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Sample records for high-dose external beam

  1. Controversies in external beam and high dose rate brachytherapy of oesophageal cancer

    International Nuclear Information System (INIS)

    Sur, R.K.; Levin, V.C.; Malas, Simon; Donde, Bernard

    1994-01-01

    Various controversies in the treatment of oesophageal carcinoma with external beam radiotherapy and high dose rate intracavitary irradiation have been reviewed. Conflicting results from different parts of the world has made it difficult to optimize the radiation dose that may give the best results. More studies and longer follow-up are needed before a definite conclusion can be made on the optimization of dose. (author). 18 refs., 2 tabs

  2. Dose-rate effects in external beam radiotherapy redux

    International Nuclear Information System (INIS)

    Ling, C. Clifton; Gerweck, Leo E.; Zaider, Marco; Yorke, Ellen

    2010-01-01

    Recent developments in external beam radiotherapy, both in technical advances and in clinical approaches, have prompted renewed discussions on the potential influence of dose-rate on radio-response in certain treatment scenarios. We consider the multiple factors that influence the dose-rate effect, e.g. radical recombination, the kinetics of sublethal damage repair for tumors and normal tissues, the difference in α/β ratio for early and late reacting tissues, and perform a comprehensive literature review. Based on radiobiological considerations and the linear-quadratic (LQ) model we estimate the influence of overall treatment time on radio-response for specific clinical situations. As the influence of dose-rate applies to both the tumor and normal tissues, in oligo-fractionated treatment using large doses per fraction, the influence of delivery prolongation is likely important, with late reacting normal tissues being generally more sensitive to the dose-rate effect than tumors and early reacting tissues. In conventional fractionated treatment using 1.8-2 Gy per fraction and treatment times of 2-10 min, the influence of dose-rate is relatively small. Lastly, the dose-rate effect in external beam radiotherapy is governed by the overall beam-on-time, not by the average linac dose-rate, nor by the instantaneous dose-rate within individual linac pulses which could be as high as 3 x 10 6 MU/min.

  3. The relationship between external beam radiotherapy dose and chronic urinary dysfunction - A methodological critique

    International Nuclear Information System (INIS)

    Rosewall, Tara; Catton, Charles; Currie, Geoffrey; Bayley, Andrew; Chung, Peter; Wheat, Janelle; Milosevic, Michael

    2010-01-01

    Purpose: To perform a methodological critique of the literature evaluating the relationship between external beam radiotherapy dose/volume parameters and chronic urinary dysfunction to determine why consistent associations between dose and dysfunction have not been found. Methods and materials: The radiotherapy literature was reviewed using various electronic medical search engines with appropriate keywords and MeSH headings. Inclusion criteria comprised of; English language articles, published between 1999 and June 2009, incorporating megavoltage external beam photons in standard-sized daily fraction. A methodological critique was then performed, evaluating the factors affected in the quantification of radiotherapy dose and chronic urinary dysfunction. Results: Nine of 22 eligible studies successfully identified a clinically and statistically significant relationship between dose and dysfunction. Accurate estimations of external beam radiotherapy dose were compromised by the frequent use of dosimetric variables which are poor surrogates for the dose received by the lower urinary tract tissue and do not incorporate the effect of daily variations in isocentre and bladder position. The precise categorization of chronic urinary dysfunction was obscured by reliance on subjective and aggregated toxicity metrics which vary over time. Conclusions: A high-level evidence-base for the relationship between external beam radiotherapy dose and chronic urinary dysfunction does not currently exist. The quantification of the actual external beam dose delivered to the functionally important tissues using dose accumulation strategies and the use of objective measures of individual manifestations of urinary dysfunction will assist in the identification of robust relationships between dose and urinary dysfunction for application in widespread clinical practice.

  4. Experimental assessment of out-of-field dose components in high energy electron beams used in external beam radiotherapy.

    Science.gov (United States)

    Alabdoaburas, Mohamad M; Mege, Jean-Pierre; Chavaudra, Jean; Bezin, Jérémi Vũ; Veres, Atilla; de Vathaire, Florent; Lefkopoulos, Dimitri; Diallo, Ibrahima

    2015-11-08

    The purpose of this work was to experimentally investigate the out-of-field dose in a water phantom, with several high energy electron beams used in external beam radiotherapy (RT). The study was carried out for 6, 9, 12, and 18 MeV electron beams, on three different linear accelerators, each equipped with a specific applicator. Measurements were performed in a water phantom, at different depths, for different applicator sizes, and off-axis distances up to 70 cm from beam central axis (CAX). Thermoluminescent powder dosimeters (TLD-700) were used. For given cases, TLD measurements were compared to EBT3 films and parallel-plane ionization chamber measurements. Also, out-of-field doses at 10 cm depth, with and without applicator, were evaluated. With the Siemens applicators, a peak dose appears at about 12-15 cm out of the field edge, at 1 cm depth, for all field sizes and energies. For the Siemens Primus, with a 10 × 10 cm(²) applicator, this peak reaches 2.3%, 1%, 0.9% and 1.3% of the maximum central axis dose (Dmax) for 6, 9, 12 and 18 MeV electron beams, respectively. For the Siemens Oncor, with a 10 × 10 cm(²) applicator, this peak dose reaches 0.8%, 1%, 1.4%, and 1.6% of Dmax for 6, 9, 12, and 14 MeV, respectively, and these values increase with applicator size. For the Varian 2300C/D, the doses at 12.5 cm out of the field edge are 0.3%, 0.6%, 0.5%, and 1.1% of Dmax for 6, 9, 12, and 18 MeV, respectively, and increase with applicator size. No peak dose is evidenced for the Varian applicator for these energies. In summary, the out-of-field dose from electron beams increases with the beam energy and the applicator size, and decreases with the distance from the beam central axis and the depth in water. It also considerably depends on the applicator types. Our results can be of interest for the dose estimations delivered in healthy tissues outside the treatment field for the RT patient, as well as in studies exploring RT long-term effects.

  5. The effect of combined external beam and high-dose intracavitary brachytherapy on dysphagia and survival in patients with advanced esophageal cancer

    International Nuclear Information System (INIS)

    Yorozu, Atsunori; Dokiya, Takushi; Ogita, Mikio; Kutsuki, Shoji

    1996-01-01

    During an 11-year period, a group of 130 patients with esophageal cancer of stages 2 to 4 were treated with external beam irradiation (40 to 60 Gy) followed by boost dose of 10 to 20 Gy of high-dose intracavitary brachytherapy. The overall 2-year survival rate was 15.4%. The significant prognostic factors were tumor size, response to external beam irradiation, pretreatment dysphagia score, and presence of distant metastases. The palliative effect was excellent; the dysphagia scores of 122 of 130 patients (93.8%) improved. The significant palliative factors were response to external beam irradiation and pretreatment dysphagia score. Tracheoesophageal fistulas developed after treatment in 13 of 130 patients (10%); 3 of the fistulas were probably related to radiotherapy. We conclude that intracavitary brachytherapy is useful in the treatment of cases of advanced cancer which show a good response to external beam irradiation and may be curative in patients with mild dysphagia. (author)

  6. An assessment of effective dose to staff in external beam radiotherapy

    International Nuclear Information System (INIS)

    Rawlings, D.J.; Nicholson, L.

    1997-01-01

    Radiation safety in external beam radiotherapy is governed by national legislation. Annual doses recorded by radiographers and others associated with external beam radiotherapy are typically much lower than the relevant dose limit. However, it is possible that larger doses might be received as a result of an accidental irradiation. In the event of a significant exposure resulting in a dose at or near a relevant dose limit, an accurate conversion has to be made from the dose meter reading to the limiting quantity. A method was devised to demonstrate ratios of effective dose to personal dose equivalent which might be anticipated in the even of an individual other than the patient being irradiated within a radiotherapy treatment room consisting of a linear accelerator. The variation of ratios obtained under different conditions is discussed. (author)

  7. High dose rate interstitial brachytherapy with external beam irradiation for localized prostate cancer. Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Hiratsuka, Junichi; Jo, Yoshimasa; Yoden, Eisaku; Tanaka, Hiroyoshi; Imajo, Yoshinari [Kawasaki Medical School, Kurashiki, Okayama (Japan); Nagase, Naomi; Narihiro, Naomasa; Kubota, Juichi

    2000-12-01

    This study was undertaken to assess the biochemical and pathological results of combined external beam radiotherapy and high dose rate Ir-192 brachytherapy (HDR-Ir192) for clinically localized prostate cancer. Between October 1997 and August 1999, 39 evaluable patients with adenocarcinoma of prostate diagnosed by biopsy were treated with interstitial and external beam irradiation. Patients ranged in age from 58-82 years, with a mean of 69.7 years. T1c, T2 and T3 tumors, according to the UICC classification system (1997), were found in 7, 21 and 11 cases respectively. The mean initial pre-treatment PSA was 35.9 ng/ml (median 13.2), with 77% of the patients having had a pre-treatment PSA greater than 10 ng/ml. Of all patients, 17 had received pre-treatment hormonal therapy. Hormonal pretreatment was stopped at the beginning of radiotherapy in all cases. External beam four-field box irradiation was given to the small pelvis to a dose of 45 Gy/25 fractions. Three HDR-Ir192 treatments were given over a 30-h period, with 5.5 Gy per fraction at the circumference of the prostate gland over the course of this study. Biochemical failure was defined as a PSA level >1.5 ng/ml and rising on three consecutive values. If serial post-treatment PSA levels showed a continuous downward trend, failure was not scored. The patient with clinical evidence of progression was classified as a clinical failure. The median follow-up at the time of evaluation was 19.6 months. A post-treatment PSA level {<=}1.0 ng/ml was seen in 26 (67%) patients, and values from >1.0 to {<=}2.0 ng/ml were seen in 10 (26%) patients. Biochemical failure was not seen in 38 patients except for one patient who developed a distant bone metastasis with negative prostatic biopsy 15 months after treatment. Biochemical control rate was 100% (38/38) except for the patient with bone metastasis classified as clinical failure. Negative biopsies 18 months after treatment were found in 93% (14/15) of patients. Only one patient

  8. High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Keisei Okamoto

    2017-02-01

    Full Text Available Purpose : To evaluate the outcomes of high-risk prostate cancer patients treated with biologically effective dose (BED ≥ 220 Gy of high-dose radiotherapy, using low-dose-rate (LDR brachytherapy in combination with external beam radiotherapy (EBRT and short-term androgen deprivation therapy (ADT. Material and methods : From 2005 to 2013, a total of 143 patients with high-risk prostate cancer were treated by radiotherapy of BED ≥ 220 Gy with a combination of LDR brachytherapy, EBRT, and androgen deprivation therapy (ADT. The high-risk patients in the present study included both high-risk and very high-risk prostate cancer. The number of high-risk features were: 60 patients with 1 high-risk factor (42%, 61 patients with 2 high-risk factors (43%, and 22 patients with 3 high-risk factors (15% including five N1 disease. External beam radiotherapy fields included prostate and seminal vesicles only or whole pelvis depending on the extension of the disease. Biochemical failure was defined by the Phoenix definition. Results : Six patients developed biochemical failure, thus providing a 5-year actual biochemical failure-free survival (BFFS rate of 95.2%. Biochemical failure was observed exclusively in cases with distant metastasis in the present study. All six patients with biochemical relapse had clinical failure due to bone metastasis, thus yielding a 5-year freedom from clinical failure (FFCF rate of 93.0%. None of the cases with N1 disease experienced biochemical failure. We observed four deaths, including one death from prostate cancer, therefore yielding a cause-specific survival (CSS rate of 97.2%, and an overall survival (OS rate of 95.5%. Conclusions : High-dose (BED ≥ 220 Gy radiotherapy by LDR in combination with EBRT has shown an excellent outcome on BFFS in high-risk and very high-risk cancer, although causal relationship between BED and BFFS remain to be explained further.

  9. A method to combine three dimensional dose distributions for external beam and brachytherapy radiation treatments for gynecological neoplasms

    International Nuclear Information System (INIS)

    Narayana, V.; Sahijdak, W.M.; Orton, C.G.

    1997-01-01

    Purpose: Radiation treatment of gynecological neoplasms, such as cervical carcinoma, usually combines external radiation therapy with one or more intracavitary brachytherapy applications. Although the dose from external beam radiation therapy and brachytherapy can be calculated and displayed in 3D individually, the dose distributions are not combined. At most, combined point doses are calculated for select points using various time-dose models. In this study, we present a methodology to combine external beam and brachytherapy treatments for gynecological neoplasms. Material and Methods: Three dimensional bio-effect treatment planning to obtain complication probability has been outlined. CT scans of the patient's pelvis with the gynecological applicator in place are used to outline normal tissue and tumor volumes. 3D external beam and brachytherapy treatment plans are developed separately and an external beam dose matrix and a brachytherapy dose matrix was calculated. The dose in each voxel was assumed to be homogeneous. The physical dose in each voxel of the dose matrix was then converted into extrapolated response dose (ERD) based on the linear quadratic model that accounts for the dose per fraction, number of fractions, dose rate, and complete or incomplete repair of sublethal damage (time between fractions). The net biological dose delivered was obtained by summing the ERD grids from external beam and brachytherapy since there was complete repair of sublethal damage between external beam and brachytherapy treatments. The normal tissue complication probability and tumor control probability were obtained using the biological dose matrix based on the critical element model. Results: The outlined method of combining external beam and brachytherapy treatments was implemented on gynecological treatments using an applicator for brachytherapy treatments. Conclusion: Implementation of the biological dose calculation that combine different modalities is extremely useful

  10. Evaluation of GafChromic EBT prototype B for external beam dose verification

    International Nuclear Information System (INIS)

    Todorovic, M.; Fischer, M.; Cremers, F.; Thom, E.; Schmidt, R.

    2006-01-01

    The capability of the new GafChromic EBT prototype B for external beam dose verification is investigated in this paper. First the general characteristics of this film (dose response, postirradiation coloration, influence of calibration field size) were derived using a flat-bed scanner. In the dose range from 0.1 to 8 Gy, the sensitivity of the EBT prototype B film is ten times higher than the response of the GafChromic HS, which so far was the GafChromic film with the highest sensitivity. Compared with the Kodak EDR2 film, the response of the EBT is higher by a factor of 3 in the dose range from 0.1 to 8 Gy. The GafChromic EBT almost does not show a temporal growth of the optical density and there is no influence of the chosen calibration field size on the dose response curve obtained from this data. A MatLab program was written to evaluate the two-dimensional dose distributions from treatment planning systems and GafChromic EBT film measurements. Verification of external beam therapy (SRT, IMRT) using the above-mentioned approach resulted in very small differences between the planned and the applied dose. The GafChromic EBT prototype B together with the flat-bed scanner and MatLab is a successful approach for making the advantages of the GafChromic films applicable for verification of external beam therapy

  11. High-dose external beam irradiation inhibits neointima formation in stented pig coronary arteries

    International Nuclear Information System (INIS)

    Verheye, Stefan; Coussement, Patrick K.; Salame, Mahomed Y.; Fallahi, Payam; Cui Jianhua; Chronos, Nicolas A.F.; King, Spencer B.; Crocker, Ian R.; Robinson, Keith A.

    2001-01-01

    Purpose: To evaluate high-dose external beam irradiation (EBRT) in a pig coronary stent preparation because low and intermediate-dose EBRT failed to show inhibition of neointima formation in stented animal models. Methods and Materials: Thirty-five stents were implanted in the coronary arteries of 17 pigs. Seven pigs were exposed to a single dose of 21 Gy EBRT immediately after stenting. Ten stented, nonirradiated pigs served as controls. After 4 weeks, the study arteries and myocardium were examined by light and scanning electron microscopy. Results: Compared with controls, 21 Gy EBRT resulted in a larger lumen area (7.57±1.67 mm 2 vs. 4.00±1.63 mm 2 , p 2 vs. 3.36±2.26 mm 2 , p<0.001) and a smaller maximal intimal thickness (0.16±0.09 mm vs. 0.68±0.31 mm, p<0.001). Unresorbed intramural hemorrhages and adherent mural thrombi were present in the irradiated vessels, which also showed incomplete re-endothelialization. The irradiated hearts demonstrated diffuse interstitial and perivascular inflammation and fibrosis. Conclusions: EBRT at 21 Gy to the entire heart significantly inhibited neointima formation in stented pig coronary arteries but also resulted in incomplete re-endothelialization, myocardial inflammation, and fibrosis. Improvements in localization and delivery techniques are required to allow clinical implementation of this technique

  12. Treatment of locally advanced breast carcinoma with high-dose external beam supervoltage radiotherapy

    International Nuclear Information System (INIS)

    Brufman, G.; Weshler, Z.; Prosnitz, L.R.; Fuks, Z.

    1981-01-01

    Between 1960 and 1978, 87 patients with locally advanced Tsub(3-4)Nsub(0-3)M 0 carcinoma of the breast were treated with 5,000 to 8,000 rad of external beam supervoltage radiotherapy. Initial clinical eradication of the tumour was observed in 76 of 87 cases (87%), but the actuarial probability of local control at 5 yr was only 53%. Furthermore, the actuarial probability of disease-free survival was 25% at 5 yr and 13% at 10 yr. Most of the patients eventually succumbed to metastatic breast carcinoma and the actuarial survival at 5 yr was 43% and at 10 yr, 16%. The addition of adjuvant low-dose chemotherapy, given to 13 patients, did not affect the rates of local control, survival or disease-free survival. The most common long-term complication was extensive and deforming radiation-induced fibrosis of the treated breast. The actuarial probability of 10-yr survival without a local recurrence and without severe fibrosis of the treated breast was only 17.5%. The role of adjuvant high-dose chemotherapy in the treatment of locally advanced breast carcinoma and the possible use of improved radiotherapy techniques to achieve a more effective long-term local control and a more desirable cosmetic end result are discussed. (author)

  13. SU-E-J-181: Effect of Prostate Motion On Combined Brachytherapy and External Beam Dose Based On Daily Motion of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Narayana, V; McLaughlin, P [Providence Cancer Center, Southfield, MI (United States); University of Michigan, Ann Arbor, MI (United States); Ealbaj, J [University of Michigan, Ann Arbor, MI (United States)

    2015-06-15

    Purpose: In this study, the adequacy of target expansions on the combined external beam and implant dose was examined based on the measured daily motion of the prostate. Methods: Thirty patients received an I–125 prostate implant prescribed to dose of 90Gy. This was followed by external beam to deliver a dose of 90Gyeq (external beam equivalent) to the prostate over 25 to 30 fractions. An ideal IMRT plan was developed by optimizing the external beam dose based on the delivered implant dose. The implant dose was converted to an equivalent external beam dose using the linear quadratic model. Patients were set up on the treatment table by daily orthogonal imaging and aligning the marker seeds in the prostate. Orthogonal images were obtained at the end of treatment to assess prostate intrafraction motion. Based on the observed motion of the markers between the initial and final images, 5 individual plans showing the actual dose delivered to the patient were calculated. A final true dose distribution was established based on summing the implant dose and the 5 external beam plans. Dose to the prostate, seminal vesicles, lymphnodes and normal tissues, rectal wall, urethra and lower sphincter were calculated and compared to ideal. On 18 patients who were sexually active, dose to the corpus cavernosum and internal pudendal artery was also calculated. Results: The average prostate motion in 3 orthogonal directions was less than 1 mm with a standard deviation of less than +2 mm. Dose and volume parameters showed that there was no decrease in dose to the targets and a marginal decrease in dose to in normal tissues. Conclusion: Dose delivered by seed implant moves with the prostate, decreasing the impact of intrafractions dose movement on actual dose delivered. Combined brachytherapy and external beam dose delivered to the prostate was not sensitive to prostate motion.

  14. Absorbed dose determination in external beam radiotherapy. An international code of practice for dosimetry based on standards of absorbed dose to water

    International Nuclear Information System (INIS)

    2000-01-01

    The International Atomic Energy Agency published in 1987 an International Code of Practice entitled 'Absorbed Dose Determination in Photon and Electron Beams' (IAEA Technical Reports Series No. 277 (TRS-277)), recommending procedures to obtain the absorbed dose in water from measurements made with an ionization chamber in external beam radiotherapy. A second edition of TRS-277 was published in 1997 updating the dosimetry of photon beams, mainly kilovoltage X rays. Another International Code of Practice for radiotherapy dosimetry entitled 'The Use of Plane-Parallel Ionization Chambers in High Energy Electron and Photon Beams' (IAEA Technical Reports Series No. 381 (TRS-381)) was published in 1997 to further update TRS-277 and complement it with respect to the area of parallel-plate ionization chambers. Both codes have proven extremely valuable for users involved in the dosimetry of the radiation beams used in radiotherapy. In TRS-277 the calibration of the ionization chambers was based on primary standards of air kerma; this procedure was also used in TRS-381, but the new trend of calibrating ionization chambers directly in a water phantom in terms of absorbed dose to water was introduced. The development of primary standards of absorbed dose to water for high energy photon and electron beams, and improvements in radiation dosimetry concepts, offer the possibility of reducing the uncertainty in the dosimetry of radiotherapy beams. The dosimetry of kilovoltage X rays, as well as that of proton and heavy ion beams, interest in which has grown considerably in recent years, can also be based on these standards. Thus a coherent dosimetry system based on standards of absorbed dose to water is possible for practically all radiotherapy beams. Many Primary Standard Dosimetry Laboratories (PSDLs) already provide calibrations in terms of absorbed dose to water at the radiation quality of 60 Co gamma rays. Some laboratories have extended calibrations to high energy photon and

  15. Polyethylene glycol hydrogel rectal spacer implantation in patients with prostate cancer undergoing combination high-dose-rate brachytherapy and external beam radiotherapy.

    Science.gov (United States)

    Yeh, Jekwon; Lehrich, Brandon; Tran, Carolyn; Mesa, Albert; Baghdassarian, Ruben; Yoshida, Jeffrey; Torrey, Robert; Gazzaniga, Michael; Weinberg, Alan; Chalfin, Stuart; Ravera, John; Tokita, Kenneth

    2016-01-01

    To present rectal toxicity rates in patients administered a polyethylene glycol (PEG) hydrogel rectal spacer in conjunction with combination high-dose-rate brachytherapy and external beam radiotherapy. Between February 2010 and April 2015, 326 prostate carcinoma patients underwent combination high-dose-rate brachytherapy of 16 Gy (average dose 15.5 Gy; standard deviation [SD] = 1.6 Gy) and external beam radiotherapy of 59.4 Gy (average dose 60.2 Gy; SD = 2.9 Gy). In conjunction with the radiation therapy regimen, each patient was injected with 10 mL of a PEG hydrogel in the anterior perirectal fat space. The injectable spacer (rectal spacer) creates a gap between the prostate and the rectum. The rectum is displaced from the radiation field, and rectal dose is substantially reduced. The goal is a reduction in rectal radiation toxicity. Clinical efficacy was determined by measuring acute and chronic rectal toxicity using the National Cancer Center Institute Common Terminology Criteria for Adverse Events v4.0 grading scheme. Median followup was 16 months. The mean anterior-posterior separation achieved was 1.6 cm (SD = 0.4 cm). Rates of acute Grade 1 and 2 rectal toxicity were 37.4% and 2.8%, respectively. There were no acute Grade 3/4 toxicities. Rates of late Grade 1, 2, and 3 rectal toxicity were 12.7%, 1.4%, and 0.7%, respectively. There were no late Grade 4 toxicities. PEG rectal spacer implantation is safe and well tolerated. Acute and chronic rectal toxicities are low despite aggressive dose escalation. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  16. Health-Related Quality of Life After Single-Fraction High-Dose-Rate Brachytherapy and Hypofractionated External Beam Radiotherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Morton, Gerard C.; Loblaw, D. Andrew; Chung, Hans; Tsang, Gail; Sankreacha, Raxa; Deabreu, Andrea; Zhang Liying; Mamedov, Alexandre; Cheung, Patrick; Batchelar, Deidre; Danjoux, Cyril; Szumacher, Ewa

    2011-01-01

    Purpose: To investigate the change in health-related quality of life for men after high-dose-rate brachytherapy and external beam radiotherapy for prostate cancer and the factors associated with this change. Methods and Materials: Eligible patients had clinically localized intermediate-risk prostate cancer. The patients received high-dose-rate brachytherapy as a single 15-Gy implant, followed by external beam radiotherapy to 37.5 Gy in 15 fractions. The patients were monitored prospectively for toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and health-related quality of life (Expanded Prostate Cancer Index Composite [EPIC]). The proportion of patients developing a clinically significant difference in the EPIC domain score (minimally important difference of >0.5 standard deviation) was determined and correlated with the baseline clinical and dosimetric factors. The study accrued 125 patients, with a median follow-up of 24 months. Results: By 24 months, 23% had Grade 2 urinary toxicity and only 5% had Grade 2 bowel toxicity, with no Grade 3 toxicity. The proportion of patients reporting a significant decrease in EPIC urinary, bowel, sexual, and hormonal domain scores was 53%, 51%, 45%, and 40% at 12 months and 57%, 65%, 51%, and 30% at 24 months, respectively. The proportion with a >1 standard deviation decrease in the EPIC urinary, bowel, sexual, and hormonal domain scores was 38%, 36%, 24%, and 20% at 12 months and 46%, 48%, 19%, and 8% at 24 months, respectively. On multivariate analysis, the dose to 10% of the urethra was associated with a decreasing EPIC urinary domain score (p = .0089) and, less strongly (p = .0312) with a decreasing hormonal domain score. No association was found between the prostate volume, bladder dose, or high-dose volume and urinary health-related quality of life. A high baseline International Index of Erectile Function score was associated (p = .0019) with a decreasing sexual domain score. The optimal maximal dose

  17. Radiation dose to laterally transposed ovaries during external beam radiotherapy for cervical cancer

    International Nuclear Information System (INIS)

    Mazonakis, Michael; Damilakis, John; Varveris, Haris; Gourtsoyiannis, Nicholas

    2006-01-01

    The purpose of this study was to estimate the radiation dose to laterally transposed ovaries from external beam radiotherapy for cervical cancer. Dose measurements were performed in a modified humanoid phantom using a 6 MV photon beam. The dependence of the ovarian dose upon the field size, the distance from the primary irradiation field and the presence of wedges or gonadal shielding was determined. For a tumor dose of 45 Gy, ovarian dose was 0.88-8.51 Gy depending on the field size employed and the location of the transposed ovary in respect to the treatment field. Positioning of 7 cm thick shielding reduced the dose to ovary by less than 19%. The use of wedges increased the ovarian dose by a factor up to 1.5. Accurate radiographic localization of the ovaries allows the use of the presented dosimetric results to obtain a reasonable prediction of the ovarian dose

  18. In-vivo (entrance) dose measurements in external beam radiotherapy with aqueous FBX dosimetry system

    International Nuclear Information System (INIS)

    Semwal, M.K.; Thakur, P.K.; Bansal, A.K.; Vidyasagar, P.B.

    2005-01-01

    FBX aqueous chemical dosimetry system has been found useful in radiotherapy owing to its low dose measuring capability. In the present work, entrance dose measurements in external beam radiotherapy on a telecobalt machine were carried out with the system on 100 patients. Treatments involving simple beam arrangement of open parallel-opposed beams in cranial and pelvic irradiations were selected for this study. In place of a spectrophotometer, a simple and inexpensive colorimeter was used for absorbance measurements. The purpose was to assess the efficacy of the FBX system for in-vivo dose measurements. The results obtained show that the average discrepancy between the measured and expected dose for both categories of patients was 0.2% (standard deviation 3.2%) with a maximum of +1 0.3%. There were 5.5% cases showing more than ± 5% discrepancy. Comparison of the results obtained with published work on entrance dose measurements, with diode detectors, shows that the inexpensive FBX system can be used for in-vivo (entrance) dose measurements for simple beam arrangements in radiotherapy and can thus serve as a useful QA tool. (author)

  19. Evaluation of surface and shallow depth dose reductions using a Superflab bolus during conventional and advanced external beam radiotherapy.

    Science.gov (United States)

    Yoon, Jihyung; Xie, Yibo; Zhang, Rui

    2018-03-01

    The purpose of this study was to evaluate a methodology to reduce scatter and leakage radiations to patients' surface and shallow depths during conventional and advanced external beam radiotherapy. Superflab boluses of different thicknesses were placed on top of a stack of solid water phantoms, and the bolus effect on surface and shallow depth doses for both open and intensity-modulated radiotherapy (IMRT) beams was evaluated using thermoluminescent dosimeters and ion chamber measurements. Contralateral breast dose reduction caused by the bolus was evaluated by delivering clinical postmastectomy radiotherapy (PMRT) plans to an anthropomorphic phantom. For the solid water phantom measurements, surface dose reduction caused by the Superflab bolus was achieved only in out-of-field area and on the incident side of the beam, and the dose reduction increased with bolus thickness. The dose reduction caused by the bolus was more significant at closer distances from the beam. Most of the dose reductions occurred in the first 2-cm depth and stopped at 4-cm depth. For clinical PMRT treatment plans, surface dose reductions using a 1-cm Superflab bolus were up to 31% and 62% for volumetric-modulated arc therapy and 4-field IMRT, respectively, but there was no dose reduction for Tomotherapy. A Superflab bolus can be used to reduce surface and shallow depth doses during external beam radiotherapy when it is placed out of the beam and on the incident side of the beam. Although we only validated this dose reduction strategy for PMRT treatments, it is applicable to any external beam radiotherapy and can potentially reduce patients' risk of developing radiation-induced side effects. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  20. Effect of beam arrangement on oral cavity dose in external beam radiotherapy of nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Wu, Vincent W.C.; Yang Zhining; Zhang Wuzhe; Wu Lili; Lin Zhixiong

    2012-01-01

    This study compared the oral cavity dose between the routine 7-beam intensity-modulated radiotherapy (IMRT) beam arrangement and 2 other 7-beam IMRT with the conventional radiotherapy beam arrangements in the treatment of nasopharyngeal carcinoma (NPC). Ten NPC patients treated by the 7-beam routine IMRT technique (IMRT-7R) between April 2009 and June 2009 were recruited. Using the same computed tomography data, target information, and dose constraints for all the contoured structures, 2 IMRT plans with alternative beam arrangements (IMRT-7M and IMRT-7P) by avoiding the anterior facial beam and 1 conventional radiotherapy plan (CONRT) were computed using the Pinnacle treatment planning system. Dose-volume histograms were generated for the planning target volumes (PTVs) and oral cavity from which the dose parameters and the conformity index of the PTV were recorded for dosimetric comparisons among the plans with different beam arrangements. The dose distributions to the PTVs were similar among the 3 IMRT beam arrangements, whereas the differences were significant between IMRT-7R and CONRT plans. For the oral cavity dose, the 3 IMRT beam arrangements did not show significant difference. Compared with IMRT-7R, CONRT plan showed a significantly lower mean dose, V30 and V-40, whereas the V-60 was significantly higher. The 2 suggested alternative beam arrangements did not significantly reduce the oral cavity dose. The impact of varying the beam angles in IMRT of NPC did not give noticeable effect on the target and oral cavity. Compared with IMRT, the 2-D conventional radiotherapy irradiated a greater high-dose volume in the oral cavity.

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

    International Nuclear Information System (INIS)

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

    1994-01-01

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

  2. Treatment of localized prostate cancer using a combination of high dose rate lridium-192 brachytherapy and external beam irradiation: Initial Australian experience

    International Nuclear Information System (INIS)

    Stevens, M.J.; Stricker, P.D.; Brenner, P.C.; Kooner, R.; O'Neil, G.F.A.; Duval, P.J.; Jagavkar, R.S.; Cross, P.; Saalfeld, J.; Martland, J.

    2003-01-01

    Combination high dose rate brachytherapy (HDRB) and external beam radiation therapy is technically and clinically feasible as definitive treatment for localized prostate cancer. We report the first large Australian experience using this technique of radiation dose escalation in 82 patients with intermediate- and high-risk disease. With a median follow up of 3 years (156 weeks), complications were low and overall prostate-specific antigen progression-free survival was 91% using the American Society for Therapeutic Radiology and Oncology consensus definition. The delivery of hypofractionated radiation through the HDRB component shortens overall treatment time and is both biologically and logistically advantageous. As a radiation boost strategy, HDRB is easy to learn and could be introduced into most facilities with brachytherapy capability. Copyright (2003) Blackwell Science Pty Ltd

  3. Beam-target interaction for high-dose, multi-pulse radiography

    International Nuclear Information System (INIS)

    DeVolder, B.G.; Kwan, T.J.T.; Snell, C.M.; Kares, R.J.; McLenithan, K.D.

    1996-01-01

    The conversion of an intense relativistic electron beam into x-rays for radiographic imaging is achieved through the bremsstrahlung process of electrons in a tantalum or tungsten target of some optimal thickness. A high-dose radiographic source with small spot size is needed to achieve desirable resolution for thick objects. Consequently, an extremely high brightness electron beam is used and a significant amount of electron beam energy can be deposited in a small area of the target. The authors describe a computational methodology used to model the beam-target interaction and the evolution of the resultant plasma. Several codes, including particle-in-cell (PIC), Monte Carlo transport, and magnetohydrodynamic (MHD) codes, contribute to simulate different parts of the problem in a linked fashion. Issues addressed by the calculations include: the effects of the time dependence of the energy profile deposited in the target; the influence of the external magnetic field on plasma expansion; the influence of the expanding plasma on the guide magnetic field; radiation effects; and multi-dimensional effects

  4. The international protocol for the dosimetry of external radiotherapy beams based on standards of absorbed dose to water

    International Nuclear Information System (INIS)

    Andreo, P.

    2001-01-01

    An International Code of Practice (CoP, or dosimetry protocol) for external beam radiotherapy dosimetry based on standards of absorbed dose to water has been published by the IAEA on behalf of IAEA, WHO, PAHO and ESTRO. The CoP provides a systematic and internationally unified approach for the determination of the absorbed dose to water in reference conditions with radiotherapy beams. The development of absorbed-dose-to-water standards for high-energy photons and electrons offers the possibility of reducing the uncertainty in the dosimetry of radiotherapy beams. Many laboratories already provide calibrations at the radiation quality of 60Co gamma-rays and some have extended calibrations to high-energy photon and electron beams. The dosimetry of kilovoltage x-rays, as well as that of proton and ion beams can also be based on these standards. Thus, a coherent dosimetry system based on the same formalism is achieved for practically all radiotherapy beams. The practical use of the CoP as simple. The document is formed by a set of different CoPs for each radiation type, which include detailed procedures and worksheets. All CoPs are based on ND,w chamber calibrations at a reference beam quality Qo, together with radiation beam quality correction factors kQ preferably measured directly for the user's chamber in a standards laboratory. Calculated values of kQ are provided together with their uncertainty estimates. Beam quality specifiers are 60Co, TPR20,10 (high-energy photons), R50 (electrons), HVL and kV (x-rays) and Rres (protons and ions) [es

  5. Peripheral photon and neutron doses from prostate cancer external beam irradiation.

    Science.gov (United States)

    Bezak, Eva; Takam, Rundgham; Marcu, Loredana G

    2015-12-01

    Peripheral photon and neutron doses from external beam radiotherapy (EBRT) are associated with increased risk of carcinogenesis in the out-of-field organs; thus, dose estimations of secondary radiation are imperative. Peripheral photon and neutron doses from EBRT of prostate carcinoma were measured in Rando phantom. (6)LiF:Mg,Cu,P and (7)LiF:Mg,Cu,P glass-rod thermoluminescence dosemeters (TLDs) were inserted in slices of a Rando phantom followed by exposure to 80 Gy with 18-MV photon four-field 3D-CRT technique. The TLDs were calibrated using 6- and 18-MV X-ray beam. Neutron dose equivalents measured with CR-39 etch-track detectors were used to derive readout-to-neutron dose conversion factor for (6)LiF:Mg,Cu,P TLDs. Average neutron dose equivalents per 1 Gy of isocentre dose were 3.8±0.9 mSv Gy(-1) for thyroid and 7.0±5.4 mSv Gy(-1) for colon. For photons, the average dose equivalents per 1 Gy of isocentre dose were 0.2±0.1 mSv Gy(-1) for thyroid and 8.1±9.7 mSv Gy(-1) for colon. Paired (6)LiF:Mg,Cu,P and (7)LiF:Mg,Cu,P TLDs can be used to measure photon and neutron doses simultaneously. Organs in close proximity to target received larger doses from photons than those from neutrons whereas distally located organs received higher neutron versus photon dose. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. External beam radiotherapy boosted with high dose rate brachytherapy in completely resected uterine sarcomas. Is this a treatment option?

    Energy Technology Data Exchange (ETDEWEB)

    Pellizzon, Antonio Cassio Assis; Novaes, Paulo Eduardo Ribeiro dos Santos; Maia, Maria Aparecida Conte; Ferrigno, Robson; Fogarolli, Ricardo; Salvajoli, Joao Vitor [Hospital de Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Oncologia de Radiacao]. E-mail: pellizzon@aol.com

    2005-04-15

    Uterine sarcoma (US) is a relative rare tumor, which accounts for only about 3-5% of all uterine cancers. Aggressive cytoreductive surgery at the time of the initial diagnosis with maximum tumor debulking may lead to a prolonged survival or cure. Objective: to identify and review the role of adjuvant external beam radiation therapy (EBRT) associated with high dose rate brachytherapy (HDRB) in the management of patients presenting US with complete resection. Material and methods: this study is a retrospective analysis of 23 patients with US treated from 10/92 to 03/03, with surgery, external beam radiation therapy (EBRT) and high dose rate brachytherapy (HDRB). The inclusion criteria for study participation included: histologically proven and graded US, completely resection of tumor, Karnofsky status 60-100, absence of significant infection, and recovery from recent surgery. Results: The median age of patients was 62 years (range 39-84); ten-year actuarial disease-free and overall survivals were 42.2% and 63.4%, respectively. On univariate analysis, predictive factors for disease-free survival (DFS) were age at initial presentation (p=0.0268), parity (p=0.0441), tumor grade (p= 0.0095), cervical or vaginal invasion (p=0.0014) and node dissection at time of surgery (p= 0.0471). On multivariate analysis, the only predictive factor was cervical or vaginal invasion (p= 0.048), hazard ratio of 4.7. Conclusion: it is quite likely that neither radiotherapy nor chemotherapy alone will appreciably improve survival in US. If radiation therapy provides better locoregional tumor control, hematogenous metastases will assume an even greater proportion of treatment failures. Unfortunately, our small and heterogeneous group analyzed precludes any definitive conclusions about the impact of HDRB associated to EBRT radiation therapy on recurrence or survival. (author)

  7. External beam radiotherapy boosted with high dose rate brachytherapy in completely resected uterine sarcomas. Is this a treatment option?

    International Nuclear Information System (INIS)

    Pellizzon, Antonio Cassio Assis; Novaes, Paulo Eduardo Ribeiro dos Santos; Maia, Maria Aparecida Conte; Ferrigno, Robson; Fogarolli, Ricardo; Salvajoli, Joao Vitor

    2005-01-01

    Uterine sarcoma (US) is a relative rare tumor, which accounts for only about 3-5% of all uterine cancers. Aggressive cytoreductive surgery at the time of the initial diagnosis with maximum tumor debulking may lead to a prolonged survival or cure. Objective: to identify and review the role of adjuvant external beam radiation therapy (EBRT) associated with high dose rate brachytherapy (HDRB) in the management of patients presenting US with complete resection. Material and methods: this study is a retrospective analysis of 23 patients with US treated from 10/92 to 03/03, with surgery, external beam radiation therapy (EBRT) and high dose rate brachytherapy (HDRB). The inclusion criteria for study participation included: histologically proven and graded US, completely resection of tumor, Karnofsky status 60-100, absence of significant infection, and recovery from recent surgery. Results: The median age of patients was 62 years (range 39-84); ten-year actuarial disease-free and overall survivals were 42.2% and 63.4%, respectively. On univariate analysis, predictive factors for disease-free survival (DFS) were age at initial presentation (p=0.0268), parity (p=0.0441), tumor grade (p= 0.0095), cervical or vaginal invasion (p=0.0014) and node dissection at time of surgery (p= 0.0471). On multivariate analysis, the only predictive factor was cervical or vaginal invasion (p= 0.048), hazard ratio of 4.7. Conclusion: it is quite likely that neither radiotherapy nor chemotherapy alone will appreciably improve survival in US. If radiation therapy provides better locoregional tumor control, hematogenous metastases will assume an even greater proportion of treatment failures. Unfortunately, our small and heterogeneous group analyzed precludes any definitive conclusions about the impact of HDRB associated to EBRT radiation therapy on recurrence or survival. (author)

  8. Six fractions per week of external beam radiotherapy and high-dose-rate brachytherapy for carcinoma of the uterine cervix: A phase I/II study

    International Nuclear Information System (INIS)

    Yoon, Sang Min; Huh, Seung Jae; Park, Won; Lee, Jeung Eun; Park, Young Je; Nam, Hee Rim; Lim, Do Hoon; Ahn, Yong Chan

    2006-01-01

    Purpose: This study evaluated the treatment results of external beam radiotherapy administered in six fractions per week and high-dose-rate (HDR) brachytherapy for the treatment of cervical cancer. Methods and Materials: From July 2000 to July 2003, 43 patients were enrolled in this study. The patients received 45 Gy from a 10-MV photon beam using four-field box or anterior-posterior beams. Parametrial regions and the pelvic side walls were boosted with up to 50.4 Gy using a midline block. The daily fraction dose was 1.8 Gy administered in six-weekly fractions, from Monday to Saturday. HDR brachytherapy was also delivered at doses of 24 Gy to point A in six fractions twice a week. The median follow-up time was 37 months (range, 9-60 months). Results: The median overall treatment time was 51 days for all patients (range, 44-62 days). Thirty-four patients (79.1%) achieved complete remission and 8 (18.6%) achieved partial remission after radiotherapy. Locoregional recurrence occurred in 5 patients (11.6%), and a distant metastasis was encountered in 6 patients (13.9%). The 3-year overall survival, locoregional, and distant metastasis-free survival rates were 74.7%, 87.8%, and 84.7%, respectively. Grade 2 and 3 late rectal complications were encountered in 3 (6.5%) and 1 (2.2%), respectively. There were no Grade 3 late bladder complications. Conclusions: Six fractions per week of external beam radiotherapy and HDR brachytherapy is an effective treatment for patients with a carcinoma of the uterine cervix and can be used as a possible alternative to concomitant chemoradiotherapy in elderly patients or in patients with co-morbidity

  9. Comparison of radioimmunotherapy and external beam radiotherapy in colon cancer xenografts

    International Nuclear Information System (INIS)

    Buras, R.R.; Wong, J.F.C.; Kuhn, J.A.; Beatty, B.G.; Williams, L.E.; Beatty, J.D.; Wanek, P.M.

    1993-01-01

    Radioimmunotherapy and external beam radiotherapy were compared in a nude mouse human colon cancer model. Radioimmunotherapy was delivered by intraperitoneal injection of 90 Y-labeled anticarcinoembryonic antigen monoclonal antibody (anti-CEA MAB). Single fraction external beam radiotherapy was delivered using a 60 Co teletherapy unit. Control groups received saline, unlabeled anit-CEA monoclonal antibody and labeled nonspecific monoclonal antibody. Tumor growth suppression was expressed as delay to reach 2g compared to saline controls. Unlabeled anti-CEA monoclonal antibody and labeled nonspecific monoclonal antibody had no effect. External beam radiotherapy of 300, 600, 1000 and 2000 cGy produced growth delays of 3, 12, 17, and 22 days, respectively. Radioimmunotherapy with 120 μCi, 175 μCi, and 225 μCi resulted in growth delays of 20, 34, and 36 days. Estimated absorbed tumor dose was 1750 cGy in the 120 μCi group. Similar comparisons were done with the more radioresistant WiDr human colon carcinoma cell line. External beam radiotherapy doses of 400, 800, 1200, and 1600 cGy resulted in growth delays of 6, 21, 36 and 48 days, respectively. Radioimmunotherapy of 120 μCi and 175 μCi resulted in growth delays of 9 and 19 days, respectively. The 120 μCi dose delivered an estimated absorbed tumor dose of 1080 cGy to WiDr tumors. In summary, for the radiosensitive LS174T line, radioimmunotherapy produced biologic effects that were comparable to a similar dose of single fraction external beam radiotherapy. For the more radioresistant WiDr tumor, radioimmunotherapy produced a biologic effect which was less than a similar dose of single fraction external beam radiotherapy. These studies suggest that a tumor's response to radioimmunotherapy relative to that of external beam radiotherapy is, in part, dependent on tumor radiosensitivity and repair capacity. 23 refs., 5 figs. 4 tabs

  10. High-dose-rate intracavitary brachytherapy combined with external beam radiotherapy for stage IIIb adenocarcinoma of the uterine cervix in Japan. A multi-institutional study of Japanese Society of Therapeutic Radiology and Oncology 2006-2007 (Study of JASTRO 2006-2007)

    International Nuclear Information System (INIS)

    Niibe, Yuzuru; Kenjo, Masahiro; Onishi, Hiroshi

    2010-01-01

    The current study was a retrospective questionnaire survey of stage IIIb adenocarcinoma of the uterine cervix treated with high-dose-rate intracavitary brachytherapy combined with external beam radiation therapy in Japan aimed to investigate the optimal dose on the basis of the biological effective dose and prognostic factors. Between 1990 and 2000, 61 patients with stage IIIb adenocarcinoma of the uterine cervix underwent high-dose-rate intracavitary brachytherapy combined with external beam radiation therapy in 19 major hospitals in Japan. This retrospective questionnaire survey was performed by mail including survey charts to be fulfilled by radiation oncologists in these 19 major hospital. Fifty had only adenocarcinoma components and 11 had adenosquamous cell carcinoma components. All patients were treated with high-dose-rate intracavitary brachytherapy combined with external beam radiation therapy. Total biological effective dose (T-BED 10 ) was calculated from the sum of the biological effective doses of the external beam radiation therapy and the intracavitary brachytherapy. Thirty-two patients underwent chemotherapy. The 5-year overall survival rate of all patients was 20.2%. Stratified by total biological effective dose, the 5-year overall survival rate was 0% for T-BED 10 10 between 75 and 100 Gy and 0% for T-BED 10 >110 Gy (P=0.15). Stratified by histopathology, the 5-year overall survival rate was 22.1% for adenocarcinoma and 13.6% for adenosquamous cell carcinoma (P=0.43). Stratified by chemotherapy, the 5-year overall survival rate was 20.3% in patients who received chemotherapy and 20.4% in patients who did not receive chemotherapy (P=0.96). The 5-year overall survival rate of stage IIIb adenocarcinoma of the uterine cervix in this retrospective questionnaire survey was 20.2%. The optimal T-BED 10 and evident prognostic factors were not clear from this questionnaire survey. (author)

  11. Characterization of the dose perturbation in tissue by stents as a function of external beam energy

    International Nuclear Information System (INIS)

    Schell, M.C.; Rosenzweig, D.P.; Weaver, K.A.; Rubin, P.

