancers: external radiotherapy, only and associated with surgery, interstitial curietherapy and non-classical techniques as per operative radiotherapy, neutron therapy and concurrent radiotherapy with chemotherapy. In order to compare their efficiency, the five-year survival are given in all cases.(10 tabs)

  6. Intraoperative radiotherapy (IORT) for locally advanced or recurrent renal cell carcinoma; Intraoperative Radiotherapie (IORT) lokal ausgedehnter und rezidivierter Nierenzellkarzinome

    Energy Technology Data Exchange (ETDEWEB)

    Eble, M.J.; Wannenmacher, M. [Radiologische Klinik, Ruprecht-Karls-Univ. Heidelberg (Germany); Staehler, G. [Urologische Klinik, Ruprecht-Karls-Univ. Heidelberg (Germany)

    1998-01-01

    In a pilot study the role of intraoperative radiotherapy in the treatment of locally advanced or recurrent renal cell cacinomas was analysed. From January 1992 to July 1994 11 patients with a primary (n=3) or recurrent renal cell carcinoma had IORT. One patient had complete resection and in 3 respectively 7 patients microscopically or macroscopically residual disease was left. Using 6 to 10 MeV, a single dose of 15 to 20 Gy was delivered to the fossa renalis and the corresponding paraaortic area. Based on three-dimensional treatment planning, additional external beam radiotherapy was given 3 to 4 weeks later (40 Gy, 2 Gy SD, 23 mV). After a mean follow-up of 24.3 months 5 patients had died of distant metastases (lung, liver, bone, mediastinum) with a mean survival time of 11.5 months. Mean disease-free interval was 6.4 months. One patient suffered from a second malignancy. Two patients are alive with distant metastases. Local tumor control in the entire group was 100%. The calculated 4-year overall and disease-free survival was 47% and 34%. The postoperative course was affected in 3 patients (abscess n=1, short dehiscence of the abdominal wound n=2). The gastrointestinal toxicity during external beam radiotherapy was low. No IORT-specific late adverse effects were observed. (orig./MG) [Deutsch] In einer Pilotstudie wurde die Wertigkeit der intraoperativen Radiotherapie bei lokal ausgedehnten primaeren oder rezidivierten Nierenzellkarzinomen ueberprueft. Von Januar 1992 bis Juli 1994 konnten bei elf Patienten mit einem primaeren (n=3) oder rezidivierten Nierenzellkarzinom intraoperativ mit 15 bis 20 Gy das Nierenlager und der Paraaortalraum bestrahlt werden. Ein Patient war vollstaendig reseziert, und bei drei bzw. sieben Patienten verblieben mikroskopische bzw. makroskopische Reste. Nach dreidimensionaler Planung wurde perkutan die Dosis mit 40 Gy aufgesaettigt (23 MV, 2 Gy ED). Nach einer mittleren Nachbeobachtung von 24,3 Monaten waren fuenf Patienten nach im

  7. Hypofractionated radiotherapy for invasive bladder cancer

    International Nuclear Information System (INIS)

    Scholten, Astrid N.; Leer, Jan-Willem H.; Collins, C. David; Wondergem, Jan; Hermans, Jo; Timothy, Adrian

    1997-01-01

    Background and purpose: The policy of the Radiotherapy Department of St. Thomas' Hospital in London for patients with invasive bladder cancer, used to be treatment with hypofractionated radiotherapy. The advantages of this fractionation scheme included reduction of the number of treatment sessions and better use of limited resources. Our results after hypofractionation were compared to series with more conventional radiotherapy. Material and methods: Between 1975 and 1985, 123 patients with a T2-T3 transitional cell carcinoma of the bladder were treated by a radical course of hypofractionated radiotherapy. Local control, survival and morbidity rates were analysed retrospectively. Results: The actuarial local control rates at 5 and 10 years were 31 and 29%, respectively. The actuarial cancer-specific 5- and 10-year survival rates were 48 and 39%, respectively. Acute side effects were observed in 87% of patients. The actuarial overall and severe late complication rates at 5 years were 33 and 9%, respectively. The local control, survival and early side effect rates we found, were in the same range as those reported in literature. Late radiation side effects however, were more common after hypofractionated radiotherapy compared to conventional radiotherapy schedules. Conclusions: We conclude that the potential advantage of a reduced number of treatment sessions may be lost in the long term, because of the higher incidence of late morbidity after hypofractionated radiotherapy. Hypofractionation however, remains a valuable technique for palliation and deserves further investigation for radical treatment where access to equipment is difficult or resources are limited

  8. Psychological and physical distress of cancer patients during radiotherapy

    International Nuclear Information System (INIS)

    Koenig, A.

    2001-05-01

    Purpose: patients undergoing radiotherapy have physical and psychological symptoms related to the underlying disease and the treatment. In order to give the best possible support to the patients, more knowledge about the amount and the changing of distress in the course of radiotherapy is of essentially importance. Methods: The distress was measured in a consecutive sample of cancer patients (n=82) undergoing radiotherapy. Each patient was given the EORTC-QLQ-C30, the HADS and a special questionnaire which ascertain radiotherapy-specific items before starting the radiotherapy, at the onset of radiotherapy, in the third week of radiotherapy and 3 weeks after the end of radiotherapy. Results: within the first week of treatment the psychological distress of the patients is increasing; 98.8 % of the patients are 'moderate distressed', 46 % 'severe distressed'. General physical symptoms seem not to be affected by the radiotherapy, there is no changing. The distress caused by the organization of the radiotherapy is decreasing, while therapy-related symptoms are increasing in the course of radiotherapy. Even after the end of the therapy these symptoms keep on causing distress, sometimes in a higher amount than before. A correlation between sex, sort of cancer and curative or palliative treatment and the amount of distress was found. Conclusion: the results stress the importance of adequate emotional support for patients undergoing radiotherapy especially in the first week of treatment and after the treatment. There is a need for the development of a valid radiotherapy - questionnaire in order to be able to measure the distress of these patients. (author)

  9. Radiotherapy of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    Heilmann, H.P.

    1982-01-01

    Radiotherapy of branchogenic carcinoma comprises; palliative treatment, postoperative or pre-operative radiotherapy, radiotherapy as part of a combination of chemotherapy and radiotherapy of small cell carcinoma and curative radiotherapy of non-operable non-small cell carcinoma. Atelectasis and obstruction are indications for palliative radiotherapy. Postoperative radiotherapy is given only in cases of incomplete resection or mediastinal metastases. In the treatment of small cell carcinoma by combined irradiation and chemotherapy the mediastinum and primary tumour are irradiated, generally after chemotherapy, and the C.N.S. receives prophylactic radiotherapy. Curative radiotherapy is indicated in cases of non-operable small cell carcinoma. Irradiation with doses of 60-70 Gy produced 5-years-survival rates of 10-14% in cases classified as T 1 -T 2 N 0 M 0 . (orig.) [de

  10. Semigroups of transcendental entire functions and their dynamics

    Indian Academy of Sciences (India)

    DINESH KUMAR

    Abstract. We investigate the dynamics of semigroups of transcendental entire func- tions using Fatou–Julia theory. Several results of the dynamics associated with iteration of a transcendental entire function have been extended to transcendental semigroups. We provide some condition for connectivity of the Julia set of the ...

  11. Entire solutions of nonlinear differential-difference equations.

    Science.gov (United States)

    Li, Cuiping; Lü, Feng; Xu, Junfeng

    2016-01-01

    In this paper, we describe the properties of entire solutions of a nonlinear differential-difference equation and a Fermat type equation, and improve several previous theorems greatly. In addition, we also deduce a uniqueness result for an entire function f(z) that shares a set with its shift [Formula: see text], which is a generalization of a result of Liu.

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

    Science.gov (United States)

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

    2015-05-02

    Radiotherapy provides significant benefits in terms of reducing risk of local recurrence and death from rectal cancer. Despite this, up-to-date cost estimates for radiotherapy are lacking, potentially inhibiting policy and decision-making. Our objective was to generate an up-to-date estimate of the cost of traditional radiotherapy for rectal cancer and model the impact of a range of potential efficiency improvements. Microcosting methods were used to estimate total direct radiotherapy costs for long- (assumed at 45-50 Gy in 25 daily fractions over a 5 week period) and short-courses (assumed at 25 Gy in 5 daily fractions over a one week period). Following interviews and on-site visits to radiotherapy departments in two designated cancer centers, a radiotherapy care pathway for a typical rectal cancer patient was developed. Total direct costs were derived by applying fixed and variable unit costs to resource use within each care phase. Costs included labor, capital, consumables and overheads. Sensitivity analyses were performed. Radiotherapy treatment was estimated to cost between €2,080 (5-fraction course) and €3,609 (25-fraction course) for an average patient in 2012. Costs were highest in the treatment planning phase for the short-course (€1,217; 58% of total costs), but highest in the radiation treatment phase for the long-course (€1,974: 60% of total costs). By simultaneously varying treatment time, capacity utilization rates and linear accelerator staff numbers, the base cost fell by 20% for 5-fractions: (€1,660) and 35% for 25-fractions: (€2,354). Traditional radiotherapy for rectal cancer is relatively inexpensive. Moreover, significant savings may be achievable through service organization and provision changes. These results suggest that a strong economic argument can be made for expanding the use of radiotherapy in rectal cancer treatment.

  13. National arrangements for radiotherapy

    International Nuclear Information System (INIS)

    2007-01-01

    After a presentation of several letters exchanged between the French health ministry and public agencies in charge of public health or nuclear safety after a radiotherapy accident in Epinal, this report comments the evolution of needs in cancerology care and the place given to radiotherapy. It outlines the technological and organisational evolution of radiotherapy and presents the distribution of radiotherapy equipment, of radio-therapists and other radiotherapy professionals in France. Within the context of radiotherapy accidents which occurred in 2007, it presents the regulatory arrangements which aimed at improving the safety, short term and middle term arrangements which are needed to support and structure radiotherapy practice quality. It stresses the fact that the system will deeply evolve by implementing a radiotherapy vigilance arrangement and a permanent follow-on and adaptation plan based on surveys and the creation of a national committee

  14. Radiotherapy of malignant lymphomas

    Energy Technology Data Exchange (ETDEWEB)

    Kujawska, J [Instytut Onkologii, Krakow (Poland)

    1979-01-01

    The paper discusses current views on the role of radiotherapy in the treatment of patients with malignant lymphomas. Principles of radiotherapy employed in the Institute of Oncology in Cracow in case of patients with malignant lymphomas are also presented.

  15. Short-course versus long-course chemoradiation in rectal cancer--time to change strategies?

    Science.gov (United States)

    Palta, Manisha; Willett, Christopher G; Czito, Brian G

    2014-09-01

    There is significant debate regarding the optimal neoadjuvant regimen for resectable rectal cancer patients. Short-course radiotherapy, a standard approach throughout most of northern Europe, is generally defined as 25 Gy in 5 fractions over the course of 1 week without the concurrent administration of chemotherapy. Long-course radiotherapy is typically defined as 45 to 50.4 Gy in 25-28 fractions with the administration of concurrent 5-fluoropyrimidine-based chemotherapy and is the standard approach in other parts of Europe and the United States. At present, two randomized trials have compared outcomes for short course radiotherapy with long-course chemoradiation showing no difference in respective study endpoints. Late toxicity data are lacking given limited follow-up. Although the ideal neoadjuvant regimen is controversial, our current bias is long-course chemoradiation to treat patients with locally advanced, resectable rectal cancer.

  16. Unintended exposure in radiotherapy: Identification of prominent causes

    International Nuclear Information System (INIS)

    Boadu, Mary; Rehani, Madan Mohan

    2009-01-01

    Background and purpose: Unintended exposures in radiotherapy are likely to occur when certain conditions that favour such exposures exist. Based on the frequency of occurrence of various causes of 100 events of unintended exposures in radiotherapy as derived from the analysis of published reports, a checklist for assessing the vulnerability of radiotherapy facilities for potential accidents has been prepared. The list presents items to be considered for safety critical assessments of a radiotherapy department for the improvement of patient safety and the entire radiotherapy processes. Materials and methods: The resources used for this paper consist of 100 unintended radiotherapy exposures and were derived from existing published reports. The analysis was performed by forming two templates: one consisting of 10 initiating events and another of 35 contributing factors. Results: Four most prominent initiating events were identified and together accounted for about 70% of all the unintended exposure events. Ten most prominent contributing factors were also identified and together accounted for about 70% of all the radiotherapy unintended exposure events covered under this study. Conclusion: With this knowledge of high frequency of occurrences, the identified four prominent initiating events and the 10 most prominent contributing factors must be checked and dealt with as a matter of priority when assessing the safety of a radiotherapy facility. A simple checklist for checking the quality assurance programmes of a radiotherapy department for every aspect of the design and delivery of radiation have been provided.

  17. Hyperthermia and radiotherapy

    International Nuclear Information System (INIS)

    Fitspatrick, C.

    1990-01-01

    Hyperthermia and radiotherapy have for long been used to assist in the control of tumours, either as separate entities, or, in a combined treatment scheme. This paper outlines why hyperthermia works, thermal dose and the considerations required in the timing when hyperthermia is combined with radiotherapy. Previously reported results for hyperthermia and radiotherapy used together are also presented. 8 refs., 8 tabs

  18. Role of radiotherapy in the treatment of multiple myeloma

    International Nuclear Information System (INIS)

    Mose, S.; Pfitzner, D.; Rahn, A.; Nierhoff, C.; Schiemann, M.; Boettcher, H.D.

    2000-01-01

    Regarding reduction of pain, treatment of (impending) fractures, and spinal cord compression radiation is an important part of palliative treatment. In our retrospective study we report the effort of radiotherapy on reduction of pain, recalcification and the reduction of neurological symptoms and evaluate factors which have an impact on therapeutic outcome. Patients and Methods: From 1. Jan 1988 to 31. Dec 1998, 42 patients (19 women, 23 men; range of ages 46 to 85 years, median age 64.9 years) with 71 target volumes were irradiated (median dose 36 Gy, 2 to 3 Gy 5 times/week) because of symptomatic disease (67/71: Osseous pain, 45/71: Fraktures/impending fractures, 13/71: Spinal cord compression). The median time from diagnosis to the first course of radiotherapy was 11.9 months (0.3 to 90 months). At the time of first irradiation, 5 and 37 patients were in tumor Stage II and III (Salmon/Durie), respectively. The median value of the Karnofsky performance was 70% (40 to 90%). Results: During follow-up (at least 6 months) in 85% of target volumes complete and partial pain relief was achieved; recurrences were seen in 8.8%. In 26/56 (46.4%) lesions evaluable a recalcification was seen whereas 17.9% showed progressive disease (comparison of radiographs before and after radiation). In 22.3% of all lesions initially with impending fracture (4/18) radiotherapy failed because of fracture after treatment. Simultaneous chemotherapy and a Karnofsky performance ≥70 had a significant impact on a positive response to treatment, respectively. Spinal cord compression symptoms were reduced in 7/13 (53.8%) of patients (scaled due to the classification by Findlay 1987). The median survival from diagnosis for the entire group was 34.9 months (7.5 to 119.3 months), after irradiation 13.1 months (0.2 to 105.3 months). Conclusion: When adequately indicated radiotherapy was shown to be an effective palliative treatment. Taking under consideration that the results are retrospective we

  19. [Role of radiotherapy in the treatment of multiple myeloma].

    Science.gov (United States)

    Mose, S; Pfitzner, D; Rahn, A; Nierhoff, C; Schiemann, M; Böttcher, H D

    2000-11-01

    Chemotherapy is the treatment of choice in multiple myeloma; but there are no curative options. Therefore, the treatment rationale is characterized by reduction of symptoms and inhibition of complications. Regarding reduction of pain, treatment of (impending) fractures, and spinal cord compression radiation is an important part of palliative treatment. In our retrospective study we report the effect of radiotherapy on reduction of pain, recalcification and the reduction of neurological symptoms and evaluate factors which have an impact on therapeutic outcome. From 1, Jan 1988 to 31, Dec 1998, 42 patients (19 women, 23 men; range of ages 46 to 85 years, median age 64.9 years) with 71 target volumes were irradiated (median dose 36 Gy, 2 to 3 Gy 5 times/week) because of symptomatic disease (67/71: osseous pain, 45/71: fractures/impending fractures, 13/71: spinal cord compression) (Tables 1 and 2). The median time from diagnosis to the first course of radiotherapy was 11.9 months (0.3 to 90 months). At the time of first irradiation, 5 and 37 patients were in tumor Stage II and III (Salmon/Durie), respectively. The median value of the Karnofsky performance was 70% (40 to 90%). During follow-up (at least 6 months) in 85% of target volumes complete and partial pain relief (measured by patients' perception and the use of analgetic medication) was achieved; recurrences were seen in 8.8%. In 26/56 (46.4%) lesions evaluable a recalcification was seen whereas 17.9% showed progressive disease (comparison of radiographs before and after radiation). In 22.3% of all lesions initially with impending fracture (4/18) radiotherapy failed because of fracture after treatment (Tables 3 and 4). Simultaneous chemotherapy and a Karnofsky performance > or = 70 had a significant impact on a positive response to treatment, respectively. Spinal cord compression symptoms were reduced in 7/13 (53.8%) of patients (scaled due to the classification by Findlay 1987). The median survival from

  20. Entire solutions of Fermat type q-difference differential equations

    Directory of Open Access Journals (Sweden)

    Kai Liu

    2013-02-01

    Full Text Available In this article, we describe the finite-order transcendental entire solutions of Fermat type $q$-difference and $q$-difference differential equations. In addition, we investigate the similarities and other properties among those solutions.

  1. [Head and neck adaptive radiotherapy].

    Science.gov (United States)

    Graff, P; Huger, S; Kirby, N; Pouliot, J

    2013-10-01

    Onboard volumetric imaging systems can provide accurate data of the patient's anatomy during a course of head and neck radiotherapy making it possible to assess the actual delivered dose and to evaluate the dosimetric impact of complex daily positioning variations and gradual anatomic changes such as geometric variations of tumors and normal tissues or shrinkage of external contours. Adaptive radiotherapy is defined as the correction of a patient's treatment planning to adapt for individual variations observed during treatment. Strategies are developed to selectively identify patients that require replanning because of an intolerable dosimetric drift. Automated tools are designed to limit time consumption. Deformable image registration algorithms are the cornerstones of these strategies, but a better understanding of their limits of validity is required before adaptive radiotherapy can be safely introduced to daily practice. Moreover, strict evaluation of the clinical benefits is yet to be proven. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  2. Rapidly alternating combination of cisplatin-based chemotherapy and hyperfractionated accelerated radiotherapy in split course for Stage IIIA and Stage IIIB non-small cell lung cancer: results of a Phase I-II study by the GOTHA group

    Energy Technology Data Exchange (ETDEWEB)

    Alberto, P.; Mermillod, B. [Hopital Cantonal Geneve, Geneva (Switzerland); Mirimanoff, R.O.; Leyvraz, S.; Nagy-Mignotte, H.; Bolla, M.; Wellmann, D.; Moro, D.; Brambilla, E. [Hopital Cantonal Universitaire, Lausanne (Switzerland)

    1995-08-01

    The prognosis of stage III non-small cell lung cancer (NSCLC) can be improved by a combination of radiotherapy (RT) and chemotherapy (CT). In this study, the GOTHA group evaluated the feasibility, tolerance, tumour response, pattern of failure and effect on survival of a combination alternating accelerated hyperfractionated (AH) RT and CT in patients with tumour stage III NSCLC. Toxic effects were leucopenia, nausea and vomiting, mucositis, diarrhoea, alopecia and peripheral neuropathy. Alternating CT and AHRT, as used in this study, were well tolerated and allowed full dose delivery within less than 12 weeks. Initial response was not predictive of survival. The survival curve is encouraging and the 5 year survival is superior to the 5% generally observed with conventionally fractionated radiotherapy. (author).

  3. Effects of radiotherapy on anti-cancer immune response: mathematical modeling

    International Nuclear Information System (INIS)

    Isaeva, O.G.; Osipov, V.A.

    2009-01-01

    The influence of radiotherapy on the tumor-immune dynamics is studied within our recent model. Simulation of the standard course of radiotherapy shows that in the case of weak immune response a few months after cure the tumor achieves the maximum size, whereas the strong immune system is able to handle the growth of survived tumor cells population. Simulation of vaccine therapy after radiotherapy has been carried out. The high efficiency of vaccination is found provided that it is assigned during a certain period of time after radiotherapy. Different strategies of radiotherapy have been considered. It is shown that hyper rectification is more effective for treatment in comparison with other cures

  4. Time management in radiation oncology: evaluation of time, attendance of medical staff, and resources during radiotherapy for prostate cancer: the DEGRO-QUIRO trial.

    Science.gov (United States)

    Keilholz, L; Willner, J; Thiel, H-J; Zamboglou, N; Sack, H; Popp, W

    2014-01-01

    In order to evaluate resource requirements, the German Society of Radiation Oncology (DEGRO) recorded the times needed for core procedures in the radio-oncological treatment of various cancer types within the scope of its QUIRO trial. The present study investigated the personnel and infrastructural resources required in radiotherapy of prostate cancer. The investigation was carried out in the setting of definitive radiotherapy of prostate cancer patients between July and October 2008 at two radiotherapy centers, both with well-trained staff and modern technical facilities at their disposal. Personnel attendance times and room occupancy times required for core procedures (modules) were each measured prospectively by two independently trained observers using time measurements differentiated on the basis of professional group (physician, physicist, and technician), 3D conformal (3D-cRT), and intensity-modulated radiotherapy (IMRT). Total time requirements of 983 min for 3D-cRT and 1485 min for step-and-shoot IMRT were measured for the technician (in terms of professional group) in all modules recorded and over the entire course of radiotherapy for prostate cancer (72-76 Gy). Times needed for the medical specialist/physician were 255 min (3D-cRT) and 271 min (IMRT), times of the physicist were 181 min (3D-cRT) and 213 min (IMRT). The difference in time was significant, although variations in time spans occurred primarily as a result of various problems during patient treatment. This investigation has permitted, for the first time, a realistic estimation of average personnel and infrastructural requirements for core procedures in quality-assured definitive radiotherapy of prostate cancer. The increased time needed for IMRT applies to the step-and-shoot procedure with verification measurements for each irradiation planning.

  5. Pade approximants for entire functions with regularly decreasing Taylor coefficients

    International Nuclear Information System (INIS)

    Rusak, V N; Starovoitov, A P

    2002-01-01

    For a class of entire functions the asymptotic behaviour of the Hadamard determinants D n,m as 0≤m≤m(n)→∞ and n→∞ is described. This enables one to study the behaviour of parabolic sequences from Pade and Chebyshev tables for many individual entire functions. The central result of the paper is as follows: for some sequences {(n,m(n))} in certain classes of entire functions (with regular Taylor coefficients) the Pade approximants {π n,m(n) }, which provide the locally best possible rational approximations, converge to the given function uniformly on the compact set D={z:|z|≤1} with asymptotically best rate

  6. Entirely saturated unilateral smear of laser spot in CCD

    International Nuclear Information System (INIS)

    Zhang Zhen; Zhou Menglian; Zhang Jianmin; Lin Xinwei

    2013-01-01

    In the video of linear CCD camera being irradiated by 532 nm CW laser, the entirely saturated unilateral smear of laser spot was found. The smear area does not represent the distribution of laser. Since this smear lies merely in one side of laser spot, it can not be induced by light leaking or carriers blooming, and it may be induced by charge transfer loss. However, the feature that the smear area is entirely saturated can not be explained by the current constant model of charge transfer inefficiency. Based on the inner structure and operating principle of buried channel CCD, a new model of charge transfer inefficiency that varies with charge quantity is proposed, which can explain the entirely saturated unilateral smear of laser spot. (authors)

  7. Entirely irrelevant distractors can capture and captivate attention.

    Science.gov (United States)

    Forster, Sophie; Lavie, Nilli

    2011-12-01

    The question of whether a stimulus onset may capture attention when it is entirely irrelevant to the task and even in the absence of any attentional settings for abrupt onset or any dynamic changes has been highly controversial. In the present study, we designed a novel irrelevant capture task to address this question. Participants engaged in a continuous task making sequential forced choice (letter or digit) responses to each item in an alphanumeric matrix that remained on screen throughout many responses. This task therefore involved no attentional settings for onset or indeed any dynamic changes, yet the brief onset of an entirely irrelevant distractor (a cartoon picture) resulted in significant slowing of the two (Experiment 1) or three (Experiment 2) responses immediately following distractor appearance These findings provide a clear demonstration of attention being captured and captivated by a distractor that is entirely irrelevant to any attentional settings of the task.

  8. Neutron radiotherapy

    International Nuclear Information System (INIS)

    Thomas, F.J.

    1987-01-01

    The rationale for the application of neutron radiation for the treatment of malignancies is well established based on radiobiological studies. These factors include the presence of tissue hypoxia, radiation response as a function of cell cycle kinetics, the repair capacity of the malignant cells and the regeneration of malignant cells during a fractionated course of radiation. Despite the constraints under which the clinical trials to date have been conducted, promising results have been obtained. Randomized trials have demonstrated that neutron therapy is the treatment of choice for inoperable salivary gland carcinomas. A randomized trial of the RTOG has demonstrated a probable advantage for neutron radiation in the treatment of advanced prostate carcinomas but is yet to be confirmed. An improvement in local control has also been observed for selected sarcomas. Equivocal or contradictory results have been obtained for squamous cell carcinomas of the head and neck, bronchogenic carcinomas, advanced rectal, transitional cell carcinomas of the bladder and cervical carcinomas. The practical consequences of these radiobiological and clinical observations on the current generation of clinical trials is discussed

  9. Selectable six-element multicoil array for entire spine imaging

    International Nuclear Information System (INIS)

    Byrne, J.W.; Bluma-Walter, J.; Prorok, R.J.

    1990-01-01

    This article introduces a new multicoil array that can provide entire spine imaging in two acquisitions with no need to manually reposition either the coil or the patient. A selectable contoured multicoil array with six elements was used to obtain coverage of the entire spine. The first four elements were used for imaging the upper spine region (cervical/thoracic) during the first acquisition, and the last four elements were used for imaging the lower spine region (thoracic/lumbar) during the second acquisition. The overall coil length was approximately 75 cm

  10. The metabolic radiotherapy. La radiotherapie metabolique

    Energy Technology Data Exchange (ETDEWEB)

    Begon, F.; Gaci, M. (Centre Hospitalier Universitaire, 86 - Poitiers (France))

    In this article, the authors recall the principles of the metabolic radiotherapy and present these main applications in the treatment of thyroid cancers, hyperthyroidism, polycythemia, arthritis, bone metastases, adrenergic neoplasms. They also present the radioimmunotherapy.

  11. Children Undergoing Radiotherapy: Swedish Parents’ Experiences and Suggestions for Improvement

    Science.gov (United States)

    Mullaney, Tara; Nilsson, Kristina; Wickart-Johansson, Gun; Svärd, Anna-Maja; Nyholm, Tufve; Lindh, Jack; Lindh, Viveca

    2015-01-01

    Approximately 300 children, from 0 to 18 years old, are diagnosed with cancer in Sweden every year. Of these children, 80–90 of them undergo radiotherapy treatment for their cancer. Although radiotherapy is an encounter with advanced technology, few studies have investigated the child’s and the parent’s view of the procedure. As part of an ongoing multicenter study aimed to improve patient preparation and the care environment in pediatric radiotherapy, this article reports the findings from interviews with parents at baseline. The aim of the present study was twofold: to describe parents’ experience when their child undergoes radiotherapy treatment, and to report parents’ suggestions for improvements during radiotherapy for their children. Sixteen mothers and sixteen fathers of children between 2–16 years old with various cancer diagnoses were interviewed. Data were analyzed using content analysis. The findings showed that cancer and treatment turns people’s lives upside down, affecting the entire family. Further, the parents experience the child’s suffering and must cope with intense feelings. Radiotherapy treatment includes preparation by skilled and empathetic staff. The parents gradually find that they can deal with the process; and lastly, parents have suggestions for improvements during the radiotherapy treatment. An overarching theme emerged: that despair gradually turns to a sense of security, with a sustained focus on and close interaction with the child. In conclusion, an extreme burden was experienced around the start of radiotherapy, though parents gradually coped with the process. PMID:26509449

  12. Radiotherapy equipment and departments in the European countries

    DEFF Research Database (Denmark)

    Grau, Cai; Defourny, Noémie; Malicki, Julian

    2014-01-01

    BACKGROUND: Documenting the distribution of radiotherapy departments and the availability of radiotherapy equipment in the European countries is an important part of HERO - the ESTRO Health Economics in Radiation Oncology project. HERO has the overall aim to develop a knowledge base...... of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The aim of the current report is to describe the distribution of radiotherapy equipment in European countries. METHODS: An 84-item questionnaire was sent out to European...... countries, principally through their national societies. The current report includes a detailed analysis of radiotherapy departments and equipment (questionnaire items 26-29), analyzed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis is based...

  13. Estimating the demand for radiotherapy from the evidence: A review of changes from 2003 to 2012

    International Nuclear Information System (INIS)

    Barton, Michael B.; Jacob, Susannah; Shafiq, Jesmin; Wong, Karen; Thompson, Stephen R.; Hanna, Timothy P.; Delaney, Geoff P.

    2014-01-01

    Background and Purpose: In 2003 we estimated that 52.3% of new cases of cancer in Australia had an indication for external beam radiotherapy at least once at some time during the course of their illness. This update reviews the contemporary evidence to define the optimal proportion of new cancers that would benefit from radiotherapy as part of their treatment and estimates the changes to the optimal radiotherapy utilisation rate from 2003 to 2012. Materials and Methods: National and international guidelines were reviewed for external beam radiotherapy indications in the management of cancers. Epidemiological data on the proportion of new cases of cancer with each indication for radiotherapy were identified. Indications and epidemiological data were merged to develop an optimal radiotherapy utilisation tree. Univariate and Monte Carlo simulations were used in sensitivity analysis. Results: The overall optimal radiotherapy utilisation rate (external beam radiotherapy) for all registered cancers in Australia changed from 52.3% in 2003 to 48.3% in 2012. Overall 8.9% of all cancer patients in Australia have at least one indication for concurrent chemo-radiotherapy during the course of their illness. Conclusions: The reduction in the radiotherapy utilisation rate was due to changes in epidemiological data, changes to radiotherapy indications and refinements of the model structure

  14. Entire functions sharing one polynomial with their derivatives

    Indian Academy of Sciences (India)

    restriction of the hyper order less than 1/2, and obtain some uniqueness theorems of a nonconstant entire function and its derivative sharing a finite nonzero complex number. CM. The results in this paper also improve some known results. Some examples are provided to show that the results in this paper are best possible.

  15. Thermodynamics of Quantum Gases for the Entire Range of Temperature

    Science.gov (United States)

    Biswas, Shyamal; Jana, Debnarayan

    2012-01-01

    We have analytically explored the thermodynamics of free Bose and Fermi gases for the entire range of temperature, and have extended the same for harmonically trapped cases. We have obtained approximate chemical potentials for the quantum gases in closed forms of temperature so that the thermodynamic properties of the quantum gases become…

  16. Evidence-based optimal number of radiotherapy fractions for cancer: A useful tool to estimate radiotherapy demand.

    Science.gov (United States)

    Wong, Karen; Delaney, Geoff P; Barton, Michael B

    2016-04-01

    The recently updated optimal radiotherapy utilisation model estimated that 48.3% of all cancer patients should receive external beam radiotherapy at least once during their disease course. Adapting this model, we constructed an evidence-based model to estimate the optimal number of fractions for notifiable cancers in Australia to determine equipment and workload implications. The optimal number of fractions was calculated based on the frequency of specific clinical conditions where radiotherapy is indicated and the evidence-based recommended number of fractions for each condition. Sensitivity analysis was performed to assess the impact of variables on the model. Of the 27 cancer sites, the optimal number of fractions for the first course of radiotherapy ranged from 0 to 23.3 per cancer patient, and 1.5 to 29.1 per treatment course. Brain, prostate and head and neck cancers had the highest average number of fractions per course. Overall, the optimal number of fractions was 9.4 per cancer patient (range 8.7-10.0) and 19.4 per course (range 18.0-20.7). These results provide valuable data for radiotherapy services planning and comparison with actual practice. The model can be easily adapted by inserting population-specific epidemiological data thus making it applicable to other jurisdictions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Radiotherapy in early stage dupuytren's contracture

    International Nuclear Information System (INIS)

    Adamietz, B.; Sauer, R.; Gruenert, J.

    2001-01-01

    Purpose: In early stage Dupuytren's contracture radiotherapy was applied to prevent disease progression. Long-term results and late toxicity of this treatment were evaluated in a retrospective analysis. Patients and Methods: Between 1982 and 1994, 99 patients (176 hands) received orthovoltage radiotherapy, which consisted of two courses with 5 x 3 Gy (total dose: 30 Gy, daily fractionated; 120 kV, 4 mm Al), separated by a 6 to 8-week pause. The Dupuytren's contracture was staged according to the classification of Tubiana et al. The long-term outcome was analyzed at last follow-up between July and November 1999. The median follow-up was 10 years (range 7-18 years). Late toxicity was assessed using the LENT-SOMA criteria. Results: In Stage N 84% and Stage N/I 67% of cases remained stable. 65% of the cases in Stage I and 83% in Stage II showed progressive nodules and cords. In case of progression we saw no complications after a second radiotherapy or salvage operation. Conclusion: Radiotherapy effectively prevents disease progression for early stage Dupuytren's contracture (Stage N, N/I). Moreover, in case of disease progression despite radiotherapy salvage surgery is still feasible. (orig.) [de

  18. Role of radiotherapy in the complex treatment for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pavlov, A S; Datsenko, V S [Tsentral' nyj Inst. Usovershenstvovaniya Vrachej, Moscow (USSR)

    1978-01-01

    Preoperational irradiation of a primary focus and all the areas of regional metastatic spreading turned out to be most effective in the case of mammary gland cancer complex treating. Postoperational radiotherapy is a less effective version of radiotherapy justified in the case of metastatic affection of lymph nodes and deliberate disturbance of ablastics during the operation. Time interval between the ending of preoperational radiotherapy and the operation must not exceed 3 weeks, as, otherwise, the biological potential of undamaged cancer cells is recovered and the hazard of appearing remote metastases increases. Additional courses of chemotherapy in the case of multiple of lymphogenic metastases improe prognosis for patients with mammary gland cancer.

  19. Radiotherapy in small countries.

    Science.gov (United States)

    Barton, Michael B; Zubizarreta, Eduardo H; Polo Rubio, J Alfredo

    2017-10-01

    To examine the availability of radiotherapy in small countries. A small country was defined as a country with a population less than one million persons. The economic status of each country was defined using the World Bank Classification. The number of cancers in each country was obtained from GLOBOCAN 2012. The number of cancer cases with an indication or radiotherapy was calculated using the CCORE model. There were 41 countries with a population of under 1 million; 15 were classified as High Income, 15 Upper Middle Income, 10 Lower Middle Income and one Low Income. 28 countries were islands. Populations ranged from 799 (Holy See) to 886450 (Fiji) and the total number of cancer cases occurring in small countries was 21,043 (range by country from 4 to 2476). Overall the total number of radiotherapy cases in small countries was 10982 (range by country from 2 to 1239). Radiotherapy was available in all HIC islands with 80 or more new cases of cancer in 2012 but was not available in any LMIC island. Fiji was the only LMIC island with a large radiotherapy caseload. Similar caseloads in non-island LMIC all had radiotherapy services. Most non-island HIC did not have radiotherapy services presumably because of the easy access to radiotherapy in neighbouring countries. There are no radiotherapy services in any LMIC islands. Copyright © 2017. Published by Elsevier Ltd.

  20. Entirely irrelevant distractors can capture and captivate attention

    OpenAIRE

    Forster, Sophie; Lavie, Nilli

    2011-01-01

    The question of whether a stimulus onset may capture attention when it is entirely irrelevant to the task and even in the absence of any attentional settings for abrupt onset or any dynamic changes has been highly controversial. In the present study, we designed a novel irrelevant capture task to address this question. Participants engaged in a continuous task making sequential forced choice (letter or digit) responses to each item in an alphanumeric matrix that remained on screen throughout ...

  1. Completely monotonic functions related to logarithmic derivatives of entire functions

    DEFF Research Database (Denmark)

    Pedersen, Henrik Laurberg

    2011-01-01

    The logarithmic derivative l(x) of an entire function of genus p and having only non-positive zeros is represented in terms of a Stieltjes function. As a consequence, (-1)p(xml(x))(m+p) is a completely monotonic function for all m ≥ 0. This generalizes earlier results on complete monotonicity...... of functions related to Euler's psi-function. Applications to Barnes' multiple gamma functions are given....

  2. Nanometer-scale anatomy of entire Stardust tracks

    Science.gov (United States)

    Nakamura-Messenger, Keiko; Keller, Lindsay P.; Clemett, Simon J.; Messenger, Scott; Ito, Motoo

    2011-07-01

    We have developed new sample preparation and analytical techniques tailored for entire aerogel tracks of Wild 2 sample analyses both on "carrot" and "bulbous" tracks. We have successfully ultramicrotomed an entire track along its axis while preserving its original shape. This innovation allowed us to examine the distribution of fragments along the entire track from the entrance hole all the way to the terminal particle. The crystalline silicates we measured have Mg-rich compositions and O isotopic compositions in the range of meteoritic materials, implying that they originated in the inner solar system. The terminal particle of the carrot track is a 16O-rich forsteritic grain that may have formed in a similar environment as Ca-, Al-rich inclusions and amoeboid olivine aggregates in primitive carbonaceous chondrites. The track also contains submicron-sized diamond grains likely formed in the solar system. Complex aromatic hydrocarbons distributed along aerogel tracks and in terminal particles. These organics are likely cometary but affected by shock heating.

  3. Feasibility study of an alternating schedule of radiotherapy and chemotherapy in advanced uterine cervical carcinoma

    International Nuclear Information System (INIS)

    Haie, C.; Chassagne, D.; Gerbaulet, A.; George, M.; Pejovic, M.H.; Horiot, J.C.; Fenton, J.; Le Floch, O.; Heron, J.F.

    1988-01-01

    36 patients with advanced cervical carcinoma stage III (24 patients) and stage IV (12 patients) entered a feasibility study of a radiotherapy and chemotherapy combination. The first three chemotherapy courses consisted of cis-platinum alone and were interdigitated with radiotherapy. Six more courses composed of an association of cis-platinum and cyclophosphamide were given after the completion of radiotherapy. Radiotherapy was delivered in two courses of 25 Gy separated by a gap of 2 weeks. The overall 4-year survival rate, cumulative loco-regional failure rate, and cumulative meatstasis rate were respectively 44%, 56% and 30% in stage III and 28%, 83% and 74% in stage IV. The incidence of immediate and late complications was low: no patient had her radiotherapy stopped because of an intolerance and two patients had their chemotherapy stopped because of an haematological intolerance. Only one patient presented a severe late clinical complication (small bowel injury). 29 refs.; 2 figs.; 4 tabs

  4. PLANNING NATIONAL RADIOTHERAPY SERVICES

    Directory of Open Access Journals (Sweden)

    Eduardo eRosenblatt

    2014-11-01

    Full Text Available Countries, states and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centres are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment.This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centres, equipment, staff, education pr

  5. Potential benefit and clinical implementation of adaptive radiotherapy

    NARCIS (Netherlands)

    Lutkenhaus, L.J.

    2016-01-01

    The success of radiotherapy is defined by how well we are able to treat the tumor, without overly damaging the healthy tissue. Over the entire treatment period, day-to-day anatomical variations will occur, which can be compensated for by using a different irradiation plan for each treatment day.

  6. To understand radiotherapy

    International Nuclear Information System (INIS)

    2009-01-01

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

  7. A roentgenologic study of diverticular throughout the entire gastrointestinal tract

    International Nuclear Information System (INIS)

    Sohn, Myung Hee; Song, Ho Young; Lim, Kyu Yeob

    1983-01-01

    Diverticulum is considered as a common lesion involving any gastrointestinal tract from the pharynx to the rectum. We reviewed 5,806 cases of upper G-I series and 801 cases of double contrast barium enema during the period from Jan.1978 to Dec. 1981 in the Department of Radiology, School of Medicine, Jeonbug National University Hospital to analyze diverticula of the entire gastrointestinal tract. The results were as follows: 1. Roentgen examination of 5,806 esophagus, stomachs, duodenums and small bowels, and 801 colons during the past four years: diverticula of the esophagus, 60 cases (1.0%); diverticula of the stomach, 42 cases (0.7%); diverticula of the duodenum, 358 cases (6.2%); diverticula of the small bowel, 20 cases (0.3%); diverticula of the colon, 26 cases (3.2%). The location of diverticula in order of frequency was duodenum, colon, esophagus, stomach and small bowel. 2. The most common site of diverticula of each gastrointestinal tract was as follows: diverticula of the esophagus, middle portion (84.7%); diverticula of the stomach, the cardia (59.5%); diverticula of the duodenum, the second portion (81.3%); diverticula of the small bowel, the jejunum (96.4%)-especially the larger percentage were observed at the upper jejunum near the ligament of Treitz; diverticula of the colon, the right sided colon (80.8%)-the cecum and ascending colon (57.1%). 3. Diverticula may occur at any age. The majority of diverticula of the entire gastrointestinal tract were observed over 40 years of age. Especially in diverticula of the duodenum and colon, their frequency increase with age. 4. Duodenal diverticula were observed more frequently in woman than in man but in diverticula of the esophagus, stomach, small bowel and colon, male was more frequently affected. 5. The size of diverticula of the entire gastrointestinal tract was variable. The majority of diverticula of the esophagus, stomach, duodenum and small bowel were intermediate in size (10-49 mm). Diverticula of

  8. Treatment outcome of localized prostate cancer by 70 Gy hypofractionated intensity-modulated radiotherapy with a customized rectal balloon

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jung; Kim, Jun Won; Hong, Sung Joon; Rha, Koon Ho; Lee, Chang Geol; Yang, Seung Choul; Choi, Young Deuk; Suh, Chang Ok; Cho, Jae Ho [Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-15

    We aimed to analyze the treatment outcome and long-term toxicity of 70 Gy hypofractionated intensity-modulated radiotherapy (IMRT) for localized prostate cancer using a customized rectal balloon. We reviewed medical records of 86 prostate cancer patients who received curative radiotherapy between January 2004 and December 2011 at our institution. Patients were designated as low (12.8%), intermediate (20.9%), or high risk (66.3%). Thirty patients received a total dose of 70 Gy in 28 fractions over 5 weeks via IMRT (the Hypo-IMRT group); 56 received 70.2 Gy in 39 fractions over 7 weeks via 3-dimensional conformal radiotherapy (the CF-3DRT group, which served as a reference for comparison). A customized rectal balloon was placed in Hypo-IMRT group throughout the entire radiotherapy course. Androgen deprivation therapy was administered to 47 patients (Hypo-IMRT group, 17; CF-3DRT group, 30). Late genitourinary (GU) and gastrointestinal (GI) toxicity were evaluated according to the Radiation Therapy Oncology Group criteria. The median follow-up period was 74.4 months (range, 18.8 to 125.9 months). The 5-year actuarial biochemical relapse-free survival rates for low-, intermediate-, and high-risk patients were 100%, 100%, and 88.5%, respectively, for the Hypo-IMRT group and 80%, 77.8%, and 63.6%, respectively, for the CF-3DRT group (p < 0.046). No patient presented with acute or late GU toxicity > or =grade 3. Late grade 3 GI toxicity occurred in 2 patients (3.6%) in the CF-3DRT group and 1 patient (3.3%) in the Hypo-IMRT group. Hypo-IMRT with a customized rectal balloon resulted in excellent biochemical control rates with minimal toxicity in localized prostate cancer patients.

  9. Implicit function with natural behavior over entire domain

    International Nuclear Information System (INIS)

    Itoh, Taku; Saitoh, Ayumu; Kamitani, Atsushi; Nakamura, Hiroaki

    2012-01-01

    To generate a smooth implicit function that behaves naturally over an entire domain, a method to smoothly combine an implicit function f(x) with a global support function g(x) has been proposed. The proposed method can be applied to large scattered point data, since the implicit function f(x) is generated by a partition-of-unity-based method. The global support function g(x) is generated by a radial basis function-based method or by the least-squares method. To ensure a smooth combination of f(x) and g(x), an appropriate weight function is employed. In numerical experiments, the proposed method is applied to large point data. The results illustrate that the proposed method can generate a smooth implicit function F(x) with natural behavior over the entire domain. In addition, on the given points, the accuracy of F(x) is exactly the same as that of f(x). Furthermore, the computational cost for generation of F(x) is almost the same as that of f(x). (author)

  10. Quality control programme for radiotherapy

    International Nuclear Information System (INIS)

    Campos de Araujo, A.M.; Viegas, C.C.B.; Viamonte, A.M.