    1997-01-01

    Purpose: External beam irradiation of coronary arteries was shown to be detrimental in an animal model for the prevention of neointimal hyperplasia in the presence of stents when orthovoltage x-ray beams are used. This present study investigated the effect of beam energy on the dose distribution in the wall of the artery as a function of energy in the presence of stents in order to ascertain the effect on the dose due to beam energy. Materials and Methods: 250 kVp x-rays and 6-MV x rays were used to irradiate a stent placed in an homogeneous phantom. Radiochromic film densitometry and Monte Carlo calculations were used to measure and to simulate the dose distribution in the proximity of the stent. Result: External beam irradiation was reported to not only fail to prevent neointimal hyperplasia, but actually accentuate the neointimal response to a prompt mechanical injury in the artery. The photoelectric effect, which dominates low-energy x-ray interactions, produces recoil electrons in the stent which enhance the dose surrounding intima. The photoelectrons generated in nickel and iron have an extremely short range in normal tissue, approximately 0.1 mm. Initial estimates of orthovoltage x-ray interactions with the stent indicate a dose enhancement in the orthovoltage range by a factor of 2 to 3 due to the rise in the photoelectric cross section in this energy range depending on the elemental composition of the stent. Film densitometry verifies this dose enhancement. The Monte Carlo calculations yield a dose enhancement and the dose fall off with distance from the stent when irradiated with orthovoltage x-rays. Conversely when the tissue and stent are irradiated with megavoltage x-rays, the dose enhancement in this region is a factor of 1.15 in close proximity to the stent and 1.0 at distances greater than 0.1 mm. 6-MV photon interactions in tissue and iron are predominantly through Compton scattering. The Compton effect is dependent on the electron density in the

  12. External beam radiotherapy for painful osseous metastases: pooled data dose response analysis

    International Nuclear Information System (INIS)

    Ben-Josef, Edgar; Shamsa, Falah; Youssef, Emad; Porter, Arthur T.

    1999-01-01

    Purpose: Although the effectiveness of external beam irradiation in palliation of pain from osseous metastases is well established, the optimal fractionation schedule has not been determined. Clinical studies to date have failed to demonstrate an advantage for higher doses. To further address this issue, we conducted a pooled dose response analysis using data from published Phase III clinical trials. Methods and Materials: Complete response (CR) was used as an endpoint because it was felt to be least susceptible to inconsistencies in assessment.The biological effective dose (BED) was calculated for each schedule using the linear-quadratic model and an α/β of 10. Using SAS version 6.12, the data were fitted using a weighted linear regression, a logistic model, and the spline technique. Finally, BED was categorized, and odds ratios for each level were calculated. Results: CR was assessed early and late in 383 and 1,007 patients, respectively. Linear regression on the early-response data yielded a poor fit and a nonsignificant dose coefficient. With the late-response data, there was an excellent fit (R-square = 0.842) and a highly significant dose coefficient (p = 0.0002). Fitting early CR to a logistic model, we could not establish a significant dose response relationship. However, with the late-response data there was an excellent fit and the dose coefficient was significantly different from zero (0.017 ± 0.00524; p = 0.0012). Application of the spline technique or removal of an outlier resulted in an improved fit (p 0.048 and p = 0.0001, respectively). Using BED of < 14.4 Gy as a reference level, the odds ratios for late CR were 2.29-3.32 (BED of 19.5-51.4 Gy, respectively). Conclusion: Our results demonstrate a clear dose-response for pain relief. Further testing of high intensity regiments is warranted

  13. Early observed transient prostate-specific antigen elevations on a pilot study of external beam radiation therapy and fractionated MRI guided High Dose Rate brachytherapy boost

    International Nuclear Information System (INIS)

    Singh, Anurag K; Godette, Denise J; Stall, Bronwyn R; Coleman, C Norman; Camphausen, Kevin; Ménard, Cynthia; Guion, Peter; Susil, Robert C; Citrin, Deborah E; Ning, Holly; Miller, Robert W; Ullman, Karen; Smith, Sharon; Crouse, Nancy Sears

    2006-01-01

    To report early observation of transient PSA elevations on this pilot study of external beam radiation therapy and magnetic resonance imaging (MRI) guided high dose rate (HDR) brachytherapy boost. Eleven patients with intermediate-risk and high-risk localized prostate cancer received MRI guided HDR brachytherapy (10.5 Gy each fraction) before and after a course of external beam radiotherapy (46 Gy). Two patients continued on hormones during follow-up and were censored for this analysis. Four patients discontinued hormone therapy after RT. Five patients did not receive hormones. PSA bounce is defined as a rise in PSA values with a subsequent fall below the nadir value or to below 20% of the maximum PSA level. Six previously published definitions of biochemical failure to distinguish true failure from were tested: definition 1, rise >0.2 ng/mL; definition 2, rise >0.4 ng/mL; definition 3, rise >35% of previous value; definition 4, ASTRO defined guidelines, definition 5 nadir + 2 ng/ml, and definition 6, nadir + 3 ng/ml. Median follow-up was 24 months (range 18–36 mo). During follow-up, the incidence of transient PSA elevation was: 55% for definition 1, 44% for definition 2, 55% for definition 3, 33% for definition 4, 11% for definition 5, and 11% for definition 6. We observed a substantial incidence of transient elevations in PSA following combined external beam radiation and HDR brachytherapy for prostate cancer. Such elevations seem to be self-limited and should not trigger initiation of salvage therapies. No definition of failure was completely predictive

  14. Low-dose-rate intraoperative brachytherapy combined with external beam irradiation in the conservative treatment of soft tissue sarcoma

    International Nuclear Information System (INIS)

    Delannes, M.; Thomas, L.; Martel, P.; Bonnevialle, P.; Stoeckle, E.; Chevreau, Ch.; Bui, B.N.; Daly-Schveitzer, N.; Pigneux, J.; Kantor, G.

    2000-01-01

    Purpose: Conservative treatment of soft tissue sarcomas most often implies combination of surgical resection and irradiation. The aim of this study was to evaluate low-dose-rate intraoperative brachytherapy, delivered as a boost, in the local control of primary tumors, with special concern about treatment complications. Methods and Materials: Between 1986 and 1995, 112 patients underwent intraoperative implant. This report focuses on the group of 58 patients with primary sarcomas treated by combination of conservative surgery, intraoperative brachytherapy, and external irradiation. Most of the tumors were located in the lower limbs (46/58--79%). Median size of the tumor was 10 cm, most of the lesions being T2-T3 (51/58--88%), Grade 2 or 3 (48/58--83%). The mean brachytherapy dose was 20 Gy and external beam irradiation dose 45 Gy. In 36/58 cases, iridium wires had to be placed on contact with neurovascular structures. Results: With a median follow-up of 54 months, the 5-year actuarial survival was 64.9%, with a 5-year actuarial local control of 89%. Of the 6 patients with local relapse, 3 were salvaged. Acute side effects, essentially wound healing problems, occurred in 20/58 patients, late side effects in 16/58 patients (7 neuropathies G2 to G4). No amputation was required. The only significant factor correlated with early side effects was the location of the tumor in the lower limb (p = 0.003), and with late side effects the vicinity of the tumor with neurovascular structures (p = 0.009). Conclusion: Brachytherapy allows early delivery of a boost dose in a reduced volume of tissue, precisely mapped by the intraoperative procedure. Combined with external beam irradiation, it is a safe and efficient treatment technique leading to high local control rates and limited functional impairment

  15. Tolerance doses of cutaneous and mucosal tissues in ring-necked parakeets (Psittacula krameri) for external beam megavoltage radiation.

    Science.gov (United States)

    Barron, Heather W; Roberts, Royce E; Latimer, Kenneth S; Hernandez-Divers, Stephen; Northrup, Nicole C

    2009-03-01

    Currently used dosages for external-beam megavoltage radiation therapy in birds have been extrapolated from mammalian patients and often appear to provide inadequate doses of radiation for effective tumor control. To determine the tolerance doses of cutaneous and mucosal tissues of normal birds in order to provide more effective radiation treatment for tumors that have been shown to be radiation responsive in other species, ingluvial mucosa and the skin over the ingluvies of 9 ring-necked parakeets (Psittacula krameri) were irradiated in 4-Gy fractions to a total dose of either 48, 60, or 72 Gy using an isocentric cobalt-60 teletherapy unit. Minimal radiation-induced epidermal changes were present in the high-dose group histologically. Neither dose-related acute nor chronic radiation effects could be detected in any group grossly in cutaneous or mucosal tissue over a 9-month period. Radiation doses of 72 Gy in 4-Gy fractions were well tolerated in the small number of ring-necked parakeets in this initial tolerance dose study.

  16. Measurement and properties of the dose-area product ratio in external small-beam radiotherapy.

    Science.gov (United States)

    Niemelä, Jarkko; Partanen, Mari; Ojala, Jarkko; Sipilä, Petri; Björkqvist, Mikko; Kapanen, Mika; Keyriläinen, Jani

    2017-06-21

    In small-beam radiation therapy (RT) the measurement of the beam quality parameter, i.e. the tissue-phantom ratio or TPR 20,10 , using a conventional point detector is a challenge. To obtain reliable results, one has to consider potential sources of error, including volume averaging and adjustment of the point detector into the narrow beam. To overcome these challenges, a different type of beam quality parameter in small beams was studied, namely the dose-area product ratio, or DAPR 20,10 . With this method, the measurement of a dose-area product (DAP) using a large-area plane-parallel chamber (LAC) eliminates the uncertainties in detector positioning and volume averaging that are present when using a point detector. In this study, the properties of the DAPR 20,10 of a cone-collimated 6 MV photon beam were investigated using Monte Carlo (MC) calculations and the obtained values were compared to measurements obtained using two LAC detectors, PTW Type 34073 and PTW Type 34070. In addition, the possibility of determining the DAP using EBT3 film and a Razor diode detector was studied. The determination of the DAPR 20,10 value was found to be feasible in external small-beam radiotherapy using cone-collimated beams with diameters from 4-40 mm, based on the results of the two LACs, the MC calculations and the Razor diode. The measurements indicated a constant DAPR 20,10 value for fields 20-40 mm in diameter, with a maximum relative change of 0.6%, but an increase of 7.0% for fields from 20-4 mm in diameter for the PTW Type 34070 chamber. Simulations and measurements showed an increase of DAPR 20,10 with increasing LAC size or dose integral area for the studied 4-40 mm cone-collimated 6 MV photon beams. This has the consequence that there should be a reference to the size of the used LAC active area or the DAP integration area with the reported DAPR 20,10 value.

  17. Measurement and properties of the dose-area product ratio in external small-beam radiotherapy

    Science.gov (United States)

    Niemelä, Jarkko; Partanen, Mari; Ojala, Jarkko; Sipilä, Petri; Björkqvist, Mikko; Kapanen, Mika; Keyriläinen, Jani

    2017-06-01

    In small-beam radiation therapy (RT) the measurement of the beam quality parameter, i.e. the tissue-phantom ratio or TPR20,10, using a conventional point detector is a challenge. To obtain reliable results, one has to consider potential sources of error, including volume averaging and adjustment of the point detector into the narrow beam. To overcome these challenges, a different type of beam quality parameter in small beams was studied, namely the dose-area product ratio, or DAPR20,10. With this method, the measurement of a dose-area product (DAP) using a large-area plane-parallel chamber (LAC) eliminates the uncertainties in detector positioning and volume averaging that are present when using a point detector. In this study, the properties of the DAPR20,10 of a cone-collimated 6 MV photon beam were investigated using Monte Carlo (MC) calculations and the obtained values were compared to measurements obtained using two LAC detectors, PTW Type 34073 and PTW Type 34070. In addition, the possibility of determining the DAP using EBT3 film and a Razor diode detector was studied. The determination of the DAPR20,10 value was found to be feasible in external small-beam radiotherapy using cone-collimated beams with diameters from 4-40 mm, based on the results of the two LACs, the MC calculations and the Razor diode. The measurements indicated a constant DAPR20,10 value for fields 20-40 mm in diameter, with a maximum relative change of 0.6%, but an increase of 7.0% for fields from 20-4 mm in diameter for the PTW Type 34070 chamber. Simulations and measurements showed an increase of DAPR20,10 with increasing LAC size or dose integral area for the studied 4-40 mm cone-collimated 6 MV photon beams. This has the consequence that there should be a reference to the size of the used LAC active area or the DAP integration area with the reported DAPR20,10 value.

  18. Radiation optic neuropathy after megavoltage external-beam irradiation: Analysis of time-dose factors

    International Nuclear Information System (INIS)

    Parsons, J.T.; Bova, F.J.; Million, R.R.

    1994-01-01

    To investigate the risk of radiation-induced optic neuropathy according to total radiotherapy dose and fraction size, based on both retrospective and prospectively collected data. Between October 1964 and May 1989, 215 optic nerves in 131 patients received fractionated external-beam irradiation during the treatment of primary extracranial head and neck tumors. All patients had a minimum of 3 years of ophthalmologic follow-up (range, 3 to 21 years). The clinical end point was visual acuity of 20/100 or worse as a result of optic nerve injury. Anterior ischemic optic neuropathy developed in five nerves (at mean and median times of 32 and 30 months, respectively, and a range of 2-4 years). Retrobulbar optic neuropathy developed in 12 nerves (at mean and median times of 47 and 28 months, respectively, and a range of 1-14 years). No injuries were observed in 106 optic nerves that received a total dose of <59 Gy. Among nerves that received doses of ≥ 60 Gy, the dose per fraction was more important than the total dose in producing optic neuropathy. The 15-year actuarial risk of optic compared with 47% when given in fraction sizes ≥1.9 Gy. The data also suggest an increased risk of optic nerve injury with increasing age. As there is no effective treatment of radiation-induced optic neuropathy, efforts should be directed at its prevention by minimizing the total dose, paying attention to the dose per fraction to the nerve, and using reduced field techniques where appropriate to limit the volume of tissues that receive high-dose irradiation. 32 refs., 5 figs., 5 tabs

  19. Feasibility study of radiophotoluminescent glass rod dosimeter postal dose intercomparison for high energy photon beam

    International Nuclear Information System (INIS)

    Rah, Jeong-Eun; Kim, Siyong; Cheong, Kwang-Ho; Lee, Jeong-Woo; Chung, Jin-Beom; Shin, Dong-Oh; Suh, Tae-Suk

    2009-01-01

    A radiophotoluminescent glass rod dosimeter (GRD) system has recently become commercially available. In this study we evaluated whether the GRD would be suitable for external dosimetric audit program in radiotherapy. For this purpose, we introduced a methodology of the absorbed dose determination with the GRD by establishing calibration coefficient and various correction factors (non-linearity dose response, fading, energy dependence and angular dependence). A feasibility test of the GRD postal dose intercomparison was also performed for eight high photon beams by considering four radiotherapy centers in Korea. In the accuracy evaluation of the GRD dosimetry established in this study, we obtained within 1.5% agreements with the ionization chamber dosimetry for the 60 Co beam. It was also observed that, in the feasibility study, all the relative deviations were smaller than 3%. Based on these results, we believe that the new GRD system has considerable potential to be used for a postal dose audit program

  20. Neoadjuvant androgen deprivation and long-term results for patients with intermediate- and high-risk prostate cancer treated with high-dose rate brachytherapy and external beam radiotherapy

    International Nuclear Information System (INIS)

    Pellizzon, Antonio Cassio Assis; Fogaroli, Ricardo Cesar; Silva, Maria Leticia Gobo; Castro, Douglas Guedes; Maia, Maria Conte

    2010-01-01

    Purpose: to evaluate the influence of neoadjuvant androgen deprivation (NAAD) and report the long term biochemical control rates according to the Phoenix Consensus Conference, and prognostic factors of intermediate- (IR) and high-risk (HR) prostate cancer treated with external beam radiotherapy and high-dose-rate brachytherapy (HDR-BT). Methods and materials: between March, 1997 and June, 2005, 184 patients considered IR or HR were treated with localized radiotherapy and HDR-BT at the Department of Radiation Oncology, Hospital A.C. Camargo, Sao Paulo, Brazil. Patient's age, Gleason score, clinical stage, initial PSA value, risk group for biochemical failure, presence of NAAD, doses of radiotherapy and HDR-BT were evaluated. Results: median age and follow-up were 70 years old (range, 47-83) and 74.5 months (range, 24-123 months), respectively. Patients considered IR were 91 (49.4%) and HR 93 (50.6%). Ninety-nine (53.8%) patients had no NAAD. The overall survival at 5 years was 93.6%. The 5-year actuarial biochemical control rates for all patients, IR and HR were 83.4%, 86.2% and 78.8%, respectively, p0.076. On univariate analysis the prognostic factors related to better biochemical control were Gleason score 45 Gy (p= 0.011) and HDR-BT dose > 20 Gy (p< 0.001). On multivariate analysis no statistical significant predictive factor related to biochemical control was found. Conclusions: the role of NAAD for IR and HR prostate cancer is still to be defined. HDR-BT combined to external radiotherapy is a successful form of treatment for these patients, with our results comparable to published data. (author)

  1. Under-utilisation of high-dose-rate brachytherapy boost in men with intermediate-high risk prostate cancer treated with external beam radiotherapy.

    Science.gov (United States)

    Ong, Wee Loon; Evans, Sue M; Millar, Jeremy L

    2018-04-01

    The aim of this study was to evaluate the use of high-dose-rate brachytherapy (HDR-BT) boost with definitive external beam radiotherapy (EBRT) in prostate cancer (CaP) management. The study population comprised men with intermediate-high risk CaP captured in the population-based Prostate Cancer Outcome Registry Victoria (PCOR-Vic), treated with EBRT from January 2010 to December 2015. The primary outcome is the proportion of men who received HDR-BT boost. Multivariate logistic regressions were used to evaluate the effect of patient-, tumour- and treatment-factors on the likelihood of HDR-BT use. Medicare Benefit Schedule (MBS) data was accessed to evaluate the Australia-wide pattern of HDR-BT use. One thousand eight hundred and six patients were included in this study - 886 (49%) intermediate-risk, and 920 (51%) high-risk CaP patients. Overall, only 124 (7%) patients had EBRT + HDR-BT - 47 (5%) intermediate-risk and 77 (8%) high-risk CaP patients (P = 0.01). There is higher proportion of patients who had HDR-BT in public institutions (7% public vs. 3% private, P = 0.005) and in metropolitan centres (9% metropolitan vs. 2% regional, P Victorian men with CaP. The decline in HDR-BT use was also observed nationally. © 2017 The Royal Australian and New Zealand College of Radiologists.

  2. External beam radiotherapy alone or combined with high-dose-rate intracavitary irradiation in the treatment of cancer of the esophagus

    International Nuclear Information System (INIS)

    Hishikawa, Y.; Taniguchi, M.; Kamikonya, N.; Tanaka, S.; Miura, T.

    1988-01-01

    Autopsy findings of 35 patients, treated with radiotherapy for an esophageal carcinoma, were reviewed. A residual tumor was seen at autopsy in 7 of 16 patients treated with high-dose-rate intracavitary irradiation following external irradiation, in 13 of 14 patients treated with external irradiation of 50 Gy or more, and in all 5 patients treated with external irradiation of less than 50 Gy. Incidence on lymph node metastasis, at autopsy, did not diifer between the combined radiotherapy group and the external irradiation groups. However, it correlated with disease stage. It was observed in 11 of 17 patients with Stage 1 and Stage 2 disease, compared to 17 of 18 patients with Stage 3 and Stage 4 disease. Distant organ metastasis, at autopsy, also did not differ between the combined radiotherapy group and the external irradiation groups, and was also correlated with disease stage. It was found in 8 of 17 patients with Stage 1 and Stage 2 disease, compared to all 18 patients with Stage 3 and Stage 4 disease. Mean survival was different between the patients treated by high-dose-rate intracavitary irradiation following external irradiation and those treated by external irradiation alone; 11.3 months in the 16 patients treated with combined therapy, as compared to 6.9 months in the 14 patients who received external irradiation of 50 Gy or more, and 3.6 months in the 5 patients who received external irradiation of less than 50 Gy. 6 refs.; 5 tabs

  3. Radiation retinopathy after external-beam irradiation: Analysis of time-dose factors

    International Nuclear Information System (INIS)

    Parsons, J.T.; Bova, F.J.; Mendenhall, W.M.

    1994-01-01

    To investigate the risk of radiation-induced retinopathy according to total radiation dose and fraction size, based on both retorspective and prospectively collected data. Between October 1964 and May 1989, 68 retinae in 64 patients received fractionated external-beam irradiation during the treatment of primary extracranial head and neck tumors. All patients had a minimum of 3 years of ophthalmologic follow-up (range, 3 to 26 years; mean, 9 years; median, 8 years). Twenty-seven eyes in 26 patients developed radiation retinopathy resulting in visual acuity of 20/200 or worse. The mean and median times to the onset of symptoms attributable to retinal ischemia were 2.8 and 2.5 years, respectively. Fourteen of the injured eyes developed rubeosis iridis and/or neovascular glaucoma. Radiation retinopathy was not observed at doses below 45 Gy, but increased steadily in incidence at doses ≥45Gy. In the range of doses between 45 and 55 Gy, there was an increased risk of injury among patients who received doses per fraction of ≥1.9Gy (p - .09). There was also a trend toward increased risk of injury among patients who received chemotherapy (two of two vs. four of ten in the 45-51 Gy range; p - .23). The lowest dose associated with retinopathy was 45 Gy delivered to a diabetic patient by twice-a-day fractionation. The data did not suggest an increased risk of radiation retinopathy with increasing age. The current study suggests the importance of total dose as well as dose per fraction, and adds support to a small body of literature suggesting that patients with diabetes mellitus or who receive chemotherapy are at increased risk of injury. A sigmoid dose-response curve is constructed from our current data and data from the literature. 36 refs., 5 figs., 4 tabs

  4. Adjuvant high-dose-rate brachytherapy after external beam radiotherapy in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Oezyar, Enis; Yildz, Ferah; Akyol, Fadil H.; Atahan, I. Lale

    2002-01-01

    Purpose: To compare the local control and survival rates obtained with either external beam radiation therapy (ERT) and adjuvant high-dose-rate (HDR) brachytherapy (BRT) or ERT alone in patients with nasopharyngeal cancer. Methods and Materials: Between December 1993 and December 1999, 144 patients (106 male, 38 female) with the diagnosis of nasopharyngeal cancer were treated with either ERT and adjuvant HDR BRT (Group A) or ERT alone (Group B) at our department. BRT was not applied in 38 patients for the following reasons: (1) Unit was unavailable (n=13), (2) Patient was younger than 18 years (n=17), (3) Patient received accelerated hyperfractionated ERT (n=6), and (4) Patient refused BRT (n=2). The median age for whole group was 43 (range: 9-82 years). According to the AJCC-1997 staging system, there were 11 (7.6%), 35 (24.3%), 38 (26.4%), and 60 (41.7%) patients in Stage I, II, III, and IV, respectively. There were 57 (39.6%) patients with T1, 41 (28.5%) with T2, 20 (13.9%) with T3, and 26 (18.1%) with T4 tumors. Histopathologic diagnosis was WHO 2-3 in 137 (95.2%) patients. ERT doses ranged between 58.8 and 74 Gy (median: 66 Gy). There were significantly more patients with young age, N2 status, and Stage III disease in Group B and with Stage II disease in Group A. Significantly more patients received chemotherapy in Group B. BRT with an HDR 192 Ir microSelectron afterloading unit was delivered in 106 patients at the conclusion of ERT using a single-channel nasal applicator. Dose was prescribed at 1 cm from the source, and total dose of 12 Gy in 3 fractions on 3 consecutive days was given immediately after ERT. Besides radiotherapy, 82 (56.9%) patients received cisplatin-based chemotherapy, as well. Follow-up time ranged between 12 and 80 months (median: 32 months). Results: The two groups were comparable in terms of local recurrence, locoregional failure, regional failure, and rate of distant metastasis. Local failure was observed in 11 (10.3%) out of 106

  5. Prostate-specific antigen bounce after high-dose rate brachytherapy with external beam radiation therapy for prostate cancer patients

    International Nuclear Information System (INIS)

    Sakamoto, Naotaka; Kakinoki, Hiroaki; Tsutsui, Akio; Yoshikawa, Masahiro; Iguchi, Atsushi; Matsunobu, Toru; Uehara, Satoru

    2008-01-01

    Prostate-specific antigen (PSA) bounce after high-dose rate (HDR) brachytherapy with external beam radiation therapy (EBRT) for prostate cancer patients was evaluated. Sixty-one patients treated with HDR-brachytherapy followed by EBRT had a minimum follow-up of 12 months (median, 24 months) in our institute. A PSA bounce was defined as a rise of at least 0.1 ng/ml greater than a previous PSA level, with a subsequent decline equal to, or less than, the initial nadir. A PSA bounce was noted in 16 (26.2%) of 61 patients (one patient had a PSA bounce twice). Median time to develop a PSA bounce was 18 months, but 23.5% developed a PSA bounce after 24 months. Median duration of PSA bounce was 6 months and 11.8% had increased PSA within a period of 12 months. Median bounce height was 0.2 ng/ml (range, 0.1 to 3.39 ng/ml). A bounce height of gerater than 2 ng/ml was seen in 11.8%. Clinical characteristics (age, prostate volume, neoadjuvant endocrine therapy, risk classification, stage, pretreatment PSA, Gleason score) do not predict whether or not there will be a PSA bounce. In patients treated with HDR-brachytherapy followed by EBRT, the incidence and characteristics of PSA bounce were similar to those in patients treated with low-dose rate brachytherapy. Physicians should be aware of the possibility of PSA bounce following HDR-brachytherapy with EBRT. (author)

  6. Knowledge-based prediction of three-dimensional dose distributions for external beam radiotherapy

    International Nuclear Information System (INIS)

    Shiraishi, Satomi; Moore, Kevin L.

    2016-01-01

    Purpose: To demonstrate knowledge-based 3D dose prediction for external beam radiotherapy. Methods: Using previously treated plans as training data, an artificial neural network (ANN) was trained to predict a dose matrix based on patient-specific geometric and planning parameters, such as the closest distance (r) to planning target volume (PTV) and organ-at-risks (OARs). Twenty-three prostate and 43 stereotactic radiosurgery/radiotherapy (SRS/SRT) cases with at least one nearby OAR were studied. All were planned with volumetric-modulated arc therapy to prescription doses of 81 Gy for prostate and 12–30 Gy for SRS. Using these clinically approved plans, ANNs were trained to predict dose matrix and the predictive accuracy was evaluated using the dose difference between the clinical plan and prediction, δD = D clin − D pred . The mean (〈δD r 〉), standard deviation (σ δD r ), and their interquartile range (IQR) for the training plans were evaluated at a 2–3 mm interval from the PTV boundary (r PTV ) to assess prediction bias and precision. Initially, unfiltered models which were trained using all plans in the cohorts were created for each treatment site. The models predict approximately the average quality of OAR sparing. Emphasizing a subset of plans that exhibited superior to the average OAR sparing during training, refined models were created to predict high-quality rectum sparing for prostate and brainstem sparing for SRS. Using the refined model, potentially suboptimal plans were identified where the model predicted further sparing of the OARs was achievable. Replans were performed to test if the OAR sparing could be improved as predicted by the model. Results: The refined models demonstrated highly accurate dose distribution prediction. For prostate cases, the average prediction bias for all voxels irrespective of organ delineation ranged from −1% to 0% with maximum IQR of 3% over r PTV ∈ [ − 6, 30] mm. The average prediction error was less

  7. Rectal Bleeding After High-Dose-Rate Brachytherapy Combined With Hypofractionated External-Beam Radiotherapy for Localized Prostate Cancer: The Relationship Between Dose-Volume Histogram Parameters and the Occurrence Rate

    International Nuclear Information System (INIS)

    Okamoto, Masahiko; Ishikawa, Hitoshi; Ebara, Takeshi; Kato, Hiroyuki; Tamaki, Tomoaki; Akimoto, Tetsuo; Ito, Kazuto; Miyakubo, Mai; Yamamoto, Takumi; Suzuki, Kazuhiro; Takahashi, Takeo; Nakano, Takashi

    2012-01-01

    Purpose: To determine the predictive risk factors for Grade 2 or worse rectal bleeding after high-dose-rate brachytherapy (HDR-BT) combined with hypofractionated external-beam radiotherapy (EBRT) for prostate cancer using dose–volume histogram analysis. Methods and Materials: The records of 216 patients treated with HDR-BT combined with EBRT were analyzed. The treatment protocols for HDR-BT were 5 Gy × five times in 3 days or 7 Gy × three, 10.5 Gy × two, or 9 Gy × two in 2 days. The EBRT doses ranged from 45 to 51 Gy with a fractional dose of 3 Gy. Results: In 20 patients Grade 2 or worse rectal bleeding developed, and the cumulative incidence rate was 9% at 5 years. By converting the HDR-BT and EBRT radiation doses into biologic effective doses (BED), the BED 3 at rectal volumes of 5% and 10% in the patients who experienced bleeding were significantly higher than those in the remaining 196 patients. Univariate analysis showed that a higher rectal BED 3–5% and the use of fewer needles in brachytherapy were correlated with the incidence of bleeding, but BED 3–5% was found to be the only significant factor on multivariate analysis. Conclusions: The radiation dose delivered to small rectal lesions as 5% is important for predicting Grade 2 or worse rectal bleeding after HDR-BT combined with EBRT for prostate cancer.

  8. Increasing Use of Dose-Escalated External Beam Radiation Therapy for Men With Nonmetastatic Prostate Cancer

    International Nuclear Information System (INIS)

    Swisher-McClure, Samuel; Mitra, Nandita; Woo, Kaitlin; Smaldone, Marc; Uzzo, Robert; Bekelman, Justin E.

    2014-01-01

    Purpose: To examine recent practice patterns, using a large national cancer registry, to understand the extent to which dose-escalated external beam radiation therapy (EBRT) has been incorporated into routine clinical practice for men with prostate cancer. Methods and Materials: We conducted a retrospective observational cohort study using the National Cancer Data Base, a nationwide oncology outcomes database in the United States. We identified 98,755 men diagnosed with nonmetastatic prostate cancer between 2006 and 2011 who received definitive EBRT and classified patients into National Comprehensive Cancer Network (NCCN) risk groups. We defined dose-escalated EBRT as total prescribed dose of ≥75.6 Gy. Using multivariable logistic regression, we examined the association of patient, clinical, and demographic characteristics with the use of dose-escalated EBRT. Results: Overall, 81.6% of men received dose-escalated EBRT during the study period. The use of dose-escalated EBRT did not vary substantially by NCCN risk group. Use of dose-escalated EBRT increased from 70.7% of patients receiving treatment in 2006 to 89.8% of patients receiving treatment in 2011. On multivariable analysis, year of diagnosis and use of intensity modulated radiation therapy were significantly associated with receipt of dose-escalated EBRT. Conclusions: Our study results indicate that dose-escalated EBRT has been widely adopted by radiation oncologists treating prostate cancer in the United States. The proportion of patients receiving dose-escalated EBRT increased nearly 20% between 2006 and 2011. We observed high utilization rates of dose-escalated EBRT within all disease risk groups. Adoption of intensity modulated radiation therapy was strongly associated with use of dose-escalated treatment

  9. Clinical result of high-dose rate intraluminal brachytherapy for esophageal carcinoma with a remote afterloading system

    International Nuclear Information System (INIS)

    Fukuda, Haruyuki; Nakajima, Toshifumi; Tada, Takuhito; Tanaka, Masahiro; Tsumura, Masashi; Onoyama, Yasuto

    1992-01-01

    During the period from 1977 through 1987, 105 patients with esophageal carcinoma were radically treated by radiotherapy. Forty-six patients receiving therapy before August 1982 were all treated by external beam therapy alone (Group 1). Since September 1982, 26 patients were treated by external beam therapy alone (Group 2) and 33 patients were treated by high-dose-rate intraluminal brachytherapy with a remote afterloading system combined with external beam therapy (Group 3). Dose of external beam therapy for Group 1, Group 2 and Group 3 patients were 66.7 Gy, 68.7 Gy and 55.9 Gy on the average. The intraluminal brachytherapy was performed with a total dose of 12 Gy consisting of 3 Gy twice a week. Ten of 72 patients (14%) treated by external beam therapy alone achieved complete response, whereas 14 of 33 patients (42%) treated by high-dose-rate intraluminal brachytherapy combined with external beam therapy had complete response. One-, and 3-year survival rates were 36% and 10% in the Group 1, 32% and 12% in the Group 2 and 56% and 36% in the Group 3. For Group 3, good survival rate was obtained in tumorous type and serrated type. Patients with tumor of less than 5 cm in Group 3 had good survival. The data suggest that the high-dose-rate intraluminal bracytherapy prescribed as a boost therapy following external beam therapy is an effective therapy modality for esophageal carcinoma which is of non-circumferential tumor or less than 5 cm. (author)

  10. 103PD brachytherapy and external beam irradiation for clinically localized, high-risk prostatic carcinoma

    International Nuclear Information System (INIS)

    Dattoli, Michael; Wallner, Kent; Sorace, Richard; Koval, John; Cash, Jennifer; Acosta, Rudolph; Brown, Charles; Etheridge, James; Binder, Michael; Brunelle, Richard; Kirwan, Novelle; Sanchez, Servando; Stein, Douglas; Wasserman, Stuart

    1996-01-01

    Purpose: To summarize biochemical failure rates and morbidity of external beam irradiation (EBRT) combined with palladium ( 103 Pd) boost for clinically localized high-risk prostate carcinoma. Methods and Materials: Seventy-three consecutive patients with stage T2a-T3 prostatic carcinoma were treated from 1991 through 1994. Each patient had at least one of the following risk factors for extracapsular disease extension: Stage T2b or greater (71 patients), Gleason score 7-10 (40 patients), prostate specific antigen (PSA) >15 (32 patients), or elevated prostatic acid phosphatase (PAP) (17 patients). Patients received 41 Gy EBRT to a limited pelvic field, followed 4 weeks later by a 103 Pd boost (prescription dose: 80 Gy). Biochemical failure was defined as a PSA greater than 1.0 ng/ml (normal 103 Pd brachytherapy for clinically localized, high-risk prostate cancer compare favorably with that reported after conventional dose EBRT alone. Morbidity has been acceptable

  11. Proton external beam in the TANDAR Accelerator

    International Nuclear Information System (INIS)

    Rey, R.; Schuff, J.A.; Perez de la Hoz, A.; Debray, M.E.; Hojman, D.; Kreiner, A.J.; Kesque, J.M.; Saint-Martin, G.; Oppezzo, O.; Bernaola, O.A.; Molinari, B.L.; Duran, H.A.; Policastro, L.; Palmieri, M.; Ibanez, J.; Stoliar, P.; Mazal, A.; Caraballo, M.E.; Burlon, A.; Cardona, M.A.; Vazquez, M.E.; Salfity, M.F.; Ozafran, M.J.; Naab, F.; Levinton, G.; Davidson, M.; Buhler, M.

    1998-01-01

    An external proton beam has been obtained in the TANDAR accelerator with radiological and biomedical purposes. The protons have excellent physical properties for their use in radiotherapy allowing a very good accuracy in the dose spatial distribution inside the tissue so in the side direction as in depth owing to the presence of Bragg curve. The advantage of the accuracy in the dose localization with proton therapy is good documented (M. Wagner, Med. Phys. 9, 749 (1982); M. Goitein and F. Chen, Med. Phys. 10, 831 (1983); M.R. Raju, Rad. Res. 145, 391 (1996)). It was obtained external proton beams with energies between 15-25 MeV, currents between 2-10 p A and a uniform transversal sections of 40 mm 2 approximately. It was realized dosimetric evaluations with CR39 and Makrofol foliation. The irradiations over biological material contained experiences In vivo with laboratory animals, cellular and bacterial crops. It was fixed the optimal conditions of position and immobilization of the Wistar rats breeding for the In vivo studies. It was chosen dilutions and sowing techniques adequate for the exposition at the cellular and bacterial crops beam. (Author)

  12. Knowledge-based prediction of three-dimensional dose distributions for external beam radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shiraishi, Satomi; Moore, Kevin L., E-mail: kevinmoore@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California 92093 (United States)

    2016-01-15

    Purpose: To demonstrate knowledge-based 3D dose prediction for external beam radiotherapy. Methods: Using previously treated plans as training data, an artificial neural network (ANN) was trained to predict a dose matrix based on patient-specific geometric and planning parameters, such as the closest distance (r) to planning target volume (PTV) and organ-at-risks (OARs). Twenty-three prostate and 43 stereotactic radiosurgery/radiotherapy (SRS/SRT) cases with at least one nearby OAR were studied. All were planned with volumetric-modulated arc therapy to prescription doses of 81 Gy for prostate and 12–30 Gy for SRS. Using these clinically approved plans, ANNs were trained to predict dose matrix and the predictive accuracy was evaluated using the dose difference between the clinical plan and prediction, δD = D{sub clin} − D{sub pred}. The mean (〈δD{sub r}〉), standard deviation (σ{sub δD{sub r}}), and their interquartile range (IQR) for the training plans were evaluated at a 2–3 mm interval from the PTV boundary (r{sub PTV}) to assess prediction bias and precision. Initially, unfiltered models which were trained using all plans in the cohorts were created for each treatment site. The models predict approximately the average quality of OAR sparing. Emphasizing a subset of plans that exhibited superior to the average OAR sparing during training, refined models were created to predict high-quality rectum sparing for prostate and brainstem sparing for SRS. Using the refined model, potentially suboptimal plans were identified where the model predicted further sparing of the OARs was achievable. Replans were performed to test if the OAR sparing could be improved as predicted by the model. Results: The refined models demonstrated highly accurate dose distribution prediction. For prostate cases, the average prediction bias for all voxels irrespective of organ delineation ranged from −1% to 0% with maximum IQR of 3% over r{sub PTV} ∈ [ − 6, 30] mm. The

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  14. 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

  15. External beam radiotherapy dose response characteristics of 1127 men with prostate cancer treated in the PSA era

    International Nuclear Information System (INIS)

    Pollack, Alan; Smith, Lewis G.; Eschenbach, Andrew C. von

    2000-01-01

    Purpose: To characterize the relationship of radiotherapy dose to prostate cancer patient outcome, with an emphasis on the influence of pretreatment prognostic variables. Methods and Materials: The 1127 Stage T1-T4 prostate cancer patients examined were treated consecutively with definitive external beam radiotherapy at the University of Texas-M.D. Anderson Cancer Center from 1987 to 1997. All had a pretreatment prostate-specific antigen (PSA) level. Treatment failure was defined as two consecutive PSA elevations on follow-up. There were 994 patients treated with a four-field box throughout to 60-70 Gy after a small reduction at 46 Gy and 161 treated with a six-field conformal boost after 46 Gy to 74-78 Gy. No patient received neoadjuvant or adjuvant androgen ablation. Median follow-up was 51.8 months. Results: Patients were divided into three radiotherapy dose groups consisting of ≤67 Gy (n = 500), >67-77 Gy (n = 495), and >77 Gy (n = 132). Relative to other prognostic factors, there were fewer patients treated to the highest dose level with a pretreatment PSA (PSAB) ≤4 or >20 ng/ml, Stage T3/T4 disease, or a Gleason score of 2-6. Actuarial 4-year freedom from biochemical failure (bNED) rates for the entire cohort were 54%, 71%, and 77% (p 67-77 Gy was associated with improved bNED rates for all PSAB (≤10 and >10), stage (T1/T2 and T3/T4), and Gleason score (2-6 and 7-10) subgroups tested. In contrast, the only prognostic group that benefited from raising dose from >67-77 Gy to >77 Gy was patients with a PSAB >10 ng/ml; although trends were noted for Stage T1/T2 and Gleason 2-6 patients. Patients with the combined features of a PSAB >10 ng/ml and Stage T1/T2 disease had 4-year bNED rates of 61% and 93% at the intermediate- and high-dose levels. A strongly significant linear association between dose (60-78 Gy) and 4-year actuarial bNED was demonstrated for patients with these intermediate-risk features. Conclusion: Prostate cancer dose response to external

  16. Conventional external beam radiation therapy and high dose rate afterloading brachytherapy as a boost for patients older than 70 years

    International Nuclear Information System (INIS)

    Pellizzon, Antonio Cassio Assis; Salvajoli, Joao Vitor; Fogaroli, Ricardo Cesar; Novaes, Paulo Eduardo R.S.; Maia, Maria Aparecida Conte; Ferrigno, Robson

    2005-01-01

    The treatment options for patients with non metastatic prostate cancer range from observation, radical prostatectomy, radiation therapy, hormonal therapy to various combination of some to all of them. Objective: we evaluated the impact on biochemical control of disease (bNED), acute and late intestinal (GI) and urological (GU) morbidity for a group of patients older than 70 years presenting initial or locally advanced prostate cancer treated with fractionated high dose rate brachytherapy (HDRB) as a boost to conventional external beam radiation therapy (RT) at the Department of Radiation Oncology from Hospital do Cancer A. C. Camargo, Sao Paulo, Brazil. Methods: a total of 56 patients older than 70 were treated from March, 1997 to June, 2002. All patients had prior to HDRB a course of RT to a median dose of 45 Gy. HDRB doses ranged from 16 Gy to 20 Gy, given in 4 fractions. Results: the median age of the patients was 74.4 years (range 70-83) and the median follow-up 33 months (range 24 to 60). The 5-year actuarial bNED rate was 77%. Acute GU and GI morbidity G1-2 were seen in 17.8% and 7.1% of patients, respectively. Late G1 or G2 GU morbidity was seen in 10.7% of the patients, while late G3 morbidity was observed in 7.1% of the patients, represented by urethral strictures. Conclusion: this group of patients had similar bNED rates when compared to literature, with acceptable morbidity rates. (author)

  17. Dose-modeling study to compare external beam techniques from protocol NSABP B-39/RTOG 0413 for patients with highly unfavorable cardiac anatomy

    International Nuclear Information System (INIS)

    Hiatt, Jessica R.; Evans, Suzanne B.; Price, Lori Lyn; Cardarelli, Gene A.; Di Petrillo, Thomas A.; Wazer, David E.

    2006-01-01

    Purpose: The aim of this study was to select patients with heart anatomy that is specifically unfavorable for tangential irradiation in whole-breast radiotherapy (WBRT), to be used as an experimental cohort to compare cardiac dosimetric and radiobiological parameters of three-dimensional conformal external beam accelerated partial breast irradiation (3D-CRT APBI) to WBRT with techniques as defined by the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 clinical trial. Methods and Materials: A dosimetric modeling study that compared WBRT and 3D-CRT APBI was performed on CT planning data from 8 patients with left-sided breast cancer. Highly unfavorable cardiac anatomy was defined by the measured contact of the myocardium with the anterior chest wall in the axial and para-sagittal planes. Treatment plans of WBRT and 3D-CRT APBI were generated for each patient in accordance with NSABP B-39/RTOG 0413 protocol. Dose-volume relationships of the heart, including the V 5 min (minimum dose delivered to 5% of the cardiac volume), biological effective dose (BED) of the V 5 min, and normal tissue complication probability (NTCP) were analyzed and compared. Results: Despite expected anatomic variation, significantly large differences were found favoring 3D-CRT APBI in cumulative dose-volume histograms (p 5 min (mean difference, 24.53 Gy; p 5 min (85%, p < 0.01). Conclusions: Use of 3D-CRT APBI can demonstrate improved sparing of the heart in select patients with highly unfavorable cardiac anatomy for WBRT, and may result in reduced risk of cardiac morbidity and mortality

  18. American Brachytherapy Society Task Group Report: Combination of brachytherapy and external beam radiation for high-risk prostate cancer.

    Science.gov (United States)

    Spratt, Daniel E; Soni, Payal D; McLaughlin, Patrick W; Merrick, Gregory S; Stock, Richard G; Blasko, John C; Zelefsky, Michael J

    To review outcomes for high-risk prostate cancer treated with combined modality radiation therapy (CMRT) utilizing external beam radiation therapy (EBRT) with a brachytherapy boost. The available literature for high-risk prostate cancer treated with combined modality radiation therapy was reviewed and summarized. At this time, the literature suggests that the majority of high-risk cancers are curable with multimodal treatment. Several large retrospective studies and three prospective randomized trials comparing CMRT to dose-escalated EBRT have demonstrated superior biochemical control with CMRT. Longer followup of the randomized trials will be required to determine if this will translate to a benefit in metastasis-free survival, disease-specific survival, and overall survival. Although greater toxicity has been associated with CMRT compared to EBRT, recent studies suggest that technological advances that allow better definition and sparing of critical adjacent structures as well as increasing experience with brachytherapy have improved implant quality and the toxicity profile of brachytherapy. The role of androgen deprivation therapy is well established in the external beam literature for high-risk disease, but there is controversy regarding the applicability of these data in the setting of dose escalation. At this time, there is not sufficient evidence for the omission of androgen deprivation therapy with dose escalation in this population. Comparisons with surgery remain limited by differences in patient selection, but the evidence would suggest better disease control with CMRT compared to surgery alone. Due to a series of technological advances, modern combination series have demonstrated unparalleled rates of disease control in the high-risk population. Given the evidence from recent randomized trials, combination therapy may become the standard of care for high-risk cancers. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All

  19. External beam irradiation for retinoblastoma: patterns of failure and dose-response analysis

    International Nuclear Information System (INIS)

    Foote, R.L.; Garretson, B.R.; Schomberg, P.J.; Buskirk, S.J.; Robertson, D.M.; Earle, J.D.

    1989-01-01

    Eighteen children with retinoblastoma (25 eyes) were treated with external beam radiation at the Mayo Clinic between January 1977 and January 1987; 15 eyes were in groups I to III and 10 were in groups IV and V. The median number of tumors per eye was 3. Radiation therapy consisted of 4- or 6-MV photons. Doses varied from 39 to 51 Gy in 1.8- to 3.0-Gy fractions. Fourteen eyes were treated through lateral fields by anterior segment-sparing techniques, and 11 eyes were treated by an anterior approach with no attempt at anterior segment sparing. All patients survived (median follow-up, 31.5 months). Cataracts developed in five eyes at a median of 23 months, four in eyes treated with anterior segment-sparing techniques. Of the 15 group I to III eyes, 6 required additional treatment; 4 were salvaged with cryotherapy or photocoagulation and 2 were enucleated. Of the 10 group IV and V eyes, 8 required additional treatment; 4 were salvaged with cryotherapy or photocoagulation, 1 with persistent disease is being followed closely, and 3 were enucleated. Ten (71%) of the 14 eyes treated with anterior segment-sparing techniques required additional treatment. Four (36%) of the 11 eyes treated with an anterior approach required additional treatment. Ninety percent of the tumors 10 disc diameters or smaller (1 disc diameter = 1.6 mm) were controlled independently of dose and fractionation used when they were not in the low-dose area of the anterior retina of an eye treated with an anterior segment-sparing technique. We find that use of lateral, anterior segment-sparing techniques has a high risk of anterior retinal tumor development and cataract formation and should be abandoned in favor of techniques that treat the entire retina

  20. External beam irradiation for retinoblastoma: patterns of failure and dose-response analysis

    Energy Technology Data Exchange (ETDEWEB)

    Foote, R.L.; Garretson, B.R.; Schomberg, P.J.; Buskirk, S.J.; Robertson, D.M.; Earle, J.D.

    1989-03-01

    Eighteen children with retinoblastoma (25 eyes) were treated with external beam radiation at the Mayo Clinic between January 1977 and January 1987; 15 eyes were in groups I to III and 10 were in groups IV and V. The median number of tumors per eye was 3. Radiation therapy consisted of 4- or 6-MV photons. Doses varied from 39 to 51 Gy in 1.8- to 3.0-Gy fractions. Fourteen eyes were treated through lateral fields by anterior segment-sparing techniques, and 11 eyes were treated by an anterior approach with no attempt at anterior segment sparing. All patients survived (median follow-up, 31.5 months). Cataracts developed in five eyes at a median of 23 months, four in eyes treated with anterior segment-sparing techniques. Of the 15 group I to III eyes, 6 required additional treatment; 4 were salvaged with cryotherapy or photocoagulation and 2 were enucleated. Of the 10 group IV and V eyes, 8 required additional treatment; 4 were salvaged with cryotherapy or photocoagulation, 1 with persistent disease is being followed closely, and 3 were enucleated. Ten (71%) of the 14 eyes treated with anterior segment-sparing techniques required additional treatment. Four (36%) of the 11 eyes treated with an anterior approach required additional treatment. Ninety percent of the tumors 10 disc diameters or smaller (1 disc diameter = 1.6 mm) were controlled independently of dose and fractionation used when they were not in the low-dose area of the anterior retina of an eye treated with an anterior segment-sparing technique. We find that use of lateral, anterior segment-sparing techniques has a high risk of anterior retinal tumor development and cataract formation and should be abandoned in favor of techniques that treat the entire retina.

  1. Potential for enhancing external beam radiotherapy for lung cancer using high-Z nanoparticles administered via inhalation

    Science.gov (United States)

    Hao, Yao; Altundal, Yucel; Moreau, Michele; Sajo, Erno; Kumar, Rajiv; Ngwa, Wilfred

    2015-09-01

    Nanoparticle-aided radiation therapy is emerging as a promising modality to enhance radiotherapy via the radiosensitizing action of high atomic number (Z) nanoparticles. However, the delivery of sufficiently potent concentrations of such nanoparticles to the tumor remain a challenge. This study investigates the dose enhancement to lung tumors due to high-Z nanoparticles (NPs) administered via inhalation during external beam radiotherapy. Here NPs investigated include: cisplatin nanoparticles (CNPs), carboplatin nanoparticles (CBNPs), and gold nanoparticles (GNPs). Using Monte Carlo-generated megavoltage energy spectra, a previously employed analytic method was used to estimate dose enhancement to lung tumors due to radiation-induced photoelectrons from the NPs administered via inhalation route (IR) in comparison to intravenous (IV) administration. Previous studies have indicated about 5% of FDA-approved cisplatin concentrations reach the lung via IV. Meanwhile recent experimental studies indicate that 3.5-14.6 times higher concentrations of NPs can reach the lung by IR compared to IV. Taking these into account, the dose enhancement factor (DEF) defined as the ratio of the radiotherapy dose with and without nanoparticles was calculated for a range of NPs concentrations and tumor sizes. The DEF for IR was then compared with that for IV. For IR with 3.5 times higher concentrations than IV, and 2 cm diameter tumor, clinically significant DEF values of up to 1.19, 1.26, and 1.51 were obtained for CNPs, CBNPs and GNPs. In comparison values of 1.06, 1.08, and 1.15 were obtained via IV administration. For IR with 14.6 times higher concentrations, even higher DEF values were obtained e.g. 1.81 for CNPs. Results also showed that the DEF increased with increasing field size or decreasing tumor volume, as expected. The results of this work indicate that IR administration of targeted high-Z CNPs/CBNPs/GNPs could enable clinically significant DEF to lung tumors compared to IV

  2. Validating dose rate calibration of radiotherapy photon beams through IAEA/WHO postal audit dosimetry service

    International Nuclear Information System (INIS)

    Jangda, A.Q.; Hussein, S.

    2012-01-01

    In external beam radiation therapy (EBRT), the quality assurance (QA) of the radiation beam is crucial to the accurate delivery of the prescribed dose to the patient. One of the dosimetric parameters that require monitoring is the beam output, specified as the dose rate on the central axis under reference conditions. The aim of this project was to validate dose rate calibration of megavoltage photon beams using the International Atomic Energy Agency (IAEA)/World Health Organisation (WHO) postal audit dosimetry service. Three photon beams were audited: a 6 MV beam from the low-energy linac and 6 and 18 MV beams from a dual high-energy linac. The agreement between our stated doses and the IAEA results was within 1% for the two 6 MV beams and within 2% for the 18 MV beam. The IAEA/WHO postal audit dosimetry service provides an independent verification of dose rate calibration protocol by an international facility. (author)

  3. Validating dose rate calibration of radiotherapy photon beams through IAEA/WHO postal audit dosimetry service.

    Science.gov (United States)

    Jangda, Abdul Qadir; Hussein, Sherali

    2012-05-01

    In external beam radiation therapy (EBRT), the quality assurance (QA) of the radiation beam is crucial to the accurate delivery of the prescribed dose to the patient. One of the dosimetric parameters that require monitoring is the beam output, specified as the dose rate on the central axis under reference conditions. The aim of this project was to validate dose rate calibration of megavoltage photon beams using the International Atomic Energy Agency (IAEA)/World Health Organisation (WHO) postal audit dosimetry service. Three photon beams were audited: a 6 MV beam from the low-energy linac and 6 and 18 MV beams from a dual high-energy linac. The agreement between our stated doses and the IAEA results was within 1% for the two 6 MV beams and within 2% for the 18 MV beam. The IAEA/WHO postal audit dosimetry service provides an independent verification of dose rate calibration protocol by an international facility.

  4. High dose rate brachytherapy in treatment of high grade astrocytomas

    International Nuclear Information System (INIS)

    Garcia-Alejo, R.; Delgado, J.M.; Cerro, E. del; Torres, J.J.; Martinez, R.

    1996-01-01

    From May 1994 to June 1995, 18 patients with high grade astrocytomas were entered prospectively on a selective protocol combining surgery, external beam radiotherapy, stereotactic interstitial implantation with HDR Iridium 192 and chemotherapy. Only those patients with tumor size 100cc or less average dimension, high grade astrocytoma, Karnofsky 70 or greater, unilateral, circumscribed, unifocal, tumor stable or responding to external radiation and supratentorial were included in the study. Ages ranged from 16 to 69 years. There were 13 males and 5 females. Surgery consisted of biopsy only in 3 patients, subtotal resection in 11, and gross total resection in 4 patients. Focal external beam radiation portals included the contrast enhancing mass on CT scan plus a 3 cm margin. The protocol called for minimum tumor dose of 60 Gy to be given in 2 Gy daily fractions. An interstitial brachytherapy boost was to be performed two weeks after the conclusion of external beam radiation. The dose was 30 Gy in 4 fractions. The authors analyze on basis on their personal experience, the possibilities and the limits offered by this therapeutic procedure in neuro-oncology. Using stereotactic techniques, interstitial brachytherapy of brain tumors was technically possible with negligible acute morbidity and mortality, and appeared to be effective and may provide for an increase in tumor control in selected cases

  5. The target volume concept at the recording of external beam radiotherapy

    International Nuclear Information System (INIS)

    Quast, U.; Glaeser, L.

    1981-01-01

    With the aim of complete, exact and reproducible manual recording and documentation of external beam radiotherapy a concept is proposed providing treatment planning and recording related to space and time for target volumes of different order corresponding to Ist, IInd or IIIrd part of treatment course, regarding all dose limiting organs at risk. The record consists of the dosage plan for medical treatment planning, the treatment plan for physical dose distribution planning and the treatment record of absorbed doses delivered as well as a checklist for patient and machine set-up, and labels for intended actions during treatment development. A clear arrangement of the record form in logical order was found, demanding exact specification of target(s) and beam(s) and their relation in space and time; asking for verbal and graphical description of target volumes, organs at risk, patient positioning, beam portals and dose reference points in terms of patients' anatomy; emphasizing the most important medical data by marked areas and leaving enough empty space for additional data, remarks or comments. During several years of clinical use these record forms proved to be suitable for all cases of external beam therapy, for complex situations of target volumes and treatment-scheduling, for all treatment techniques and radiation qualities and for all ways of physical treatment planning. They can be extended to automatic treatment verification, monitoring and recording as well as to the application of in-vivo-measurements of absorbed doses. (orig.) [de

  6. Modulation of toxicity following external beam irradiation preceded by high-dose rate brachytherapy in inoperable oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Taal, B.G.; Aleman, B.M.P.; Koning, C.C.E.; Boot, H. [Nederlands Kanker Inst. `Antoni van Leeuwenhoekhuis`, Amsterdam (Netherlands)

    1996-09-01

    To induce fast relief of dysphagia in inoperable oesephageal cancer, we applied high-dose rate (HDR) intraluminal irradiation followed by external irradiation (EBRT) in a phase II study. 15 patients (group A: n = 15; 10 men, 5 women; median age 66 years) were treated with 10 Gy HDR brachytherapy plus 40 Gy EBRT (15 fractions of 2.67 Gy). Severe side-effects were encountered in 60% of patients: 3 late ulceration, 2 pending fistula and 2 patients with fatal haemorrhage after an interval of 6 months. Overall response was excellent: 9 complete remissions (60%) and 6 partial responses (40%). Because of the high toxicity rate, in a subsequent study (group B: n = 30; 23 mean, 7 women; median age 66 years) the EBRT scheme was changed using smaller fractions (2.0 Gy) to reach the same total dose of 40 Gy. The complication rate (17%) was significantly reduced, while the overall response remained excellent (83%): 17 complete and 8 partial responses. The impressive change in complication rate of HDR brachytherapy and EBRT stresses the impact of the fraction per dose and illustrates the small therapeutic margins. (author).

  7. Modulation of toxicity following external beam irradiation preceded by high-dose rate brachytherapy in inoperable oesophageal cancer

    International Nuclear Information System (INIS)

    Taal, B.G.; Aleman, B.M.P.; Koning, C.C.E.; Boot, H.

    1996-01-01

    To induce fast relief of dysphagia in inoperable oesephageal cancer, we applied high-dose rate (HDR) intraluminal irradiation followed by external irradiation (EBRT) in a phase II study. 15 patients (group A: n = 15; 10 men, 5 women; median age 66 years) were treated with 10 Gy HDR brachytherapy plus 40 Gy EBRT (15 fractions of 2.67 Gy). Severe side-effects were encountered in 60% of patients: 3 late ulceration, 2 pending fistula and 2 patients with fatal haemorrhage after an interval of 6 months. Overall response was excellent: 9 complete remissions (60%) and 6 partial responses (40%). Because of the high toxicity rate, in a subsequent study (group B: n = 30; 23 mean, 7 women; median age 66 years) the EBRT scheme was changed using smaller fractions (2.0 Gy) to reach the same total dose of 40 Gy. The complication rate (17%) was significantly reduced, while the overall response remained excellent (83%): 17 complete and 8 partial responses. The impressive change in complication rate of HDR brachytherapy and EBRT stresses the impact of the fraction per dose and illustrates the small therapeutic margins. (author)

  8. Improving external beam radiotherapy by combination with internal irradiation.

    Science.gov (United States)

    Dietrich, A; Koi, L; Zöphel, K; Sihver, W; Kotzerke, J; Baumann, M; Krause, M

    2015-07-01

    The efficacy of external beam radiotherapy (EBRT) is dose dependent, but the dose that can be applied to solid tumour lesions is limited by the sensitivity of the surrounding tissue. The combination of EBRT with systemically applied radioimmunotherapy (RIT) is a promising approach to increase efficacy of radiotherapy. Toxicities of both treatment modalities of this combination of internal and external radiotherapy (CIERT) are not additive, as different organs at risk are in target. However, advantages of both single treatments are combined, for example, precise high dose delivery to the bulk tumour via standard EBRT, which can be increased by addition of RIT, and potential targeting of micrometastases by RIT. Eventually, theragnostic radionuclide pairs can be used to predict uptake of the radiotherapeutic drug prior to and during therapy and find individual patients who may benefit from this treatment. This review aims to highlight the outcome of pre-clinical studies on CIERT and resultant questions for translation into the clinic. Few clinical data are available until now and reasons as well as challenges for clinical implementation are discussed.

  9. Updated results of high-dose rate brachytherapy and external beam radiotherapy for locally and locally advanced prostate cancer using the RTOG-ASTRO phoenix definition

    Directory of Open Access Journals (Sweden)

    Antonio C. Pellizzon

    2008-06-01

    Full Text Available PURPOSE: To evaluate the prognostic factors for patients with local or locally advanced prostate cancer treated with external beam radiotherapy (RT and high dose rate brachytherapy (HDR according to the RTOG-ASTRO Phoenix Consensus Conference. MATERIALS AND METHODS: The charts of 209 patients treated between 1997 and 2005 with localized RT and HDR as a boost at the Department of Radiation Oncology, AC Camargo Hospital, Sao Paulo, Brazil were reviewed. Clinical and treatment parameters i.e.: patient's age, Gleason score, clinical stage, initial PSA (iPSA, risk group (RG for biochemical failure, doses of RT and HDR were evaluated. Median age and median follow-up time were 68 and 5.3 years, respectively. Median RT and HDR doses were 45 Gy and 20 Gy. RESULTS: Disease specific survival (DSS at 3.3 year was 94.2%. Regarding RG, for the LR (low risk, IR (intermediate risk and HR (high risk, the DSS rates at 3.3 years were 91.5%, 90.2% and 88.5%, respectively. On univariate analysis prognostic factors related to DSS were RG (p = 0.040, Gleason score ≤ 6 ng/mL (p = 0.002, total dose of HDR ≥ 20 Gy (p < 0.001 On multivariate analysis the only statistical significant predictive factor for biochemical control (bNED was the RG, p < 0.001 (CI - 1.147-3.561. CONCLUSIONS: Although the radiation dose administered to the prostate is an important factor related to bNED, this could not be established with statistical significance in this group of patients. To date , in our own experience, HDR associated to RT could be considered a successful approach in the treatment of prostate cancer.

  10. The influence of single and fractionated dose external beam irradiation on injury-induced arterial smooth muscle cell proliferation

    International Nuclear Information System (INIS)

    Schaefer, U.; Micke, O.; Dorszewski, A.; Breithardt, G.; Willich, N.

    1997-01-01

    Purpose/Objective: Restenosis after catheter-based revascularization has been demonstrated to be primarily caused by smooth muscle cell proliferation. This study examined the effects of external beam irradiation on neointimal proliferation after external injury to the central artery of the rabbit ear. Materials and Methods: 40 male New Zealand White rabbits were used in this study. Crush lesions were performed on each ear under general anesthesia and bilateral auricular nerve blockade. A single dose of 12 Gy (n=10), 16 Gy (n=10), or 20 Gy (n=10) and a fractionated dose of 4 x 5 Gy (n=10) gamma radiation was delivered to the left or right central artery of the ear 24 hours after injury; the contralateral central artery served as control. All rabbits were sacrificed after twenty-one days and the central arteries of the ear were fixed for morphometric measurements. Results: Mean (± SD) neointimal area was 0.062 ± 0.005 mm 2 (12 Gy), 0.022 ± 0,005 mm 2 (16 Gy), 0,028 ± 0,006 mm 2 and 0.038 mm 2 ± 0,02 mm 2 (4 x 5 Gy) in irradiated arteries compared with 0,081 ± 0,009 mm 2 in the control group. Mean (±SD) luminal area was 0.049 ± 0.004 mm 2 (12 Gy), 0.059 ± 0.002 mm 2 (16 Gy), 0.072 ± 0,006 mm 2 (20 Gy) and 0.048 mm 2 ± 0,018 mm 2 (4 x 5 Gy) in irradiated arteries compared with 0,043 ± 0,008 mm 2 in the control group. The difference in neointimal and luminal area between control and irradiated arteries was significant (p<0.05) only for the 16 and 20 Gy group compared to control. Conclusion: We conclude that in this model, external beam X-ray irradiation was successful in reducing neointimal proliferation after injury of the central artery of the rabbit ear. The optimal dose seems to be a single dose of 16 Gy - 20 Gy. Only a less prominent effect was noted for a fractionated dose of 4 x 5 Gy. Whether this approach can be used successfully to inhibit restenosis in the clinical setting requires further investigation

  11. On the absorbed dose determination method in high energy photon beams

    International Nuclear Information System (INIS)

    Scarlat, F.; Scarisoreanu, A.; Oane, M.; Mitru, E.; Avadanei, C.

    2008-01-01

    The absorbed dose determination method in water, based on standards of air kerma or exposure in high energy photon beams generated by electron with energies in the range of 1 MeV to 50 MeV is presented herein. The method is based on IAEA-398, AAPM TG-51, DIN 6800-2, IAEA-381, IAEA-277 and NACP-80 recommendations. The dosimetry equipment is composed of UNIDOS T 10005 electrometer and different ionization chambers calibrated in air kerma method in a Co 60 beam. Starting from the general formalism showed in IAEA-381, the determination of absorbed dose in water, under reference conditions in high energy photon beams, is given. This method was adopted for the secondary standard dosimetry laboratory (SSDL) in NILPRP-Bucharest

  12. Implementation of a system for external audits beam radiation therapy in terms of reference no

    International Nuclear Information System (INIS)

    Alonso Samper, Jose Luis; Dominguez, Lourdes; Alert Silva, Jose; Alfonso Laguardia, Rodolfo; Larrinaga Cortina, Eduardo; Garcia Yip, Fernando; Rodriguez Machado, Jorge; Morales Lopez, Jorge Luis; Silvestre Patallo, Ileana

    2009-01-01

    This paper presents our experience in implementing a external audit system for radiotherapy beam in no reference conditions with the use of CIRS and a summary of the measurements with him made.This paper presents our experience in implementing a external audit system for radiotherapy beam in no reference conditions with the use of CIRS and a summary of the measurements with him made. Centers were audited with external beam high-energy Co-60, 6 MV and 15 MV and were considered 4 treatment planning systems (TPS): AMEPLAN, Theraplan Plus, Precise Plan and MIRS to calculate doses prescribed in each test case. All measurements were acquired by the audit team using the anthropomorphic phantom CIRS, Semiflex chamber PTW 31010 and PTW electrometer STATES. The implementation and development of the external audits of beams radiotherapy in terms of 'no reference' has brought an improvement in both clinical aspects of treatment and the radiation safety and the quality control, has given us greater confidence and for this reason we believe has become essential. (Author)

  13. The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy.

    Science.gov (United States)

    Wu, Rui-Yi; Wang, Guo-Min; Xu, Lei; Zhang, Bo-Heng; Xu, Ye-Qing; Zeng, Zhao-Chong; Chen, Bing

    2011-05-01

    The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (+) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU+LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy (CRT). We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU+LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU+LRT treatment. There were significant differences among four groups with regard to overall survival (OS) and disease-specific survival (DSS) curves (P = 0.018 and 0.015). Further comparison between each pair of groups suggested that the long-term DSS of the HIFU+LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU+LRT group and the CRT group. Multivariable Cox's proportional hazard model showed that both HIFU+LRT and CRT were independently associated with DSS (P = 0.001 and 0.035) and had protective effects with regard to the risk of death. Compared with CRT, HIFU+LRT significantly decreased incidences of radiation-related late gastrointestinal (GI) and genitourinary (GU) toxicity grade ≥ II. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and regional lymph node metastases after HT. As an alternative to CRT, HIFU+LRT showed good efficacy and better safety.

  14. Normal tissue tolerance to external beam radiation therapy: Thyroid; Dose de tolerance des tissus sains: la thyroide

    Energy Technology Data Exchange (ETDEWEB)

    Berges, O.; Giraud, P. [Service d' oncologie-radiotherapie, hopital europeen Georges-Pompidou, universite Paris Descartes, 75 - Paris (France); Belkacemi, Y. [Service d' oncologie-radiotherapie, CHU Henri-Mondor, universite Paris 12, 94 - Creteil (France)

    2010-07-15

    The thyroid is the most developed endocrine gland of the body. Due to its anatomical location, it may be exposed to ionizing radiation in external radiotherapy involving head and neck. This review aims to describe the thyroid radiation disorders, probably under-reported in the literature, their risk factors and follow-up procedures. The functional changes after external beam radiation consists mainly of late effects occurring beyond 6 months, and are represented by the clinical and subclinical hypothyroidism. Its incidence is approximately 20 to 30% and it can occur after more than 25 years after radiation exposure. Hyperthyroidism and auto-immune manifestations have been described in a lesser proportion. The morphological changes consist of benign lesions, primarily adenomas, and malignant lesions, the most feared and which incidence is 0.35%. The onset of hypothyroidism depends of the total dose delivered to the gland, and the irradiated. Modern techniques of conformal radiotherapy with modulated intensity could improve the preservation of the thyroid, at the expense of the increase in low doses and the theoretical risk of secondary cancers. (authors)

  15. External Auditing on Absorbed Dose Using a Solid Water Phantom for Domestic Radiotherapy Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Chang Heon; Kim, Jung In; Park, Jong Min; Park, Yang Kyun; Ye, Sung Joon [Medical Research Center, Seoul National University College of Medicine, Seoul (Korea, Republic of); Cho, Kun Woo; Cho, Woon Kap [Radiation Research, Korean Institute of Nuclear Safety, Daejeon (Korea, Republic of); Lim, Chun Il [Korea Food and Drug Administration, Seoul (Korea, Republic of)

    2010-11-15

    We report the results of an external audit on the absorbed dose of radiotherapy beams independently performed by third parties. For this effort, we developed a method to measure the absorbed dose to water in an easy and convenient setup of solid water phantom. In 2008, 12 radiotherapy centers voluntarily participated in the external auditing program and 47 beams of X-ray and electron were independently calibrated by the third party's American Association of Physicists in Medicine (AAPM) task group (TG)-51 protocol. Even though the AAPM TG-51 protocol recommended the use of water, water as a phantom has a few disadvantages, especially in a busy clinic. Instead, we used solid water phantom due to its reproducibility and convenience in terms of setup and transport. Dose conversion factors between solid water and water were determined for photon and electron beams of various energies by using a scaling method and experimental measurements. Most of the beams (74%) were within {+-}2% of the deviation from the third party's protocol. However, two of 20 X-ray beams and three of 27 electron beams were out of the tolerance ({+-}3%), including two beams with a >10% deviation. X-ray beams of higher than 6 MV had no conversion factors, while a 6 MV absorbed dose to a solid water phantom was 0.4% less than the dose to water. The electron dose conversion factors between the solid water phantom and water were determined: The higher the electron energy, the less is the conversion factor. The total uncertainty of the TG-51 protocol measurement using a solid water phantom was determined to be {+-}1.5%. The developed method was successfully applied for the external auditing program, which could be evolved into a credential program of multi-institutional clinical trials. This dosimetry saved time for measuring doses as well as decreased the uncertainty of measurement possibly resulting from the reference setup in water.

  16. Combined external beam and intraluminal radiotherapy for irresectable Klatskin tumors

    Energy Technology Data Exchange (ETDEWEB)

    Schleicher, U.M. [Klinik fuer Strahlentherapie, Technische Hochschule Aachen (Germany); Staatz, G. [Klinik fuer Radiologische Diagnostik, Technische Hochschule Aachen (Germany); Alzen, G. [Klinik fuer Radiologische Diagnostik, Technische Hochschule Aachen (Germany); Abt. Kinderradiologie, Giessen Univ. (Germany); Andreopoulos, D. [Klinik fuer Strahlentherapie, Technische Hochschule Aachen (Germany); BOC Oncology Centre, Nikosia (Cyprus)

    2002-12-01

    Background: In most cases of proximal cholangiocarcinoma, curative surgery is not possible. Radiotherapy can be used for palliative treatment. We report our experience with combined external beam and intraluminal radiotherapy of advanced Klatskin's tumors. Patients and Methods: 30 patients were treated for extrahepatic proximal bile duct cancer. Our schedule consisted for external beam radiotherapy (median dose 30 Gy) and a high-dose-rate brachytherapy boost (median dose 40 Gy) delivered in four or five fractions, which could be applied completely in twelve of our patients. 15 patients in the brachytherapy and nine patients in the non-brachytherapy group received additional low-dose chemotherapy with 5-fluorouracil. Results: The brachytherapy boost dose improved the effect of external beam radiotherapy by increasing survival from a median of 3.9 months in the non-brachytherapy group to 9.1 months in the brachytherapy group. The effect was obvious in patients receiving a brachytherapy dose above 30 Gy, and in those without jaundice at the beginning of radiotherapy (p<0.05). Conclusions: The poor prognosis in patients with advanced Klatskin's tumors may be improved by combination therapy, with the role of brachytherapy and chemotherapy still to be defined. Our results suggest that patients without jaundice should be offered brachytherapy, and that a full dose of more than 30 Gy should be applied. (orig.) [German] Hintergrund: Bei den meisten Patienten mit proximalen Cholangiokarzinomen ist eine kurative Operation nicht mehr moeglich. Im Rahmen der Palliativbehandlung kann die Strahlentherapie eingesetzt werden. Wir berichten ueber unsere Erfahrungen mit der Kombination aus perkutaner und intraluminaler Strahlentherapie fortgeschrittener Klatskin-Tumoren. Patienten und Methode: 30 Patienten wurden wegen extrahepatischer proximaler Gallengangskarzinome behandelt. Unser Therapieschema umfasste eine perkutane Strahlentherapie (mediane Dosis: 30 Gy) sowie einen

  17. Electron beam irradiation facility for low to high dose irradiation applications

    International Nuclear Information System (INIS)

    Petwal, V.C.; Wanmode, Yashwant; Verma, Vijay Pal; Bhisikar, Abhay; Dwivedi, Jishnu; Shrivastava, P.; Gupta, P.D.

    2013-01-01

    Electron beam based irradiation facilities are becoming more and more popular over the conventional irradiator facilities due to many inherent advantages such as tunability of beam energy, availability of radiation both in electron mode and X-ray mode, wide range of the dose rate, control of radiation from a ON-OFF switch and other safety related merits. A prototype experimental facility based on electron accelerator has been set-up at RRCAT to meet the low-dose, medium dose and high-dose requirements for radiation processing of food, agricultural and medical products. The facility can be operated in the energy range from 7-10 MeV at variable power level from 0.05-3 kW to meet the dose rate requirement of 100 Gy to kGy. The facility is also equipped with a Bremsstrahlung converter optimized for X-ray irradiation at 7.5 MV. Availability of dose delivery in wide range with precision control and measurement has made the facility an excellent tool for researchers interested in electron/X-ray beam irradiation. A precision dosimetry lab based on alanine EPR and radiochromic film dosimetry system have been established to characterize the radiation field and precise dose measurements. Electron beam scattering technique has been developed to achieve low dose requirement for EB irradiation of various seeds such as groundnut, wheat, soybeans, moong beans, black gram etc. for mutation related studies. This paper describes various features of the facility together with the dosimetric measurements carried out for qualification of the facility and recent irradiation experiments carried out using this facility. (author)

  18. Studies on the dose distribution and treatment technique of high energy electron beams

    International Nuclear Information System (INIS)

    Lee, D.H.; Chu, S.S.

    1978-01-01

    Some important properties of high energy electron beams from the linear accelerator, LMR-13, installed in the Yonsei Cancer Center were studied. The results of experimental studies on the problems associated with the 8, 10, and 12 MeV electron beam therapy were as followings; The ionization type dosemeters calibrated by 90 Sr standard source were suitable to the measurements of the outputs and the obsorbed doses in accuracy point of view, and dose measurements using ionization chambers were difficult when measuring doses in small field size and the regions of rapid fall off. The electron energies were measured precisely with an energy spectrometer, and the practical electron energy was calculated within 5% error in the maximum range of the high energy electron beam in water. The correcting factors of perturbated dose distributions owing to radiation field, energy, and materials of the treatment cone were checked and described systematically and thus the variation of dose distributions due to the non-homogeneities of tissues and slopping skin surfaces were completely compensated. The electron beams were adequately diffused using the scatterers, and minimized the bremsstrahlung, irradiation field size, and materials of scatterers. Thus, the therapeutic capacity with the limited electron energy could be extended by improving the dose distributions. (author)

  19. Experimental research on fresh mussel meat irradiated by high-dose electron beam

    International Nuclear Information System (INIS)

    Xiao Lin; Lu Ruifeng; Hu Huachao; Wang Chaoqi; Liu Yanna

    2011-01-01

    The sterilization storage of fresh mussel irradiated high-dose electron beam was studied. From the subjective assessment by the weighted average of the test and other determined parameters, it can be concluded that the flavor of fresh mussel meat sealed canned food irradiated by high-dose electron beam has not been significant affected, and various micro-organisms can be killed effectively, which means that the irradiated fresh mussel meat can be preserved for long-term at room temperature. Therefore the method might resolve the problems induced by traditional frozen preservation methods. (authors)

  20. Comparative study of reference points by dosimetric analyses for late complications after uniform external radiotherapy and high-dose-rate brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    Chen, S.-W.; Liang, J.-A.; Yeh, L.-S.; Yang, S.-N.; Shiau, A.-C.; Lin, F.-J.

    2004-01-01

    Purpose: This study aimed to correlate and compare the predictive values of rectal and bladder reference doses of uniform external beam radiotherapy without shielding and high-dose-rate intracavitary brachytherapy (HDRICB) with late sequelae in patients with uterine cervical cancer. Methods and materials: Between September 1992 and December 1998, 154 patients who survived more than 12 months after treatment were studied. Initially, they were treated with 10-MV X-rays (44 to 45 Gy/22 to 25 fractions over 4 to 5 weeks) to the whole pelvis, after which HDRICB was performed using 192 Ir remote afterloading at 1-week intervals for 4 weeks. The standard prescribed dose for each HDRICB was 6.0 Gy to point A. Patient- and treatment-related-factors were evaluated for late rectal complications using logistic regression modeling. Results: The probability of rectal complications showed better correlation of dose-response with increasing total ICRU (International Committee on Radiotherapy Units and Measurements) rectal dose. Multivariate logistic regression demonstrated a high risk of late rectal sequelae in patients who developed rectal complications (p 0.0001;relative risk, 15.06;95% CI, 2.89∼43.7) and total ICRU rectal dose greater than 16 Gy (p = 0.02;relative risk, 2.07;95% CI, 1.13∼4.55). The high risk factors for bladder complications were seen in patients who developed rectal complications (p = 0.0001;relative risk, 15.2;95% CI, 2.81∼44.9) and total ICRU bladder dose greater than 24 Gy (p = 0.02;relative risk, 8.93;95% CI, 1.79∼33.1). Conclusion: This study demonstrated the predictive value of ICRU rectal and bladder reference dosing in HDRICB for patients receiving uniform external beam radiation therapy without central shielding. Patients who had a total ICRU rectal dose greater than 16 Gy, or a total ICRU bladder dose over 24 Gy, were at risk of late sequelae

  1. High dose-per-pulse electron beam dosimetry: Usability and dose-rate independence of EBT3 Gafchromic films.

    Science.gov (United States)

    Jaccard, Maud; Petersson, Kristoffer; Buchillier, Thierry; Germond, Jean-François; Durán, Maria Teresa; Vozenin, Marie-Catherine; Bourhis, Jean; Bochud, François O; Bailat, Claude

    2017-02-01

    The aim of this study was to assess the suitability of Gafchromic EBT3 films for reference dose measurements in the beam of a prototype high dose-per-pulse linear accelerator (linac), capable of delivering electron beams with a mean dose-rate (Ḋ m ) ranging from 0.07 to 3000 Gy/s and a dose-rate in pulse (Ḋ p ) of up to 8 × 10 6 Gy/s. To do this, we evaluated the overall uncertainties in EBT3 film dosimetry as well as the energy and dose-rate dependence of their response. Our dosimetric system was composed of EBT3 Gafchromic films in combination with a flatbed scanner and was calibrated against an ionization chamber traceable to primary standard. All sources of uncertainties in EBT3 dosimetry were carefully analyzed using irradiations at a clinical radiotherapy linac. Energy dependence was investigated with the same machine by acquiring and comparing calibration curves for three different beam energies (4, 8 and 12 MeV), for doses between 0.25 and 30 Gy. Ḋ m dependence was studied at the clinical linac by changing the pulse repetition frequency (f) of the beam in order to vary Ḋ m between 0.55 and 4.40 Gy/min, while Ḋ p dependence was probed at the prototype machine for Ḋ p ranging from 7 × 10 3 to 8 × 10 6 Gy/s. Ḋ p dependence was first determined by studying the correlation between the dose measured by films and the charge of electrons measured at the exit of the machine by an induction torus. Furthermore, we compared doses from the films to independently calibrated thermo-luminescent dosimeters (TLD) that have been reported as being dose-rate independent up to such high dose-rates. We report that uncertainty below 4% (k = 2) can be achieved in the dose range between 3 and 17 Gy. Results also demonstrated that EBT3 films did not display any detectable energy dependence for electron beam energies between 4 and 12 MeV. No Ḋ m dependence was found either. In addition, we obtained excellent consistency between films and TLDs over the entire Ḋ p

  2. Absolute and relative dose measurements with Gafchromic trade mark sign EBT film for high energy electron beams with different doses per pulse

    International Nuclear Information System (INIS)

    Fiandra, Christian; Ragona, Riccardo; Ricardi, Umberto; Anglesio, Silvia; Giglioli, Francesca Romana

    2008-01-01

    The authors have evaluated the accuracy, in absolute and relative dose measurements, of the Gafchromic trade mark sign EBT film in pulsed high-energy electron beams. Typically, the electron beams used in radiotherapy have a dose-per-pulse value of less than 0.1 mGy/pulse. However, very high dose-per-pulse electron beams are employed in certain linear accelerators dedicated to intraoperatory radiation therapy (IORT). In this study, the absorbed dose measurements with Gafchromic trade mark sign EBT in both low (less than 0.3 mGy per pulse) and high (30 and 70 mGy per pulse) dose-per-pulse electron beams were compared with ferrous sulfate chemical Fricke dosimetry (operated by the Italian Primary Standard Dosimetry Laboratory), a method independent of the dose per pulse. A summary of Gafchromic trade mark sign EBT in relative and absolute beam output determination is reported. This study demonstrates the independence of Gafchromic trade mark sign EBT absorption as a function of dose per pulse at different dose levels. A good agreement (within 3%) was found with Fricke dosimeters for plane-base IORT applicators. Comparison with a diode detector is presented for relative dose measurements, showing acceptable agreement both in the steep dose falloff zone and in the homogeneous dose region. This work also provides experimental values for recombination correction factor (K sat ) of a Roos (plane parallel) ionization chamber calculated on the basis of theoretical models for charge recombination.

  3. Influence of external beam technique and brachytherapy quality assurance on the side effects in the combined external beam- and brachytherapy treatment of local advanced prostate cancer

    International Nuclear Information System (INIS)

    Kovacs, G.; Galalae, R.; Wirth, B.; Bertermann, H.; Wilhelm, R.; Kohr, P.; Kimmig, B.

    1996-01-01

    Transrectal ultrasound(TRUS) guided HDR implantation of the prostate has been established at the Kiel University by Bertermann and Brix in 1986 and there are to date 179 (T1b-T3 No Mo) patients treated in a combined modality. The dose for the implant was 2x 15 Gy on the capsule of the prostate in 14-20 days. For local and regional lymph nodes 20 Gy external beam therapy (AP-PA pelvic portals), 20 Gy with an individual transmission block (100% for subclinical disease, 70% and 50% according to the implant dosimetry for the prostate) and 10 Gy small volume irradiation for the prostate was applied, conventional fractioned. Total dose after the therapy 70 Gy for the prostate and 50 Gy for the subclinical disease in 6-7 weeks. As a quality control method we use since 1991 in vivo dosimetry on the medial rectum wall as well as in the prostatic part of the urethra. Regular follow-up 3-118 months after therapy (median 55) with PSA, digital rectal examination, control TRUS with volumetry (after one year with biopsy) and bone scan. There were no major early side effects within the first three months. Proctitis till 1991 with a duration up to 12 months 49%, prolonging more than one year in 23 %, (total proctitis 72.6%). Dysuria in up to 12 months 30 %, long lasting 30% (total number of dysuria 60 %). Erectile dysfunction in 56 %. Because of the number of the side effects 1991 we changed the external beam technique: instead of the biaxial arch therapy the AP-PA portals, and reduced irradiated volume (from 6480 cm 3 to 5040 cm 3 ). We introduced instead of the small volume arch therapy for 10 Gy external boost the box-technique with shielding the back part of the rectum and the upper part of the bladder resulting additional volume reduction. Through the 15 Gy HDR brachytherapy dose on the prostate capsule there are up to 8 Gy on the medial rectal wall, measured by in vivo dosimetry. This dose could not be responsible for the high number of side effects (see gynecological

  4. On the absorbed dose determination method in high energy electrons beams

    International Nuclear Information System (INIS)

    Scarlat, F.; Scarisoreanu, A.; Oane, M.; Mitru, E.; Avadanei, C.

    2008-01-01

    The absorbed dose determination method in water for electron beams with energies in the range from 1 MeV to 50 MeV is presented herein. The dosimetry equipment for measurements is composed of an UNIDOS.PTW electrometer and different ionization chambers calibrated in air kerma in a Co 60 beam. Starting from the code of practice for high energy electron beams, this paper describes the method adopted by the secondary standard dosimetry laboratory (SSDL) in NILPRP - Bucharest

  5. Short-term Androgen-Deprivation Therapy Improves Prostate Cancer-Specific Mortality in Intermediate-Risk Prostate Cancer Patients Undergoing Dose-Escalated External Beam Radiation Therapy

    International Nuclear Information System (INIS)

    Zumsteg, Zachary S.; Spratt, Daniel E.; Pei, Xin; Yamada, Yoshiya; Kalikstein, Abraham; Kuk, Deborah; Zhang, Zhigang; Zelefsky, Michael J.

    2013-01-01

    Purpose: We investigated the benefit of short-term androgen-deprivation therapy (ADT) in patients with intermediate-risk prostate cancer (PC) receiving dose-escalated external beam radiation therapy. Methods and Materials: The present retrospective study comprised 710 intermediate-risk PC patients receiving external beam radiation therapy with doses of ≥81 Gy at a single institution from 1992 to 2005, including 357 patients receiving neoadjuvant and concurrent ADT. Prostate-specific antigen recurrence-free survival (PSA-RFS) and distant metastasis (DM) were compared using the Kaplan-Meier method and Cox proportional hazards models. PC-specific mortality (PCSM) was assessed using competing-risks analysis. Results: The median follow-up was 7.9 years. Despite being more likely to have higher PSA levels, Gleason score 4 + 3 = 7, multiple National Comprehensive Cancer Network intermediate-risk factors, and older age (P≤.001 for all comparisons), patients receiving ADT had improved PSA-RFS (hazard ratio [HR], 0.598; 95% confidence interval [CI], 0.435-0.841; P=.003), DM (HR, 0.424; 95% CI, 0.219-0.819; P=.011), and PCSM (HR, 0.380; 95% CI, 0.157-0.921; P=.032) on univariate analysis. Using multivariate analysis, ADT was an even stronger predictor of improved PSA-RFS (adjusted HR [AHR], 0.516; 95% CI, 0.360-0.739; P<.001), DM (AHR, 0.347; 95% CI, 0.176-0.685; P=.002), and PCSM (AHR, 0.297; 95% CI, 0.128-0.685; P=.004). Gleason score 4 + 3 = 7 and ≥50% positive biopsy cores were other independent predictors of PCSM. Conclusions: Short-term ADT improves PSA-RFS, DM, and PCSM in patients with intermediate-risk PC undergoing dose-escalated external beam radiation therapy

  6. Studies of absorbed dose determinations and spatial dose distributions for high energy proton beams

    International Nuclear Information System (INIS)

    Hiraoka, Takeshi

    1982-01-01

    Absolute dose determinations were made with three types of ionization chamber and a Faraday cup. Methane based tissue equivalent (TE) gas, nitrogen, carbon dioxide, air were used as an ionizing gas with flow rate of 10 ml per minute. Measurements were made at the entrance position of unmodulated beams and for a beam of a spread out Bragg peak at a depth of 17.3 mm in water. For both positions, the mean value of dose determined by the ionization chambers was 0.993 +- 0.014 cGy for which the value of TE gas was taken as unity. The agreement between the doses estimated by the ionization chambers and the Faraday cup was within 5%. Total uncertainty estimated in the ionization chamber and the Faraday cup determinations is 6 and 4%, respectively. Common sources of error in calculating the dose from ionization chamber measurements are depend on the factors of ion recombination, W value, and mass stopping power ratio. These factors were studied by both experimentally and theoretically. The observed values for the factors show a good agreement to the predicted one. Proton beam dosimetry intercomparison between Japan and the United States was held. Good agreement was obtained with standard deviation of 1.6%. The value of the TE calorimeter is close to the mean value of all. In the proton spot scanning system, lateral dose distributions at any depth for one spot beam can be simulated by the Gaussian distribution. From the Gaussian distributions and the central axis depth doses for one spot beam, it is easy to calculate isodose distributions in the desired field by superposition of dose distribution for one spot beam. Calculated and observed isodose curves were agreed within 1 mm at any dose levels. (J.P.N.)

  7. Dose estimation in embryo or fetus in external fields

    International Nuclear Information System (INIS)

    Gregori, Beatriz N.

    2001-01-01

    The embryo or the fetus can be irradiated as result of radiological procedures of diagnosis of therapy in where the beam effects directly on the same one or in tissues or peripherical organs. Some authors have suggested that in the first stages of the pregnancy the dose in ovaries can be the good estimated of the dose in embryo or fetus. In advanced conditions of the development, probably also in the early stage, is more appropriated to specify the dose in the embryo or fetus equal of the uterus. The dose in the uterus is a good estimated so much for external irradiation as for radionuclides incorporation

  8. Beam intensity monitoring for the external proton beam at LAMPF

    International Nuclear Information System (INIS)

    Barrett, R.J.; Anderson, B.D.; Willard, H.B.; Anderson, A.N.; Jarmie, N.

    1975-07-01

    Three different intensity monitors were tested in the external proton beam at LAMPF, and together cover the entire range of beam currents available. A 800 kg Faraday cup was installed and used to measure the absolute intensity to better than 1 percent for beam currents up to several nanoamperes. A high gain ion chamber was used as part of the calibration procedure for the Faraday cup, and was found to be useful when monitoring very small beam intensities, being reliable down to the few picoampere level. A secondary emission monitor was also tested, calibrated, and found to be trustworthy only for beams of greater than 50 pA intensity. (auth)

  9. Internal hemipelvectomy with intraoperative and external beam radiotherapy in the limb-sparing treatment of a pelvic girdle chondrosarcoma

    NARCIS (Netherlands)

    Hoekstra, HJ; Szabo, BG

    The case of a patient with an extensive pelvic girdle chondrosarcoma treated with internal hemipelvectomy and intraoperative radiotherapy, followed by adjuvant high-dose external beam radiotherapy, with a successful attempt in achieving long-term local tumor control and limb-sparing treatment is

  10. Backscatter dose from metallic materials due to obliquely incident high-energy photon beams

    International Nuclear Information System (INIS)

    Nadrowitz, Roger; Feyerabend, Thomas

    2001-01-01

    If metallic material is exposed to ionizing radiation of sufficient high energy, an increase in dose due to backscatter radiation occurs in front of this material. Our purpose in this study was to quantify these doses at variable distances between scattering materials and the detector at axial beam angles between 0 deg. (zero angle in beams eye view) and 90 deg. . Copper, silver and lead sheets embedded in a phantom of perspex were exposed to 10 MV-bremsstrahlung. The detector we developed is based on the fluorescence property of pyromellitic acid (1,2,4,5 benzenetetracarboxylic acid) after exposure to ionizing radiation. Our results show that the additional doses and the corresponding dose distribution in front of the scattering materials depend quantitatively and qualitatively on the beam angle. The backscatter dose increases with varying beam angle from 0 deg. to 90 deg. up to a maximum at 55 deg. for copper and silver. At angles of 0 deg. and 55 deg. the integral backscatter doses over a tissue-equivalent depth of 2 mm are 11.2% and 21.6% for copper and 24% and 28% for silver, respectively. In contrast, in front of lead there are no obvious differences of the measured backscatter doses at angles between 0 deg. and 55 deg. With a further increase of the beam angle from 55 deg. to 90 deg. the backscatter dose decreases steeply for all three materials. In front of copper a markedly lower penetrating depth of the backscattered electrons was found for an angle of 0 deg. compared to 55 deg. This dependence from the beam angle was less pronounced in front of silver and not detectable in front of lead. In conclusion, the dependence of the backscatter dose from the angle between axial beam and scattering material must be considered, as higher scattering doses have to be considered than previously expected. This may have a clinical impact since the surface of metallic implants is usually curved

  11. Backscatter dose from metallic materials due to obliquely incident high-energy photon beams

    Energy Technology Data Exchange (ETDEWEB)

    Nadrowitz, Roger; Feyerabend, Thomas [Medical University of Luebeck, Germany, Department of Radiotherapy and Nuclear Medicine, Ratzeburger Allee 160, Luebeck, D-23538 (Germany)

    2001-06-01

    If metallic material is exposed to ionizing radiation of sufficient high energy, an increase in dose due to backscatter radiation occurs in front of this material. Our purpose in this study was to quantify these doses at variable distances between scattering materials and the detector at axial beam angles between 0 deg. (zero angle in beams eye view) and 90 deg. . Copper, silver and lead sheets embedded in a phantom of perspex were exposed to 10 MV-bremsstrahlung. The detector we developed is based on the fluorescence property of pyromellitic acid (1,2,4,5 benzenetetracarboxylic acid) after exposure to ionizing radiation. Our results show that the additional doses and the corresponding dose distribution in front of the scattering materials depend quantitatively and qualitatively on the beam angle. The backscatter dose increases with varying beam angle from 0 deg. to 90 deg. up to a maximum at 55 deg. for copper and silver. At angles of 0 deg. and 55 deg. the integral backscatter doses over a tissue-equivalent depth of 2 mm are 11.2% and 21.6% for copper and 24% and 28% for silver, respectively. In contrast, in front of lead there are no obvious differences of the measured backscatter doses at angles between 0 deg. and 55 deg. With a further increase of the beam angle from 55 deg. to 90 deg. the backscatter dose decreases steeply for all three materials. In front of copper a markedly lower penetrating depth of the backscattered electrons was found for an angle of 0 deg. compared to 55 deg. This dependence from the beam angle was less pronounced in front of silver and not detectable in front of lead. In conclusion, the dependence of the backscatter dose from the angle between axial beam and scattering material must be considered, as higher scattering doses have to be considered than previously expected. This may have a clinical impact since the surface of metallic implants is usually curved.