    2002-01-01

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

  11. SU-E-J-211: Design and Study of In-House Software Based Respiratory Motion Monitoring, Controlling and Breath-Hold Device for Gated Radiotherapy

    International Nuclear Information System (INIS)

    Shanmugam, Senthilkumar

    2014-01-01

    Purpose: The purpose of this present work was to fabricate an in-house software based respiratory monitoring, controlling and breath-hold device using computer software programme which guides the patient to have uniform breath hold in response to request during the gated radiotherapy. Methods: The respiratory controlling device consists of a computer, inhouse software, video goggles, a highly sensitive sensor for measurement of distance, mounting systems, a camera, a respiratory signal device, a speaker and a visual indicator. The computer is used to display the respiratory movements of the patient with digital as well as analogue respiration indicators during the respiration cycle, to control, breath-hold and analyze the respiratory movement using indigenously developed software. Results: Studies were conducted with anthropomophic phantoms by simulating the respiratory motion on phantoms and recording the respective movements using the respiratory monitoring device. The results show good agreement between the simulated and measured movements. Further studies were conducted for 60 cancer patients with several types of cancers in the thoracic region. The respiratory movement cycles for each fraction of radiotherapy treatment were recorded and compared. Alarm indications are provided in the system to indicate when the patient breathing movement exceeds the threshold level. This will help the patient to maintain uniform breath hold during the radiotherapy treatment. Our preliminary clinical test results indicate that our device is highly reliable and able to maintain the uniform respiratory motion and breathe hold during the entire course of gated radiotherapy treatment. Conclusion: An indigenous respiratory monitoring device to guide the patient to have uniform breath hold device was fabricated. The alarm feature and the visual waveform indicator in the system guide the patient to have normal respiration. The signal from the device can be connected to the radiation

  12. SU-E-J-211: Design and Study of In-House Software Based Respiratory Motion Monitoring, Controlling and Breath-Hold Device for Gated Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shanmugam, Senthilkumar [Madurai Medical College ' Govt. Rajaji Hospital, Madurai (India)

    2014-06-01

    Purpose: The purpose of this present work was to fabricate an in-house software based respiratory monitoring, controlling and breath-hold device using computer software programme which guides the patient to have uniform breath hold in response to request during the gated radiotherapy. Methods: The respiratory controlling device consists of a computer, inhouse software, video goggles, a highly sensitive sensor for measurement of distance, mounting systems, a camera, a respiratory signal device, a speaker and a visual indicator. The computer is used to display the respiratory movements of the patient with digital as well as analogue respiration indicators during the respiration cycle, to control, breath-hold and analyze the respiratory movement using indigenously developed software. Results: Studies were conducted with anthropomophic phantoms by simulating the respiratory motion on phantoms and recording the respective movements using the respiratory monitoring device. The results show good agreement between the simulated and measured movements. Further studies were conducted for 60 cancer patients with several types of cancers in the thoracic region. The respiratory movement cycles for each fraction of radiotherapy treatment were recorded and compared. Alarm indications are provided in the system to indicate when the patient breathing movement exceeds the threshold level. This will help the patient to maintain uniform breath hold during the radiotherapy treatment. Our preliminary clinical test results indicate that our device is highly reliable and able to maintain the uniform respiratory motion and breathe hold during the entire course of gated radiotherapy treatment. Conclusion: An indigenous respiratory monitoring device to guide the patient to have uniform breath hold device was fabricated. The alarm feature and the visual waveform indicator in the system guide the patient to have normal respiration. The signal from the device can be connected to the radiation

  13. Risk factors for radiotherapy incidents and impact of an online electronic reporting system

    International Nuclear Information System (INIS)

    Chang, David W.; Cheetham, Lynn; Marvelde, Luc te; Bressel, Mathias; Kron, Tomas; Gill, Suki; Tai, Keen Hun; Ball, David; Rose, William; Silva, Linas; Foroudi, Farshad

    2014-01-01

    Background and purpose: To ascertain the rate, type, significance, trends and the potential risk factors associated with radiotherapy incidents in a large academic department. Materials and methods: Data for all radiotherapy activities from July 2001 to January 2011 were reviewed from radiotherapy incident reporting forms. Patient and treatment data were obtained from the radiotherapy record and verification database (MOSAIQ) and the patient database (HOSPRO). Logistic regression analyses were performed to determine variables associated with radiotherapy incidents. Results: In that time, 65,376 courses of radiotherapy were delivered with a reported incident rate of 2.64 per 100 courses. The rate of incidents per course increased (1.96 per 100 courses to 3.52 per 100 courses, p < 0.001) whereas the proportion of reported incidents resulting in >5% deviation in dose (10.50 to 2.75%, p < 0.001) had decreased after the introduction of an online electronic reporting system. The following variables were associated with an increased rate of incidents: afternoon treatment time, paediatric patients, males, inpatients, palliative plans, head-and-neck, skin, sarcoma and haematological malignancies. In general, complex plans were associated with higher incidence rates. Conclusion: Radiotherapy incidents were infrequent and most did not result in significant dose deviation. A number of risk factors were identified and these could be used to highlight high-risk cases in the future. Introduction of an online electronic reporting system resulted in a significant increase in the number of incidents being reported

  14. Patterns of retreatment with radiotherapy in a large academic centre

    International Nuclear Information System (INIS)

    Khor, Richard; Ball, David; Duchesne, Gillian; Bressel, Mathias; Tai, Keen Hun; Tedesco, Jo; Gill, Suki; Fitzpatrick, Claire; Foroudi, Farshad; Rose, William

    2013-01-01

    To characterise retreatment rates with radiotherapy at a large multifacility academic radiotherapy centre and assess the effect of distance on retreatment rate. Electronic administrative records were reviewed for patients receiving radiotherapy between 1998 and 2010 at regional and metropolitan facilities. Course-level data were reconstructed from electronic administrative databases. Intent of therapy, treatment dates and diagnosis were available for analysis. Retreatment characteristics were derived, including proportion of patients receiving retreatment, proportion of total radiotherapy prescriptions dedicated to retreatment and retreatment per treating facility. Travel distance for each patient to their treatment centre was estimated, and retreatment rates were reported as a function of increasing distance. A total of 48,200 patients were treated with 66,277 treatment courses during the study period. Retreatment courses constituted 25.2% of all courses prescribed. During the study period, 20.4% of all patients received at least one treatment course. Of these, the average number of retreatment courses prescribed was 1.84. Patients treated with radical intent had a retreatment rate of 13% compared with 45% for those treated initially with palliative intent. Retreatment rates in individual tumour sites ranged from 1.3 to 44.4%. The retreatment rate for those living less than 100km from treatment facility was 24.8%, and 20.5% for those living more than 100km from treatment centre (P<0.001) Retreatment accounted for over one quarter of radiotherapy courses, with the rate influenced by casemix and follow-up duration. With increasing distance from treatment centre, a decrease in retreatment rate was observed.

  15. Historical review of radiotherapy

    International Nuclear Information System (INIS)

    Onai, Yoshio

    1993-01-01

    The techniques of radiotherapy have been improved by development of particle accelerators, radionuclides and computers. This paper presents a historical review of the physical and technical aspects of radiotherapy in Japan. Changes in the kinds of radiation, such as X-rays, gamma rays, electrons, neutrons and protons used for external radiotherapy, and the equipment involved are described chronologically, and historical changes in the quality of radiotherapy apparatus are outlined. Patient data acquisition equipment, such as X-ray simulator and X-ray CT, beam modifying devices, patient setup devices, and devices to verify treatment fields and patient doses are reviewed historically. Radiation sources for brachytherapy and internal radiotherapy, and remotely controlled afterloading systems are reviewed chronologically. Historical changes in methods to evaluate absorbed doses, dose monitor systems and beam data acquisition systems are outlined. Changes in methods of calculating dose distributions for external X-ray and electron therapy, brachytherapy and internal radiotherapy by unsealded radionuclides are described and calculation techniques for treatment planning system are reviewed. Annual figures in the numbers of radiotherapy equipment, such as telecobalt and telecesium units, linear accelerators, betatrons, microtrons, stereotactic gamma units, conformation radiotherapy units, remotely controlled afterloading systems, and associated equipment such as X-ray simulators and treatment planning systems are provided, as are changes in the number of accelerators by maximum X-ray energy and maximum electron energy, and in the number of licensed hospitals and clinics using small sealed sources. Changes in techniques of external radiotherapy and brachytherapy are described briefly from the point of view of dose distributions. (author)

  16. Radiological incidents in radiotherapy

    International Nuclear Information System (INIS)

    Hobzova, L.; Novotny, J.

    2008-01-01

    In many countries a reporting system of radiological incidents to national regulatory body exists and providers of radiotherapy treatment are obliged to report all major and/or in some countries all incidents occurring in institution. State Office for Nuclear Safety (SONS) is providing a systematic guidance for radiotherapy departments from 1997 by requiring inclusion of radiation safety problems into Quality assurance manual, which is the basic document for obtaining a license of SONS for handling with sources of ionizing radiation. For that purpose SONS also issued the recommendation 'Introduction of QA system for important sources in radiotherapy-radiological incidents' in which the radiological incidents are defined and the basic guidance for their classification (category A, B, C, D), investigation and reporting are given. At regular periods the SONS in co-operation with radiotherapy centers is making a survey of all radiological incidents occurring in institutions and it is presenting obtained information in synoptic communication (2003 Motolske dny, 2005 Novy Jicin). This presentation is another summary report of radiological incidents that occurred in our radiotherapy institutions during last 3 years. Emphasis is given not only to survey and statistics, but also to analysis of reasons of the radiological incidents and to their detection and prevention. Analyses of incidents in radiotherapy have led to a much broader understanding of incident causation. Information about the error should be shared as early as possible during or after investigation by all radiotherapy centers. Learning from incidents, errors and near misses should be a part of improvement of the QA system in institutions. Generally, it is recommended that all radiotherapy facilities should participate in the reporting, analyzing and learning system to facilitate the dissemination of knowledge throughout the whole country to prevent errors in radiotherapy.(authors)

  17. Twenty-five year outcome of sequential abdominopelvic radiotherapy and alkylating agent chemotherapy for ovarian carcinoma

    International Nuclear Information System (INIS)

    Bellairs, Ellen E.; Twiggs, Leo B.; Potish, Roger A.

    1997-01-01

    Purpose: A prospective study of sequential surgery, abdominopelvic radiotherapy and single agent alkylating chemotherapy was conducted to evaluate survival and toxicity in the management of ovarian carcinoma. Methods: From 1970-1976, 95 women with stage I-III epithelial ovarian carcinoma were scheduled to receive postoperative radiotherapy consisting of 20.0 Gy to the whole abdomen (1.0 Gy/day), a 29.75 Gy pelvic boost (1.75 Gy/day) and 10 subsequent courses of Melphalan (1 mg/kg/course). Endpoints were overall survival, disease-free survival(DFS), and acute and chronic toxicity. Results: The evaluable 94 patients included 19 stage I, 25 stage II, and 50 stage III. Of the latter, 21 had no palpable disease postoperatively (IIIN) and 29 had postoperative palpable disease (IIIP). Overall survival at 5, 10, 15 and 20 years was 42%, 30%, 23% and 22%. DFS for the entire group was 54% at 5 years and remained 50% from 10 to 25 years. All but two recurrences were noted within the first 27 months. No recurrence or treatment-related deaths occurred after 8 years. After 10 years, the survival of the study group became parallel to the general population. Prognostic factors were only related to stage (p<.001) and the presence of postoperative palpable disease(p<.001). DFS at 25 years was 95 % for stage I, 71% at 5 years and 66% from 10 to 25 years for stage II, and 17% at 5 years and 11% thereafter for stage III patients(p<.001). Although no stage IIIP patients were cured, 25% lived beyond 2 years. Five year DFS was significantly better in IIIN (45%) vs. IIIP (0%) patients (p<.001). The 65 patients without postoperative palpable disease, (stage I-IIIN) achieved DFS at 5 and 25 years of 69%, and 61%, respectively. Of 31 patients undergoing a second-look surgery, 84% were found to be free of tumor. Two recurred at 3.5 and 7 years after surgery. Acute tolerance was acceptable. Chronic toxicity included an 11.7% rate of small bowel obstruction requiring surgery and a 3% rate of

  18. Radiotherapy indications - rectum cancer

    International Nuclear Information System (INIS)

    2009-05-01

    This document is addressed to oncologists radiotherapists and to any health professional concerned by rectum cancer treatment. Rectum cancer therapy is based on various technical procedures including surgery, radiotherapy and systemic treatments defined for each patient according to his clinical situation. This document precises the specific situations where radiotherapy can be employed. However, the radiotherapy decision must be taken with respect to other therapeutic alternatives. Such a decision must be validated and must be the object of a discussion in the framework of a pluri-disciplinary consultation. (J.S.)

  19. No turnover in lens lipids for the entire human lifespan.

    Science.gov (United States)

    Hughes, Jessica R; Levchenko, Vladimir A; Blanksby, Stephen J; Mitchell, Todd W; Williams, Alan; Truscott, Roger J W

    2015-03-11

    Lipids are critical to cellular function and it is generally accepted that lipid turnover is rapid and dysregulation in turnover results in disease (Dawidowicz 1987; Phillips et al., 2009; Liu et al., 2013). In this study, we present an intriguing counter-example by demonstrating that in the center of the human ocular lens, there is no lipid turnover in fiber cells during the entire human lifespan. This discovery, combined with prior demonstration of pronounced changes in the lens lipid composition over a lifetime (Hughes et al., 2012), suggests that some lipid classes break down in the body over several decades, whereas others are stable. Such substantial changes in lens cell membranes may play a role in the genesis of age-related eye disorders. Whether long-lived lipids are present in other tissues is not yet known, but this may prove to be important in understanding the development of age-related diseases.

  20. Waste management aspects of entire PWR LOOP decontamination

    International Nuclear Information System (INIS)

    Murray, A.P.; Roesmer, J.

    1988-01-01

    The waste management parameters for decontamination of an entire PWR primary circuit have been determined for dilute alkaline-permanganate/citric acid (APCA), LOMI, ozone and cerium acid process variations. APCA processes generate the largest waste volumes; over 140 m 3 (5000 ft 3 ) in some cases. This represents a potential disposal cost of one million dollars. The cation regeneration column makes the greatest contribution to the disposal volume. In contrast, the LOMI process generates approximately half as much waste, but it is expected to contain relatively high metal concentrations (200-800 ppm). The ozone and cerium acid processes product the least waste, usually under 45 m 3 . These waste volume estimates represent considerable fractions of a utility's annual disposal volume. Consequently, improved waste processing technology is required, and several approaches are suggested

  1. Esophageal perforation during or after conformal radiotherapy for esophageal carcinoma

    International Nuclear Information System (INIS)

    Chen Haiyan; Ma Xiumei; Ye Ming; Hou Yanli; Xie Huaying; Bai Yongrui

    2014-01-01

    The aim of this study was to analyze the risk factors and prognosis for patients with esophageal perforation occurring during or after radiotherapy for esophageal carcinoma. We retrospectively analyzed 322 patients with esophageal carcinoma. These patients received radiotherapy for unresectable esophageal tumors, residual tumors after operation, or local recurrence. Of these, 12 had radiotherapy to the esophagus before being admitted, 68 patients had concurrent chemoradiotherapy (CRT), and 18 patients had esophageal perforation after RT (5.8%). Covered self-expandable metallic stents were placed in 11 patients. Two patients continued RT after stenting and control of infection; one of these suffered a new perforation, and the other had a massive hemorrhage. The median overall survival was 2 months (0-3 months) compared with 17 months in the non-perforation group. In univariate analysis, the Karnofsky performance status (KPS) being ≤ 70, age younger than 60, T4 stage, a second course of radiotherapy to the esophagus, extracapsular lymph nodes (LN) involving the esophagus, a total dose > 100 Gy (biologically effective dose -10 ), and CRT were risk factors for perforation. In multivariate analysis, age younger than 60, extracapsular LN involving the esophagus, T4 stage, and a second course of radiotherapy to the esophagus were risk factors. In conclusion, patients with T4 stage, extracapsular LN involving the esophagus, and those receiving a second course of RT should be given particular care to avoid perforation. The prognosis after perforation was poor. (author)

  2. Parents' Lived Experiences During Their Children's Radiotherapy.

    Science.gov (United States)

    Gårdling, Jenny; Törnqvist, Erna; Edwinson Månsson, Marie; Hallström, Inger

    The aim of radiotherapy is to provide a cure and/or symptomatic relief for children with cancer. Treatment is delivered on a daily basis, 5 days per week, over the course of 5 to 35 days. Many parents find that leaving their children alone during treatment and exposing them to radiation is a challenging experience. To gain an understanding of parents' lived experiences, 10 parents were asked to keep a diary while their children underwent radiotherapy. A descriptive inductive design with a hermeneutic-phenomenological approach was chosen to analyze the diaries. The parents were asked to write down their lived experiences while their children underwent radiotherapy. Daily notes, both short and long, were desirable. The parents described radiotherapy as a balancing act involving a constant attempt to maintain a balance between coercing and protecting their children in order to improve their children's chances of survival. Meanwhile, the parents themselves were struggling with their own despair and feelings of powerlessness. While protecting their children, they experienced a sense of hope and felt that they had gained control. Parents' daily written reflections are important for clinical practice and provide vital knowledge. Parents need support when focusing on coercing and protecting their children and help with information and routines that enable them gain control.

  3. Radiotherapy injuries in children

    International Nuclear Information System (INIS)

    Kalifa, G.; Bennet, J.; Couanet, D.; Masselot, J.

    1985-01-01

    Side effects of radiotherapy in pediatrics are reviewed including bone injuries and radio-induced bone tumors; nervous system injuries with emphasis on hypothalamus, pituitary gland, brain and spinal cord; lung, digestive system and urinary tract injuries [fr

  4. The metabolic radiotherapy

    International Nuclear Information System (INIS)

    Begon, F.; Gaci, M.

    1993-01-01

    In this article, the authors recall the principles of the metabolic radiotherapy and present these main applications in the treatment of thyroid cancers, hyperthyroidism, polycythemia, arthritis, bone metastases, adrenergic neoplasms. They also present the radioimmunotherapy

  5. A case study of the neuropsychological outcomes following microsurgery, conventional radiotherapy and stereotactic radiotherapy for an adult's recurrent craniopharyngioma.

    Science.gov (United States)

    Preece, David; Allan, Alfred; Becerra, Rodrigo

    2016-01-01

    To examine the neuropsychological outcomes for an adult patient, 2 years after receiving microsurgery and conventional radiotherapy for a recurrent craniopharyngioma; and the impact of a further intervention, stereotactic radiotherapy, on this level of neuropsychological functioning. JD, a 30 year old male whose recurrent craniopharyngioma had 2 years earlier been treated with two operations and conventional radiotherapy. JD was assessed (using standardized clinical tests) before and after a course of stereotactic radiotherapy. Prior to stereotactic radiotherapy (and 2 years after microsurgery and conventional radiotherapy) JD's IQ was intact, but considerable impairments were present in executive functioning, memory, theory of mind and processing speed. Fifteen months after stereotactic radiotherapy, all neuropsychological domains remained largely static or improved, supporting the utility of this treatment option in the neuropsychological domain. However, deficits in executive functioning, memory and processing speed remained. These findings suggest that, even after multiple treatments, substantial cognitive impairments can be present in an adult patient with a recurrent craniopharyngioma. This profile of deficits underlines the inadequacy of relying purely on IQ as a marker for cognitive health in this population and emphasizes the need to include neuropsychological impairments as a focus of rehabilitation with these patients.

  6. Clinical practice of radiotherapy

    International Nuclear Information System (INIS)

    Tobias, J.S.

    1992-01-01

    After describing the recent advances in radiotherapy, this brief article presents in tabular form the changing indications for radiotherapy for tumours of the skin, head and neck, adult CNS, lung, thyroid, thymus, breast, female genital tract, soft tissue sarcoma, genitourinary tract, bone sarcoma, Hodgkin's disease, non-Hodgkin lymphoma, multiple myeloma, leukemia and paediatric malignancy. For each tumour type, information is provided for the radiosensitivity, the radiocurability, complications and five-year survival. Combined modality treatment is also briefly discussed. (UK)

  7. Nanoparticle-guided radiotherapy

    DEFF Research Database (Denmark)

    2012-01-01

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

  8. Clinical practice of radiotherapy

    International Nuclear Information System (INIS)

    Horiuchi, Junichi; Masaki, Norie; Onoyama, Yasuto

    1987-01-01

    This chapter presents in greater detail radiotherapy used in each clinical setting. The descriptions are given under the following sections: the tongue and oral cavity; the maxilla, larynx, and pharynx; brain tumors; the eyes and orbit; pediatric tumors; lung cancer; the esophagus; breast cancer; the abdominal digestive system; the urogenital system; the uterine cervix; the ovaries and vulva; bone and soft tissues; the skin; hematopoietic tumors; lymph node metastases; and radiotherapy as palliative treatment. (Namekawa, K.)

  9. Patients and radiotherapy

    International Nuclear Information System (INIS)

    Eardley, A.

    1986-01-01

    The results of interviews with thirty discharged patients who had undergone radical radiotherapy for cancer of the head and neck are presented. Patients were asked whether their side-effects had got worse or had stayed the same, what effect their side effects had had on eating and drinking and whether they had felt depressed during this period. Measures which could be taken to improve patients' experiences of radiotherapy are discussed. (U.K.)

  10. Radiotherapy and oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sealy, R [Cape Town Univ. (South Africa). Dept. of Radiotherapy

    1982-08-01

    A general review article for the non-radiotherapist. The historical, physical and biological background is briefly reviewed. Mention is made of the effects of fraction size, hyperbaric oxygen, neutron beams and radiation sensitizers. The use of chemotherapy and radiotherapy is discussed, as well as the selection of patients for radiotherapy and the treatment of neck nodes. The author suggests a therapeutic approach to the various disease sites and finally reviews some of the literature on radiation caries and jaw necrosis.

  11. Satellite altimetry based rating curves throughout the entire Amazon basin

    Science.gov (United States)

    Paris, A.; Calmant, S.; Paiva, R. C.; Collischonn, W.; Silva, J. S.; Bonnet, M.; Seyler, F.

    2013-05-01

    The Amazonian basin is the largest hydrological basin all over the world. In the recent past years, the basin has experienced an unusual succession of extreme draughts and floods, which origin is still a matter of debate. Yet, the amount of data available is poor, both over time and space scales, due to factor like basin's size, access difficulty and so on. One of the major locks is to get discharge series distributed over the entire basin. Satellite altimetry can be used to improve our knowledge of the hydrological stream flow conditions in the basin, through rating curves. Rating curves are mathematical relationships between stage and discharge at a given place. The common way to determine the parameters of the relationship is to compute the non-linear regression between the discharge and stage series. In this study, the discharge data was obtained by simulation through the entire basin using the MGB-IPH model with TRMM Merge input rainfall data and assimilation of gage data, run from 1998 to 2010. The stage dataset is made of ~800 altimetry series at ENVISAT and JASON-2 virtual stations. Altimetry series span between 2002 and 2010. In the present work we present the benefits of using stochastic methods instead of probabilistic ones to determine a dataset of rating curve parameters which are consistent throughout the entire Amazon basin. The rating curve parameters have been computed using a parameter optimization technique based on Markov Chain Monte Carlo sampler and Bayesian inference scheme. This technique provides an estimate of the best parameters for the rating curve, but also their posterior probability distribution, allowing the determination of a credibility interval for the rating curve. Also is included in the rating curve determination the error over discharges estimates from the MGB-IPH model. These MGB-IPH errors come from either errors in the discharge derived from the gage readings or errors in the satellite rainfall estimates. The present

  12. Developing noise control strategies for entire railway networks

    Science.gov (United States)

    Oertli, Jakob

    2006-06-01

    The EU Environmental Noise Directive (2002/49) requires member states to deliver noise maps to the commission by 2007 and action plans by 2008 both for agglomerations as well as for major roads, railways and airports. Noise mitigation projects resulting from action plans are usually very expensive and therefore may threaten the economic viability of the railways in the current harsh competitive transport market, thus hindering sustainable transport policies. It is therefore of vital interest that the action plans and the resulting projects are designed in the most cost-effective way possible. The EU and Union of Railways (UIC) sponsored project Strategies and Tools to Assess and Implement noise Reducing measures for Railway Systems (STAIRRS) recognized this need and developed a tool, with which such optimal solutions can be obtained for entire railway networks. Since data collection is the most expensive part of the analysis, noise mapping data is ideally collected in such a way that it can be used for the calculation of the different scenarios, from which the most cost-effective action plans are chosen. The paper shows how the STAIRRS tool is used for this purpose and how cost-effectiveness considerations have led to optimal railway noise mitigation strategies in Switzerland and have given a basis for noise related decision making in Luxembourg.

  13. Use of the entire spectrum of irradiated alanine for dosimetry

    International Nuclear Information System (INIS)

    Dolo, J.M.; Moignau, F.

    2005-01-01

    Alanine is an amino acid commonly used in ESR dosimetry as a reference detector. The classic approach for the measurement of irradiated samples is to determine the amplitude of the central peak of the first derivative spectrum. It is generally considered that this technique represents the best and most reproducible solution for achieving an accurate proportionality between the concentration of free radicals inside the resonant cavity, characterized by the amplitude, and the dose. It is also accepted that this central peak corresponds to the free radical CH 3 .CHCOO - . The hyperfine structure of this radical in the spectrum shows five main peaks with the approximate ratios 1:4:6:4:1 as regards coupling. This paper presents another approach featuring analysis of the entire spectrum: (i) ratios of identified peaks (ii) ratio variation vs time with regard to several parameters affecting fading. These variations in the alanine spectrum are probably correlated with the variation of the concentrations of different free radical species. These variations and their positions in the spectrum are very important constraints that increase the uncertainty of this type of measurement

  14. Adverse effects of radiotherapy on the central nervous system

    International Nuclear Information System (INIS)

    Mocquard, Y.; Marion, J.L.; Goas, J.Y.

    1985-01-01

    Adverse effects of radiotherapy on the central nervous system are increasingly met with. Both the brain and spinal cord may be involved. Whereas some forms have a favorable outcome, many run a relentlessly progressive course, failing to respond to treatment. Improvement of radiation protocols should achieve a lower complication rate [fr

  15. Spinocellular carcinoma of the lip, effects of radiotherapy

    International Nuclear Information System (INIS)

    Hess, U.

    1979-01-01

    109 cases of spinocellular carcinoma of the lip were studied with a view to sex dependence, occupation, family disposition and colour of the skin, eyes and hair. Etiology, clinical aspects and course of lip carcinoma were studied. The results obtained with radiotherapy (X-ray therapy) are described and discussed. (APR) [de

  16. Pain and quality of life following palliative radiotherapy of bone metastases

    International Nuclear Information System (INIS)

    Sauer, N.; Wild, B.; Henningsen, P.; Jakobsen, T.; Leising, D.; Treiber, M.

    2006-01-01

    Pain and quality of life following palliative radiotherapy of bone metastases Background and purpose: palliative irradiation is used to provide pain relief and to increase quality of life. Most studies exclude patients with advanced cancer disease and, therefore, a positive selection results. This prospective clinical study investigates the effect of palliative radiotherapy on pain and quality of life of patients with painful bone metastases. Patients and methods: 263 patients with bone metastases due to advanced cancer were observed with respect to pain and quality of life during a 2-month course of radiotherapy. Missing data were substituted by the LOCF method (last observation carried forward) to prevent a biased reduction of data. Results: radiotherapy resulted in pain relief. In the complete group, pain medication was not increased. Quality of life was not affected positively. Side effects of radiotherapy increased remarkably. Conclusion: Radiotherapy leads to pain relief. However, risks and benefits must be considered critically due to side effects. (orig.)

  17. QA programme in external radiotherapy in Romania - status and perspective

    International Nuclear Information System (INIS)

    Dumitrescu, A.; Milu, C.

    2008-01-01

    Full text: Recognizing the importance of quality assurance in radiotherapy and the need to make access to radiation standards traceable to the international measurement system for every radiotherapy center, the Romanian national secondary standard dosimetry laboratory (SSDL) has started in 1999 - together with IAEA - a national quality audit programme in all the centers for external radiotherapy from Romania. At present, there are 17 radiotherapy centers in Romania, and a total of 19 teletherapy units and 4 LINCs. The programme has 3 phases: the first phase was to organize a survey in all radiotherapy centers, to collect general information on their radio therapists, medical physicists, type of equipment, dosimeters, etc. Following the survey, a quality assurance network was set up, and on-site dosimetry reviews were arranged according to a suitable timetable. The second phase consisted in performing the reference dosimetry and the calibration of the equipment. Then, a quality audit system based on mailed TLDs has been applied to all radiation beams produced by cobalt-60 therapy units and medical accelerators, in order to identify discrepancies in dosimetry larger than ± 3%. At the same time, the beam calibration performed by the SSDLs was verified. The results of the first survey were analyzed, and corrective actions were taken. A second survey was then organized, based on the mailed TLDs. This paper presents in detail the entire QA programme, its results, and the actions that are to be taken in order to improve the accuracy and consistency of the dosimetry in clinical radiotherapy in Romania. (author)

  18. Radiotherapy of lymphogranulomatosis. Present position and controversies

    Energy Technology Data Exchange (ETDEWEB)

    Roettinger, E M; Sack, H [Koeln Univ. (Germany, F.R.). Inst. und Poliklinik fuer Strahlentherapie

    1976-03-01

    Increased knowledge about the course of lymphogranulomatosis and technological progress in radiotherapy during the past 20 years have brought permanent recovery for a major part of patients from this disease which had been infaust before. The supplementation of the local radiotherapy by the systematic effects of chemotherapy enables us at the same time to control the infiltrations and disseminations which cannot be manifested clinically especially in malignant forms and later stages. The good healing results obtained presuppose careful clinical examination of the patient and attentive care during the therapy with regard to the potential complications of radio- and chemotherapy. As potential complications which may occur according to the method used we may name damage to the kidneys, radiopneumonia or pulmonal fibrosis, myocarditis or pericarditis, oeosophagitis, enteritis, and hepatitis. Relatively seldom we see the permanent depression of the bone marrow, induction of leucaemia, and myxoedema. All these complications can occure more frequently in the case of additional chemotherapy.

  19. Stereotactic Radiosurgery and Hypofractionated Radiotherapy for Glioblastoma.

    Science.gov (United States)

    Shah, Jennifer L; Li, Gordon; Shaffer, Jenny L; Azoulay, Melissa I; Gibbs, Iris C; Nagpal, Seema; Soltys, Scott G

    2018-01-01

    Glioblastoma is the most common primary brain tumor in adults. Standard therapy depends on patient age and performance status but principally involves surgical resection followed by a 6-wk course of radiation therapy given concurrently with temozolomide chemotherapy. Despite such treatment, prognosis remains poor, with a median survival of 16 mo. Challenges in achieving local control, maintaining quality of life, and limiting toxicity plague treatment strategies for this disease. Radiotherapy dose intensification through hypofractionation and stereotactic radiosurgery is a promising strategy that has been explored to meet these challenges. We review the use of hypofractionated radiotherapy and stereotactic radiosurgery for patients with newly diagnosed and recurrent glioblastoma. Copyright © 2017 by the Congress of Neurological Surgeons.

  20. Postoperative radiotherapy for intracranial meningioma

    International Nuclear Information System (INIS)

    Chun, Ha Chung; Lee, Myung Za

    2001-01-01

    To evaluate the effectiveness and tolerance of postoperative external radiotherapy for patients with intracranial meningiomas. The records of thirty three patients with intracranial meningiomas who were treated with postoperative external irradiation at our institution between Feb, 1988 and Nov, 1999 were retrospectively analyzed. Median age of patients at diagnosis was 53 years with range of 17 to 68 years. Sites of involvement were parasagital, cerebral convexity, sphenoid ridge, parasellar and tentorium cerebella. Of 33 evaluated patients, 15 transitional, 10 meningotheliomatous, 4 hemangiopericytic, 3 atypical and 1 malignant meningioma were identified. Four patients underwent biopsy alone and remaining 29 patients underwent total tumor resection. A dose of 50 to 60 Gy was delivered in 28-35 daily fractions over a period of 5 to 7 weeks. Follow-up period ranged from 12 months to 8 years. The actuarial survival rates at 5 and 7 years for entire group of patients were 78% and 67%, respectively. The corresponding disease free survival rates were 73% and 61 %, respectively. The overall local control rate at 5 years was 83%. One out of 25 patients in benign group developed local failure, while 4 out of 8 patients in malignant group did local failure (p <0.05), Of 4 patients who underwent biopsy alone, 2 developed local failure. There was no significant difference in 5 year actuarial survival between patients who underwent total tumor resection and those who did biopsy alone. Patients whose age is under 60 showed slightly better survival than those whose age is 60 or older, although this was not statistically significant. There was no documented late complications in any patients. Based on our study, we might conclude that postoperative external beam radiotherapy tends to improve survival of patients with intracranial meningiomas comparing with surgery alone

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

    International Nuclear Information System (INIS)

    Arenas, Meritxell; Sabater, Sebastià; Gascón, Marina; Henríquez, Ivan; Bueno, M José; Rius, Àngels; Rovirosa, Àngels; Gómez, David; Lafuerza, Anna; Biete, Albert; Colomer, Jordi

    2014-01-01

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

  2. Intraoperative radiotherapy - Current status

    International Nuclear Information System (INIS)

    Gunderson, Leonard L.; Willett, Christopher G.; Harrison, Louis B.

    1997-01-01

    Purpose/Objective: Intraoperative irradiation (IORT) in its broadest sense refers to the delivery of irradiation at the time of an operation. This refresher course will discuss the use of both electrons (IOERT) and high dose rate brachytherapy (IOHDR) in conjunction with surgical exploration and resection ± external irradiation/chemotherapy. Both IORT methods have evolved with similar philosophies as an attempt to achieve higher effective doses of irradiation while dose limiting structures are surgically displaced. The rationale for each is supported by excellent local control ± survival results achieved with brachytherapy alone or as a boost to external irradiation in organ preservation efforts in traditional sites (head and neck, breast, gynecologic) wherein a boost dose could be delivered to smaller volumes than could usually be accomplished with external irradiation alone. IOERT has been a tool in modern radiotherapy in Japan since the 1960's and in the U.S. since the mid 1970's. Results from randomized and nonrandomized trials will be presented in the refresher course with major emphasis on GI sites (gastric, pancreas, colorectal) since the data is more mature. While the largest clinical experience with IOERT (± external irradiation/chemotherapy, maximal resection) has been with gastrointestinal cancers in adults, moderate experience has also been obtained with locally advanced retroperitoneal sarcomas and recurrent genitourinary and gynecologic cancers. With primary colorectal cancers that are unresectable for cure or for locally recurrent colorectal cancers, both local control and long-term survival appear to be improved with the aggressive combinations including IOERT when compared to results achieved with conventional treatment. When residual disease exists after resection of gastric cancers, IOERT ± external radiation has achieved optimistic survival results in trials in Japan, the U.S., Spain and China. With locally unresectable pancreatic cancer, an

  3. Advice concerning radiotherapy

    International Nuclear Information System (INIS)

    1984-01-01

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

  4. Accuracy requirements in radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Buzdar, S. A.; Afzal, M.; Nazir, A.; Gadhi, M. A.

    2013-01-01

    Radiation therapy attempts to deliver ionizing radiation to the tumour and can improve the survival chances and/or quality of life of patients. There are chances of errors and uncertainties in the entire process of radiotherapy that may affect the accuracy and precision of treatment management and decrease degree of conformation. All expected inaccuracies, like radiation dose determination, volume calculation, complete evaluation of the full extent of the tumour, biological behaviour of specific tumour types, organ motion during radiotherapy, imaging, biological/molecular uncertainties, sub-clinical diseases, microscopic spread of the disease, uncertainty in normal tissue responses and radiation morbidity need sound appreciation. Conformity can be increased by reduction of such inaccuracies. With the yearly increase in computing speed and advancement in other technologies the future will provide the opportunity to optimize a greater number of variables and reduce the errors in the treatment planning process. In multi-disciplined task of radiotherapy, efforts are needed to overcome the errors and uncertainty, not only by the physicists but also by radiologists, pathologists and oncologists to reduce molecular and biological uncertainties. The radiation therapy physics is advancing towards an optimal goal that is definitely to improve accuracy where necessary and to reduce uncertainty where possible. (author)

  5. Kinematics of the entire East African Rift from GPS velocities

    Science.gov (United States)

    Floyd, M.; King, R. W.

    2017-12-01

    Through a collaborative effort of the GeoPRISMS East Africa Rift GPS Working Group, we have collected and collated all of the publicly available continuous and survey-mode data for the entire rift system between 1994 and 2017 and processed these data as part of a larger velocity solution for Africa, Arabia and western Eurasia. We present here our velocity solution encompassing the major bounding plates and intervening terranes along the East African Rift from the Red Sea to the Malawi Rift and adjacent regions for GPS sites with data spans of at least 2.4 years, and north and east velocity uncertainties less than 1.5 mm/yr. To obtain realistic uncertainties for the velocity estimates, we attempted at each stage of the analysis to account for the character of the noise: During phase processing, we used an elevation-dependent weighting based on the phase residuals for each station; we then examined each position time series, removing outliers and reweighting appropriately to account for the white noise component of the errors; and e accounted for temporal correlations by estimating an equivalent random-walk magnitude for each continuous site and applying the median value (0.5 mm/√yr) to all survey-mode sites. We rigorously estimate relative rotation rates of Nubia, by choosing subset of well-determined sites such that the effective weights of western, northeastern and southern Africa were roughly equivalent, and Somalia, for which the estimate is dominated by three sites (MALI, RCMN, SEY1) whose uncertainties are a factor of 2-3 smaller than those of the other sites. For both plates, the weighted root-mean-square of the velocity residuals is 0.5 mm/yr. Our unified velocity solution provides a geodetic framework and constraints on the continental-scale kinematics of surface motions as well as more local effects both within and outside of the rift structures. Specific focus areas with denser coverage than previous fields include the Danakil block, the Afar Rift, the

  6. Chemotherapy disruption of efficient radiotherapy

    International Nuclear Information System (INIS)

    Nervi, C.; Friedman, M.

    1974-01-01

    Studies on the use of chemotherapy in combination with radiotherapy are reviewed. Some topics discussed are: indications for the use of combined chemotherapy and radiotherapy; improvement of the therapeutic ratio following the use of methotrexate; advantages of preirradiation and postirradiation chemotherapy; side effects following simultaneous chemotherapy and radiotherapy; and effects of chemotherapy on cure rate of radiosensitive and radioresistant tumors. (U.S.)

  7. Radiotherapy of pineal tumors

    International Nuclear Information System (INIS)

    Danoff, B.; Sheline, G.E.

    1984-01-01

    Radiotherapy has universally been used in the treatment of pineal tumors and suprasellar germinomas. Recently however, major technical advances related to the use of the operating microscope and development of microsurgical techniques have prompted a renewed interest in the direct surgical approach for biopsy and/or excision. This interest has resulted in a controversy regarding the role of surgery prior to radiotherapy. Because of the heterogeneity of tumors occurring in the pineal region (i.e., germ cell tumors, pineal parenchymal tumors, glial tumors, and cysts) and their differing biological behavior, controversy also surrounds aspects of radiotherapy such as: the optimal radiation dose, the volume to be irradiated, and indications for prophylactic spinal irradiation. A review of the available data is presented in an attempt to answer these questions

  8. Cancer research and radiotherapy

    International Nuclear Information System (INIS)

    Matsuzawa, Taiju

    1978-01-01

    An actual condition of cancer, and the basis and a future view of radiotherapy were described by adding generally established biological and biochemical knowledge to the author's research. It was described that the relapse of cancer after irradiation was induced from outside of cancerous mass, and the nature of relapsed cancerous cells group was also stated. The histological structure of cancer from a view of cell movement and radioresistant cancerous cells group were described. The differentiation of cancerous cells were described, and a study of inhibition of cancer by redifferentiation was considered. It is important to grasp characteristics and a limit of radiotherapy for cancer, to systematize and materialize reasonable therapy which uses drug and immunotherapy together with surgery, and to use radiotherapy reasonably together with redifferentiation therapy of cancerous cells by extracting characteristics and a limit of radiationtherapy from an actual condition of cancer. (Serizawa, K.)

  9. Role of radiotherapy in the treatment of multiple myeloma; Wertigkeit der Radiotherapie in der Behandlung des multiplen Myeloms

    Energy Technology Data Exchange (ETDEWEB)

    Mose, S.; Pfitzner, D.; Rahn, A.; Nierhoff, C.; Schiemann, M.; Boettcher, H.D. [Frankfurt Univ. (Germany). Klinik fuer Strahlentherapie und Nuklearmedizin

    2000-11-01

    Regarding reduction of pain, treatment of (impending) fractures, and spinal cord compression radiation is an important part of palliative treatment. In our retrospective study we report the effort of radiotherapy on reduction of pain, recalcification and the reduction of neurological symptoms and evaluate factors which have an impact on therapeutic outcome. Patients and Methods: From 1. Jan 1988 to 31. Dec 1998, 42 patients (19 women, 23 men; range of ages 46 to 85 years, median age 64.9 years) with 71 target volumes were irradiated (median dose 36 Gy, 2 to 3 Gy 5 times/week) because of symptomatic disease (67/71: Osseous pain, 45/71: Fraktures/impending fractures, 13/71: Spinal cord compression). The median time from diagnosis to the first course of radiotherapy was 11.9 months (0.3 to 90 months). At the time of first irradiation, 5 and 37 patients were in tumor Stage II and III (Salmon/Durie), respectively. The median value of the Karnofsky performance was 70% (40 to 90%). Results: During follow-up (at least 6 months) in 85% of target volumes complete and partial pain relief was achieved; recurrences were seen in 8.8%. In 26/56 (46.4%) lesions evaluable a recalcification was seen whereas 17.9% showed progressive disease (comparison of radiographs before and after radiation). In 22.3% of all lesions initially with impending fracture (4/18) radiotherapy failed because of fracture after treatment. Simultaneous chemotherapy and a Karnofsky performance {>=}70 had a significant impact on a positive response to treatment, respectively. Spinal cord compression symptoms were reduced in 7/13 (53.8%) of patients (scaled due to the classification by Findlay 1987). The median survival from diagnosis for the entire group was 34.9 months (7.5 to 119.3 months), after irradiation 13.1 months (0.2 to 105.3 months). Conclusion: When adequately indicated radiotherapy was shown to be an effective palliative treatment. Taking under consideration that the results are retrospective we

  10. Radiotherapy for the medulloblastoma

    International Nuclear Information System (INIS)

    Gose, Kyuhei; Imajo, Yoshinari; Imanaka, Kazufumi

    1983-01-01

    Eighteen patients with medulloblastoma, treated between 1972 and 1981, at Kobe University School of Medicine, were retrospectively studied. Of those completing post operative irradiation, 50% have survived for 2 years, 15% for 5 years and mean survival periods was 22.2 months. 13 out of 18 patients developed local recurrence and spinal dissemination. The mean time from the initial radiotherapy to recurrence was 8.5 months. It was suggested that posterior fossa should recieve 5,000 rad, the spine should 2,000 rad and recurrences should be treated by the combination of radiotherapy and chemotherapy. (author)

  11. Arterial disease after radiotherapy

    International Nuclear Information System (INIS)

    Bigot, J.M.; Mathieu, D.; Reizine, D.

    1983-01-01

    Disease of the large arterial vessels is a relatively unknown complication of radiotherapy. However, it should be considered in the same manner as the other complications of irradiation when a tumour recurrence is suspected. The experimental studies of Kirkpatrick and Konings, demonstrating the synergy between irradiation and hypercholesterolemia in the precocity and gravity of vascular complications are recalled. The different localisations reported in the litterature are discussed: coronary, pulmonary, thoracic aorta, supra aortic, renal, digestive and ilio-femoral arteries. Finally, the difficulty of diagnosis of post-radiotherapy without clinical, radiological or anatomopathological confirmation, is underlined [fr

  12. Second cancers following radiotherapy

    International Nuclear Information System (INIS)

    Tubiana, M.

    1983-01-01

    Published reports have shown that there is an increased incidence of second malignancies, particularly sarcomas, following high dose radiotherapy in cancer treatment. However, this increased risk is very small and is relatively negligeable when one considers the beneficial effects of radiotherapy in cancer treatment. This incidence of radiation induced cancer appears to be higher in certain groups of patients, such as children and patients with Hodgkin's disease. In view of scarcity of published data, controlled surveys remain necessary for the quantitative assessment of the cancer risk in various subgroups of irradited patients [fr

  13. Xerostomia induced by radiotherapy

    Directory of Open Access Journals (Sweden)

    Alimi D

    2015-08-01

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

  14. Chemo-radiotherapy for localized pancreatic cancer: increased dose intensity and reduced acute toxicity with concomitant radiotherapy and protracted venous infusion 5-fluorouracil

    International Nuclear Information System (INIS)

    Poen, Joseph C.; Collins, Helen L.; Niederhuber, John E.; Oberhelman, Harry A.; Vierra, Mark A.; Bastidas, Augusto J.; Young, Harvey S.; Slosberg, Edward A.; Jeffrey, Brooke R.; Longacre, Teri A.; Goffinet, Don R.

    1996-01-01

    Purpose: Although concomitant radiotherapy (RT) and bolus 5-Fluorouracil (5-FU) have been shown to improve survival in patients with resectable or locally advanced pancreatic cancer, most patients will eventually succumb to their disease. Since 1994, we have attempted to improve efficacy by administering 5-FU by protracted venous infusion (PVI). This study compares the dose intensity and acute toxicity of our current regimen utilizing 5-FU by PVI with our prior regimen of radiotherapy and bolus 5-FU. Materials and Methods: Since January, 1986, 77 patients with resectable or locally advanced adenocarcinoma of the pancreas were treated with radiation therapy. Thirteen received radiation therapy alone or a planned split-course treatment and were therefore excluded from this study. The remaining 64 patients were treated with continuous course RT and concurrent 5-FU by bolus injection for 3 days during weeks 1 and 5 (n=44) or by PVI 5-FU throughout the entire course of radiotherapy (n=20). Patients were treated on 6 or 15 MV linear accelerators with 3-4 custom shaped fields to target doses of 40-50 Gy following pancreaticoduodenectomy or 50-60 Gy for locally advanced disease. 5-FU target doses were 500 mg/m 2 for bolus injection and 200-225 mg/m 2 /day for PVI. Dose intensity was assessed for both 5-FU and radiotherapy by calculating total doses (mg/m 2 and Gy, respectively) and dose/week of treatment. The Cooperative Group Common Toxicity Scale was used to score acute hematologic and gastrointestinal toxicity. Only those endpoints which could be reliably and objectively quantified (e.g. blood counts, weight loss, treatment interruption) were evaluated. Patients with resectable and locally advanced disease were jointly and independently evaluated. Results: The patient characteristics and radiotherapy treatment techniques were similar between the two treatment groups. The mean irradiated volume was 1,323 cm 3 (95% CI: 1,210-1,436). Chemotherapy and radiotherapy dose

  15. Intestinal lymphangiectasia secondary to radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Rao, S.S.; Dundas, S.; Holdsworth, C.D.