  12. Treatment of the prostate cancer with high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Martinez, Alvaro; Torres Silva, Felipe

    2002-01-01

    The prostate cancer treatment in early stages is controversial. The high dose rate brachytherapy has been used like monotherapy or boost with external beam radiotherapy in advanced disease. This paper describes the technique and the advantages over other modalities

  13. Shear behavior of concrete beams externally prestressed with Parafil ropes

    Directory of Open Access Journals (Sweden)

    A.H. Ghallab

    2013-03-01

    Full Text Available Although extensive work has been carried out investigating the use of external prestressing system for flexural strengthening, a few studies regarding the shear behavior of externally prestressed beams can be found. Five beams, four of them were externally strengthened using Parafil rope, were loaded up to failure to investigate the effect of shear span/depth ratio, external prestressing force and concrete strength on their shear behavior. Test results showed that the shear span to depth ratio has a significant effect on both the shear strength and failure mode of the strengthened beams and the presence of external prestressing force increased the ultimate load of the tested beams by about 75%. Equations proposed by different codes for both the conventional reinforced concrete beams and for ordinary prestressed beams were used to evaluate the obtained experimental results. In general, codes equations showed a high level of conservatism in predicting the shear strength of the beams. Also, using the full strength rather than half of the concrete shear strength in the Egyptian code PC-method improves the accuracy of the calculated ultimate shear strength.

  14. High-Dose-Rate Brachytherapy of a Single Implant With Two Fractions Combined With External Beam Radiotherapy for Hormone-Naive Prostate Cancer

    International Nuclear Information System (INIS)

    Sato, Morio; Mori, Takashi; Shirai, Shintaro; Kishi, Kazushi; Inagaki, Takeshi; Hara, Isao

    2008-01-01

    Purpose: To evaluate the preliminary outcomes of high-dose-rate (HDR) brachytherapy of a single implant with two fractions and external beam radiotherapy (EBRT) for hormone-naive prostate cancer. Methods and Materials: Between March 2000 and Sept 2003, a total of 53 patients with tumor Stage T1c-T3b N0 M0 prostate cancer were treated with HDR brachytherapy boost doses (7.5 Gy/fraction) and 50-Gy EBRT during a 5.5-week period. Median follow-up was 61 months. Patients were divided into groups with localized (T1c-T2b) and advanced disease (T3a-T3b). We used the American Society for Therapeutic Radiology and Oncology (ASTRO) definition for biochemical failure. According to recommendations of the Radiation Therapy Oncology Group-ASTRO Phoenix Consensus Conference, biochemical failure-free control rates (BF-FCRs) at 3 years were investigated as 2 years short of the median follow-up. Results: Between April 2000 and Sept 2007, Common Terminology Criteria for Adverse Events Version 2.0 late Grade 2 genitourinary and gastrointestinal toxicity rates were 0% and 3.8%, respectively. Erectile preservation was 25% at 5 years. Overall survival was 88.1% and cause-specific survival was 100%. At 3 years, ASTRO BF-FCRs of the localized and advanced groups were 100% and 42%, respectively (p = 0.001). Conclusions: The HDR brachytherapy of a single implant with two fractions plus EBRT is effective in treating patients with localized hormone-naive prostate cancer, with the least genitourinary and gastrointestinal toxicities; however, longer median BF-FCR follow-up is required to assess these findings

  15. Neural Stem Cell-Preserving External-Beam Radiotherapy of Central Nervous System Malignancies

    International Nuclear Information System (INIS)

    Barani, Igor J.; Cuttino, Laurie W.; Benedict, Stanley H.; Todor, Dorin; Bump, Edward A.; Wu Yan; Chung, Theodore D.; Broaddus, William C.; Lin, Peck-Sun

    2007-01-01

    Purpose: Recent discoveries have implicated neural stem cells (NSC) as the source of plasticity and repair in the mature mammalian brain. Treatment-induced NSC dysfunction may lead to observed toxicity. This study evaluates the feasibility of NSC-preserving external beam radiotherapy. Methods and Materials: A single computed tomography (CT) dataset depicting a right periventricular lesion was used in this study as this location reflects the most problematic geometric arrangement with respect to NSC preservation. Conventional and NSC preserving radiotherapy (RT) plans were generated for the same lesion using two clinical scenarios: cerebral metastatic disease and primary high-grade glioma. Disease-specific target volumes were used. Metastatic disease was conventionally treated with whole-brain radiotherapy (WBRT) to 3,750 cGy (15 fractions) followed by a single stereotactic radiosurgery (SRS) boost of 1,800 cGy to gross disease only. High-grade glioma was treated with conventional opposed lateral and anterior superior oblique beams to 4,600 cGy (23 fractions) followed by a 1,400 cGy (7 fractions) boost. NSC preservation was achieved in both scenarios with inverse-planned intensity modulated radiotherapy (IMRT). Results: Cumulative dose reductions of 65% (metastatic disease) and 25% (high-grade glioma) to the total volume of the intracranial NSC compartments were achieved with NSC-preserving IMRT plans. The reduction of entry and exit dose to NSC niches located contralateral to the target contributed most to NSC preservation. Conclusions: Neural stem cells preservation with current external beam radiotherapy techniques is achievable in context of both metastatic brain disease and high-grade glioma, even when the target is located adjacent to a stem cell compartment. Further investigation with clinical trials is warranted to evaluate whether NSC preservation will result in reduced toxicity

  16. High-Dose-Rate Brachytherapy and External-Beam Radiotherapy for Hormone-Naïve Low- and Intermediate-Risk Prostate Cancer: A 7-Year Experience

    International Nuclear Information System (INIS)

    Aluwini, Shafak; Rooij, Peter H. van; Kirkels, Wim J.; Jansen, Peter P.; Praag, John O.; Bangma, Chris H.; Kolkman-Deurloo, Inger-Karine K.

    2012-01-01

    Purpose: To report clinical outcomes and early and late complications in 264 hormone-naïve patients with low- and intermediate-risk prostate cancer treated with high-dose-rate brachytherapy (HDR-BT) in combination with external-beam radiotherapy (EBRT). Methods and Materials: Between February 2000 and July 2007, 264 patients underwent HDR-BT in combination with EBRT as a treatment for their low- to intermediate-risk prostate cancer. The HDR-BT was performed using ultrasound-based implantation. The total HDR-BT dose was 18 Gy in 3 fractions within 24 h, with a 6-h minimum interval. The EBRT started 2 weeks after HDR-BT and was delivered in 25 fractions of 1.8 Gy to 45 Gy within 5 weeks. Results: After a mean follow-up of 74.5 months, 4 patients (1.5%) showed prostate-specific antigen progression according to the American Society for Radiation Oncology definition and 8 patients (3%) according to the Phoenix definition. A biopsy-proven local recurrence was registered in 1 patient (0.4%), and clinical progression (bone metastases) was documented in 2 patients (0.7%). Seven-year actuarial freedom from biochemical failure was 97%, and 7-year disease-specific survival and overall survival were 100% and 91%, respectively. Toxicities were comparable to other series. Conclusions: Treatment with interstitial HDR-BT plus EBRT shows a low incidence of late complications and a favorable oncologic outcome after 7 years follow-up.

  17. External beam radiation for retinoblastoma: Results, patterns of failure, and a proposal for treatment guidelines

    International Nuclear Information System (INIS)

    Hernandez, J. Carlos; Brady, Luther W.; Shields, Jerry A.; Shields, Carol L.; Potter, Patrick de; Karlsson, Ulf L.; Markoe, Arnold M.; Amendola, Beatriz E.; Singh, Arun

    1996-01-01

    Purpose: To analyze treatment results and patterns of failure following external beam radiation for retinoblastoma and propose treatment guidelines according to specific clinical variables. Methods and Materials: We analyzed 27 patients (34 eyes) with retinoblastoma who received external beam radiation as initial treatment at Hahnemann University Hospital from October 1980 to December 1991 and have been followed for at least 1 year. Of the 34 eyes, 14 were Groups I-II (Reese-Ellsworth classification), 7 were Group III, and 13 were Groups IV-V. Doses ranged from 34.5-49.5 Gy (mean 44.3 Gy, median 45 Gy) in 1.5-2.0 Gy fractions generally delivered through anterior and lateral wedged pair fields. Results: At a mean follow up of 35.2 months (range 12-93 months), local tumor control was obtained in 44% (15 out of 34) of eyes with external beam radiation alone. Salvage therapy (plaque brachytherapy, cryotherapy, and/or photocoagulation) controlled an additional 10 eyes (29.5%), so that overall ocular survival has been 73.5%. Local tumor control with external beam radiotherapy alone was obtained in 78.5% (11 out of 14) of eyes in Groups I-II, but in only 20% (4 out of 20) of eyes in Groups III-V. A total of 67 existing tumors were identified prior to treatment in the 34 treated eyes and local control with external beam radiation alone was obtained in 87% (46 out of 53) of tumors measuring 15 mm or less and in 50% (7 out of 14) of tumors measuring more than 15 mm. When analyzing patterns of failure in the 19 eyes that relapsed, a total of 28 failure sites were identified and consisted of progression of vitreous seeds in seven instances (25% of failure sites) recurrences from previously existing tumors in 10 instances (36% of failure sites) and development of new tumors in previously uninvolved retina in 11 instances (39% of failure sites). Conclusions: 1) We find that external beam radiation to a dose of 45 Gy in fractions of 1.5 to 2.0 Gy provides adequate tumor control

  18. Study of dose distribution in high energy photon beam used in radiotherapy

    International Nuclear Information System (INIS)

    Rafaravavy, R.; Raoelina Andriambololona; Bridier, A.

    2007-01-01

    The dose distribution in a medium traversed by a photon beam depends on beam energy, field size and medium nature. Percent depth dose (PDD), Dose Profile (DP) and Opening Collimator Factor (OCF) curves will be established to study this distribution. So, the PDD curves are composed by tree parts: the build-up region, the maximal dose and the quasi-equilibrium region. The maximum dose depth and the dose in depth increase with increasing photon beam energy but the dose surface decreases. The PDD increases with increasing field size.

  19. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pellizzon, Antonio Cassio Assis, E-mail: acapellizzon@hcancer.org.br [A.C. Camargo Cancer Center, Sao Paulo, SP (Brazil). Departamento de Radioterapia

    2016-05-15

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. (author)

  20. External Beam Radiation Therapy for Cancer

    Science.gov (United States)

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

  1. Concept and computation of radiation dose at high energies

    International Nuclear Information System (INIS)

    Sarkar, P.K.

    2010-01-01

    Computational dosimetry, a subdiscipline of computational physics devoted to radiation metrology, is determination of absorbed dose and other dose related quantities by numbers. Computations are done separately both for external and internal dosimetry. The methodology used in external beam dosimetry is necessarily a combination of experimental radiation dosimetry and theoretical dose computation since it is not feasible to plan any physical dose measurements from inside a living human body

  2. Guide for External Beam Radiotherapy. Procedures 2007

    International Nuclear Information System (INIS)

    Ardiet, Jean-Michel; Bourhis, Jean; Eschwege, Francois; Gerard, Jean-Pierre; Martin, Philippe; Mazeron, Jean-Jacques; Barillot, Isabelle; Bey, Pierre; Cosset, Jean-Marc; Thomas, Olivier; Bolla, Michel; Bourguignon, Michel; Godet, Jean-Luc; Krembel, David; Valero, Marc; Bara, Christine; Beauvais-March, Helene; Derreumaux, Sylvie; Vidal, Jean-Pierre; Drouard, Jean; Sarrazin, Thierry; Lindecker-Cournil, Valerie; Robin, Sun Hee Lee; Thevenet, Nicolas; Depenweiller, Christian; Le Tallec, Philippe; Ortholan, Cecile; Aimone, Nicole; Baldeschi, Carine; Cantelli, Andree; Estivalet, Stephane; Le Prince, Cyrille; QUERO, Laurent; Costa, Andre; Gerard, Jean-Pierre; Ardiet, Jean-Michel; Bensadoun, Rene-Jean; Bourhis, Jean; Calais, Gilles; Lartigau, Eric; Ginot, Aurelie; Girard, Nicolas; Mornex, Francoise; Bolla, Michel; Chauvet, Bruno; Maingon, Philippe; Martin, Etienne; Azria, David; Gerard, Jean-Pierre; Grehange, Gilles; Hennequin, Christophe; Peiffert, Didier; Toledano, Alain; Belkacemi, Yazid; Courdi, Adel; Belliere, Aurelie; Peignaux, Karine; Mahe, Marc; Bondiau, Pierre-Yves; Kantor, Guy; Lepechoux, Cecile; Carrie, Christian; Claude, Line

    2007-01-01

    In order to optimize quality and security in the delivery of radiation treatment, the French SFRO (Societe francaise de radiotherapie oncologique) is publishing a Guide for Radiotherapy. This guide is realized according to the HAS (Haute Autorite de sante) methodology of 'structured experts consensus'. This document is made of two parts: a general description of external beam radiation therapy and chapters describing the technical procedures of the main tumors to be irradiated (24). For each procedure, a special attention is given to dose constraints in the organs at risk. This guide will be regularly updated

  3. Absorbed-dose beam quality conversion factors for cylindrical chambers in high energy photon beams.

    Science.gov (United States)

    Seuntjens, J P; Ross, C K; Shortt, K R; Rogers, D W

    2000-12-01

    Recent working groups of the AAPM [Almond et al., Med. Phys. 26, 1847 (1999)] and the IAEA (Andreo et al., Draft V.7 of "An International Code of Practice for Dosimetry based on Standards of Absorbed Dose to Water," IAEA, 2000) have described guidelines to base reference dosimetry of high energy photon beams on absorbed dose to water standards. In these protocols use is made of the absorbed-dose beam quality conversion factor, kQ which scales an absorbed-dose calibration factor at the reference quality 60Co to a quality Q, and which is calculated based on state-of-the-art ion chamber theory and data. In this paper we present the measurement and analysis of beam quality conversion factors kQ for cylindrical chambers in high-energy photon beams. At least three chambers of six different types were calibrated against the Canadian primary standard for absorbed dose based on a sealed water calorimeter at 60Co [TPR10(20)=0.572, %dd(10)x=58.4], 10 MV [TPR10(20)=0.682, %dd(10)x=69.6), 20 MV (TPR10(20)=0.758, %dd(10)x= 80.5] and 30 MV [TPR10(20) = 0.794, %dd(10)x= 88.4]. The uncertainty on the calorimetric determination of kQ for a single chamber is typically 0.36% and the overall 1sigma uncertainty on a set of chambers of the same type is typically 0.45%. The maximum deviation between a measured kQ and the TG-51 protocol value is 0.8%. The overall rms deviation between measurement and the TG-51 values, based on 20 chambers at the three energies, is 0.41%. When the effect of a 1 mm PMMA waterproofing sleeve is taken into account in the calculations, the maximum deviation is 1.1% and the overall rms deviation between measurement and calculation 0.48%. When the beam is specified using TPR10(20), and measurements are compared with kQ values calculated using the version of TG-21 with corrected formalism and data, differences are up to 1.6% when no sleeve corrections are taken into account. For the NE2571 and the NE2611A chamber types, for which the most literature data are

  4. External proton and Li beams

    International Nuclear Information System (INIS)

    Schuff, Juan A.; Burlon, Alejandro A.; Debray, Mario E.; Kesque, Jose M.; Kreiner, Andres J.; Stoliar, Pablo A.; Naab, Fabian; Ozafran, Mabel J.; Vazquez, Monica E.; Perez de la Hoz, A.; Somacal, Hector; Valda, Alejandro; Canevas, S.; Ruffolo, M.; Tasat, D.R.; Muhlmann, M. C.

    2000-01-01

    In the frame of a feasibility study to introduce proton therapy in Argentina in a collaborative agreement between the Physics and Radiobiology Departments of the National Atomic Energy Commission or Argentina and the Centre de Protontherapie de Orsay, France, external proton and Li beams were produced at the TANDAR accelerator in Buenos Aires. The specific aim of this work was to start radiobiology studies on cell cultures and small laboratory animals. In particular we seek to determine here the relative biological effectiveness, RBE, for proton and Li beams as a function of energy for different tumor and normal cell lines. The 24 MeV proton beam was diffused using a 25 μm gold foil and extracted through a Kapton window to obtain a homogeneous field (constant to 95%) of about 7 cm in diameter. Measurements were carried out with quasi-monoenergetic beams (of 20.2 ± 0.07 MeV, 2.9 ± 0.10 MeV y 1.5 ± 0.1 MeV for protons and 21.4 ± 0.4 MeV for Lithium). Proton fluence and Bragg peaks were measured. The dose delivered in each case was monitored on-line with a calibrated transmission ionization chamber. Three cell lines PDV, PDVC 57 and V 79 (as a reference) were irradiated with γ-rays, proton and lithium beams with linear energy transfer (LET) from 2 to 100 keV/μm. RBE values in the range of 1.2-5.9 were obtained. In addition preliminary studies on chromosomal aberrations and viability of alveolar macrophages were carried out. (author)

  5. Radiobiological comparison of external beam irradiation and radioimmunotherapy in renal cell carcinoma xenografts

    International Nuclear Information System (INIS)

    Wessels, B.W.; Vessella, R.L.; Palme, D.F. II; Berkopec, J.M.; Smith, G.K.; Bradley, E.W.

    1989-01-01

    Growth delay was measured in TK-82 renal cell carcinoma (RCC) xenografts implanted in nude mice receiving single fraction external beam irradiation (SF-XRT), multifraction external beam irradiation (MF-XRT), or radioimmunotherapy (RIT). Thermoluminescent dosimeter(s) (TLD) and autoradiography were used to ascertain the average absorbed dose delivered and the degree of heterogeneous uptake of radiolabeled antibody for the RIT irradiations. For intravenous administered activities of 100, 200, 400, and 600 microCi of I-131 labeled A6H antibody, volume doubling times (VDT) and TLD absorbed dose measurements for each administered activity were 7 days (341 cGy), 38 days (383 cGy), 85 days (886 cGy) and no regrowth (1034 cGy), respectively. For SF-XRT irradiations of 500, 1000, and 1500 cGy, VDT times were 11, 62, and 103 days, respectively. MF-XRT of 4 X 250 cGy over a 2-week period yielded a VDT of 25 days. Marked peripheral activity deposition was noted on most autoradiographs from multiple tumor samples. These data suggest that an equivalent to superior tumor growth delay is obtained for absorbed doses delivered by exponentially decaying low dose rate radioimmunotherapy RIT compared to similar doses of acute dose rate XRT as quantitated by the TLD method

  6. Megavoltage external beam irradiation of craniopharyngiomas: Analysis of tumor control and morbidity

    International Nuclear Information System (INIS)

    Flickinger, J.C.; Lunsford, L.D.; Singer, J.; Cano, E.R.; Deutsch, M.

    1990-01-01

    From 1971 to 1985, 21 patients received megavoltage external beam radiation therapy at the University of Pittsburgh for control of craniopharyngioma. Minimum tumor doses prescribed to the 95% isodose volume ranged between 51.3 to 70.0 Gy. Median total dose was 60.00 Gy and median dose per fraction was 1.83 Gy. Three deaths occurred from intercurrent disease and no deaths from tumor progression. Actuarial overall survival was 89% and 82% at 5 and 10 years. Actuarial local control was 95% at 5 and 10 years. Radiation related complications included one patient with optic neuropathy, one with brain necrosis, and one that developed optic neuropathy followed by brain necrosis. The high dose group of patients who received a NSD or Neuret equivalent of greater than 60 Gy at 1.8 Gy per fraction had a significantly greater risk of radiation complications (p = .024). The actuarial risk at 5 years for optic neuropathy was 30% and brain necrosis was 12.5% in the high dose group. Tumor control in the high dose group was not shown to be significantly better. Any possible benefit in tumor control in treating patients with craniopharyngioma with doses above 60 Gy at 1.8 Gy per fraction appears to be offset by the increased risk of radiation injury

  7. The prediction of late rectal complications in patients treated with high dose-rate brachytherapy for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Clark, Brenda G.; Souhami, Luis; Roman, Ted N.; Chappell, Rick; Evans, Michael D.C.; Fowler, Jack F.

    1997-01-01

    Purpose: The aim of this work is to investigate an unusually high rate of late rectal complications in a group of 43 patients treated with concomitant irradiation and chemotherapy for carcinoma of the cervix between December 1988 and April 1991, with a view to identifying predictive factors. Methods and Materials: The biologically effective dose received by each patient to the rectal reference point defined by the International Commission of Radiation Units and Measurements, Report 38, were calculated. Radiotherapy consisted of 46 Gy external beam irradiation plus three high dose-rate intracavitary treatments of 10 Gy each prescribed to point A. Cisplatin 30 mg/m 2 was given weekly throughout the duration of the irradiation. The results have been compared to data from 119 patients treated with irradiation alone to assess the confounding effect of the cisplatin. Results: The relationship between the biologically effective dose delivered to the rectal reference point and the development of late complications shows a strong dose-response with a threshold for complications occurring at approximately 125 Gy 3 corresponding to a brachytherapy dose of approximately 8 Gy per fraction. This value is approximately the same biologically effective dose threshold as that found for external beam irradiation in the head and neck region. The data from the group of patients treated without cisplatin is comparable to the data from the first group of patients in the lower dose ranges; the higher doses were not used and thus are not available for comparison. Conclusion: Using the linear quadratic model applied to our clinical results, we have established a threshold for late rectal complications for patients treated with external beam irradiation and high dose-rate brachytherapy for carcinoma of the cervix. This threshold is consistent with similar data for external beam irradiation in the head and neck region

  8. Anticipated Intraoperative Electron Beam Boost, External Beam Radiation Therapy, and Limb-Sparing Surgical Resection for Patients with Pediatric Soft-Tissue Sarcomas of the Extremity: A Multicentric Pooled Analysis of Long-Term Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Sole, Claudio V., E-mail: cvsole@uc.cl [Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); School of Medicine, Complutense University, Madrid (Spain); Service of Radiation Oncology, Instituto de Radiomedicina, Santiago (Chile); Calvo, Felipe A. [Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); School of Medicine, Complutense University, Madrid (Spain); Polo, Alfredo [Service of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid (Spain); Cambeiro, Mauricio [Service of Radiation Oncology, Clínica Universidad de Navarra, Pamplona (Spain); Alvarez, Ana; Gonzalez, Carmen [Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); Gonzalez, Jose [Service of Pediatric Orthopedics and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid (Spain); San Julian, Mikel [Service of Orthopedics and Traumatology, Clínica Universidad de Navarra, Pamplona (Spain); Martinez-Monge, Rafael [Service of Radiation Oncology, Clínica Universidad de Navarra, Pamplona (Spain)

    2014-09-01

    Purpose: To perform a joint analysis of data from 3 contributing centers within the intraoperative electron-beam radiation therapy (IOERT)-Spanish program, to determine the potential of IOERT as an anticipated boost before external beam radiation therapy in the multidisciplinary treatment of pediatric extremity soft-tissue sarcomas. Methods and Materials: From June 1993 to May 2013, 62 patients (aged <21 years) with a histologic diagnosis of primary extremity soft-tissue sarcoma with absence of distant metastases, undergoing limb-sparing grossly resected surgery, external beam radiation therapy (median dose 40 Gy) and IOERT (median dose 10 Gy) were considered eligible for this analysis. Results: After a median follow-up of 66 months (range, 4-235 months), 10-year local control, disease-free survival, and overall survival was 85%, 76%, and 81%, respectively. In multivariate analysis after adjustment for other covariates, tumor size >5 cm (P=.04) and R1 margin status (P=.04) remained significantly associated with local relapse. In regard to overall survival only margin status (P=.04) retained association on multivariate analysis. Ten patients (16%) reported severe chronic toxicity events (all grade 3). Conclusions: An anticipated IOERT boost allowed for external beam radiation therapy dose reduction, with high local control and acceptably low toxicity rates. The combined radiosurgical approach needs to be tested in a prospective trial to confirm these results.

  9. Anticipated Intraoperative Electron Beam Boost, External Beam Radiation Therapy, and Limb-Sparing Surgical Resection for Patients with Pediatric Soft-Tissue Sarcomas of the Extremity: A Multicentric Pooled Analysis of Long-Term Outcomes

    International Nuclear Information System (INIS)

    Sole, Claudio V.; Calvo, Felipe A.; Polo, Alfredo; Cambeiro, Mauricio; Alvarez, Ana; Gonzalez, Carmen; Gonzalez, Jose; San Julian, Mikel; Martinez-Monge, Rafael

    2014-01-01

    Purpose: To perform a joint analysis of data from 3 contributing centers within the intraoperative electron-beam radiation therapy (IOERT)-Spanish program, to determine the potential of IOERT as an anticipated boost before external beam radiation therapy in the multidisciplinary treatment of pediatric extremity soft-tissue sarcomas. Methods and Materials: From June 1993 to May 2013, 62 patients (aged <21 years) with a histologic diagnosis of primary extremity soft-tissue sarcoma with absence of distant metastases, undergoing limb-sparing grossly resected surgery, external beam radiation therapy (median dose 40 Gy) and IOERT (median dose 10 Gy) were considered eligible for this analysis. Results: After a median follow-up of 66 months (range, 4-235 months), 10-year local control, disease-free survival, and overall survival was 85%, 76%, and 81%, respectively. In multivariate analysis after adjustment for other covariates, tumor size >5 cm (P=.04) and R1 margin status (P=.04) remained significantly associated with local relapse. In regard to overall survival only margin status (P=.04) retained association on multivariate analysis. Ten patients (16%) reported severe chronic toxicity events (all grade 3). Conclusions: An anticipated IOERT boost allowed for external beam radiation therapy dose reduction, with high local control and acceptably low toxicity rates. The combined radiosurgical approach needs to be tested in a prospective trial to confirm these results

  10. A phase I/II study of external beam radiation, brachytherapy and concurrent chemotherapy in localized cancer of the esophagus (RTOG 9207)

    International Nuclear Information System (INIS)

    Gaspar, L.E.; Qian, C.; Kocha, W.I.; Coia, L.R.; Herskovic, A.; Graham, M.

    1996-01-01

    Introduction: A multi-institutional, prospective study was designed to determine the feasibility and toxicity of chemotherapy, external beam irradiation and esophageal brachytherapy (EB) in a potentially curable group of patients with adenocarcinoma or squamous cell carcinoma of the esophagus. Methods: Planned treatment was 50 Gy external beam radiation (25 fractions/5 wks) followed 2 weeks later by EB (either HDR 5 Gy wks 8,9 and 10 for a total of 15 Gy or LDR 20 Gy wk 8). The protocol was later revised to delete the LDR alternative due to poor accrual and decrease the HDR dose to 10 Gy, ie 5 Gy wks 8 and 9. Chemotherapy was given wks 1,5,8 and 11 with DDP 75 mg/m2 and 5-FU 1000 mg/m2/24 hrs, 96 hour infusion. Data is available on 50 patients (46 squamous, 3 adenocarcinoma) treated on the HDR alternative (EB dose 15 Gy and 10 Gy in 40 and 10 patients, respectively. Results: Thirty-five patients (70%) were able to complete external beam, EB and at least 2 courses of chemotherapy. Estimated survival rate at 12 months is 48%. Life-threatening toxicity or death occurred in 13 (26%) and 4 (8%) patients, respectively. Treatment-related esophageal fistulas occurred in 6 patients (12%) at 0.5 to 6.2 months from the first day of brachytherapy, leading to death in 3. So far all treatment-related fistulas occurred in the 15 Gy EB group. Conclusions: Survival following this combination of chemotherapy, external beam radiation and EB does not appear to be different from survival seen following chemotherapy and external beam radiation only. Based on the high incidence of fistulas, we urge extreme caution in employing EB as a boost following concurrent chemotherapy and external beam radiation with the schema utilized in this prospective study

  11. Charge collection efficiency in ionization chambers exposed to electron beams with high dose per pulse

    Energy Technology Data Exchange (ETDEWEB)

    Laitano, R F [Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti, ENEA Centro Ricerche Casaccia, c.p. 2400 Rome (Italy); Guerra, A S [Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti, ENEA Centro Ricerche Casaccia, c.p. 2400 Rome (Italy); Pimpinella, M [Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti, ENEA Centro Ricerche Casaccia, c.p. 2400 Rome (Italy); Caporali, C [Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti, ENEA Centro Ricerche Casaccia, c.p. 2400 Rome (Italy); Petrucci, A [A.C.O. S. Filippo Neri, U.O. Fisica Sanitaria, Rome (Italy)

    2006-12-21

    The correction for charge recombination was determined for different plane-parallel ionization chambers exposed to clinical electron beams with low and high dose per pulse, respectively. The electron energy was nearly the same (about 7 and 9 MeV) for any of the beams used. Boag's two-voltage analysis (TVA) was used to determine the correction for ion losses, k{sub s}, relevant to each chamber considered. The presence of free electrons in the air of the chamber cavity was accounted for in determining k{sub s} by TVA. The determination of k{sub s} was made on the basis of the models for ion recombination proposed in past years by Boag, Hochhaeuser and Balk to account for the presence of free electrons. The absorbed dose measurements in both low-dose-per-pulse (less than 0.3 mGy per pulse) and high-dose-per-pulse (20-120 mGy per pulse range) electron beams were compared with ferrous sulphate chemical dosimetry, a method independent of the dose per pulse. The results of the comparison support the conclusion that one of the models is more adequate to correct for ion recombination, even in high-dose-per-pulse conditions, provided that the fraction of free electrons is properly assessed. In this respect the drift velocity and the time constant for attachment of electrons in the air of the chamber cavity are rather critical parameters because of their dependence on chamber dimensions and operational conditions. Finally, a determination of the factor k{sub s} was also made by zero extrapolation of the 1/Q versus 1/V saturation curves, leading to the conclusion that this method does not provide consistent results in high-dose-per-pulse beams.

  12. Dose evaluation of narrow-beam

    International Nuclear Information System (INIS)

    Goto, Shinichi

    1999-01-01

    Reliability of the dose from the narrow photon beam becomes more important since the single high-dose rate radiosurgery becoming popular. The dose evaluation for the optimal dose is difficult due to absence of lateral electronic equilibrium. Data necessary for treatment regimen are TMR (tissue maximum ratio), OCR (off center ratio) and S c,p (total scatter factor). The narrow-beam was 10 MV X-ray from Varian Clinac 2100C equipped with cylindrical Fischer collimator CBI system. Detection was performed by Kodak XV-2 film, a PTW natural diamond detector M60003, Scanditronics silicon detector EDD-5 or Fujitec micro-chamber FDC-9.4C. Phantoms were the water equivalent one (PTW, RW3), water one (PTW, MP3 system) and Wellhofer WP600 system. Factors above were actually measured to reveal that in the dose evaluation of narrow photon beam, TMR should be measured by micro-chamber, OCR, by film, and S c,p , by the two. The use of diamond detector was recommended for more precise measurement and evaluation of the dose. The importance of water phantom in the radiosurgery system was also shown. (K.H.)

  13. External doses of residents near semipalatinsk nuclear test site

    International Nuclear Information System (INIS)

    Takada, Jun; Hoshi, Masaharu; Nagatomo, Tsuneto

    1999-01-01

    Accumulated external radiation doses of residents near the Semipalatinsk nuclear test site of the former USSR are presented as a results of study by the thermoluminescence technique for bricks sampled at several settlements in 1995 and 1996. The external doses that we evaluated from exposed bricks were up to about 100 cGy for resident. The external doses at several points in the center of Semipalatinsk City ranged from a background level to 60 cGy, which was remarkably high compared with the previously reported values based on military data. (author)

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

    Directory of Open Access Journals (Sweden)

    Kazuhisa Nakajima

    2014-12-01

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

  15. SU-E-T-403: Evaluation of the Beam Performance of a Varian TrueBeam Linear Accelerator Under External Device-Based Gated Delivery Conditions

    International Nuclear Information System (INIS)

    Kobulnicky, K; Pawlak, D; Purwar, A

    2015-01-01

    Purpose: To examine the beam performance of a Varian TrueBeam linear accelerator under external device-based gated delivery conditions. Methods: Six gating cycles were used to evaluate the gating performance of a standard production TrueBeam system that was not specially tuned in any way. The system was equipped with a factory installed external gating interface (EXGI). An in-house EXGI tester box was used to simulate the input gating signals. The gating cycles were selected based on long beam-on and short beam-off times, short beam-on and long beam-off times, or equal beam on and off times to check linac performance. The beam latencies were measured as the time difference between the logic high gating signal and the first or last target pulses with an oscilloscope. Tissue-Phantom Ratio, beam flatness, and dose distributions from 5 different plans were measured using the 6 different gating durations and the un-gated irradiation. A PTW 729 2-D array was used to compare 5 plans versus the un-gated delivery with a 1%/1mm gamma index passing criteria. Results: The beam latencies of the linac were based off of 20 samples for beam-on and beam-off, for each gating cycle. The average beam-on delays were measured to be between 57 and 66msec, with a maximum of 88 msec. The beam off latencies averaged between 19 and 26msec, with a maximum of 48 msec. TPR20,10 measurements showed beam energy stability within 0.5% of the un-gated delivery. Beam flatness was better than 2.5% for all gated cycles. All but two deliveries, the open field with 4 seconds on, 1 second off, and a five field IMRT plan with 0.5 seconds on, 2.5 seconds off, had >90% passing rate. Conclusion: TrueBeam demonstrates excellent beam stability with minimal beam latencies under external device-based gated operations. Dosimetric measurements show minimal variation in beam energy, flatness, and plan delivery. Authors are employees of Varian Medical Systems, Inc

  16. SU-E-T-403: Evaluation of the Beam Performance of a Varian TrueBeam Linear Accelerator Under External Device-Based Gated Delivery Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Kobulnicky, K; Pawlak, D; Purwar, A [Varian Medical Systems, Inc., Palo Alto, CA (United States)

    2015-06-15

    Purpose: To examine the beam performance of a Varian TrueBeam linear accelerator under external device-based gated delivery conditions. Methods: Six gating cycles were used to evaluate the gating performance of a standard production TrueBeam system that was not specially tuned in any way. The system was equipped with a factory installed external gating interface (EXGI). An in-house EXGI tester box was used to simulate the input gating signals. The gating cycles were selected based on long beam-on and short beam-off times, short beam-on and long beam-off times, or equal beam on and off times to check linac performance. The beam latencies were measured as the time difference between the logic high gating signal and the first or last target pulses with an oscilloscope. Tissue-Phantom Ratio, beam flatness, and dose distributions from 5 different plans were measured using the 6 different gating durations and the un-gated irradiation. A PTW 729 2-D array was used to compare 5 plans versus the un-gated delivery with a 1%/1mm gamma index passing criteria. Results: The beam latencies of the linac were based off of 20 samples for beam-on and beam-off, for each gating cycle. The average beam-on delays were measured to be between 57 and 66msec, with a maximum of 88 msec. The beam off latencies averaged between 19 and 26msec, with a maximum of 48 msec. TPR20,10 measurements showed beam energy stability within 0.5% of the un-gated delivery. Beam flatness was better than 2.5% for all gated cycles. All but two deliveries, the open field with 4 seconds on, 1 second off, and a five field IMRT plan with 0.5 seconds on, 2.5 seconds off, had >90% passing rate. Conclusion: TrueBeam demonstrates excellent beam stability with minimal beam latencies under external device-based gated operations. Dosimetric measurements show minimal variation in beam energy, flatness, and plan delivery. Authors are employees of Varian Medical Systems, Inc.

  17. Study of absorbed dose distribution to high energy electron beams

    International Nuclear Information System (INIS)

    Cecatti, E.R.

    1983-01-01

    The depth absorbed dose distribution by electron beams was studied. The influence of the beam energy, the energy spread, field size and design characteristics of the accelerator was relieved. Three accelerators with different scattering and collimation systems were studied leading todifferent depth dose distributions. A theoretical model was constructed in order to explain the increase in the depth dose in the build-up region with the increase of the energy. The model utilizes a three-dimensional formalism based on the Fermi-Eyges multiple scattering theory, with the introduction of modifications that takes into account the criation of secondary electrons. (Author) [pt

  18. Beam-beam effects under the influence of external noise

    International Nuclear Information System (INIS)

    Ohmi, K

    2014-01-01

    Fast external noise, which gives fluctuation into the beam orbit, is discussed in connection with beam-beam effects. Phase noise from crab cavities and detection devices (position monitor) and kicker noise from the bunch by bunch feedback system are the sources. Beam-beam collisions with fast orbit fluctuations with turn by turn or multi-turn correlations, cause emittance growth and luminosity degradation. We discuss the tolerance of the noise amplitude for LHC and HL-LHC

  19. Preoperative external beam radiotherapy and reduced dose brachytherapy for carcinoma of the cervix: survival and pathological response

    International Nuclear Information System (INIS)

    Jacinto, Alexandre A; Maia, Maria AC; Fogaroli, Ricardo C; Castilho, Marcus S; Novaes, Paulo ERS; Novick, Pablo R; Viani, Gustavo A; Salvajoli, João V; Ferrigno, Robson; Pellizzon, Antonio Cássio A; Lima, Stella SS

    2007-01-01

    To evaluate the pathologic response of cervical carcinoma to external beam radiotherapy (EBRT) and high dose rate brachytherapy (HDRB) and outcome. Between 1992 and 2001, 67 patients with cervical carcinoma were submitted to preoperative radiotherapy. Sixty-five patients were stage IIb. Preoperative treatment included 45 Gy EBRT and 12 Gy HDRB. Patients were submitted to surgery after a mean time of 82 days. Lymphadenectomy was performed in 81% of patients. Eleven patients with residual cervix residual disease on pathological specimen were submitted to 2 additional insertions of HDRB. median follow up was 72 months. Five-year cause specific survival was 75%, overall survival 65%, local control 95%. Complete pelvic pathological response was seen in 40%. Surgery performed later than 80 days was associated with pathological response. Pelvic nodal involvement was found in 12%. Complete pelvic pathological response and negative lymphnodes were associated with better outcome (p = .03 and p = .005). Late grade 3 and 4 urinary and intestinal adverse effects were seen in 12 and 2% of patients. Time allowed between RT and surgery correlated with pathological response. Pelvic pathological response was associated with improved outcome. Postoperative additional HDRB did not improve therapeutic results. Treatment was well tolerated

  20. Development of an external Faraday cup for beam current measurements

    International Nuclear Information System (INIS)

    Kim, Kye-Ryung; Jung, Myung-Hwan; Ra, Se-Jin; Lee, Seok-Ki

    2010-01-01

    In general, beam current measurements are very important for many kinds of experiments using highly energetic particle beams at accelerators, such as cyclotrons, linacs, etc. The Faraday cup is known to be one of the most popular beam current measurement tools. We developed an external Faraday cup to measure the beam current at a dedicated beam line for low-flux experiments installed at the MC-50 cyclotron of Korea Institute of Radiological and Medical Sciences (KIRAMS). It was designed for external beam current measurements and is composed of a vacuum chamber, an entrance window, a collimator, a electrostatic suppressor ring, and a cup. The window is made of 75-um-thick Kapton film, and the diameter of the collimator is 10 mm or 20 mm. The ring and the cup has 5-cm inner diameters, and the thickness of the bottom of the cup is 2 cm, which is enough to absorb the total proton energy up to 45 MeV. Using this external Faraday cup, we measured the beam current from the cyclotron, and we compared measured flux to the results from film dosimetry using GAF films.

  1. Phase I study of twice-weekly gemcitabine and concomitant external-beam radiotherapy in patients with adenocarcinoma of the pancreas

    International Nuclear Information System (INIS)

    Pipas, J. Marc; Mitchell, Sandra E.; Barth, Richard J.; Vera-Gimon, Raul; Rathmann, Joerg; Meyer, Louise P.; Wagman, Richard S.; Lewis, Lionel D.; McDonnell, Carol; Colacchio, Thomas A.; Perez, Raymond P.

    2001-01-01

    Purpose: To determine the maximum tolerated dose and dose-limiting toxicity associated with twice-weekly gemcitabine and concomitant external-beam radiotherapy in patients with adenocarcinoma of the pancreas. Methods and Materials: Twenty-one patients with biopsy-proven adenocarcinoma of the pancreas were treated with external-beam radiotherapy to a dose of 50.4 Gy in 28 fractions, concurrent with gemcitabine, infused over 30 min before irradiation on a Monday and Thursday schedule. The dose of gemcitabine was escalated in 5 cohorts of 3-6 patients each. Initial gemcitabine dose was 10 mg/m 2 , with dose escalation until dose-limiting toxicity was observed. Results: The maximum tolerated dose of gemcitabine was 50 mg/m 2 , when given in a twice-weekly schedule with radiation. Dose-limiting toxicity was seen in 2 patients at 60 mg/m 2 , and consisted of severe upper gastrointestinal bleeding approximately 1 month after completion of treatment. Six patients had radiographic evidence of response to treatment, and 5 of these underwent complete surgical resection. Three patients who underwent complete resection had been deemed to have unresectable tumors before enrollment on trial. Four patients are alive, including 2 without evidence of disease more than 1 year after resection. Conclusion: The combination of external-beam radiation and twice-weekly gemcitabine at a dose of 50 mg/m 2 is well tolerated and shows promising activity for the treatment of pancreatic cancer. Our data suggest a higher maximum tolerated dose and different dose-limiting toxicity than previously reported. Further investigation of this regimen is warranted

  2. Out-of-Field Dose Equivalents Delivered by Passively Scattered Therapeutic Proton Beams for Clinically Relevant Field Configurations

    International Nuclear Information System (INIS)

    Wroe, Andrew; Clasie, Ben; Kooy, Hanne; Flanz, Jay; Schulte, Reinhard; Rosenfeld, Anatoly

    2009-01-01

    Purpose: Microdosimetric measurements were performed at Massachusetts General Hospital, Boston, MA, to assess the dose equivalent external to passively delivered proton fields for various clinical treatment scenarios. Methods and Materials: Treatment fields evaluated included a prostate cancer field, cranial and spinal medulloblastoma fields, ocular melanoma field, and a field for an intracranial stereotactic treatment. Measurements were completed with patient-specific configurations of clinically relevant treatment settings using a silicon-on-insulator microdosimeter placed on the surface of and at various depths within a homogeneous Lucite phantom. The dose equivalent and average quality factor were assessed as a function of both lateral displacement from the treatment field edge and distance downstream of the beam's distal edge. Results: Dose-equivalent value range was 8.3-0.3 mSv/Gy (2.5-60-cm lateral displacement) for a typical prostate cancer field, 10.8-0.58 mSv/Gy (2.5-40-cm lateral displacement) for the cranial medulloblastoma field, 2.5-0.58 mSv/Gy (5-20-cm lateral displacement) for the spinal medulloblastoma field, and 0.5-0.08 mSv/Gy (2.5-10-cm lateral displacement) for the ocular melanoma field. Measurements of external field dose equivalent for the stereotactic field case showed differences as high as 50% depending on the modality of beam collimation. Average quality factors derived from this work ranged from 2-7, with the value dependent on the position within the phantom in relation to the primary beam. Conclusions: This work provides a valuable and clinically relevant comparison of the external field dose equivalents for various passively scattered proton treatment fields

  3. A simple and fast physics-based analytical method to calculate therapeutic and stray doses from external beam, megavoltage x-ray therapy.

    Science.gov (United States)

    Jagetic, Lydia J; Newhauser, Wayne D

    2015-06-21

    State-of-the-art radiotherapy treatment planning systems provide reliable estimates of the therapeutic radiation but are known to underestimate or neglect the stray radiation exposures. Most commonly, stray radiation exposures are reconstructed using empirical formulas or lookup tables. The purpose of this study was to develop the basic physics of a model capable of calculating the total absorbed dose both inside and outside of the therapeutic radiation beam for external beam photon therapy. The model was developed using measurements of total absorbed dose in a water-box phantom from a 6 MV medical linear accelerator to calculate dose profiles in both the in-plane and cross-plane direction for a variety of square field sizes and depths in water. The water-box phantom facilitated development of the basic physical aspects of the model. RMS discrepancies between measured and calculated total absorbed dose values in water were less than 9.3% for all fields studied. Computation times for 10 million dose points within a homogeneous phantom were approximately 4 min. These results suggest that the basic physics of the model are sufficiently simple, fast, and accurate to serve as a foundation for a variety of clinical and research applications, some of which may require that the model be extended or simplified based on the needs of the user. A potentially important advantage of a physics-based approach is that the model is more readily adaptable to a wide variety of treatment units and treatment techniques than with empirical models.

  4. Coupled PIXE and RBS using a 6MeV 4He2+ external beam: A new experimental device for particle detection and dose monitoring

    International Nuclear Information System (INIS)

    Mathis, F.; Moignard, B.; Pichon, L.; Dubreuil, O.; Salomon, J.

    2005-01-01

    AGLAE (Accelerateur Grand Louvre d'Analyses Elementaire), the IBA facility of the 'Centre de Recherche et de Restauration des Musees de France' (C2RMF) has been equipped for several years with an external micro-beam line, in order to perform ion beam analysis on materials relevant to cultural heritage. This beam line is undergoing constant improvement. Recently, a new extraction nozzle for the external beam of the accelerator has been designed in order to obtain simultaneously from the same spot: - detection of the X-ray emission by two detectors, for low and high energies; - detection of the backscattered particles for a backscattering angle between 170 and 175 deg., thanks to an annular surface barrier detector included in the nozzle; - particle current monitoring by intermittent beam deflection on a reference material included in the system. This technical development has been induced by the study of artificial patinas on archaeological copper-alloy objects and the attempt to characterize them with a 6MeV 4 He 2+ beam, an unusual beam for this type of investigation. A detailed description of the new device and some results on an application of the use of high-energy alpha beam in PIXE and RBS made on a Roman strigil are presented here

  5. Single-Fraction High-Dose-Rate Brachytherapy and Hypofractionated External Beam Radiation Therapy in the Treatment of Intermediate-Risk Prostate Cancer - Long Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Cury, Fabio L., E-mail: fabio.cury@muhc.mcgill.ca [Department of Radiation Oncology, McGill University Health Centre, Montreal, QC (Canada); Duclos, Marie [Department of Radiation Oncology, McGill University Health Centre, Montreal, QC (Canada); Aprikian, Armen [Department of Urology, McGill University Health Centre, Montreal, QC (Canada); Patrocinio, Horacio [Department of Medical Physics, McGill University Health Centre, Montreal, QC (Canada); Kassouf, Wassim [Department of Urology, McGill University Health Centre, Montreal, QC (Canada); Shenouda, George; Faria, Sergio; David, Marc; Souhami, Luis [Department of Radiation Oncology, McGill University Health Centre, Montreal, QC (Canada)

    2012-03-15

    Purpose: We present the long-term results of a cohort of patients with intermediate-risk prostate cancer (PC) treated with single-fraction high-dose-rate brachytherapy (HDRB) combined with hypofractionated external beam radiation therapy (HypoRT). Methods and Materials: Patients were treated exclusively with HDRB and HypoRT. HDRB delivered a dose of 10 Gy to the prostate surface and HypoRT consisted of 50 Gy delivered in 20 daily fractions. The first 121 consecutive patients with a minimum of 2 years posttreatment follow-up were assessed for toxicity and disease control. Results: The median follow-up was 65.2 months. No acute Grade III or higher toxicity was seen. Late Grade II gastrointestinal toxicity was seen in 9 patients (7.4%) and Grade III in 2 (1.6%). Late Grade III genitourinary toxicity was seen in 2 patients (1.6%). After a 24-month follow-up, a rebiopsy was offered to the first 58 consecutively treated patients, and 44 patients agreed with the procedure. Negative biopsies were found in 40 patients (91%). The 5-year biochemical relapse-free survival rate was 90.7% (95% CI, 84.5-96.9%), with 13 patients presenting biochemical failure. Among them, 9 were diagnosed with distant metastasis. Prostate cancer-specific and overall survival rates at 5 years were 100% and 98.8% (95% CI, 96.4-100%), respectively. Conclusion: The combination of HDRB and HypoRT is well tolerated, with acceptable toxicity rates. Furthermore, results from rebiopsies revealed an encouraging rate of local control. These results confirm that the use of conformal RT techniques, adapted to specific biological tumor characteristics, have the potential to improve the therapeutic ratio in intermediate-risk PC patients.

  6. High dose-per-pulse electron beam dosimetry: Commissioning of the Oriatron eRT6 prototype linear accelerator for preclinical use.

    Science.gov (United States)

    Jaccard, Maud; Durán, Maria Teresa; Petersson, Kristoffer; Germond, Jean-François; Liger, Philippe; Vozenin, Marie-Catherine; Bourhis, Jean; Bochud, François; Bailat, Claude

    2018-02-01

    The Oriatron eRT6 is an experimental high dose-per-pulse linear accelerator (linac) which was designed to deliver an electron beam with variable dose-rates, ranging from a few Gy/min up to hundreds of Gy/s. It was built to study the radiobiological effects of high dose-per-pulse/dose-rate electron beam irradiation, in the context of preclinical and cognitive studies. In this work, we report on the commissioning and beam monitoring of the Oriatron eRT6 prototype linac. The beam was characterized in different steps. The output stability was studied by performing repeated measurements over a period of 20 months. The relative output variations caused by changing beam parameters, such as the temporal electron pulse width, the pulse repetition frequency and the pulse amplitude were also analyzed. Finally, depth dose curves and field sizes were measured for two different beam settings, resulting in one beam with a conventional radiotherapy dose-rate and one with a much higher dose-rate. Measurements were performed with Gafchromic EBT3 films and with a PTW Advanced Markus ionization chamber. In addition, we developed a beam current monitoring system based on the signals from an induction torus positioned at the beam exit of the waveguide and from a graphite beam collimator. The stability of the output over repeated measurements was found to be good, with a standard deviation smaller than 1%. However, non-negligible day-to-day variations of the beam output were observed. Those output variations showed different trends depending on the dose-rate. The analysis of the relative output variation as a function of various beam parameters showed that in a given configuration, the dose-rate could be reliably varied over three orders of magnitude. Interdependence effects on the output variation between the parameters were also observed. The beam energy and field size were found to be slightly dose-rate-dependent and suitable mainly for small animal irradiation. The beam monitoring

  7. TH-CD-201-09: High Spatial Resolution Absorbed Dose to Water Measurements Using Optical Calorimetry in Megavoltage External Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Flores-Martinez, E; DeWerd, L [School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI (United States); Radtke, J [University of Wisconsin, Madison, WI (United States)

    2016-06-15

    Purpose: To develop and implement a high spatial resolution calorimeter methodology to measure absorbed dose to water (ADW) using phase shifts (PSs) of light passing through a water phantom and to compare measurements with theoretical calculations. Methods: Radiation-induced temperature changes were measured using the PSs of a He-Ne laser beam passing through a (10×10×10) cm{sup 3} water phantom. PSs were measured using a Michelson interferometer and recording the time-dependent fringe patterns on a CCD camera. The phantom was positioned at the center of the radiation field. A Varian 21EX was used to deliver 500 MU from a 9 MeV beam using a (6×6) cm{sup 2} cone. A 127cm SSD was used and the PSs were measured at depths ranging from of 1.90cm to 2.10cm in steps of 0.05cm by taking profiles at the corresponding rows across the image. PSs were computed by taking the difference between pre- and post-irradiation image frames and then measuring the amplitude of the resulting image profiles. An amplitude-to-PS calibration curve was generated using a piezoelectric transducer to mechanically induce PSs between 0.05 and 1.50 radians in steps of 0.05 radians. The temperature dependence of the refractive index of water at 632.8nm was used to convert PSs to ADW. Measured results were compared with ADW values calculated using the linac output calibration and commissioning data. Results: Milli-radian resolution in PS measurement was achieved using the described methodology. Measured radiation-induced PSs ranged from 0.10 ± 0.01 to 0.12 ± 0.01 radians at the investigated depths. After converting PSs to ADW, measured and calculated ADW values agreed within the measurement uncertainty. Conclusion: This work shows that interferometer-based calorimetry measurements are capable of achieving sub-millimeter resolution measuring 2D temperature/dose distributions, which are particularly useful for characterizing beams from modalities such as SRS, proton therapy, or microbeams.

  8. Three-dimensional electron-beam dose calculations

    International Nuclear Information System (INIS)

    Shiu, A.S.

    1988-01-01

    The MDAH pencil-beam algorithm developed by Hogstrom et al (1981) has been widely used in clinics for electron-beam dose calculations for radiotherapy treatment planning. The primary objective of this research was to address several deficiencies of that algorithm and to develop an enhanced version. Two enhancements were incorporated into the pencil-beam algorithm; one models fluence rather than planar fluence, and the other models the bremsstrahlung dose using measured beam data. Comparisons of the resulting calculated dose distributions with measured dose distributions for several test phantoms have been made. From these results it is concluded (1) that the fluence-based algorithm is more accurate to use for the dose calculation in an inhomogeneous slab phantom, and (2) the fluence-based calculation provides only a limited improvement to the accuracy the calculated dose in the region just downstream of the lateral edge of an inhomogeneity. A pencil-beam redefinition model was developed for the calculation of electron-beam dose distributions in three dimensions

  9. Genitourinary Toxicity After High-Dose-Rate (HDR) Brachytherapy Combined With Hypofractionated External Beam Radiotherapy for Localized Prostate Cancer: An Analysis to Determine the Correlation Between Dose-Volume Histogram Parameters in HDR Brachytherapy and Severity of Toxicity

    International Nuclear Information System (INIS)

    Ishiyama, Hiromichi; Kitano, Masashi; Satoh, Takefumi; Kotani, Shouko; Uemae, Mineko; Matsumoto, Kazumasa; Okusa, Hiroshi; Tabata, Ken-ichi; Baba, Shiro; Hayakawa, Kazushige

    2009-01-01

    Purpose: To evaluate the severity of genitourinary (GU) toxicity in high-dose-rate (HDR) brachytherapy combined with hypofractionated external beam radiotherapy (EBRT) for prostate cancer and to explore factors that might affect the severity of GU toxicity. Methods and Materials: A total of 100 Japanese men with prostate cancer underwent 192 Ir HDR brachytherapy combined with hypofractionated EBRT. Mean (SD) dose to 90% of the planning target volume was 6.3 (0.7) Gy per fraction of HDR. After 5 fractions of HDR treatment, EBRT with 10 fractions of 3 Gy was administrated. The urethral volume receiving 1-15 Gy per fraction in HDR brachytherapy (V1-V15) and the dose to at least 5-100% of urethral volume in HDR brachytherapy (D5-D100) were compared between patients with Grade 3 toxicity and those with Grade 0-2 toxicity. Prostate volume, patient age, and International Prostate Symptom Score were also compared between the two groups. Results: Of the 100 patients, 6 displayed Grade 3 acute GU toxicity, and 12 displayed Grade 3 late GU toxicity. Regarding acute GU toxicity, values of V1, V2, V3, and V4 were significantly higher in patients with Grade 3 toxicity than in those with Grade 0-2 toxicity. Regarding late GU toxicity, values of D70, D80, V12, and V13 were significantly higher in patients with Grade 3 toxicity than in those with Grade 0-2 toxicity. Conclusions: The severity of GU toxicity in HDR brachytherapy combined with hypofractionated EBRT for prostate cancer was relatively high. The volume of prostatic urethra was associated with grade of acute GU toxicity, and urethral dose was associated with grade of late GU toxicity.

  10. Modification and validation of an analytical source model for external beam radiotherapy Monte Carlo dose calculations

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, Scott E., E-mail: sedavids@utmb.edu [Radiation Oncology, The University of Texas Medical Branch, Galveston, Texas 77555 (United States); Cui, Jing [Radiation Oncology, University of Southern California, Los Angeles, California 90033 (United States); Kry, Stephen; Ibbott, Geoffrey S.; Followill, David S. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Deasy, Joseph O. [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065 (United States); Vicic, Milos [Department of Applied Physics, University of Belgrade, Belgrade 11000 (Serbia); White, R. Allen [Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)

    2016-08-15

    points tested. The model was capable of predicting the depth of the maximum dose within 1 mm. Anthropomorphic phantom benchmark testing of modulated and patterned MLCs treatment plans showed agreement to measurement within 3% in target regions using thermoluminescent dosimeters (TLD). Using radiochromic film normalized to TLD, a gamma criteria of 3% of maximum dose and 2 mm DTA was applied with a pass rate of least 85% in the high dose, high gradient, and low dose regions. Finally, recalculations of patient plans using DPM showed good agreement relative to a commercial TPS when comparing dose volume histograms and 2D dose distributions. Conclusions: A unique analytical source model coupled to the dose planning method Monte Carlo dose calculation code has been modified and validated using basic beam data and anthropomorphic phantom measurement. While this tool can be applied in general use for a particular linac model, specifically it was developed to provide a singular methodology to independently assess treatment plan dose distributions from those clinical institutions participating in National Cancer Institute trials.

  11. A comparison of protocols for external beam radiotherapy beam calibrations

    International Nuclear Information System (INIS)

    Saeed Al-Ahbabi, Salma; Bradley, D.A.; Beyomi, M.; Alkatib, Z.; Adhaheri, S.; Darmaki, M.; Nisbet, A.

    2012-01-01

    A number of codes of practice (CoP) for electron and photon radiotherapy beam dosimetry are currently in use. Comparison is made of the more widely used of these, specifically those of the International Atomic Energy Agency (IAEA TRS-398), the American Association of Physicists in Medicine (AAPM TG-51) and the Institute of Physics and Engineering in Medicine (IPEM 2003). All are based on calibration of ionization chambers in terms of absorbed dose to water, each seeking to reduce uncertainty in delivered dose, providing an even stronger system of primary standards than previous air-kerma based approaches. They also provide a firm, traceable and straight-forward formalism. Included in making dose assessments for the three CoP are calibration coefficients for a range of beam quality indices. Measurements have been performed using clinical photon and electron beams, the absorbed dose to water being obtained following the recommendations given by each code. Electron beam comparisons have been carried out using measurements for electron beams of nominal energies 6, 9, 12, 16 and 20 MeV. Comparisons were also carried out for photon beams of nominal energies 6 and 18 MV. For photon beams use was made of NE2571 cylindrical graphite walled ionization chambers, cross-calibrated against an NE2611 Secondary Standard; for electron beams, PTW Markus and NACP-02 plane-parallel chambers were used. Irradiations were made using Varian 600C/2100C linacs, supported by water tanks and Virtual Water™ phantoms. The absorbed doses for photon and electron beams obtained following these CoP are all in good agreement, with deviations of less than 2%. A number of studies have been carried out by different groups in different countries to examine the consistency of dosimetry codes of practice or protocols. The aim of these studies is to confirm that the goal of those codes is met, namely uniformity in establishment of dosimetry of all radiation beam types used in cancer therapy in the world

  12. Anatomy-based inverse optimization in high-dose-rate brachytherapy combined with hypofractionated external beam radiotherapy for localized prostate cancer: Comparison of incidence of acute genitourinary toxicity between anatomy-based inverse optimization and geometric optimization

    International Nuclear Information System (INIS)

    Akimoto, Tetsuo; Katoh, Hiroyuki; Kitamoto, Yoshizumi; Shirai, Katsuyuki; Shioya, Mariko; Nakano, Takashi

    2006-01-01

    Purpose: To evaluate the advantages of anatomy-based inverse optimization (IO) in planning high-dose-rate (HDR) brachytherapy. Methods and Materials: A total of 114 patients who received HDR brachytherapy (9 Gy in two fractions) combined with hypofractionated external beam radiotherapy (EBRT) were analyzed. The dose distributions of HDR brachytherapy were optimized using geometric optimization (GO) in 70 patients and by anatomy-based IO in the remaining 44 patients. The correlation between the dose-volume histogram parameters, including the urethral dose and the incidence of acute genitourinary (GU) toxicity, was evaluated. Results: The averaged values of the percentage of volume receiving 80-150% of the prescribed minimal peripheral dose (V 8 -V 15 ) of the urethra generated by anatomy-based IO were significantly lower than the corresponding values generated by GO. Similarly, the averaged values of the minimal dose received by 5-50% of the target volume (D 5 -D 5 ) obtained using anatomy-based IO were significantly lower than those obtained using GO. Regarding acute toxicity, Grade 2 or worse acute GU toxicity developed in 23% of all patients, but was significantly lower in patients for whom anatomy-based IO (16%) was used than in those for whom GO was used (37%), consistent with the reduced urethral dose (p <0.01). Conclusion: The results of this study suggest that anatomy-based IO is superior to GO for dose optimization in HDR brachytherapy for prostate cancer

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

    Directory of Open Access Journals (Sweden)

    Joakim eda Silva

    2015-12-01

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

  14. Dose properties of x-ray beams produced by laser-wakefield-accelerated electrons

    International Nuclear Information System (INIS)

    Kainz, K K; Hogstrom, K R; Antolak, J A; Almond, P R; Bloch, C D

    2005-01-01

    Given that laser wakefield acceleration (LWFA) has been demonstrated experimentally to accelerate electron beams to energies beyond 25 MeV, it is reasonable to assess the ability of existing LWFA technology to compete with conventional radiofrequency linear accelerators in producing electron and x-ray beams for external-beam radiotherapy. We present calculations of the dose distributions (off-axis dose profiles and central-axis depth dose) and dose rates of x-ray beams that can be produced from electron beams that are generated using state-of-the-art LWFA. Subsets of an LWFA electron energy distribution were propagated through the treatment head elements (presuming an existing design for an x-ray production target and flattening filter) implemented within the EGSnrc Monte Carlo code. Three x-ray energy configurations (6 MV, 10 MV and 18 MV) were studied, and the energy width ΔE of the electron-beam subsets varied from 0.5 MeV to 12.5 MeV. As ΔE increased from 0.5 MeV to 4.5 MeV, we found that the off-axis and central-axis dose profiles for x-rays were minimally affected (to within about 3%), a result slightly different from prior calculations of electron beams broadened by scattering foils. For ΔE of the order of 12 MeV, the effect on the off-axis profile was of the order of 10%, but the central-axis depth dose was affected by less than 2% for depths in excess of about 5 cm beyond d max . Although increasing ΔE beyond 6.5 MeV increased the dose rate at d max by more than 10 times, the absolute dose rates were about 3 orders of magnitude below those observed for LWFA-based electron beams at comparable energies. For a practical LWFA-based x-ray device, the beam current must be increased by about 4-5 orders of magnitude. (note)

  15. The METAS absorbed dose to water calibration service for high energy photon and electron beam radiotherapy

    International Nuclear Information System (INIS)

    Stucki, G.; Muench, W.; Quintel, H.

    2002-01-01

    Full text: The Swiss Federal Office of Metrology and Accreditation (METAS) provides an absorbed dose to water calibration service for reference dosimeters using 60 Co γ radiation, ten X-ray beam qualities between TPR 20,10 =0.639 and 0.802 and ten electron beam qualities between R 50 =1.75 gcm -2 and 8.54 gcm -2 . A 22 MeV microtron accelerator with a conventional treatment head is used as radiation source for the high energy photon and electron beams. The treatment head produces clinical beams. The METAS absorbed dose calibration service for high energy photons is based on a primary standard sealed water calorimeter of the Domen type, that is used to calibrate several METAS transfer standards of type NE2611A and NE2571A in terms of absorbed dose to water in the energy range from 60 Co to TPR 20,10 = 0.802. User reference dosimeters are compared with the transfer standards to give calibration factors in absorbed dose to water with an uncertainty of 1.0% for 60 Co γ radiation and 1.4% for higher energies (coverage factor k=2). The calibration service was launched in 1997. The calibration factors measured by METAS have been compared with those derived from the Code of Practice of the International Atomic Energy Agency using the calculated k Q factors listed in table 14. The comparison showed a maximum difference of 0.8% for the NE25611A and NE 2571A chambers. At 60 Co γ radiation the METAS primary standard of absorbed dose to water was bilaterally compared with the primary standards of the Bureau International des Poids et Mesures BIPM (Sevres) as well as of the National Research Council NRC (Canada). In either case the standards were in agreement within the comparison uncertainties. The METAS absorbed dose calibration service for high energy electron beams is based on a primary standard chemical dosimeter. A monoenergetic electron beam of precisely known particle energy and beam charge is totally absorbed in Fricke solution (ferrous ammonium sulphate) of a given

  16. High Power Diode Lasers with External Feedback: Overview and Prospects

    DEFF Research Database (Denmark)

    Chi, Mingjun; Petersen, Paul Michael

    2012-01-01

    In summary, different external-cavity feedback techniques to improve the spatial beam quality and narrow the linewidth of the output beam from both BALs and TDLs are presented. Broad-area diode laser system with external-cavity feedback around 800 nm can produce several Watts of output power...... with a good beam quality. Tapered diode laser systems with external-cavity feedback around 800 and 1060 nm can deliver more than 2 W output power with diffraction-limited beam quality and can be operated in single-longitudinal mode. These high-brightness, narrow linewidth, and tunable external-cavity diode...... lasers emerge as the next generation of compact lasers that have the potential of replacing conventional high power laser systems in many existing applications....

  17. Evaluation of internal and external doses from $^{11}C$ produced in the air in high energy proton accelerator tunnels

    CERN Document Server

    Endo, A; Kanda, Y; Oishi, T; Kondo, K

    2001-01-01

    Air has been irradiated with high energy protons at the 12 GeV proton synchrotron to obtain the following parameters essential for the internal dose evaluation from airborne /sup 11/C produced through nuclear spallation reactions: the abundance of gaseous and particulate /sup 11/C, chemical forms, and particle size distribution. It was found that more than 98% of /sup 11/C is present as gas and the rest is aerosol. The gaseous components were only /sup 11/CO and /sup 11/CO/sub 2/ and their proportions were approximately 80% and 20%, respectively. The particulate /sup 11/C was found to be sulphate and/or nitrate aerosols having a log-normal size distribution; the measurement using a diffusion battery showed a geometric mean radius of 0.035 mu m and a geometric standard deviation of 1.8 at a beam intensity of 6.8*10/sup 11/ proton.pulse /sup -1/ and an irradiation time of 9.6 min. By taking the chemical composition and particle size into account, effective doses both from internal and from external exposures pe...

  18. In vivo dosimetry in external beam radiotherapy

    International Nuclear Information System (INIS)

    Mijnheer, Ben; Beddar, Sam; Izewska, Joanna; Reft, Chester

    2013-01-01

    In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors’ opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks

  19. In vivo dosimetry in external beam radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mijnheer, Ben [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX (Netherlands); Beddar, Sam [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Izewska, Joanna [Division of Human Health, International Atomic Energy Agency, Vienna 1400 (Austria); Reft, Chester [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois 60637 (United States)

    2013-07-15

    In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors' opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks.

  20. Absorbed dose optimization in the microplanar beam radiotherapy

    International Nuclear Information System (INIS)

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

    1996-01-01

    Full text: Recent advances in synchrotron generated X-ray beams with high fluence rate, small divergence and sharply defined microbeam margins permit investigation of the application of an array of closely spaced, parallel or converging microbeams for radiotherapy. The proposed technique takes advantage of the repair mechanism hypothesis of capillary endothelial cells between alternate microbeam zones, which regenerates the lethally irradiated capillaries. Unlike a pencil beam, more accurate dose calculation, beam width and spacing are essential to minimise radiation damage to normal tissue cells outside the target. The absorbed dose between microbeam zones should be kept below the threshold for irreversible radiation damage. Thus the peak-to-valley ratio for the dose distribution should be optimized. The absorbed dose profile depends on the energy of the incident beam and the composition and density of the medium. Using Monte Carlo computations, the radial absorbed dose of single 24 x 24 μm 2 cross-section X-ray beams of different energies in a tissue/lung/tissue phantom was investigated. The results indicated that at 100 keV, closely spaced square cross-sectional microbeams can be applied to the lung. A bundle of parallel 24 μm-wide planar microbeams spaced at 200 μm intervals provides much more irradiation coverage of tissue than is provided by a bundle of parallel, square cross-sectional microbeam, although the former is associated with much smaller Peak (maximum absorbed dose on the beam axis) -to-Valley ( minimum interbeam absorbed dose ) ratios than the latter. In this study the lateral and depth dose of single and multiple microplanar beams with beam dimensions of width 24 μm and 48 μm and height 2-20 cm with energy of 100 keV in a tissue/lung/tissue phantom are investigated. The EGS4 Monte Carlo code is used to calculate dose profiles at different depths and bundles of beams (2 x 2 cm 2 to 20 x 20 cm 2 square cross section) with a 150 μm 200 μm and

  1. Out-of-field doses and neutron dose equivalents for electron beams from modern Varian and Elekta linear accelerators.

    Science.gov (United States)

    Cardenas, Carlos E; Nitsch, Paige L; Kudchadker, Rajat J; Howell, Rebecca M; Kry, Stephen F

    2016-07-08

    Out-of-field doses from radiotherapy can cause harmful side effects or eventually lead to secondary cancers. Scattered doses outside the applicator field, neutron source strength values, and neutron dose equivalents have not been broadly investigated for high-energy electron beams. To better understand the extent of these exposures, we measured out-of-field dose characteristics of electron applicators for high-energy electron beams on two Varian 21iXs, a Varian TrueBeam, and an Elekta Versa HD operating at various energy levels. Out-of-field dose profiles and percent depth-dose curves were measured in a Wellhofer water phantom using a Farmer ion chamber. Neutron dose was assessed using a combination of moderator buckets and gold activation foils placed on the treatment couch at various locations in the patient plane on both the Varian 21iX and Elekta Versa HD linear accelerators. Our findings showed that out-of-field electron doses were highest for the highest electron energies. These doses typically decreased with increasing distance from the field edge but showed substantial increases over some distance ranges. The Elekta linear accelerator had higher electron out-of-field doses than the Varian units examined, and the Elekta dose profiles exhibited a second dose peak about 20 to 30 cm from central-axis, which was found to be higher than typical out-of-field doses from photon beams. Electron doses decreased sharply with depth before becoming nearly constant; the dose was found to decrease to a depth of approximately E(MeV)/4 in cm. With respect to neutron dosimetry, Q values and neutron dose equivalents increased with electron beam energy. Neutron contamination from electron beams was found to be much lower than that from photon beams. Even though the neutron dose equivalent for electron beams represented a small portion of neutron doses observed under photon beams, neutron doses from electron beams may need to be considered for special cases.

  2. Dose-response characteristics of low- and intermediate-risk prostate cancer treated with external beam radiotherapy

    International Nuclear Information System (INIS)

    Cheung, Rex; Tucker, Susan L.; Lee, Andrew K.; Crevoisier, Renaud de; Dong Lei; Kamat, Ashish; Pisters, Louis; Kuban, Deborah

    2005-01-01

    Purpose: In this era of dose escalation, the benefit of higher radiation doses for low-risk prostate cancer remains controversial. For intermediate-risk patients, the data suggest a benefit from higher doses. However, the quantitative characterization of the benefit for these patients is scarce. We investigated the radiation dose-response relation of tumor control probability in low-risk and intermediate-risk prostate cancer patients treated with radiotherapy alone. We also investigated the differences in the dose-response characteristics using the American Society for Therapeutic Radiology and Oncology (ASTRO) definition vs. an alternative biochemical failure definition. Methods and materials: This study included 235 low-risk and 387 intermediate-risk prostate cancer patients treated with external beam radiotherapy without hormonal treatment between 1987 and 1998. The low-risk patients had 1992 American Joint Committee on Cancer Stage T2a or less disease as determined by digital rectal examination, prostate-specific antigen (PSA) levels of ≤10 ng/mL, and biopsy Gleason scores of ≤6. The intermediate-risk patients had one or more of the following: Stage T2b-c, PSA level of ≤20 ng/mL but >10 ng/mL, and/or Gleason score of 7, without any of the following high-risk features: Stage T3 or greater, PSA >20 ng/mL, or Gleason score ≥8. The logistic models were fitted to the data at varying points after treatment, and the dose-response parameters were estimated. We used two biochemical failure definitions. The ASTRO PSA failure was defined as three consecutive PSA rises, with the time to failure backdated to the mid-point between the nadir and the first rise. The second biochemical failure definition used was a PSA rise of ≥2 ng/mL above the current PSA nadir (CN + 2). The failure date was defined as the time at which the event occurred. Local, nodal, and distant relapses and the use of salvage hormonal therapy were also failures. Results: On the basis of the

  3. External doses from radioactive fallout. Dosimetry and levels

    International Nuclear Information System (INIS)

    Woehni, T.

    1995-01-01

    The design, manufacture and calibration of a TL-based dosemeter for measurement of low level external photon radiation are presented. The dosemeter is based on CaF 2 with 2 mm brass filter for energy compensation. It is able to resolve a 8% dose increase relative to natural background radiation. With this dosemeter external dose measurements were made in 6 villages in a heavily contaminated region in Russia (Chernobyl fallout), in order to assess external doses to the population. The results were analyzed in the light of additional existing information on radioactive deposition, social habits, decontamination measures and other influencing technical and physical factors. The observed dose values were lower than theoretical estimates of external doses based on published values for external dose levels relative to the level of contamination. 84 refs., 7 figs., 5 tabs

  4. External doses from radioactive fallout. Dosimetry and levels

    Energy Technology Data Exchange (ETDEWEB)

    Woehni, T

    1996-12-31

    The design, manufacture and calibration of a TL-based dosemeter for measurement of low level external photon radiation are presented. The dosemeter is based on CaF{sub 2} with 2 mm brass filter for energy compensation. It is able to resolve a 8% dose increase relative to natural background radiation. With this dosemeter external dose measurements were made in 6 villages in a heavily contaminated region in Russia (Chernobyl fallout), in order to assess external doses to the population. The results were analyzed in the light of additional existing information on radioactive deposition, social habits, decontamination measures and other influencing technical and physical factors. The observed dose values were lower than theoretical estimates of external doses based on published values for external dose levels relative to the level of contamination. 84 refs., 7 figs., 5 tabs.

  5. External doses from radioactive fallout. Dosimetry and levels

    Energy Technology Data Exchange (ETDEWEB)

    Woehni, T.

    1995-12-31

    The design, manufacture and calibration of a TL-based dosemeter for measurement of low level external photon radiation are presented. The dosemeter is based on CaF{sub 2} with 2 mm brass filter for energy compensation. It is able to resolve a 8% dose increase relative to natural background radiation. With this dosemeter external dose measurements were made in 6 villages in a heavily contaminated region in Russia (Chernobyl fallout), in order to assess external doses to the population. The results were analyzed in the light of additional existing information on radioactive deposition, social habits, decontamination measures and other influencing technical and physical factors. The observed dose values were lower than theoretical estimates of external doses based on published values for external dose levels relative to the level of contamination. 84 refs., 7 figs., 5 tabs.

  6. CONTINOUS EXTRACTED BEAM IN THE AGS FAST EXTERNAL BEAM LINE

    International Nuclear Information System (INIS)

    GLENN, J.W.; TSOUPAS, N.; BROWN, K.A.; BIRYUKOV, V.M.

    2001-01-01

    A method to split off a few percent of the 6 x 10 13 AGS beam delivered to the Slow External Beam (SEB) lines and send it down the Fast External Beam line (FEB) has been developed. The mission is to feed a counter experiment off the FEB that directly measures the neutrino mass using the muon storage ring. The use of normal thin septum splitters would have an excessive loss overhead and been optically difficult. The AGS Slow Extraction uses a third integer resonance with sextuple strength so the resonance width is a few percent of the beam width. This results in a low density tail which will be clipped by a bent crystal and deflected into the FEB channel. This clipping off of the tail should reduce losses in the SEB transport line. Details of modeled orbits, particle distribution and extraction trajectories into and out off the crystal will be given

  7. Preparation Of Thermoluminescence Dosimeters For External Radiotherapy Beam Audit In Malaysia

    International Nuclear Information System (INIS)

    Norhayati Abdullah; Siti Sara Deraman; Taiman Kadni; Mohd Taufik Dollah; Norhayati Salleh

    2014-01-01

    The external beam audit is a part of the Quality Assurance Programme (QAP) in radiotherapy that should be carried out to check the accuracy of dose delivered by the radiotherapy treatment units are within the tolerance limit of A ± 5 % as recommended by the International Commission of Radiation Units and Measurements (ICRU) Report No. 24. In this work, thermoluminescence dosimeters (TLD) in powder form were chosen to be used in the dose quality audit for the radiotherapy treatment units in Malaysia. As a preparation, the characterizations of a new batch of TLD-100 powders were studied. The studies include checks for the response of TLD-100 before and after pre-annealing process, reproducibility and linearity of TL signal. Results show that the response of TLD-100 powder after pre-annealing increases by 65 % compared with before pre-annealing process. These TLD-100 powders also provide reliable and consistent readings for the absorbed dose to water within the range of 150 cGy to 250 cGy with the maximum standard uncertainty of 0.554 μC. Finally, the calibration curves for 6 MV and 10 MV photon beams were established. These curves will be used in determining the absorbed dose to water (Dw) from user's irradiated TLDs. The expanded uncertainty (coverage factor k=2) of Dw determination was estimated to be 4.1 %. As a conclusion, these TLD-100 powders are ready to be used as a transfer detector for evaluating the accuracy of user's delivery dose in the radiotherapy beam audit program in Malaysia. (author)

  8. High-dose proton beam therapy for sinonasal mucosal malignant melanoma

    International Nuclear Information System (INIS)

    Fuji, Hiroshi; Yoshikawa, Shusuke; Kasami, Masako; Murayama, Shigeyuki; Onitsuka, Tetsuro; Kashiwagi, Hiroya; Kiyohara, Yoshio

    2014-01-01

    The significance of definitive radiotherapy for sinonasal mucosal melanoma (SMM) is sill controvertial. This study was to evaluate the role of high-dose proton beam therapy (PBT) in patients with SMM. The cases of 20 patients with SMM localized to the primary site who were treated by PBT between 2006 and 2012 were retrospectively analyzed. The patterns of overall survival and morbidity were assessed. The median follow-up time was 35 months (range, 6–77 months). The 5-year overall and disease-free survival rates were 51% and 38%, respectively. Four patients showed local failure, 2 showed regrowth of the primary tumor, and 2 showed new sinonasal tumors beyond the primary site. The 5-year local control rate after PBT was 62%. Nodal and distant failure was seen in 7 patients. Three grade 4 late toxicities were observed in tumor-involved optic nerve. Our findings suggested that high-dose PBT is an effective local treatment that is less invasive than surgery but with comparable outcomes

  9. Evaluation of off-axis wedge correction factor using diode dosimeters for estimation of delivered dose in external radiotherapy

    International Nuclear Information System (INIS)

    Allahverdi, Mahmoud; Shirazi, Alireza; Geraily, Ghazale; Mohammadkarim, Alireza; Esfehani, Mahbod; Nedaie, Hasanali

    2012-01-01

    An in vivo dosimetry system, using p-type diode dosimeters, was characterized for clinical applications of treatment machines ranging in megavoltage energies. This paper investigates two different models of diodes for externally wedged beams and explains a new algorithm for the calculation of the target dose at various tissue depths in external radiotherapy. The values of off-axis wedge correction factors were determined at two different positions in the wedged (toward the thick and thin edges) and in the non-wedged directions on entrance and exit surfaces of a polystyrene phantom in 60 Co and 6 MV photon beams. Depth transmission was defined on the entrance and exit surfaces to obtain the off-axis wedge correction factor at any depth. As the sensitivity of the diodes depends on physical characteristics (field size, source-skin distance (SSD), thickness, backscatter), correction factors were applied to the diode reading when measuring conditions different from calibration situations. The results indicate that needful correction factors for 60 Co wedged photons are usually larger than those for 6 MV wedged photon beams. In vivo dosimetry performed with the proposed algorithms at externally wedged beams has negligible probable errors (less than 0.5%) and is a reliable method for patient dose control. (author)

  10. Evaluation of off-axis wedge correction factor using diode dosimeters for estimation of delivered dose in external radiotherapy

    Directory of Open Access Journals (Sweden)

    Mahmoud Allahverdi

    2012-01-01

    Full Text Available An in vivo dosimetry system, using p-type diode dosimeters, was characterized for clinical applications of treatment machines ranging in megavoltage energies. This paper investigates two different models of diodes for externally wedged beams and explains a new algorithm for the calculation of the target dose at various tissue depths in external radiotherapy. The values of off-axis wedge correction factors were determined at two different positions in the wedged (toward the thick and thin edges and in the non-wedged directions on entrance and exit surfaces of a polystyrene phantom in 60 Co and 6 MV photon beams. Depth transmission was defined on the entrance and exit surfaces to obtain the off-axis wedge correction factor at any depth. As the sensitivity of the diodes depends on physical characteristics [field size, source-skin distance (SSD, thickness, backscatter], correction factors were applied to the diode reading when measuring conditions different from calibration situations . The results indicate that needful correction factors for 60 Co wedged photons are usually larger than those for 6 MV wedged photon beams. In vivo dosimetry performed with the proposed algorithms at externally wedged beams has negligible probable errors (less than 0.5% and is a reliable method for patient dose control.

  11. Proton external beam in the TANDAR Accelerator; Haz externo de protones en el acelerador TANDAR

    Energy Technology Data Exchange (ETDEWEB)

    Rey, R; Schuff, J A; Perez de la Hoz, A.; Debray, M E; Hojman, D; Kreiner, A J; Kesque, J M; Saint-Martin, G; Oppezzo, O; Bernaola, O A; Molinari, B L; Duran, H A; Policastro, L; Palmieri, M; Ibanez, J; Stoliar, P; Mazal, A; Caraballo, M E; Burlon, A; Cardona, M A; Vazquez, M E; Salfity, M F; Ozafran, M J; Naab, F; Levinton, G; Davidson, M; Buhler, M [Departamento de Fisica, Comision Nacional de Energia Atomica, Av. Gral. Paz 1499, C.P. 1650 San Martin, Buenos Aires (Argentina)

    1999-12-31

    An external proton beam has been obtained in the TANDAR accelerator with radiological and biomedical purposes. The protons have excellent physical properties for their use in radiotherapy allowing a very good accuracy in the dose spatial distribution inside the tissue so in the side direction as in depth owing to the presence of Bragg curve. The advantage of the accuracy in the dose localization with proton therapy is good documented (M. Wagner, Med. Phys. 9, 749 (1982); M. Goitein and F. Chen, Med. Phys. 10, 831 (1983); M.R. Raju, Rad. Res. 145, 391 (1996)). It was obtained external proton beams with energies between 15-25 MeV, currents between 2-10 p A and a uniform transversal sections of 40 mm{sup 2} approximately. It was realized dosimetric evaluations with CR39 and Makrofol foliation. The irradiations over biological material contained experiences In vivo with laboratory animals, cellular and bacterial crops. It was fixed the optimal conditions of position and immobilization of the Wistar rats breeding for the In vivo studies. It was chosen dilutions and sowing techniques adequate for the exposition at the cellular and bacterial crops beam. (Author)

  12. Proton external beam in the TANDAR Accelerator; Haz externo de protones en el acelerador TANDAR

    Energy Technology Data Exchange (ETDEWEB)

    Rey, R.; Schuff, J.A.; Perez de la Hoz, A.; Debray, M.E.; Hojman, D.; Kreiner, A.J.; Kesque, J.M.; Saint-Martin, G.; Oppezzo, O.; Bernaola, O.A.; Molinari, B.L.; Duran, H.A.; Policastro, L.; Palmieri, M.; Ibanez, J.; Stoliar, P.; Mazal, A.; Caraballo, M.E.; Burlon, A.; Cardona, M.A.; Vazquez, M.E.; Salfity, M.F.; Ozafran, M.J.; Naab, F.; Levinton, G.; Davidson, M.; Buhler, M. [Departamento de Fisica, Comision Nacional de Energia Atomica, Av. Gral. Paz 1499, C.P. 1650 San Martin, Buenos Aires (Argentina)

    1998-12-31

    An external proton beam has been obtained in the TANDAR accelerator with radiological and biomedical purposes. The protons have excellent physical properties for their use in radiotherapy allowing a very good accuracy in the dose spatial distribution inside the tissue so in the side direction as in depth owing to the presence of Bragg curve. The advantage of the accuracy in the dose localization with proton therapy is good documented (M. Wagner, Med. Phys. 9, 749 (1982); M. Goitein and F. Chen, Med. Phys. 10, 831 (1983); M.R. Raju, Rad. Res. 145, 391 (1996)). It was obtained external proton beams with energies between 15-25 MeV, currents between 2-10 p A and a uniform transversal sections of 40 mm{sup 2} approximately. It was realized dosimetric evaluations with CR39 and Makrofol foliation. The irradiations over biological material contained experiences In vivo with laboratory animals, cellular and bacterial crops. It was fixed the optimal conditions of position and immobilization of the Wistar rats breeding for the In vivo studies. It was chosen dilutions and sowing techniques adequate for the exposition at the cellular and bacterial crops beam. (Author)

  13. Field size and dose distribution of electron beam

    International Nuclear Information System (INIS)

    Kang, Wee Saing

    1980-01-01

    The author concerns some relations between the field size and dose distribution of electron beams. The doses of electron beams are measured by either an ion chamber with an electrometer or by film for dosimetry. We analyzes qualitatively some relations; the energy of incident electron beams and depths of maximum dose, field sizes of electron beams and depth of maximum dose, field size and scatter factor, electron energy and scatter factor, collimator shape and scatter factor, electron energy and surface dose, field size and surface dose, field size and central axis depth dose, and field size and practical range. He meets with some results. They are that the field size of electron beam has influence on the depth of maximum dose, scatter factor, surface dose and central axis depth dose, scatter factor depends on the field size and energy of electron beam, and the shape of the collimator, and the depth of maximum dose and the surface dose depend on the energy of electron beam, but the practical range of electron beam is independent of field size

  14. Investigations of DNA damage induction and repair resulting from cellular exposure to high dose-rate pulsed proton beams

    International Nuclear Information System (INIS)

    Renis, M.; Malfa, G.; Tomasello, B.; Borghesi, M.; Schettino, G.; Favetta, M.; Romano, F.; Cirrone, G. A. P.; Manti, L.

    2013-01-01

    Studies regarding the radiobiological effects of low dose radiation, microbeam irradiation services have been developed in the world and today laser acceleration of protons and heavy ions may be used in radiation therapy. The application of different facilities is essential for studying bystander effects and relating signalling phenomena in different cells or tissues. In particular the use of ion beams results advantageous in cancer radiotherapy compared to more commonly used X-rays, since the ability of ions in delivering lethal amount of doses into the target tumour avoiding or limiting damage to the contiguous healthy tissues. At the INFN-LNS in Catania, a multidisciplinary radiobiology group is strategically structured aimed to develop radiobiological research, finalised to therapeutic applications, compatible with the use of high dose laser-driven ion beams. The characteristic non-continuous dose rates with several orders of magnitude of laser-driven ion beams makes this facility very interesting in the cellular systems' response to ultra-high dose rates with non-conventional pulse time intervals cellular studies. Our group have projected to examine the effect of high dose laser-driven ion beams on two cellular types: foetal fibroblasts (normal control cells) and DU145 (prostate cancer cells), studying the modulation of some different bio-molecular parameters, in particular cell proliferation and viability, DNA damage, redox cellular status, morphological alterations of both the cytoskeleton components and some cell organelles and the possible presence of apoptotic or necrotic cell death. Our group performed preliminary experiments with high energy (60 MeV), dose rate of 10 Gy/min, doses of 1, 2, 3 Gy and LET 1 keV/μm on human foetal fibroblasts (control cells). We observed that cell viability was not influenced by the characteristics of the beam, the irradiation conditions or the analysis time. Conversely, DNA damage was present at time 0, immediately

  15. Investigations of DNA damage induction and repair resulting from cellular exposure to high dose-rate pulsed proton beams

    Energy Technology Data Exchange (ETDEWEB)

    Renis, M.; Malfa, G.; Tomasello, B. [Drug Sciences Department, University of Catania, Catania (Italy); Borghesi, M.; Schettino, G. [Queen' s University Belfast, Northern Ireland (United Kingdom); Favetta, M.; Romano, F.; Cirrone, G. A. P. [National Institute for Nuclear Physics (INFN-LNS), Catania (Italy); Manti, L. [Physics Science Department, University of Naples Federico II, Naples, and National Institute for Nuclear Physics (INFN), Naples (Italy)

    2013-07-26

    Studies regarding the radiobiological effects of low dose radiation, microbeam irradiation services have been developed in the world and today laser acceleration of protons and heavy ions may be used in radiation therapy. The application of different facilities is essential for studying bystander effects and relating signalling phenomena in different cells or tissues. In particular the use of ion beams results advantageous in cancer radiotherapy compared to more commonly used X-rays, since the ability of ions in delivering lethal amount of doses into the target tumour avoiding or limiting damage to the contiguous healthy tissues. At the INFN-LNS in Catania, a multidisciplinary radiobiology group is strategically structured aimed to develop radiobiological research, finalised to therapeutic applications, compatible with the use of high dose laser-driven ion beams. The characteristic non-continuous dose rates with several orders of magnitude of laser-driven ion beams makes this facility very interesting in the cellular systems' response to ultra-high dose rates with non-conventional pulse time intervals cellular studies. Our group have projected to examine the effect of high dose laser-driven ion beams on two cellular types: foetal fibroblasts (normal control cells) and DU145 (prostate cancer cells), studying the modulation of some different bio-molecular parameters, in particular cell proliferation and viability, DNA damage, redox cellular status, morphological alterations of both the cytoskeleton components and some cell organelles and the possible presence of apoptotic or necrotic cell death. Our group performed preliminary experiments with high energy (60 MeV), dose rate of 10 Gy/min, doses of 1, 2, 3 Gy and LET 1 keV/μm on human foetal fibroblasts (control cells). We observed that cell viability was not influenced by the characteristics of the beam, the irradiation conditions or the analysis time. Conversely, DNA damage was present at time 0, immediately

  16. Radiobiological response to ultra-short pulsed megavoltage electron beams of ultra-high pulse dose rate.

    Science.gov (United States)

    Beyreuther, Elke; Karsch, Leonhard; Laschinsky, Lydia; Leßmann, Elisabeth; Naumburger, Doreen; Oppelt, Melanie; Richter, Christian; Schürer, Michael; Woithe, Julia; Pawelke, Jörg

    2015-08-01

    In line with the long-term aim of establishing the laser-based particle acceleration for future medical application, the radiobiological consequences of the typical ultra-short pulses and ultra-high pulse dose rate can be investigated with electron delivery. The radiation source ELBE (Electron Linac for beams with high Brilliance and low Emittance) was used to mimic the quasi-continuous electron beam of a clinical linear accelerator (LINAC) for comparison with electron pulses at the ultra-high pulse dose rate of 10(10) Gy min(-1) either at the low frequency of a laser accelerator or at 13 MHz avoiding effects of prolonged dose delivery. The impact of pulse structure was analyzed by clonogenic survival assay and by the number of residual DNA double-strand breaks remaining 24 h after irradiation of two human squamous cell carcinoma lines of differing radiosensitivity. The radiation response of both cell lines was found to be independent from electron pulse structure for the two endpoints under investigation. The results reveal, that ultra-high pulse dose rates of 10(10) Gy min(-1) and the low repetition rate of laser accelerated electrons have no statistically significant influence (within the 95% confidence intervals) on the radiobiological effectiveness of megavoltage electrons.

  17. Intermediate-term results of image-guided brachytherapy and high-technology external beam radiotherapy in cervical cancer: Chiang Mai University experience.

    Science.gov (United States)

    Tharavichitkul, Ekkasit; Chakrabandhu, Somvilai; Wanwilairat, Somsak; Tippanya, Damrongsak; Nobnop, Wannapha; Pukanhaphan, Nantaka; Galalae, Razvan M; Chitapanarux, Imjai

    2013-07-01

    To evaluate the outcomes of image-guided brachytherapy combined with 3D conformal or intensity modulated external beam radiotherapy (3D CRT/IMRT) in cervical cancer at Chiang Mai University. From 2008 to 2011, forty-seven patients with locally advanced cervical cancer were enrolled in this study. All patients received high-technology (3D CRT/IMRT) whole pelvic radiotherapy with a total dose of 45-46 Gy plus image-guided High-Dose-Rate intracavitary brachytherapy 6.5-7 Gy × 4 fractions to a High-Risk Clinical Target Volume (HR-CTV) according to GEC-ESTRO recommendations. The dose parameters of the HR-CTV for bladder, rectum and sigmoid colon were recorded, as well as toxicity profiles. In addition, the endpoints for local control, disease-free, metastasis-free survival and overall survival were calculated. At the median follow-up time of 26 months, the local control, disease-free survival, and overall survival rates were 97.9%, 85.1%, and 93.6%, respectively. The mean dose of HR-CTV, bladder, rectum and sigmoid were 93.1, 88.2, 69.6, and 72 Gy, respectively. In terms of late toxicity, the incidence of grade 3-4 bladder and rectum morbidity was 2.1% and 2.1%, respectively. A combination of image-guided brachytherapy and IMRT/3D CRT showed very promising results of local control, disease-free survival, metastasis-free survival and overall survival rates. It also caused a low incidence of grade 3-4 toxicity in treated study patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. [Study of the influence of uniform transverse magnetic field on the dose distribution of high energy electron beam using Monte Carlo method].

    Science.gov (United States)

    You, Shihu; Xu, Yun; Wu, Zhangwen; Hou, Qing; Guo, Chengjun

    2014-12-01

    In the present work, Monte Carlo simulations were employed to study the characteristics of the dose distribution of high energy electron beam in the presence of uniform transverse magnetic field. The simulations carried out the transport processes of the 30 MeV electron beam in the homogeneous water phantom with different magnetic field. It was found that the dose distribution of the 30 MeV electron beam had changed significantly because of the magnetic field. The result showed that the range of the electron beam was decreased obviously and it formed a very high dose peak at the end of the range, and the ratio of maximum dose to the dose of the surface was greatly increased. The results of this study demonstrated that we could change the depth dose distribution of electron beam which is analogous to the heavy ion by modulating the energy of the electron and magnetic field. It means that using magnetic fields in conjunction with electron radiation therapy has great application prospect, but it also has brought new challenges for the research of dose algorithm.