    1987-01-01

    We report a case of intestinal lymphangiectasia secondary to radiotherapy and chemotherapy. The patient also had small bowel bacterial overgrowth and pancreatic insufficiency. Lymphatic ectasia as a histological feature has been described previously in association with postradiotherapy malabsorption, but radiation-induced lymphangiectasia producing clinical manifestations has hitherto not been reported. Replacement of dietary long-chain fats with medium-chain triglycerides, pancreatic enzyme supplements, and a short course of oxytetracycline, resulted in dramatic clinical improvement. The possibility of intestinal lymphangiectasia should be borne in mind in patients with postradiotherapy malabsorption. A low serum albumin and lymphocyte count should draw attention to this possibility

  16. TECHNICAL COURSES

    CERN Multimedia

    Enseignement Technique; Technical Training; Monique Duval - Tel. 74924

    2000-01-01

    C++ for Particle Physicists By Paul KUNZ Please note that Paul Kunz will be giving his very popular and highly recommended C++ course again on 20 ­ 24 November. The course costs 200 CHF, and advance registration is required. People with CERN EDH accounts can apply electronically directly from the Web course description page : C++ for Particle Physicists Team Visitors should ask their Group Leader to send an e-mail to the DTO of EP Division, M. Burri, referring to the ‘C++ for Particle Physicists’ course and giving their name, CERN ID number, the Team account number to which the course fee should be charged, and VERY IMPORTANTLY an email address to which an invitation to the course can be sent.

  17. NEW COURSES

    CERN Document Server

    Enseignement Technique; Tél. 74924; Technical Training; Monique Duval; Tel. 74924

    2000-01-01

    C++ for Particle Physicists By Paul KUNZ Please note that Paul Kunz will be giving his very popular and highly recommended C++ course again on 20-24 November. The course costs 200 CHF, and advance registration is required. People with CERN EDH accounts can apply electronically directly from the Web course description page : http://www.cern.ch/Training/ENSTEC/P9798/Software/cpppp_e.htm Team Visitors should ask their Group Leader to send an e-mail to the DTO of EP Division, M. Burri, referring to the ‘C++ for Particle Physicists’ course and giving their name, CERN ID number, the Team account number to which the course fee should be charged, and VERY IMPORTANTLY an email address to which an invitation to the course can be sent.

  18. TECHNICAL COURSES

    CERN Multimedia

    Technical Training; Tel. 74924

    2000-01-01

    C++ for Particle Physicists By Paul KUNZ Please note that Paul Kunz will be giving his very popular and highly recommended C++ course again on 20 ­ 24 November. The course costs 200 CHF, and advance registration is required. People with CERN EDH accounts can apply electronically directly from the Web course description page : http://www.cern.ch/Training/ENSTEC/P9798/Software/cpppp_e.htm Team Visitors should ask their Group Leader to send an e-mail to the DTO of EP Division, M. Burri, referring to the ‘C++ for Particle Physicists’ course and giving their name, CERN ID number, the Team account number to which the course fee should be charged, and VERY IMPORTANTLY an email address to which an invitation to the course can be sent.

  19. Comparison of induction chemotherapy before radiotherapy with radiotherapy only in patients with locally advanced squamous cell carcinoma of the lung

    International Nuclear Information System (INIS)

    Brodin, O.; Nou, E.; Mercke, C.

    1996-01-01

    The aim of this randomised trial was to investigate the effect of induction chemotherapy before radiotherapy on survival in 302 patients with non-resectable squamous cell carcinoma of the lung. Radiotherapy, 56 Gy to the chest, was given to 154 patients and combined treatment, with chemotherapy preceding the radiotherapy, to 148 patients. Chemotherapy consisted of three courses of cisplatin (120 mg/m 2 ) and etoposide (100 mg/m 2 i.v. for 3 days) administered every fourth week. Median survival was 10.5 months in the radiotherapy arm and 11 months in the combined treatment arm. The 2-year survival rate was 17% in the radiotherapy arm and 21% in the combined treatment arm. Addition of chemotherapy seemed to significantly improve survival, according to the Cox multivariate analysis (P = 0.04), but as only a trend according to life-table analysis (P = 0.11). Chemotherapy also accomplished a trend towards improved local control (P 0.08) and towards decreased metastatic disease (P = 0.10). 2 patients in the combined treatment arm, but none in the radiotherapy ar, died from toxicity. The conclusion was that the value of the chemotherapy used in this study was very modest, but the results strongly support further research for more efficient drugs and combinations. (author)

  20. A Software Configuration Management Course

    DEFF Research Database (Denmark)

    Asklund, U.; Bendix, Lars Gotfred

    2003-01-01

    Software Configuration Management has been a big success in research and creation of tools. There are also many vendors in the market of selling courses to companies. However, in the education sector Software Configuration Management has still not quite made it - at least not into the university...... curriculum. It is either not taught at all or is just a minor part of a general course in software engineering. In this paper, we report on our experience with giving a full course entirely dedicated to Software Configuration Management topics and start a discussion of what ideally should be the goal...

  1. Success Stories in Radiotherapy Development Projects: Radiotherapy Service in Mauritania. Chapter 28.5

    International Nuclear Information System (INIS)

    Rosenblatt, E.; Zubizarreta, E.; Djeutie, A.; Meghzifene, A.; Mohamedou, M.M.

    2017-01-01

    Mauritania, a country of 3.4 million people, did not have any radiotherapy facility until 2009. As is usually the case in countries without radiotherapy services, cancer patients with a need for this treatment travelled to neighbouring countries (Morocco or Tunisia) or to Europe to receive it, or switched to alternative forms of care. Cancer is a rising cause of death in Mauritania. According to WHO estimates, about 2200 people died of cancer in 2011, of whom 1400 were aged below 70 years of age. The number of patients sent abroad for treatment by the National Health Insurance Fund rose to 500 patients in 2007, causing a significant drain on the State budget. Cancer was the main cause of health related travel abroad. The average cost of such travel was two million ouguiya per patient (US $8000). Through a technical cooperation project initiated in 2009 between the Mauritanian Government and the IAEA, the latter assisted the country with the establishment and operation of its first radiotherapy facility. The National Oncology Centre, including a radiotherapy department, was built in Nouakchott in 2010 and began operation in early 2011 with a limited staff, all hired from abroad. Its equipment includes a modern medical linac with a multileaf collimator and portal imaging, a CT simulator, a 3-D CRT TPS and a remote afterloading HDR brachytherapy system. The centre was planned with an additional bunker, where a second accelerator can be installed in the future. Except for the training of the Department Head, the entire professional team has been trained through the IAEA’s technical cooperation fellowship programme. The centre treated a total of 250 patients in 2012 and treated 176 in the first half of 2013. Most patients undergo simulation and computerized radiotherapy treatment planning. The centre ensures the sustainability of the equipment through full maintenance contracts for the major radiation equipment and source replacements for the HDR brachytherapy unit.

  2. Anxiety and depression in patients receiving radiotherapy. Prospective study

    International Nuclear Information System (INIS)

    Chaturvedi, S.K.; Chandra, P.S.; Channabasavanna, S.M.; Anantha, N.; Reddy, B.K.M.; Sharma, S.

    1994-01-01

    The objective of this study was to detect the prevalence of anxiety and depressive disorders using the Hospital Anxiety and Depression Scale (HADS) prospectively in patients receiving Radiotherapy (RT) during and after treatment. 140 consecutive cancer patients referred for radiotherapy and their care givers were included. All patients were administered the Hospital Anxiety and Depression Scale (HADS) conducted at intake, just before starting RT, after finishing the course of RT, and at 3-4 months follow-up. Anxiety and depression are detected frequently in patients receiving RT both prior to treatment and later during follow-up

  3. Analysis of the actual number of physicians in radiotherapy units in Germany

    International Nuclear Information System (INIS)

    Guttenberger, R.; Witucki, G.

    2002-01-01

    Background: Physician workload directly influences the ability of an institution to provide high standards in radiotherapy services. Materials and Methods: Data of 189 radiotherapy units of the DEGRO survey 2000 complemented and corrected (Table 1) are analyzed with simple and multiple linear regression (models in Table 2). Results: In 21 private radiotherapy facilities actual numbers of physicians split up in 0.19 for every 1,000 megavoltage courses per year, 1.8 per megavoltage unit, 0.68 for every ten beds for inpatients minus 0.67 or plus 1.2 physicians per facility providing radiotherapy only or combined with other services, respectively. Radiotherapy units in hospitals were analyzed in two groups, i.e. radiotherapy only (n=69) or in combination with other services (n=59). In the latter, reported numbers of physicians split up in 3.2 for every 1,000 megavoltage courses per year, minus 0.13 per megavoltage unit, 0.87 for every ten beds for inpatients, plus 2.2 per facility. Units providing radiotherapy only had 0.86 physicians for every 1,000 megavoltage courses per year plus 1.0 per megavoltage unit plus 0.97 for every ten beds plus 1.0 per facility. In 36 radiotherapy university clinics actual numbers of physicians split up in 2.4 for every 1,000 megavoltage courses per year, 1.7 per megavoltage unit, 0.86 for every ten beds for inpatients, plus 1.5 per clinic. For confidence limits see Table 3, for results of univariate analysis Figures 1 and 2. Conclusion: In German radiotherapy facilities, physician workload varies considerably. It exceeds that reported for the USA by a substantial margin. (orig.) [de

  4. Erythropoietin and radiotherapy; Erythropoietine et radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-01-15

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

  5. Uterine cervix cancer treatment in IIB, IIIA and IIIB stages with external radiotherapy versus external radiotherapy and scintiscanning of low dose. ION SOLCA. Years 1998-2000

    International Nuclear Information System (INIS)

    Sanchez, Doris; Falquez, Roberto

    2002-01-01

    We realized study of retrospective accomplished in course of years 1998-2000, reviewing clinical charts of statistical department of ION SOLCA. We reviewed 544 cases in 1998, 603 patients in 1999, and 630 cases in 2000. In the radiotherapy service, 133 patients received treatment with external radiotherapy between February 1998 to February 1999 in IIB, IIIA, IIIB stages and only 80 patients were treated with external radiotherapy and scintiscanning of low dose rate in the same stages between March 1999 to March 2000. (The author)

  6. Palliative radiotherapy in plasma cell myeloma

    International Nuclear Information System (INIS)

    Adamietz, I.A.; Schoeber, C.; Schulte, R.W.M.; Renner, K.; Peest, D.

    1991-01-01

    Pain symptoms caused by bone lesions of multiple myeloma can be relieved by a local irradiation treatment. To estimate the influence of systemic treatment on the palliative effect of local radiotherapy the records of 70 myeloma patients treated with chemotherapy combined with or followed by local irradiation were reviewed. The local response rate, defined as complete pain relief at the irradiated site, was 80 percent in patients receiving irradiation during chemotherapy (melphalan and prednisone) and this palliative effect endured 31.8+-3.6 months. If irradiation was started in the period without systemic treatment the local response rate was 39.6 percent and lasted 24.8+-17.9 months. In sites treated with more than one radiotherapy course 94 percent response after the 1st treatment, 56 percent after the 2nd and no response after the 3rd was achieved. The duration of local pain control was positively related to the applied radiation dose. It is concluded that irradiation during concomitant chemotherapy is superior to radiotherapy performed in a period without systemic treatment. Local long-term palliation can only be achieved by a sufficient high radiation dose. (author). 24 refs.; 2 figs.; 2 tabs

  7. Radiotherapy, the experience of the patients

    International Nuclear Information System (INIS)

    Verres, R.; Klusmann, D.

    1998-01-01

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

  8. Multileaf collimator in radiotherapy

    International Nuclear Information System (INIS)

    Jeraj, M.; Robar, V.

    2004-01-01

    Background. Basic goal of radiotherapy treatment is the irradiation of a target volume while minimizing the amount of radiation absorbed in healthy tissue. Shaping the beam is an important way of minimizing the absorbed dose in healthy tissue and critical structures. Conventional collimator jaws are used for shaping a rectangular treatment field; but, as usually treatment volume is not rectangular, additional shaping is required. On a linear accelerator, lead blocks or individually made Cerroben TM blocks are attached onto the treatment head under standard collimating system. Another option is the use of multileaf collimator (MLC). Conclusions. Multileaf collimator is becoming the main tool for beam shaping on the linear accelerator. It is a simple and useful system in the preparation and performance of radiotherapy treatment. Multileaf collimators are reliable, as their manufacturers developed various mechanisms for their precision, control and reliability, together with reduction of leakage and transmission of radiation between and through the leaves. Multileaf collimator is known today as a very useful clinical system for simple field shaping, but its use is getting even more important in dynamic radiotherapy, with the leaves moving during irradiation. This enables a precise dose delivery on any part of a treated volume. Intensity modulated radiotherapy (IMRT), the therapy of the future, is based on the dynamic use of MLC. (author)

  9. [Radiotherapy of oropharynx carcinoma].

    Science.gov (United States)

    Servagi Vernat, S; Tochet, F; Vieillevigne, L; Pointreau, Y; Maingon, P; Giraud, P

    2016-09-01

    Indication, doses, technique of radiotherapy and concomitant chemotherapy for oropharynx carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  10. Quality indicators in radiotherapy

    International Nuclear Information System (INIS)

    Cionini, Luca; Gardani, Gianstefano; Gabriele, Pietro; Magri, Secondo; Morosini, Pier Luigi; Rosi, Antonella; Viti, Vincenza

    2007-01-01

    Background and purpose: There is a widespread and increasing tendency to develop hospital performance indicators in the field of accreditation/certification systems and quality benchmarking. A study has been undertaken to develop a set of performance indicators for a typical radiotherapy Centre and to evaluate their ability to provide a continuous quality improvement. Materials and methods: A working group consisting of radiation oncologists, medical physicists and radiation technologists under the coordination of experts in health technology assessment has elaborated a set of general indicators able to monitor performances and the quality level of a typical radiotherapy Centre. The work has been carried out through four steps: a preliminary set of indicators was selected; data on these indicators were collected in a number of Italian radiotherapy Centres and medical physics Services; problems in collection and analysis of data were discussed; a final set of indicators was developed. Results: A final set of 13 indicators is here presented. They concern general structural and/or operational features, health physics activities and accuracy and technical complexity of the treatment. Conclusions: The indicators tested in a few Italian Centres of radiotherapy and medical physics Services are now ready to be utilized by a larger community

  11. Bowel disease after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Schofield, P.F.; Holden, D.; Carr, N.D. (Christie Hospital and Holt Radium Inst., Manchester (UK))

    1983-06-01

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

  12. Radiotherapy of breast fibrosis

    International Nuclear Information System (INIS)

    Heibel, J.H.

    1979-01-01

    In a retrospective study radiotherapy of breast fibrosis in hormone-treated men with histologically confirmed prostate carcinoma was examined. 10 patients had received hormones even before irradiation, 113 obtained hormone administration only after irradiation. The objective size of the glandular body and the overall size of the breast were measured with a special method developed by the author. 46 patients indicated complaints. With hypertrophic mamma and hypertrophic mamilla in 67 examined patients, 127 different symptoms resulted in total. Four patients of the group who had obtained hormones before irradiation, suffered from subjective symptoms. It resulted that radiotherapy of breast fibrosis carried out during hormone treatment is no gynecomastia prophylaxis, that already existent mamma hypertrophies are irreversible, but that existent sensations were notably reduced within 6 months after irradiation therapy. These results indicate the necessity of a radiotherapy of the mamma fibrosis before the hormone treatment is begun. Particularly in cases of higher operative risks, also the possibility of preferring radiotherapy to mastectomy should be fully utilized, in view of adequate or even better therapeutic results. (orig./MG) [de

  13. Gamma apparatuses for radiotherapy

    International Nuclear Information System (INIS)

    Sul'kin, A.G.

    1986-01-01

    Scientific and technical achievements in development and application of gamma therapeutic apparatuses for external and intracavity irradiations are generalized. Radiation-physical parameters of apparatuses providing usability of progressive methods in radiotherapy of onclogical patients are given. Optimization of main apparatus elements, ensurance of its operation reliability, reduction of errors of irradiation plan reproduction are considered. Attention is paid to radiation safety

  14. Four R's of radiotherapy

    International Nuclear Information System (INIS)

    Withers, H.R.

    1975-01-01

    Radiotherapy given as multiple doses can be effective in sterilizing cancers, but the processes whereby the neoplasm is eradicated and the normal tissues are preserved are not fully understood. The differential between normal tissue and tumor response is enhanced by dose fractionation, single doses resulting in severe normal tissue injury when the dose is sufficient to control a proportion of treated tumors. Data are reviewed from radiobiological studies on laboratory animals and cultured cells that have thrown some light on four of the phenomena that influence the outcome of fractionated-dose radiotherapy, one or more of which may account for the relative sparing of normal tissues. These are repair of sublethal injury in normal and neoplastic cells, reoxygenation of the tumor, redistribution through the division cycle, and regeneration of surviving normal and malignant cells between dose fractions. These have been called the four R's of fractionated radiotherapy. Other factors are involved in the outcome of multifraction radiotherapy, including maintenance of the architectural integrity of the normal tissues, the volume of tissue irradi []ted, the tumor bed, and the immunocompetence of the host. (90 references) (CH)

  15. Cerebral function estimation using electro-encephalography for the patients with brain tumor managed by radiotherapy

    International Nuclear Information System (INIS)

    Mariya, Yasushi; Saito, Fumio; Kimura, Tamaki

    1999-01-01

    Cerebral function of 12 patients accompanied with brain tumor, managed by radiotherapy, were serially estimated using electroencephalography (EEG), and the results were compared with tumor responses, analyzed by magnetic resonance imaging (MRI), and clinical courses. After radiotherapy, EEG findings were improved in 7 patients, unchanged in 3, and worsened in 1. Clinical courses were generally correlated with serial changes in EEG findings and tumor responses. However, in 3 patients, clinical courses were explained better with EEG findings than tumor responses. It is suggested that the combination of EEG and image analysis is clinically useful for comprehensive estimation of radiotherapeutic effects. (author)

  16. Radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Krause, S.; Herfarth, K.

    2011-01-01

    With the development of modern radiation techniques, such as intensity-modulated radiotherapy (IMRT), a dose escalation in the definitive radiotherapy of prostate cancer and a consecutive improvement in biochemical recurrence-free survival (BFS) could be achieved. Among others, investigators at the Memorial Sloan-Kettering Cancer Center (MSKCC) saw 5-year BFS rates of up to 98%. A further gain in effectiveness and safety is expected of hypofractionation schedules, as suggested by data published by Kupelian et al., who saw a low 5-year rate of grade ≥2 rectal side-effects of 4.5%. However, randomized studies are just beginning to mature. Patients with intermediate or high-risk tumors should receive neoadjuvant (NHT) and adjuvant (AHT) androgen deprivation. Bolla et al. could show an increase in 5-year overall survival from 62-78%. The inclusion of the whole pelvis in the treatment field (WPRT) is still controversial. The RTOG 94-13 study showed a significant advantage in disease-free survival after 60 months but long-term data did not yield significant differences between WPRT and irradiation of the prostate alone. The German Society of Urology strongly recommends adjuvant radiotherapy of the prostate bed for pT3 N0 tumors with positive margins. In a pT3 N0 R0 or pT2 N0 R+ situation, adjuvant radiotherapy should at least be considered. So far, no randomized data on NHT and AHT have been published, so androgen deprivation remains an individual decision in the postoperative setting. In a retrospective analysis Spiotto et al. reported a positive effect for adjuvant WPRT and biochemical control. This article summarizes the essential publications on definitive and adjuvant radiotherapy and discusses the additional use of androgen deprivation and WPRT. (orig.) [de

  17. Radiotherapy and brachytherapy

    International Nuclear Information System (INIS)

    2007-02-01

    This presentation first defines the radiotherapy and brachytherapy techniques, indicates the used ionizing radiations (electromagnetic and particles), describes the mechanisms and processes of action of ionizing radiations: they can be physical by photon-matter interactions (Compton effect and photoelectric effect) or due to electron-matter interactions (excitation, ionization), physical-chemical by direct or indirect action (DNA damage), cellular (mitotic or apoptotic death), tissue (sane and tumorous tissues and differential effect). It discusses the biological efficiency of these treatments which depends on different parameters: intrinsic radio-sensitivity, time (session fractioning and organisation in time), oxygen, radiation quality, cellular cycle, dose rate, temperature. It presents the different types of radiotherapy: external radiotherapy (general sequence, delineation, dosimetry, protection of critical organs, treatment session, quality control, monitoring consultation) and briefly presents some specific techniques (total body irradiation, total cutaneous electron therapy, pre-operation radiotherapy, radio-surgery, hadron-therapy). It proposes an overview of the main indications for this treatment: brain tumours, upper aero digestive tract tumours, bronchial tumours, oesophagus, stomach and pancreas tumours, breast tumours, cervix cancer, rectum tumour, and so on, and indicates the possible associated treatments. The next part addresses brachytherapy. It presents the principles and comments the differences with radiotherapy. It indicates the used radio-elements (Caesium 137, Iridium 192, Iodine 125), describes the implementation techniques (plastic tubes, use of iodine 125, intracavitary and endo-luminal radiation therapy). It proposes an overview of the different treated tumours (skin, breast, prostates, bronchial, oesophagus, ENT) and indicates possible early and late secondary effects for different organs

  18. French Courses

    CERN Multimedia

    2012-01-01

    General and Professional French Courses These courses are open to all persons working on the CERN site, and to their spouses. The next session will take place from 28 January to 5 April 2013. Oral Expression This course is aimed for students with a good knowledge of French who want to enhance their speaking skills. Speaking activities will include discussions, meeting simulations, role-plays etc. The next session will take place from 28 January to 5 April 2013. Writing professional documents in French These courses are designed for non-French speakers with a very good standard of spoken French. The next session will take place from 28 January to 5 April 2013. For registration and further information on the courses, please consult our Web pages or contact Kerstin Fuhrmeister.

  19. "Dropbox" Brings Course Management Back to Teachers

    Science.gov (United States)

    Niles, Thaddeus M.

    2013-01-01

    Course management software (CMS) allows teachers to deliver content electronically and manage collaborative coursework, either blending with face-to-face interactions or as the core of an entirely virtual classroom environment. CMS often takes the form of an electronic storehouse of course materials with which students can interact, a virtual…

  20. Students Matter: Quality Measurements in Online Courses

    Science.gov (United States)

    Unal, Zafer; Unal, Aslihan

    2016-01-01

    Quality Matters (QM) is a peer review process designed to certify the quality of online courses and online components. It has generated widespread interest and received national recognition for its peer-based approach to quality assurance and continuous improvement in online education. While the entire QM online course design process is…

  1. Teaching Accounting Courses Online: One Instructor's Experience

    Science.gov (United States)

    Dusing, Gregory M.; Hosler, Jonathan C.; Ragan, Joseph M.

    2012-01-01

    Accounting programs at colleges and universities across the country are offering more online courses, and in some cases entire degree programs. Given increasing enrollments in online accounting education, it is important that accounting educators become aware of the things that work and the things that don't work when delivering courses over the…

  2. Efficacy of radiotherapy of oral mucosa cancer

    International Nuclear Information System (INIS)

    Vorob'ev, Yu.I.; Garbuzov, M.I.; Sarantseva, I.P.; Popov, N.V.; Pereslegin, O.I.

    1986-01-01

    An analysis of 10-year experience of a radiological department (962 patients) indicated late admission of oral mucosa cancer patients for specialized treatment: 75-85% of the patients were admitted with Stage 2-4 disease. The assessment of the efficacy of radiotherapy according to the 3 ad 5-year survival rates showed that better results were obtained for buccal mucosa cancer and the worst for mouth fundus cancer. Regional metastates are a poor prognostic sign, particularly fixed metastases in patients with tongue and mouth fundus cancer. Combined therapy turned out be the most effective in tongue cancer. In different variants of dose delivery in time the most favorable results were obtained with small fractionation (a conventional course). However it should be noted that a split course was usually applied to weak elderly patients with advanced stages of disease

  3. Radiotherapy staffing in the European countries

    DEFF Research Database (Denmark)

    Lievens, Yolande; Defourny, Noémie; Coffey, Mary

    2014-01-01

    includes a detailed analysis of radiotherapy staffing (questionnaire items 47-60), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40...... of countries can be distinguished on the basis of available personnel resources and socio-economic status. CONCLUSIONS: The average personnel figures in Europe are now consistent with, or even more favourable than the QUARTS recommendations, probably reflecting a combination of better availability as such......, in parallel with the current use of more complex treatments than a decade ago. A considerable variation in available personnel and delivered courses per year however persists among the highest and lowest staffing levels. This not only reflects the variation in cancer incidence and socio-economic determinants...

  4. Train medical physicist-urgent need for advanced radiotherapy

    International Nuclear Information System (INIS)

    Hareyama, Masato; Teshima, Teruki; Yamamoto, Tokihiro; Haga, Akihiro; Nakagawa, Keiichi; Uesaka, Mitsuru

    2008-01-01

    A Japanese advanced charged particle therapy for cancer that places fewer physical burdens on patients is leading the world and stereotactic radiotherapy and intensity-modulated radiotherapy (IMRT) have been implemented also as a high precision radiotherapy. For the further advancement and dissemination of the therapy, training and qualification of medical physicists has become more needed. Cancer professional train course plan has been performed at many universities in Japan partly to train medical physicists. This special issue consists of seven relevant articles from experts of academia. Medical physicists have been qualified by the Japan Radiological Society, but should have national qualification such as to carry out the R and D of therapy equipment. This has been supported by many academia such as the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) but not by the Japan Association of Radiological Technologists (JART). (T. Tanaka)

  5. Radiotherapy in massive angiomatous osteolysis (Gorham-Stout's syndrome)

    International Nuclear Information System (INIS)

    Bek, V.; Haicl, Z.; Kolar, J.; Bednar, B.; Karlova Universita, Prague; Institute for Postgraduate Medical and Pharmaceutical Studies, Prague; Karlova Universita, Prague

    1981-01-01

    The cases of two young men with the Gorham-Stout's syndrome of massive angiomatous osteolysis are presented. Attempted surgical removal of the pathological angiomatous tissue proved unsuccessful. Telegammatherapy with each patient receiving total focal dose of 40.0 Gy fractionated over a period of 4 weeks resulted in speedy and complete arrest of osteolysis, and in partial recalcification of the bone tissue destroyed. In one patient the favourable condition has been lasting for 9 years, in the other for 8 months from the end of the course of radiotherapy. The authors discuss the cause of a central fracture of the first patient's left acetabulum which was noted 5 years after the radiotherapy. Proceeding from their experience so far, the authors describe radiotherapy in the Gorham-Stout's syndrome as a method of choice, and give a list of the therapeutical principles. (orig.) [de

  6. English courses

    CERN Multimedia

    HR Department

    2010-01-01

    New courses University of Cambridge ESOL examination course We will be starting two new courses in October leading to the Cambridge First Certificate in English (level B2 of the European Framework) and the Cambridge Advanced English (level C1) examinations. These courses will consist of two semesters of 15 weeks with two two-hourly classes per week. There will be an average of eight students per class. Normally the examination will be taken in June 2011 but strong participants could take it earlier. People wishing to take these courses should enrol: http://cta.cern.ch/cta2/f?p=110:9:1927376177842004::NO::X_COURSE_ID,X_STATUS:4133%2CD and they will then be required to take a placement test to check that their level of English is of an appropriate level. Please note that we need a minimum of seven students enrolled to open a session. For further information please contact Tessa Osborne 72957. General and Professional English Courses The next session will take place: From 4th October 2010 to 5th Feb...

  7. Radiotherapy in addition to radical surgery in rectal cancer: evidence for a dose-response effect favoring preoperative treatment

    International Nuclear Information System (INIS)

    Glimelius, Bengt; Isacsson, Ulf; Jung, Bo; Paahlman, Lars

    1997-01-01

    Purpose: This study explored the relationship between radiation dose and reduction in local recurrence rate after preoperative and postoperative radiotherapy in rectal cancer. Methods and Materials: All randomized trials initiated prior to 1988 comparing preoperative and postoperative radiotherapy with surgery alone or with each other were included. Local failure rates were available in 5626 randomized patients. The linear quadratic formula was used to compensate for different radiotherapy schedules. Results: For preoperative radiotherapy, a clear dose-response relationship could be established. For postoperative radiotherapy, the range of doses was narrow, and a dose-response relationship could not be demonstrated. At similar doses, preoperative radiotherapy appeared to be more efficient in reducing local failure rate than postoperative. The only trial comparing preoperative with postoperative radiotherapy confirms this notion. A 15-20 Gy higher dose may be required postoperatively than preoperatively to reach similar efficacy. Neither approach alone significantly influences survival, although it is likely that a small survival benefit may be seen after preoperative radiotherapy. Conclusions: The information from the entire randomized experience suggests that preoperative radiotherapy may be more dose efficient than postoperative radiotherapy

  8. Entrance and peripheral dose measurements during radiotherapy

    International Nuclear Information System (INIS)

    Sulieman, A.; Kappas, K.; Theodorou, K.

    2008-01-01

    In vivo dosimetry of entrance dose was performed using thermoluminescent dosimeters (TLD) in order to evaluate the clinical application of the build up caps in patient dose measurements and for different treatment techniques. Peripheral dose (thyroid and skin) was measured for patients during breast radiotherapy to evaluate the probability of secondary cancer induction. TLD-100 chips were used with different Copper build up caps (for 6 MV and 15 MV photon beams from two linear accelerators. Entrance doses were measured for patients during radiotherapy course for breast, head and neck, abdomen and pelvis malignancies. The measured entrance dose for the different patients for 6 MV beams is found to be within the ±2.6% compared to the dose derived from theoretical estimation (normalized dose at D max ). The same measurements for 15 MV beams are found to be ±3 %. The perturbation value can reach up to 20% of the D max , which acts as a limitation for entrance dose measurements. An average thyroid skin dose of 3.7% of the prescribed dose was measured per treatment session while the mean skin dose breast treatment session is estimated to be 42% of D max , for both internal and external fields. These results are comparable in those of the in vivo of reported in literature. The risk of fatality due to thyroid cancer per treatment course is 3x10 -3

  9. Multileaf collimator for radiotherapy machines

    International Nuclear Information System (INIS)

    Nunan, C.S.

    1989-01-01

    This patent describes an apparatus for radiotherapy treatment of a patient. It comprises: an electron linear accelerator means for generating x-rays at an x-ray source target; a set of four moveable jaws mounted on a jaw frame between the x-ray source target and the patient. The set of jaws defining a rectangular x-ray field; mounting means for mounting a leaf means on the jaw frame; the mounting means including a main leaf support frame; a pair of subframes, each of which is linearly movable mounted from the frame. The subframes being coplanar; a multiplicity of leaves of material substantially opaque to x-rays. The leaves provided with means to make them linearly movable relative to each subframe, each leaf being capable of extension beyond a field mid-line, the length of each leaf being shorter than half of a maximum field length capability of the jaws measured in the direction and plane of the leaves; leaf drive means; and computer control means for controlling the subframe drive means and the leaf drive means to provide a dynamically changing radiation field shape during the course of radiation treatment of the patient

  10. Palliative radiotherapy in locally advanced head and neck cancer-A prospective trial

    Directory of Open Access Journals (Sweden)

    Ghoshal Sushmita

    2004-01-01

    Full Text Available AIM: To evaluate the role of palliative radiotherapy for symptom control in patients with locally advanced head and neck cancer. MATERIALS AND METHODS: 25 patients with stage 3 and stage 4 head and neck cancer were treated with a short course of palliative radiotherapy (30 Gray (Gy in 10 fractions over 2 weeks. Baseline symptoms were assessed using a 11 point numerical scale for pain, dysphagia, cough, insomnia and dyspnoea. The primary end point was relief of symptoms in the fourth week after radiotherapy. Percentage symptom relief was quantified by the patient using a rupee scale. RESULTS: All 22 patients with pain and 90% of patients with dysphagia, dyspnoea and disturbed sleep had greater than 50% relief in symptoms after radiotherapy. Cough was relieved in sixty percent of cases. CONCLUSION: A short course of radiation can be an effective method of symptom palliation in head and neck cancers.

  11. SU-E-T-51: Bayesian Network Models for Radiotherapy Error Detection

    International Nuclear Information System (INIS)

    Kalet, A; Phillips, M; Gennari, J

    2014-01-01

    Purpose: To develop a probabilistic model of radiotherapy plans using Bayesian networks that will detect potential errors in radiation delivery. Methods: Semi-structured interviews with medical physicists and other domain experts were employed to generate a set of layered nodes and arcs forming a Bayesian Network (BN) which encapsulates relevant radiotherapy concepts and their associated interdependencies. Concepts in the final network were limited to those whose parameters are represented in the institutional database at a level significant enough to develop mathematical distributions. The concept-relation knowledge base was constructed using the Web Ontology Language (OWL) and translated into Hugin Expert Bayes Network files via the the RHugin package in the R statistical programming language. A subset of de-identified data derived from a Mosaiq relational database representing 1937 unique prescription cases was processed and pre-screened for errors and then used by the Hugin implementation of the Estimation-Maximization (EM) algorithm for machine learning all parameter distributions. Individual networks were generated for each of several commonly treated anatomic regions identified by ICD-9 neoplasm categories including lung, brain, lymphoma, and female breast. Results: The resulting Bayesian networks represent a large part of the probabilistic knowledge inherent in treatment planning. By populating the networks entirely with data captured from a clinical oncology information management system over the course of several years of normal practice, we were able to create accurate probability tables with no additional time spent by experts or clinicians. These probabilistic descriptions of the treatment planning allow one to check if a treatment plan is within the normal scope of practice, given some initial set of clinical evidence and thereby detect for potential outliers to be flagged for further investigation. Conclusion: The networks developed here support the

  12. SU-E-T-51: Bayesian Network Models for Radiotherapy Error Detection

    Energy Technology Data Exchange (ETDEWEB)

    Kalet, A; Phillips, M; Gennari, J [UniversityWashington, Seattle, WA (United States)

    2014-06-01

    Purpose: To develop a probabilistic model of radiotherapy plans using Bayesian networks that will detect potential errors in radiation delivery. Methods: Semi-structured interviews with medical physicists and other domain experts were employed to generate a set of layered nodes and arcs forming a Bayesian Network (BN) which encapsulates relevant radiotherapy concepts and their associated interdependencies. Concepts in the final network were limited to those whose parameters are represented in the institutional database at a level significant enough to develop mathematical distributions. The concept-relation knowledge base was constructed using the Web Ontology Language (OWL) and translated into Hugin Expert Bayes Network files via the the RHugin package in the R statistical programming language. A subset of de-identified data derived from a Mosaiq relational database representing 1937 unique prescription cases was processed and pre-screened for errors and then used by the Hugin implementation of the Estimation-Maximization (EM) algorithm for machine learning all parameter distributions. Individual networks were generated for each of several commonly treated anatomic regions identified by ICD-9 neoplasm categories including lung, brain, lymphoma, and female breast. Results: The resulting Bayesian networks represent a large part of the probabilistic knowledge inherent in treatment planning. By populating the networks entirely with data captured from a clinical oncology information management system over the course of several years of normal practice, we were able to create accurate probability tables with no additional time spent by experts or clinicians. These probabilistic descriptions of the treatment planning allow one to check if a treatment plan is within the normal scope of practice, given some initial set of clinical evidence and thereby detect for potential outliers to be flagged for further investigation. Conclusion: The networks developed here support the

  13. External audit in radiotherapy dosimetry

    International Nuclear Information System (INIS)

    Thwaites, D.I.; Western General Hospital, Edinburgh

    1996-01-01

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

  14. Combined radiotherapy-chemotherapy

    International Nuclear Information System (INIS)

    Steel, G.G.

    1989-01-01

    This paper presents the clinically confirmed benefits of combined chemotherapy-radiotherapy. They have been found in a small group of diseases that respond to chemotherapy alone. According to the author, only when a drug or drug combination has the ability to eradicate occult disease or substantially to reduce the size of objectively measurable disease is there likely to be an demonstrable benefit from its use in conjunction with radiotherapy. It is the author's belief that the immediate future lies in selecting drugs and patients in which a good chemotherapeutic response can be expected, avoiding drugs that seriously enhance radiation damage to normal tissues and keeping drug and radiation treatments far enough apart in time to minimize interactions

  15. A case of laryngeal palsy and persistent aspiration pneumonia following radiotherapy for laryngeal carcinoma

    International Nuclear Information System (INIS)

    Nakao, Kazunari; Tayama, Niro; Mizuno, Masahiro; Niimi, Seiji.

    1997-01-01

    A 80-year-old man developed impairment in his laryngeal movement, vocal fold fixation and severe misdeglutition after radiotherapy for laryngeal carcinoma. Despite of several surgical treatments for aspiration pneumonia, the misdeglutition did not cease because of the stiffness in his larynx until a laryngectomy was finally performed. The resected larynx showed marked fibrosis, and it was considered as a late complication of radiotherapy. The treatment course in this difficult case is discussed. (author)

  16. Merkel cell tumour of the face successfully treated with radical radiotherapy

    International Nuclear Information System (INIS)

    Pople, I.K.

    1988-01-01

    A case of Merkel cell tumour of the face and its dramatic response to a course of radical radiotherapy is presented below. The patient has been free of recurrence for 18 months and has suffered minimal side-effects from the treatment. This suggests that radical radiotherapy, as opposed to the standard wide excision, may be preferred first-line treatment for at least some of these rare, but highly malignant tumours. (author)

  17. Conformal radiotherapy: a glossary

    International Nuclear Information System (INIS)

    Dubray, B.; Giraud, P.; Beaudre, A.

    1999-01-01

    Most of the concepts and terms related to conformal radiotherapy were produced by English-speaking authors and eventually validated by international groups of experts, whose working language was also English. Therefore, a significant part of this literature is poorly accessible to the French-speaking radiation oncology community. The present paper gathers the 'official' definitions already published in French, along with propositions for the remaining terms which should be submitted to a more formal and representative validation process. (author)

  18. Imagination in radiotherapy

    International Nuclear Information System (INIS)

    Pourrez, A.; Truc, G.; Santona, M.; Crehange, G.; Peignaux, K.; Martin, E.; Maingon, P.

    2010-01-01

    Based on a questionnaire given to the patients of a radiotherapy department and to the personnel of a centre of struggle against cancer, the study aimed at revealing imagination and representations about such an advanced medical technology, radio-physics and radioactivity. The patients and personnel were asked to answer the questionnaire with free words, images, or by expressing their own intimate or cultural visions of this environment. Implications on patients' anguish are foreseen. Short communication

  19. The pioneer of radiotherapy

    International Nuclear Information System (INIS)

    Camilleri, J.P.; Coursaget, J.

    2005-09-01

    This work narrates the history of the birth of a new field, the radiology and its application to radiotherapy for these multiform pathologies that are the cancers. Two leading figures will favour this field: Marie Curie, physicist and twice awarded by nobel price, and Claudius Regaud, histologist and become a specialist of the action of ionizing radiations on tissues. They will create the Curie Institute, in relation with the Radium Institute and the support of the Pasteur Institute in 1920. (N.C.)

  20. Quality control in radiotherapy

    International Nuclear Information System (INIS)

    Batalla, A.

    2009-01-01

    The authors discuss the modalities and periodicities of internal quality control on radiotherapy installations. They indicate the different concerned systems and the aspects and items to be controlled (patient and personnel security, apparatus mechanical characteristics, beam quality, image quality, isodose and irradiation duration calculation, data transfer). They present the measurement instruments and tools used for the mechanical controls, dose measurement, beam homogeneity and symmetry, anatomic data acquisition systems, and dose distribution and control imagery calculation

  1. Radiotherapy of endocrine orbitopathy

    International Nuclear Information System (INIS)

    Weischedel, U.; Wieland, C.

    1985-01-01

    After a review of the history and a discussion of recent theories about pathogenesis of endocrine ophthalmopathy the authros give a report on their radiotherapeutical treatment results with cobalt-60-γ-rays in 50 patients. Amelioration was achieved in 50% of the cases, in the other 50% no progression was seen. Radiotherapy is of antiphlogistic and functional effectivity and should be integrated in the treatment regime in early stages. (orig.) [de

  2. Surveillance after prostate cancer radiotherapy

    International Nuclear Information System (INIS)

    Supiot, S.; Rio, E.; Clement-Colmou, K.; Bouchot, O.; Rigaud, J.

    2011-01-01

    Follow-up after prostate cancer radiotherapy aims at detecting local or metastatic relapse, as well as long-term toxicity, requiring adapted treatments. Several scientific societies have published guidelines including clinical, biological and imaging recommendations. More data suggest a role for aggressive salvage therapy in case of local failure following radiotherapy. An adequate follow-up is required for the sake of patients' safety, i.e. to a posteriori validate dose constraints and radiation technique in each radiotherapy department. (authors)

  3. Radiotherapy of vertebral hemangiomas

    International Nuclear Information System (INIS)

    Sakata, Kohichi; Hareyama, Masato; Oouchi, Atushi; Sido, Mitsuo; Nagakura, Hisayasu; Tamakawa, Mituharu; Akiba, Hidenari; Morita, Kazuo

    1997-01-01

    Between 1975 and 1996, 14 patients (11 females, 3 males) with vertebral hemangioma received treatment with radiotherapy. Thirteen patients had a history of back pain or lumbago and 2 patients had neurological symptoms such as sensory impairment or paraplegia. The standard dose administered was 36 Gy in 18 fractions (five treatments per week). In the 13 patients with pain, this was completely or partially relieved. The condition of a man with hypesthesia of the legs deteriorated and a woman with paraplegia who was treated with decompressive laminectomy followed by radiotherapy recovered completely after irradiation. CT scan before irradiation showed thickened trabeculae as small punctate areas of sclerosis in all patients. At MR imaging before irradiation, T2-weighted MR images showed areas of high intensity in all patients and MR images demonstrated lesion enhancement. However, none of the patients who were treated successfully with radiation demonstrated any changes of the affected vertebra in the conventional radiographic films, CT scan or MR imaging, even 5 years after irradiation. Radiological imaging is indispensable for the diagnosis of vertebral hemangiomas but does not appear to be useful for evaluating the effects of radiotherapy. (orig.)

  4. Radiotherapy in Cancer Management

    International Nuclear Information System (INIS)

    Abdel-Wahab, M.

    2015-01-01

    Radiotherapy has been used for curative or palliative treatment of cancer, either alone or increasingly as part of a multimodality approach in conjunction with chemotherapy, immunotherapy or surgery. Radiation must be delivered in the safest and most effective way. The use of radiologic and nuclear medicine diagnostic techniques, e.g., the use of CT (Computerized Tomography) and PET/CT allow better detection and staging of diseases by displaying both morphological and functional abnormalities within the affected organs and are essential in the process of radiotherapy planning. Technical advances in radiotherapy have allowed better targeting of tumors, sparing of normal tissue and, in the case of radiosurgery, a decrease in the number of treatments. The IAEA Programme in Human Health aims to enhance the capabilities in Member States to address needs related to the treatment of diseases, including cancer, through the application of nuclear techniques. The Programme supports quality assurance in radiation medicine; DIRAC, the only radiation oncology-specific resource database world-wide; significant, innovative education and training programmes through telemedicine and e-learning accessible via the human health campus website. Technical expertise for country– and region–specific technical cooperation radiation-medicine projects is provided to establish or enhance radiation medicine worldwide. (author)

  5. Palliative prostate radiotherapy for symptomatic advanced prostate cancer

    International Nuclear Information System (INIS)

    Din, Omar S.; Thanvi, Narottam; Ferguson, Catherine J.; Kirkbride, Peter

    2009-01-01

    Background and purpose: To report the results for the use of short-course palliative radiotherapy to the prostate for localised symptoms. Materials and methods: Fifty-eight patients were identified from radiotherapy records between 2003 and 2007. Data were collected retrospectively on patients' demographics, radiotherapy details and response. Symptoms and toxicity were scored, retrospectively, according to the following scale: 0 = no symptoms, 1 = mild symptoms, 2 = moderate symptoms, and 3 = severe symptoms. Results: All the 58 patients had advanced prostate carcinoma. The median age at radiotherapy was 76.6 years (range 54-91). Fifty-six patients (97%) had hormone refractory disease. Twenty-seven patients (47%) had evidence of metastatic disease. 20Gy in 5 fractions was the most commonly used fractionation. The most frequent baseline symptom was haematuria (54%). Eighty-nine percent (31/35) of the patients had a complete or partial resolution of symptoms at 4 months. Response rates for individual symptoms (including unknown responses) were: rectal symptoms (75%), pelvic pain (69%), urinary obstruction (54%) and haematuria (42%). A >50% reduction in PSA occurred in five patients. Toxicity was mild to moderate only and was self-limiting. Conclusion: Palliative radiotherapy to the prostate gland for local symptoms appears to be an effective means of palliation with minimal toxic side effects. Prospective studies are now required to assess its benefits in more detail.

  6. Standardization of radiotherapy for less radio-curable malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Asakawa, Hiroshi; Yamada, Shogo [Miyagi Prefectural Adult Disease Center, Natori (Japan)

    1982-09-01

    Standardization of radiotherapy for esophageal and gastric cancer was discussed, as the representatives of less radio-curable malignancies. In esophageal carcinoma, it was concluded that radiotherapy should be valuable as a curative procedure. The curative indications for radiotherapy should be the cases of T1-2 N0-1M0 with tumorous or some ulcerous types of carcinoma. Target volume should be defined to the small region, including the primary tumor and the regional lymph node (N1). The dose of 60 to 70 Gy should be optimal and given with the homogeneity of 90%. In gastric carcinoma, it seemed that radiotherapy was a palliative treatment for inoperable carcinoma and should be indicated for the cases of T1-3NxM0 with radio-responsive tumor. Target volume should be localized to the primary lesion and the dose of 50 to 60 Gy should be given as the maximum. Split course radiotherapy was recommended to avoid the serious complications.

  7. Potentials of radiotherapy in inoperable tumours of the central nervous system in childhood

    International Nuclear Information System (INIS)

    Kocsis, Bela; Horvath, Akos; Varjas, Geza; Bajcsay, Andras; Kaldau, Ferenc; Pap, Lilla

    1990-01-01

    16 patients under 16 years were irradiated because of inoperable tumours in the central nervous system. Irradiations were performed by cobalt-60 facility and by a Neptun 10-p linear accelerator, and the results were evaluated. In these cases radiotherapy has an important role as it is the only definitive therapeutical intervention. Radiotherapy should be attempted even if the histological verification is impossible and only the clinical course referres to malignant process. Radiotherapy must be carried out on the basis of CT scan controlled irradiation plan. The 3-year survival rate was 14 per cent in the authors' material. (author) 16 refs.; 5 figs.; 3 tabs

  8. English course

    CERN Multimedia

    HR Department

    2011-01-01

    General and Professional English Courses The next sessions will take place: From 3rd October 2011 to beginning of February 2012 (break at Christmas). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Kerstin Fuhrmeister, tel. 70896. Oral Expression The next sessions will take place from 3rd October 2011 to beginning of February 2012 (break at Christmas). This course is intended for people with a good knowledge of English who want to enhance their speaking skills. There will be on average of 8 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Kerstin Fuhrmeister, tel. 70896. Writing Professional Documents in English - Administrative Wr...

  9. Language Courses

    CERN Multimedia

    HR Department

    2010-01-01

    General and Professional English Courses The next session will take place: from 1st March to end of June 2010 (1/2 weeks break at Easter). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages or contact Nathalie Dumeaux, tel. 78144. Oral Expression The next session will take place from 1st March to end of June 2010 (1/2 weeks break at Easter). This course is intended for people with a good knowledge of English who want to enhance their speaking skills. There will be on average of 8 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. Duration: 30 hours Price: 660 CHF (for a minimum of 8 students) More details Writing Professional Documents in English The next session will take place from 1st March to end of June 2010 (1/2 weeks break at Easter). This course is designed for people with a good le...

  10. NEW COURSES

    CERN Multimedia

    Technical Training; Tel. 74924

    2001-01-01

    Hands-on Training Support for the Windows 2000 Migration Please note that the set of hands-on courses listed below has been added to the Technical Training Programme to support the labwide migration to Windows 2000. If there is enough demand it is planned to organise sessions throughout the summer period. Anyone interested is asked to register for the course(s) of their choice by accessing the web course description from : http://training.web.cern.ch/Training/Welcome.html As soon as a minimum number of applications have been received dates will be fixed and published in the weekly bulletin and on the web. Please note that in order to get maximum benefit from these courses it is important to have Windows 2000 installed on your computer either before or immediately after you attend the session. People who do not have access to a Windows 2000 PC are strongly recommended to plan their training to coincide with the migration of their PC. A migration plan has been prepared in agreement with the NICE 2000 divisiona...

  11. French courses

    CERN Document Server

    HR Department

    2012-01-01

    General and Professional French Courses The next session will take place from 2nd May to 6th July 2012. These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages or contact Kerstin Fuhrmeister.   Oral Expression This course is aimed for students with a good knowledge of French who want to enhance their speaking skills. Speaking activities will include discussions, meeting simulations, role-plays etc. Suitable candidates should contact Kerstin Fuhrmeister (70896) in order to arrange an appointment for a test. The next session will take place from 2nd May to 6th July 2012.   Writing professional documents in French These courses are designed for non-French speakers with a very good standard of spoken French. Suitable candidates should contact Kerstin Fuhrmeister (70896) in order to arrange an appointment for a test. The next session will take place from 2nd May to ...

  12. Language courses

    CERN Multimedia

    2014-01-01

    General and Professional French Courses The next session will take place from 5 May to 11 July 2014. These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://hr-training.web.cern.ch/hr-training/ or contact Kerstin Fuhrmeister (kerstin.fuhrmeister@cern.ch). Oral Expression This course is aimed for students with a good knowledge of French who want to enhance their speaking skills. Speaking activities will include discussions, meeting simulations, role-plays etc. Suitable candidates should contact Kerstin Fuhrmeister (70896) in order to arrange an appointment for a test. The next session will take place from 5 May to 11 July 2014. Writing professional documents in French These courses are designed for non-French speakers with a very good standard of spoken French. Suitable candidates should contact Kerstin Fuhrmeister (70896) in order to arrange an appointment for a test. The next session...

  13. French courses

    CERN Document Server

    2013-01-01

    General and Professional French Courses The next session will take place from 29 April to 5 July 2013. These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages or contact Kerstin Fuhrmeister (kerstin.fuhrmeister@cern.ch). Oral Expression This course is aimed for students with a good knowledge of French who want to enhance their speaking skills. Speaking activities will include discussions, meeting simulations, role-plays etc. Suitable candidates should contact Kerstin Fuhrmeister (70896) in order to arrange an appointment for a test. The next session will take place from 29 April to 5 July 2013. Writing professional documents in French These courses are designed for non-French speakers with a very good standard of spoken French. Suitable candidates should contact Kerstin Fuhrmeister (70896) in order to arrange an appointment for a test. The next session will take place from 29 April to 5 July...

  14. Leukemia risk following radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Curtis, R.E.; Boice, J.D. Jr.; Stovall, M.; Flannery, J.T.; Moloney, W.C.

    1989-01-01

    To evaluate further the relationship between high-dose radiotherapy and leukemia incidence, a nested case-control study was conducted in a cohort of 22,753 women who were 18-month survivors of invasive breast cancer diagnosed from 1935 to 1972. Women treated for breast cancer after 1973 were excluded to minimize the possible confounding influence of treatment with chemotherapeutic agents. The cases had histologically confirmed leukemia reported to the Connecticut Tumor Registry (CTR) between 1935 and 1984. A total of 48 cases of leukemia following breast cancer were included in the study. Two controls were individually matched to each leukemia case on the basis of age, calendar year when diagnosed with breast cancer, and survival time. Leukemia diagnoses were verified by one hematologist. Radiation dose to active bone marrow was estimated by medical physicists on the basis of the original radiotherapy records of study subjects. Local radiation doses to each of the 16 bone marrow components for each patient were reconstructed; the dose averaged over the entire body was 530 rad (5.3 Gy). Based on this dosage and assuming a linear relationship between dose and affect, a relative risk (RR) in excess of 10 would have been expected. However, there was little evidence that radiotherapy increased the overall risk of leukemia (RR = 1.16; 90% confidence interval [CI], 0.6 to 2.1). The risk of chronic lymphocytic leukemia, one of the few malignancies without evidence for an association with ionizing radiation, was not significantly increased (RR = 1.8; n = 10); nor was the risk for all other forms of leukemia (RR = 1.0; n = 38). There was no indication that risk varied over categories of radiation dose

  15. A Personal Appraisal of the MIBiol Courses in Entomology and Plant Pathology at Wolverhampton Polytechnic, 1967-71

    Science.gov (United States)

    Ayerst, G.; Gower, A. M.

    1972-01-01

    Article provides brief description of two microbiology courses at the college level which have multiple characteristics. Course I provides instruction based on papers in biology and in a special subject. Course II is devoted entirely to the special subject. (PS)

  16. Alternating radiotherapy and chemotherapy schedules in small cell lung cancer, limited disease

    International Nuclear Information System (INIS)

    Arriagada, R.; Le Chevalier, T.; Baldeyrou, P.

    1985-01-01

    Sixty-three evaluable patients with limited small cell lung carcinoma were entered into two pilot studies alternating 6 cycles of combination chemotherapy with 3 courses of mediastinal radiotherapy as induction treatment. The first course of radiotherapy started 10 days after the second cycle of chemotherapy; there was a 7 day rest between chemotherapy and radiotherapy courses. This 6 month induction treatment was followed by a maintenance chemotherapy. The total mediastinal radiation dose was increased from 4500 rad in the first study to 5500 rad in the second. Both protocols obtained a complete response (CR) rate of greater than 85%. Local control at 2 years was 61% in the first study and 82% in the second. Acute and delayed toxicity effects are discussed

  17. Entrepreneurship Course

    CERN Multimedia

    2003-01-01

    +++++++ Turn your idea into a company +++++++ Starting date: Thursday 23 October 2003 Timing: Every Thursday from 5 p.m. to 9 p.m. Venue: University of Geneva, Sciences II Duration: 1 semester Registration: http://www.startupcafe.ch/learn More Information: info@createswitzerland.ch Deadline to submit the application: 10 October 2003. Check the CREATE website for alternative dates and venues. The course is restricted to 30 pre-selected participants. The course covers important aspects of launching a business from initial idea to growth and international expansion and addresses two kind of skills requested to start a high tech company which are divided into personal skills (entrepreneur skills) and those to start a company (Start-up tools). The 14 week course is free of charge. For any question, please, contact Ilias.Goulas@cern.ch from the Technology Transfer Group (http://cern.ch/ttdb).

  18. Dose response relationship in local radiotherapy for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Park, Hee Chul; Seong, Jin Sil; Han, Kwang Hyub; Chon, Chae Yoon; Moon, Young Myoung; Song, Jae Seok; Suh, Chang Ok

    2001-01-01

    In this study, it was investigated whether dose response relation existed or not in local radiotherapy for primary hepatocellular carcinoma. From January 1992 to March 2000, 158 patients were included in present study. Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two thirds of the entire liver, and performance status on the ECOG scale of more than 3. Radiotherapy was given to the field including tumor with generous margin using 6, 10-MV X-ray. Mean tumor dose was 48.2±7.9 Gy in daily 1.8 Gy fractions. Tumor response was based on diagnostic radiologic examinations such as CT scan, MR imaging, hepatic artery angiography at 4-8 weeks following completion of treatment. Statistical analysis was done to investigate the existence of dose response relationship of local radiotherapy when it was applied to the treatment of primary hepatocellular carcinoma. An objective response was observed in 106 of 158 patients, giving a response rate of 67. 1%. Statistical analysis revealed that total dose was the most significant factor in relation to tumor response when local radiotherapy was applied to the treatment of primary hepatocellular carcinoma. Only 29.2% showed objective response in patients treated with dose less than 40 Gy, while 68.6% and 77.1 % showed major response in patients with 40-50 Gy and more than 50 Gy, respectively. Child-Pugh classification was significant factor in the development of ascites, overt radiation induced liver disease and gastroenteritis. Radiation dose was an important factor for development of radiation induced gastroduodenal ulcer. Present study showed the existence of dose response relationship in local radiotherapy for primary hepatocellular carcinoma. Only radiotherapy dose was a significant factor to predict the objective response. Further study is required to predict the maximal tolerance dose in consideration of liver function and non-irradiated liver

  19. Organizational, technical, physical and clinical quality standards for radiotherapy

    Science.gov (United States)

    Bogusz-Czerniewicz, Marta; Kaźmierczak, Daniel

    2012-01-01

    Background Indisputably, radiotherapy has become an entirely interdisciplinary specialty. This situation requires efficient planning, verification, monitoring, quality control and constant improvement of all aspects of service delivery, referring both to patients’ (including diagnosis, prescription and method of treatment, its justification, realization and follow up) and organizational, technical and physics matters. Aim The aim of this work was to develop technical, physics and clinical quality standards for radiotherapy. This paper presents chosen standards for each of the aforementioned category. Materials and methods For the development of quality standards the comparison analysis of EU and Polish acts of law passed between 1980 and 2010 was conducted, the universal industrial ISO norm 9001:2008 referring to quality management system was reviewed. Recommendations of this norm were completed with detailed quality standards based on the author's 11 year work experience and the review of articles on quality assurance and quality control standards for radiotherapy published between 1984 and 2009 and the review of current recommendations and guidelines of American, International, European and National bodies (associations, societies, agencies such as AAPM, ESTRO, IAEA, and OECI) for quality assurance and quality management in radiotherapy. Results As a result 352 quality standards for radiotherapy were developed and categorized into the following three groups: (1) organizational standards, (2) physics and technical standards and (3) clinical standards. Conclusions Proposed quality standards for radiotherapy, can be used by any institution using ionizing radiation for medical procedures. Nevertheless standards are only of value if they are implemented, reviewed, audited and improved and if there is a clear mechanism in place to monitor and address failure to meet agreed standards. PMID:24377023

  20. Comparative evaluation of multiple fractions per day radiotherapy and conventional fractionated radiotherapy in squamous cell carcinoma of esophagus

    International Nuclear Information System (INIS)

    Andrabi, W.H.; Akhtar, S.; Kharadi, M.Y.; Mushtaq, G.; Zargar, S.A.

    1999-01-01

    Dose fractionated is important in radiotherapy in order to achieve the desired results. There are regimes which are accepted and followed worldwide. Five fractions per week for a full course of treatment is regarded as standard fractionation regimen. Interest has lately been developed to alter this and try regimes like hyper and accelerated fractionations. In the former, smaller doses per fraction than usual are given in several fractions on each treating day, with no change in overall time. In the latter, conventionally sized fractions are given as two or three per day with a shortening of overall time. As the dose fraction in our case is high, we spilt the full course of treatment introducing a gap of one week between the treatment schedules. The results obtained are fairly good in comparison with conventional radiotherapy regimes. (author)

  1. Computer Assisted Instruction in Teacher Education: A Full Length Course.

    Science.gov (United States)

    Cartwright, G. Phillip

    Pennsylvania State University has developed, evaluated, and implemented a series of modules and an entire three-credit teacher education course which is offered completely by microcomputer. The course is entitled "Educating Special Learners." The modules use the Apple II series and the IBM PC series. Evaluation of the course, based on…

  2. Hyperfractionated abdominal radiotherapy in children. Efficacy and tolerance in 13 cases

    International Nuclear Information System (INIS)

    Lagrange, J.L.; Roullet, B.; Cosset, J.M.; Sarrazin, D.; Lemerle, J.

    1984-01-01

    The experience at IGR has shown that hyperfractionation, especially abdominal has been well tolerated in adult patients. This finding led to employ this technic in the pediatric population who had failed standard treatment. An experience with hyperfractionated radiotherapy of the abdomen and liver in children, is reported. The children were treated 4 days per week, receiving 5 fractions daily of 0.7 Gy, with a 2 hours interval between each treatment. A total dose of 28 Gy was delivered in 40 fractions over 12 days. A second course of irradiation was delivered in 5 patients, 3 with abdominal treatment and 2 with liver irradiation. The vital organs were shielded with blocks at normal dose tolerance levels. The results are encouraging since an immediate efficacy was observed in 8 of 13 patients. Long term survivals were observed in 4 patients with nephroblastomas and 1 patient with a hepatoblastoma. On the other hand acute gastrointestinal tolerance seemed less good in the children than previously observed in the adults. Five radiation hepatitis appeared, immediately after the irradiation, whom four children irradiated to the entire abdomen [fr

  3. Bystander effects and radiotherapy.

    Science.gov (United States)

    Marín, Alicia; Martín, Margarita; Liñán, Olga; Alvarenga, Felipe; López, Mario; Fernández, Laura; Büchser, David; Cerezo, Laura

    2015-01-01

    Radiation-induced bystander effects are defined as biological effects expressed after irradiation by cells whose nuclei have not been directly irradiated. These effects include DNA damage, chromosomal instability, mutation, and apoptosis. There is considerable evidence that ionizing radiation affects cells located near the site of irradiation, which respond individually and collectively as part of a large interconnected web. These bystander signals can alter the dynamic equilibrium between proliferation, apoptosis, quiescence or differentiation. The aim of this review is to examine the most important biological effects of this phenomenon with regard to areas of major interest in radiotherapy. Such aspects include radiation-induced bystander effects during the cell cycle under hypoxic conditions when administering fractionated modalities or combined radio-chemotherapy. Other relevant aspects include individual variation and genetics in toxicity of bystander factors and normal tissue collateral damage. In advanced radiotherapy techniques, such as intensity-modulated radiation therapy (IMRT), the high degree of dose conformity to the target volume reduces the dose and, therefore, the risk of complications, to normal tissues. However, significant doses can accumulate out-of-field due to photon scattering and this may impact cellular response in these regions. Protons may offer a solution to reduce out-of-field doses. The bystander effect has numerous associated phenomena, including adaptive response, genomic instability, and abscopal effects. Also, the bystander effect can influence radiation protection and oxidative stress. It is essential that we understand the mechanisms underlying the bystander effect in order to more accurately assess radiation risk and to evaluate protocols for cancer radiotherapy.

  4. Radiotherapy and pulmonary fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Sone, S; Miyata, Y; Tachiiri, H [Osaka Univ. (Japan). Faculty of Medicine

    1975-04-01

    Clinical findings of radiation pneumonitis and pulmonary fibrosis were outlined, and the relationship between occurence of these disorders and radiotherapy, clinical findings and X-ray picture were studied. Standard radiation dose as cell lethal response of carcinoma of the lung were 4,500 to 5,500 rad in 4 to 5.5 weeks in undifferentiated carcinoma, 6,000 to 7,000 rad in 6 to 7 weeks in squamous cell carcinoma, 7,000 to 9,000 rad in 7 to 9 weeks in adenocarcinoma, 4,500 to 5,000 rad in 4 to 5 weeks in the large sized cancer of the esophagus, 6,500 to 7,000 rad in 5 to 7 weeks in the small sized cancer of the esophagus, and irradiation of these amount of dose caused hazards in pulmonary function. Pathological and clinical findings of pulmonary hazards within 6 month period after irradiation, factors causing them and changes in X-ray pictures before and after irradiation were observed and discussed in clinical cases: the case of breast cancer in which 3,000 R/6 times/18 days of 5.5 MeV Liniac electron was irradiated to the chest wall, and the case of pulmonary cancer in which 5,000 rad/25 times/34 days of 6 MeV Liniac X-ray was irradiated in opposite 2 ports radiation beam treatment. The former revealed alveolar lesion and interlobular pleuritis at 4 month later, and remarkable lesion of pulmonary fibrosis was followed at 9 month after radiotherapy. The later developed radiation pneumonitis 1 month after radiotherapy, of which lesion extended to the upper part by 3 months later, and cancer recurred 6.5 month later.

  5. Radiotherapy for eyelid cancer

    International Nuclear Information System (INIS)

    Saika, Kazumi

    2001-01-01

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

  6. Radiotherapy of benign diseases

    International Nuclear Information System (INIS)

    Haase, W.

    1982-01-01

    Still today radiotherapy is of decisive relevance for several benign diseases. The following ones are briefly described in this introductory article: 1. Certain inflammatory and degenerative diseases as furuncles in the face, acute thrombophlebitis, recurrent sudoriparous abscesses, degenerative skeletal diseases, cervical syndrome and others; 2. rheumatic joint diseases; 3. Bechterew's disease; 4. primary presenile osteoporosis; 5. synringomyelia; 6. endocrine ophthalmopathy; 7. hypertrophic processes of the connective tissue; 8. hemangiomas. A detailed discussion and a profit-risk analysis is provided in the individual chapters of the magazine. (MG) [de

  7. Large field radiotherapy

    International Nuclear Information System (INIS)

    Vanasek, J.; Chvojka, Z.; Zouhar, M.

    1984-01-01

    Calculations may prove that irradiation procedures, commonly used in radiotherapy and represented by large-capacity irradiation techniques, do not exceed certain limits of integral doses with favourable radiobiological action on the organism. On the other hand integral doses in supralethal whole-body irradiation, used in the therapy of acute leukemia, represent radiobiological values which without extreme and exceptional further interventions and teamwork are not compatible with life, and the radiotherapeutist cannot use such high doses without the backing of a large team. (author)

  8. Microplanar beams for radiotherapy

    International Nuclear Information System (INIS)

    Company, F.Z.; Allen, B.J.

    1996-01-01

    Recent advances in synchrotron generated X-ray beams with high fluence rate permit the investigation of the application of an array of closely spaced, parallel or converging microbeams in radiotherapy. The proposed technique takes advantage of the hypothesised repair mechanism of capillary cells between alternate microbeam zones, which replaces the lethally irradiated endothelial cells. In this study using the Monte Carlo method, the lateral and depth dose of a single planar microbeam of 100 keV in a tissue/lung/tissue phantom is investigated. Poster 195. (author)

  9. Course Programme

    DEFF Research Database (Denmark)

    Tvedebrink, Tenna Doktor Olsen

    2015-01-01

    Welcome to your first DESIGN course: ‘Mapping Meals and their Spaces’. I hope you are ready to learn about the emerging discipline of Food Design and the so‐called “Design Thinking” perspective, as well as how to implement the interdisciplinary knowledge characterizing your new education Integrated...

  10. Language courses

    CERN Multimedia

    2013-01-01

    General and Professional French Courses: The next session will take place from 7 October to 13 December 2013. These courses are open to all persons working on the CERN site, and to their spouses. Oral Expression: This course is aimed for students with a good knowledge of French who want to enhance their speaking skills. Speaking activities will include discussions, meeting simulations, role-plays etc. The next session will take place from 7 October to 13 December 2013. Writing professional documents in French: These courses are designed for non-French speakers with a very good standard of spoken French. The next session will take place from 7 October to 13 December 2013. Cours d'anglais général et professionnel: La prochaine session se déroulera du 7 octobre 2013 au 31 janvier 2014 (interruption à Noël). Ces cours s'adressent à toute personne travaillant au CERN ainsi qu'à leur conjoint. Oral Expression: F...

  11. Course Layout

    OpenAIRE

    2005-01-01

    present roll Presentation roll Interactive Media Element This is an interactive diagram of a MATLAB course layout covering 16 topics in 4 different main areas: Basics of MATLAB, Numerical Methods in MATLAB, Symbolic Manipulations in MATLAB, Mathematical Modeling in MATLAB and Simulink AE2440 Introduction to Digital Computation

  12. Language Courses

    CERN Document Server

    2007-01-01

    General and Professional English Courses The next session will be held from 26 February or 5 March to end of June 2007 (1/2 week's break at Easter). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Françoise Benz, tel. 73127. Oral Expression The next session will be held from 26 February or 5 March to end of June 2007 (1/2 week's break at Easter). This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be a maximum of 10 participants in a class. Speaking activities will include discussions, meeting simulations, role-play, etc., depending on the needs of the students. Duration: 30 hours Price: 660 CHF (for a minimum of 8 students). Writing Professional Documents in English The next session will be held from 26 February or 5 March to e...

  13. Language courses

    CERN Multimedia

    2006-01-01

    General and Professional English Courses The next session will take place from beginning of October 2006 to beginning of February 2007 (3 weeks break at Christmas).These courses are open to all persons working on the CERN site and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Tessa Osborne, tel.16 23 40. Oral Expression The next session will take place from beginning of October 2006 to beginning of February 2007 (3 weeks break at Christmas).This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be a maximum of 10 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc., depending on the needs of the students. Duration: 30 hours (2 hours a week) Price: 660 CHF (for a minimum of 8 students). Writing Professional Documents in English The next...

  14. Radiotherapy may improve overall survival of patients with T3/T4 transitional cell carcinoma of the renal pelvis or ureter and delay bladder tumour relapse

    Directory of Open Access Journals (Sweden)

    Wu Li-Li

    2011-07-01

    Full Text Available Abstract Background Since transitional cell carcinoma (TCC of the upper urinary tract is a relatively uncommon malignancy, the role of adjuvant radiotherapy is unknown. Methods We treated 133 patients with TCC of the renal pelvis or ureter at our institution between 1998 and 2008. The 67 patients who received external beam radiotherapy (EBRT following surgery were assigned to the radiation group (RT. The clinical target volume included the renal fossa, the course of the ureter to the entire bladder, and the paracaval and para-aortic lymph nodes, which were at risk of harbouring metastatic disease in 53 patients. The tumour bed or residual tumour was targeted in 14 patients. The median radiation dose administered was 50 Gy. The 66 patients who received intravesical chemotherapy were assigned to the non-radiation group (non-RT. Results The overall survival rates for the RT and non-RT groups were not significantly different (p = 0.198. However, there was a significant difference between the survival rates for these groups based on patients with T3/T4 stage cancer. A significant difference was observed in the bladder tumour relapse rate between the irradiated and non-irradiated bladder groups (p = 0.004. Multivariate analysis indicated that improved overall survival was associated with age grade 3 hematologic symptoms also occurred. Conclusion EBRT may improve overall survival for patients with T3/T4 cancer of the renal pelvis or ureter and delay bladder tumour recurrence in all patients.

  15. mkt 571 new,uop mkt 571 new,uop mkt 571 new complete course,uop mkt 571 new entire course

    OpenAIRE

    admin

    2018-01-01

    UOP MKT 571 Final Exam Guide (New, 2018) NEW Check this A+ tutorial guideline at http://www.assignmentcloud.com/mkt-571-uop/mkt-571-final-exam-guide-new-2018-new For more classes visit http://www.uopassignments.com/ 1. A fundamental and distinctive mode of expression that appears in a field of human endeavor is called a __________. • style • theme • trend • pattern 2. A firm should use undifferentiated marketing...

  16. Breast cancer radiotherapy: controversies and prospectives

    Institute of Scientific and Technical Information of China (English)

    YU Jin-ming; WANG Yong-sheng

    2008-01-01

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

  17. Radiotherapy for esophageal cancer

    International Nuclear Information System (INIS)

    Oshitani, Takashi; Kuwata, Yoichiro; Kano, Kyoko

    1988-01-01

    Esophageal carcinoma were treated by high-dose-rate intracavitary irradiation using specially designed balloon application at Hyogo medical Center for Adults. 32 patients were treated from January 1982 through July 1986. According to the stage of UICC (1978), 10 patients were classified into stage I, 7 into II, 13 into III and 2 into IV. Acturial 5 year survival rate was 17.9 % in all 32 patients and that of 23 patients who received radical radiotherapy was 24 %. Local CR rate was 66 %. However, since 9 (53 %) of 17 CR patients were relapsed, local control rate for 2 years was 25 %. Mild adverse effects were experienced in 9 (47 %) of 19 CR patients. Our balloon applicator was easily fixed, could have an adequate space from esophageal mucosa and clarify the tumor site by filling with 20 % gastrografin. It is concluded that high-dose-rate intracavitary irradiation with our balloon applicator is an effective boost therapy and decline a lethal adverse effect in radiotherapy for esophageal carcinoma. (author)

  18. Radiotherapy of bladder cancer

    International Nuclear Information System (INIS)

    Ikeda, Yoshiyuki

    1978-01-01

    Methods of treating bladder cancer include surgery, radiotherapy and chemotherapy, as well as various combinations of these. The author investigated clinically and histopathologically the therapeutic results of preoperative irradiation in cases of bladder cancer. 1. The survival rates (crude survival rates) in forty cases of bladder cancer were 90% after one year, 62.5% after three years and 46% after five years from the treatment. 2. As the result of irradiation, urogram improved in 25%, which was comparatively remarkable in high stage cases. There were no cases of deterioration of urogram findings caused by irradiation. Cystoscopy revealed disappearance or remarkable shrinkage of the tumors in 35% of the total cases and effects of the irradiation was observed not correlated to the stage and grade. 3. With respect to the histopathological changes, the changes became greater as the dosage increased and the higher the stage and grade were the more remarkable tendency was observed. 4. From our clinical observations such as urogram, cystoscopy and histopathologically, we estimated the optimum dosage of preoperative irradiation for bladder cancer is 3000 - 4000 rad. Thus, we concluded that the radiotherapy is effective in reducing both surgical invasion and postoperative recurrence. (author)

  19. Proton minibeam radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Girst, Stefanie

    2016-03-08

    The risk of developing adverse side effects in the normal tissue after radiotherapy is often limiting for the dose that can be applied to the tumor. Proton minibeam radiotherapy, a spatially fractionated radiotherapy method using sub-millimeter proton beams, similar to grid therapy or microbeam radiation radiotherapy (MRT) using X-rays, has recently been invented at the ion microprobe SNAKE in Munich. The aim of this new concept is to minimize normal tissue injuries in the entrance channel and especially in the skin by irradiating only a small percentage of the cells in the total irradiation field, while maintaining tumor control via a homogeneous dose in the tumor, just like in conventional broad beam radiotherapy. This can be achieved by optimizing minibeam sizes and distances according to the prevailing tumor size and depth such that after widening of the minibeams due to proton interactions in the tissue, the overlapping minibeams produce a homogeneous dose distribution throughout the tumor. The aim of this work was to elucidate the prospects of minibeam radiation therapy compared to conventional homogeneous broad beam radiotherapy in theory and in experimental studies at the ion microprobe SNAKE. Treatment plans for model tumors of different sizes and depths were created using the planning software LAPCERR, to elaborate suitable minibeam sizes and distances for the individual tumors. Radiotherapy-relevant inter-beam distances required to obtain a homogeneous dose in the target volume were found to be in the millimeter range. First experiments using proton minibeams of only 10 μm and 50 μm size (termed microchannels in the corresponding publication Zlobinskaya et al. 2013) and therapy-conform larger dimensions of 100 μm and 180 μm were performed in the artificial human in-vitro skin model EpiDermFT trademark (MatTek). The corresponding inter-beam distances were 500 μm, 1mm and 1.8 mm, respectively, leading to irradiation of only a few percent of the cells

  20. General principles of radiotherapy

    International Nuclear Information System (INIS)

    Easson, E.C.

    1985-01-01

    The daily practice of any established branch of medicine should be based on some acceptable principles. This chapter is concerned with the general principles on which the radiotherapy of the Manchester school is based. Though many radiotherapists in other centres would doubtless accept these principles, there are sufficiently wide differences in practice throughout the world to suggest that some therapists adhere to a fundamentally different philosophy. The authors believe it is important, especially for those beginning their formal training in radiotherapy, to subscribe to an internally consistent school of thought, employing methods of treatment for each type of lesion in each anatomical site that are based on accepted principles and subjected to continuous rigorous scrutiny to test their effectiveness. Not only must each therapeutic technique be evaluated, but the underlying principles too must be questioned if and when this seems indicated. It is a feature of this hospital that similar lesions are all treated by the same technique, so long as statistical evidence justifies such a policy. All members of the staff adhere to the accepted policy until or unless reliable reasons are adduced to change this policy

  1. Fertility impairment in radiotherapy

    Directory of Open Access Journals (Sweden)

    Marta Biedka

    2016-02-01

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

  2. Transverse tomography and radiotherapy

    International Nuclear Information System (INIS)

    Leer, J.W.H.

    1982-01-01

    This study was intended to delineate the indications for radiotherapy treatment-planning with the help of computerized axial tomography (C.T.) and transverse analog tomography (T.A.T.). Radiotherapy localisation procedures with the conventional method (simulator), with the CT-scanner and with the transverse analog tomograph (T.A.T., Simtomix, Oldelft) were compared. As criterium for evaluation differences in reconstruction drawing based on these methods were used. A certain method was judged ''superior'' to another if the delineation of the target volume was more accurate, if a better impression was gained of the site of (for irradiation) organs at risk, or if the localisation could only be performed with that method. The selected group of patients consisted of 120 patients for whom a reconstruction drawing in the transverse plane was made according to the treatment philosophy. In this group CT-assisted localisation was judged on 68 occasions superior to the conventional method. In a number of cases it was found that a ''standard'' change in a standard target volume, on the base of augmented anatomical knowledge, made the conventional method sufficient. The use of CT-scanner for treatment planning was estimated. For ca. 270/1000 new patients a CT-scan is helpful (diagnostic scan), for 140 of them the scan is necessary (planning scan). The quality of the anatomical information obtained with the T.A.T. does not yet fall within acceptable limits, but progress has been made. (Auth.)

  3. Erythropoietin and radiotherapy

    International Nuclear Information System (INIS)

    Le Fur, E.; Albarghach, M.N.; Pradier, O.

    2010-01-01

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

  4. Advances in radiotherapy

    International Nuclear Information System (INIS)

    Mackie, T.R.

    2005-01-01

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

  5. Modern indications for post-mastectomy radiotherapy application

    International Nuclear Information System (INIS)

    Parvanova, V.

    2002-01-01

    Before the effective adjuvant chemotherapy, post-mastectomy chemotherapy was usually used in breast cancer patients. The interest in this approach was revived after a number of studies were successful in identifying patient subgroups with 20 and 40 percent of locoregional relapses following mastectomy and chemotherapy. These subgroups including women presenting 4 and more positive lymph odes or an advanced primary tumor (measuring 5 cm or more, or a neoplasm invading skin or contiguous musculature) are taken to be the most likely to benefit from a course od post-mastectomy radiotherapy. Recent randomized trials demonstrate adequate tumor control and heightened overall survival rates when mastectomy is supplemented by radiotherapy. A currently performed meta-analysis of over 22000 women comparing groups with and without adjuvant radiotherapy point to an improvement in locoregional tumor control rates from 70 to 90 percent. The result of a 20-year follow-up study document a significant improvement of overall and disease-specific survivalship. These are findings lending support to the concept that improving locoregional tumor control rates in breast cancer may account for an increase of overall survivorship. Regardless of a rather short follow-up of women undergoing updated radiotherapy techniques, the preliminary results do not show increased incidence of vascular death, but pos-mastectomy radiotherapy continues to be associated with an elevated hand edema risk. For the time being, the role of post-mastectomy radiotherapy in women presenting 1 to 3 positive axillary lymph nodes remains not well enough clarified, and needs further evaluation in randomized clinical trials. (authors)

  6. Testicular dose and hormonal changes after radiotherapy of rectal cancer

    International Nuclear Information System (INIS)

    Hermann, Robert M.; Henkel, Karsten; Christiansen, Hans; Vorwerk, Hilke; Hille, Andrea; Hess, Clemens F.; Schmidberger, Heinz

    2005-01-01

    Background and purpose: To measure the dose received by the testicles during radiotherapy for rectal cancer and to determine the contribution of each field of the pelvic box and the relevance for hormonal status. Materials and methods: In 11 patients (mean age 55.2 years) testicular doses were measured with an ionisation chamber between 7 and 10 times during the course of pelvic radiotherapy (50 Gy) for rectal carcinoma. Before and several months after radiotherapy luteinizing hormone, follicle stimulating hormone and total testosterone serum levels were determined. Results: The mean cumulative radiation exposure to the testicles was 3.56 Gy (0.7-8.4 Gy; 7.1% of the prescribed dose). Seventy-three percent received more than 2 Gy to the testicles. Fifty-eight percent of the measured dose was contributed by the p.a. field, 30% by the a.p. field and 12% by the lateral fields. Mean LH and FSH levels were significantly increased after therapy (350%/185% of the pre-treatment values), testosterone levels decreased to 78%. No correlation could be found between changes of hormones and doses to the testis, probably due to the low number of evaluated patients. Conclusions: Radiotherapy of rectal carcinoma causes significant damage to the testis, as shown by increased levels of gonadotropins after radiotherapy. Most of the gonadal dose is delivered by the p.a. field, due to the divergence of the p.a. beam towards the testicles. The reduction in testosterone level may be of clinical concern. Patients who will receive radiotherapy for rectal carcinoma must be instructed about a high risk of permanent infertility, and the risk of endocrine failure (hypogonadism). Larger studies are needed to establish the correlation between testicular radiation dose and hormonal changes in this group of patients

  7. Quality assurance in radiotherapy - a clinical point of view

    International Nuclear Information System (INIS)

    Merkle, K.; Lessel, A.; Huettner, J.

    1990-01-01

    Despite the advanced treatment methods now available, the total result in 5-year survival is 40-50% of all patients with malignancies and 20% of these patients will have the chance of a 10-year survival. In the course of their disease a radiotherapy is indicated in about 2/3 of all patients. Thus, radiotherapy makes quite a considerable contribution to the qualitative improvement of the treatment of patients with malignancies. Eradication of the tumor and protection of normal tissue can only be a compromise between tumor control and the production of complications. For the risk assessment of radiotherapy, the steepness of dose-response curves is of paramount importance. That means, small errors in defining and delivering dose can have catastrophic results in terms of failure to control the patient's disease and, on the other side, in terms of complications, that means in quality of life. Although the costs of therapy, in absolute values, vary from one country to the other, it can be stated in rough approximation that a failed radiotherapy will make rise the costs by a factor of 3. According to the fact that in 30-40% of patients, who received radiotherapy, the initial treatment failed to control the primary disease, the enormous additional costs involved become obvious, not to speak of the main argument - the regrowth of the patients's tumor. For the improvement of this situation quality assurance (QA) is an essential prerequisite, which should be guaranteed in all successive steps of radiotherapy. In the paper an analysis is given for all individual steps in the chain of radiotherapeutic measures. (author)

  8. Recommendations for safer radiotherapy: what’s the message?

    Directory of Open Access Journals (Sweden)

    Peter eDunscombe

    2012-09-01

    Full Text Available Radiotherapy, with close to a million courses delivered per year in North America, is a very safe and effective intervention for a devastating disease. However, although rare, several deeply regrettable incidents have occurred in radiotherapy and have rightly been the subject of considerable public interest. Partly in response to reports of these incidents a variety of authoritative organizations across the globe has harnessed the expertise amongst their members in attempts to identify the measures that will make radiotherapy safer. While the intentions of all these organizations are clearly good it is challenging for the health care providers in the clinic to know where to start with so much advice coming from so many directions. Through a mapping exercise we have identified commonalities between recommendations made in seven authoritative documents and identified those issues most frequently cited. The documents reviewed contain a total of 117 recommendations. Using the 37 recommendations in Towards Safer Radiotherapy as the initial base layer, recommendations in the other documents were mapped, adding to the base layer to accommodate all the recommendations from the additional six documents as necessary. This mapping exercise resulted in the distillation of the original 117 recommendations down to 61 unique recommendations. Twelve topics were identified in three or more of the documents as being pertinent to the improvement of patient safety in radiotherapy. They are, in order of most to least cited: training, staffing, documentation, incident learning, communication, check lists, quality control and preventive maintenance, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment and safety culture. This analysis provides guidance for the selection of those activities most likely to enhance safety and quality in radiotherapy based on the frequency of citation in selected recent authoritative literature.

  9. External beam radiotherapy in the management of ovarian carcinoma

    International Nuclear Information System (INIS)

    Reinfuss, Marian; Zbigniew, Kojs; Skolyszewski, Jan

    1993-01-01

    Between 1970 and 1983, 345 patients with ovarian cancer clinical stage I, II and III were irradiated postoperatively. Five-year NED survival was achieved in 41.7% of patients. The most important prognostic factors were histological grade and clinical stage of cancer. Postoperative external beam radiotherapy appeared to be highly efficient for the patients with microscopic residual disease, giving 70% 5-year survival, and moderately efficient for patients with small, i.e. ≤3 cm in diameter residual disease, giving 40% 5-year survival. The optimal technique of irradiation appeared to be the irradiation given to the entire abdominal cavity with additional irradiation coned down to the pelvis. External beam radiotherapy was ineffective in patients with gross residual disease, i.e. >3 cm in diameter, and useless as palliative treatment given to patients with inoperable cancer of the ovary. (author). tabs., figs

  10. On the growth estimates of entire functions of double complex variables

    Directory of Open Access Journals (Sweden)

    Sanjib Datta

    2017-08-01

    Full Text Available Recently Datta et al. (2016 introduced the idea of relative type and relative weak type of entire functions of two complex variables with respect to another entire function of two complex variables and prove some related growth properties of it. In this paper, further we study some growth properties of entire functions of two complex variables on the basis of their relative types and relative weak types as introduced by Datta et al (2016.

  11. Effects of radiotherapy on non-specific immunological parameters in patients with malignant brain tumors

    International Nuclear Information System (INIS)

    Yamashita, Junkoh; Iwaki, Kazuo; Ohtsuka, Shin-ichi; Yamasaki, Toshiki; Gi, Hidefuku

    1983-01-01

    The non-specific immunological parameters of 37 patients with malignant brain tumors were analysed by means of 1) purified protein derivative (PPD) skin test, 2) lymphocyte counts, and 3) phytohemagglutinin (PHA) blastogenesis. The PPD skin reaction and PHA blastogenesis were already depressed preoperatively in patients with malignant brain tumors as compared to those in normal controls. When radiotherapy was confined to the head, lymphocyte counts and PHA blastogenesis were further depressed, but gradually recovered to preoperative levels within 6 months after the completion of radiotherapy. In the cases with medulloblastoma and germinoma who received whole cerebrospinal axis irradiation, lymphocyte counts and PHA blastogenesis were more markedly depressed and took more than 6 months after completion of the radiotherapy to recover to their preoperative levels. The result of the PPD skin test, on the other hand, was not affected and was rather enhanced by radiotherapy, showing a marked dissociation from the changes in lymphocyte counts and PHA blastogenesis. The results of PPD skin test on discharge from hospital were relatively well correlated with the prognosis of the patients. The profound immunosuppressive influence of radiotherapy and the natural course of recovery should be taken into consideration if any immunological treatments are to be undertaken with or after the course of radiotherapy. (author)

  12. Radiotherapy gel dosimetry

    International Nuclear Information System (INIS)

    Baldock, C.

    2002-01-01

    In radiotherapy, the primary objective is to deliver a prescribed dose of radiation to a tumour or lesion within a patient while minimising the dose delivered to the surrounding healthy tissue. Traditional radiotherapy treatments usually involve simple external or internal irradiations of a tumour. External irradiations are normally achieved in the clinic with photon or electron beams produced by high energy linear accelerators. The photon or electron beams are collimated into regular shapes as they emerge from the treatment head of the unit which is supported by a gantry that can be rotated isocentrically to any position. A discrete number of photon or electron beams with different angles of incidence that intersect at the iso-centre are used to produce a region of high dose around the tumour volume (positioned at the iso-centre). Internal irradiations are normally achieved in the clinic by implanting radioactive sources in and around the tumour or lesion. Such irradiations are characterised by very high doses local to the tumour. Radioactive sources are also used to prevent post-angioplasty restenosis by inserting sources into arteries. Usually when treating a tumour, a compromise is made between tumour control and complications arising from normal tissue damage. One measure of this compromise, the therapeutic ratio, is defined as the radiation dose producing complications in 50% of patients divided by the dose providing tumour control in 50% of the patients. The therapeutic ratio depends on the radiobiological characteristics of the cancerous tissue and surrounding healthy tissues and on the radiation dose distribution achieved by the radiotherapy treatment. It is generally believed that the therapeutic ratio can be minimised by optimising the conformation of the radiation dose distribution to the target volume. This is difficult with traditional radiotherapy techniques since they do not produce dose distributions that adequately cover tumour volumes of complex

  13. Quadrantectomy and adjuvant radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Gabriele, A.M.; Boidi Trotti, A.; Tardy, A.

    1987-01-01

    The conservative treatment of early breast cancer always requires irradiation of residual mammary tissue. The preliminary results obtained in 45 early breast cancer patients, who received quadrantectomy plus axillary dissection, followed by radiation of residual breast are reported. Radiation was performed by the two opposed field technique. In some cases the residual breast tissue was compressed using a special accessory provided with the Theratron 780. In addition to the tumor dose of 50 GY, 10 GY boots was added to the surgical scar using 7 MeV electrons. The 6 patients with positive axillary nodes received 6 courses of adjuvant chemotherapy (CMF) after radiotherapy. All patients are currently alive and free of disease. The 64% (29 patients) were followed up for at least 5 years, and 36% (16 patients) for at least 3 years. Only 2 cases of local recurrence were encountered (4,4%). The esthetic result was satisfactory in all cases. No side effects due to treatment were noted

  14. Breast cellulitis after conservative surgery and radiotherapy

    International Nuclear Information System (INIS)

    Rescigno, J.; McCormick, B.; Brown, A.E.; Myskowski, P.L.

    1994-01-01

    Cellulitis is a previously unreported complication of conservative surgery and radiation therapy for early stage breast cancer. Patients who presented with breast cellulitis after conservative therapy are described. Eleven patients that developed cellulitis of the breast over a 38-month period of observation are the subject of this report. Clinical characteristics of patients with cellulitis and their treatment and outcome are reported. Potential patient and treatment-related correlates for the development of cellulitis are analyzed. The risk of cellulitis persists years after initial breast cancer therapy. The clinical course of the patients was variable: some patients required aggressive, long-duration antibiotic therapy, while others had rapid resolution with antibiotics. Three patients suffered from multiple episodes of cellulitis. Patients with breast cancer treated with conservative surgery and radiotherapy are at risk for breast cellulitis. Systematic characterization of cases of cellulitis may provide insight into diagnosis, prevention, and more effective therapy for this uncommon complication. 15 refs., 1 fig., 2 tabs

  15. Stereotactic radiotherapy in pediatric indications

    International Nuclear Information System (INIS)

    Bernier-Chastagner, V.; Supiot, S.; Carrie, C.; Helfre, S.

    2012-01-01

    Stereotactic radiotherapy is a very high precision procedure, which has been limited to radiosurgery for a long time. Technological improvements allowed the development of radiotherapy in stereotactic conditions, leading to a lot of innovations. Previously indicated for cerebral pathologies, this procedure is now developed for extra-cerebral locations. In paediatrics, stereotactic radiotherapy is still limited, delivered precociously, due to the possibility of long-term late effects that needs to be addressed. This review reports the different useful conditions, technical evolutions, and the current validated paediatric indications, with differences from adults, and future directions. (authors)

  16. Adaptive Motion Compensation in Radiotherapy

    CERN Document Server

    Murphy, Martin J

    2011-01-01

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

  17. Development of targeted radiotherapy systems

    International Nuclear Information System (INIS)

    Ferro, Guillermina; Villarreal, Jose E.; Garcia, Laura; Tendilla, Jose I.; Paredes, Lydia; Murphy, Consuelo A.; Pedraza, Martha

    2001-01-01

    Conventional or external beam radiotherapy, has been a viable alternative for cancer treatment. Although this technique is effective, its use is limited if the patient has multiple malignant lesions (metastases). An alternative approach is based on the design of radiopharmaceuticals that, to be administered in the patient, are directed specifically toward the target cell producing a selective radiation delivery. This treatment is known as targeted radiotherapy. We have summarized and discussed some results related to our investigations on the development of targeted radiotherapy systems, including aspects of internal dosimetry

  18. The dosimetric control in radiotherapy

    International Nuclear Information System (INIS)

    Veres, A.

    2009-01-01

    The author first presents the thermoluminescent dosimetry method developed by the Equal-Estro Laboratory to control radiotherapy systems, according to which dosimeters are mailed by the radiotherapy centres to the laboratory, and then analyzed with respect to the level of dose bias. In a second part, he discusses the different techniques used for the dosimetric control of new radiotherapy methods (intensity-modulated radiation therapy, tomo-therapy) for which film dosimetry is applied. He also evokes the development of new phantoms and the development of a method for the dosimetric control of proton beams

  19. Radiotherapy in the management of non-metastatic prostate cancer: Current standards and future opportunities

    International Nuclear Information System (INIS)

    Forman, Jeffrey D.