  19. Evaluation of the response of concurrent high dose rate intracavitary brachytherapy with external beam radiotherapy in management of early stage carcinoma cervix.

    Science.gov (United States)

    Patidar, Arvind Kumar; Kumar, H S; Walke, Rahul V; Hirapara, Pushpendra H; Jakhar, Shankar Lal; Bardia, M R

    2012-10-01

    To evaluate local disease control and early complications of concomitant brachytherapy with external beam-radiotherapy in early stage carcinoma cervix. Fifty patients of early stage carcinoma cervix (FIGO-IB/IIA) were randomly divided into study group concomitant external beam irradiation (EBRT) and HDR-ICBT (intra-cavitary brachytherapy, xrt = 50 Gy/25 Fr, HDR 5.2 Gy*5 Fr) and the control group EBRT followed by HDR-ICBT (xrt = 50 Gy/25 Fr, HDR 7.5 Gy*3 Fr). Acute reactions and local disease response were compared between treatment and at 6-month follow up. Median overall treatment times were 38 and 61 days in the study and the control groups, respectively. Acute skin reactions and diarrhea were more in the study but manageable. At the completion of the study, there were 80 and 68 % complete responses, 16 and 20 % partial responses, 0 and 8 % stable diseases in the study group and the control group, respectively. Response was better in the study group but statistically insignificant. Larger number of patients and longer follow up are required to arrive at concrete conclusion.

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

    International Nuclear Information System (INIS)

    Das, I; Andersen, A; Coutinho, L

    2015-01-01

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

  1. Comparison of film measurements and Monte Carlo simulations of dose delivered with very high-energy electron beams in a polystyrene phantom.

    Science.gov (United States)

    Bazalova-Carter, Magdalena; Liu, Michael; Palma, Bianey; Dunning, Michael; McCormick, Doug; Hemsing, Erik; Nelson, Janice; Jobe, Keith; Colby, Eric; Koong, Albert C; Tantawi, Sami; Dolgashev, Valery; Maxim, Peter G; Loo, Billy W

    2015-04-01

    To measure radiation dose in a water-equivalent medium from very high-energy electron (VHEE) beams and make comparisons to Monte Carlo (MC) simulation results. Dose in a polystyrene phantom delivered by an experimental VHEE beam line was measured with Gafchromic films for three 50 MeV and two 70 MeV Gaussian beams of 4.0-6.9 mm FWHM and compared to corresponding MC-simulated dose distributions. MC dose in the polystyrene phantom was calculated with the EGSnrc/BEAMnrc and DOSXYZnrc codes based on the experimental setup. Additionally, the effect of 2% beam energy measurement uncertainty and possible non-zero beam angular spread on MC dose distributions was evaluated. MC simulated percentage depth dose (PDD) curves agreed with measurements within 4% for all beam sizes at both 50 and 70 MeV VHEE beams. Central axis PDD at 8 cm depth ranged from 14% to 19% for the 5.4-6.9 mm 50 MeV beams and it ranged from 14% to 18% for the 4.0-4.5 mm 70 MeV beams. MC simulated relative beam profiles of regularly shaped Gaussian beams evaluated at depths of 0.64 to 7.46 cm agreed with measurements to within 5%. A 2% beam energy uncertainty and 0.286° beam angular spread corresponded to a maximum 3.0% and 3.8% difference in depth dose curves of the 50 and 70 MeV electron beams, respectively. Absolute dose differences between MC simulations and film measurements of regularly shaped Gaussian beams were between 10% and 42%. The authors demonstrate that relative dose distributions for VHEE beams of 50-70 MeV can be measured with Gafchromic films and modeled with Monte Carlo simulations to an accuracy of 5%. The reported absolute dose differences likely caused by imperfect beam steering and subsequent charge loss revealed the importance of accurate VHEE beam control and diagnostics.

  2. Comparison of film measurements and Monte Carlo simulations of dose delivered with very high-energy electron beams in a polystyrene phantom

    Energy Technology Data Exchange (ETDEWEB)

    Bazalova-Carter, Magdalena; Liu, Michael; Palma, Bianey; Koong, Albert C.; Maxim, Peter G., E-mail: Peter.Maxim@Stanford.edu, E-mail: BWLoo@Stanford.edu; Loo, Billy W., E-mail: Peter.Maxim@Stanford.edu, E-mail: BWLoo@Stanford.edu [Department of Radiation Oncology, Stanford University, Stanford, California 94305-5847 (United States); Dunning, Michael; McCormick, Doug; Hemsing, Erik; Nelson, Janice; Jobe, Keith; Colby, Eric; Tantawi, Sami; Dolgashev, Valery [SLAC National Accelerator Laboratory, Menlo Park, California 94025 (United States)

    2015-04-15

    Purpose: To measure radiation dose in a water-equivalent medium from very high-energy electron (VHEE) beams and make comparisons to Monte Carlo (MC) simulation results. Methods: Dose in a polystyrene phantom delivered by an experimental VHEE beam line was measured with Gafchromic films for three 50 MeV and two 70 MeV Gaussian beams of 4.0–6.9 mm FWHM and compared to corresponding MC-simulated dose distributions. MC dose in the polystyrene phantom was calculated with the EGSnrc/BEAMnrc and DOSXYZnrc codes based on the experimental setup. Additionally, the effect of 2% beam energy measurement uncertainty and possible non-zero beam angular spread on MC dose distributions was evaluated. Results: MC simulated percentage depth dose (PDD) curves agreed with measurements within 4% for all beam sizes at both 50 and 70 MeV VHEE beams. Central axis PDD at 8 cm depth ranged from 14% to 19% for the 5.4–6.9 mm 50 MeV beams and it ranged from 14% to 18% for the 4.0–4.5 mm 70 MeV beams. MC simulated relative beam profiles of regularly shaped Gaussian beams evaluated at depths of 0.64 to 7.46 cm agreed with measurements to within 5%. A 2% beam energy uncertainty and 0.286° beam angular spread corresponded to a maximum 3.0% and 3.8% difference in depth dose curves of the 50 and 70 MeV electron beams, respectively. Absolute dose differences between MC simulations and film measurements of regularly shaped Gaussian beams were between 10% and 42%. Conclusions: The authors demonstrate that relative dose distributions for VHEE beams of 50–70 MeV can be measured with Gafchromic films and modeled with Monte Carlo simulations to an accuracy of 5%. The reported absolute dose differences likely caused by imperfect beam steering and subsequent charge loss revealed the importance of accurate VHEE beam control and diagnostics.

  3. Research of transportation efficiency of low-energy high- current electron beam in plasma channel in external magnetic field

    International Nuclear Information System (INIS)

    Vagin, E S; Grigoriev, V P

    2015-01-01

    Effective high current (5-20 kA) and low energy (tens of keV) electrons beam transportation is possible only with almost complete charging neutralization. It is also necessary to use quite high current neutralization for elimination beam self-pinching effect. The research is based on the self-consistent mathematical model that takes into account beam and plasma particles dynamic, current and charge neutralization of electron beam and examines the transportation of electron beam into a chamber with low-pressure plasma in magnetic field. A numerical study was conducted using particle in cell (PIC) method. The study was performed with various system parameters: rise time and magnitude of the beam current, gas pressure and plasma density and geometry of the system. Regularities of local virtual cathode field generated by the beam in the plasma channel, as well as ranges of parameters that let transportation beam with minimal losses, depending on the external magnetic field were determined through a series of numerical studies. In addition, the assessment of the impact of the plasma ion mobility during the transition period and during steady beam was performed. (paper)

  4. Comparison of the outcome and morbidity for localized or locally advanced prostate cancer treated by high-dose-rate brachytherapy plus external beam radiotherapy (EBRT) versus EBRT alone

    International Nuclear Information System (INIS)

    Fang Fumin; Wang Yuming; Wang Chongjong; Huang Hsuanying; Chiang Pohui

    2008-01-01

    The objective of this study was to compare the survival, gastrointestinal (GI) and genitourinary (GU) toxicity for localized or locally advanced prostate cancer treated by high-dose-rate-brachytherapy (HDR-BT) plus external beam radiotherapy (EBRT) versus EBRT alone at a single institute in Taiwan. Eighty-eight patients with T1c-T3b prostate cancer consecutively treated by EBRT alone (33 patients) or HDR-BT+EBRT (55 patients) were studied. The median dose of EBRT was 70.2 Gy in the EBRT group and 50.4 Gy in the HDR-BT group. HDR-BT was performed 2-3 weeks before EBRT, with 12.6 Gy in three fractions over 24 h. Five patients (15.2%) in the EBRT group and seven (12.7%) in the HDR-BT group developed a biochemical relapse. The 5-year actuarial biochemical relapse-free survival rates were 65.0% in the EBRT group and 66.7% in the HDR-BT group (P=0.76). The 5-year actuarial likelihood of late ≥Grade 2 and ≥Grade 3 GI toxicity in the EBRT versus HDR-BT group was 62.8 versus 7.7% (P<0.001) and 19.6 versus 0% (P=0.001), respectively. In a multivariate analysis, the only predictor for late GI toxicity was the mode of RT. The 5-year actuarial likelihood of late ≥Grade 2 and ≥Grade 3 GU toxicity in the EBRT versus HDR-BT group was 14.8 versus 15.9% (P=0.86) and 3.6 versus 8.5% (P=0.40), respectively. The addition of HDR-BT before EBRT with a reduced dose from the EBRT produces a comparable survival outcome and GU toxicity but a significantly less GI toxicity for prostate cancer patients. (author)

  5. Dosimetric quality assurance of highly conformal external beam treatments: from 2D phantom comparisons to 4D patient dose reconstruction

    International Nuclear Information System (INIS)

    Feygelman, V; Nelms, B

    2013-01-01

    As IMRT technology continues to evolve, so do the dosimetric QA methods. A historical review of those is presented, starting with longstanding techniques such as film and ion chamber in a phantom and progressing towards 3D and 4D dose reconstruction in the patient. Regarding patient-specific QA, we envision that the currently prevalent limited comparison of dose distributions in the phantom by γ-analysis will be eventually replaced by clinically meaningful patient dose analyses with improved sensitivity and specificity. In a larger sense, we envision a future of QA built upon lessons from the rich history of ''quality'' as a science and philosophy. This future will aim to improve quality (and ultimately reduce cost) via advanced commissioning processes that succeed in detecting and rooting out systematic errors upstream of patient treatment, thus reducing our reliance on, and the resource burden associated with, per-beam/per-plan inspection.

  6. Dosimetric quality assurance of highly conformal external beam treatments: from 2D phantom comparisons to 4D patient dose reconstruction

    Science.gov (United States)

    Feygelman, V.; Nelms, B.

    2013-06-01

    As IMRT technology continues to evolve, so do the dosimetric QA methods. A historical review of those is presented, starting with longstanding techniques such as film and ion chamber in a phantom and progressing towards 3D and 4D dose reconstruction in the patient. Regarding patient-specific QA, we envision that the currently prevalent limited comparison of dose distributions in the phantom by γ-analysis will be eventually replaced by clinically meaningful patient dose analyses with improved sensitivity and specificity. In a larger sense, we envision a future of QA built upon lessons from the rich history of "quality" as a science and philosophy. This future will aim to improve quality (and ultimately reduce cost) via advanced commissioning processes that succeed in detecting and rooting out systematic errors upstream of patient treatment, thus reducing our reliance on, and the resource burden associated with, per-beam/per-plan inspection.

  7. External Beam Radiotherapy for Prostate Cancer Patients on Anticoagulation Therapy: How Significant is the Bleeding Toxicity?

    International Nuclear Information System (INIS)

    Choe, Kevin S.; Jani, Ashesh B.; Liauw, Stanley L.

    2010-01-01

    Purpose: To characterize the bleeding toxicity associated with external beam radiotherapy for prostate cancer patients receiving anticoagulation (AC) therapy. Methods and Materials: The study cohort consisted of 568 patients with adenocarcinoma of the prostate who were treated with definitive external beam radiotherapy. Of these men, 79 were receiving AC therapy with either warfarin or clopidogrel. All patients were treated with three-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Bleeding complications were recorded during treatment and subsequent follow-up visits. Results: With a median follow-up of 48 months, the 4-year actuarial risk of Grade 3 or worse bleeding toxicity was 15.5% for those receiving AC therapy compared with 3.6% among those not receiving AC (p < .0001). On multivariate analysis, AC therapy was the only significant factor associated with Grade 3 or worse bleeding (p < .0001). For patients taking AC therapy, the crude rate of bleeding was 39.2%. Multivariate analysis within the AC group demonstrated that a higher radiotherapy dose (p = .0408), intensity-modulated radiotherapy (p = 0.0136), and previous transurethral resection of the prostate (p = .0001) were associated with Grade 2 or worse bleeding toxicity. Androgen deprivation therapy was protective against bleeding, with borderline significance (p = 0.0599). Dose-volume histogram analysis revealed that Grade 3 or worse bleeding was minimized if the percentage of the rectum receiving ≥70 Gy was <10% or the rectum receiving ≥50 Gy was <50%. Conclusion: Patients taking AC therapy have a substantial risk of bleeding toxicity from external beam radiotherapy. In this setting, dose escalation or intensity-modulated radiotherapy should be used judiciously. With adherence to strict dose-volume histogram criteria and minimizing hotspots, the risk of severe bleeding might be reduced.

  8. Characterization of a power bipolar transistor as high-dose dosimeter for 1.9-2.2 MeV electron beams

    Energy Technology Data Exchange (ETDEWEB)

    Fuochi, P.G., E-mail: fuochi@isof.cnr.i [ISOF-CNR Institute, Via P. Gobetti 101, I-40129, Bologna (Italy); Lavalle, M.; Corda, U. [ISOF-CNR Institute, Via P. Gobetti 101, I-40129, Bologna (Italy); Kuntz, F.; Plumeri, S. [Aerial, Parc d' Innovation Rue Laurent Fries F-67400 Illkirch (France); Gombia, E. [IMEM-CNR Institute, Viale delle Scienze 37 A, Loc. Fontanini, 43010 Parma (Italy)

    2010-04-15

    Results of the characterization studies on a power bipolar transistor investigated as a possible radiation dosimeter under laboratory condition using electron beams of energies from 2.2 to 8.6 MeV and gamma rays from a {sup 60}Co source and tested in industrial irradiation plants having high-activity {sup 60}Co gamma-source and high-energy, high-power electron beam have previously been reported. The present paper describes recent studies performed on this type of bipolar transistor irradiated with 1.9 and 2.2 MeV electron beams in the dose range 5-50 kGy. Dose response, post-irradiation heat treatment and stability, effects of temperature during irradiation in the range from -104 to +22 deg. C, dependence on temperature during reading in the range 20-50 deg. C, and the difference in response of the transistors irradiated from the plastic side and the copper side are reported. DLTS measurements performed on the irradiated devices to identify the recombination centres introduced by radiation and their dependence on dose and energy of the electron beam are also reported.

  9. Dose-Volume Parameters of the Corpora Cavernosa Do Not Correlate With Erectile Dysfunction After External Beam Radiotherapy for Prostate Cancer: Results From a Dose-Escalation Trial

    International Nuclear Information System (INIS)

    Wielen, Gerard J. van der; Hoogeman, Mischa S.; Dohle, Gert R.; Putten, Wim L.J. van; Incrocci, Luca

    2008-01-01

    Purpose: To analyze the correlation between dose-volume parameters of the corpora cavernosa and erectile dysfunction (ED) after external beam radiotherapy (EBRT) for prostate cancer. Methods and Materials: Between June 1997 and February 2003, a randomized dose-escalation trial comparing 68 Gy and 78 Gy was conducted. Patients at our institute were asked to participate in an additional part of the trial evaluating sexual function. After exclusion of patients with less than 2 years of follow-up, ED at baseline, or treatment with hormonal therapy, 96 patients were eligible. The proximal corpora cavernosa (crura), the superiormost 1-cm segment of the crura, and the penile bulb were contoured on the planning computed tomography scan and dose-volume parameters were calculated. Results: Two years after EBRT, 35 of the 96 patients had developed ED. No statistically significant correlations between ED 2 years after EBRT and dose-volume parameters of the crura, the superiormost 1-cm segment of the crura, or the penile bulb were found. The few patients using potency aids typically indicated to have ED. Conclusion: No correlation was found between ED after EBRT for prostate cancer and radiation dose to the crura or penile bulb. The present study is the largest study evaluating the correlation between ED and radiation dose to the corpora cavernosa after EBRT for prostate cancer. Until there is clear evidence that sparing the penile bulb or crura will reduce ED after EBRT, we advise to be careful in sparing these structures, especially when this involves reducing treatment margins

  10. External dose-rate conversion factors for calculation of dose to the public

    Energy Technology Data Exchange (ETDEWEB)

    1988-07-01

    This report presents a tabulation of dose-rate conversion factors for external exposure to photons and electrons emitted by radionuclides in the environment. This report was prepared in conjunction with criteria for limiting dose equivalents to members of the public from operations of the US Department of Energy (DOE). The dose-rate conversion factors are provided for use by the DOE and its contractors in performing calculations of external dose equivalents to members of the public. The dose-rate conversion factors for external exposure to photons and electrons presented in this report are based on a methodology developed at Oak Ridge National Laboratory. However, some adjustments of the previously documented methodology have been made in obtaining the dose-rate conversion factors in this report. 42 refs., 1 fig., 4 tabs.

  11. Peripheral dose outside applicators in electron beams

    International Nuclear Information System (INIS)

    Chow, James C L; Grigorov, Grigor N

    2006-01-01

    The peripheral dose outside the applicators in electron beams was studied using a Varian 21 EX linear accelerator. To measure the peripheral dose profiles and point doses for the applicator, a solid water phantom was used with calibrated Kodak TL films. Peak dose spot was observed in the 4 MeV beam outside the applicator. The peripheral dose peak was very small in the 6 MeV beam and was ignorable at higher energies. Using the 10 x 10 cm 2 cutout and applicator, the dose peak for the 4 MeV beam was about 12 cm away from the field central beam axis (CAX) and the peripheral dose profiles did not change with depths measured at 0.2, 0.5 and 1 cm. The peripheral doses and profiles were further measured by varying the angle of obliquity, cutout and applicator size for the 4 MeV beam. The local peak dose was increased with about 3% per degree angle of obliquity, and was about 1% of the prescribed dose (angle of obliquity equals zero) at 1 cm depth in the phantom using the 10 x 10 cm 2 cutout and applicator. The peak dose position was also shifted 7 mm towards the CAX when the angle of obliquity was increased from 0 to 15 deg. (note)

  12. Clinical meaning of radiodermatitis considering the surface dose of supervoltage electron beam

    Energy Technology Data Exchange (ETDEWEB)

    Hiraki, T [Kanazawa Univ. (Japan). School of Paramedicine; Rikimaru, S; Kakishita, M; Kuranishi, M

    1975-12-01

    In our experience using supervoltage betatron electron beam, the skin surface dose of the electron decreased when the energy became either greater or less than 18 MeV. When we considered 18 MeV to be a 100% dose, the dose with 4 MeV, which was the least amount, corresponded to 81% of the dose. The skin surface dose of 10 MeV betatron electrons or more became greater than the 90% standard tumor dose. An external irradiation of more than 10 MeV should not be applied to neoplasms of which the curative ratio is less than 1.0. Therefore another methods such as intraoperative irradiation, should be used. The surface skin dose about 4 to 6 MeV betatron postoperative irradiation, particularly after resection of breast cancer, was less than the skin dose with 10 MeV. Close care should be taken to prevent hot lesions which are caused by duplication of irradiation fields. It should be kept in mind that the late effects of hot lesions caused by electron beam irradiation with an energy of 10 MeV or more are serious.

  13. Comparison of treatment using teletherapy (external beam radiation) alone versus teletherapy combined with brachytherapy for advanced squamous cell carcinoma of the esophagus

    International Nuclear Information System (INIS)

    Samea, Renato; Lourenco, Laercio Gomes

    2011-01-01

    Background - Squamous cell carcinoma of the esophagus is still a difficult tumor to treat with very poor prognosis. Aim - To compare the response to teletherapy treatment (external beam radiotherapy) alone versus teletherapy combined with brachytherapy for patients with advanced squamous cell carcinoma of the esophagus. Methods - Were studied 49 patients with advanced squamous cell carcinoma of the esophagus on clinical stage III (TNM-1999). They were separated into two groups. The first, underwent radiation therapy alone with linear accelerator of particles, average dose of 6000 cGy and the second to external beam radiation therapy at a dose of 5040 cGy combined with brachytherapy with Iridium 192 at a dose of 1500 cGy. Brachytherapy started one to two weeks after the end of teletherapy, and it was divided into three weekly applications of 500 cGy. Age, gender, race, habits (smoking and drinking), body mass index (BMI), complications with treatment benefits (pain relief and food satisfaction) and survival were analyzed. Results - The quality of life (food satisfaction, and pain palliation of dysphagia) were better in the group treated with external beam radiation therapy combined with brachytherapy. Survival was higher in the brachytherapy combined with external beam radiation therapy alone. Conclusion - Although the cure rate of squamous cell cancer of the esophagus is almost nil when treated with irradiation alone, this therapy is a form of palliative treatment for most patients in whom surgical contraindication exists. (author)

  14. Comparison of treatment using teletherapy (external beam radiation) alone versus teletherapy combined with brachytherapy for advanced squamous cell carcinoma of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Samea, Renato; Lourenco, Laercio Gomes, E-mail: renatosamea@globo.com [Department of Surgical Oncology of Dr. Arnaldo Vieira de Carvalho Hospital, Sao Paulo, SP (Brazil)

    2011-10-15

    Background - Squamous cell carcinoma of the esophagus is still a difficult tumor to treat with very poor prognosis. Aim - To compare the response to teletherapy treatment (external beam radiotherapy) alone versus teletherapy combined with brachytherapy for patients with advanced squamous cell carcinoma of the esophagus. Methods - Were studied 49 patients with advanced squamous cell carcinoma of the esophagus on clinical stage III (TNM-1999). They were separated into two groups. The first, underwent radiation therapy alone with linear accelerator of particles, average dose of 6000 cGy and the second to external beam radiation therapy at a dose of 5040 cGy combined with brachytherapy with Iridium 192 at a dose of 1500 cGy. Brachytherapy started one to two weeks after the end of teletherapy, and it was divided into three weekly applications of 500 cGy. Age, gender, race, habits (smoking and drinking), body mass index (BMI), complications with treatment benefits (pain relief and food satisfaction) and survival were analyzed. Results - The quality of life (food satisfaction, and pain palliation of dysphagia) were better in the group treated with external beam radiation therapy combined with brachytherapy. Survival was higher in the brachytherapy combined with external beam radiation therapy alone. Conclusion - Although the cure rate of squamous cell cancer of the esophagus is almost nil when treated with irradiation alone, this therapy is a form of palliative treatment for most patients in whom surgical contraindication exists. (author)

  15. Intercomparison of radiotherapy treatment planning systems using calculated and measured dose distributions for external photon and electron beams

    International Nuclear Information System (INIS)

    Kosunen, A.; Jaervinen, H.; Vatnitskij, S.; Ermakov, I.; Chervjakov, A.; Kulmala, J.; Pitkaenen, M.; Vaeyrynen, T.; Vaeaenaenen, A.

    1991-02-01

    The requirement of 5 % overall accuracy for the target absorbed dose in radiotherapy implies that the accuracy of the relative dose calculation should be within only a few per cent. According to the recommendation by the International Commission on radiation units and measurements (ICRU), a computer-produced dose distribution can be considered to be accurate enough if it differs from the results of relative dose measurements by less than 2 %, or 2 mm in the position of isodose curves involving very steep dose gradients. In this study five treatment planning systems, currently used by the hospitals in Finland or in the USSR, were intercompared with respect to the above requirement. Five typical cases of irradiation were selected: regular fields, oblique incidence, irregular field, wedge field and inhomogeneity in a water equivalent phantom. Complete dose distributions were used for the intercomparison, and the beam data for each TPS was that pertaining to the beam where the comparative relative measurements were performed. The results indicate that the dose distributions produced by different TPS:s can differ from each other as well as from the measured dose distributions up to a level which is not acceptable in terms of the above requirement. Greatest differences seem to be related to the omission or undue consideration of the scatter components of the beam. A suitable quality assurance program for the systematic testing of the performance of the treatment planning systems could be based on a selection of tests as used in this study.(orig.)

  16. Measurement and comparison of individual external doses of high-school students living in Japan, France, Poland and Belarus—the ‘D-shuttle’ project—

    International Nuclear Information System (INIS)

    Adachi, N; Adamovitch, V; Adjovi, Y; Antonietti, H; Arkoun, G; Blanchard, M; Aida, K; Akamatsu, H; Akiyama, S; Akli, A; Bernard, E; Ando, A; Andrault, T; Ayrault, D; Anzai, S; Avenoso, C; Bernardini, L; Berthet, E; Banasiewicz, M; Banaśkiewicz, M

    2016-01-01

    Twelve high schools in Japan (of which six are in Fukushima Prefecture), four in France, eight in Poland and two in Belarus cooperated in the measurement and comparison of individual external doses in 2014. In total 216 high-school students and teachers participated in the study. Each participant wore an electronic personal dosimeter ‘D-shuttle’ for two weeks, and kept a journal of his/her whereabouts and activities. The distributions of annual external doses estimated for each region overlap with each other, demonstrating that the personal external individual doses in locations where residence is currently allowed in Fukushima Prefecture and in Belarus are well within the range of estimated annual doses due to the terrestrial background radiation level of other regions/countries. (paper)

  17. A Phase II study of external-beam radiotherapy and endovascular brachytherapy with PTA and stenting for femoropopliteal artery restenosis

    International Nuclear Information System (INIS)

    Narayan, Kailash; Denton, Michael; Das, Ram; Bernshaw, David; Rolfo, Aldo; Dyk, Sylvia van; Mirakian, Alex

    2006-01-01

    Purpose: To assess the safety and seek evidence of efficacy of combined external-beam radiotherapy (EBRT) and endovascular brachytherapy in the treatment of stenotic vascular lesions. Methods and Materials: Seventeen patients with high risk for restenosis of femoropopliteal arteries were enrolled in this study from February 2000 to August 2002. The external beam radiotherapy regimen consisted of 10 Gy in 5 fractions of 2 Gy, starting on Day 0. This was followed on Day 6 by angiography, stent placement, and intraluminal brachytherapy to a dose of 10 Gy at 1.2 mm from stent surface. The EBRT was continued from the same day to another 10 Gy in 2 Gy daily fractions for 5 days. Results: The follow up ranged from 33 months to 60 months. At the time of analysis 15 of 17 patients were alive with patent stents. Of these, 10 were symptom-free. Two patients died of unrelated causes. Conclusions: The combination of EBRT and endovascular brachytherapy provided adequate dose distribution without any geographical miss or 'candy wrapper' restenosis. No incidence of aneurysmal dilation of radiated vascular segment was observed. The treatment was feasible, well tolerated, and achieved 88% stenosis free survival

  18. Dose evaluation for external exposure in radiation accidents

    International Nuclear Information System (INIS)

    Maruyama, Takashi

    1989-01-01

    Abnormal exposures including emergency and accidental are categorized into external exposure and internal contamination, although both of these may be associated with external contamination. From a point of view of lifesaving in the abnormal exposures, it is primarily important to evaluate radiation dose of exposed persons as soon as possible. This report reviews the status of early dosimetry in the accidental exposures and discusses the optimum methodology of the early dose determination for external exposures in abnormal exposures. Personal monitors generally give an indication of dose to an exposed person only at a single part of the body. The data obtained from the personal monitors should be interpreted with care and in the light of information about the circumstances of exposure. In most cases, the records of environmental monitors or the survey with area monitors provide valuable information on the radiation fields. In the some cases, the reconstruction of the abnormal exposure is required for the dose evaluation by means of phantom experiments. In the case of neutron exposures, activation products in the body or its components or personnel possession can be useful for the early dosimetry. If the dose received by the whole body is evaluated as being very high, clinical observations and biological investigations may be more important guide to initial medical treatment than the early dosimetry. For the dose evaluation of general public, depending on the size of abnormal exposure, information that could be valuable in the assessment of abnormal exposures will come from the early dose estimates with environmental monitors and radiation survey meters. (author)

  19. Results in patients treated with high-dose-rate interstitial brachytherapy for oral tongue cancer

    International Nuclear Information System (INIS)

    Yamamoto, Michinori; Shirane, Makoto; Ueda, Tsutomu; Miyahara, Nobuyuki

    2006-01-01

    Eight patients were treated with high-dose-rate interstitial brachytherapy for oral tongue cancer between September 2000 and August 2004. The patient distribution was 1 T1, 5 T2, 1 T3, and 1 T4a. Patients received 50-60 Gy in 10 fractions over seven days with high-dose-rate brachytherapy. Six of the eight patients were treated with a combination of external beam radiotherapy (20-30 Gy) and interstitial brachytherapy. The two-year primary local control rate was 83% for initial case. High-dose-rate brachytherapy was performed safely even for an aged person, and was a useful treatment modality for oral tongue cancer. (author)

  20. Skin dose from radiotherapy X-ray beams: the influence of energy

    International Nuclear Information System (INIS)

    Butson, M.J.; Metcalfe, P.E.; University of Wollongong, Wollongong, NSW; Mathur, J.N.

    1997-01-01

    Skin-sparing properties of megavoltage photon beams are compromised by electron contamination. Higher energy beams do not necessarily produce lower surface and basal cell layer doses due to this electron contamination. For a 5x5 cm field size the surface doses for 6 MVp and 18 M)p X-ray beams are 10% and 7% of their respective maxima. However, at a field size of 40 x 40cm the percentage surface dose is 42% for both 6 MVp and 18 MVp beams. The introduction of beam modifying devices such as block trays can further reduce the skin-sparing advantages of high energy photon beams. Using a 10 mm perspex block tray, the surface doses for 6 MVp and 18 MVp beams with a 5 x 5 cm field size are 10% and 8%, respectively. At 40 x 40cm, surface doses are 61% and 63% for 6 MVp and 18 MVp beams, respectively. This trend is followed at the basal cell layer depth. At a depth of 1 mm, 18 MVp beam doses are always at least 5% smaller than 6 MVp doses for the same depth at all field sizes when normalized to their respective Dmax values. Results have shown that higher energy photon beams produce a negligible reduction of the delivered dose to the basal cell layer (0.1 mm). Only a small increase in skin sparing is seen at the dermal layer (1 mm), which can be negated by the increased exit dose from an opposing field. (authors)

  1. Bio-physical effects of scanned proton beams: measurements and models for discrete high dose rates scanning systems

    International Nuclear Information System (INIS)

    De-Marzi, Ludovic

    2016-01-01

    The main objective of this thesis is to develop and optimize algorithms for intensity modulated proton therapy, taking into account the physical and biological pencil beam properties. A model based on the summation and fluence weighted division of the pencil beams has been used. A new parameterization of the lateral dose distribution has been developed using a combination of three Gaussian functions. The algorithms have been implemented into a treatment planning system, then experimentally validated and compared with Monte Carlo simulations. Some approximations have been made and validated in order to achieve reasonable calculation times for clinical purposes. In a second phase, a collaboration with Institut Curie radiobiological teams has been started in order to implement radiobiological parameters and results into the optimization loop of the treatment planning process. Indeed, scanned pencil beams are pulsed and delivered at high dose rates (from 10 to 100 Gy/s), and the relative biological efficiency of protons is still relatively unknown given the wide diversity of use of these beams: the different models available and their dependence with linear energy transfers have been studied. A good agreement between dose calculations and measurements (deviations lower than 3 % and 2 mm) has been obtained. An experimental protocol has been set in order to qualify pulsed high dose rate effects and preliminary results obtained on one cell line suggested variations of the biological efficiency up to 10 %, though with large uncertainties. (author) [fr

  2. External beam radiation therapy and a low-dose-rate brachytherapy boost without or with androgen deprivation therapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Tobin J.; Hutchinson, Sean Z.; Shrinath, Kushagra; Cruz, Alex A.; Figura, Nicholas B.; Nethers, Kevin; Biagioli, Matthew C.; Fernandez, Daniel C.; Heysek, Randy V.; Wilder, Richard B., E-mail: richard.wilder@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States)

    2014-07-15

    Purpose: To assess outcomes with external beam radiation therapy (EBRT) and a low-dose-rate (LDR) brachytherapy boost without or with androgen deprivation therapy (ADT) for prostate cancer. Materials and Methods: From January 2001 through August 2011, 120 intermediate-risk or high-risk prostate cancer patients were treated with EBRT to a total dose of 4,500 cGy in 25 daily fractions and a palladium-103 LDR brachytherapy boost of 10,000 cGy (n = 90) or an iodine-125 LDR brachytherapy boost of 11,000 cGy (n = 30). ADT, consisting of a gonadotropin-releasing hormone agonist ± an anti-androgen, was administered to 29/92 (32%) intermediate-risk patients for a median duration of 4 months and 26/28 (93%) high-risk patients for a median duration of 28 months. Results: Median follow-up was 5.2 years (range, 1.1-12.8 years). There was no statistically-significant difference in biochemical disease-free survival (bDFS), distant metastasis-free survival (DMFS), or overall survival (OS) without or with ADT. Also, there was no statistically-significant difference in bDFS, DMFS, or OS with a palladium-103 vs. an iodine-125 LDR brachytherapy boost. Conclusions: There was no statistically-significant difference in outcomes with the addition of ADT, though the power of the current study was limited. The Radiation Therapy Oncology Group 0815 and 0924 phase III trials, which have accrual targets of more than 1,500 men, will help to clarify the role ADT in locally-advanced prostate cancer patients treated with EBRT and a brachytherapy boost. Palladium-103 and iodine-125 provide similar bDFS, DMFS, and OS. (author)

  3. Conventional external beam radiotherapy for central nervous system malignancies

    International Nuclear Information System (INIS)

    Halperin, E.C.; Burger, P.C.

    1985-01-01

    Fractionated external beam photon radiotherapy is an important component of the clinical management of malignant disease of the central nervous system. The practicing neurologist or neurosurgeon frequently relies on the consultative and treatment skills of a radiotherapist. This article provides a review for the nonradiotherapist of the place of conventional external beam radiotherapy in neuro-oncology. 23 references

  4. Characterization of a microDiamond detector in high-dose-per-pulse electron beams for intra operative radiation therapy.

    Science.gov (United States)

    Di Venanzio, C; Marinelli, Marco; Tonnetti, A; Verona-Rinati, G; Falco, M D; Pimpinella, M; Ciccotelli, A; De Stefano, S; Felici, G; Marangoni, F

    2015-12-01

    To characterize a synthetic diamond dosimeter (PTW Freiburg microDiamond 60019) in high dose-per-pulse electron beams produced by an Intra Operative Radiation Therapy (IORT) dedicated accelerator. The dosimetric properties of the microDiamond were assessed under 6, 8 and 9 MeV electron beams by a NOVAC11 mobile accelerator (Sordina IORT Technologies S.p.A.). The characterization was carried out with dose-per-pulse ranging from 26 to 105 mGy per pulse. The microDiamond performance was compared with an Advanced Markus ionization chamber and a PTW silicon diode E in terms of dose linearity, percentage depth dose (PDD) curves, beam profiles and output factors. A good linearity of the microDiamond response was verified in the dose range from 0.2 Gy to 28 Gy. A sensitivity of 1.29 nC/Gy was measured under IORT electron beams, resulting within 1% with respect to the one obtained in reference condition under (60)Co gamma irradiation. PDD measurements were found in agreement with the ones by the reference dosimeters, with differences in R50 values below 0.3 mm. Profile measurements evidenced a high spatial resolution of the microDiamond, slightly worse than the one of the silicon diode. The penumbra widths measured by the microDiamond resulted approximately 0.5 mm larger than the ones by the Silicon diode. Output factors measured by the microDiamond were found within 2% with those obtained by the Advanced Markus down to 3 cm diameter field sizes. The microDiamond dosimeter was demonstrated to be suitable for precise dosimetry in IORT applications under high dose-per-pulse conditions. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  5. Organ dose conversion coefficients based on a voxel mouse model and MCNP code for external photon irradiation.

    Science.gov (United States)

    Zhang, Xiaomin; Xie, Xiangdong; Cheng, Jie; Ning, Jing; Yuan, Yong; Pan, Jie; Yang, Guoshan

    2012-01-01

    A set of conversion coefficients from kerma free-in-air to the organ absorbed dose for external photon beams from 10 keV to 10 MeV are presented based on a newly developed voxel mouse model, for the purpose of radiation effect evaluation. The voxel mouse model was developed from colour images of successive cryosections of a normal nude male mouse, in which 14 organs or tissues were segmented manually and filled with different colours, while each colour was tagged by a specific ID number for implementation of mouse model in Monte Carlo N-particle code (MCNP). Monte Carlo simulation with MCNP was carried out to obtain organ dose conversion coefficients for 22 external monoenergetic photon beams between 10 keV and 10 MeV under five different irradiation geometries conditions (left lateral, right lateral, dorsal-ventral, ventral-dorsal, and isotropic). Organ dose conversion coefficients were presented in tables and compared with the published data based on a rat model to investigate the effect of body size and weight on the organ dose. The calculated and comparison results show that the organ dose conversion coefficients varying the photon energy exhibits similar trend for most organs except for the bone and skin, and the organ dose is sensitive to body size and weight at a photon energy approximately <0.1 MeV.

  6. Evaluation of secondary electron filter for removing contaminant electrons from high-energy 6 MV x-ray beam

    International Nuclear Information System (INIS)

    Kumagai, Kozo

    1988-01-01

    When using high energy X-rays, the dose increases at the skin surface and build-up region of beam contamination of secondary electrons coming out from the inner surface of the lineac head. At our radiotherapy department, many cases of external otitis from severe skin reactions, particularly resulting from whole brain irradiation of primary and metastatic brain tumors with a 6 MV X-ray lineac, have been encountered. An investigation was made of the physical aspects of a 6 MV X-ray beam using three electron filters, lead lucite, lead glass and lucite to remove secondary electrons. Transparent materials for filters should be preferable for locating the light field. The following results were obtained: 1) For removing secondary electrons, a lead lucite filter was found best. 2) The lead lucite filter proved most effective for removing secondary electrons from the area of treatment. It reduced the dose of irradiation to the skin surface and build-up region, and furthermore improved the depth dose relative to that without filters. 3) From a clinical standpoint, skin reactions such as external otitis remarkably decreased using a lead lucite filter. 4) It thus appears necessary to use a high energy X-ray with newly designed filters to reduce beam contamination of secondary electrons. (author)

  7. 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

  8. Severe dry-eye syndrome following external beam irradiation

    International Nuclear Information System (INIS)

    Parsons, J.T.; Bova, F.J.; Million, R.R.

    1994-01-01

    There are limited data in the literature on the probability of dry-eye complications according to radiotherapy dose. This study investigates the risk of radiation-induced severe dry-eye syndrome in patients in whom an entire orbit was exposed to fractionated external beam irradiation. Between October 1964 and May 1989, 33 patients with extracranial head and neck tumors received irradiation of an entire orbit. Most patients were treated with 60 Co. The dose to the lacrimal apparatus was calculated at a depth of 1 cm from the anterior skin surface, the approximate depth of the major lacrimal gland. The end point of the study was severe dry-eye syndrome sufficient to produce visual loss secondary to corneal opacification, ulceration, or vascularization. Twenty patients developed severe dry-eye syndrome. All 17 patients who received dose ≥57Gy developed severe dry-eye syndrome. Three (19%) of 16 patients who received doses ≥45 Gy developed severe dry-eye syndrome; injuries in the latter group were much more slower to develop (4 to 11 years) than in the higher dose group, in whom corneal vascularization and opacification were usually pronounced within 9-10 months. There were no data for the range of doses between 45.01 and 56.99 Gy. The data did not suggest an increased risk of severe dry-eye syndrome with increasing age. Data from the current series and the literature are combined to construct a sigmoid dose response curve. The incidence of injury increases from 0% reported after doses ≥30 Gy to 100% after doses ≥57 Gy. 13 refs., 3 figs., 5 tabs

  9. Late rectal bleeding and genitourinary morbidity after high dose rate brachytherapy combined with hypofractionated external beam radiotherapy for localized prostate cancer

    International Nuclear Information System (INIS)

    Ebara, Takeshi; Akimoto, Tetsuo; Kato, Hiroyuki

    2007-01-01

    The purpose of this study was to evaluate late rectal bleeding and genitourinary (GU) morbidity in patients consecutively treated with combined high-dose-rate (HDR) brachytherapy and external beam radiation therapy (EBRT). Data from 80 patients treated consecutively from October 2000 to May 2004 were analyzed. The median age was 69 years old, median follow-up 31 months, ranging from 17-59 months. All patients received endocrine therapy before radiation therapy. The patients were divided into low-, intermediate- and high-risk groups (4/24/52 patients) according to the risk factors defined by T-classification, prostatic specific antigen (PSA) and Gleason score. Fractionation schedules for HDR brachytherapy were prospectively changed, and EBRT was fixed with 3 Gy fractions to 51 Gy. The distribution of fractionation was scheduled as follows; 5 Gy x 5 times in 14 patients, 7 Gy x 3 times in 19 patients, and 9 Gy x 2 times in 47 patients. The rectal bleeding was graded using the toxicity criteria of the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer while the genitourinary morbidities were graded using the toxicity criteria of the Common Terminology Criteria for Adverse Events v.3.0. Grade 2 or worse rectal bleeding developed in 9 patients (11.3%) with the 2-year actuarial probability at 11.2%. Grade 2 and 3 rectal bleeding was recognized in 8 and 1 patients, respectively. Grade 3 morbidity developed in the biopsied sites that were performed in the other hospital. No significant difference was observed in any HDR brachytherapy fractionation schedule. Grade 2 or worse GU morbidities were recognized in 30 patients (37.5%), consisting of 29 Grade 2 patients and 1 Grade 3 patient. Twenty-one patients in Grade 2 morbidity had an increase in the frequency of urination or nocturia, and urethral strictures developed in 3 patients. The 3-year actuarial probability of urethral stricture was 6.0%. One patient experienced Grade 3

  10. ASCENDE-RT: An Analysis of Treatment-Related Morbidity for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost with a Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Rodda, Sree; Tyldesley, Scott; Morris, W. James; Keyes, Mira; Halperin, Ross; Pai, Howard; McKenzie, Michael; Duncan, Graeme; Morton, Gerard; Hamm, Jeremy; Murray, Nevin

    2017-01-01

    Purpose: To report the genitourinary (GU) and gastrointestinal (GI) morbidity and erectile dysfunction in a randomized trial comparing 2 methods of dose escalation for high- and intermediate-risk prostate cancer. Methods and Materials: ASCENDE-RT (Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy) enrolled 398 men, median age 68 years, who were then randomized to either a standard arm that included 12 months of androgen deprivation therapy and pelvic irradiation to 46 Gy followed by a dose-escalated external beam radiation therapy (DE-EBRT) boost to 78 Gy, or an experimental arm that substituted a low-dose-rate prostate brachytherapy (LDR-PB) boost. At clinic visits, investigators recorded GU and GI morbidity and information on urinary continence, catheter use, and erectile function. Exclusion of 15 who received nonprotocol treatment and correction of 14 crossover events left 195 men who actually received a DE-EBRT boost and 188, an LDR-PB boost. Median follow-up was 6.5 years. Results: The LDR-PB boost increased the risk of needing temporary catheterization and/or requiring incontinence pads. At 5 years the cumulative incidence of grade 3 GU events was 18.4% for LDR-PB, versus 5.2% for DE-EBRT (P<.001). Compared with the cumulative incidence, the 5-year prevalence of grade 3 GU morbidity was substantially lower for both arms (8.6% vs 2.2%, P=.058). The 5-year cumulative incidence of grade 3 GI events was 8.1% for LDR-PB, versus 3.2% for DE-EBRT (P=.124). The 5-year prevalence of grade 3 GI toxicity was lower than the cumulative incidence for both arms (1.0% vs 2.2%, respectively). Among men reporting adequate baseline erections, 45% of LDR-PB patients reported similar erectile function at 5 years, versus 37% after DE-EBRT (P=.30). Conclusions: The incidence of acute and late GU morbidity was higher after LDR-PB boost, and there was a nonsignificant trend for worse GI morbidity. No differences in the frequency of

  11. ASCENDE-RT: An Analysis of Treatment-Related Morbidity for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost with a Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rodda, Sree [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Tyldesley, Scott [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Morris, W. James, E-mail: jmorris@bccancer.bc.ca [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Keyes, Mira [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Halperin, Ross [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Pai, Howard [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency, Vancouver Island Centre, Victoria, British Columbia (Canada); McKenzie, Michael; Duncan, Graeme [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Morton, Gerard [Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Hamm, Jeremy [Department of Population Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Murray, Nevin [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Medicine, University of British Columbia, Vancouver, British Columbia (Canada)

    2017-06-01

    Purpose: To report the genitourinary (GU) and gastrointestinal (GI) morbidity and erectile dysfunction in a randomized trial comparing 2 methods of dose escalation for high- and intermediate-risk prostate cancer. Methods and Materials: ASCENDE-RT (Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy) enrolled 398 men, median age 68 years, who were then randomized to either a standard arm that included 12 months of androgen deprivation therapy and pelvic irradiation to 46 Gy followed by a dose-escalated external beam radiation therapy (DE-EBRT) boost to 78 Gy, or an experimental arm that substituted a low-dose-rate prostate brachytherapy (LDR-PB) boost. At clinic visits, investigators recorded GU and GI morbidity and information on urinary continence, catheter use, and erectile function. Exclusion of 15 who received nonprotocol treatment and correction of 14 crossover events left 195 men who actually received a DE-EBRT boost and 188, an LDR-PB boost. Median follow-up was 6.5 years. Results: The LDR-PB boost increased the risk of needing temporary catheterization and/or requiring incontinence pads. At 5 years the cumulative incidence of grade 3 GU events was 18.4% for LDR-PB, versus 5.2% for DE-EBRT (P<.001). Compared with the cumulative incidence, the 5-year prevalence of grade 3 GU morbidity was substantially lower for both arms (8.6% vs 2.2%, P=.058). The 5-year cumulative incidence of grade 3 GI events was 8.1% for LDR-PB, versus 3.2% for DE-EBRT (P=.124). The 5-year prevalence of grade 3 GI toxicity was lower than the cumulative incidence for both arms (1.0% vs 2.2%, respectively). Among men reporting adequate baseline erections, 45% of LDR-PB patients reported similar erectile function at 5 years, versus 37% after DE-EBRT (P=.30). Conclusions: The incidence of acute and late GU morbidity was higher after LDR-PB boost, and there was a nonsignificant trend for worse GI morbidity. No differences in the frequency of

  12. Biological-effective versus conventional dose volume histograms correlated with late genitourinary and gastrointestinal toxicity after external beam radiotherapy for prostate cancer: a matched pair analysis

    Directory of Open Access Journals (Sweden)

    Roeske John C

    2003-05-01

    Full Text Available Abstract Background To determine whether the dose-volume histograms (DVH's for the rectum and bladder constructed using biological-effective dose (BED-DVH's better correlate with late gastrointestinal (GI and genitourinary (GU toxicity after treatment with external beam radiotherapy for prostate cancer than conventional DVH's (C-DVH's. Methods The charts of 190 patients treated with external beam radiotherapy with a minimum follow-up of 2 years were reviewed. Six patients (3.2% were found to have RTOG grade 3 GI toxicity, and similarly 6 patients (3.2% were found to have RTOG grade 3 GU toxicity. Average late C-DVH's and BED-DVH's of the bladder and rectum were computed for these patients as well as for matched-pair control patients. For each matched pair the following measures of normalized difference in the DVH's were computed: (a δAUC = (Area Under Curve [AUC] in grade 3 patient – AUC in grade 0 patient/(AUC in grade 0 patient and (b δV60 = (Percent volume receiving = 60 Gy [V60] in grade 3 patient – V60 in grade 0 patient/(V60 in grade 0 patient. Results As expected, the grade 3 curve is to the right of and above the grade 0 curve for all four sets of average DVH's – suggesting that both the C-DVH and the BED-DVH can be used for predicting late toxicity. δAUC was higher for the BED-DVH's than for the C-DVH's – 0.27 vs 0.23 (p = 0.036 for the rectum and 0.24 vs 0.20 (p = 0.065 for the bladder. δV60 was also higher for the BED-DVH's than for the C-DVH's – 2.73 vs 1.49 for the rectum (p = 0.021 and 1.64 vs 0.71 (p = 0.021 for the bladder. Conclusions When considering well-established dosimetric endpoints used in evaluating treatment plans, BED-DVH's for the rectum and bladder correlate better with late toxicity than C-DVH's and should be considered when attempting to minimize late GI and GU toxicity after external beam radiotherapy for prostate cancer.