    1997-01-01

    Objectives: The intent of this course is to review issues involved in the management of non-metastatic prostate cancer and to clarify the role of external beam radiotherapy, the use of neo-adjuvant and adjuvant hormonal therapy in conjunction with the radiation, the management of patients with regional metastases and recurrent disease following surgery and radiation. At the end of this course, participants should be able to fluently discuss management issues and strategies across the entire spectrum of non-metastatic prostate cancer. - Pre-treatment prognostic factors including clinical stage, grade, and pre-treatment PSA, will be presented and their relative value in determining therapeutic strategies will be discussed. Strategies to be discussed include standard dose radiation, escalated dose radiation, particle radiation and the use of adjuvant and neo-adjuvant hormonal therapy. - The process of simulation and field design will be presented, the value of CT-based treatment planning, beams-eye view design and the relative value of three-dimensional treatment planning will be discussed. - The significance of prostate and patient movement and strategies for dealing with this will also be presented so that what constitutes an adequate simulation and margin of treatment can be clarified. - The management of newly diagnosed patients, covering the range of low stage/low grade to locally advanced prostate cancer will be discussed. - The relative value of increasing dose, the relative value of using neo-adjuvant and/or adjuvant hormone therapy and the indications for escalated dose will be presented. - Strategies for managing post-prostatectomy patients will be reviewed. Data on adjuvant and therapeutic irradiation for biochemical failure will be presented and a strategy for management will be discussed. - How to deal with patients with residual disease post radiation will be discussed and the relative value of cryotherapy, salvage prostatectomy or hormonal therapy will

  20. Acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus: a retrospective case-control study

    International Nuclear Information System (INIS)

    Patel, Ajaykumar B; Hallemeier, Christopher L; Petersen, Ivy A; Jensen, Ashley W; Osborn, Thomas G; Miller, Robert C

    2012-01-01

    The purpose of this study was to evaluate acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus (DLE). A retrospective review was performed of patients with DLE who received radiotherapy at our institution between 1980 and 2005. Patients with other connective tissue disorders were excluded. Control patients were matched 2:1 with the DLE treatment courses based on age, cancer diagnosis, year of treatment, radiotherapy dose, and sex. Acute (within 30 days from the completion of radiotherapy) and late toxicities were evaluated for each treatment course using the Common Terminology Criteria for Adverse Events Version 3.0. Twelve patients with DLE received a total of 15 radiotherapy courses. The median follow-up time was 2.6 years (range, 0.0-15.2 years). Acute toxicity of any organ was observed in 10 (67%) treatment courses, of which 2 (13%) were Grade 3 or higher. Acute Grade 1 or 2 dermatologic toxicity was observed in 8 courses (53%). Late toxicity of any organ was observed in 7 of 12 (58%) evaluable treatment courses, of which 3 (23%) were grade 3 or higher. Late grade 1 or 2 dermatologic toxicity was observed in 5 (42%) courses. No patient experienced acute or late Grade 3 or higher dermatologic toxicity. The rates of any organ or dermatologic acute and late toxicity were not significantly different between DLE and control treatment courses. Our findings do not suggest an increased risk of toxicity to the skin or other organs in patients with DLE receiving radiotherapy

  1. Acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus: a retrospective case-control study

    Directory of Open Access Journals (Sweden)

    Patel Ajaykumar B

    2012-02-01

    Full Text Available Abstract Background The purpose of this study was to evaluate acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus (DLE. Methods A retrospective review was performed of patients with DLE who received radiotherapy at our institution between 1980 and 2005. Patients with other connective tissue disorders were excluded. Control patients were matched 2:1 with the DLE treatment courses based on age, cancer diagnosis, year of treatment, radiotherapy dose, and sex. Acute (within 30 days from the completion of radiotherapy and late toxicities were evaluated for each treatment course using the Common Terminology Criteria for Adverse Events Version 3.0. Results Twelve patients with DLE received a total of 15 radiotherapy courses. The median follow-up time was 2.6 years (range, 0.0-15.2 years. Acute toxicity of any organ was observed in 10 (67% treatment courses, of which 2 (13% were Grade 3 or higher. Acute Grade 1 or 2 dermatologic toxicity was observed in 8 courses (53%. Late toxicity of any organ was observed in 7 of 12 (58% evaluable treatment courses, of which 3 (23% were grade 3 or higher. Late grade 1 or 2 dermatologic toxicity was observed in 5 (42% courses. No patient experienced acute or late Grade 3 or higher dermatologic toxicity. The rates of any organ or dermatologic acute and late toxicity were not significantly different between DLE and control treatment courses. Conclusions Our findings do not suggest an increased risk of toxicity to the skin or other organs in patients with DLE receiving radiotherapy.

  2. Effect of bleomycin-radiotherapy combination in management of head and neck squamous cell carcinoma

    International Nuclear Information System (INIS)

    Shah, P.M.; Shukla, S.N.; Patel, K.M.; Patel, N.L.; Baboo, H.A.; Patel, D.D.

    1981-01-01

    Twenty-five patients with head and neck squamous cell carcinoma were treated with bleomycin-radiotherapy protocol, 15 mg bleomycin I.V. on alternate days followed by radiation within half an hour. The average total dose of bleomycin was 150 mg. Radiotherapy was given daily. Two patients were lost to follow-up very early in the course of the treatment and were removed from the study for statistical purposes. Thirty-six patients with head and neck squamous cell carcinoma who were treated with radiotherapy alone during the same period were used as controls. The patients were followed for two years. The incidence of response rate did not differ significantly between regimens; however, the incidence of side effects with bleomycin-radiotherapy, 82.61%, is significantly more than that of radiotherapy alone (52.78%). Median survial time (MST) of those responding to bleomycin-radiotherapy protocol was seven months and 12 days and for radiotherapy responders was six months. Neither the response rate nor the MST improve significantly after pretreatment with bleomycin. On the contrary, the incidence of side effects increased significantly

  3. Oropharyngeal carcinoma treated with radiotherapy: a 30-year experience

    International Nuclear Information System (INIS)

    Fein, Douglas A.; Lee, W. Robert; Amos, Warren R.; Hinerman, Russell W.; Parsons, James T.; Mendenhall, William M.; Stringer, Scott P.; Cassisi, Nicholas J.; Million, Rodney R.

    1996-01-01

    Purpose: This study was done to determine the outcome in patients with oropharyngeal carcinoma treated at the University of Florida with radiotherapy alone to the primary site, for comparison with reported results of other types of treatment. Methods and Materials: Of a consecutive cohort of 785 patients with biopsy-proven, previously untreated, invasive squamous cell carcinoma of the oropharynx, this report is based on the 490 patients who had continuous-course irradiation with curative intent at the University of Florida between October 1964 and January 1991. All patients had a minimum 2-year follow-up. Forty-eight percent had Stage T3 or T4 disease, and 64% had clinically apparent neck node metastases. The median radiation dose was 68 Gy for once-a-day treatment and 76.8 Gy for twice-a-day treatment. Patients with advanced neck node disease had planned neck dissection(s) after radiotherapy. Results: The overall local control rate after radiotherapy alone was 73%. The ultimate local control rate (including surgical salvage) was 78%. At 5 years, the probability of control of neck disease was 85%; control above the clavicles, 67%; absolute survival, 44%; cause-specific survival, 77%; distant metastasis (as the first or only site of failure), 11%. Thirteen patients (2.6%) experienced severe treatment complications. Conclusion: Radiotherapy results in tumor control and survival rates comparable with rates achieved with combined irradiation and surgery, with less morbidity

  4. Tumours following retinoblastoma radiotherapy

    International Nuclear Information System (INIS)

    Mollot, J.-P.

    1978-01-01

    Radioinduced tumours in young patients irradiated in childhood for retinoblastoma take on a particularly deadly aspect. The onset of this true clinical entity characterized by a long post-irradiation latency period induced by a dose above 6000 rads is a real tragedy. The vast majority of patients then enter into a long martyrdom ending in death. The only cure is surgical, but seldom possible. Treatment is limited to palliative radiotherapy, effective for a while, and chemiotherapy as a last resort but often difficult to prescribe. Prevention alone is the answer. The quality and reliability of the radiotherapeutic treatment depend not only on the personal talent of the radiotherapist but above all on the standard of the equipment. A strong reduction in the doses employed as well as recent technological progress improving the material, its precision and reproducibility appear already to have lowered the frequency curve of these fatal radioinduced tumours [fr

  5. [Radiotherapy for nasopharyngeal carcinoma].

    Science.gov (United States)

    Maingon, P; Blanchard, P; Bidault, F; Calmels, L

    2016-09-01

    Nasapharyngeal carcinoma is a rare disease. Oftenly, the diagnostic is made for advanced disease. Localized tumors, T1 or T2 NO observed a good prognosis and are locally controlled in more than 90 % of the cases by radiotherapy alone. The standard treatment of locally advanced disease is combined chemoradiation. A special vigilance of fast decrease of the volume of the pathological lymph nodes, sometimes associated to loss of weight might indicate an adaptive dosimetric revision. The treatment of recurrent disease is of great importance. Surgical indications are limited but should be discussed in multidisciplinary tumor board when possible. Surgical nodal sampling has to be proposed for nodal recurrence as well as reirradiation, which could be indicated according to the technical issues. Copyright © 2016. Published by Elsevier SAS.

  6. Image guided multibeam radiotherapy

    International Nuclear Information System (INIS)

    Freijo, J.L.

    2008-01-01

    This paper provides an outlook of the status of the first development stages for an updated design of radiotherapy conformal system based on tumor 3D images obtained as an output the last generation imaging machines as PET, CT and MR which offer a very valuable output in cancer diagnosis. Prospective evaluation of current software codes and acquisition of useful experience in surgical planning involves a multidisciplinary process as an initial and unavoidable stage to develop an expert software and user skills which assures the delivery of the radiation dose is done correctly in geometry and value in each voxel as a radiation protection basic condition. The validation of the images obtained has been done by the production of anatomical models of interest regions by rapid proto typing of the 3D segmented images and its evaluation by contrasting with the real regions during surgical procedures. (author)

  7. Device for radiotherapy

    International Nuclear Information System (INIS)

    Levinta, A.

    2002-01-01

    The invention refers to medicine, in particular to radiology. Summary of the invention consists in that the device for the radiotherapy includes a base a headrest, a mechanism for head fixation, means for placement of the formation element, the mechanism for head fixation representing a semicircle situated in horizontal position and fixed to the base with the possibility of displacement, in the centre of which it is installed a fixing arm, and the means for placement of the formation elements representing at least two semicircles, mounted in vertical position and fixed into supports with the possibility of mutual swiveling of each of them, between the headrest and the base being installed the neck support

  8. Radiotherapy. 2. rev. ed.

    International Nuclear Information System (INIS)

    Wannenmacher, Michael; Debus, Juergen; Wenz, Frederik

    2013-01-01

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

  9. Radiotherapy on hidradenocarcinoma.

    Science.gov (United States)

    Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

    2011-01-01

    Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. POST OPERATIVE RADIOTHERAPY ALLOWS BETTER LOCAL CONTROL AND SHOULD BE MANDATORY WHEN HISTOLOGICAL FEATURES PREDICTIVE OF RECURRENCE ARE PRESENT: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread.

  10. Anatomical imaging for radiotherapy

    International Nuclear Information System (INIS)

    Evans, Philip M

    2008-01-01

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

  11. A randomised controlled trial to evaluate both the role and the optimal fractionation of radiotherapy in the conservative management of early breast cancer.

    Science.gov (United States)

    Spooner, D; Stocken, D D; Jordan, S; Bathers, S; Dunn, J A; Jevons, C; Dodson, L; Morrison, J M; Oates, G D; Grieve, R J

    2012-12-01

    Postoperative radiotherapy is routinely used in early breast cancer employing either 50 Gy in 25 daily fractions (long course) or 40 Gy in 15 daily fractions (short course). The role of radiotherapy and shorter fractionation regimens require validation. Patients with clinical stage I and II disease were randomised to receive immediate radiotherapy or delayed salvage treatment (no radiotherapy). Patients receiving radiotherapy were further randomised between long (50 Gy in 25 daily fractions) or short (40 Gy in 15 daily fractions) regimens. The primary outcome measure was time to first locoregional relapse. Reported results are at a median follow-up of 16.9 years (interquartile range 15.4-18.8). In total, 707 women were recruited between 1985 and 1992: median age 59 years (range 28-80), 68% postmenopausal, median tumour size 2.0 cm (range 0.12-8.0); 271 patients have relapsed: 110 radiotherapy, 161 no radiotherapy. The site of first relapse was locoregional158 (64%) and distant 87 (36%). There was an estimated 24% reduction in the risk of any competing event (local relapse, distant relapse or death) with radiotherapy (hazard ratio = 0.76; 95% confidence interval 0.65, 0.88). The benefit of radiotherapy treatment for all competing event types was statistically significant (X(Wald)(2) = 36.04, P < 0.001). Immediate radiotherapy reduced the risk of locoregional relapse by 62% (hazard ratio = 0.38; 95% confidence interval 0.27, 0.53), consistent across prognostic subgroups. No differences were seen between either radiotherapy fractionation schedules. This study confirmed better locoregional control for patients with early breast cancer receiving radiotherapy. A radiotherapy schedule of 40 Gy in 15 daily fractions is an efficient and effective regimen that is at least as good as the international conventional regimen of 50 Gy in 25 daily fractions. Copyright © 2012. Published by Elsevier Ltd.

  12. Enhanced pulmonary toxicity with bleomycin and radiotherapy in oat cell lung cancer

    International Nuclear Information System (INIS)

    Einhorn, L.; Krause, M.; Hornback, N.; Furnas, B.

    1976-01-01

    In a recently completed study, combination chemotherapy consisting of bleomycin, adriamycin, cyclophosphamide, and vincristine was given to 29 patients with oat cell lung cancer. There were no cases of pulmonary fibrosis in these 29 patients. Although several of these patients had prior radiotherapy, none had concomitant radiotherapy and chemotherapy. This same four-drug chemotherapy regimen was combined with concomitant radiotherapy in 13 patients with oat cell lung cancer. There were three cases of fatal pulmonary fibrosis and two other cases of clinically significant pulmonary fibrosis. All five cases of pulmonary fibrosis occurred several weeks after completion of a six-week course of bleomycin (total dosage 90 units). It is concluded that bleomycin cannot be safely administered while patients are receiving radiotherapy of the lung

  13. Decision logics in radiotherapy

    International Nuclear Information System (INIS)

    Gauwerky, F.

    1979-01-01

    Decisions in planning procedures can generally, at least for beam therapy to deep seated tumors, be based on a self-consistent system of criteria of optimization, namely: 1. The absorbed dose to the target volume must be applied as uniformly as possible. 2. Absorbed doses to organs (volumes) at risk must be as low as possible, at least below an accepted limit. 3. Radiation effects to outside volumes must be kept as low as possible. Whereas these criteria, as being reduced to the simplest possible requirements, have to be regarded as the stable elements, the radiotherapy parameters, such as geometric arrangements, special techniques, absorbed dose contributions to reference points or systems, have to be taken as the variables within decision processes. The properties of the criteria which have widely proved to be valuable in routine clinical practice, have been investigated in relation to the theoretical system of axioms as it is e.g. offered by Karl Popper's general logics of scientific research. An axiomatic system, as it is demanded (after Popper) must be a) free of discrepancies, i.e. self-consistent (not any sentence can be derived), b) independent, that is, one axiom cannot be derived from another one within the system, c) sufficient for deduction of statements needed, d) necessary, that is complete. All these requirements are fitting also to the offered system of radiotherapy optimization criteria. It has been demonstrated, that Popper's axiomatic system can be regarded as to be the general case for all scientific fields of application, the set of optimization criteria being a special system for radiation therapy, which would have been derivable from Popper's theory. Also practical use could be demonstrated. (orig./ORU) [de

  14. Why Radiotherapy Works. Chapter 6

    International Nuclear Information System (INIS)

    Tashiro, S.; Nishibuchi, I.; Wondergem, J.

    2017-01-01

    The history of radiotherapy began in 1895, when Röntgen discovered X rays, and in the following year, radiation was used for medical treatment. In the early days, the development of radiotherapy was based extensively on empiricism. Radiotherapists worked closely with radiation biologists in attempting to describe and understand the phenomena produced by ionizing radiation in the clinic and in biological systems. During the ensuing 120 years, radiotherapy has been improved significantly and, in addition to radiation biology, medical physics has played an important role in the design and development of equipment, quality assurance and dosimetry. Over recent decades, advances have been made in the field of molecular biology. Currently available techniques enable us to elucidate the molecular mechanisms of cellular response to ionizing irradiation, and it is anticipated that the role and contributions of radiation biology in radiotherapy will remain relevant. This chapter describes the clinically important biological points, including knowledge from current molecular biology.

  15. Radiotherapy in the Hodgkin's disease

    International Nuclear Information System (INIS)

    Pinto, A.C.L.C.; Moura, J.E.F.M. de; Leite, M.T.T.; Santa Casa de Misericordia de Belo Horizonte

    1983-01-01

    An up-to-date summary of Hodgkin's disease is presented taking into account its natural history, dissemination patterns, history, staging and therapeutic sugestions, with special regard to radiotherapy. (Author) [pt

  16. Targeted intraoperative radiotherapy in oncology

    CERN Document Server

    Keshtgar, Mohammed; Wenz, Frederik

    2014-01-01

    Targeted intraoperative radiotherapy is a major advance in the management of cancer patients. With an emphasis on practical aspects, this book offers an ideal introduction to this innovative  technology for clinicians.

  17. The biological basis of radiotherapy

    International Nuclear Information System (INIS)

    Steel, G.G.; Adams, G.E.; Horwich, A.

    1989-01-01

    The focus of this book is the biological basis of radiotherapy. The papers presented include: Temporal stages of radiation action:free radical processes; The molecular basis of radiosensitivity; and Radiation damage to early-reacting normal tissue

  18. Effect of faecal soiling on skatole and androstenone occurrence in organic entire male pigs

    DEFF Research Database (Denmark)

    Thomsen, Rikke; Edwards, Sandra; Jensen, Bent Borg

    2015-01-01

    Production of entire male pigs could be a future strategy for organic pig production. However, production of entire males leads to increased risk of carcasses with elevated boar taint levels. It is hypothesized that skatole levels in pig meat are affected by faecal soiling and that organic housing...

  19. Radiotherapy of presenile spinal osteoporosis

    International Nuclear Information System (INIS)

    Keim, H.M.; Schiebusch, M.

    1982-01-01

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

  20. Fournier gangrene: a rare case of necrotizing fasciitis of the entire right hemi-pelvis in a diabetic female.

    Science.gov (United States)

    Taylor, Gregory M; Hess, David V

    2018-02-01

    Fournier's gangrene, a rare polymicrobial infection that affects the genitals and perineum, can present as an insidious onset to a rapid and fulminant course. Early recognition, diagnosis, initiation of broad-spectrum antibiotics and prompt surgical treatment remain the foundation of management. If treatment is not initiated aggressively, the patient will likely rapidly deteriorate, leading to organ failure and death. We present the case of a 58-year-old diabetic female presenting febrile, hypoxic, with severe respiratory distress and evidence of septic shock, found to have necrotizing fasciitis of the entire right hemi-pelvis. Despite rapid recognition, IV antibiotics and operative management, the patient went to the intensive-care unit on multiple pressors and died 24 h later.

  1. Contact radiotherapy. Report of technological assessment

    International Nuclear Information System (INIS)

    Ortholan, Cecile; Melin, Nicole; Lee-Robin, Sun Hae; David, Denis Jean; Pages, Frederique; Devaud, Christine; Noel, Georges; Biga, Julie; Moty-Monnereau, Celine; Canet, Philippe; Lascols, Sylvie; Lamas, Muriel; Ramdine, Jessica; Tuil, Louise

    2008-10-01

    This report aims at assessing safety, indications, the role in therapeutic strategy, and efficiency of contact radiotherapy. It also aims at answering questions like: is the contact radiotherapy technique validated? What are the indications for contact radiotherapy? What about the efficiency and safety of contact radiotherapy? After a presentation of preliminary notions on radiotherapy (radiation types, dose, and irradiation techniques), the report presents this specific technique of contact radiotherapy: definition, devices, use recommendations, issues of radiation protection, modalities of performance of a contact radiotherapy session, and concerned pathologies. Then, based on a literature survey, this report addresses the various concerned tumours (skin, rectum, brain, breast), indicates some general information about these tumours (epidemiological data, anatomy and classification, therapeutic options, radiotherapy), and proposes an assessment of the efficiency and safety of contact radiotherapy

  2. Intraoperative radiotherapy in breast cancer: literature review

    International Nuclear Information System (INIS)

    Alfaro Hidalgo, Sabrina A.

    2013-01-01

    A literature review was performed on intraoperative radiotherapy of breast cancer. The strength and attractiveness is established of techniques of partial irradiation in the treatment of breast cancer. The benefit is originated to restrict the area immediate of radiotherapy to the tumor bed or quadrant index and identifying the benefit of being applied during the radiotherapy while surgical lumpectomy. The impact of local recurrence has been established using intraoperative radiotherapy. The advantages of intraoperative radiotherapy was compared in the management of the conservative surgery in early stages of breast cancer with external radiotherapy. Different methods of intraoperative radiotherapy have been compared and individual impact on local recurrence ranges. Intraoperative radiotherapy has had many advantages: radiobiological, technical, clinical, psychological and economical in the handling of conservative surgery in early stages of breast cancer, compared with external radiotherapy [es

  3. English Course

    CERN Multimedia

    HR Department

    2012-01-01

    Cours d'anglais général et professionnel : La prochaine session se déroulera : du 27 février au 22 juin 2012. Ces cours s'adressent à toute personne travaillant au CERN ainsi qu'à leur conjoint. Pour vous inscrire et voir tout le détail des cours proposés, consultez nos pages Web: http://cern.ch/Training Vous pouvez aussi contacter Kerstin Fuhrmeister, tél. 70896. Oral Expression The next sessions will take place from 27 February to 22 June, 2012.  This course is intended for people with a good knowledge of English who want to enhance their speaking skills. There will be on average of 8 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. For registration and further information on the courses, please consult our Web page: http://cern.ch/Training or contact Kerstin Fuhrmeister, tel. ...

  4. Language courses

    CERN Multimedia

    2014-01-01

    Cours d’anglais général et professionnel La prochaine session se déroulera du 22 septembre au 12 décembre. Ces cours s’adressent à toute personne travaillant au CERN ainsi qu’à leur conjoint. Pour vous inscrire et voir tout le détail des cours proposés, consultez nos pages web : http://cern.ch/Training. Oral Expression The next session will take place from 29 September to 5 December. This course is intended for people with a good knowledge of English who want to enhance their speaking skills. There will be an average of 8 participants in a class. Speaking activities will include discussions, meeting simulations, role plays etc. depending on the needs of the students. Writing Professional Documents in English – Administrative Writing Professional Documents in English – Technical The next session will take place from 29 September to 5 December. These courses are...

  5. English courses

    CERN Multimedia

    2013-01-01

    Cours d'anglais général et professionnel La prochaine session se déroulera du 4 mars jusqu’au 21 juin 2013. Ces cours s'adressent à toute personne travaillant au CERN ainsi qu'à leur conjoint. Pour le détail des cours proposés, consultez nos pages web. Oral Expression The next sessions will take place from 4 March to 21 June 2013. This course is intended for people with a good knowledge of English who want to enhance their speaking skills. There will be on average of 8 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. More information here. Writing Professional Documents in English - Administrative Writing Professional Documents in English - Technical The next sessions will take place from 4 March to 21 June 2013. These courses are designed for people with a goo...

  6. Bone Health and Pelvic Radiotherapy.

    Science.gov (United States)

    Higham, C E; Faithfull, S

    2015-11-01

    Survivors who have received pelvic radiotherapy make up many of the long-term cancer population, with therapies for gynaecological, bowel, bladder and prostate malignancies. Individuals who receive radiotherapy to the pelvis as part of their cancer treatment are at risk of insufficiency fractures. Symptoms of insufficiency fractures include pelvic and back pain and immobility, which can affect substantially quality of life. This constellation of symptoms can occur within 2 months of radiotherapy up to 63 months post-treatment, with a median incidence of 6-20 months. As a condition it is under reported and evidence is poor as to the contributing risk factors, causation and best management to improve the patient's bone health and mobility. As radiotherapy advances, chronic symptoms, such as insufficiency fractures, as a consequence of treatment need to be better understood and reviewed. This overview explores the current evidence for the effect of radiotherapy on bone health and insufficiency fractures and identifies what we know and where gaps in our knowledge lie. The overview concludes with the need to take seriously complaints of pelvic pain from patients after pelvic radiotherapy and to investigate and manage these symptoms more effectively. There is a clear need for definitive research in this field to provide the evidence-based guidance much needed in practice. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  7. Assessment of tumor control following definitive radiotherapy in carcinoma of the prostate: A continuing dilemma

    International Nuclear Information System (INIS)

    Pilepich, M.V.

    1987-01-01

    Evaluation of tumor response and tumor control after definitive radiotherapy is a relatively simple task in most malignancies arising at sites amenable to clinical examination (inspection and palpation). The rates of tumor regression following irradiation are quite variable. While some types of cancer regress completely during the radiotherapy course, some may take weeks or months to resolve. Occasionally, residual induration or a residual mass may persist for prolonged periods (many months), prompting the clinician to consider a biopsy for evaluation of the tumor status. In these circumstances histological examination may show necrotic tumor or residual fibrotic tissue. Finding viable-appearing tumor cells beyond the immediate postirradiation period (several weeks to a few months after completion of the radiotherapy course) is generally accepted as an equivalent of failure to eradicate the tumor. However, in a few types of cancer, presence of histologically identifiable and apparently viable tumor cells over protracted periods does not necessarily imply treatment failure

  8. Normalization of serum testosterone levels in patients treated with neoadjuvant hormonal therapy and three-dimensional conformal radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Padula, Gilbert D.A.; Zelefsky, Michael J.; Venkatraman, Ennapadam S.; Fuks, Zvi; Lee, Henry J.; Natale, Linda; Leibel, Steven A.

    2002-01-01

    Purpose: To determine the expected time to serum testosterone normalization after short-course neoadjuvant androgen deprivation therapy (NAAD) and three-dimensional conformal radiotherapy for patients with localized prostate cancer and to identify pretreatment predictors that correlated with the time to testosterone normalization. Methods: Between 1993 and 1999, 88 patients with localized prostate cancer, treated with NAAD and external beam radiotherapy, were prospectively monitored after treatment with sequential testosterone levels. NAAD was administered before and during the entire course of radiotherapy and discontinued at the end of treatment. The median duration of NAAD was 6 months. The actuarial rate of serum testosterone normalization from the end of treatment was evaluated, and the presence or absence of androgen deprivation-related symptoms was correlated with serum testosterone levels. Symptoms assessed included weight gain, loss of libido, breast tenderness, breast enlargement, hot flashes, and fatigue. Results: Serum testosterone levels returned to the normal range in 57 (65%) of the 88 patients and failed to normalize in 31 patients (35%). The median time to normalization was 18.3 months. The actuarial rate of normalization at 3, 6, 12, and 24 months was 10%, 26%, 38%, and 59%, respectively. In a multivariate analysis, a pretreatment testosterone level in the lower range of normal was the only variable that predicted for delayed testosterone normalization after NAAD (p=0.00047). Among 45 patients with information concerning androgen deprivation-related symptoms recorded 1 year after cessation of NAAD, 24 (53%) had normalized testosterone levels, but in 21 patients (47%), the levels had not yet returned to normal. At 1 year, only 1 (4%) of 24 patients whose testosterone level had returned to normal experienced NAAD-related symptoms compared with 14 (67%) of 21 patients who did not have normal testosterone levels (p<0.001). Conclusion: Testosterone

  9. Intravesical Glycosaminoglycan Replacement with Chondroitin Sulphate (Gepan? instill) in Patients with Chronic Radiotherapy- or Chemotherapy-Associated Cystitis

    OpenAIRE

    Schwalenberg, Thilo; Berger, Frank Peter; Horn, Lars Christian; Thi, Phuc Ho; Stolzenburg, Jens?Uwe; Neuhaus, Jochen

    2015-01-01

    Background and Objective Intravesical instillation of glycosaminoglycans is a promising option for the treatment of chronic cystitis, as it supports the regeneration of the damaged urothelial layer. We investigated the efficacy of short-term intravesical chondroitin sulphate treatment (six courses of instillation) in patients with chronic radiotherapy- or chemotherapy-associated cystitis. Methods This prospective, observational study included patients with chronic radiotherapy- or chemotherap...

  10. 75 FR 52360 - Upper Truckee River Restoration and Golf Course Reconfiguration Project, El Dorado County, CA

    Science.gov (United States)

    2010-08-25

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Upper Truckee River Restoration and Golf Course... and comment the draft EIR/EIS for the Upper Truckee River Restoration and Golf Course Reconfiguration... include continuing existing golf course use, removal of the entire Lake Tahoe Golf Course, or...

  11. Gene therapy and radiotherapy in malignant tumor

    International Nuclear Information System (INIS)

    Zhang Yaowen; Cao Yongzhen; Li Jin; Wang Qin

    2008-01-01

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

  12. Oxygenation of cervical cancers during radiotherapy and radiotherapy + cis-retinoic acid/interferon

    International Nuclear Information System (INIS)

    Dunst, Jeurgen; Heansgen, Gabriele; Lautenschleager, Christine; Feuchsel, Glenn; Becker, Axel

    1999-01-01

    Purpose: We have evaluated the tumor tissue pO 2 in cervical cancers during radiotherapy with special emphasis on the course of the pO 2 in primarily hypoxic tumors and in patients treated with radiotherapy plus 13-cis-retinoic acid/interferon-α-2a. Methods and Materials: From June 1995 through April 1997, 49 patients with squamous cell carcinoma FIGO IIB-IVA of the cervix who were treated with definitve radiotherapy with curative intent underwent polarographic measurement of tumor tissue pO 2 with an Eppendorf pO 2 -histograph prior to and during radiation treatment. Radiotherapy consisted of external irradiation with 50.4 Gy in 28 fractions of 1.8 Gy plus high dose rate (HDR) brachytherapy. Twenty-two patients had additional treatment with 13-cis-retinoic acid (cRA, isotretinoin) and interferon-α-2a (IFN-α-2a). Therapy with cRA/IFN in these patients started 2 weeks before radiotherapy; during this induction period, cRA was administered in a dosage of 1 mg per kilogram body weight orally daily and IFN-α-2a in a dosage of 6 x 10 6 I.U. subcutaneously daily. After start of external radiotherapy (XRT), cRA/IFN was continued concomitantly with radiotherapy in reduced doses (0.5 mg cRA per kg body weight orally daily plus 3 x 10 6 I.U. IFN-α-2a subcutaneously three times weekly until the end of the radiation treatment). pO 2 measurements were performed prior to radiotherapy, at 20 Gy, and at the end of radiotherapy. Results: A poor oxygenation defined as a median pO 2 of 10 mm Hg or less was present in 15/38 tumors (39%) in which measurements prior to any treatment were done. Low pO 2 readings below 5 mm Hg were present in 70% of all tumors prior to treatment. In 13 of 15 hypoxic tumors, pO 2 measurements at 19.8 Gy were performed. In these tumors, a significant increase of the median pO 2 from 6.0 ± 3.1 mm Hg to 20.7 ± 21.2 mm Hg was found, p 2 was more pronounced in patients with radiotherapy plus additional cRA/IFN treatment as compared to patients treated

  13. Radioprotectors in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-03-01

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

  14. Pinnacle Scripts: Clearing automated treatment in external radiotherapy after unscheduled interruptions

    International Nuclear Information System (INIS)

    Jover Perez, C. I.; Alaman Sanchez, C.; Osorio Ceballos, J. L.; Real Nunez, R. del; Almansa Lopez, J.

    2013-01-01

    The stops not foreseen during the usual course of radiotherapy treatment affect the quality of the same. The calculation of dosage compensation is the tool that have physicists and radiation therapists in order to mitigate the effect of these disruptions and achieve an effective treatment. (Author)

  15. Acute mucositis in the stimulated oral mucosa of patients during radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Maciejewski, B.; Zajusz, A.; Pilecki, B.; Swiatnicka, J.; Skladowski, K.; Trott, K.R.

    1991-01-01

    In 16 patients treated for squamous cell carcinoma of the oral cavity or oropharynx with an accelerated split course regimen, acute mucosal reactions were significantly less in the left buccal mucosa which had been repeatedly painted with 2% silver-nitrate solution for several days before radiotherapy than in the unpainted right buccal mucosa. (author). 8 refs., 3 figs., 1 tab

  16. Pain and quality of life following palliative radiotherapy of bone metastases; Der Einfluss palliativer Strahlentherapie auf Schmerz und Lebensqualitaet bei Patienten mit Knochenmetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Sauer, N.; Wild, B.; Henningsen, P.; Jakobsen, T. [Klinik fuer Psychosomatische und Allgemeine Klinische Medizin, Univ. Heidelberg (Germany); Leising, D. [Inst. fuer Psychologie, Univ. Wuerzburg (Germany); Treiber, M. [Radiologische Universitaetsklinik, Heidelberg (Germany)

    2006-09-15

    Pain and quality of life following palliative radiotherapy of bone metastases Background and purpose: palliative irradiation is used to provide pain relief and to increase quality of life. Most studies exclude patients with advanced cancer disease and, therefore, a positive selection results. This prospective clinical study investigates the effect of palliative radiotherapy on pain and quality of life of patients with painful bone metastases. Patients and methods: 263 patients with bone metastases due to advanced cancer were observed with respect to pain and quality of life during a 2-month course of radiotherapy. Missing data were substituted by the LOCF method (last observation carried forward) to prevent a biased reduction of data. Results: radiotherapy resulted in pain relief. In the complete group, pain medication was not increased. Quality of life was not affected positively. Side effects of radiotherapy increased remarkably. Conclusion: Radiotherapy leads to pain relief. However, risks and benefits must be considered critically due to side effects. (orig.)

  17. A multi-modality concept for radiotherapy planning with imaging techniques

    International Nuclear Information System (INIS)

    Schultze, J.

    1993-01-01

    The reported multi-modality concept of radiotherapy planning in the LAN can be realised in any hospital with standard equipment, although in some cases by way of auxiliary configurations. A software is currently developed as a tool for reducing the entire planning work. The heart of any radiotherapy planning is the therapy simulator, which has to be abreast with the requirements of modern radiotherapy. Integration of tomograpy, digitalisation, and electronic data processing has added important modalities to therapy planning which allow more precise target volume definition, and better biophysical planning. This is what is needed in order to achieve well differentiated radiotherapy for treatment of the manifold tumors, and the quality standards expected by the supervisory quality assurance regime and the population. At present, the CT data still are transferred indirect, on storage media, to the EDP processing system of the radiotherapy planning system. Based on the tomographic slices given by the imaging data, the contours and technical problem solutions are derived automatically, either for multi-field radiotherapy or moving field irradiation, depending on the anatomy or the targets to be protected from ionizing radiation. (orig./VHE) [de

  18. Adjuvant radiotherapy after transoral laser microsurgery for advanced squamous carcinoma of the head and neck

    International Nuclear Information System (INIS)

    Pradier, Olivier; Christiansen, Hans; Schmidberger, Heinz; Martin, Alexios; Jaeckel, Martin C.; Steiner, Wolfgang; Ambrosch, Petra; Kahler, Elke; Hess, Clemens F.

    2005-01-01

    Purpose: To evaluate the efficacy of an adjuvant radiotherapy after transoral laser microsurgery for advanced squamous cell carcinoma of the head and neck and to show that a less invasive surgery with organ preservation in combination with radiotherapy is an alternative to a radical treatment. Patients and Methods: Between 1987 and 2000, 208 patients with advanced squamous cell carcinoma of the head and neck were treated with postoperative radiotherapy after surgical CO 2 laser resection. Primary sites included oral cavity, 38; oropharynx, 88; larynx, 36; hypopharynx, 46. Disease stages were as follows: Stage III, 40 patients; Stage IV, 168 patients. Before 1994, the treatment consisted of a split-course radiotherapy with carboplatinum (Treatment A). After 1994, the patients received a conventional radiotherapy (Treatment B). Results: Patients had 5-year locoregional control and disease-specific survival (DSS) rates of 68% and 48%, respectively. The 5-year DSS was 70% and 44% for Stages III and IV, respectively (p = 0.00127). Patients treated with a hemoglobin level greater or equal to 13.5 g/dL before radiotherapy had a 5-year DSS of 55% as compared with 39% for patients treated with a hemoglobin level greater than 13.5 g/dL (p = 0.0054). Conclusion: In this series of patients with advanced head-and-neck tumors, transoral laser surgery in combination with adjuvant radiotherapy resulted in locoregional control and DSS rates similar to those reported for radical surgery followed by radiotherapy. Treatment B has clearly been superior to Treatment A. A further improvement of our treatment regimen might be expected by the combination of adjuvant radiotherapy with concomitant platinum-based chemotherapy

  19. Prostatic cancer: intolerance and morbidity of external radiotherapy

    International Nuclear Information System (INIS)

    Douchez, J.; Fregevu, Y.; Allain, Y.M.; Cellier, P.; Fenton, J.; Hay, M.; Le Bourgeois, J.P.; Vincent, F.

    1985-01-01

    The pertherapeutic intolerance and morbidity are analyzed in a groupe of 597 patients with localized prostatic carcinoma treated by definitive radiotherapy between 1975 and 1982. Minimum follow-up is 2 years, median is 46 months. The results are compared to following parameters: associated diseases, associated surgical treatments, doses and irradiated target volumes. Pertherapeutic intolerance manifestations were found in 73% of patients and lead to complications. Urinary incontinence and chronic cystitis were more frequent after transurethral resection or prostatic target volume and by split course irradiation. Chronic diarrhea was more frequent when using large target volume. Leg edema was closely associated with pelvic lymphadenectomy. The control of pertherapeutic manifestations and the prevention of complications should improve survival in patients treated by external radiotherapy [fr

  20. [Rules and regulations applying to incidents in radiotherapy].

    Science.gov (United States)

    Lohr, F; Baus, W; Vorwerk, H; Schlömp, B; André, L; Georg, D; Hodapp, N

    2012-07-01

    Radiotherapy is an essential and reliable element of the treatment armamentarium in oncology. Numerous rules, regulations, and protocols minimize the associated risks. It can, however, never be excluded that errors in the treatment delivery chain result in inadequate tumor doses or unnecessary damage to organs at risk. A legal framework governs the management of such incidents. The most important European and North American regulations are reported. Various directives issued by the European Union are differently implemented nationally. This applies particularly to the characterization of incidents that must be reported to authorities. Reporting thresholds, audit systems, and the extent of the integration of voluntary reporting systems vary. Radiotherapy incidents are dealt with differently on an international level. Changes are to be expected based on the European Basic Safety Standards Directive that is currently being prepared and will have to be implemented nationally in due course.

  1. The Palliative Radiotherapy in Bone Metastases

    International Nuclear Information System (INIS)

    Choi, Young Min; Lee, Hyung Sik; Hur, Won Joo

    1994-01-01

    To objectively compare the response of the palliative radiotherapy in bone metastatic patients which decreases pain and prevents pathologic fractures, we introduced and applied the RTOG pain and narcotic measure system. From Oct in 1991 to July in 1993, thirty-two patients with painful bone metastases, 17 of them were solitary lesions and others were multiple lesions, were treated with mainly 6 MV photon otherwise 15 MV photon. Radiation doses to bone metastatic sites ranged about from 2000 to 4600cGy. Responses of radiation therapy were compared with days of pre-RT, RT finish, 3, 6, 9 months after the start of RT and solitary versus multiple lesions and follow up scores according to the RTOG measure system. Survival analysis was done. Pain and narcotic score of the entire patients were 7.3, 7.8 at the pre-RT period and 2.6, 3.9 at the immediate or 2 weeks after RT, which was 64%, 50% decrement compared with the pre-RT score. Pain scores of 3, 6 and 9 months after the beginning of irradiation were 3.6, 3.7 and 3.3. The best response found in the breast and prostate primaries was 84%, 78% decrement of pain score as compared with pre-RT score (statistically insignificant). Median survival was 5.5 months and mean survival was 5 months. We conclude that the RTOG pain and narcotic measure system in relatively effective scale in the comparison of before and after palliative irradiation to the painful bone metastatic sites but more detailed parameters will be required in the narcotic scoring system. More aggressive but less or similar toxic radiotherapy is needed in the patients having relatively long life expected time

  2. Monte Carlo simulation of efficient data acquisition for an entire-body PET scanner

    Energy Technology Data Exchange (ETDEWEB)

    Isnaini, Ismet; Obi, Takashi [Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8503 (Japan); Yoshida, Eiji, E-mail: rush@nirs.go.jp [National Institute of Radiological Sciences, 4-9-1 Inage-ku, Chiba 263-8555 (Japan); Yamaya, Taiga [National Institute of Radiological Sciences, 4-9-1 Inage-ku, Chiba 263-8555 (Japan)

    2014-07-01

    Conventional PET scanners can image the whole body using many bed positions. On the other hand, an entire-body PET scanner with an extended axial FOV, which can trace whole-body uptake images at the same time and improve sensitivity dynamically, has been desired. The entire-body PET scanner would have to process a large amount of data effectively. As a result, the entire-body PET scanner has high dead time at a multiplex detector grouping process. Also, the entire-body PET scanner has many oblique line-of-responses. In this work, we study an efficient data acquisition for the entire-body PET scanner using the Monte Carlo simulation. The simulated entire-body PET scanner based on depth-of-interaction detectors has a 2016-mm axial field-of-view (FOV) and an 80-cm ring diameter. Since the entire-body PET scanner has higher single data loss than a conventional PET scanner at grouping circuits, the NECR of the entire-body PET scanner decreases. But, single data loss is mitigated by separating the axially arranged detector into multiple parts. Our choice of 3 groups of axially-arranged detectors has shown to increase the peak NECR by 41%. An appropriate choice of maximum ring difference (MRD) will also maintain the same high performance of sensitivity and high peak NECR while at the same time reduces the data size. The extremely-oblique line of response for large axial FOV does not contribute much to the performance of the scanner. The total sensitivity with full MRD increased only 15% than that with about half MRD. The peak NECR was saturated at about half MRD. The entire-body PET scanner promises to provide a large axial FOV and to have sufficient performance values without using the full data.

  3. Stability of percutaneously implanted markers for lung stereotactic radiotherapy

    DEFF Research Database (Denmark)

    Persson, Gitte Bjørnsen Fredberg; Josipovic, Mirjana; Von Der Recke, Peter

    2013-01-01

    The purpose of this study was to evaluate the stability of complex markers implanted into lung tumors throughout a course of stereotactic body radiotherapy (SBRT). Fifteen patients referred for lung SBRT were prospectively included. Radio-opaque markers were implanted percutaneously, guided...... mm in one or more registrations throughout the SBRT course. This is the first study to evaluate stability of complex markers implanted percutaneously into lung tumors for image guidance in SBRT. We conclude that the observed stability of marker position within the tumor indicates that complex markers...... can be used as surrogates for tumor position during a short course of SBRT as long as the uncertainties related to their position within the tumor are incorporated into the planning target volume....

  4. Hyperfractionated radiotherapy with simultaneous chemotherapy in Ewing's sarcoma

    International Nuclear Information System (INIS)

    Dunst, J.; Sauer, R.; Burgers, J.M.V.; Hawlicek, R.; Trott, K.R.; Juergens, H.

    1988-01-01

    In 1981, the German Society of Pediatric Oncology initiated a multi-institutional study for the treatment of Ewing's sarcoma. The protocol (Cooperative Ewing's Sarcoma Study, CESS 81) consisted of four courses of a four-drug-regimen (VACA), each course taking nine weeks. Local therapy (radical surgery or resection plus irradiation or radiotherapy alone) was performed after the second course. The results of CESS 81 can be summarized as follows: VACA-chemotherapy is effective in controlling systemic disease. Initial tumor mass and response to initial chemotherapy are of major prognostic value for local control and survival. Permanent local control is a problem, especially in irradiated patients. The high local failure rate in irradiated patients in CESS 81 could be attributable to the following reasons: Late start of local therapy (after 18 weeks of chemotherapy), uneven distribution of prognostic parameters: Large tumors were more often irradiated than operated, protocol deviations in irradiated patients. (orig.)

  5. Entire Functions of Bounded L-Index: Its Zeros and Behavior of Partial Logarithmic Derivatives

    Directory of Open Access Journals (Sweden)

    Andriy Bandura

    2017-01-01

    Full Text Available In this paper, we obtain new sufficient conditions of boundedness of L-index in joint variables for entire function in Cn functions. They give an estimate of maximum modulus of an entire function by its minimum modulus on a skeleton in a polydisc and describe the behavior of all partial logarithmic derivatives and the distribution of zeros. In some sense, the obtained results are new for entire functions of bounded index and l-index in C too. They generalize known results of Fricke, Sheremeta, and Kuzyk.

  6. Entire solutions of a diffusive and competitive Lotka–Volterra type system with nonlocal delays

    International Nuclear Information System (INIS)

    Wang, Mingxin; Lv, Guangying

    2010-01-01

    This paper is concerned with the entire solution of a diffusive and competitive Lotka–Volterra type system with nonlocal delays. The existence of the entire solution is proved by transforming the system with nonlocal delays to a four-dimensional system without delay and using the comparing argument and the sub-super-solution method. Here an entire solution means a classical solution defined for all space and time variables, which behaves as two wave fronts coming from both sides of the x-axis

  7. TLD audit in radiotherapy in the Czech Republic

    International Nuclear Information System (INIS)

    Kroutilikova, D.; Zackova, H.; Judas, L.

    1998-01-01

    National Radiation Protection Institute in Prague organizes the TLD audit. The aim of the TLD postal audit is to provide control of the clinical dosimetry in the Czech Republic for purposes of state supervision in radiotherapy, to investigate and to reduce uncertainties involved in the measurements of absorbed dose and to improve consistency in dose determination in the regional radiotherapy centers. TLD audit covers absorbed dose measurements under reference conditions for 60 Co and 137 Cs beams, high-energy X-ray and electron beams of of linear accelerators and betatrons. The thermo-luminescence dosemeters are sent regularly to all radiotherapy centers. Absorbed dose measures by the TLD is compared to absorbed dose stated by radiotherapy center. Encapsulated LiF:Mg, Ti powder is used for the measurement. Deviation of 3% between stated and TLD measured dose is considered for photons and ±5% for electron beams. First TLD audit was started in 1997. A total of 135 beams was checked. There were found seven major deviations (more than ±6%), which were very carefully investigated. Medical Physicists from these departments reported a set-up mistake. However, at most of those hospitals with major deviations, an in situ audit in details was made soon after TLD audit. There were found discrepancies of clinical dosimetry but also bad technical state of some of the irradiation units. In 1998, second course TLD audit was started. No major deviation was found. Regular TLD audit seems to be a good way to eliminate big mistakes in the basic clinical dosimetry. Repeated audit in the regional radiotherapy centers that had major deviation during the first audit exhibited improvement of their dosimetry. It is intended to broaden the method and to control also beam parameters by means of a multi-purpose phantom. (authors)

  8. Recommendations for safer radiotherapy: what’s the message?

    Energy Technology Data Exchange (ETDEWEB)

    Dunscombe, Peter, E-mail: peter.dunscombe@albertahealthservices.ca [Department of Oncology, University of Calgary, Calgary, AB (Canada)

    2012-09-28

    Radiotherapy, with close to a million courses delivered per year in North America, is a very safe and effective intervention for a devastating disease. However, although rare, several deeply regrettable incidents have occurred in radiotherapy and have rightly been the subject of considerable public interest. Partly in response to reports of these incidents a variety of authoritative organizations across the globe has harnessed the expertise amongst their members in attempts to identify the measures that will make radiotherapy safer. While the intentions of all these organizations are clearly good it is challenging for the health care providers in the clinic to know where to start with so much advice coming from so many directions. Through a mapping exercise we have identified commonalities between recommendations made in seven authoritative documents and identified those issues most frequently cited. The documents reviewed contain a total of 117 recommendations. Using the 37 recommendations in “Towards Safer Radiotherapy” as the initial base layer, recommendations in the other documents were mapped, adding to the base layer to accommodate all the recommendations from the additional six documents as necessary. This mapping exercise resulted in the distillation of the original 117 recommendations down to 61 unique recommendations. Twelve topics were identified in three or more of the documents as being pertinent to the improvement of patient safety in radiotherapy. They are, in order of most to least cited: training, staffing, documentation, incident learning, communication, check lists, quality control and preventive maintenance, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment, and safety culture. This analysis provides guidance for the selection of those activities most likely to enhance safety and quality in radiotherapy based on the frequency of citation in selected recent authoritative literature.

  9. Recommendations for safer radiotherapy: what’s the message?

    International Nuclear Information System (INIS)

    Dunscombe, Peter

    2012-01-01

    Radiotherapy, with close to a million courses delivered per year in North America, is a very safe and effective intervention for a devastating disease. However, although rare, several deeply regrettable incidents have occurred in radiotherapy and have rightly been the subject of considerable public interest. Partly in response to reports of these incidents a variety of authoritative organizations across the globe has harnessed the expertise amongst their members in attempts to identify the measures that will make radiotherapy safer. While the intentions of all these organizations are clearly good it is challenging for the health care providers in the clinic to know where to start with so much advice coming from so many directions. Through a mapping exercise we have identified commonalities between recommendations made in seven authoritative documents and identified those issues most frequently cited. The documents reviewed contain a total of 117 recommendations. Using the 37 recommendations in “Towards Safer Radiotherapy” as the initial base layer, recommendations in the other documents were mapped, adding to the base layer to accommodate all the recommendations from the additional six documents as necessary. This mapping exercise resulted in the distillation of the original 117 recommendations down to 61 unique recommendations. Twelve topics were identified in three or more of the documents as being pertinent to the improvement of patient safety in radiotherapy. They are, in order of most to least cited: training, staffing, documentation, incident learning, communication, check lists, quality control and preventive maintenance, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment, and safety culture. This analysis provides guidance for the selection of those activities most likely to enhance safety and quality in radiotherapy based on the frequency of citation in selected recent authoritative literature.

  10. Treatment of primary brain lymphoma without immune deficiency, The importance of chemotherapy before radiotherapy

    Directory of Open Access Journals (Sweden)

    Keihani M

    1999-09-01

    Full Text Available The purpose of this study was to find a more efficacious treatment for patients with primary central nervous system Lymphoma using chemotherapy. The objective was to determine the optimal time for radiotherapy treatment in relation to chemotherapy. Retrospective evaluation in patients with brain lymphoma was conducted from 1992 to 1998. Twenty-three patients were evaluated. Patients were divided into two groups based on the timing of radiotherapy in relation to the chemotherapy. The first group of patients (n=13 initially received radiotherapy followed by chemotherapy. Five of these patients receied classic CHOP (cyclophosphamide, Doxorubicine, Vincistine and Prednisone, six patients received Cis-platin (60 Megs/M2 and Etoposide (120 Megs/M2 and two patients received Cis-platin (60 Megs/M2, Etoposide (120 Megs/M2 and Cytarabine (600 Megs/M2 every 2 to 3 weeks. The second group of patients (Group II, n=10 received the followeing treatment regimen: a course of BCNU 120 Megs/M2 with Ifosfamide 1200 Megs/M2, Mesna and Etoposide 120 Megs/M2 on the first day of treatment (course A. Two weeks later, treatment was continued with a course of Cis-platin 35 Megs/M2 and Cytarabine 600 Megs/M2 (course B. The treatment was continued 14 days later with a course of Mitoxantron 12 Megs/M2, Ifosfamide 1200 Megs/M2 puls Mesna (course C. After the fourth week of chemotherapy, these patients received radiotherapy to the brain (5000 RADS in 4 weeks. During radiotherapy and at the beginning of course chemotherapy, intrathecal therapy with Methorexate 12 Megs/M2 and Cytarabine 60 Megs/M2 was given. Immediately after radiotherapy, the same chemothotrexate 12 Megs/M2 and Cytarabine 60 Megs/M2 was given. Immediately after radiotherapy, the same chemotherapy treatment was repeated to a total of 3 times. After complete clearance of the tumor determined by MRI and absence of tumor cells in the spinal fluid, the chemotherapeutic regimen was repeated one last time. The

  11. East Asian Cinema (College Course File).

    Science.gov (United States)

    Ehrlich, Linda; Ma, Ning

    1990-01-01

    Provides guidelines for instructors who teach entire courses on (or who include) films from Japan and China. Considers issues of concern in contemporary Asian cinema such as conflicts between tradition and modernity, indigenous definitions of cultural identity and artistic form, and internationalization. (KEH)

  12. Available evidence on re-irradiation with stereotactic ablative radiotherapy following high-dose previous thoracic radiotherapy for lung malignancies.

    Science.gov (United States)

    De Bari, Berardino; Filippi, Andrea Riccardo; Mazzola, Rosario; Bonomo, Pierluigi; Trovò, Marco; Livi, Lorenzo; Alongi, Filippo

    2015-06-01

    Patients affected with intra-thoracic recurrences of primary or secondary lung malignancies after a first course of definitive radiotherapy have limited therapeutic options, and they are often treated with a palliative intent. Re-irradiation with stereotactic ablative radiotherapy (SABR) represents an appealing approach, due to the optimized dose distribution that allows for high-dose delivery with better sparing of organs at risk. This strategy has the goal of long-term control and even cure. Aim of this review is to report and discuss published data on re-irradiation with SABR in terms of efficacy and toxicity. Results indicate that thoracic re-irradiation may offer satisfactory disease control, however the data on outcome and toxicity are derived from low quality retrospective studies, and results should be cautiously interpreted. As SABR may be associated with serious toxicity, attention should be paid for an accurate patients' selection. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. A comparative study of external radiotherapy alone versus external radiotherapy + brachytherapy in carcinoma cervix stage III B

    International Nuclear Information System (INIS)

    Bardia, M.R.; Bhargava, S.C.; Chaudhary, R.K.; Agrawal, V.K.; Singh, K.; Vyas, R.

    1987-01-01

    Carcinoma of the cervix is the commonest cancer seen in women at Sardar Patel Medical College, Bikaner (Rajasthan). In the present study external radio-therapy and brachytherapy are used in carcinoma cervix stage III B. After 4000 to 4500 rads to pelvis by external radio-therapy, patient was assessed for intra cavitary application. Total given dose to point A was 7500 rads, to point B was 5000 rads. If patient was not suitable a split course was given where patient was asked to come after 3 weeks for intracavitary application. A comparative study of both methods was done. There was significant improvement in the control of central disease by applying intracavitary source. Radiation reactions were comparable. (author). 4 tables, 10 refs

  14. Voice following radiotherapy

    International Nuclear Information System (INIS)

    Stoicheff, M.L.

    1975-01-01

    This study was undertaken to provide information on the voice of patients following radiotherapy for glottic cancer. Part I presents findings from questionnaires returned by 227 of 235 patients successfully irradiated for glottic cancer from 1960 through 1971. Part II presents preliminary findings on the speaking fundamental frequencies of 22 irradiated patients. Normal to near-normal voice was reported by 83 percent of the 227 patients; however, 80 percent did indicate persisting vocal difficulties such as fatiguing of voice with much usage, inability to sing, reduced loudness, hoarse voice quality and inability to shout. Amount of talking during treatments appeared to affect length of time for voice to recover following treatments in those cases where it took from nine to 26 weeks; also, with increasing years since treatment, patients rated their voices more favorably. Smoking habits following treatments improved significantly with only 27 percent smoking heavily as compared with 65 percent prior to radiation therapy. No correlation was found between smoking (during or after treatments) and vocal ratings or between smoking and length of time for voice to recover. There was no relationship found between reported vocal ratings and stage of the disease

  15. Proton radiotherapy: some perspectives

    International Nuclear Information System (INIS)

    Kirn, T.F.

    1988-01-01

    A news article highlighting the use of protons in radiotherapy is presented. Development of stereotaxic radiosurgery is the result of contributions from physicists, radiologists, and neurosurgeons, says Jacob Fabrikant, MD, head of the Arteriovenous Malformation Program at the University of California's Lawrence Berkeley laboratory. It also appears to have been the product of Harvard University (Boston) and University of California (Berkeley) cooperation. Robert R. Wilson, PhD, now a professor emeritus at Cornell University, Ithaca, NY, is credited with proposing the medical use of charged particles. Wilson, a physicist, says that the idea occurred to him while he was at Berkeley in the mid-1940's, designing the cyclotron to be built at Harvard. Although he was aware of their work, he does not remember discussing it with Robert Stone, MD, or John Lawrence, MD, who only a few years earlier at Berkeley had begun the initial medical experiments with neutrons. Wilson says that it simply occurred to him that in certain instances charged particles had two advantages over x-rays

  16. Automatization in radiotherapy

    International Nuclear Information System (INIS)

    Schraub, S.; Dutou, L.; Bernard, D.; Koechlin, M.; Beer-Gabel, J.

    1978-01-01

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

  17. Erythropoietin in radiotherapy

    International Nuclear Information System (INIS)

    Guttenburger, R.

    2003-01-01

    A high blood hemoglobin level is an independent factor for good prognosis as demonstrated in retrospective and prospective studies in a number of cancer sites. However, there is still debate on how hemoglobin affects outcome after radiotherapy. The issues are: 1. How about the predictive power and the magnitude of effect in various tumor entities? 2. Are all potential mechanisms for the hemoglobin effect considered? 3. Do EPO receptors found on tumor and normal cells outside the bone marrow play a role? Experimental and clinical data on anemia and its treatment have been extensively discussed. So far, the means to manipulate the hemoglobin level, their indication and administration are to be clarified. The issues are: 1. Why does transfusion not improve prognosis? 2. What have we learned from trials using EPO to stimulate endogenous Hb production? 3. What are the potential pitfalls of correcting anemia with EPO? 4. What is the optimal design of EPO-RT trials? Although there are still more questions than answers, the therapeutic potential of erythropoietin is of considerable interest to radiation oncologists. This report gives a summary reviewing the topic and ends on a note of caution: Mild anemia in cancer patients is no indication to use EPO outside clinical trials

  18. Intensity modulated conformal radiotherapy

    International Nuclear Information System (INIS)

    Noel, Georges; Moty-Monnereau, Celine; Meyer, Aurelia; David, Pauline; Pages, Frederique; Muller, Felix; Lee-Robin, Sun Hae; David, Denis Jean

    2006-12-01

    This publication reports the assessment of intensity-modulated conformal radiotherapy (IMCR). This assessment is based on a literature survey which focussed on indications, efficiency and safety on the short term, on the risk of radio-induced cancer on the long term, on the role in the therapeutic strategy, on the conditions of execution, on the impact on morbidity-mortality and life quality, on the impact on the health system and on public health policies and program. This assessment is also based on the opinion of a group of experts regarding the technical benefit of IMCR, its indications depending on the cancer type, safety in terms of radio-induced cancers, and conditions of execution. Before this assessment, the report thus indicates indications for which the use of IMCR can be considered as sufficient or not determined. It also proposes a technical description of IMCR and helical tomo-therapy, discusses the use of this technique for various pathologies or tumours, analyses the present situation of care in France, and comments the identification of this technique in foreign classifications

  19. Hyperthermia and radiotherapy

    International Nuclear Information System (INIS)

    Dietzel, F.

    1979-01-01

    Of decisive importance for superadditive enhancement is the close temporal correlation of hyperthermia and radiotherapy. It is recommended to first irradiate and then use heat treatment in order to ensure that dividable tumour cells are irradiated before hyperthermia. To achieve an optimal enhancing effect, temperatures of appr. 42 0 are sufficient. In order to be able to neglect temperature regulation and convection effects, hyperthermia for clinical use must be carried out in doses high enough to ensure that it can be finished within 3-4 minutes. It is necessary to make efforts to find out which forms of application can be realised in order to reach deeper tissue regions, thus making possible at least a half-depth-therapy. Up to day, only the 2 cm near to the surface can be heated in a sufficiently homogeneous way. In the FRG, there are more than 200 high-volt-therapy systems, including electron accelerators and telegamma systems. This is a dense network of radiation-therapeutical supply. An improved therapy effect of loose ionising rays which, with the help of the hypertherming, would almost be equal to irradiation with high ionisation density, is not only of scientific interest, but also of high interest for public health. (orig./MG) 891 MG/orig.- 892 RDG [de

  20. Asymptotic behavior of the logarithmic derivative for entire functions of order zero

    Directory of Open Access Journals (Sweden)

    M. V. Zabolotskyj

    2014-12-01

    Full Text Available We get an approximation theorem for the logarithmic derivative $F$ of entire functions of order zero and, with it's help, establish the asymptotic of $ F $ outside the exceptional set.

  1. T helper type 1 memory cells disseminate postoperative ileus over the entire intestinal tract

    NARCIS (Netherlands)

    Engel, Daniel R.; Koscielny, Arne; Wehner, Sven; Maurer, Juliane; Schiwon, Marzena; Franken, Lars; Schumak, Beatrix; Limmer, Andreas; Sparwasser, Tim; Hirner, Andreas; Knolle, Percy A.; Kalff, Jörg C.; Kurts, Christian

    2010-01-01

    Localized abdominal surgery can lead to disruption of motility in the entire gastrointestinal tract (postoperative ileus). Intestinal macrophages produce mediators that paralyze myocytes, but it is unclear how the macrophages are activated, especially those in unmanipulated intestinal areas. Here we

  2. Approaches to radiotherapy in metastatic spinal cord compression.

    Science.gov (United States)

    Suppl, Morten Hiul

    2018-04-01

    Metastatic spinal cord compression is caused by the progression of metastatic lesions within the vicinity of the spinal cord. The consequences are very severe with loss of neurological function and severe pain. The standard treatment is surgical intervention followed by radiotherapy or radiotherapy alone. However, the majority of patients are treated with radiotherapy only due to contraindications to surgery and technical inoperability. Stereotactic body radiotherapy is a technology to deliver higher radiation dose to the radiotherapy target with the use of spatial coordinates. This modality has shown positive results in treating lesions in brain and lungs. Hence, it could prove beneficial in metastatic spinal cord compression. We designed and planned a trial to investigate this method in patients with metastatic spinal cord compression. The method was usable but the trial was stopped prematurely due to low accrual that made comparison with surgery impossible. Low accrual is a known problem for trials evaluating new approaches in radiotherapy. Target definition in radiotherapy of metastatic spinal cord compression is defined by patient history, examination and imaging. Functional imaging could provide information to guide target definition with the sparring of normal tissue e.g. spinal cord and hematopoietic tissue of the bone marrow. In future trials this may be used for dose escalation of spinal metastases. The trial showed that PET/MRI was feasible in this group of patients but did not change the radiotherapy target in the included patients. Neurological outcome is similar irrespective of course length and therefore single fraction radiotherapy is recommended for the majority of patients. In-field recurrence is a risk factor of both short and long fractionation schemes and re-irradiation have the potential risk of radiation-induced myelopathy. In a retrospective study of re-irradiation, we investigated the incidence of radiation-induced myelopathy. In our study

  3. Image-guided radiotherapy for effective radiotherapy delivery

    CERN Document Server

    Karlsson, Ulf Lennart

    2016-01-01

    Image-guided radiotherapy (IGRT) is a new radiotherapy technology that combines the rapid dose fall off associated with intensity-modulated radiotherapy (IMRT) and daily tumor imaging allowing for high precision tumor dose delivery and effective sparing of surrounding normal organs. The new radiation technology requires close collaboration between radiologists, nuclear medicine specialists, and radiation oncologists to avoid marginal miss. Modern diagnostic imaging such as positron emission tomography (PET) scans, positron emission tomography with Computed Tomograpgy (PET-CT), and magnetic resonance imaging (MRI) allows the radiation oncologist to target the positive tumor with high accuracy. As the tumor is well visualized during radiation treatment, the margins required to avoid geographic miss can be safely reduced , thus sparing the normal organs from excessive radiation. When the tumor is located close to critical radiosensitive structures such as the spinal cord, IGRT can deliver a high dose of radiatio...

  4. Quality Characteristics and Composition of the Muscle from Entire and Castrate Elk in Korea

    Directory of Open Access Journals (Sweden)

    Sang-Woo Kim

    2016-05-01

    Full Text Available The objective of the research was to determine the chemical composition as well as the physicochemical properties of the longissimus muscle from Korean entire and castrate elk. Twelve elk stags were raised and fed on concentrate with ad libitum hay. All animals were equally divided into castrated and non-castrated (entire males, and slaughtered at 5 year of age. It was found that entire elk, in comparison with castrate elk, had higher content of moisture and lower content of fat (p<0.05. Compared with entire males, the castrates had lower pH and shear force values (p<0.05. However, castrates had higher L*, a*, and b* values compared with entires (p<0.05. An analysis of the fatty acid profile revealed that the muscles of entire and castrate elk had the most abundant concentrations of the following fatty acids: palmitic acid (C16:0 of the saturated fatty acid, and oleic acid (C18:1n-9 of the unsaturated fatty acid. The entire elk contains higher proportions of linoleic acid (C18:3n6, eicosenoic acid (C20:1n9, and arachidonic acid (C20:4n6 (p<0.05. Cholesterol content in elk was not affected by castration. The predominant free amino acid was glutamic acid related to umami taste. It is apparent that the castrate animals carried higher content of histidine, isoleucine, and leucine than those of the entire group (p<0.05. In this study, it was concluded that venison quality of elk is affected by castration and these results can provide fundamental information for venison production.

  5. Patient costs associated with external beam radiotherapy treatment for localized prostate cancer: the benefits of hypofractionated over conventionally fractionated radiotherapy.

    Science.gov (United States)

    Sethukavalan, Perakaa; Cheung, Patrick; Tang, Colin I; Quon, Harvey; Morton, Gerard; Nam, Robert; Loblaw, Andrew

    2012-04-01

    To estimate the out-of-pocket costs for patients undergoing external beam radiotherapy (EBRT) for prostate cancer and calculate the patient-related savings of being treated with a 5-fraction versus a standard 39-fraction approach. Seventy patients accrued to the pHART3 (n = 84) study were analyzed for out-of-pocket patient costs as a result of undergoing treatment. All costs are in Canadian dollars. Using the postal code of the patient's residence, the distance between the hospital and patient home was found using Google Maps. The Canada Revenue Agency automobile allowance rate was then applied to determine the cost per kilometer driven. The average cost of travel from the hospital and pHART3 patient's residence was $246 per person after five trips. In a standard fractionation regimen, pHART3 patients would have incurred an average cost of $1921 after 39 visits. The patients receiving hypofractionated radiotherapy would have paid an average of $38 in parking while those receiving conventional treatment would have paid $293. The difference in out-of-pocket costs for the patients receiving a standard versus hypofractionated treatment was $1930. Medium term prospective data shows that hypofractionated radiotherapy is an effective treatment method for localized prostate cancer. Compared to standard EBRT, hypofractionated radiotherapy requires significantly fewer visits. Due to the long distance patients may have to travel to the cancer center and the expense of parking, the short course treatment saves each patient an average of $1900. A randomized study of standard versus hypofractionated accelerated radiotherapy should be conducted to confirm a favorable efficacy and tolerability profile of the shorter fractionation scheme.

  6. Epigenetics in radiotherapy: Where are we heading?

    International Nuclear Information System (INIS)

    Smits, Kim M.; Melotte, Veerle; Niessen, Hanneke E.C.; Dubois, Ludwig; Oberije, Cary; Troost, Esther G.C.; Starmans, Maud H.W.; Boutros, Paul C.; Vooijs, Marc; Engeland, Manon van; Lambin, Philippe

    2014-01-01

    Radiotherapy is an important component of anti-cancer treatment. However, not all cancer patients respond to radiotherapy, and with current knowledge clinicians are unable to predict which patients are at high risk of recurrence after radiotherapy. There is therefore an urgent need for biomarkers to guide clinical decision-making. Although the importance of epigenetic alterations is widely accepted, their application as biomarkers in radiotherapy has not been studied extensively. In addition, it has been suggested that radiotherapy itself introduces epigenetic alterations. As epigenetic alterations can potentially be reversed by drug treatment, they are interesting candidate targets for anticancer therapy or radiotherapy sensitizers. The application of demethylating drugs or histone deacetylase inhibitors to sensitize patients for radiotherapy has been studied in vitro, in vivo as well as in clinical trials with promising results. This review describes the current knowledge on epigenetics in radiotherapy

  7. Technological advances in radiotherapy of rectal cancer

    DEFF Research Database (Denmark)

    Appelt, Ane L; Sebag-Montefiore, David

    2016-01-01

    PURPOSE OF REVIEW: This review summarizes the available evidence for the use of modern radiotherapy techniques for chemoradiotherapy for rectal cancer, with specific focus on intensity-modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) techniques. RECENT FINDINGS: The dosimetric...

  8. Protection of patient In radiotherapy

    International Nuclear Information System (INIS)

    Deiyi, P.

    2013-04-01

    The purpose of this project is to clarify some aspects about protection of patient in radiotherapy. Therefore, some basic information about how the use of ionizing radiation in medicine has brought tremendous health benefits to the population globally, the requirement of radiation protection (Justification of practices, Dose limitation and Optimization of protection), and the deterministic and stochastic effects of radiation are presented. The aim of radiotherapy is to use ionizing radiation to cure diseases or make the symptoms of a disease less severe. Also presented are layout of a radiotherapy facility (controlled areas, supervised areas, mazes, door and interlocks, patient observation and communication, and warning sign and lights), radionuclides commonly used for radiation therapy and their main emissions, equipment and devices used in radiotherapy, aspect of protection of patient in radiotherapy such as: leakage test, source on/off, emergency buttons, radiation oncology team, treatment planning, room monitoring, equipment or for protection and Cobalt-60 unit stuck source. The advantages of brachytherapy, leakage from the treatment head and radiation incidents resulting from incorrect dose calibration are discussed. The importance of minimization dose exposure, by considering the basic principles of: time, distance and shielding are also stated. These principles prevent deterministic effects and limit stochastic effects of radiation. (author)

  9. Small animal radiotherapy research platforms

    Energy Technology Data Exchange (ETDEWEB)

    Verhaegen, Frank; Granton, Patrick [Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Tryggestad, Erik, E-mail: frank.verhaegen@maastro.nl [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21231 (United States)

    2011-06-21

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

  10. Small animal radiotherapy research platforms

    Science.gov (United States)

    Verhaegen, Frank; Granton, Patrick; Tryggestad, Erik

    2011-06-01

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

  11. Small animal radiotherapy research platforms

    International Nuclear Information System (INIS)

    Verhaegen, Frank; Granton, Patrick; Tryggestad, Erik

    2011-01-01

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

  12. Curative radiotherapy of supraglottic cancer

    International Nuclear Information System (INIS)

    Kim, Yong Ho; Chai, Gyu Young

    1998-01-01

    The purpose of this study was to evaluate the efficacy of curative radiotherapy in the management of supraglottic cancer. Twenty-one patients with squamous cell carcinoma of the supraglottis were treated with radiotherapy at Gyeongsang National University Hospital between 1990 and 1994. Median follow-up period was 36 months and 95% were observed for at least 2 years. Actuarial survival rate at 5 years was 39.3% for 21 patients. The 5-year actuarial survival rate was 75.0% in Stage I, 42.9% in Stage II, 33.3% in Stage III, and 28.6% in Stage IV(p=0.54). The 5-year local control rate was 52.0% for 21 patients. The 5-year local control rate was 75.0% in Stage I, 57.1% in Stage II, 66.7% in Stage III, and 28.6% in Stage IV(p=0.33). Double primary cancer was developed in 3 patients and those were all esophageal cancers. In early stage(Stage I and II) supraglottic cancer, curative radiotherapy would be a treatment of choice and surgery would be better to be reserved for salvage of radiotherapy failure. In advanced stage(Stage III and IV), radiotherapy alone is inadequate for curative therapy and combination with surgery should be done in operable patients. This report emphasizes the importance of esophagoscopy and esophagogram at the follow-up of patients with supraglottic cancer

  13. Definitive Radiotherapy of Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Lee, Jong Young; Park, Kyung Ran

    1995-01-01

    Purpose : The effect of dose escalation of up to 6500 cGy on local control and survival was investigated in locally advanced non-small cell lung cancer. Materials and Methods : Ninety eight patients with biopsy-proven unresectable non-small cell lung cancer without distant metastases or medically inoperable patients with lower-stage were treated with definitive radiotherapy alone. Group A were treated by thoracic irradiation, 6000 cGy or less in total tumor dose with daily fractions of 180 to 200 cGy: and group B was treated with 6500 cGy of same daily fractions. Results : The actuarial overall survival rate for the entire group was 54% at 1 year, 26.6% at 2 years and 16.4% at 3 years with a median survival time of 13 months. Statistically significant prognostic factors that affect survival rate were stage and N-stage. However, no improvement in local control and survival has been seen with higher dose radiotherapy(group B). Conclusion : Dose escalation of up to 6500 cGy was no effect on local control and survival rate. To increase the survival rate of non-small cell lung cancer hyperfractionated radiotherapy or concurrent chemoradiotherapy should be considered

  14. Radiotherapy and skin tumors; Radiotherapie et tumeurs curanees

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-09-01

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

  15. Impact of radiotherapy on myasthenia gravis in patients with malignant thymomas

    International Nuclear Information System (INIS)

    Hou Xiuyu; Xu Yonggang; Gao Hong; Li Ming; Li Gaofeng; Liu Mingyuan

    2006-01-01

    Objective: To evaluate the change of myasthenia gravis(MG) during radiotherapy for patients with malignant thymomas. Methods: Forty-five with malignant thymomas patients with were analyzed. The median total dose was DT54.2 Gy in 1.8-2.0 Gy/fraction, 5 clays a week. Anti-cholinesterase, such as pyridostigmine was used to control the MG symptoms. Results: Forty-five patients completed radiotherapy on schedule except one from whom the treatment was was with drawn because of respiratory muscle involvement. Among these 44 patients, myasthenic symptom was relieved in 4 to various degrees, 4 progressed, 34 no change and 2 developed cholinergic crisis. Myasthenic symptom was not changed in one patient for whom radiotherapy had been standed before operation nor during the course of postoperative radiotherapy. Conclusions: A course of radiotherapy of DT54.2 Gy, on fractionation of DT1.8-2.0 Gy modal would not aggravate myasthenia. However, proper use of anti-cholinesterase, careful observation and timely drug-adjustment are necessary. (authors)

  16. Imposition of a delay prior to beginning radiotherapy: impact on mood states for cancer patients

    International Nuclear Information System (INIS)

    Merker, R.A.

    1988-01-01

    Waiting lists for radiotherapy are a recent phenomenon in highly populated areas and, coupled with the public's awareness of the nature of cancer and the need for immediate treatment, a psychological dilemma has emerged. Since virtually all patients are now assigned to the radiotherapy waiting list, a random sample of patients who would begin radiotherapy immediately following their initial consultation was created. Quality of life, in terms of self-reported mood indices, was assessed at five points in time for each patient using the Profile of Mood States. Approximately 25% of the delayed patients chose to leave the waiting list and seek treatment elsewhere. The most striking finding was that patients who began radiotherapy immediately experienced improved quality of life during the course of treatment as per Forester, et al., (1985). In contrast, the patients who spent time (1-8 weeks) on a treatment waiting list experienced a decrease in quality of life over their course of radiotherapy and even more so at a month following the end of treatment

  17. Course Convenience, Perceived Learning, and Course Satisfaction across Course Formats

    Science.gov (United States)

    Sanford, Douglas; Ross, Douglas; Rosenbloom, Alfred; Singer, Daniel

    2017-01-01

    Students' desire for course convenience may lead to their preference for online courses. But in their desire for convenience, are students sacrificing satisfaction or perceived learning? This article investigates the moderating impact of course format on the relationship between convenience and both perceived learning and satisfaction. Moderated…

  18. X-ray radiotherapy

    International Nuclear Information System (INIS)

    Tronc, D.

    1995-01-01

    Full text: The most common form of radio therapy is X-ray therapy, where a beam of photons or their parent electrons break down hydrogen bonds within the body's cells and remove certain DNA information necessary for cell multiplication. This process can eradicate malignant cells leading to complete recovery, to the remission of some cancers, or at least to a degree of pain relief. The radiotherapy instrument is usually an electron linac, and the electrons are used either directly in 'electrotherapy' for some 10% of patients, or the electrons bombard a conversion target creating a broad beam of high energy photons or 'penetration X-rays'. The simplest machine consists of several accelerating sections at around 3 GHz, accelerating electrons to 6 MeV; a cooled tungsten target is used to produce a 4 Gray/min X-ray field which can be collimated into a rectangular shape at the patient position. This tiny linac is mounted inside a rotating isocentric gantry above the patient who must remain perfectly still. Several convergent beams can also be used to increase the delivered dose. More sophisticated accelerators operate at up to 18 MeV to increase penetration depths and decrease skin exposure. Alternatively, electrotherapy can be used with different energies for lower and variable penetration depths - approximately 0.5 cm per MeV. In this way surface tissue may be treated without affecting deeper and more critical anatomical regions. This type of linac, 1 to 2 metres long, is mounted parallel to the patient with a bending magnet to direct the beam to the radiotherapy system, which includes the target, thick movable collimator jaws, a beam field equalizer, dose rate and optical field simulation and energy controls. There are over 2000 acceleratorbased X-ray treatment units worldwide. Western countries have up to two units per million population, whereas in developing countries such as Bangladesh, the density is only one per 100 million. Several

  19. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno

    2014-01-01

    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...... the effect of stereotactic radiotherapy compared to observation, microsurgical resection, any other treatment modality, or a combination of two or more of the above approaches for vestibular schwannoma. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL......; Web of Science; CAB Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the search was 24 July 2014. SELECTION CRITERIA: Randomised controlled trials (RCTs) exploring the efficacy of stereotactic radiotherapy compared with observation alone, microsurgical...

  20. Dosimetry in radiotherapy. V.1

    International Nuclear Information System (INIS)

    1988-01-01

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

  1. Computerised tomography in radiotherapy planning

    International Nuclear Information System (INIS)

    Badcock, P.C.

    1983-01-01

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

  2. Expanding global access to radiotherapy.

    Science.gov (United States)

    Atun, Rifat; Jaffray, David A; Barton, Michael B; Bray, Freddie; Baumann, Michael; Vikram, Bhadrasain; Hanna, Timothy P; Knaul, Felicia M; Lievens, Yolande; Lui, Tracey Y M; Milosevic, Michael; O'Sullivan, Brian; Rodin, Danielle L; Rosenblatt, Eduardo; Van Dyk, Jacob; Yap, Mei Ling; Zubizarreta, Eduardo; Gospodarowicz, Mary

    2015-09-01

    Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even

  3. The radiological protection in the radiotherapy

    International Nuclear Information System (INIS)

    Castaneda M, A.; Gonzalez N, A. G.

    2010-09-01

    The cancer incidence in the world has been increased with the course of the time. Fifty percent of the patients receive radiotherapy, as much in the initial treatment, as in the recurrence cases or palliatives. At the moment is considered that in 1998 there were 2,500 teletherapy machines in operation in the countries in development and for the year 2015 will be necessary 10,000. In Mexico the use of these teletherapy units goes back to the year of 1956, when the effort of the Dr. Noriega Limon was consolidated with the installation of the first teletherapy unit with a cobalt 60 source in the National Medical Center of the IMSS. In the same decade the operation began of the Calibration Secondary Center located in the facilities of the General Hospital of Assistance and Health Secretary where a group of seven physicists began in the metrology techniques. Also the national authority in matter of the ionizing radiations use appears and promulgates the first Law in Nuclear Matter. The application has extended in the country, as well as other techniques that have gone incorporating for the cancer treatment. Such as: the brachytherapy, the stereo ataxia and the ophthalmic applicators. In the current application of the radiotherapy several factors are interrelated that have for objective that the dose to the workers and the public is as low as reasonably it can be achieved and that the patient receives the dose prescribed by the medical treatable in the organ or tissue and in the orderly quantity with the minor damage for the healthy tissues. To reach all this, it is necessary to have equipment s, systems, procedures, personal and standards that improve their quality in a gradual but firm way, also the good communication and comprehension among authorities are fundamental for this noble task. (Author)

  4. Hyperthermia and radiotherapy

    International Nuclear Information System (INIS)

    Lindholm, C.E.

    1992-01-01

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

  5. Definition of stereotactic body radiotherapy. Principles and practice for the treatment of stage I non-small cell lung cancer

    International Nuclear Information System (INIS)

    Guckenberger, M.; Sauer, O.; Andratschke, N.; Alheit, H.; Holy, R.; Moustakis, C.; Nestle, U.

    2014-01-01

    This report from the Stereotactic Radiotherapy Working Group of the German Society of Radiation Oncology (Deutschen Gesellschaft fuer Radioonkologie, DEGRO) provides a definition of stereotactic body radiotherapy (SBRT) that agrees with that of other international societies. SBRT is defined as a method of external beam radiotherapy (EBRT) that accurately delivers a high irradiation dose to an extracranial target in one or few treatment fractions. Detailed recommendations concerning the principles and practice of SBRT for early stage non-small cell lung cancer (NSCLC) are given. These cover the entire treatment process; from patient selection, staging, treatment planning and delivery to follow-up. SBRT was identified as the method of choice when compared to best supportive care (BSC), conventionally fractionated radiotherapy and radiofrequency ablation. Based on current evidence, SBRT appears to be on a par with sublobar resection and is an effective treatment option in operable patients who refuse lobectomy. (orig.) [de

  6. [Thermoplastic mask in radiotherapy: a source of anxiety for the patient?].

    Science.gov (United States)

    Arino, C; Stadelmaier, N; Dupin, C; Kantor, G; Henriques de Figueiredo, B

    2014-12-01

    The thermoplastic mask often used to immobilize patients in radiotherapy can cause varying levels of stress and anxiety. This study aimed at evaluating the anxiety related to the use of radiotherapy masks and the coping strategies adopted by patients. Nineteen patients treated with radiotherapy mask for head and neck cancer, a brain tumour or a lymphoma, were met twice by a psychologist, either after the making of the mask and the first course of radiotherapy, or in the middle and at the end of treatment. Thirty-four semi-structured interviews were treated using a thematic content analysis and 13 patients answered to anxiety (STAI-YB) and coping (WCC) scales. The STAI-YB anxiety scores related to wearing the masks were low during the radiotherapy treatment period, and were confirmed by the remarks of patients recorded during the semi-structured interviews. Most patients had a positive perception of the mask, and considered it as a friend or protection. Twelve out of the 13 patients admitting to anxiety benefited from problem focused coping strategies. Thermoplastic mask-related anxiety is low and possibly lies in the positive representation patients have about the mask. The explanations provided by health professionals on the radiotherapy mask possibly have a very positive effect on this perception. Copyright © 2014 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  7. Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions.

    Science.gov (United States)

    Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Stangier, Ulrich

    2014-07-01

    The evaluation of treatment integrity (therapist adherence and competence) is a necessary condition to ensure the internal and external validity of psychotherapy research. However, the evaluation process is associated with high costs, because therapy sessions must be rated by experienced clinicians. It is debatable whether rating session segments is an adequate alternative to rating entire sessions. Four judges evaluated treatment integrity (i.e., therapist adherence and competence) in 84 randomly selected videotapes of cognitive-behavioral therapy for major depressive disorder, social anxiety disorder, and hypochondriasis (from three different treatment outcome studies). In each case, two judges provided ratings based on entire therapy sessions and two on session segments only (i.e., the middle third of the entire sessions). Interrater reliability of adherence and competence evaluations proved satisfactory for ratings based on segments and the level of reliability did not differ from ratings based on entire sessions. Ratings of treatment integrity that were based on entire sessions and session segments were strongly correlated (r=.62 for adherence and r=.73 for competence). The relationship between treatment integrity and outcome was comparable for ratings based on session segments and those based on entire sessions. However, significant relationships between therapist competence and therapy outcome were only found in the treatment of social anxiety disorder. Ratings based on segments proved to be adequate for the evaluation of treatment integrity. The findings demonstrate that session segments are an adequate and cost-effective alternative to entire sessions for the evaluation of therapist adherence and competence. Copyright © 2014. Published by Elsevier Ltd.

  8. Clinical quality standards for radiotherapy

    Science.gov (United States)

    2012-01-01

    Aim of the study The technological progress that is currently being witnessed in the areas of diagnostic imaging, treatment planning systems and therapeutic equipment has caused radiotherapy to become a high-tech and interdisciplinary domain involving staff of various backgrounds. This allows steady improvement in therapy results, but at the same time makes the diagnostic, imaging and therapeutic processes more complex and complicated, requiring every stage of those processes to be planned, organized, controlled and improved so as to assure high quality of services provided. The aim of this paper is to present clinical quality standards for radiotherapy as developed by the author. Material and methods In order to develop the quality standards, a comparative analysis was performed between European and Polish legal acts adopted in the period of 1980-2006 and the universal industrial ISO 9001:2008 standard, defining requirements for quality management systems, and relevant articles published in 1984-2009 were reviewed, including applicable guidelines and recommendations of American, international, European and Polish bodies, such as the American Association of Physicists in Medicine (AAPM), the European Society for Radiotherapy & Oncology (ESTRO), the International Atomic Energy Agency (IAEA), and the Organisation of European Cancer Institutes (OECI) on quality assurance and management in radiotherapy. Results As a result, 352 quality standards for radiotherapy were developed and categorized into the following three groups: 1 – organizational standards; 2 – physico-technical standards and 3 – clinical standards. Conclusion Proposed clinical quality standards for radiotherapy can be used by any institution using ionizing radiation for medical purposes. However, standards are of value only if they are implemented, reviewed, audited and improved, and if there is a clear mechanism in place to monitor and address failure to meet agreed standards. PMID:23788854

  9. Costing in Radiotherapy. Chapter 18

    International Nuclear Information System (INIS)

    Zubizarreta, E.; Lievens, Y.; Levin, V.C.; Van Der Merwe, D.

    2017-01-01

    The available literature on the cost of radiotherapy yields a large variation in data related to the specifics of the methodology used (the viewpoint of the analysis, time frame, health care system, etc.) and to the cost components and radiotherapy activities included. To overcome this difficulty, the reimbursement paid by medical insurance is commonly used as a proxy for the actual radiotherapy costs. Costs, however, generally bear little or no resemblance to charges, as the latter also include allowances for non-capacity use and profit margins. Accurate resource cost data are therefore more valid and should ideally be used in the context of economic evaluations and public health provisions. In addition to the theoretical problems related to obtaining accurate costs, it is difficult to interpret cost data across country borders because of differences in economics. If this is already the case for high income countries, using these cost data for low and middle income countries (LMICs) is even more problematic. Thus, there clearly is a need for calculations performed from the viewpoint of LMICs to prevent misapprehensions based on conclusions derived from data from their high income counterparts. The IAEA endeavours to assist Member States in accumulating appropriate and sufficient cost data for the initiation or expansion of radiation oncology services. Although relatively simple and easy to understand, the IAEA has found that in many countries where it has been involved in the establishment of new radiotherapy departments, the basic principles of cost calculation for radiotherapy facilities were not followed by the local planners. Radiotherapy needs careful planning, organization and a strong quality assurance (QA) programme in order to deliver safe treatments, due to the complexity of the planning and treatment process and the possibility of systematic errors. Administrators should be aware that the cost of building a radiotherapy facility and buying machines

  10. Who risk profile in radiotherapy

    International Nuclear Information System (INIS)

    Barton, M.; Sharfiq, J.; Nobleet, D.; Lemer, C.

    2009-01-01

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

  11. Nasopharyngeal angiofibroma treated with radiotherapy

    Directory of Open Access Journals (Sweden)

    Janaki M

    2007-01-01

    Full Text Available Nasopharyngeal angiofibroma is a rare, highly vascular, benign, locally aggressive tumor, affecting boys of adolescent age. The aggressiveness and high vascularity makes surgery and even a biopsy difficult in majority of cases. Although surgery is the treatment of choice in early cases, considerable debate exists regarding the treatment of advanced disease with intracranial extension. Radiotherapy provides a good response and also avoids surgery-associated morbidity. We are herewith reporting a case of nasopharyngeal angiofibroma who showed complete hemostasis and improvement in vision to radiotherapy

  12. Metrological issues in molecular radiotherapy

    International Nuclear Information System (INIS)

    D'Arienzo, Marco; Capogni, Marco; Smyth, Vere; Cox, Maurice; Johansson, Lena; Bobin, Christophe

    2014-01-01

    The therapeutic effect from molecular radiation therapy (MRT), on both tumour and normal tissue, is determined by the radiation absorbed dose. Recent research indicates that as a consequence of biological variation across patients the absorbed dose can vary, for the same administered activity, by as much as two orders of magnitude. The international collaborative EURAMET-EMRP project Metrology for molecular radiotherapy (MetroMRT) is addressing this problem. The overall aim of the project is to develop methods of calibrating and verifying clinical dosimetry in MRT. In the present paper an overview of the metrological issues in molecular radiotherapy is provided. (authors)

  13. Retrospective case-control study of surgical treatment of stage IB-IIA cervical carcinomas after neoadjuvant radiotherapy

    International Nuclear Information System (INIS)

    Cigriejiene, V. M.; Kajenas, S.; Balnys, M.; Mikuckaite, L.

    2004-01-01

    To evaluate if preoperative radiotherapy influences course of operation (radical hysterectomy and lymphadenectomy) and postoperative period in series of stage IB-IIA cervical carcinomas. Retrospective comparative study was performed. During the study we analyzed 101 case histories of patients who underwent radical type II hysterectomy with lymphadenectomy in Kaunas University of Medicine Hospital and Kaunas Hospital of Oncology between 1995 and 2002. Mean operation time was shorter, hemoglobin and hematocrit values after operation were better, stay in hospital was longer, demand for narcotic analgetics was bigger, function of ovaries was maintained more rarely (p 0.05). In our study, preoperative radiotherapy did not seem to complicate course of radical hysterectomy. (author)

  14. Sequential hemi-body radiotherapy in advanced multiple myeloma

    International Nuclear Information System (INIS)

    Jaffe, J.P.; Bosch, A.; Raich, P.C.

    1979-01-01

    Eleven patients with advanced multiple myeloma refractory to standard chemotherapy were treated with a regimen of sequential hemi-body radiotherapy consisting of 800 rad midplane in a single dose to each half. 9/10 patients experienced significant relief of skeletal pain and there were 5/11 objective tumor responses with one complete remission. Treatment-related morbidity was significant and consisted primarily of nausea and emesis, bone marrow suppression, and pneumonitis. This therapy is helpful in the management of advanced myeloma, and should be studied earlier in the course of the disease

  15. Radiotherapy and wound healing: principles, management and prospects (review).

    Science.gov (United States)

    Gieringer, Matthias; Gosepath, Jan; Naim, Ramin

    2011-08-01

    Radiation therapy is a major therapeutic modality in the management of cancer patients. Over 60% of these patients receive radiotherapy at some point during their course of treatment and over 90% will develop skin reactions after therapy. Problematic wound healing in radiation-damaged tissue constitutes a major surgical difficulty and despite all efforts, irradiated skin remains a therapeutic challenge. This review provides an overview of the fundamental principles of radiation therapy with regards to the wound healing in normal and irradiated skin. Furthermore, it presents techniques that describe how to prevent and manage skin side effects as well as prospects that may improve cutaneous wound repair in general and in irradiated skin.