  13. Dose behind various immobilization and beam-modifying devices

    International Nuclear Information System (INIS)

    Mellenberg, David E.

    1995-01-01

    Purpose: To quantify the degradation of skin sparing associated with using beam modifiers such as compensators, immobilization devices, and custom blocks for high energy photon beams. Methods and Materials: The degradation of skin sparing was quantified by measuring dose build-up curves with an extrapolation chamber for 6 and 15 MV photon beams. Uniform thickness compensators made of gypsum and lead, thermoplastic mask material, immobilization cradle foam, and cerrobend custom blocks were placed in geometries that mimic relevant clinical situations. Results: Compensators, whether made of gypsum or lead, placed in the linear accelerator's wedge slot did not significantly effect the depth dose curve's build-up region. Immobilization devices such as cradle foam or thermoplastic placed in contact with the patient degrade the skin sparing expected from high energy photon beams proportional to their thickness and density. Measurements behind custom blocks show that surface and near surface doses for a blocked field are best described by build-up curves for an equivalent size open field. Conclusions: These results allow explanation and possibly prediction of skin reactions on patients in which compensators, foam immobilization cradles, thermoplastic masks, or custom blocks are used. These results also provide a baseline by which substitute materials can be evaluated

  14. Monte Carlo investigation of the low-dose envelope from scanned proton pencil beams

    International Nuclear Information System (INIS)

    Sawakuchi, Gabriel O; Titt, Uwe; Mirkovic, Dragan; Ciangaru, George; Zhu, X Ronald; Sahoo, Narayan; Gillin, Michael T; Mohan, Radhe

    2010-01-01

    Scanned proton pencil beams carry a low-dose envelope that extends several centimeters from the individual beam's central axis. Thus, the total delivered dose depends on the size of the target volume and the corresponding number and intensity of beams necessary to cover the target volume uniformly. This dependence must be considered in dose calculation algorithms used by treatment planning systems. In this work, we investigated the sources of particles contributing to the low-dose envelope using the Monte Carlo technique. We used a validated model of our institution's scanning beam line to determine the contributions to the low-dose envelope from secondary particles created in a water phantom and particles scattered in beam line components. Our results suggested that, for high-energy beams, secondary particles produced by nuclear interactions in the water phantom are the major contributors to the low-dose envelope. For low-energy beams, the low-dose envelope is dominated by particles undergoing multiple Coulomb scattering in the beam line components and water phantom. Clearly, in the latter situation, the low-dose envelope depends directly on beam line design features. Finally, we investigated the dosimetric consequences of the low-dose envelope. Our results showed that if not modeled properly the low-dose envelope may cause clinically relevant dose disturbance in the target volume. This work suggested that this low-dose envelope is beam line specific for low-energy beams, should be thoroughly experimentally characterized and validated during commissioning of the treatment planning system, and therefore is of great concern for accurate delivery of proton scanning beam doses.

  15. The clinical meaning of radiodermatitis considering the surface dose of supervoltage electron beam

    International Nuclear Information System (INIS)

    Hiraki, Tatsunosuke; Rikimaru, Shigeho; Kakishita, Masao; Kuranishi, Makoto.

    1975-01-01

    In our experience using supervoltage betatron electron beam, the skin surface dose of the electron decreased when the energy became either greater of less than 18 MeV. When we considered 18 MeV to be a 100% dose, the dose with 4 MeV, which was the least amount, corresponded to 81% of the dose. The skin surface dose of 10 MeV betatron electrons or more became greater than the 90% standard tumor dose. An external irradiation of more than 10 MeV should not be applied to neoplasms of which the curative ratio is less than 1.0. Therefore another methods such as intraoperative irradiation, should be used. The surface skin dose about 4-6 MeV betatron postoperative irradiation, particularly after resection of breast cancer, was less than the skin dose with 10 MeV. Close care should be taken to prevent hot lesions which are caused by duplication of irradiation fields. It should be kept in mind that the late effects of hot lesions caused by electron beam irradiation with an energy of 10 MeV or more are serious. (Kashu, E.)

  16. Beam related response of in vivo diode detectors for external radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Baci, Syrja, E-mail: sbarci2013@gmail.com [Department of Physics, Faculty of Natural Sciences, University of Gjirokastra, “Eqrem Çabej” (Albania); Telhaj, Ervis [Department of Medical Physics, Hygeia Hospital Tirana (Albania); Malkaj, Partizan [Department of Physical Engineering, Polytechnic University, Tirana (Albania)

    2016-03-25

    In Vivo Dosimetry (IVD) is a set of methods used in cancer treatment clinics to determine the real dose of radiation absorbed by target volume in a patient’s body. IVD has been widely implemented in radiotherapy treatment centers and is now recommended part of Quality Assurance program by many International health and radiation organizations. Because of cost and lack of specialized personnel, IVD has not been practiced as yet, in Albanian radiotherapy clinics. At Hygeia Hospital Tirana, patients are irradiated with high energy photons generated by Elekta Synergy Accelerators. We have recently started experimenting with the purpose of establishing an IVD practice at this hospital. The first set of experiments was aimed at calibration of diodes that are going to be used for IVD. PMMA, phantoms by PTW were used to calibrate p – type Si, semiconductor diode dosimeters, made by PTW Freiburg for entrance dose. Response of the detectors is affected by energy of the beam, accumulated radiation dose, dose rate, temperature, angle against the beam axis, etc. Here we present the work done for calculating calibration factor and correction factors of source to surface distance, field size, and beam incidence for the entrance dose for both 6 MV photon beam and 18 MV photon beam. Dependence of dosimeter response was found to be more pronounced with source to surface distance as compared to other variables investigated.

  17. Beam related response of in vivo diode detectors for external radiotherapy

    International Nuclear Information System (INIS)

    Baci, Syrja; Telhaj, Ervis; Malkaj, Partizan

    2016-01-01

    In Vivo Dosimetry (IVD) is a set of methods used in cancer treatment clinics to determine the real dose of radiation absorbed by target volume in a patient’s body. IVD has been widely implemented in radiotherapy treatment centers and is now recommended part of Quality Assurance program by many International health and radiation organizations. Because of cost and lack of specialized personnel, IVD has not been practiced as yet, in Albanian radiotherapy clinics. At Hygeia Hospital Tirana, patients are irradiated with high energy photons generated by Elekta Synergy Accelerators. We have recently started experimenting with the purpose of establishing an IVD practice at this hospital. The first set of experiments was aimed at calibration of diodes that are going to be used for IVD. PMMA, phantoms by PTW were used to calibrate p – type Si, semiconductor diode dosimeters, made by PTW Freiburg for entrance dose. Response of the detectors is affected by energy of the beam, accumulated radiation dose, dose rate, temperature, angle against the beam axis, etc. Here we present the work done for calculating calibration factor and correction factors of source to surface distance, field size, and beam incidence for the entrance dose for both 6 MV photon beam and 18 MV photon beam. Dependence of dosimeter response was found to be more pronounced with source to surface distance as compared to other variables investigated.

  18. Calculation of microplanar beam dose profiles in a tissue/lung/tissue phantom

    International Nuclear Information System (INIS)

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

    1998-01-01

    Recent advances in synchrotron generated x-ray beams with a high fluence rate permit investigation of the application of an array of closely spaced, parallel or converging microplanar beams in radiotherapy. The proposed technique takes advantage of the hypothesized repair mechanism of capillary cells between alternate microbeam zones, which regenerates the lethally irradiated endothelial cells. The lateral and depth doses of 100 keV microplanar beams are investigated for different beam dimensions and spacings in a tissue, lung and tissue/lung/tissue phantom. The EGS4 Monte Carlo code is used to calculate dose profiles at different depths and bundles of beams (up to 20x20cm square cross section). The maximum dose on the beam axis (peak) and the minimum interbeam dose (valley) are compared at different depths, bundles, heights, widths and beam spacings. (author)

  19. Interstitial gold and external beam irradiation for prostate cancer

    International Nuclear Information System (INIS)

    Boileau, M.A.; Dowling, R.A.; Gonzales, M.; Handel, P.H.; Benson, G.S.; Corriere, J.N. Jr.

    1988-01-01

    We treated 65 patients with prostatic cancer confined clinically to the prostate or periprostatic area during an 8-year period. Seven patients had stage A2, 38 stage B and 20 stage C disease. All 65 patients underwent staging pelvic lymphadenectomy and implantation of gold grains into the prostate (mean dose 3,167 rad). A total of 64 patients then completed a course of external beam irradiation to a mean total tumor dose of 6,965 rad. Complications of therapy were mild and limited (less than 3 months in duration) in most patients, and they included radiation cystitis (32 per cent), diarrhea (31 per cent), extremity lymphedema (7.7 per cent) and wound infection (3 per cent). Two patients suffered urinary incontinence after therapy and 2 (3 per cent) had diarrhea more than 3 months in duration. The actuarial 5-year survival rate for all patients was 87 per cent and the 5-year survival free of disease was 72 per cent

  20. Combination of high-dose rate brachytherapy and external beam radiotherapy for the treatment of advanced scalp angiosarcoma - case report

    International Nuclear Information System (INIS)

    Gentil, Andre Cavalcanti; Lima Junior, Carlos Genesio Bezerra; Soboll, Danyel Scheidegger; Novaes, Paulo Eduardo R.S.; Pereira, Adelino Jose; Pellizon, Antonio Carlos Assis

    2001-01-01

    The authors report a case of a patient with an extensive angiosarcoma of the scalp that was submitted only to radiotherapy with a combination of orthovoltage roentgentherapy and high-dose rate brachytherapy, using a mould. The clinical and technical features as well as the therapeutic outcome are presented, and the usefulness and peculiarities of high-dose rate brachytherapy for this particular indication is discussed. A comparative analysis of the difficulties and limitations of employing low-dose rate brachytherapy is also presented. The authors concluded that high-dose rate brachytherapy might be an useful, practical and safe option to treat neoplastic lesions of the scalp, and an alternative treatment to electrontherapy. (author)

  1. Long-Term Results of an RTOG Phase II Trial (00-19) of External-Beam Radiation Therapy Combined With Permanent Source Brachytherapy for Intermediate-Risk Clinically Localized Adenocarcinoma of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Lawton, Colleen A., E-mail: clawton@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Yan, Yan [Radiation Therapy Oncology Group Statistical Center, Philadelphia, PA (United States); Lee, W. Robert [Department of Radiation Oncology, Duke University School of Medicine, Durham, NC (United States); Gillin, Michael [Department of Radiation Oncology, MD Anderson Cancer Center, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Firat, Selim [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Baikadi, Madhava [Department of Radiation Oncology, Northeast Radiation Oncology Center, Scranton, PA (United States); Crook, Juanita [Department of Radiation Oncology, University of British Columbia, Kelowna, BC (Canada); Kuettel, Michael [Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY (United States); Morton, Gerald [Department of Radiation Oncology, Toronto-Sunnybrook Regional Cancer Center, Toronto, ON (Canada); Sandler, Howard [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA (United States)

    2012-04-01

    Purpose: External-beam radiation therapy combined with low-doserate permanent brachytherapy are commonly used to treat men with localized prostate cancer. This Phase II trial was performed to document late gastrointestinal or genitourinary toxicity as well as biochemical control for this treatment in a multi-institutional cooperative group setting. This report defines the long-term results of this trial. Methods and Materials: All eligible patients received external-beam radiation (45 Gy in 25 fractions) followed 2-6 weeks later by a permanent iodine 125 implant of 108 Gy. Late toxicity was defined by the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late radiation morbidity scoring scheme. Biochemical control was defined by the American Society for Therapeutic Radiology and Oncology (ASTRO) Consensus definition and the ASTRO Phoenix definition. Results: One hundred thirty-eight patients were enrolled from 20 institutions, and 131 were eligible. Median follow-up (living patients) was 8.2 years (range, 2.7-9.3 years). The 8-year estimate of late grade >3 genitourinary and/or gastrointestinal toxicity was 15%. The most common grade >3 toxicities were urinary frequency, dysuria, and proctitis. There were two grade 4 toxicities, both bladder necrosis, and no grade 5 toxicities. In addition, 42% of patients complained of grade 3 impotence (no erections) at 8 years. The 8-year estimate of biochemical failure was 18% and 21% by the Phoenix and ASTRO consensus definitions, respectively. Conclusion: Biochemical control for this treatment seems durable with 8 years of follow-up and is similar to high-dose external beam radiation alone or brachytherapy alone. Late toxicity in this multi-institutional trial is higher than reports from similar cohorts of patients treated with high-dose external-beam radiation alone or permanent low-doserate brachytherapy alone, perhaps suggesting further attention to strategies that limit doses to

  2. Modelling lateral beam quality variations in pencil kernel based photon dose calculations

    International Nuclear Information System (INIS)

    Nyholm, T; Olofsson, J; Ahnesjoe, A; Karlsson, M

    2006-01-01

    Standard treatment machines for external radiotherapy are designed to yield flat dose distributions at a representative treatment depth. The common method to reach this goal is to use a flattening filter to decrease the fluence in the centre of the beam. A side effect of this filtering is that the average energy of the beam is generally lower at a distance from the central axis, a phenomenon commonly referred to as off-axis softening. The off-axis softening results in a relative change in beam quality that is almost independent of machine brand and model. Central axis dose calculations using pencil beam kernels show no drastic loss in accuracy when the off-axis beam quality variations are neglected. However, for dose calculated at off-axis positions the effect should be considered, otherwise errors of several per cent can be introduced. This work proposes a method to explicitly include the effect of off-axis softening in pencil kernel based photon dose calculations for arbitrary positions in a radiation field. Variations of pencil kernel values are modelled through a generic relation between half value layer (HVL) thickness and off-axis position for standard treatment machines. The pencil kernel integration for dose calculation is performed through sampling of energy fluence and beam quality in sectors of concentric circles around the calculation point. The method is fully based on generic data and therefore does not require any specific measurements for characterization of the off-axis softening effect, provided that the machine performance is in agreement with the assumed HVL variations. The model is verified versus profile measurements at different depths and through a model self-consistency check, using the dose calculation model to estimate HVL values at off-axis positions. A comparison between calculated and measured profiles at different depths showed a maximum relative error of 4% without explicit modelling of off-axis softening. The maximum relative error

  3. Treatment Results of PDR Brachytherapy Combined With External Beam Radiotherapy in 106 Patients With Intermediate- to High-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Pieters, Bradley R.; Geijsen, Elisabeth D.; Koedooder, Kees; Blank, Leo E.C.M.; Rezaie, Elisa; Grient, Johan N.B. van der; Reijke, Theo M. de; Koning, Caro C.E.

    2011-01-01

    Purpose: To evaluate treatment outcome of pulsed dose-rate brachytherapy (PDR) combined with external-beam radiotherapy (EBRT) for the treatment of prostate cancer. Methods and Materials: Between 2002 and 2007, 106 patients were treated by EBRT combined with PDR and followed prospectively. Two, 38, and 66 patients were classified as low-, intermediate-, and high-risk disease respectively according to the National Comprehensive Cancer Network criteria. EBRT dose was 46 Gy in 2.0-Gy fractions. PDR dose was increased stepwise from 24.96 to 28.80 Gy. Biochemical disease free survival and overall survival were determined by the Kaplan-Meier method. Cumulative incidence of late gastrointestinal (GI) and genitourinary (GU) toxicity were scored, according to the Common Terminology Criteria for Adverse Events. Results: The 3- and 5-year biochemical nonevidence of disease (bNED) were 92.8% (95% confidence interval [CI], 87.1-98.5) and 89.5% (95% CI, 85.2-93.8), respectively. Overall survival at 3 and 5 years was 99% (95% CI, 96-100) and 96% (95% CI, 90-100), respectively. The 3- and 5-year Grade 2 GI toxicity was 5.3% (95% CI, 0-10.6) and 12.0% (95% CI, 1.4-22.6), respectively. No Grade 3 or higher GI toxicity was observed. The 3- and 5-year Grade 2 or higher GU toxicity was 18.7% (95% CI, 10.3-27.1) and 26.9% (95% CI, 15.1-38.7), respectively. Conclusion: Results on tumor control and late toxicity of EBRT combined with PDR are good and comparable to results obtained with EBRT combined with high-dose-rate brachytherapy for the treatment of prostate cancer.

  4. Dose distribution in the area of the operative cicatrice and the problem of local reccurences during postoperative external beam gamma therapy of breast cancer

    International Nuclear Information System (INIS)

    Todorov, Y.; Ivanova, K.; Penchev, V.

    1982-01-01

    Five-year experience is recorded with treatment of 503 patients with breast cancer, who received postoperative external beam gamma therapy, and the developement of local reccurences. Results are reported of dosimetric studies in the irradiated area, especially the thoracic wall, where total focal doses of 50 had been realized. The clinical results of treatment are discussed on this basis. Comparison is made with data available in the literature on the incidence, localization and time of development of local reccurences and the methods of treatment of the basic disease. The need of postoperative radiation treatment, particularly in the later stages of the disease, is pointed out. (authors)

  5. Serum testosterone levels after external beam radiation for clinically localized prostate cancer

    International Nuclear Information System (INIS)

    Zagars, Gunar K.; Pollack, Alan

    1997-01-01

    Purpose: To determine whether serum total testosterone levels change after external beam radiation therapy for localized prostate cancer. Methods and Materials: Eighty-five men with clinically localized prostate cancer (T1-T3, N0/NX, M0) who underwent external beam radiation therapy without androgen ablation had pretreatment and 3-month posttreatment total serum testosterone levels determined by radioimmunoassay. Scattered doses to the testicles were measured with thermoluminescent dosimetry in 10 men. Results: Pretreatment serum testosterone levels ranged from 185 to 783 ng/dl, with a mean of 400 ng/dl and a median of 390 ng/dl. The coefficient of variation was 30%. Postradiation 3-month testosterone levels ranged from 163 ng/dl to 796 ng/dl, with mean and median values of 356 ng/dl and 327 ng/ml, respectively. The coefficient of variation was 34%. The 3-month value was significantly lower than the pretreatment value (Wilcoxon paired p = 0.0001). The mean absolute fall was 94 ng/dl and the mean percentage fall was 9%. Although the fall in testosterone level was statistically significant, the difference was very small quantitatively. In contrast, serum prostate-specific antigen levels fell dramatically by 3 months after radiation. Testicular scattered doses ranged from 1.84 to 2.42 Gy, with a mean of 2.07 Gy for a prostatic tumor dose of 68 Gy. Conclusions: Although significant, the fall in serum testosterone level after radiation for localized prostate cancer was small and likely of no pathophysiologic consequence. It is unlikely that scattered testicular radiation plays any significant role in the genesis of this change in testosterone level, which most likely occurs as a nonspecific stress response

  6. 10 CFR 835.203 - Combining internal and external equivalent doses.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Combining internal and external equivalent doses. 835.203 Section 835.203 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Standards for Internal and External Exposure § 835.203 Combining internal and external equivalent doses. (a) The total effective dose...

  7. Three-dimensional high dose rate dosimetry of electron beams. A combined radiochromic film, EPR and calorimetric dosimetry

    International Nuclear Information System (INIS)

    Secerov, B.; Milosavljevic, B.H.; Bacic, G.; Belgrade Univ.

    2002-01-01

    Complete text of publication follows. Aim. To examine the suitability of radiochromic film (RCF) dosimeters in determining 3D dose distribution from a pulsed electron beam source by comparing their response with alanine EPR dosimetry and calorimetry. Experimental. A FWT-60 radiochromic films (Far West Technology Inc) were used while alanine films were home made. To obtain the dose vs. penetration depth relationship, a stack of 13 films separated by aluminium plates and/or alanine films was placed perpendicular to the electron beam (Febetron, 20 ns, 1.8 MeV, 10 12 Gy/s, dose range up to 100 kGy). RC films were calibrated using 60-Co source and Fricke dosimetry. The absorbance of irradiated films was measured using 2D microdensitometry. Calorimetry was performed with a homemade quasy-adiabatic aluminum calorimeter. Results and Discussion. Microdensitometry of films (5 x 5 cm) enabled the 3D mapping of the entire radiation field with in plane resolution of 0.12 mm. The total dose for each film was obtained by image segmentation to correct for the non-linear response of films. Integrated dose for the entire stack was in good agreement (within 5%) with total absorbed energy as determined with calorimetry. The dose distribution along the beam center was determined using alanine films (1 x 1 cm) and EPR spectroscopy, and again a good agreement with the dose determined by microdensitometry of the central portion of RC films. In conclusion, the results indicate that RC films can be used for determination of 3D dose distribution even at very high dose rates

  8. Effects of internal and external scatter on the build-up characteristics of Monte Carlo calculated absorbed dose for electron irradiation

    International Nuclear Information System (INIS)

    Lin, H.; Wu, DS.; Wu, AD.

    2005-01-01

    The effects of internal and external scatter on surface, build-up and depth dose characteristics simulated by Monte Carlo code EGSnrc for varying field size and SSD for a 10 MeV monoenergetic electron beam with and without an accelerator model are extensively studied in this paper. In particular, sub-millimetre surface PDD was investigated. The percentage depth doses affected significantly by the external scatter show a larger build-up dose. A forward shifted Dmax depth and a sharper fall-off region compared to PDDs with only internal scatter considered. The surface dose with both internal and external scatter shows a marked decrease at 110 cm SSD, and then slight further changes with the increasing SSD since few external scattered particles from accelerator model can reach the phantom for large SSDs. The sharp PDD increase for the 5 cm x 5 cm field compared to other fields seen when only internal scatter is considered is significantly less when external scatter is also present. The effect of external scatter on surface PDD is more pronounced for large fields than small fields (5 cm x 5 cm field)

  9. Analysis of records of external occupational dose records in Brazil

    International Nuclear Information System (INIS)

    Mauricio, Claudia L.P.; Silva, Herica L.R. da; Silva, Claudio Ribeiro da

    2014-01-01

    Brazil, a continental country, with actually more than 150,000 workers under individual monitoring for ionizing radiation, has implemented in 1987 a centralized system for storage of external occupational dose. This database has been improved over the years and is now a web-based information system called Brazilian External Occupational Dose Management Database System - GDOSE. This paper presents an overview of the Brazilian external occupational dose over the years. The estimated annual average effective dose shows a decrease from 2.4 mSv in 1987 to about 0.6 mSv, having been a marked reduction from 1987 to 1990. Analyzing by type of controlled practice, one sees that the medical and dental radiology is the area with the largest number of users of individual monitors (70%); followed by education practices (8%) and the industrial radiography (7%). Additionally to photon whole body monitoring; neutron monitors are used in maintenance (36%), reactor (30%) and education (27%); and extremity monitors, in education (27%), nuclear medicine (22%) and radiology (19%). In terms of collective dose, the highest values are also found in conventional radiology, but the highest average dose values are those of interventional radiology. Nuclear medicine, R and D and radiotherapy also have average annual effective dose higher than 1 mSv. However, there is some very high dose values registered in GDOSE that give false information. This should be better analyzed in the future. Annual doses above 500 are certainly not realistic. (author)

  10. Dose estimation in embryo or fetus in external fields; Estimacion de dosis en embrion o feto

    Energy Technology Data Exchange (ETDEWEB)

    Gregori, Beatriz N [Autoridad Regulatoria Nuclear, Buenos Aires (Argentina)

    2001-07-01

    The embryo or the fetus can be irradiated as result of radiological procedures of diagnosis of therapy in where the beam effects directly on the same one or in tissues or peripherical organs. Some authors have suggested that in the first stages of the pregnancy the dose in ovaries can be the good estimated of the dose in embryo or fetus. In advanced conditions of the development, probably also in the early stage, is more appropriated to specify the dose in the embryo or fetus equal of the uterus. The dose in the uterus is a good estimated so much for external irradiation as for radionuclides incorporation.

  11. Dosimetric Considerations to Determine the Optimal Technique for Localized Prostate Cancer Among External Photon, Proton, or Carbon-Ion Therapy and High-Dose-Rate or Low-Dose-Rate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Georg, Dietmar, E-mail: Dietmar.Georg@akhwien.at [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Hopfgartner, Johannes [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Gòra, Joanna [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Kuess, Peter [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Kragl, Gabriele [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Berger, Daniel [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Hegazy, Neamat [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Goldner, Gregor; Georg, Petra [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria)

    2014-03-01

    Purpose: To assess the dosimetric differences among volumetric modulated arc therapy (VMAT), scanned proton therapy (intensity-modulated proton therapy, IMPT), scanned carbon-ion therapy (intensity-modulated carbon-ion therapy, IMIT), and low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy (BT) treatment of localized prostate cancer. Methods and Materials: Ten patients were considered for this planning study. For external beam radiation therapy (EBRT), planning target volume was created by adding a margin of 5 mm (lateral/anterior–posterior) and 8 mm (superior–inferior) to the clinical target volume. Bladder wall (BW), rectal wall (RW), femoral heads, urethra, and pelvic tissue were considered as organs at risk. For VMAT and IMPT, 78 Gy(relative biological effectiveness, RBE)/2 Gy were prescribed. The IMIT was based on 66 Gy(RBE)/20 fractions. The clinical target volume planning aims for HDR-BT ({sup 192}Ir) and LDR-BT ({sup 125}I) were D{sub 90%} ≥34 Gy in 8.5 Gy per fraction and D{sub 90%} ≥145 Gy. Both physical and RBE-weighted dose distributions for protons and carbon-ions were converted to dose distributions based on 2-Gy(IsoE) fractions. From these dose distributions various dose and dose–volume parameters were extracted. Results: Rectal wall exposure 30-70 Gy(IsoE) was reduced for IMIT, LDR-BT, and HDR-BT when compared with VMAT and IMPT. The high-dose region of the BW dose–volume histogram above 50 Gy(IsoE) of IMPT resembled the VMAT shape, whereas all other techniques showed a significantly lower high-dose region. For all 3 EBRT techniques similar urethra D{sub mean} around 74 Gy(IsoE) were obtained. The LDR-BT results were approximately 30 Gy(IsoE) higher, HDR-BT 10 Gy(IsoE) lower. Normal tissue and femoral head sparing was best with BT. Conclusion: Despite the different EBRT prescription and fractionation schemes, the high-dose regions of BW and RW expressed in Gy(IsoE) were on the same order of magnitude. Brachytherapy techniques

  12. Dosimetric Considerations to Determine the Optimal Technique for Localized Prostate Cancer Among External Photon, Proton, or Carbon-Ion Therapy and High-Dose-Rate or Low-Dose-Rate Brachytherapy

    International Nuclear Information System (INIS)

    Georg, Dietmar; Hopfgartner, Johannes; Gòra, Joanna; Kuess, Peter; Kragl, Gabriele; Berger, Daniel; Hegazy, Neamat; Goldner, Gregor; Georg, Petra

    2014-01-01

    Purpose: To assess the dosimetric differences among volumetric modulated arc therapy (VMAT), scanned proton therapy (intensity-modulated proton therapy, IMPT), scanned carbon-ion therapy (intensity-modulated carbon-ion therapy, IMIT), and low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy (BT) treatment of localized prostate cancer. Methods and Materials: Ten patients were considered for this planning study. For external beam radiation therapy (EBRT), planning target volume was created by adding a margin of 5 mm (lateral/anterior–posterior) and 8 mm (superior–inferior) to the clinical target volume. Bladder wall (BW), rectal wall (RW), femoral heads, urethra, and pelvic tissue were considered as organs at risk. For VMAT and IMPT, 78 Gy(relative biological effectiveness, RBE)/2 Gy were prescribed. The IMIT was based on 66 Gy(RBE)/20 fractions. The clinical target volume planning aims for HDR-BT ( 192 Ir) and LDR-BT ( 125 I) were D 90% ≥34 Gy in 8.5 Gy per fraction and D 90% ≥145 Gy. Both physical and RBE-weighted dose distributions for protons and carbon-ions were converted to dose distributions based on 2-Gy(IsoE) fractions. From these dose distributions various dose and dose–volume parameters were extracted. Results: Rectal wall exposure 30-70 Gy(IsoE) was reduced for IMIT, LDR-BT, and HDR-BT when compared with VMAT and IMPT. The high-dose region of the BW dose–volume histogram above 50 Gy(IsoE) of IMPT resembled the VMAT shape, whereas all other techniques showed a significantly lower high-dose region. For all 3 EBRT techniques similar urethra D mean around 74 Gy(IsoE) were obtained. The LDR-BT results were approximately 30 Gy(IsoE) higher, HDR-BT 10 Gy(IsoE) lower. Normal tissue and femoral head sparing was best with BT. Conclusion: Despite the different EBRT prescription and fractionation schemes, the high-dose regions of BW and RW expressed in Gy(IsoE) were on the same order of magnitude. Brachytherapy techniques were clearly superior in

  13. Personnel external dose monitoring system

    International Nuclear Information System (INIS)

    Zhao Hengyuan

    1989-01-01

    The status and trend of personnel external dose monitoring system are introduced briefly. Their characteristics, functions and TLD bedges of some commercially available automatic TLD system, including UD-710A (Matsushita, Japan), Harshaw-2271, 2276 (Harshaw, USA), Harshaw-8000 (Harshaw/Filtrol), Studsvik-1313 (Sweden) and Pitman-800 (UK) were depicted in detail. Finally, personnel dose management and record keeping system were presented and two examples were given

  14. Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

    International Nuclear Information System (INIS)

    Alvarez R, J T; Tovar M, V M

    2008-01-01

    A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described--for eleven 60 Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 deg. C plus 24 hrs 80 deg. C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal D W = 2 Gy·c) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gy in terms of absorbed dose to water D W for 60 Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals

  15. Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

    Science.gov (United States)

    Álvarez R., J. T.; Tovar M., V. M.

    2008-08-01

    A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described—for eleven 60 Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 °C plus 24 hrs 80 °C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal DW = 2 Gy ṡ c ) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gy in terms of absorbed dose to water DW for 60 Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals.

  16. A criterion-based audit of the technical quality of external beam radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Brundage, Michael; Danielson, Brita; Pearcey, Robert; Bass, Brenda; Pickles, Tom; Bahary, Jean-Paul; Peng, Yingwei; Wallace, David; Mackillop, William

    2013-01-01

    Purpose: To evaluate the technical quality of external beam radiotherapy for prostate cancer in Canada. Methods: This was a multi-institution, retrospective study of a random sample of patients undergoing radiotherapy (RT) for prostate cancer in Canada. Patterns of care were determined by abstracting details of the patients’ management from original records. The quality of patient’s technical care was measured against a previously published, comprehensive suite of quality indicators. Results: 32 of the 37 RT centres participated. The total study population of 810 patients included 25% low-risk, 44% intermediate-risk, and 28% high-risk cases. 649 received external beam RT (EBRT) only, for whom compliance with 12 indicators of the quality of pre-treatment assessment ranged from 56% (sexual function documented) to 96% (staging bone scan obtained in high-risk patients). Compliance with treatment-related indicators ranged from 78% (dose to prostate ⩾74 Gy in intermediate risk patients not receiving hormone therapy) to 100% (3DCRT or IMRT plan). Compliance varied among centres; no centre demonstrated 100% compliance on all indicators and every centre was 100% compliant on at least some indicators. The number of assessment-related indicators (n = 13) with which a given centre was 100% compliant ranged from 4 to 11 (median 7) and the number of the treatment-specific indicators (n = 8) with which a given centre was 100% compliant ranged from 6 to 8 (median 8). ADT therapy was utilised in most high-risk cases (191, 92.3%). Conclusions: While patterns of prostate cancer care in Canada vary somewhat, compliance on the majority of quality indicators is very high. However, all centres showed room for improvement on several indicators and few individual patients received care that met target benchmarks on all quality measures. This variation is particularly important for indicators such as delivered dose where impact on disease outcome is known to exist, and suggests that

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

    International Nuclear Information System (INIS)

    1999-01-01

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

  18. Injectable silver nanosensors: in vivo dosimetry for external beam radiotherapy using positron emission tomography

    DEFF Research Database (Denmark)

    Christensen, Anders Nymark; Rydhög, J. S.; Søndergaard, Rikke Vicki

    2016-01-01

    Development of safe and efficient radiotherapy routines requires quantification of the delivered absorbed dose to the cancer tissue in individual patients. In vivo dosimetry can provide accurate information about the absorbed dose delivered during treatment. In the current study, a novel silver......-nanosensor formulation based on poly(vinylpyrrolidinone)-coated silver nanoparticles formulated in a gelation matrix composed of sucrose acetate isobutyrate has been developed for use as an in vivo dosimeter for external beam radiotherapy. In situ photonuclear reactions trigger the formation of radioactive (106)Ag......, which enables post treatment verification of the delivered dose using positron emission tomography imaging. The silver-nanosensor was investigated in a tissue equivalent thorax phantom using clinical settings and workflow for both standard fractionated radiotherapy (2 Gy) and stereotactic radiotherapy...

  19. Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis.

    Science.gov (United States)

    Blake, P; Swart, Ann Marie; Orton, J; Kitchener, H; Whelan, T; Lukka, H; Eisenhauer, E; Bacon, M; Tu, D; Parmar, M K B; Amos, C; Murray, C; Qian, W

    2009-01-10

    Early endometrial cancer with low-risk pathological features can be successfully treated by surgery alone. External beam radiotherapy added to surgery has been investigated in several small trials, which have mainly included women at intermediate risk of recurrence. In these trials, postoperative radiotherapy has been shown to reduce the risk of isolated local recurrence but there is no evidence that it improves recurrence-free or overall survival. We report the findings from the ASTEC and EN.5 trials, which investigated adjuvant external beam radiotherapy in women with early-stage disease and pathological features suggestive of intermediate or high risk of recurrence and death from endometrial cancer. Between July, 1996, and March, 2005, 905 (789 ASTEC, 116 EN.5) women with intermediate-risk or high-risk early-stage disease from 112 centres in seven countries (UK, Canada, Poland, Norway, New Zealand, Australia, USA) were randomly assigned after surgery to observation (453) or to external beam radiotherapy (452). A target dose of 40-46 Gy in 20-25 daily fractions to the pelvis, treating five times a week, was specified. Primary outcome measure was overall survival, and all analyses were by intention to treat. These trials were registered ISRCTN 16571884 (ASTEC) and NCT 00002807 (EN.5). After a median follow-up of 58 months, 135 women (68 observation, 67 external beam radiotherapy) had died. There was no evidence that overall survival with external beam radiotherapy was better than observation, hazard ratio 1.05 (95% CI 0.75-1.48; p=0.77). 5-year overall survival was 84% in both groups. Combining data from ASTEC and EN.5 in a meta-analysis of trials confirmed that there was no benefit in terms of overall survival (hazard ratio 1.04; 95% CI 0.84-1.29) and can reliably exclude an absolute benefit of external beam radiotherapy at 5 years of more than 3%. With brachytherapy used in 53% of women in ASTEC/EN.5, the local recurrence rate in the observation group at 5 years

  20. External beam radiotherapy of localized prostatic adenocarcinoma. Evaluation of conformal therapy, field number and target margins

    International Nuclear Information System (INIS)

    Lennernaes, B.; Rikner, G.; Letocha, H.; Nilsson, S.

    1995-01-01

    The purpose of the present study was to identify factors of importance in the planning of external beam radiotherapy of prostatic adenocarcinoma. Seven patients with urogenital cancers were planned for external radiotherapy of the prostate. Four different techniques were used, viz. a 4-field box technique and four-, five- or six-field conformal therapy set-ups combined with three different margins (1-3 cm). The evaluations were based on the doses delivered to the rectum and the urinary bladder. A normal tissue complication probability (NTCP) was calculated for each plan using Lyman's dose volume reduction method. The most important factors that resulted in a decrease of the dose delivered to the rectum and the bladder were the use of conformal therapy and smaller margins. Conformal therapy seemed more important for the dose distribution in the urinary bladder. Five- and six-field set-ups were not significantly better than those with four fields. NTCP calculations were in accordance with the evaluation of the dose volume histograms. To conclude, four-field conformal therapy utilizing reduced margins improves the dose distribution to the rectum and the urinary bladder in the radiotherapy of prostatic adenocarcinoma. (orig.)

  1. Perspectives in absorbed dose metrology with regard to the technical evolutions of external beam radiotherapy

    International Nuclear Information System (INIS)

    Chauvenet, B.; Bordy, J.M.; Barthe, J.

    2009-01-01

    This paper presents several R and D axes in absorbed close metrology to meet the needs resulting from the technical evolutions of external beam radiotherapy. The facilities in operation in France have considerably evolved under the impulse of the plan Cancer launched in 2003: replacements and increase of the number of accelerators, substitution of accelerators for telecobalt almost completed and acquisition of innovative facilities for tomo-therapy and stereotaxy. The increasing versatility of facilities makes possible the rapid evolution of treatment modalities, allowing to better delimit irradiation to tumoral tissues and spare surrounding healthy tissues and organs at risk. This leads to a better treatment efficacy through dose escalation. National metrology laboratories must offer responses adapted to the new need, i.e. not restrict themselves to the establishment of references under conventional conditions defined at international level, contribute to the improvement of uncertainties at all levels of reference transfer to practitioners: primary measurements under conditions as close as possible to those of treatment, characterization of transfer and treatment control dosimeters., metrological validation of treatment planning tools... Those axes have been identified as priorities for the next years in ionizing radiation metrology at the European level and included in the European. Metrology Research Programme. A project dealing with some of those topics has been selected in the frame of the Eranet+ Call EMRP 2007 and is now starting. The LNE-LAM is strongly engaged in it. (authors)

  2. Current algorithms for computed electron beam dose planning

    International Nuclear Information System (INIS)

    Brahme, A.

    1985-01-01

    Two- and sometimes three-dimensional computer algorithms for electron beam irradiation are capable of taking all irregularities of the body cross-section and the properties of the various tissues into account. This is achieved by dividing the incoming broad beams into a number of narrow pencil beams, the penetration of which can be described by essentially one-dimensional formalisms. The constituent pencil beams are most often described by Gaussian, experimentally or theoretically derived distributions. The accuracy of different dose planning algorithms is discussed in some detail based on their ability to take the different physical interaction processes of high energy electrons into account. It is shown that those programs that take the deviations from the simple Gaussian model into account give the best agreement with experimental results. With such programs a dosimetric relative accuracy of about 5% is generally achieved except in the most complex inhomogeneity configurations. Finally, the present limitations and possible future developments of electron dose planning are discussed. (orig.)

  3. Thyroid doses from external gamma-exposure following the Chernobyl accident

    International Nuclear Information System (INIS)

    Tretyakevich, Sergey; Kukhta, Tatyana; Minenko, Victor; Drozdovitch, Vladimir; Luckyanov, Nickolas; Gavrilin, Yury; Khrouch, Valeri; Shinkarev, Sergey

    2008-01-01

    Full text: An increase of thyroid cancer incidence among children in Belarus has been observed after the Chernobyl accident. The main contributor to the thyroid dose was caused by 131 I intake with fresh milk in 1986. Other contributions to the thyroid dose (external gamma-exposure, short-lived iodine isotopes, internal radiocesium) were small in comparison to the dose from 131 I intakes soon after the accident. However, exposures to external radiation continued for a number of years after the accident. Thyroid doses from external gamma-exposure following the Chernobyl accident were mainly caused by gamma-exposure to 24 nuclides: 95 Zr, 95 Nb, 99 Mo, 99 mTc, 103 Ru, 103m Rh, 106 Ru, 125 Sb, 125m Te, 131m Te, 131 I, 132 Te, 132 I, 133 I, 135 I, 134 Cs, 136 Cs, 137 Cs, 140 Ba, 140 La, 141 Ce, 144 Ce, 144 Pr, 239 Np. Data of personal interview were used to take into account the personal residence history for the time elapsed from the Chernobyl accident until the interview (10 to 15 years later). Cumulative thyroid doses caused by external gamma-exposure during the passage of the radioactive cloud and from the ground contamination following the Chernobyl accident have been reconstructed. The median thyroid dose from external gamma-exposure to ∼11,770 cohort members of an epidemiological study was estimated to be ∼6 mGy. There are ∼3,400 persons with external dose estimates that exceed 20 mGy. Exposure from radionuclides deposited on the ground was the main source of external dose. The contribution from the passing radioactive cloud to external dose was found to be negligible. (author)

  4. Validation of calculated tissue maximum ratio obtained from measured percentage depth dose (PPD) data for high energy photon beam ( 6 MV and 15 MV)

    International Nuclear Information System (INIS)

    Osei, J.E.

    2014-07-01

    During external beam radiotherapy treatments, high doses are delivered to the cancerous cell. Accuracy and precision of dose delivery are primary requirements for effective and efficiency in treatment. This leads to the consideration of treatment parameters such as percentage depth dose (PDD), tissue air ratio (TAR) and tissue phantom ratio (TPR), which show the dose distribution in the patient. Nevertheless, tissue air ratio (TAR) for treatment time calculation, calls for the need to measure in-air-dose rate. For lower energies, measurement is not a problem but for higher energies, in-air measurement is not attainable due to the large build-up material required for the measurement. Tissue maximum ratio (TMR) is the quantity required to replace tissue air ratio (TAR) for high energy photon beam. It is known that tissue maximum ratio (TMR) is an important dosimetric function in radiotherapy treatment. As the calculation methods used to determine tissue maximum ratio (TMR) from percentage depth dose (PDD) were derived by considering the differences between TMR and PDD such as geometry and field size, where phantom scatter or peak scatter factors are used to correct dosimetric variation due to field size difference. The purpose of this study is to examine the accuracy of calculated tissue maximum ratio (TMR) data with measured TMR values for 6 MV and 15 MV photon beam at Sweden Ghana Medical Centre. With the help of the Blue motorize water phantom and the Omni pro-Accept software, Pdd values from which TMRs are calculated were measured at 100 cm source-to-surface distance (SSD) for various square field sizes from 5x5 cm to 40x40 cm and depth of 1.5 cm to 25 cm for 6 MV and 15 MV x-ray beam. With the same field sizes, depths and energies, the TMR values were measured. The validity of the calculated data was determined by making a comparison with values measured experimentally at some selected field sizes and depths. The results show that; the reference depth of maximum

  5. 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

  6. External beam radiotherapy alone in advanced esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Sung Ja; Chung, Woong Ki; Nah, Byung Sik; Nam, Taek Keun [College of Medicine, Chonnam National Univ., Kwangju (Korea, Republic of)

    1999-09-01

    We performed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. One hundred and six patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (94%) and ranged from 1 month to 92 months (median; 6 months). The median age was 62 years old and male to female ratio was 104:2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was performed in 83%. Mean tumor dose delivered with curative aim was 58.6 Gy (55-70.8 Gy) and median duration of the radiation therapy was days. The median survival of all patients was 6 months and 1-year and 2-year overall survival rate was 27% and 12%, respectively. Improvement of dysphagia was obtained in most patients except for 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32% (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30% respectively, while those of the nonresponder was 4 months and 0% respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 months and 16% while those of the patients who could not tolerate regular diet was 3 months and 0%, respectively (p=0.004). The survival difference between the patients with 5 cm or less tumor length and those with more than 5 cm tumor length was marginally statistically significant (p=0.06). However, the survival difference according to the periesophageal invasion or mediastinal lymphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor, length, and

  7. External beam radiotherapy for unresectable pancreatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kagami, Yoshikazu; Nishio, Masamichi; Narimatsu, Naoto; Ogawa, Hajime; Betsuyaku, Takashi; Hirata, Kouji; Ikeda, Shigeyuki (Sapporo National Hospital (Japan). Hokkaido Cancer Center)

    1992-04-01

    Between 1980 to 1989, 24 patients with unresectable pancreatic cancer (10 with localized tumor alone and 14 with distant metastases) have been treated with external beam radiation at Sapporo National Hospital, Hokkaido Cancer Center. Response rate of pancreatic tumor treated with external beam radiation was 33.3% (7/21) with no complete response. Median survival time of the patients with localized tumor was 10 months and that of the patients with distant metastases was 3 months. Relief of pain occurred in 92.9% (12/13) of patients having pain due to pancreatic tumor and in 75% (3/4) of patients having pain due to bone metastases. Major complication was gastric ulcer which developed in 5 patients of 21 patients given stomach irradiation. We concluded that unresectable pancreatic cancer would be frequently indicated for radiotherapy. (author).