  16. High-throughput continuous hydrothermal synthesis of an entire nanoceramic phase diagram.

    Science.gov (United States)

    Weng, Xiaole; Cockcroft, Jeremy K; Hyett, Geoffrey; Vickers, Martin; Boldrin, Paul; Tang, Chiu C; Thompson, Stephen P; Parker, Julia E; Knowles, Jonathan C; Rehman, Ihtesham; Parkin, Ivan; Evans, Julian R G; Darr, Jawwad A

    2009-01-01

    A novel High-Throughput Continuous Hydrothermal (HiTCH) flow synthesis reactor was used to make directly and rapidly a 66-sample nanoparticle library (entire phase diagram) of nanocrystalline Ce(x)Zr(y)Y(z)O(2-delta) in less than 12 h. High resolution PXRD data were obtained for the entire heat-treated library (at 1000 degrees C/1 h) in less than a day using the new robotic beamline I11, located at Diamond Light Source (DLS). This allowed Rietveld-quality powder X-ray diffraction (PXRD) data collection of the entire 66-sample library in <1 day. Consequently, the authors rapidly mapped out phase behavior and sintering behaviors for the entire library. Out of the entire 66-sample heat-treated library, the PXRD data suggests that 43 possess the fluorite structure, of which 30 (out of 36) are ternary compositions. The speed, quantity and quality of data obtained by our new approach, offers an exciting new development which will allow structure-property relationships to be accessed for nanoceramics in much shorter time periods.

  17. Basic study of entire whole-body PET scanners based on the OpenPET geometry

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Eiji, E-mail: rush@nirs.go.j [National Institute of Radiological Sciences, 4-9-1 Inage-ku, Chiba 263-8555 (Japan); Yamaya, Taiga; Nishikido, Fumihiko; Inadama, Naoko; Murayama, Hideo [National Institute of Radiological Sciences, 4-9-1 Inage-ku, Chiba 263-8555 (Japan)

    2010-09-21

    A conventional PET scanner has a 15-25 cm axial field-of-view (FOV) and images a whole body using about six bed positions. An OpenPET geometry can extend the axial FOV with a limited number of detectors. The entire whole-body PET scanner must be able to process a large amount of data effectively. In this work, we study feasibility of the fully 3D entire whole-body PET scanner using the GATE simulation. The OpenPET has 12 block detector rings with the ring diameter of 840 mm and each block detector ring consists of 48 depth-of-interaction (DOI) detectors. The OpenPET has the axial length of 895.95 mm with five parts of 58.95 mm open gaps. The OpenPET has higher single data loss than a conventional PET scanner at grouping circuits. NECR of the OpenPET decreases by single data loss. But single data loss is mitigated by separating the axially arranged detector into two parts. Also, multiple coincidences are found to be important for the entire whole-body PET scanner. The entire whole-body PET scanner with the OpenPET geometry promises to provide a large axial FOV with the open space and to have sufficient performance values. But single data loss at the grouping circuits and multiple coincidences are limited to the peak noise equivalent count rate (NECR) for the entire whole-body PET scanner.

  18. External Beam Radiotherapy for Carcinoma of the Extrahepatic Biliary System

    International Nuclear Information System (INIS)

    Chun, Ha Chung; Lee, Myung Za

    1996-01-01

    Purpose : To evaluate the effectiveness and tolerance of patients of external beam radiotherapy of carcinoma of the extrahepatic biliary system (EHBS) including gall bladder (GB) and extrahepatic bile ducts (EHBD) and to define the role of radiotherapy for these tumors. Methods and Materials : We retrospectively analyzed the records of 43 patients with carcinoma of the EHBS treated with external beam radiotherapy at our institution between April, 1986 and July, 1994. Twenty three patients had GB cancers and remaining 20 patients did EHBD cancers. Of those 23 GB cancers, 2 had Stage II, 12 did Stage III and 9 did Stage IV disease, respectively. Male to female ratio was 11 to 12. Fifteen patients underwent radical surgery with curative intent and 8 patients did biopsy and bypass surgery alone. Postoperatively 16 patients were irradiated with 4500 cGy or higher doses and 4 patients with 3180 to 4140 cGy. Follow up periods ranged from 8 to 34 months. Results : overall median survival time of patients with GB cancer was 11 months. Median survival time for patients with Stage III and IV disease were 14 months and 5 months, respectively. Corresponding two year survival rates were 36%(4/11) and 13%(1/8), respectively. Those who underwent surgery with curative intent showed significantly better survival at 12 months than those who underwent bypass surgery alone(67% vs 13%). None of the patients died of treatment related complications. Median survival time for entire group of 20 EHBD patients was 10 months. Median survivals of 10 Stage III and 7 Stage IV disease were 10 and 8 months, respectively. Two patients who underwent Whipple's procedure had 11 and 14 month survival and those treated with resection and drainage showed median survival of 10 month. Conclusion : Postoperative external beam radiotherapy for carcinoma of the extrahepatic billary system is well tolerated and might improve survival of patients. especially those with respectable lesions with microscopic or

  19. Experience in the radical radiotherapy of cancer in the bilharzial bladder: the use of misonidazole

    International Nuclear Information System (INIS)

    Awwad, H.K.; Akhoush, H.; El-Merzabani, M.; El Badawy, S.; Barsoum, M.; Abd El Baki, H.

    1984-01-01

    The results of application of a protracted split-course radiotherapy regimen in T 3 carcinoma in the bilharzial bladder are presented. A total dose of 70 Gy spread over 61 days was divided into four courses separated by gaps of 1, 2 and 1 week, respectively. Each of the first three sessions comprised eight fractions, 2.5 Gy each, while four such fractions were given during the fourth course. Patients were randomized between radiotherapy alone (32 patients) and radiotherapy plus misonidazole (MIS) (30 patients). The drug was given in a daily oral dose of 0.5 g/m 2 , 3.5 h prior to each radiation treatment. The treatment was well tolerated and MIS did not augment the radiation reaction. Mild or moderate peripheral neuropathy was experienced by 63% of patients of the group. Age and degree of upper obstructive uropathy were the most important determinants of the risk of neuropathy. The 2-year disease-free actuarial survival rates amounted to 58% and 44% in the MIS and radiotherapy alone groups respectively; the difference is not significant. The results were significantly better in case of transitional cell (67%) than squamous cell cancer (29%) but were independent of the histological grade. A strong correlation was found between the magnitude of tumour volume reduction after 40 Gy and the long-term end results. (Auth.)

  20. Experience in the radical radiotherapy of cancer in the bilharzial bladder: the use of misonidazole

    Energy Technology Data Exchange (ETDEWEB)

    Awwad, H.K.; Akhoush, H.; El-Merzabani, M.; El Badawy, S.; Barsoum, M.; Abd El Baki, H. (National Cancer Institute, Cairo (Egypt). Radiotherapy Dept.)

    1984-06-01

    The results of application of a protracted split-course radiotherapy regimen in T/sub 3/ carcinoma in the bilharzial bladder are presented. A total dose of 70 Gy spread over 61 days was divided into four courses separated by gaps of 1, 2 and 1 week, respectively. Each of the first three sessions comprised eight fractions, 2.5 Gy each, while four such fractions were given during the fourth course. Patients were randomized between radiotherapy alone (32 patients) and radiotherapy plus misonidazole (MIS) (30 patients). The drug was given in a daily oral dose of 0.5 g/m/sup 2/, 3.5 h prior to each radiation treatment. The treatment was well tolerated and MIS did not augment the radiation reaction. Mild or moderate peripheral neuropathy was experienced by 63% of patients of the group. Age and degree of upper obstructive uropathy were the most important determinants of the risk of neuropathy. The 2-year disease-free actuarial survival rates amounted to 58% and 44% in the MIS and radiotherapy alone groups respectively; the difference is not significant. The results were significantly better in case of transitional cell (67%) than squamous cell cancer (29%) but were independent of the histological grade. A strong correlation was found between the magnitude of tumour volume reduction after 40 Gy and the long-term end results.

  1. Results of different modes conformal radiotherapy in treatment of cervical cancer

    International Nuclear Information System (INIS)

    Baranovs'ka, L.M.; Yivankova, V.S.; Khrulenko, T.V.; Skomorokhova, T.V.; Gorelyina, G.L.

    2017-01-01

    Development of techniques for cytotoxic treatment applying different modes of conformal radiotherapy, brachytherapy and high-energy (high dose rate - HDR) is one of the promising areas of optimization and efficiency of conservative treatment of patients with regional forms of cervical cancer. At Radiation Oncology Department, National Cancer Institute, 89 patients with stage 2b-3b cervical cancer, aged 29 to 70, underwent examination and combined radiotherapy course. The patients were divided into 2 main groups (56 patients) depending on the mode of developed conformal radiation therapy, and a control group made up by 33 patients (classic, default conformal radiotherapy). Results. Along with external beam radiotherapy, the patients of Group 2 were provided with conformal radiotherapy carried out by means of the linear accelerator of electrons in the mode of enhanced multi fractionation of irradiation dose applied to the small pelvis area (tumor and lymph efflux channels) with the single tumor dose 1.3 Gy twice per day once 4-6 hours up to the total radiation dose of 45 Gy applied to the small pelvis lymph nodes. The patients of Group 1 and the ones of the control group underwent conformal radiotherapy in the mode of standard fractionation applied to the small pelvis area with the single tumor dose of 1.8 Gy up to the total radiation dose of 45 Gy. Conformal radiotherapy was carried out for the patients of Group 1 associated with chemoradiomodifiers (tegafur, cisplatin). At the stage 2 of combined radiotherapy course, all patients underwent HDR brachytherapy via Co60 source in the mode of the single tumor dose of 5 Gy at point A up to the total radiation dose of 35-40 Gy. Therefore, employing accelerated mode of multifractiation in conformal radiotherapy of patients with regional cervical cancer makes it possible to enhance canrcinocidal irradiation doses applied to a tumor, and an interval between radiotherapy fractions provides conditions for initiation of

  2. Regression and local control rates after radiotherapy for jugulotympanic paragangliomas: Systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Hulsteijn, Leonie T. van; Corssmit, Eleonora P.M.; Coremans, Ida E.M.; Smit, Johannes W.A.; Jansen, Jeroen C.; Dekkers, Olaf M.

    2013-01-01

    The primary treatment goal of radiotherapy for paragangliomas of the head and neck region (HNPGLs) is local control of the tumor, i.e. stabilization of tumor volume. Interestingly, regression of tumor volume has also been reported. Up to the present, no meta-analysis has been performed giving an overview of regression rates after radiotherapy in HNPGLs. The main objective was to perform a systematic review and meta-analysis to assess regression of tumor volume in HNPGL-patients after radiotherapy. A second outcome was local tumor control. Design of the study is systematic review and meta-analysis. PubMed, EMBASE, Web of Science, COCHRANE and Academic Search Premier and references of key articles were searched in March 2012 to identify potentially relevant studies. Considering the indolent course of HNPGLs, only studies with ⩾12 months follow-up were eligible. Main outcomes were the pooled proportions of regression and local control after radiotherapy as initial, combined (i.e. directly post-operatively or post-embolization) or salvage treatment (i.e. after initial treatment has failed) for HNPGLs. A meta-analysis was performed with an exact likelihood approach using a logistic regression with a random effect at the study level. Pooled proportions with 95% confidence intervals (CI) were reported. Fifteen studies were included, concerning a total of 283 jugulotympanic HNPGLs in 276 patients. Pooled regression proportions for initial, combined and salvage treatment were respectively 21%, 33% and 52% in radiosurgery studies and 4%, 0% and 64% in external beam radiotherapy studies. Pooled local control proportions for radiotherapy as initial, combined and salvage treatment ranged from 79% to 100%. Radiotherapy for jugulotympanic paragangliomas results in excellent local tumor control and therefore is a valuable treatment for these types of tumors. The effects of radiotherapy on regression of tumor volume remain ambiguous, although the data suggest that regression can

  3. DOSE-ESCALATED EXTERNAL BEAM RADIOTHERAPY DURING HORMONO-RADIOTHERAPY FOR PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    Yu. V. Gumenetskaya

    2016-01-01

    Full Text Available Introduction. The introduction of modern technologies of conformal external beam radiotherapy (EBRT into clinical practice for the treatment of prostate cancer requires proper quality assurance measures as well as a careful analysis of both the efficacy and toxicity data of treatments. The purpose of this study was to inves- tigate tolerance and the immediate efficacy of conformal dose-escalated EBRT during hormono-radiotherapy for prostate cancer. material and methods. The study involved 156 prostate cancer patients treated with EBRT. Among them, 30 patients received a total dose of 70 Gy, and in 126 patients the total dose was esca- lated to 72-76 Gy (median total dose - 74.0 Gy. Fifty-nine patients received intensity modulated radiation therapy. Results. The prescribed course of treatment was completed in all the patients with prostate cancer. Acute radiation-induced bladder reactions (RTOG were observed in 50 (32.1 % patients, of whom 48 (30.8 % experienced grade I reactions, and 2 (1.3 % experienced grade II reactions. Eighteen (11.5 % patients had radiation-induced rectum reactions, not above grade I. The development of grade II dysuric phenomena necessitated treatment interruption only in two patients. Of 9 (5.8 % patients who had late bladder complica- tions (RTOG/EORTC, 8 (5.1 % patients developed grade I complications, and one (0.6 % patient developed grade II complications. Of 11 (7.1 % patients who had rectum complications, 8 (5.1 % patients developed grade I complications, and 3 (1.9 % patients developed grade II complications. No patients experienced the increase in toxicity of treatment during dose escalation up to a total dose exceeding 70 Gy. During the follow-up period, only one patient developed recurrent disease. Conclusion. The results of our study suggest acceptable levels of toxicity following a continuous course of dose-escalated EBRT given in conjunction with hormono-radiotherapy to prostate cancer patients. Further

  4. Chondrosarcoma of bone complicating Ollier's disease: Report of a favourable response to radiotherapy

    International Nuclear Information System (INIS)

    Le, A.; Ball, D.; Pitman, A.; Fox, R.; King, K.

    2003-01-01

    Because chondrosarcoma of bone is traditionally thought to be a radioresistant malignancy, it is usually managed surgically. We report a case of multifocal chondrosarcoma arising in Ollier's disease for which the patient declined surgery. He was given a course of radical radiotherapy that resulted in symptom palliation and a radiologically confirmed remission that not only palliated his symptoms but also enabled him to achieve his goal of pursuing his profession before he died, 16 months later of multifocal sarcomatous transformation and metastatic disease. It is concluded that in patients with inoperable chondrosarcoma, radiotherapy can provide palliative benefit. Copyright (2003) Blackwell Science Pty Ltd

  5. Immediate hematopoietic toxicity of combined chemotherapy-radiotherapy in Hodgkin's disease

    International Nuclear Information System (INIS)

    Peiffert, D.; Bey, P.; Conroy, T.; Lederlin, P.; Witz, F.

    1989-01-01

    The hematologic immediate toxicity during radiotherapy for Hodgkin's disease was studied from a series of 72 patients who received 3 courses or more of chemotherapy before radiotherapy. The toxicity in the group of 36 of them who received total nodal irradiation (TNI) was the most important. Sixteen of the 28 TNI had irradiation interrupted, 12 of them began with inverted Y type. The blood cells count at the beginning of the treatment was crucial; only 16% of the patients had interruption of irradiation when the blood cells count was normal; on the other side, 63% had interruption when the blood cells count was abnormal (P [fr

  6. Factors that affect the accuracy in the precise radiotherapy for abdomen tumors

    International Nuclear Information System (INIS)

    Yang Tieming; Ju Yongjian

    2008-01-01

    The precise radiotherapy has been widely used in the clinics. But there are many factors that affect the accuracy in the course of implementation. Finally the effect of radiotherapy is affected. These factors are reviewed. And the previous research data about the abdomen tumors is summed up. Also how the accuracy was affected by the respiratory movement, positioning, position fixed technology, weight, retraction and motion of the tumor and the situation of surrounding organs will be analyzed. At last, how to avoid these errors in clinics will be discussed. (authors)

  7. Radiotherapy combined with aclarubicin and neocarzinostatin for cancer of the gallbladder

    International Nuclear Information System (INIS)

    Okuyama, Shin-ichi; Mishina, Hitoshi; Funaki, Ken-ichi; Mori, Toshihiko

    1991-01-01

    Cancer of the gallbladder is radioresistant. When it was found inoperable, she was subjected to radiotherapy combined with aclarubicin and neocarzinostatin. Therapeutic effectiveness was confirmed at autopsy as she later succumbed to uterine cervical cancer. Thus, the present radiochemotherapeutic regimen would probably provide a means of overcoming those radioresistant inoperable malignancies. Intravenous administrations of appropriate antibiotics such as azthreonam and reniran may probably be helpful in the prevention and treatment of septic peritonitis possible during the course of reinforced radiotherapy of the abdomen. (author)

  8. Therapeutic Results of Radiotherapy in Rectal Carcinoma -Comparison of Sandwich Technique Radiotherapy with Postoperative Radiotherapy

    International Nuclear Information System (INIS)

    Huh, Gil Cha; Suh, Hyun Suk; Lee, Hyuk Sang; Kim, Re Hwe; Kim, Chul Soo; Kim, Hong Yong; Kim, Sung Rok

    1996-01-01

    Purpose : To evaluate the potential advantage for 'sandwich' technique radiotherapy compared to postoperative radiotherapy in respectable rectal cancer. Between January 1989 and May 1994, 60 patients with respectable rectal cancer were treated at Inje University Seoul and Sanggye Paik Hospital.Fifty one patients were available for analysis : 20 patients were treated with sandwich technique radiotherapy and 31 patients were treated with postoperative radiotherapy. In sandwich technique radiotherapy(RT), patients were treated with preoperative RT 1500 cGy/5fx followed by immediate curative resection. Patients staged as Astler-Coller B2, C were considered for postoperative RT with 2500-4500 cGy. In postoperative RT, total radiation dose of 4500-6120 cGy, 180 cGy daily at 4-6 weeks was delivered. Patients were followed for median period of 25 months. Results : The overall 5-year survival rates for sandwich technique RT group and postoperative RT group were 60% and 71%, respectively(p>0.05). The 5-year disease free survival rates for each group were 63%. There was no difference in local failure rate between two groups(11% versus 7%). Incidence of distant metastasis was 11%(2/20) in the sandwich technique RT group and 20%(6/31) in the postoperative RT group(p>0.05). The frequencies of acute and chronic complications were comparable in both groups. Conclusion : The sandwich technique radiotherapy group shows local recurrence and survival similar to those of postoperative RT alone group but reduced distant metastasis compared to postoperative RT group. But long term follow-up and large number of patients is needed to make an any firm conclusion regarding the value of this sandwich technique RT

  9. Designing Online Education Courses.

    Science.gov (United States)

    Trentin, Guglielmo

    2001-01-01

    Focuses on the main elements that characterize online course design. Topics include design constraints; analysis of learning needs; defining objectives; course prerequisites; content structuring; course flexibility; learning strategies; evaluation criteria; course activities; course structure; communication architecture; and design evaluation.…

  10. Radiotherapy in early stage dupuytren's contracture; Die Radiotherapie des Morbus Dupuytren im Fruehstadium. Langzeitresultate nach einer medianen Nachbeobachtungszeit von 10 Jahren

    Energy Technology Data Exchange (ETDEWEB)

    Adamietz, B.; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Keilholz, L. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Praxis fuer Strahlentherapie, Klinikum Fuerth (Germany); Gruenert, J. [Abt. fuer Plastische und Handchirurgie der Chirurgischen Universitaetsklinik Erlangen-Nuernberg, Erlangen (Germany)

    2001-11-01

    Purpose: In early stage Dupuytren's contracture radiotherapy was applied to prevent disease progression. Long-term results and late toxicity of this treatment were evaluated in a retrospective analysis. Patients and Methods: Between 1982 and 1994, 99 patients (176 hands) received orthovoltage radiotherapy, which consisted of two courses with 5 x 3 Gy (total dose: 30 Gy, daily fractionated; 120 kV, 4 mm Al), separated by a 6 to 8-week pause. The Dupuytren's contracture was staged according to the classification of Tubiana et al. The long-term outcome was analyzed at last follow-up between July and November 1999. The median follow-up was 10 years (range 7-18 years). Late toxicity was assessed using the LENT-SOMA criteria. Results: In Stage N 84% and Stage N/I 67% of cases remained stable. 65% of the cases in Stage I and 83% in Stage II showed progressive nodules and cords. In case of progression we saw no complications after a second radiotherapy or salvage operation. Conclusion: Radiotherapy effectively prevents disease progression for early stage Dupuytren's contracture (Stage N, N/I). Moreover, in case of disease progression despite radiotherapy salvage surgery is still feasible. (orig.) [German] Hintergrund: Im Fruehstadium des Morbus Dupuytren wird die externe Radiotherapie mit dem Ziel eingesetzt, den progressiven Verlauf der Erkrankung zu verhindern. Eine aktuelle Langzeitverlaufskontrolle soll die Ergebnisse und Nebenwirkungen der Radiotherapie darstellen. Patienten und Methode: Wir untersuchten 99 Patienten (176 Haende), welche sich von 1982-1994 einer Radiotherapie an unserer Klinik unterzogen. Jeder Patient erhielt zwei Serien einer Radiotherapie mit jeweils 5 x 3 Gy (Gesamtdosis 30 Gy, 120 kV, 4 mm Al, Bestrahlungspause von 6-8 Wochen nach 15 Gy). Die Beugekontraktur wurde nach Tubiana et al. eingeteilt. Von Juli bis November 1999 erfolgte nach einer medianen Nachbeobachtungszeit von 10 Jahren (7-18 Jahre) eine Kontrolluntersuchung. Die

  11. Construction of a remote radiotherapy planning system

    International Nuclear Information System (INIS)

    Ogawa, Yoshihiro; Nemoto, Kenji; Takahashi, Chiaki; Takai, Yoshihiro; Yamada, Shogo; Seiji, Hiromasa; Sasaki, Kazuya

    2005-01-01

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

  12. Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy

    International Nuclear Information System (INIS)

    Haefner, Matthias F.; Lang, Kristin; Krug, David; Koerber, Stefan A.; Debus, Juergen; Sterzing, Florian; Uhlmann, Lorenz; Kieser, Meinhard

    2015-01-01

    The aim of this study was to evaluate the effectiveness and tolerability of definitive chemo-radiation or radiotherapy alone in patients with esophageal cancer. We retrospectively analyzed the medical records of n = 238 patients with squamous cell carcinoma or adenocarcinoma of the esophagus treated with definitive radiotherapy with or without concomitant chemotherapy at our institution between 2000 and 2012. Patients of all stages were included to represent actual clinical routine. We performed univariate and multivariate analysis to identify prognostic factors for overall survival (OS) and progression-free survival (PFS). Moreover, treatment-related toxicity and patterns of recurrence were assessed. Patients received either chemo-radiation (64%), radiotherapy plus cetuximab (10%) or radiotherapy alone (26%). In 69%, a boost was applied, resulting in a median cumulative dose of 55.8 Gy; the remaining 31% received a median total dose of 50 Gy. For the entire cohort, the median OS and PFS were 15.0 and 11.0 months, respectively. In multivariate analysis, important prognostic factors for OS and PFS were T stage (OS: P = 0.005; PFS: P = 0.006), M stage (OS: P = 0.015; PFS: P = 0.003), concomitant chemotherapy (P < 0.001) and radiation doses of >55 Gy (OS: P = 0.019; PFS: P = 0.022). Recurrences occurred predominantly as local in-field relapse or distant metastases. Toxicity was dominated by nutritional impairment (12.6% with G3/4 dysphagia) and chemo-associated side effects. Definitive chemo-radiation in patients with esophageal cancer results in survival rates comparable with surgical treatment approaches. However, local and distant recurrence considerably restrict prognosis. Further advances in radio-oncological treatment strategies are necessary for improving outcome. (author)

  13. Existence of entire solutions of some non-linear differential-difference equations.

    Science.gov (United States)

    Chen, Minfeng; Gao, Zongsheng; Du, Yunfei

    2017-01-01

    In this paper, we investigate the admissible entire solutions of finite order of the differential-difference equations [Formula: see text] and [Formula: see text], where [Formula: see text], [Formula: see text] are two non-zero polynomials, [Formula: see text] is a polynomial and [Formula: see text]. In addition, we investigate the non-existence of entire solutions of finite order of the differential-difference equation [Formula: see text], where [Formula: see text], [Formula: see text] are two non-constant polynomials, [Formula: see text], m , n are positive integers and satisfy [Formula: see text] except for [Formula: see text], [Formula: see text].

  14. MRI of occult sacral insufficiency fractures following radiotherapy

    International Nuclear Information System (INIS)

    Mammone, J.F.; Schweitzer, M.E.

    1995-01-01

    Following radiation therapy, marrow abnormalities noted on magnetic resonance imaging (MRI) are frequent and may mimic metastases. Specific radiotherapy changes are usually easily identifiable; however, traumatic lesions cause more interpretive difficulties. We assessed the incidence and MRI characteristics of insufficiency fractures in this population. During a 5-year span (1987-1991), 546 patients received pelvic radiotherapy for primary malignancies. MRI was performed in 25 of these patients at least 3 months after treatment. The mean dose in this group was 53 Gy. These MRI scans were retrospectively reviewed for the appearance of the sacrum with particular attention to the presence of insufficiency fractures. This was correlated with clinical course and scintigraphic findings. Presumed insufficiency fractures on MRI paralleled the sacral side of the sacroiliac joint, enhanced with Gd-DTPA, were most prominent or initially seen anteriorly, and had ill-defined margins on all imaging sequences. The incidence of occult sacral insufficiency fractures was at least 20%. Insufficiency fractures of the sacrum in the post-radiotherapy patient are a relatively frequent occurrence which can mimic metastases. Consideration of this phenomenon and knowledge of differential features may avoid overdiagnosis of osseous metastases. (orig.)

  15. Radiation dose in radiotherapy from prescription to delivery

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    Cancer incidence is increasing in developed as well as in developing countries. Cancer may be expected to become a prominent problem and this will result in public pressure for higher priorities on cancer care. In some relatively advanced developing countries radiation therapy is applied in about 50% of all detected cancer cases. Approximately half of these treatments have curative intent. Surgery and radiotherapy applied individually or combined result in the cure of about 40% of all patients. The application of chemotherapy alone has curative effects only on a small percentage of cancer patients. It is encouraging to note that the results achieved by radiation therapy show continuous improvement. This can be traced back to a number of developments: increased knowledge regarding tumour and normal tissue response to radiation, early diagnosis with improved tumour localisation, improved dosimetry and dose planning. The introduction of modern equipment has been crucial in these developments and makes possible a more accurate target delineation, better treatment planning resulting in irradiation of the Planning Target Volume (PTV) with a highly uniform dose and, simultaneously, a reduction in dose to healthy tissues outside the PTV. Experience shows that high quality radiotherapy can only be achieved if its conducted by a skilled team working closely together with good communication between various categories of staff. Therefore, seminars and training courses covering all aspects of radiotherapy and dosimetry are of great importance and should be held regionally or nationally on a regular basis. Refs, figs, tabs.

  16. Radiation dose in radiotherapy from prescription to delivery

    International Nuclear Information System (INIS)

    1996-08-01

    Cancer incidence is increasing in developed as well as in developing countries. Cancer may be expected to become a prominent problem and this will result in public pressure for higher priorities on cancer care. In some relatively advanced developing countries radiation therapy is applied in about 50% of all detected cancer cases. Approximately half of these treatments have curative intent. Surgery and radiotherapy applied individually or combined result in the cure of about 40% of all patients. The application of chemotherapy alone has curative effects only on a small percentage of cancer patients. It is encouraging to note that the results achieved by radiation therapy show continuous improvement. This can be traced back to a number of developments: increased knowledge regarding tumour and normal tissue response to radiation, early diagnosis with improved tumour localisation, improved dosimetry and dose planning. The introduction of modern equipment has been crucial in these developments and makes possible a more accurate target delineation, better treatment planning resulting in irradiation of the Planning Target Volume (PTV) with a highly uniform dose and, simultaneously, a reduction in dose to healthy tissues outside the PTV. Experience shows that high quality radiotherapy can only be achieved if its conducted by a skilled team working closely together with good communication between various categories of staff. Therefore, seminars and training courses covering all aspects of radiotherapy and dosimetry are of great importance and should be held regionally or nationally on a regular basis. Refs, figs, tabs

  17. Quality-of-life assessment during palliative radiotherapy

    International Nuclear Information System (INIS)

    Kearsley, J.H.

    1998-01-01

    A total of 164 consecutive patients with a range of biopsy-proven locally advanced or metastatic cancers were interviewed to assess quality of life using the Rotterdam Symptom Check List (RSCL) at three longitudinal time intervals during a course of palliative radiotherapy. Of the 164 patients, 120 were able to complete all 3 questionnaires. Paired t-tests were used to assess the significance of changes in the patients' mean scores over time. Of the 33 symptoms assessed in the RSCL, changes in the degree of symptomatology were highly consistent with changes expected in clinical practice, as a result of either disease progression or side effects of treatment. It is concluded that the RSCL provides a practical assessment of various symptoms in patients receiving palliative radiotherapy, and that the changes in symptom profile over time are relevant to clinical practice. The RSCL has never been previously used in the assessment of palliative radiotherapy, and the present study validates this instrument. Copyright (1998) Blackwell Science Pty Ltd

  18. Radiotherapy of chondrosarcoma of bone

    International Nuclear Information System (INIS)

    Harwood, A.R.; Krajbich, J.I.; Fornasier, V.L.

    1980-01-01

    A retrospective analysis of 31 cases of chondrosarcoma of bone treated by radiotherapy is presented. In comparison with other large series, our group of patients were found to have been unfavourably selected with respect to the known prognostic factors: histology site, adequacy of operative treatment, and presenting symptoms. Twelve patients with primary chondrosarcoma were radically irradiated; 6 of these 12 have been alive and well without tumor for periods ranging from three and a half to 16 years and 3 of these are alive and well for 15 years or more following radiotherapy. The other 6 patients responded or desease stabilized following radiotherapy for periods ranging from 16 months to eight years. One poorly differentiated tumor was radically irradiated and did not respond. Eleven patients were irradiated palliatively, generally with low doses of irradiation, and only 4 responded transiently for periods ranging from three to 12 months. Seven patients with mesenchymal and dedifferentiated tumors were radically irradiated. Four responded or disease stabilized, and 1 of these patients was alive and well at 3 years; 3 did not respond. Six died with distant metastasis. It is concluded that chondrosarcoma of bone is a radioresponsive tumor and the place of radiotherapy in the treatment of this disease and the reason for its being labelled a radioresistant tumor are discussed. The problems of assessing response of chondrosarcoma to therapy are also discussed. It is suggested that chemotherapy may have a role in the management of mesenchymal and dedifferentiated chondrosarcoma

  19. Genetic Radiotherapy of Prostate Cancer

    Science.gov (United States)

    2004-12-01

    14. Lamberts SWJ, van der Lely A-J, de Herder WW, Hofland 30. Danielson S, Kilstrup M, Barilla K, Jochimsen B, Neuhard LJ. Octreotide. N Engl J Med...Kilstrup M, Barilla K, et al: Characteriza- Cobngcysiedans xpsin,5furytieexposure, and radiotherapy increases cytotoxicity to cholangio- tion of the

  20. Palliative radiotherapy in developing countries

    International Nuclear Information System (INIS)

    Allen, B.J.

    2010-01-01

    Full text: The International Agency for Research on Cancer predicts that cancer incidence in developing countries will increase dramatically in the first two decades of this millennium. Already some 80% of cancer patients in developing countries present with incurable disease. [n many cases pain is a severe problem and palliation is needed to improve quality of life as well as extending survival. This paper will consider the physical and clinical aspects of palliative radiotherapy (PRT), choice of radiation modality, alternative approaches to imaging and therapy and cost-benefit considerations. The potential benefits of a dedicated palliative centre include lower cost and therefore more centres, enabling more patients access to regional palliative care. Whilst there is an obvious need for palliative radiotherapy, simple curative treatments could also be managed. C060 radiotherapy has important advantages in developing countries, because of the higher initial cost of a linear accelerator, as well as the need for reliable power supply and the level of skill required by linac technicians and physicists. The beam characteristics of both C060 units and low energy linacs are compared and both are found to be acceptable for palliation. The concept of telemedicine is also discussed, using mobile phones and internet communication to allow rural clinics to receive support from specialists based in the cities, to send images for remote diagnosis and remote dose planning for radiotherapy. (author)

  1. Radiotherapy in primary cerebral lymphoma

    International Nuclear Information System (INIS)

    Legros, L.; Benezery, K.; Lagrange, J.L.

    1999-01-01

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

  2. Thalassaemic osteoarthropathy treated with radiotherapy

    International Nuclear Information System (INIS)

    Davies, A.N.

    1993-01-01

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

  3. Arterial occlusive disease after radiotherapy

    International Nuclear Information System (INIS)

    Piedbois, P.; Mazeron, J.J.; Le Bourgeois, J.P.; Becquemin, J.P.; Blanc, I.; Lange, F.; Melliere, D.

    1990-01-01

    Fourteen cases of arterial occlusion or severe narrowing following radiotherapy are studied in order to assess the possible etiological role of such therapy in arterial lesion. Surgical results are also discussed in terms of long-term efficacy. The average time of occurrence after radiotherapy was 8 years post-radiotherapy. This series includes 7 supra-aortic trunk stenoses and 7 abdominal aorta trunk stenoses. The doses received in the volumes iradiated ranged from 47 to 70 Gy with standard fractionation. Association of atherosclerotic risk factors was present in 12 patients, but stenoses were usually confined to irradiated areas, and at imes occurred in uncommon sites. Surgical management included 11 by-passes, 2 endarterectomies and one percutaneous transluminal angioplasty. All patients experienced immediate and satisfactory functional improvements. Three patients were re-operated on because of the re-occlusion of the by-pass and graft infection. On the whole, stenoses in previously irradiated areas showed no particular difficulties for surgical treatment. It was concluded that radiotherapy seems to be a definite risk factor for arterial occlusion or narrowing, especially in association in association with atherosclerotic risk factors. (author). 45 refs.; 3 figs.; 2 tabs

  4. External radiotherapy of pituitary adenomas

    International Nuclear Information System (INIS)

    Zierhut, Dietmar; Flentje, Michael; Adolph, Juergen; Erdmann, Johannes; Raue, Friedhelm; Wannenmacher, Michael

    1995-01-01

    Purpose: To evaluate therapeutic outcome and side effects of radiotherapy in pituitary adenomas as sole or combined treatment. Methods and Materials: Retrospective analysis of 138 patients (74 male, 64 female) irradiated for pituitary adenoma from 1972 to 1991 was performed. Mean age was 49.7 years (15-80 years). Regular follow-up (in the mean 6.53 ± 3.99 years) included radiodiagnostical [computed tomography (CT), magnetic resonance imaging (MRI), x-ray], endocrinological, and ophthalmological examinations. Seventy patients suffered from nonfunctional pituitary adenoma, 50 patients suffered from growth-hormone producing adenomas, 11 had prolactinomas, and 7 patients had adrenocorticotropic hormone (ACTH) producing pituitary adenomas. In 99 patients surgery was followed by radiotherapy in case of suspected remaining tumor (invasive growth of the adenoma, assessment of the surgeon, pathologic CT after surgery, persisting hormonal overproduction). Twenty-three patients were treated for recurrence of disease after surgery and 16 patients received radiation as primary treatment. Total doses from 40-60 Gy (mean: 45.5 Gy) were given with single doses of 2 Gy 4 to five times a week. Results: Tumor control was achieved in 131 patients (94.9%). In seven patients, recurrence of disease was diagnosed in the mean 2.9 years (9-98 months) after radiotherapy and salvaged by surgery. A statistically significant dose-response relationship was found in favor of doses ≥ 45 Gy. Ninety percent of the patients with hormonally active pituitary adenomas had a benefit from radiotherapy in means of complete termination (38%) or at least reduction (52%) of hormonal overproduction. Partial or complete hypopituitarism after radiotherapy developed, depending on hormonal axis, in 12 (prolactin) to 27% (follicle-stimulating hormone FSH) of patients who had not already had hypopituitarism prior to radiation. Two out of 138 patients suffered reduction of visual acuity, which was, in part

  5. Temporal lobe injury after re-irradiation of locally recurrent nasopharyngeal carcinoma using intensity modulated radiotherapy: clinical characteristics and prognostic factors.

    Science.gov (United States)

    Liu, Shuai; Lu, Taixiang; Zhao, Chong; Shen, Jingxian; Tian, Yunming; Guan, Ying; Zeng, Lei; Xiao, Weiwei; Huang, Shaomin; Han, Fei

    2014-09-01

    Temporal lobe injury (TLI) is a debilitating complication after radiotherapy for nasopharyngeal carcinoma (NPC), especially in patients who suffer treatment relapses and receive re-irradiation. We explored the clinical characteristics and prognostic factors of TLI in locally recurrent NPC (rNPC) patients after re-irradiation using intensity modulated radiotherapy (IMRT). A total of 454 temporal lobes (TLs) from 227 locally rNPC patients were reviewed. The clinical characteristics of TLI were analyzed. In the two radiotherapy courses, the equivalent dose in 2 Gy per fraction (EQD2) for the TLs was recalculated to facilitate comparison of the individual data. The median follow-up time was 31 (range, 3-127) months. After re-irradiation using IMRT, 31.3 % (71/227) of patients developed TLI. The median latency of TLI was 15 (range, 4-100) months. Univariate and multivariate analysis showed that the interval time (IT) between the two courses of radiotherapy and the summation of the maximum doses of the two radiotherapy courses (EQD2 - ∑max) were independent factors influencing TLI. The 5-year incidence of TLI for an IT ≤26 or >26 months was 35.9 and 53.7 % respectively (p = 0.024). The median maximum doses delivered to the injured TLs were significantly higher than was the case for the uninjured TLs after two courses of radiotherapy (135.3 and 129.8 Gy, respectively: p 2-year interval was found to be relatively safe.

  6. Setup Variations in Radiotherapy of Esophageal Cancer: Evaluation by Daily Megavoltage Computed Tomographic Localization

    International Nuclear Information System (INIS)

    Chen, Y.-J.; Han Chunhui; Liu An; Schultheiss, Timothy E.; Kernstine, Kemp H.; Shibata, Stephen; Vora, Nayana L.; Pezner, Richard D.; Wong, Jeffrey Y.C.

    2007-01-01

    Purpose: To use pretreatment megavoltage computed tomography (MVCT) scans to evaluate setup variations in anterior-posterior (AP), lateral, and superior-inferior (SI) directions and rotational variations, including pitch, roll, and yaw, for esophageal cancer patients treated with helical tomotherapy. Methods and Materials: Ten patients with locally advanced esophageal cancer treated by combined chemoradiation using helical tomotherapy were selected. After patients were positioned using their skin tattoos/marks, MVCT scans were performed before every treatment and automatically registered to planning kilovoltage CT scans according to bony landmarks. Image registration data were used to adjust patient setups before treatment. A total of 250 MVCT scans were analyzed. Correlations between setup variations and body habitus, including height, weight, relative weight change, body surface area, and patient age, were evaluated. Results: The standard deviations for systematic setup corrections in AP, lateral, and SI directions and pitch, roll, and yaw rotations were 1.5, 3.7, and 4.8 mm and 0.5 deg., 1.2 deg., and 0.8 deg., respectively. The appropriate averages of random setup variations in AP, lateral, and SI directions and pitch, roll, and yaw rotations were 2.9, 5.2, and 4.4 mm, and 1.0 deg., 1.2 deg., and 1.1 deg., respectively. Setup variations were stable throughout the entire course of radiotherapy in all three translational and three rotational displacements, with little change in magnitude. No significant correlations were found between setup variations and body habitus variables. Conclusions: Daily MVCT scans before each treatment can effectively detect setup errors and thereby reduce planning target volume (PTV) margins. This will reduce radiation dose to critical organs and may translate into lower treatment-related toxicities

  7. Daily variations in delivered doses in patients treated with radiotherapy for localized prostate cancer

    International Nuclear Information System (INIS)

    Kupelian, Patrick A.; Langen, Katja M.; Zeidan, Omar A.; Meeks, Sanford L.; Willoughby, Twyla R.; Wagner, Thomas H.; Jeswani, Sam; Ruchala, Kenneth J.; Haimerl, Jason; Olivera, Gustavo H.

    2006-01-01

    Purpose: The aim of this work was to study the variations in delivered doses to the prostate, rectum, and bladder during a full course of image-guided external beam radiotherapy. Methods and Materials: Ten patients with localized prostate cancer were treated with helical tomotherapy to 78 Gy at 2 Gy per fraction in 39 fractions. Daily target localization was performed using intraprostatic fiducials and daily megavoltage pelvic computed tomography (CT) scans, resulting in a total of 390 CT scans. The prostate, rectum, and bladder were manually contoured on each CT by a single physician. Daily dosimetric analysis was performed with dose recalculation. The study endpoints were D95 (dose to 95% of the prostate), rV2 (absolute rectal volume receiving 2 Gy), and bV2 (absolute bladder volume receiving 2 Gy). Results: For the entire cohort, the average D95 (±SD) was 2.02 ± 0.04 Gy (range, 1.79-2.20 Gy). The average rV2 (±SD) was 7.0 ± 8.1 cc (range, 0.1-67.3 cc). The average bV2 (±SD) was 8.7 ± 6.8 cc (range, 0.3-36.8 cc). Unlike doses for the prostate, there was significant daily variation in rectal and bladder doses, mostly because of variations in volume and shape of these organs. Conclusion: Large variations in delivered doses to the rectum and bladder can be documented with daily megavoltage CT scans. Image guidance for the targeting of the prostate, even with intraprostatic fiducials, does not take into account the variation in actual rectal and bladder doses. The clinical impact of techniques that take into account such dosimetric parameters in daily patient set-ups should be investigated

  8. Stereotactic intracranial radiotherapy: Dose prescription

    International Nuclear Information System (INIS)

    Schlienger, M.; Lartigau, E.; Nataf, F.; Mornex, F.; Latorzeff, I.; Lisbona, A.; Mahe, M.

    2012-01-01

    The aim of this article was the study of the successive steps permitting the prescription of dose in stereotactic intracranial radiotherapy, which includes radiosurgery and fractionated stereotactic radiotherapy. The successive steps studied are: the choice of stereotactic intracranial radiotherapy among the therapeutic options, based on curative or palliative treatment intent, then the selection of lesions according to size/volume, pathological type and their number permitting the choice between radiosurgery or fractionated stereotactic radiotherapy, which have the same methodological basis. Clinical experience has determined the level of dose to treat the lesions and limit the irradiation of healthy adjacent tissues and organs at risk structures. The last step is the optimization of the different parameters to obtain a safe compromise between the lesion dose and healthy adjacent structures. Study of dose-volume histograms, coverage indices and 3D imaging permit the optimization of irradiation. For lesions close to or included in a critical area, the prescribed dose is planned using the inverse planing method. Implementation of the successively described steps is mandatory to insure the prescription of an optimized dose. The whole procedure is based on the delineation of the lesion and adjacent healthy tissues. There are sometimes difficulties to assess the delineation and the volume of the target, however improvement of local control rates and reduction of secondary effects are the proof that the totality of the successive procedures are progressively improved. In practice, stereotactic intracranial radiotherapy is a continually improved treatment method, which constantly benefits from improvements in the choice of indications, imaging, techniques of irradiation, planing/optimization methodology and irradiation technique and from data collected from prolonged follow-up. (authors)

  9. Effect of radiotherapy on immunity function of cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Li Xinli; Zhu Shentao; Xu Jiuhong

    2003-01-01

    Objective: In order to observe the effect of radiotherapy on immunity function of cancer patients receiving radiotherapy. Methods: Cellular immunity is determined by APAAP; Humoral immunity is determined by transmission method. Results: The items of cellular immunity is lower than the control after radiotherapy. These items decrease continually. The difference between before and after radiotherapy has statistic significance. Of all Humoral immunity items, IgA, IgM decreased after radiotherapy and the difference has statistic significance. Conclusions: Radiotherapy can damage patients' immunity function

  10. 77 FR 61650 - The Entire United States and U.S. Territories

    Science.gov (United States)

    2012-10-10

    ... given that as a result of Public Law 106-50, the Veterans entrepreneurship and Small Business... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13332 Disaster ZZ-00008] The Entire United States and U.S. Territories AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is...

  11. Homomorphisms and functional calculus on algebras on entire functions on Banach spaces

    Directory of Open Access Journals (Sweden)

    H. M. Pryimak

    2015-07-01

    Full Text Available The paper is devoted to study homomorphisms of algebras of entire functionson Banach spaces to a commutative Banach algebra. In particular, it is proposed amethod to construct homomorphisms vanishing on homogeneouspolynomials of degree less or equal that a fixed number $n.$

  12. ON ENTIRE SOLUTIONS OF TWO TYPES OF SYSTEMS OF COMPLEX DIFFERENTIAL-DIFFERENCE EQUATIONS

    Institute of Scientific and Technical Information of China (English)

    Lingyun GAO

    2017-01-01

    In this paper,we will mainly investigate entire solutions with finite order of two types of systems of differential-difference equations,and obtain some interesting results.It extends some results concerning complex differential (difference) equations to the systems of differential-difference equations.

  13. T1rho mapping of entire femoral cartilage using depth- and angle-dependent analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nozaki, Taiki; Kaneko, Yasuhito; Yu, Hon J.; Yoshioka, Hiroshi [University of California Irvine, Department of Radiological Sciences, Orange, CA (United States); Kaneshiro, Kayleigh [University of California Irvine, School of Medicine, Irvine, CA (United States); Schwarzkopf, Ran [University of California Irvine, Department of Orthopedic Surgery, Irvine, CA (United States); Hara, Takeshi [Gifu University Graduate School of Medicine, Department of Intelligent Image Information, Division of Regeneration and Advanced Medical Sciences, Gifu (Japan)

    2016-06-15

    To create and evaluate normalized T1rho profiles of the entire femoral cartilage in healthy subjects with three-dimensional (3D) angle- and depth-dependent analysis. T1rho images of the knee from 20 healthy volunteers were acquired on a 3.0-T unit. Cartilage segmentation of the entire femur was performed slice-by-slice by a board-certified radiologist. The T1rho depth/angle-dependent profile was investigated by partitioning cartilage into superficial and deep layers, and angular segmentation in increments of 4 over the length of segmented cartilage. Average T1rho values were calculated with normalized T1rho profiles. Surface maps and 3D graphs were created. T1rho profiles have regional and depth variations, with no significant magic angle effect. Average T1rho values in the superficial layer of the femoral cartilage were higher than those in the deep layer in most locations (p < 0.05). T1rho values in the deep layer of the weight-bearing portions of the medial and lateral condyles were lower than those of the corresponding non-weight-bearing portions (p < 0.05). Surface maps and 3D graphs demonstrated that cartilage T1rho values were not homogeneous over the entire femur. Normalized T1rho profiles from the entire femoral cartilage will be useful for diagnosing local or early T1rho abnormalities and osteoarthritis in clinical applications. (orig.)

  14. Characterisations of Partition of Unities Generated by Entire Functions in Cd

    DEFF Research Database (Denmark)

    Christensen, Ole; Kim, Hong Oh; Kim, Rae Young

    2017-01-01

    Collections of functions forming a partition of unity play an important role in analysis. In this paper we characterise for any N∈N the entire functions P for which the partition of unity condition ∑n∈ZdP(x+n)χ[0,N]d(x+n)=1 holds for all x∈Rd. The general characterisation leads to various easy wa...

  15. On entire functions restricted to intervals, partition of unities, and dual Gabor frames

    DEFF Research Database (Denmark)

    Christensen, Ole; Kim, Hong Oh; Kim, Rae Young

    2014-01-01

    Partition of unities appears in many places in analysis. Typically it is generated by compactly supported functions with a certain regularity. In this paper we consider partition of unities obtained as integer-translates of entire functions restricted to finite intervals. We characterize the enti...

  16. T1rho mapping of entire femoral cartilage using depth- and angle-dependent analysis

    International Nuclear Information System (INIS)

    Nozaki, Taiki; Kaneko, Yasuhito; Yu, Hon J.; Yoshioka, Hiroshi; Kaneshiro, Kayleigh; Schwarzkopf, Ran; Hara, Takeshi

    2016-01-01

    To create and evaluate normalized T1rho profiles of the entire femoral cartilage in healthy subjects with three-dimensional (3D) angle- and depth-dependent analysis. T1rho images of the knee from 20 healthy volunteers were acquired on a 3.0-T unit. Cartilage segmentation of the entire femur was performed slice-by-slice by a board-certified radiologist. The T1rho depth/angle-dependent profile was investigated by partitioning cartilage into superficial and deep layers, and angular segmentation in increments of 4 over the length of segmented cartilage. Average T1rho values were calculated with normalized T1rho profiles. Surface maps and 3D graphs were created. T1rho profiles have regional and depth variations, with no significant magic angle effect. Average T1rho values in the superficial layer of the femoral cartilage were higher than those in the deep layer in most locations (p < 0.05). T1rho values in the deep layer of the weight-bearing portions of the medial and lateral condyles were lower than those of the corresponding non-weight-bearing portions (p < 0.05). Surface maps and 3D graphs demonstrated that cartilage T1rho values were not homogeneous over the entire femur. Normalized T1rho profiles from the entire femoral cartilage will be useful for diagnosing local or early T1rho abnormalities and osteoarthritis in clinical applications. (orig.)

  17. Weight and season affects androstenone and skatole occurrence in entire male pigs in organic pig production

    DEFF Research Database (Denmark)

    Thomsen, Rikke; Edwards, Sandra; Jensen, Bent Borg

    2015-01-01

    was found between seasons. The study concludes that decreasing live weight at slaughter could be an applicable management tool to reduce risk of boar taint and the level of tainted carcasses for a future production of entire male pigs within the organic pig production system, although further studies...... are needed as great variation in boar taint was found also for low weight animals...

  18. Estimation of body tissue gain of entire and castrated male pigs at ...

    African Journals Online (AJOL)

    Rates of tissue gain and body composition of 18 entire (E) and 18 castrated (C) male pigs, fed at one of two levels of feeding (high (H) or low (L)), were investigated in a 2x2 factorial experiment. Calorimetric, energy and nitrogen balances were carried out on each animal at 30, 60 and 90 kg live weight. The animals were ...

  19. Chloride and sodium uptake potential over an entire rotation of Populus irrigated with landfill leachate

    Science.gov (United States)

    Jill A. Zalesny; Ronald S., Jr. Zalesny

    2009-01-01

    There is a need for information about the response of Populus genotypes to repeated application of high-salinity water and nutrient sources throughout an entire rotation. We have combined establishment biomass and uptake data with mid- and full-rotation growth data to project potential chloride (Cl−) and sodium (Na...

  20. Extension of Inverses of Entire Functions of Genus 1 and 2 to the Upper Half Plane

    DEFF Research Database (Denmark)

    Pedersen, Henrik Laurberg

    2013-01-01

    Any entire function of genus 1 which is positive on the positive real axis and which has only negative zeros decreases on some unbounded interval of the positive axis. The inverse of its reciprocal is shown to have an extension from that interval to a Pick-function in the upper half plane...

  1. Adaptive treatment-length optimization in spatiobiologically integrated radiotherapy

    Science.gov (United States)

    Ajdari, Ali; Ghate, Archis; Kim, Minsun

    2018-04-01

    Recent theoretical research on spatiobiologically integrated radiotherapy has focused on optimization models that adapt fluence-maps to the evolution of tumor state, for example, cell densities, as observed in quantitative functional images acquired over the treatment course. We propose an optimization model that adapts the length of the treatment course as well as the fluence-maps to such imaged tumor state. Specifically, after observing the tumor cell densities at the beginning of a session, the treatment planner solves a group of convex optimization problems to determine an optimal number of remaining treatment sessions, and a corresponding optimal fluence-map for each of these sessions. The objective is to minimize the total number of tumor cells remaining (TNTCR) at the end of this proposed treatment course, subject to upper limits on the biologically effective dose delivered to the organs-at-risk. This fluence-map is administered in future sessions until the next image is available, and then the number of sessions and the fluence-map are re-optimized based on the latest cell density information. We demonstrate via computer simulations on five head-and-neck test cases that such adaptive treatment-length and fluence-map planning reduces the TNTCR and increases the biological effect on the tumor while employing shorter treatment courses, as compared to only adapting fluence-maps and using a pre-determined treatment course length based on one-size-fits-all guidelines.

  2. Taking pain into care during radiotherapy: evaluation and return on experience; Prise en charge de la douleur en cours de radiotherapie: evaluation et retour d'experience

    Energy Technology Data Exchange (ETDEWEB)

    Marque, A.; Thureau, S.; Mezzani, S.; Nkhali, L.; Schulz, A.L.; Bulard, D.; Sebag, D.; Le Tallec, P.; Charrier, E.; Dubray, B. [CRLCC Henri-Becquerel, Rouen (France)

    2011-10-15

    The authors report the assessment of the proportion of patients suffering from pain in a radiotherapy department, and discuss the modalities to take them into care. The study is based on questionnaires given to more than 400 patients and addressing pain occurrence, intensity and treatment. It appears that pain has been under-evaluated and insufficiently treated. A training course has been implemented for physicians and operators for pain assessment, and painkiller or analgesic medicines have been made available. Short communication

  3. A phase I trial of pre-operative radiotherapy for prostate cancer: Clinical and translational studies

    International Nuclear Information System (INIS)

    Supiot, Stephane; Shubbar, Shubber; Fleshner, Neil; Warde, Padraig; Hersey, Karen; Wallace, Kris; Cole, Heather; Sweet, Joan; Tsihlias, John; Jewett, Michael A.S.; Klotz, Laurence; Bristow, Robert G.

    2008-01-01

    Background and purpose: Selected patients undergoing radical prostatectomy for localized prostate cancer can be at high-risk for pT3 disease and require subsequent radiotherapy. In a phase I trial, we investigated the feasibility of pre-operative radiotherapy for this patient subset. Materials and methods: Eligibility criteria were: T1/T2N0M0 tumors plus (i) Gleason ≥ 7, PSA > 10 ng/ml and 15 ng/ml and less WAF associated with reduced cell proliferation. Conclusion: Intra-operative morbidity is low following short-course, pre-operative radiotherapy. A phase II trial is planned to fully document biochemical response with this combined-modality approach

  4. Detection of macroglobulins in mammary tissue prior to and following radiotherapy

    International Nuclear Information System (INIS)

    Kozlov, D.V.

    1996-01-01

    Specimens of breast cancer tissue obtained during operation were immunohistochemically examined before and after radiotherapy and compared with fibroadenoma and intact mammary gland. Statistically reliable shifts on the microglobulin protein levels were revealed in fibroadenoma: the content of alpha 2 -microglobulin (AMG) and pregnancy-associated alpha 2 -glycoprotein (PAG) was increased in the parenchyma, whereas in the stroma the level of this latter protein was decreased. In breast cancer the increase of PAG level in the parenchyma and decrease of AMG biosynthesis were still more expressed. Radiotherapy inverted the time course of these protein in cancer parenchyma and stroma. Remembering about the important role of macroglobulins in tumor growth, measurements thereof may be used as additional tests in the diagnosis of breast tumors and in assessment of radiotherapy efficacy [ru

  5. Hypnotherapy in radiotherapy patients: A randomized trial

    International Nuclear Information System (INIS)

    Stalpers, Lukas J.A.; Costa, Hanna C. da; Merbis, Merijn A.E.; Fortuin, Andries A.; Muller, Martin J.; Dam, Frits van

    2005-01-01

    Purpose: To determine whether hypnotherapy reduces anxiety and improves the quality of life in cancer patients undergoing curative radiotherapy (RT). Methods and materials: After providing written informed consent, 69 patients were randomized between standard curative RT alone (36 controls) and RT plus hypnotherapy (33 patients). Patients in the hypnotherapy group received hypnotherapy at the intake, before RT simulation, before the first RT session, and halfway between the RT course. Anxiety was evaluated by the State-Trait Anxiety Inventory DY-1 form at six points. Quality of life was measured by the Rand Medical Outcomes Study 36-item Health Survey (SF-36) at five points. Additionally, patients answered a questionnaire to evaluate their experience and the possible benefits of this research project. Results: No statistically significant difference was found in anxiety or quality of life between the hypnotherapy and control groups. However, significantly more patients in the hypnotherapy group indicated an improvement in mental (p < 0.05) and overall (p < 0.05) well-being. Conclusion: Hypnotherapy did not reduce anxiety or improve the quality of life in cancer patients undergoing curative RT. The absence of statistically significant differences between the two groups contrasts with the hypnotherapy patients' own sense of mental and overall well-being, which was significantly greater after hypnotherapy. It cannot be excluded that the extra attention by the hypnotherapist was responsible for this beneficial effect in the hypnotherapy group. An attention-only control group would be necessary to control for this effect

  6. Results of radiotherapy of Duplay's syndrome

    International Nuclear Information System (INIS)

    Kreisfeldt, E.

    1979-01-01

    The observed patient group comprised 185 persons who underwent treatment during 1970 and 1976. The sexual distribution within this group is normal. The age peak ranges between 50 and 60 years. In a late inquiry 31.9% of the patients can indicate the freedom from pain. 29.2% tell about a good, 18.4% about moderate success. In about one half of the treated persons roentgenologically visible calcareous deposits were detected. In both groups their treatment led to an equally good result. However, an accumulation of diseases with calcifications is found in patients who were younger than 50 years. In acute cases without previous treatment the achieved result was better than in those who had been treated already elsewhere. Acute cases respond considerably better to the treatment than the chronicaal ones. For the acute cases also a notably inferior recidivity rate was found. In 38% of all cases recidivation was observed. For the acute cases this rate is only 16%. Although investigations exist which do not hint at an autonomous course of this disease, a therapeutic treatment is not considered as superfluous. Considering the known risks due to ionizing irradiation, radiotherapy of periarticular fibrositis is recommended particularly for patients older than 40 years. (orig./MG) [de

  7. Online Adaptive Replanning Method for Prostate Radiotherapy

    International Nuclear Information System (INIS)

    Ahunbay, Ergun E.; Peng Cheng; Holmes, Shannon; Godley, Andrew; Lawton, Colleen; Li, X. Allen

    2010-01-01

    Purpose: To report the application of an adaptive replanning technique for prostate cancer radiotherapy (RT), consisting of two steps: (1) segment aperture morphing (SAM), and (2) segment weight optimization (SWO), to account for interfraction variations. Methods and Materials: The new 'SAM+SWO' scheme was retroactively applied to the daily CT images acquired for 10 prostate cancer patients on a linear accelerator and CT-on-Rails combination during the course of RT. Doses generated by the SAM+SWO scheme based on the daily CT images were compared with doses generated after patient repositioning using the current planning target volume (PTV) margin (5 mm, 3 mm toward rectum) and a reduced margin (2 mm), along with full reoptimization scans based on the daily CT images to evaluate dosimetry benefits. Results: For all cases studied, the online replanning method provided significantly better target coverage when compared with repositioning with reduced PTV (13% increase in minimum prostate dose) and improved organ sparing when compared with repositioning with regular PTV (13% decrease in the generalized equivalent uniform dose of rectum). The time required to complete the online replanning process was 6 ± 2 minutes. Conclusion: The proposed online replanning method can be used to account for interfraction variations for prostate RT with a practically acceptable time frame (5-10 min) and with significant dosimetric benefits. On the basis of this study, the developed online replanning scheme is being implemented in the clinic for prostate RT.

  8. Peculiarities of radiotherapy in the elderly

    International Nuclear Information System (INIS)

    Chen, Michael Jenwei; Nadalin, Wladimir

    2010-01-01

    It is known that the aging of the world population during the twentieth century and the beginning of this new century is a first-order challenge for nations, especially in the socio-economic field. An important aspect of the aging of global population is that, for older age groups, the prevalence of degenerative diseases is also higher, including malignancies. On the other hand, among the population of patients with cancer, half of these patients will receive radiation therapy at some point in their illness and their individual characteristics can somehow influence the prognosis, the indication and daily doses of treatment prescriptions. In this context, the health assistance for the elderly patient with cancer should be seen as an important challenge, mainly due to two factors: an increased demand for treatments, in quantitative terms, and physiological characteristics unique to this population, which can influence the therapeutic decision-making. This review proposes a discussion of some relevant aspects of both the physiology of the elderly, which may influence the course of radiation therapy, as well as of some technical advances in radiotherapy, which can in turn benefit these patients by offering, for example, lower toxicity, greater effectiveness and speed. (author)

  9. Entirely S-protected chitosan: A promising mucoadhesive excipient for metronidazole vaginal tablets.

    Science.gov (United States)

    Lupo, Noemi; Fodor, Benjamin; Muhammad, Ijaz; Yaqoob, Muhammad; Matuszczak, Barbara; Bernkop-Schnürch, Andreas

    2017-12-01

    Synthesis and evaluation of an entirely S-protected chitosan as mucoadhesive excipient for vaginal drug delivery. N-acetyl-cysteine was linked to 6-mercaptonicotinamide via disulphide exchange reaction. The obtained ligand, NAC-6-MNA, was subsequently attached to chitosan by carbodiimide mediated amide bond formation in two concentrations. The synthesized S-protected chitosan was chemically characterized and mucoadhesive properties and stability against oxidation were investigated. Moreover, metronidazole tablets comprising the S-protected chitosan were evaluated regarding water uptake capacity, disintegration behaviour, residence time on vaginal mucosa, release of the encapsulated drug and antimicrobial activity. S-protected chitosan displayed 160±19 (CS-MNA-160) and 320±38 (CS-MNA-320)µmol of ligand per gram of polymer. At pH 4.2, CS-MNA-160 and CS-MNA-320 showed 5.2-fold and 6.2-fold increase in mucus viscosity in comparison to unmodified chitosan (One-way ANOVA, pchitosan remained stable against oxidation in presence of 0.5%v/v hydrogen peroxide. Metronidazole tablets consisting in S-protected chitosan showed prolonged residence time on vaginal mucosa and improved water uptake capacity and disintegration time in comparison to tablets consisting of unmodified chitosan. Moreover, CS-MNA-320 metronidazole tablets displayed prolonged drug release and antimicrobial activity. On the basis of the achieved results, entirely S-protected chitosan represents a promising excipient for the development of metronidazole vaginal tablets. S-protected thiomers are polymers modified with thiol groups protected by aromatic ligands and characterized by strong mucoadhesive properties and high stability against oxidation. Up to date, the entirely S-protection of thiol groups was achieved via the synthesis of the ligand 2-((2-amino-2-carboxyethyl)disulfanyl)nicotinic acid) which can be directly bound to the backbone of polymers bearing carboxylic moieties as pectin. However, this

  10. A decade of investment in radiotherapy in New South Wales: why does the gap between optimal and actual persist?

    International Nuclear Information System (INIS)

    Barton, Michael B.; Delaney, Geoff P.

    2011-01-01

    There is a gap between optimal and actual radiotherapy utilization (RTU) rates in New South Wales (NSW). It is uncertain if this is because these investments have been insufficient to meet demand, or demand has been over-estimated. In this study we assess trends in infrastructure, staffing and productivity in NSW over the last 10 years. The NSW Radiotherapy Management Information System reports annually on activity including new patients, new courses, retreatments, attendances, radiotherapy fields and Area Health Service (AHS) of residence. Data are obtained from interstate radiotherapy departments that treat NSW residents. A census of equipment and staffing is reported. RTU was defined as the number of new cases in a year treated by radiotherapy divided by the number of new cases of cancer in that year. From 1999 to 2008, 115 941 NSW residents received at least one course of radiotherapy. During this time period there were 325 965 new diagnoses of cancer reported by the Central Cancer Registry. RTU was 38% in 1999 and in 2008. The number of linear accelerators increased from 34 to 42 between 1999 and 2008 but the number of accelerators per 1000 new cases of cancer remained static at 1.2. For AHSs, there was a significant relationship between more linear accelerators per 1000 patients and higher RTU (P = 0.0023). Radiotherapy utilization in NSW has remained at 38% for the period 1999 to 2008 because investment in new facilities only just kept pace with the increase in the number of new cases of cancer with an indication for radiotherapy. Some regional AHS have shown significant increases in RTU with new facilities.

  11. 4D planning over the full course of fractionation: assessment of the benefit of tumor trailing

    Science.gov (United States)

    McQuaid, D.; Bortfeld, T.

    2011-11-01

    Tumor trailing techniques have been proposed as a method of reducing the problem of intrafraction motion in radiotherapy. However the dosimetric assessment of trailing strategies is complicated by the requirement to study dose deposition over a full fraction delivery. Common 4D planning strategies allowing assessment of dosimetric motion effects study a single cycle acquired with 4DCT. In this paper, a methodology to assess dose deposited over an entire treatment course is advanced and used to assess the potential benefit of tumor trailing strategies for lung cancer patients. Two digital phantoms mimicking patient anatomy were each programmed to follow the tumor respiratory trajectory observed from 33 lung cancer patients. The two phantoms were designed to represent the cases of a small (volume = 13.6 cm3) and large (volume = 181.7 cm3) lung lesion. Motion margins required to obtain CTV coverage by 95% of the prescription dose to 90% of the available cases were computed for a standard treatment strategy and a trailing treatment strategy. The trailing strategy facilitated a margin reduction of over 30% relative to the conventional delivery. When the dose was computed across the entire delivery for the 33 cases, the trailing strategy was found to significantly reduce the underdosage to the outlier cases and the reduced trailing margin facilitated a 15% (small lesion) and 4% (large lesion) reduction for the mean lung dose and 7% (small lesion) and 10% (large lesion) for the mean esophagus dose. Finally, for comparison an ideal continuous tracking strategy was assessed and found to further reduce the mean lung and esophagus dose. However, this improvement comes at the price of increased delivery complexity and increased reliance on tumor localization accuracy.

  12. 4D planning over the full course of fractionation: assessment of the benefit of tumor trailing

    International Nuclear Information System (INIS)

    McQuaid, D; Bortfeld, T

    2011-01-01

    Tumor trailing techniques have been proposed as a method of reducing the problem of intrafraction motion in radiotherapy. However the dosimetric assessment of trailing strategies is complicated by the requirement to study dose deposition over a full fraction delivery. Common 4D planning strategies allowing assessment of dosimetric motion effects study a single cycle acquired with 4DCT. In this paper, a methodology to assess dose deposited over an entire treatment course is advanced and used to assess the potential benefit of tumor trailing strategies for lung cancer patients. Two digital phantoms mimicking patient anatomy were each programmed to follow the tumor respiratory trajectory observed from 33 lung cancer patients. The two phantoms were designed to represent the cases of a small (volume = 13.6 cm 3 ) and large (volume = 181.7 cm 3 ) lung lesion. Motion margins required to obtain CTV coverage by 95% of the prescription dose to 90% of the available cases were computed for a standard treatment strategy and a trailing treatment strategy. The trailing strategy facilitated a margin reduction of over 30% relative to the conventional delivery. When the dose was computed across the entire delivery for the 33 cases, the trailing strategy was found to significantly reduce the underdosage to the outlier cases and the reduced trailing margin facilitated a 15% (small lesion) and 4% (large lesion) reduction for the mean lung dose and 7% (small lesion) and 10% (large lesion) for the mean esophagus dose. Finally, for comparison an ideal continuous tracking strategy was assessed and found to further reduce the mean lung and esophagus dose. However, this improvement comes at the price of increased delivery complexity and increased reliance on tumor localization accuracy.

  13. National arrangements for radiotherapy; Mesures nationales pour la radiotherapie. Travail collectif des missions

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    After a presentation of several letters exchanged between the French health ministry and public agencies in charge of public health or nuclear safety after a radiotherapy accident in Epinal, this report comments the evolution of needs in cancerology care and the place given to radiotherapy. It outlines the technological and organisational evolution of radiotherapy and presents the distribution of radiotherapy equipment, of radio-therapists and other radiotherapy professionals in France. Within the context of radiotherapy accidents which occurred in 2007, it presents the regulatory arrangements which aimed at improving the safety, short term and middle term arrangements which are needed to support and structure radiotherapy practice quality. It stresses the fact that the system will deeply evolve by implementing a radiotherapy vigilance arrangement and a permanent follow-on and adaptation plan based on surveys and the creation of a national committee.

  14. EMERGENCE OF ENTIRELY NEW POISONING IN RURAL INDIA; AN UPCOMING HEALTH HAZARD TO THE COMMUNITY HEALTH.

    Directory of Open Access Journals (Sweden)

    A Kumar

    2012-10-01

    Full Text Available Acute agrochemical poisoning is a leading cause of mortality and morbidity in India. Pendimethalin (herbicide and Pancycuron (fungicide are frequently used worldwide and considered quite a remarkably safe one for humans. Their acute toxicity is not yet widely known. Here we are reporting cases of their acute poisoning in young. To the best of our knowledge not a single such case of their poisoning has been reported so far in india. Such poisoning by entirely new compounds is an emerging problem in the tropics. In this communication we are reporting such unusual and entirely new toxicities and trying to highlight the need of their early recognition and timely management in rural regions where health facilities are already at the stake.

  15. Dose-response relationship in local radiotherapy for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Park, Hee Chul; Seong, Jinsil; Han, Kwang Hyub; Chon, Chae Yoon; Moon, Young Myoung; Suh, Chang Ok

    2002-01-01

    Purpose: Dose escalation using three-dimensional conformal radiotherapy (3D-CRT) is based on the hypothesis that increasing the dose can enhance tumor control. This study aimed to determine whether a dose-response relationship exists in local radiotherapy for primary hepatocellular carcinoma (HCC). Methods and Materials: One hundred fifty-eight patients were enrolled in the present study between January 1992 and March 2000. The exclusion criteria included the presence of an extrahepatic metastasis, liver cirrhosis of Child class C, tumors occupying more than two-thirds of the entire liver, and a performance status on the Eastern Cooperative Oncology Group scale of more than 3. Radiotherapy was given to the field, including the tumor, with generous margin using 6- or 10-MV X-rays. The mean radiation dose was 48.2 ± 7.9 Gy in daily 1.8-Gy fractions. The tumor response was assessed based on diagnostic radiologic examinations, including a computed tomography scan, magnetic resonance imaging, and hepatic artery angiography 4-8 weeks after the completion of treatment. Liver toxicity and gastrointestinal complications were evaluated. Results: An objective response was observed in 106 of 158 (67.1%) patients. Statistical analysis revealed that the total dose was the most significant factor associated with the tumor response. The response rates in patients treated with doses 50 Gy were 29.2%, 68.6%, and 77.1%, respectively. Survivals at 1 and 2 years after radiotherapy were 41.8% and 19.9%, respectively, with a median survival time of 10 months. The rate of liver toxicity according to the doses 50 Gy was 4.2%, 5.9%, and 8.4%, respectively, and the rate of gastrointestinal complications was 4.2%, 9.9%, and 13.2%, respectively. Conclusions: The present study showed the existence of a dose-response relationship in local radiotherapy for primary HCC. Only the radiation dose was a significant factor for predicting an objective response. The results of this study showed that 3D

  16. The situation of radiotherapy in 2011

    International Nuclear Information System (INIS)

    2012-06-01

    Published within the frame of the French 2009-2013 cancer plan, this report proposes an analysis of the situation of radiotherapy in France. More particularly, it analyses the French offer in terms of radiotherapy treatments and the French position in Europe. A second part analyses equipment (accelerators and other equipment) and techniques aimed at radiotherapy treatment preparation and delivery. The following techniques are addressed: three-dimensional conformational, intensity modulation, intracranial and extracranial stereotactic, image-guided, total body irradiation, hadron-therapy, and peri-operative radiotherapy. The last parts analyse the activity of radiotherapy centres in terms of treated patients, of patient age structure, of sessions and preparations, and of treated pathologies, the medical and paramedical personnel in charge of radiotherapy, and financial and cost aspects

  17. Psychosocial effects of radiotherapy after mastectomy

    International Nuclear Information System (INIS)

    Hughson, A.V.M.; Cooper, A.F.; Smith, D.C.; McArdle, C.S.

    1987-01-01

    Psychosocial morbidity was measured in 47 patients who received postoperative radiotherapy and in 38 who received no further treatment after mastectomy. Roughly one third of all patients experienced depression or anxiety. One month after operation, before radiotherapy, there were no significant differences between the two groups in any of the measures of psychosocial morbidity. Knowledge of impending treatment did not seem to influence morbidity. At three months patients who had completed radiotherapy had significantly more somatic symptoms and social dysfunction than those not so treated. At six months the radiotherapy group continued to show more somatic symptoms, but a year after operation there were no significant differences between the groups. Although several patients who received radiotherapy were upset by their treatment, the study failed to confirm that depression and anxiety were commoner among those given radiotherapy than among patients given no further treatment. (author)

  18. Gel dosimetry for conformal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gambarini, G [Department of Physics of the University and INFN, Milan (Italy)

    2005-07-01

    With the continuum development of conformal radio therapies, aimed at delivering high dose to tumor tissue and low dose to the healthy tissue around, the necessities has appeared of suitable improvement of dosimetry techniques giving the possibility of obtaining dose images to be compared with diagnostic images. Also if wide software has been developed for calculating dose distributions in the fields of various radiotherapy units, experimental verifications are necessary, in particular in the case of complex geometries in conformal radiotherapy. Gel dosimetry is a promising method for imaging the absorbed dose in tissue-equivalent phantoms, with the possibility of 3D reconstruction of the spatial dose distribution, with milli metric resolution. Optical imaging of gel dosimeters, based on visible light absorbance analysis, has shown to be a reliable technique for achieving dose distributions. (Author)

  19. Realization of entirely solid lithium ion batteries; Realisation d`accumulateurs a ions lithium entierement solides

    Energy Technology Data Exchange (ETDEWEB)

    Brousse, T.; Marchand, R.; Fragnaud, P.; Schleich, D.M. [Laboratoire de Genie des Materiaux, ISITEM, 44 - Nantes (France); Bohnke, O. [Universite du Maine, 72 - Le Mans (France). Laboratoire des Fluorures; West, K. [Technical University of Denmark, Lyngby (Denmark). Dept. of Chemistry

    1996-12-31

    This paper presents a prototype of an entirely inorganic lithium ions battery cell. LiCoO{sub 2} thin film cathodes and Li{sub 4/3}Ti{sub 5/3}O{sub 4} thin film anodes have been deposited on Li{sub 3x}La{sub 2/3-x}TiO{sub 3} sintered solid electrolyte pellets and the performances of these battery cells have been tested. (J.S.) 5 refs.

  20. The use of entire agreement clauses in contracts governed by Danish law

    DEFF Research Database (Denmark)

    Mitkidis, Katerina

    2017-01-01

    The article analyses the use of entire agreement (EA) clauses in contracts governed by Danish law. It (i) reviews the practice, based on interviews conducted with the representatives of Danish firms, judiciary and legal profession, (ii) analyses the implications of the practice under Danish...... contract law and related case law and (iii) offers recommendations on how EA clauses can be amended to minimise associated legal risks....

  1. Infarction of the entire corpus callosum as a complication in subarachnoid hemorrhage: A case report

    Directory of Open Access Journals (Sweden)

    Satoru Takahashi, M.D.

    2017-03-01

    Full Text Available The corpus callosum is the major commissural pathway connecting the cerebral hemispheres. This pathway receives its blood supply from anterior communicating artery, pericallosal artery, and posterior pericallosal artery. However, in some cases, the entire corpus callosum is supplied by median callosal artery; thus, occlusion of this artery can lead to infarction of the entire corpus callosum. Few reports have described this type of infarction, and no reports after subarachnoid hemorrhage (SAH exist. Here, we report on a 42-year-old female who was diagnosed with SAH after two aneurysms were discovered in bifurcation of left anterior cerebral artery (A1-A2. After successful clipping was performed, the patient was alert and had no neurological deficits; moreover, the computed tomography images that were acquired after the operation showed no evidence of infarction. Nine days after admittance to the hospital, drowsiness and weakness of the left limbs with brain swelling appeared and decompressive hemi-craniectomy was performed. Diagnostic cerebral angiography revealed vasospasms in both anterior and middle cerebral arteries, thus fasudil hydrochloride was administered intra-arterially. While blood flow in all arteries improved, diffusion-weighted magnetic resonance imaging detected infarction along the entire length of the corpus callosum and in the medial region of the right frontal lobe. We believe this infarction was due to secondary ischemia of median callosal artery. This case reminded us of the anatomical variation wherein median callosal artery is the sole blood supply line for the corpus callosum and demonstrated that infarction of the entire corpus callosum is possible.

  2. Assessing Discount Rate for a Project Financed Entirely with Equity Capital

    Directory of Open Access Journals (Sweden)

    Nicoleta Vintila

    2007-09-01

    Full Text Available Estimating discount rate for an investment project is one of the most challenging tasks incapital budgeting. In this paper we discuss different kind of models for cost of equity capital proposed infinance literature (static CAPM, conditional CAPM, APT, build-up model, focusing especially on advantagesand disadvantages of using each of them. In the final section, we estimate the discount rate fora certain project financed entirely with equity capital, using a version of build-up model.

  3. Efficient algorithms for accurate hierarchical clustering of huge datasets: tackling the entire protein space

    OpenAIRE

    Loewenstein, Yaniv; Portugaly, Elon; Fromer, Menachem; Linial, Michal

    2008-01-01

    Motivation: UPGMA (average linking) is probably the most popular algorithm for hierarchical data clustering, especially in computational biology. However, UPGMA requires the entire dissimilarity matrix in memory. Due to this prohibitive requirement, UPGMA is not scalable to very large datasets. Application: We present a novel class of memory-constrained UPGMA (MC-UPGMA) algorithms. Given any practical memory size constraint, this framework guarantees the correct clustering solution without ex...

  4. Realization of entirely solid lithium ion batteries; Realisation d`accumulateurs a ions lithium entierement solides

    Energy Technology Data Exchange (ETDEWEB)

    Brousse, T; Marchand, R; Fragnaud, P; Schleich, D M [Laboratoire de Genie des Materiaux, ISITEM, 44 - Nantes (France); Bohnke, O [Universite du Maine, 72 - Le Mans (France). Laboratoire des Fluorures; West, K [Technical University of Denmark, Lyngby (Denmark). Dept. of Chemistry

    1997-12-31

    This paper presents a prototype of an entirely inorganic lithium ions battery cell. LiCoO{sub 2} thin film cathodes and Li{sub 4/3}Ti{sub 5/3}O{sub 4} thin film anodes have been deposited on Li{sub 3x}La{sub 2/3-x}TiO{sub 3} sintered solid electrolyte pellets and the performances of these battery cells have been tested. (J.S.) 5 refs.

  5. A landing theorem for entire functions with bounded post-singular sets

    OpenAIRE

    Benini, Anna Miriam; Rempe-Gillen, Lasse

    2017-01-01

    The Douady-Hubbard landing theorem for periodic external rays is one of the cornerstones of the study of polynomial dynamics. It states that, for a complex polynomial with bounded postcritical set, every periodic external ray lands at a repelling or parabolic periodic point, and conversely every repelling or parabolic point is the landing point of at least one periodic external ray. We prove an analogue of this theorem for an entire function with bounded postsingular set: every periodic dread...

  6. Badminton: Course Proposal.

    Science.gov (United States)

    Yeo, David G.

    A proposal is presented for a Community College of Philadelphia Life Sciences and Allied Health Services course in Badminton. Following a standard cover form, a statement of purpose explains that the course is designed to introduce students to the techniques, knowledge, and strategies of badminton. Next, course goals and a course outline are…

  7. Radiotherapy of metastatic spinal cord compression in very elderly patients

    International Nuclear Information System (INIS)

    Rades, Dirk; Hoskin, Peter J.; Karstens, Johann H.; Rudat, Volker; Veninga, Theo; Stalpers, Lukas J.A.; Schild, Steven E.; Dunst, Juergen

    2007-01-01

    Purpose: Owing to the aging of the population, the proportion of elderly patients receiving cancer treatment has increased. This study investigated the results of radiotherapy (RT) for metastatic spinal cord compression (MSCC) in the very elderly, because few data are available for these patients. Methods and Materials: The data from 308 patients aged ≥75 years who received short-course (treatment time 1-5 days) or long-course RT (2-4 weeks) for MSCC were retrospectively analyzed for functional outcome, local control, and survival. Furthermore, nine potential prognostic factors were investigated: gender, performance status, interval from tumor diagnosis to MSCC, tumor type, number of involved vertebrae, other bone or visceral metastases, ambulatory status, and speed at which motor deficits developed. Results: Improvement of motor deficits occurred in 25% of patients, with no further progression of MSCC in an additional 59%. The 1-year local control and survival rate was 92% and 43%, respectively. Improved functional outcomes were associated with ambulatory status and slower developing motor deficits. Improved local control resulted from long-course RT. Improved survival was associated with a longer interval from tumor diagnosis to MSCC, tumor type (breast/prostate cancer, myeloma/lymphoma), lack of visceral or other bone metastases, ambulatory status, and a slower development of motor deficits. Conclusion: Short- and long-course RT are similarly effective in patients aged ≥75 years regarding functional outcome and survival. Long-course RT provided better local control. Patients with better expected survival should receive long-course RT and others short-course RT. The criteria for selection of an appropriate regimen for MSCC in very elderly patients should be the same as for younger individuals

  8. Massive and Reproducible Production of Liver Buds Entirely from Human Pluripotent Stem Cells

    Directory of Open Access Journals (Sweden)

    Takanori Takebe

    2017-12-01

    Full Text Available Summary: Organoid technology provides a revolutionary paradigm toward therapy but has yet to be applied in humans, mainly because of reproducibility and scalability challenges. Here, we overcome these limitations by evolving a scalable organ bud production platform entirely from human induced pluripotent stem cells (iPSC. By conducting massive “reverse” screen experiments, we identified three progenitor populations that can effectively generate liver buds in a highly reproducible manner: hepatic endoderm, endothelium, and septum mesenchyme. Furthermore, we achieved human scalability by developing an omni-well-array culture platform for mass producing homogeneous and miniaturized liver buds on a clinically relevant large scale (>108. Vascularized and functional liver tissues generated entirely from iPSCs significantly improved subsequent hepatic functionalization potentiated by stage-matched developmental progenitor interactions, enabling functional rescue against acute liver failure via transplantation. Overall, our study provides a stringent manufacturing platform for multicellular organoid supply, thus facilitating clinical and pharmaceutical applications especially for the treatment of liver diseases through multi-industrial collaborations. : With the goal of clinical translation of liver bud transplant therapy, Takebe et al. established a massive organoid production platform from endoderm, endothelial, and mesenchymal progenitor populations specified entirely from human iPSCs, reproducibly demonstrating functionality both in vitro and in vivo. Keywords: iPSC, liver bud, organoid, transplantation, self-organization, endothelial, mesenchymal, liver failure, clinical grade

  9. Conformal radiotherapy: principles and classification

    International Nuclear Information System (INIS)

    Rosenwald, J.C.; Gaboriaud, G.; Pontvert, D.

    1999-01-01

    'Conformal radiotherapy' is the name fixed by usage and given to a new form of radiotherapy resulting from the technological improvements observed during the last ten years. While this terminology is now widely used, no precise definition can be found in the literature. Conformal radiotherapy refers to an approach in which the dose distribution is more closely 'conformed' or adapted to the actual shape of the target volume. However, the achievement of a consensus on a more specific definition is hampered by various difficulties, namely in characterizing the degree of 'conformality'. We have therefore suggested a classification scheme be established on the basis of the tools and the procedures actually used for all steps of the process, i.e., from prescription to treatment completion. Our classification consists of four levels: schematically, at level 0, there is no conformation (rectangular fields); at level 1, a simple conformation takes place, on the basis of conventional 2D imaging; at level 2, a 3D reconstruction of the structures is used for a more accurate conformation; and level 3 includes research and advanced dynamic techniques. We have used our personal experience, contacts with colleagues and data from the literature to analyze all the steps of the planning process, and to define the tools and procedures relevant to a given level. The corresponding tables have been discussed and approved at the European level within the Dynarad concerted action. It is proposed that the term 'conformal radiotherapy' be restricted to procedures where all steps are at least at level 2. (author)

  10. Radiotherapy Proton Interactions in Matter

    OpenAIRE

    Gottschalk, Bernard

    2018-01-01

    A survey of physics useful to proton radiotherapy, centered on stopping, scattering and hard scatters: 1. Introduction 2. The fundamental formula dose = fluence x mass stopping power. Practical units, comments on effective stopping power. 3. Range: experimental definition, Beth-Bloch CSDA theory, range-energy tables and approximations, range straggling. 4. Multiple Coulomb Scattering: suggested reading, elements of Moliere theory, the Gaussian approximation, scattering power. 5. Hard scatters...

  11. Breast post-radiotherapy angiosarcoma

    International Nuclear Information System (INIS)

    Chavez, O.; Ocampo, P.; Repetto, M.; Schulz, D.; Rompato, S.; Batagelj, E.; Spadavecchia, G.

    2007-01-01

    Breast angiosarcoma after radiotherapy represents a rare pathology that have been increasing in the recent years because of the tendency to treat breast cancer with conservative therapeutic treatments. The forecast depends on the histological degree being the majority of high degree, with frequent lymphatic and local recurrences plus distance metastasis. The selected treatment is the mastectomy and also should be considered the adjuvant chemotherapy [es

  12. Fingerprints identification of radiotherapy patients

    International Nuclear Information System (INIS)

    Lartigau, E.F.; Forrest, M.; Audebaud, S.; Dewitte, A.; Giscard, S.; Leclercq, B.

    2012-01-01

    The identification of patient plays a key role in the quality and safety of radiotherapy. It does impact on all professional staff and on patients. After the regulatory authority approval (Cnil), a pilot study has been performed on 1901 patients. Acceptance has been very high (> 93%) with a low risk of mis-identification (< 0.1%). The next step will be to implement and test a bimodal system in order to improve registration capacity and sensitivity. (authors)

  13. Ptanning radiotherapy of brain neoplasms

    International Nuclear Information System (INIS)

    Smirnov, R.V.

    1982-01-01

    It is emphasized that radiotherapy planing of neuro-oncologicai patients secures maximum optimization of radiation treatment. The planning involves preparation of anatomical profile diagrams of patient's head with plotted focal contrours; choise of ionizinq radiation type, directions of the working beam and dimensions and number of irradiation fields; choise of single dose vaiues and detemination of optimat distribution of integarl does in time; determination of focal projection on head surface of patients

  14. Effect of radiation in radiotherapy

    International Nuclear Information System (INIS)

    Hirata, Hideki; Fujibuchi, Toshio; Saito, Tsutomu

    2013-01-01

    The title subject is easily explained for the deterministic effect, secondary cancer formation and case reports of accidental exposure at radiotherapy. For the deterministic effect, the dose-effect relationship is sigmoidal in normal and cancer tissues, and the more separated are their curves, the more favorable is the radiotherapy. TD 5/5 is the tolerable dose to yield <5% of irreversible radiation injury to the normal tissue within 5 years after the therapy and is generally dose-limiting. The curves are of various shapes depending on the tissue composition that its functional subunit (FSU) is parallel like lobules of the liver, or in series like neuron. Symptoms appear complicated on these factors. Recent development of CT-based therapeutic planning has made it possible to analyze the partial tissue volume to be irradiated and its absorbed dose by the relationship (dose volume histogram, DVH) between the electron density vs CT value regardless to anatomy. The normal tissue complication probability is a model composed from the physical DVH and biological factors of FSU composition and cellular radiation susceptibility, and is a measure of the irreversible late effect manifested in normal tissues. Epidemiology has shown the increased risk of secondary cancer formation by radiotherapy. Children are highly susceptible to this, and in adults undergoing the therapy of a certain cancer, it is known that the risk of radiation carcinogenesis is increased in the particular tissue. There are presented such case reports of accidental excessive exposure at radiotherapy as caused by an inappropriate use of detector, partial loss of data in a therapeutic planning device, reading of reversed MRI image, and too much repeated use of the old-type electric portal imaging device. (T.T.)

  15. Digital linear accelerator: The advantages for radiotherapy

    International Nuclear Information System (INIS)

    Andric, S.; Maksimovic, M.; Dekic, M.; Clark, T.

    1998-01-01

    Technical performances of Digital Linear Accelerator were presented to point out its advantages for clinical radiotherapy treatment. The accelerator installation is earned out at Military Medical Academy, Radiotherapy Department, by Medes and Elekta companies. The unit offers many technical advantages with possibility of introduction new conformal treatment techniques as stereotactic radiosurgery, total body and total skin irradiation. In the paper are underlined advantages in relation to running conventional accelerator units at Yugoslav radiotherapy departments, both from technical and medical point of view. (author)

  16. Experiment on radiotherapy of postnatal mastitis

    International Nuclear Information System (INIS)

    Zhut'ko, A.A.

    1978-01-01

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

  17. Natural history of intracranial meningioma after radiotherapy

    International Nuclear Information System (INIS)

    Monzen, Yoshio

    1999-01-01

    The author examined the natural history of intracranial meningioma after radiotherapy using CT or MR imaging. Twenty patients with intracranial meningioma received radiotherapy from a high-energy linear accelerator (4-10 MV X rays) from 1980 to 1996. The total doses were 50 Gy to the tumor bed in single doses of 2 Gy in 5 weekly fractions. Meningiomas in 10 of 20 patients were reduced within 1 to 38 months after radiotherapy, the average being 11 months. The tumors were controlled for a median of 60 months after radiotherapy (range 19-126 months). Four other patients have shown no change in tumor size after radiotherapy. The tumors were controlled for a median of 70 months after radiotherapy (range 37-127 months). The other six patients have shown tumor growth within 3 to 25 months after radiotherapy, after which the tumors stopped growing for a median of 71 months (range 2-181 months). Neither tumor size nor histological type was related to response. The growth of tumors was controlled by radiotherapy for a median duration of 43 months in the meningothelial type, 52 months in the fibroblastic type, and 61 months in the transitional type. The median duration for all benign tumors was 52 months. A moderate correlation was noted between tumor response and functional outcome after radiotherapy in 9 patients with neurological deficits. The natural histories of intracranial meningiomas after radiotherapy were grouped into three categories. Some tumors showed no change in size over a long period. This was a characteristic response after radiotherapy that differed from that of other brain tumors. The results of this study provide important information for the follow-up of intracranial meningiomas after radiotherapy. (author)

  18. Malignant astrocytoma following radiotherapy for craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Menon G

    2007-01-01

    Full Text Available Radiation induced gliomas are uncommon. Occurrence of glioma following radiotherapy for craniopharyngiomas is extremely uncommon and only eight case reports have been so far published. We present our experience with one similar case of temporal gliomas occurring twelve years following radiotherapy for a sub totally excised craniopharyngioma. Although the exact mechanism of gliomas formation is unclear, their occurrence following conventional radiotherapy is a distinct possibility and signifies a poor prognosis.

  19. Art therapy using famous painting appreciation maintains fatigue levels during radiotherapy in cancer patients

    Science.gov (United States)

    Koom, Woong Sub; Choi, Mi Yeon; Lee, Jeongshim; Park, Eun Jung; Kim, Ju Hye; Kim, Sun-Hyun; Kim, Yong Bae

    2016-01-01

    Purpose: The purpose of this study was to evaluate the efficacy of art therapy to control fatigue in cancer patients during course of radiotherapy and its impact on quality of life (QoL). Materials and Methods: Fifty cancer patients receiving radiotherapy received weekly art therapy sessions using famous painting appreciation. Fatigue and QoL were assessed using the Brief Fatigue Inventory (BFI) Scale and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) at baseline before starting radiotherapy, every week for 4 weeks during radiotherapy, and at the end of radiotherapy. Mean changes of scores over time were analyzed using a generalized linear mixed model. Results: Of the 50 patients, 34 (68%) participated in 4 sessions of art therapy. Generalized linear mixed models testing for the effect of time on mean score changes showed no significant changes in scores from baseline for the BFI and FACIT-F. The mean BFI score and FACIT-F total score changed from 3.1 to 2.7 and from 110.7 to 109.2, respectively. Art therapy based on the appreciation of famous paintings led to increases in self-esteem by increasing self-realization and forming social relationships. Conclusion: Fatigue and QoL in cancer patients with art therapy do not deteriorate during a period of radiotherapy. Despite the single-arm small number of participants and pilot design, this study provides a strong initial demonstration that art therapy of appreciation for famous painting is worthy of further study for fatigue and QoL improvement. Further, it can play an important role in routine practice in cancer patients during radiotherapy. PMID:27306778

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-01

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