  8. Experimental verification of a commercial Monte Carlo-based dose calculation module for high-energy photon beams

    International Nuclear Information System (INIS)

    Kuenzler, Thomas; Fotina, Irina; Stock, Markus; Georg, Dietmar

    2009-01-01

    The dosimetric performance of a Monte Carlo algorithm as implemented in a commercial treatment planning system (iPlan, BrainLAB) was investigated. After commissioning and basic beam data tests in homogenous phantoms, a variety of single regular beams and clinical field arrangements were tested in heterogeneous conditions (conformal therapy, arc therapy and intensity-modulated radiotherapy including simultaneous integrated boosts). More specifically, a cork phantom containing a concave-shaped target was designed to challenge the Monte Carlo algorithm in more complex treatment cases. All test irradiations were performed on an Elekta linac providing 6, 10 and 18 MV photon beams. Absolute and relative dose measurements were performed with ion chambers and near tissue equivalent radiochromic films which were placed within a transverse plane of the cork phantom. For simple fields, a 1D gamma (γ) procedure with a 2% dose difference and a 2 mm distance to agreement (DTA) was applied to depth dose curves, as well as to inplane and crossplane profiles. The average gamma value was 0.21 for all energies of simple test cases. For depth dose curves in asymmetric beams similar gamma results as for symmetric beams were obtained. Simple regular fields showed excellent absolute dosimetric agreement to measurement values with a dose difference of 0.1% ± 0.9% (1 standard deviation) at the dose prescription point. A more detailed analysis at tissue interfaces revealed dose discrepancies of 2.9% for an 18 MV energy 10 x 10 cm 2 field at the first density interface from tissue to lung equivalent material. Small fields (2 x 2 cm 2 ) have their largest discrepancy in the re-build-up at the second interface (from lung to tissue equivalent material), with a local dose difference of about 9% and a DTA of 1.1 mm for 18 MV. Conformal field arrangements, arc therapy, as well as IMRT beams and simultaneous integrated boosts were in good agreement with absolute dose measurements in the

  9. Reducing the risk of radiocarcinogenesis in paediatric patients treated with external beam radiotherapy

    International Nuclear Information System (INIS)

    Taylor, M.L.; Franich, R.D.; Kron, Tomas

    2010-01-01

    Full text: The aim of this study was to determine readily-implementable means of out-of-field dose reduction in paediatric patients undergoing external beam radiotherapy for intracranial lesions. [n this way, the risk of secondary cancer induction may be reduced. Dose measurements were taken using LiF:Mg, Cu, P TLD 1 00 H chips in a 5 year old paediatric phantom. Multiple TLDs were placed at: the right and left lenses of the eye, optic nerve, brain, thyroid, lungs, heart, kidneys, abdomen and gonads. Varian 600 C and Varian Trilogy linear accelerators, both at 6 MV, were investigated, using different delivery parameters. Most of the out-of-field dose at large distances is attributable to leakage. The difference between stereotactic and larger field sizes is less significant far from the primary field. Out-of-field dose from the Trilogy was 40% higher than the 600 e . Aligning the craniocaudal axis of the patient with the x-plane of the collimator results in a dose reduction of 40%, for both machines. - A simple shielding arrangement may halve out-of-field dose. (author)

  10. Phantom study of radiation doses outside the target volume brachytherapy versus external radiotherapy of early breast cancer

    International Nuclear Information System (INIS)

    Johansson, Bengt; Persson, Essie; Westman, Gunnar; Persliden, Jan

    2003-01-01

    Background and purpose: Brachytherapy is sometimes suggested as an adjuvant treatment after surgery of some tumours. When introducing this, it would be useful to have an estimate of the dose distribution to different body sites, both near and distant to target, comparing conventional external irradiation to brachytherapy. The aim of the present study was to determine radiation doses with both methods at different body sites, near and distant to target, in an experimental situation on an operated left sided breast cancer on a female Alderson phantom. Methods: Five external beam treatments with isocentric tangential fields were given by a linear accelerator. A specified dose of 1.0 Gy was given to the whole left sided breast volume. Five interstitial brachytherapy treatments were given to the upper, lateral quadrant of the left breast by a two plane, 10 needles implant. A dose of 1.0 Gy specified according to the Paris system was administered by a pulsed dose rate afterloading machine. Absorbed dose in different fixed dose points were measured by thermoluminescence dosimeters. Results: Both methods yielded an absorbed dose of the same size to the bone marrow and internal organs distant to target, 1.0-1.4% of the prescribed dose. There was a trend of lower doses to the lower half of the trunk and higher doses to the upper half of the trunk, respectively, by brachytherapy. A 90% reduction of absorbed dose with brachytherapy compared to external irradiation was found in the near-target region within 5 cm from target boundary where parts of the left lung and the heart are situated. If an adjuvant dose of 50 Gy is given with the external radiotherapy and brachytherapy, the absorbed dose in a part of the myocardium could be reduced from 31.8 to 2.1 Gy. Conclusions: Near target, brachytherapy yielded a considerably lower absorbed dose which is of special importance when considering radiation effects on the myocard and lungs. We could not demonstrate any difference of

  11. High dose-per-pulse electron beam dosimetry - A model to correct for the ion recombination in the Advanced Markus ionization chamber.

    Science.gov (United States)

    Petersson, Kristoffer; Jaccard, Maud; Germond, Jean-François; Buchillier, Thierry; Bochud, François; Bourhis, Jean; Vozenin, Marie-Catherine; Bailat, Claude

    2017-03-01

    The purpose of this work was to establish an empirical model of the ion recombination in the Advanced Markus ionization chamber for measurements in high dose rate/dose-per-pulse electron beams. In addition, we compared the observed ion recombination to calculations using the standard Boag two-voltage-analysis method, the more general theoretical Boag models, and the semiempirical general equation presented by Burns and McEwen. Two independent methods were used to investigate the ion recombination: (a) Varying the grid tension of the linear accelerator (linac) gun (controls the linac output) and measuring the relative effect the grid tension has on the chamber response at different source-to-surface distances (SSD). (b) Performing simultaneous dose measurements and comparing the dose-response, in beams with varying dose rate/dose-per-pulse, with the chamber together with dose rate/dose-per-pulse independent Gafchromic™ EBT3 film. Three individual Advanced Markus chambers were used for the measurements with both methods. All measurements were performed in electron beams with varying mean dose rate, dose rate within pulse, and dose-per-pulse (10 -2  ≤ mean dose rate ≤ 10 3 Gy/s, 10 2  ≤ mean dose rate within pulse ≤ 10 7  Gy/s, 10 -4  ≤ dose-per-pulse ≤ 10 1  Gy), which was achieved by independently varying the linac gun grid tension, and the SSD. The results demonstrate how the ion collection efficiency of the chamber decreased as the dose-per-pulse increased, and that the ion recombination was dependent on the dose-per-pulse rather than the dose rate, a behavior predicted by Boag theory. The general theoretical Boag models agreed well with the data over the entire investigated dose-per-pulse range, but only for a low polarizing chamber voltage (50 V). However, the two-voltage-analysis method and the Burns & McEwen equation only agreed with the data at low dose-per-pulse values (≤ 10 -2 and ≤ 10 -1  Gy, respectively). An empirical

  12. A new mapping acquisition and processing system for simultaneous PIXE-RBS analysis with external beam

    International Nuclear Information System (INIS)

    Pichon, L.; Beck, L.; Walter, Ph.; Moignard, B.; Guillou, T.

    2010-01-01

    The combination of ion beam analysis techniques is particularly fruitful for the study of cultural heritage objects. For several years, the AGLAE facility of the Louvre laboratory has been implementing these techniques with an external beam. The recent set-up permits to carry out PIXE, PIGE and RBS simultaneously on the same analyzed spot with a particle beam of approximately 20 μm diameter. A new mapping system has been developed in order to provide elemental concentration maps from the PIXE and RBS spectra. This system combines the Genie2000 spectroscopy software with a homemade software that creates maps by handling acquisition with the object position. Each pixel of each PIXE and RBS maps contains the spectrum normalised by the dose. After analysing each pixel of the PIXE maps (low and high energy X-ray spectra) with the Gupixwin peak-fitting software, quantitative elemental concentrations are obtained for the major and trace elements. This paper presents the quantitative elemental maps extracted from the PIXE spectra and the development of RBS data processing for light element distribution and thin layer characterization. Examples on rock painting and lustrous ceramics will be presented.

  13. Study of dose calculation and beam parameters optimization with genetic algorithm in IMRT

    International Nuclear Information System (INIS)

    Chen Chaomin; Tang Mutao; Zhou Linghong; Lv Qingwen; Wang Zhuoyu; Chen Guangjie

    2006-01-01

    Objective: To study the construction of dose calculation model and the method of automatic beam parameters selection in IMRT. Methods: The three-dimension convolution dose calculation model of photon was constructed with the methods of Fast Fourier Transform. The objective function based on dose constrain was used to evaluate the fitness of individuals. The beam weights were optimized with genetic algorithm. Results: After 100 iterative analyses, the treatment planning system produced highly conformal and homogeneous dose distributions. Conclusion: the throe-dimension convolution dose calculation model of photon gave more accurate results than the conventional models; genetic algorithm is valid and efficient in IMRT beam parameters optimization. (authors)

  14. WRAITH, Internal and External Doses from Atmospheric Release of Isotopes

    International Nuclear Information System (INIS)

    1984-01-01

    1 - Description of problem or function: WRAITH calculates the atmospheric transport of radioactive material to each of a number of downwind receptor points and the external and internal doses to a reference man at each of the receptor points. 2 - Method of solution: The movement of the released material through the atmosphere is calculated using a bivariate straight-line Gaussian distribution model with Pasquill values for standard deviations. The quantity of material in the released cloud is modified during its transit time to account for radioactive decay and daughter production. External doses due to exposure to the cloud can be calculated using a semi-infinite cloud approximation or a 'finite plume' three-dimensional point-kernel numerical integration technique. Internal doses due to acute inhalation are calculated using the ICRP Task Group Model and a four-segmented gastro- intestinal tract model. Translocation of the material between body compartments and retention in the body compartments are calculated using multiple exponential retention functions. Internal doses to each organ are calculated as sums of cross-organ doses with each target organ irradiated by radioactive material in a number of source organs. All doses are calculated in rads with separate values determined for high-LET and low-LET radiation. 3 - Restrictions on the complexity of the problem: - Doses to only three target organs (total body, red bone marrow, and the lungs) are considered and acute inhalation is the only pathway for material to enter the body. The dose response model is not valid for high-LET radiation other than alphas. The high-LET calculation ignores the contributions of neutrons, spontaneous fission fragments, and alpha recoil nuclei

  15. Late change of normal tissue treated either by high dose rate or low dose rate interstitial brachytherapy. A retrospective comparative study on oral and oropharyngeal mucosa

    International Nuclear Information System (INIS)

    Nose, Takayuki; Koizumi, Masahiko; Nishiyama, Kinji; Inoue, Toshihiko

    2002-01-01

    The purpose of this study was to compare late changes of normal tissue treated either by high dose rate (HDR) or low dose rate (LDR) interstitial brachytherapy. For HDR group, 22 oropharynx cancer patients who were treated by HDR Ir-192 interstitial brachytherapy with/without external beam radiotherapy in Osaka (Osaka Medical Center for Cancer and Cardiovascular Diseases and Osaka University Hospital) during June 1994 through April 2000 and came to the follow-up clinics during July 2000 through December 2000 were studied. For LDR group, 26 oropharynx cancer patients who were treated by LDR Ir-192 interstitial brachytherapy with/without external beam radiotherapy in Nancy (Centre Alexis Vautrin) during February 1989 through July 1998 and came to the follow-up clinics during April 1999 through July 1999 were studied. The standard HDR schedules were 54 Gy/9 fr/5-6 days for monotherapy and 18-24 Gy/3-4 fr/2-3 days following 45 Gy external beam radiotherapy. The standard LDR schedules were 65 Gy/5-6 days for monotherapy and 15-25 Gy/2-3 days following 50 Gy external beam radiotherapy. For evaluation of the late changes, we scored the mucosal and muscular changes inside the treated volume using the modified Dische score system and the RTOG/EORTC late radiation morbidity scoring scheme. For 6 items of the modified Dische score system, no significant difference was found between HDR and LDR groups. For the remaining 2 items (pallor, mobility impairment of faucial pillars), LDR group showed higher scores (p=0.010, 0.002). LDR group showed a trend toward higher scores for the RTOG/EORTC scheme (p=0.059). Some predict late effects by HDR interstitial brachytherapy to be severer than by LDR because no dose-rate effects can be expected. Our study, however, showed at least equivalent or even milder late changes by HDR. Appropriate fractionation schedule and extra geometrical sparing effects by optimized dose distribution of HDR group might result in milder late changes. With our

  16. SU-F-T-137: Out-Of-Beam Dose for a Compact Double-Scattering Proton Beam Therapy System

    Energy Technology Data Exchange (ETDEWEB)

    Islam, M; Ahmad, S; Jin, H [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)

    2016-06-15

    Purpose: The out-of-beam dose is important for understanding the peripheral dose in radiation therapy. In proton radiotherapy, the study of out-of-beam dose is scarce and the treatment planning system (TPS) based on pencil beam algorithm cannot accurately predict the out-of-beam dose. This study investigates the out-of-beam dose for the single-room Mevion S250 double scattering proton therapy system using experimentally measured and treatment planning software generated data. The results are compared with those reported for conventional photon beam therapy. However, this study does not incorporate the neutron contribution in the scattered dose. Methods: A total of seven proton treatment plans were generated using Varian Eclipse TPS for three different sites (brain, lung, and pelvis) in an anthropomorphic phantom. Three field sizes of 5×5, 10×10, and 20×20 cm{sup 2} (lung only) with typical clinical range (13.3–22.8 g/cm{sup 2}) and modulation widths (5.3–14.0 g/cm{sup 2}) were used. A single beam was employed in each treatment plan to deliver a dose of 181.8 cGy (200.0 cGy (RBE)) to the selected target. The out-of-beam dose was measured at 2.0, 5.0, 10.0, and 15.0 cm from the beam edge in the phantom using a thimble chamber (PTW TN31010). Results: The out-of-beam dose generally increased with field size, range, and volume irradiated. For all the plans, the scattered dose sharply fell off with distance. At 2.0 cm, the out-of-beam dose ranged from 0.35% to 2.16% of the delivered dose; however, the dose was clinically negligible (<0.3%) at a distance of 5.0 cm and greater. In photon therapy, the slightly greater out-of-beam dose was reported (TG36; 4%, 2%, and 1% for 2.0, 5.0, and 10.0 cm, respectively, using 6 MV beam). Conclusion: The measured out-of-beam dose in proton therapy excluding neutron contribution was observed higher than the TPS calculated dose and comparable to that of photon beam therapy.

  17. Summary and recommendations of a National Cancer Institute workshop on issues limiting the clinical use of Monte Carlo dose calculation algorithms for megavoltage external beam radiation therapy

    International Nuclear Information System (INIS)

    Fraass, Benedick A.; Smathers, James; Deye, James

    2003-01-01

    Due to the significant interest in Monte Carlo dose calculations for external beam megavoltage radiation therapy from both the research and commercial communities, a workshop was held in October 2001 to assess the status of this computational method with regard to use for clinical treatment planning. The Radiation Research Program of the National Cancer Institute, in conjunction with the Nuclear Data and Analysis Group at the Oak Ridge National Laboratory, gathered a group of experts in clinical radiation therapy treatment planning and Monte Carlo dose calculations, and examined issues involved in clinical implementation of Monte Carlo dose calculation methods in clinical radiotherapy. The workshop examined the current status of Monte Carlo algorithms, the rationale for using Monte Carlo, algorithmic concerns, clinical issues, and verification methodologies. Based on these discussions, the workshop developed recommendations for future NCI-funded research and development efforts. This paper briefly summarizes the issues presented at the workshop and the recommendations developed by the group

  18. Dose properties of a laser accelerated electron beam and prospects for clinical application

    International Nuclear Information System (INIS)

    Kainz, K.K.; Hogstrom, K.R.; Antolak, J.A.; Almond, P.R.; Bloch, C.D.; Chiu, C.; Fomytskyi, M.; Raischel, F.; Downer, M.; Tajima, T.

    2004-01-01

    Laser wakefield acceleration (LWFA) technology has evolved to where it should be evaluated for its potential as a future competitor to existing technology that produces electron and x-ray beams. The purpose of the present work is to investigate the dosimetric properties of an electron beam that should be achievable using existing LWFA technology, and to document the necessary improvements to make radiotherapy application for LWFA viable. This paper first qualitatively reviews the fundamental principles of LWFA and describes a potential design for a 30 cm accelerator chamber containing a gas target. Electron beam energy spectra, upon which our dose calculations are based, were obtained from a uniform energy distribution and from two-dimensional particle-in-cell (2D PIC) simulations. The 2D PIC simulation parameters are consistent with those reported by a previous LWFA experiment. According to the 2D PIC simulations, only approximately 0.3% of the LWFA electrons are emitted with an energy greater than 1 MeV. We studied only the high-energy electrons to determine their potential for clinical electron beams of central energy from 9 to 21 MeV. Each electron beam was broadened and flattened by designing a dual scattering foil system to produce a uniform beam (103%>off-axis ratio>95%) over a 25x25 cm2 field. An energy window (ΔE) ranging from 0.5 to 6.5 MeV was selected to study central-axis depth dose, beam flatness, and dose rate. Dose was calculated in water at a 100 cm source-to-surface distance using the EGS/BEAM Monte Carlo algorithm. Calculations showed that the beam flatness was fairly insensitive to ΔE. However, since the falloff of the depth-dose curve (R 10 -R 90 ) and the dose rate both increase with ΔE, a tradeoff between minimizing (R 10 -R 90 ) and maximizing dose rate is implied. If ΔE is constrained so that R 10 -R 90 is within 0.5 cm of its value for a monoenergetic beam, the maximum practical dose rate based on 2D PIC is approximately 0.1 Gy min-1

  19. Prestress Force Identification for Externally Prestressed Concrete Beam Based on Frequency Equation and Measured Frequencies

    Directory of Open Access Journals (Sweden)

    Luning Shi

    2014-01-01

    Full Text Available A prestress force identification method for externally prestressed concrete uniform beam based on the frequency equation and the measured frequencies is developed. For the purpose of the prestress force identification accuracy, we first look for the appropriate method to solve the free vibration equation of externally prestressed concrete beam and then combine the measured frequencies with frequency equation to identify the prestress force. To obtain the exact solution of the free vibration equation of multispan externally prestressed concrete beam, an analytical model of externally prestressed concrete beam is set up based on the Bernoulli-Euler beam theory and the function relation between prestress variation and vibration displacement is built. The multispan externally prestressed concrete beam is taken as the multiple single-span beams which must meet the bending moment and rotation angle boundary conditions, the free vibration equation is solved using sublevel simultaneous method and the semi-analytical solution of the free vibration equation which considered the influence of prestress on section rigidity and beam length is obtained. Taking simply supported concrete beam and two-span concrete beam with external tendons as examples, frequency function curves are obtained with the measured frequencies into it and the prestress force can be identified using the abscissa of the crosspoint of frequency functions. Identification value of the prestress force is in good agreement with the test results. The method can accurately identify prestress force of externally prestressed concrete beam and trace the trend of effective prestress force.

  20. Assessment of uncertainties of external dose estimation after the Chernobyl accident

    International Nuclear Information System (INIS)

    Kruk, Julianna

    2008-01-01

    in one-storied wooden houses can be considered as a constant. In this case the value of the uncertainty factor is equal 1.42. Basically the variability of cesium ground deposition in settlement influences on discrepancy of dose estimation (92 %). In the pessimistic case dose calculation was based only on an existing data of Cs-137 deposition for each suffered settlement. The dose factors describing structure of housing and share distribution of inhabitants are chosen as the average values for an 'indefinite' case. The dose coefficient of housing can essentially vary from value for wood bungalow to high-rise building. The type of probability function this parameter agrees with log-normal distribution. The part of living in different type of housing also is charactering with high spread in values: from 0 to 1. Failing of knowledge the type of probability function of this parameter can be chosen as an equiprobable. The received value for the factor of uncertainty for this case is equal 2.89. Thus the greatest uncertainty (82 %) of discrepancy of an estimation of the external dose is brought with absence of data about a share of the living population in the certain type of an apartment house. The contribution to uncertainty of cesium deposition has made 16.5 percent. (author)

  1. Nuclear medicine external individual occupational doses in Rio de Janeiro

    International Nuclear Information System (INIS)

    Mauricio, Claudia L.P.; Lima, Ana Luiza S.; Silva, Herica L.R. da; Santos, Denison Souza; Silva, Claudio Ribeiro da

    2009-01-01

    According to the Brazilian National Database there are about 300 Nuclear Medicine Services (NMS) in Brazil, 44 of them located in the State of Rio de Janeiro (RJ). Individual dose measurements are an important input for the evaluation of occupational exposure in order to demonstrate the effectiveness of radioprotection implementation and to keep individual doses as low as possible. In Brazil, most nuclear medicine (NM) staff is routinely monitored for external dose. The internal committed dose is estimated only in abnormal conditions. This paper makes a statistics analysis of all the RJ NMS annual external occupational doses in year 2005. A study of the evolution of monthly external individual doses higher than 4.00 mSv from 2004 to 2008 is also presented. The number of registered thorax monthly dose higher than 4.0 mSv is increasing, as its value. In this period the highest dose measured reaches 56.9 mSv, in one month, in 2008. About 50% of the annual doses are smaller than the monthly record level of 0.20 mSv. In 2005, around 100 professionals of RJ NMS received annual doses higher than 4.0 mSv, considering only external doses, but no one receives doses higher than 20.0 mSv. Extremities dosimeters are used by about 15% of the staff. In some cases, these doses are more than 10 times higher than the dose in thorax. This study shows the importance to improve radiation protection procedures in NM. (author)

  2. Oblique incidence of electron beams - comparisons between calculated and measured dose distributions

    International Nuclear Information System (INIS)

    Karcher, J.; Paulsen, F.; Christ, G.

    2005-01-01

    Clinical applications of high-energy electron beams, for example for the irradiation of internal mammary lymph nodes, can lead to oblique incidence of the beams. It is well known that oblique incidence of electron beams can alter the depth dose distribution as well as the specific dose per monitor unit. The dose per monitor unit is the absorbed dose in a point of interest of a beam, which is reached with a specific dose monitor value (DIN 6814-8[5]). Dose distribution and dose per monitor unit at oblique incidence were measured with a small-volume thimble chamber in a water phantom, and compared to both normal incidence and calculations of the Helax TMS 6.1 treatment planning system. At 4 MeV and 60 degrees, the maximum measured dose per monitor unit at oblique incidence was decreased up to 11%, whereas at 18MeV and 60 degrees this was increased up to 15% compared to normal incidence. Comparisons of measured and calculated dose distributions showed that the predicted dose at shallow depths is usually higher than the measured one, whereas it is smaller at depths beyond the depth of maximum dose. On the basis of the results of these comparisons, normalization depths and correction factors for the dose monitor value were suggested to correct the calculations of the dose per monitor unit. (orig.)

  3. Dose measurement, its distribution and individual external dose assessments of inhabitants on high background radiation area in China

    Energy Technology Data Exchange (ETDEWEB)

    Koga, Taeko; Morishima, Hiroshige [Kinki Univ., Atomic Energy Research Institute, Osaka (Japan); Tatsumi, Kusuo [Kinki Univ., Life Science Research Institute, Osaka (Japan); Nakai, Sayaka; Sugahara, Tsutomu [Health Research Foundation, Kyoto (Japan); Yuan Yongling [Labor Hygiene Institute of Hunan Prov. (China); Wei Luxin [Laboratory of Industorial Hygiene, Ministry of Health (China)

    2001-01-01

    As a part of the China-Japan cooperative research on the natural radiation epidemiology, we have carried out a dose-assessment study to evaluate the external to natural radiation in the high background radiation area (HBRA) of Yangjiang in Guangdong province and in the control area (CA) of Enping prefecture since 1991. Because of the difficulties in measuring the individual doses of all inhabitants directly by the personal dosimeters, an indirect method was applied to estimate the exposed dose rates from the environmental radiation dose rates measured by survey meters and the occupancy factors of each hamlet. An individual radiation dose roughly correlates with the environmental radiation dose and the life style of the inhabitant. We have analyzed the environmental radiation doses in the hamlets and the variation of the occupancy factors to obtain the parameters of dose estimation on the inhabitants in selected hamlets; Madi and the several hamlets of the different level doses in HBRA and Hampizai hamlet in CA. With these parameters, we made estimations of individual dose rates and compared them with those obtained from the direct measurement using dosimeters carried by selected individuals. The results obtained are as follows: (1) The environmental radiation dose rates are influenced by the natural radioactive nuclide concentrations in building materials, the age of the building and the arrangement of the houses in a hamlet. There existed a fairly large and heterogeneous distribution of indoor and outdoor environmental radiation. The indoor radiation dose rates were due to the exposure from the natural radioactive nuclides in the building materials and they were about twice higher than the outdoor radiation dose rates. This difference was not observed in CA. (2) The occupancy factor was affected by the age of individuals and the seasons of a year. Indoor occupancy factors were higher for infants and aged individuals than for other age groups. This lead to higher

  4. Dose measurement, its distribution and individual external dose assessments of inhabitants on high background radiation area in China

    International Nuclear Information System (INIS)

    Koga, Taeko; Morishima, Hiroshige; Tatsumi, Kusuo; Nakai, Sayaka; Sugahara, Tsutomu; Yuan Yongling; Wei Luxin

    2001-01-01

    As a part of the China-Japan cooperative research on the natural radiation epidemiology, we have carried out a dose-assessment study to evaluate the external to natural radiation in the high background radiation area (HBRA) of Yangjiang in Guangdong province and in the control area (CA) of Enping prefecture since 1991. Because of the difficulties in measuring the individual doses of all inhabitants directly by the personal dosimeters, an indirect method was applied to estimate the exposed dose rates from the environmental radiation dose rates measured by survey meters and the occupancy factors of each hamlet. An individual radiation dose roughly correlates with the environmental radiation dose and the life style of the inhabitant. We have analyzed the environmental radiation doses in the hamlets and the variation of the occupancy factors to obtain the parameters of dose estimation on the inhabitants in selected hamlets; Madi and the several hamlets of the different level doses in HBRA and Hampizai hamlet in CA. With these parameters, we made estimations of individual dose rates and compared them with those obtained from the direct measurement using dosimeters carried by selected individuals. The results obtained are as follows: 1) The environmental radiation dose rates are influenced by the natural radioactive nuclide concentrations in building materials, the age of the building and the arrangement of the houses in a hamlet. There existed a fairly large and heterogeneous distribution of indoor and outdoor environmental radiation. The indoor radiation dose rates were due to the exposure from the natural radioactive nuclides in the building materials and they were about twice higher than the outdoor radiation dose rates. This difference was not observed in CA. 2) The occupancy factor was affected by the age of individuals and the seasons of a year. Indoor occupancy factors were higher for infants and aged individuals than for other age groups. This lead to higher

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

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  6. Monitoring external beam radiotherapy using real-time beam visualization

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, Cesare H. [Department of Mechanical Engineering and Department of Radiation Oncology, Stanford University, Stanford, California 94305 (United States); Naczynski, Dominik J.; Yu, Shu-Jung S.; Xing, Lei, E-mail: lei@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California 94305 (United States)

    2015-01-15

    Purpose: To characterize the performance of a novel radiation therapy monitoring technique that utilizes a flexible scintillating film, common optical detectors, and image processing algorithms for real-time beam visualization (RT-BV). Methods: Scintillating films were formed by mixing Gd{sub 2}O{sub 2}S:Tb (GOS) with silicone and casting the mixture at room temperature. The films were placed in the path of therapeutic beams generated by medical linear accelerators (LINAC). The emitted light was subsequently captured using a CMOS digital camera. Image processing algorithms were used to extract the intensity, shape, and location of the radiation field at various beam energies, dose rates, and collimator locations. The measurement results were compared with known collimator settings to validate the performance of the imaging system. Results: The RT-BV system achieved a sufficient contrast-to-noise ratio to enable real-time monitoring of the LINAC beam at 20 fps with normal ambient lighting in the LINAC room. The RT-BV system successfully identified collimator movements with sub-millimeter resolution. Conclusions: The RT-BV system is capable of localizing radiation therapy beams with sub-millimeter precision and tracking beam movement at video-rate exposure.

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

    International Nuclear Information System (INIS)

    Luechtenborg, Robert

    2012-01-01

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

  8. Conventional and conformal technique of external beam radiotherapy in locally advanced cervical cancer: Dose distribution, tumor response, and side effects

    Science.gov (United States)

    Mutrikah, N.; Winarno, H.; Amalia, T.; Djakaria, M.

    2017-08-01

    The objective of this study was to compare conventional and conformal techniques of external beam radiotherapy (EBRT) in terms of the dose distribution, tumor response, and side effects in the treatment of locally advanced cervical cancer patients. A retrospective cohort study was conducted on cervical cancer patients who underwent EBRT before brachytherapy in the Radiotherapy Department of Cipto Mangunkusumo Hospital. The prescribed dose distribution, tumor response, and acute side effects of EBRT using conventional and conformal techniques were investigated. In total, 51 patients who underwent EBRT using conventional techniques (25 cases using Cobalt-60 and 26 cases using a linear accelerator (LINAC)) and 29 patients who underwent EBRT using conformal techniques were included in the study. The distribution of the prescribed dose in the target had an impact on the patient’s final response to EBRT. The complete response rate of patients to conformal techniques was significantly greater (58%) than that of patients to conventional techniques (42%). No severe acute local side effects were seen in any of the patients (Radiation Therapy Oncology Group (RTOG) grades 3-4). The distribution of the dose and volume to the gastrointestinal tract affected the proportion of mild acute side effects (RTOG grades 1-2). The urinary bladder was significantly greater using conventional techniques (Cobalt-60/LINAC) than using conformal techniques at 72% and 78% compared to 28% and 22%, respectively. The use of conformal techniques in pelvic radiation therapy is suggested in radiotherapy centers with CT simulators and 3D Radiotherapy Treatment Planning Systems (RTPSs) to decrease some uncertainties in radiotherapy planning. The use of AP/PA pelvic radiation techniques with Cobalt-60 should be limited in body thicknesses equal to or less than 18 cm. When using conformal techniques, delineation should be applied in the small bowel, as it is considered a critical organ according to RTOG

  9. Dose escalation using conformal high-dose-rate brachytherapy improves outcome in unfavorable prostate cancer.

    Science.gov (United States)

    Martinez, Alvaro A; Gustafson, Gary; Gonzalez, José; Armour, Elwood; Mitchell, Chris; Edmundson, Gregory; Spencer, William; Stromberg, Jannifer; Huang, Raywin; Vicini, Frank

    2002-06-01

    To overcome radioresistance for patients with unfavorable prostate cancer, a prospective trial of pelvic external beam irradiation (EBRT) interdigitated with dose-escalating conformal high-dose-rate (HDR) prostate brachytherapy was performed. Between November 1991 and August 2000, 207 patients were treated with 46 Gy pelvic EBRT and increasing HDR brachytherapy boost doses (5.50-11.5 Gy/fraction) during 5 weeks. The eligibility criteria were pretreatment prostate-specific antigen level >or=10.0 ng/mL, Gleason score >or=7, or clinical Stage T2b or higher. Patients were divided into 2 dose levels, low-dose biologically effective dose 93 Gy (149 patients). No patient received hormones. We used the American Society for Therapeutic Radiology and Oncology definition for biochemical failure. The median age was 69 years. The mean follow-up for the group was 4.4 years, and for the low and high-dose levels, it was 7.0 and 3.4 years, respectively. The actuarial 5-year biochemical control rate was 74%, and the overall, cause-specific, and disease-free survival rate was 92%, 98%, and 68%, respectively. The 5-year biochemical control rate for the low-dose group was 52%; the rate for the high-dose group was 87% (p failure. The Radiation Therapy Oncology Group Grade 3 gastrointestinal/genitourinary complications ranged from 0.5% to 9%. The actuarial 5-year impotency rate was 51%. Pelvic EBRT interdigitated with transrectal ultrasound-guided real-time conformal HDR prostate brachytherapy boost is both a precise dose delivery system and a very effective treatment for unfavorable prostate cancer. We demonstrated an incremental beneficial effect on biochemical control and cause-specific survival with higher doses. These results, coupled with the low risk of complications, the advantage of not being radioactive after implantation, and the real-time interactive planning, define a new standard for treatment.

  10. Assessment of external dose indoors in Lithuania

    International Nuclear Information System (INIS)

    Pilkyte, L.; Butkus, D.; Morkunas, G.

    2006-01-01

    The aim of this paper was an assessment of external exposure indoors and its dependence on construction materials and indoor radon concentrations in Lithuanian living houses. Relationship of absorbed dose rate in air indoors and activity indexes of the most commonly used construction materials (wood, concrete and bricks) have been studied using results received in measurements done in >4700 rooms in 1995-2005. Possible connections of dose rate indoors with indoor radon concentrations are also discussed. Findings of this study helped to make an assessment of the mean value of effective dose of Lithuanian population due to external exposure indoors which is equal to 0.58 mSv y -1 . The received data might also be used in improvement of quality of personal dosimetric measurements done in premises constructed of different construction materials. (authors)

  11. Development and Commissioning of an External Beam Facility in the Union College Ion Beam Analysis Laboratory

    Science.gov (United States)

    Yoskowitz, Joshua; Clark, Morgan; Labrake, Scott; Vineyard, Michael

    2015-10-01

    We have developed an external beam facility for the 1.1-MV tandem Pelletron accelerator in the Union College Ion Beam Analysis Laboratory. The beam is extracted from an aluminum pipe through a 1 / 4 ' ' diameter window with a 7.5- μm thick Kapton foil. This external beam facility allows us to perform ion beam analysis on samples that cannot be put under vacuum, including wet samples and samples too large to fit into the scattering chamber. We have commissioned the new facility by performing proton induced X-ray emission (PIXE) analysis of several samples of environmental interest. These include samples of artificial turf, running tracks, and a human tooth with an amalgam filling. A 1.7-MeV external proton beam was incident on the samples positioned 2 cm from the window. The resulting X-rays were measured using a silicon drift detector and were analyzed using GUPIX software to determine the concentrations of elements in the samples. The results on the human tooth indicate that while significant concentrations of Hg, Ag, and Sn are present in the amalgam filling, only trace amounts of Hg appear to have leached into the tooth. The artificial turf and running tracks show rather large concentrations of a broad range of elements and trace amounts of Pb in the turf infill.

  12. Cobalt-60 Machines and Medical Linear Accelerators: Competing Technologies for External Beam Radiotherapy.

    Science.gov (United States)

    Healy, B J; van der Merwe, D; Christaki, K E; Meghzifene, A

    2017-02-01

    Medical linear accelerators (linacs) and cobalt-60 machines are both mature technologies for external beam radiotherapy. A comparison is made between these two technologies in terms of infrastructure and maintenance, dosimetry, shielding requirements, staffing, costs, security, patient throughput and clinical use. Infrastructure and maintenance are more demanding for linacs due to the complex electric componentry. In dosimetry, a higher beam energy, modulated dose rate and smaller focal spot size mean that it is easier to create an optimised treatment with a linac for conformal dose coverage of the tumour while sparing healthy organs at risk. In shielding, the requirements for a concrete bunker are similar for cobalt-60 machines and linacs but extra shielding and protection from neutrons are required for linacs. Staffing levels can be higher for linacs and more staff training is required for linacs. Life cycle costs are higher for linacs, especially multi-energy linacs. Security is more complex for cobalt-60 machines because of the high activity radioactive source. Patient throughput can be affected by source decay for cobalt-60 machines but poor maintenance and breakdowns can severely affect patient throughput for linacs. In clinical use, more complex treatment techniques are easier to achieve with linacs, and the availability of electron beams on high-energy linacs can be useful for certain treatments. In summary, there is no simple answer to the question of the choice of either cobalt-60 machines or linacs for radiotherapy in low- and middle-income countries. In fact a radiotherapy department with a combination of technologies, including orthovoltage X-ray units, may be an option. Local needs, conditions and resources will have to be factored into any decision on technology taking into account the characteristics of both forms of teletherapy, with the primary goal being the sustainability of the radiotherapy service over the useful lifetime of the equipment

  13. Dose measurement, its distribution and individual external dose assessments of inhabitants in the high background radiation areas in China

    International Nuclear Information System (INIS)

    Morishima, Hiroshige; Koga, Taeko; Tatsumi, Kusuo; Nakai, Sayaka; Sugahara, Tsutomu; Yuan Yongling; Wei Luxin

    2000-01-01

    As a part of the China-Japan cooperative research on natural radiation epidemiology, we have carried out a dose-assessment study to evaluate the external exposure to natural radiation in the high background radiation areas (HBRA) of Yangjiang in Guangdong province and in the control areas (CA) of Enping prefecture since 1991. Because of the difficulties in measuring the individual doses of all inhabitants directly by personal dosimeters, an indirect method was applied in which the exposed individual doses were estimated from the environmental radiation doses measured by survey meters and the occupancy factors of each hamlet. We analyzed the dose in the hamlets and the variation in the occupancy factors to obtain the parameters of dose estimation on the inhabitants in selected hamlets; Madi and several hamlets of different dose levels in HBRA and Hampizai hamlet in CA. With these parameters, we estimated individual dose rates and compared them with those obtained from direct measurement using dosimeters carried by selected individuals. The results obtained are as follows. The environmental radiation doses are influenced by the natural radioactive nuclide concentrations in building materials, the age of the building and the arrangement of the houses in a hamlet. There existed a fairly large and heterogeneous distribution of indoor and outdoor environmental radiations. The indoor radiation doses were due to exposure from the natural radioactive nuclides in the building materials and were about two times as large as the outdoor radiation doses. The difference between indoor and outdoor doses was not observed in CA. The occupancy factor was influenced by the age of individuals and by the season of the year. The occupancy factor was higher for infants and aged individuals than for other age groups. This lead to higher dose rates of exposure to those age groups. A good correlation was observed between the dose assessed indirectly and that measured directly and the

  14. Dose measurement, its distribution and individual external dose assessments of inhabitants in the high background radiation areas in China

    Energy Technology Data Exchange (ETDEWEB)

    Morishima, Hiroshige; Koga, Taeko [Kinki Univ., Higashi-Osaka, Osaka (Japan). Atomic Energy Research Inst.; Tatsumi, Kusuo; Nakai, Sayaka; Sugahara, Tsutomu; Yuan Yongling; Wei Luxin

    2000-10-01

    As a part of the China-Japan cooperative research on natural radiation epidemiology, we have carried out a dose-assessment study to evaluate the external exposure to natural radiation in the high background radiation areas (HBRA) of Yangjiang in Guangdong province and in the control areas (CA) of Enping prefecture since 1991. Because of the difficulties in measuring the individual doses of all inhabitants directly by personal dosimeters, an indirect method was applied in which the exposed individual doses were estimated from the environmental radiation doses measured by survey meters and the occupancy factors of each hamlet. We analyzed the dose in the hamlets and the variation in the occupancy factors to obtain the parameters of dose estimation on the inhabitants in selected hamlets; Madi and several hamlets of different dose levels in HBRA and Hampizai hamlet in CA. With these parameters, we estimated individual dose rates and compared them with those obtained from direct measurement using dosimeters carried by selected individuals. The results obtained are as follows. The environmental radiation doses are influenced by the natural radioactive nuclide concentrations in building materials, the age of the building and the arrangement of the houses in a hamlet. There existed a fairly large and heterogeneous distribution of indoor and outdoor environmental radiations. The indoor radiation doses were due to exposure from the natural radioactive nuclides in the building materials and were about two times as large as the outdoor radiation doses. The difference between indoor and outdoor doses was not observed in CA. The occupancy factor was influenced by the age of individuals and by the season of the year. The occupancy factor was higher for infants and aged individuals than for other age groups. This lead to higher dose rates of exposure to those age groups. A good correlation was observed between the dose assessed indirectly and that measured directly and the

  15. Monte Carlo dose calculation improvements for low energy electron beams using eMC

    International Nuclear Information System (INIS)

    Fix, Michael K; Frei, Daniel; Volken, Werner; Born, Ernst J; Manser, Peter; Neuenschwander, Hans

    2010-01-01

    The electron Monte Carlo (eMC) dose calculation algorithm in Eclipse (Varian Medical Systems) is based on the macro MC method and is able to predict dose distributions for high energy electron beams with high accuracy. However, there are limitations for low energy electron beams. This work aims to improve the accuracy of the dose calculation using eMC for 4 and 6 MeV electron beams of Varian linear accelerators. Improvements implemented into the eMC include (1) improved determination of the initial electron energy spectrum by increased resolution of mono-energetic depth dose curves used during beam configuration; (2) inclusion of all the scrapers of the applicator in the beam model; (3) reduction of the maximum size of the sphere to be selected within the macro MC transport when the energy of the incident electron is below certain thresholds. The impact of these changes in eMC is investigated by comparing calculated dose distributions for 4 and 6 MeV electron beams at source to surface distance (SSD) of 100 and 110 cm with applicators ranging from 6 x 6 to 25 x 25 cm 2 of a Varian Clinac 2300C/D with the corresponding measurements. Dose differences between calculated and measured absolute depth dose curves are reduced from 6% to less than 1.5% for both energies and all applicators considered at SSD of 100 cm. Using the original eMC implementation, absolute dose profiles at depths of 1 cm, d max and R50 in water lead to dose differences of up to 8% for applicators larger than 15 x 15 cm 2 at SSD 100 cm. Those differences are now reduced to less than 2% for all dose profiles investigated when the improved version of eMC is used. At SSD of 110 cm the dose difference for the original eMC version is even more pronounced and can be larger than 10%. Those differences are reduced to within 2% or 2 mm with the improved version of eMC. In this work several enhancements were made in the eMC algorithm leading to significant improvements in the accuracy of the dose calculation

  16. Monte Carlo dose calculation improvements for low energy electron beams using eMC.

    Science.gov (United States)

    Fix, Michael K; Frei, Daniel; Volken, Werner; Neuenschwander, Hans; Born, Ernst J; Manser, Peter

    2010-08-21

    The electron Monte Carlo (eMC) dose calculation algorithm in Eclipse (Varian Medical Systems) is based on the macro MC method and is able to predict dose distributions for high energy electron beams with high accuracy. However, there are limitations for low energy electron beams. This work aims to improve the accuracy of the dose calculation using eMC for 4 and 6 MeV electron beams of Varian linear accelerators. Improvements implemented into the eMC include (1) improved determination of the initial electron energy spectrum by increased resolution of mono-energetic depth dose curves used during beam configuration; (2) inclusion of all the scrapers of the applicator in the beam model; (3) reduction of the maximum size of the sphere to be selected within the macro MC transport when the energy of the incident electron is below certain thresholds. The impact of these changes in eMC is investigated by comparing calculated dose distributions for 4 and 6 MeV electron beams at source to surface distance (SSD) of 100 and 110 cm with applicators ranging from 6 x 6 to 25 x 25 cm(2) of a Varian Clinac 2300C/D with the corresponding measurements. Dose differences between calculated and measured absolute depth dose curves are reduced from 6% to less than 1.5% for both energies and all applicators considered at SSD of 100 cm. Using the original eMC implementation, absolute dose profiles at depths of 1 cm, d(max) and R50 in water lead to dose differences of up to 8% for applicators larger than 15 x 15 cm(2) at SSD 100 cm. Those differences are now reduced to less than 2% for all dose profiles investigated when the improved version of eMC is used. At SSD of 110 cm the dose difference for the original eMC version is even more pronounced and can be larger than 10%. Those differences are reduced to within 2% or 2 mm with the improved version of eMC. In this work several enhancements were made in the eMC algorithm leading to significant improvements in the accuracy of the dose

  17. Perspectives in absorbed dose metrology with regard to the technical evolutions of external beam radiotherapy; Perspectives en metrologie de la dose face aux evolutions techniques de la radiotherapie externe

    Energy Technology Data Exchange (ETDEWEB)

    Chauvenet, B.; Bordy, J.M. [CEA Saclay, Lab. National Henri Becquerel (LNE-LNHB), 91 - Gif-sur-Yvette (France); Barthe, J. [CEA Saclay (LIST), 91 - Gif-sur-Yvette (France)

    2009-07-01

    This paper presents several R and D axes in absorbed close metrology to meet the needs resulting from the technical evolutions of external beam radiotherapy. The facilities in operation in France have considerably evolved under the impulse of the plan Cancer launched in 2003: replacements and increase of the number of accelerators, substitution of accelerators for telecobalt almost completed and acquisition of innovative facilities for tomo-therapy and stereotaxy. The increasing versatility of facilities makes possible the rapid evolution of treatment modalities, allowing to better delimit irradiation to tumoral tissues and spare surrounding healthy tissues and organs at risk. This leads to a better treatment efficacy through dose escalation. National metrology laboratories must offer responses adapted to the new need, i.e. not restrict themselves to the establishment of references under conventional conditions defined at international level, contribute to the improvement of uncertainties at all levels of reference transfer to practitioners: primary measurements under conditions as close as possible to those of treatment, characterization of transfer and treatment control dosimeters., metrological validation of treatment planning tools... Those axes have been identified as priorities for the next years in ionizing radiation metrology at the European level and included in the European. Metrology Research Programme. A project dealing with some of those topics has been selected in the frame of the Eranet+ Call EMRP 2007 and is now starting. The LNE-LAM is strongly engaged in it. (authors)

  18. Complete response in a patient with gynecological hidradenocarcinoma treated with exclusive external beam radiotherapy and brachytherapy: a case report.

    Science.gov (United States)

    Giannelli, Flavio; Chiola, Ilaria; Belgioia, Liliana; Garelli, Stefania; Pastorino, Alice; Marcenaro, Michela; Mammoliti, Serafina; Costantini, Sergio; Bizzarri, Nicolò; Vellone, Valerio; Barra, Salvina; Corvò, Renzo

    2017-12-01

    Hidradenocarcinoma (HC) is a very rare disease. This case report illustrates a successful treatment of a 60-year-old woman with vulvo-vaginal localization of hidradenocarcinoma treated with external beam radiotherapy delivered by helical tomotherapy with a simultaneous integrated boost (SIB), followed by brachytherapy. External beam radiotherapy dose prescription was 50.4 Gy in 28 fractions, five fractions per week to whole pelvis (planning target volume 1 - PTV1), 60.2 Gy in 28 fractions to SIB1 (fundus of uterus and right inguinal node), and 58.8 Gy in 28 fractions to SIB2 (lower/middle third of vagina, paraurethral region and right inguinal lymph nodes). Brachytherapy dose prescription was 28 Gy in 4 fractions for cervix, fundus of uterus and upper third of vagina (HR-CTV1), and 22 Gy in 4 fractions to middle third of vagina and paraurethral region (HR-CTV2). D 90 for whole treatment was 91.9 Gy and 86.0 Gy for HR-CTV1 and HR-CTV2, respectively. Patient remained 12-months disease-free without treatment related side effects.

  19. Complete response in a patient with gynecological hidradenocarcinoma treated with exclusive external beam radiotherapy and brachytherapy: a case report

    Directory of Open Access Journals (Sweden)

    Flavio Giannelli

    2017-12-01

    Full Text Available Hidradenocarcinoma (HC is a very rare disease. This case report illustrates a successful treatment of a 60-year-old woman with vulvo-vaginal localization of hidradenocarcinoma treated with external beam radiotherapy delivered by helical tomotherapy with a simultaneous integrated boost (SIB, followed by brachytherapy. External beam radiotherapy dose prescription was 50.4 Gy in 28 fractions, five fractions per week to whole pelvis (planning target volume 1 – PTV1, 60.2 Gy in 28 fractions to SIB1 (fundus of uterus and right inguinal node, and 58.8 Gy in 28 fractions to SIB2 (lower/middle third of vagina, paraurethral region and right inguinal lymph nodes. Brachytherapy dose prescription was 28 Gy in 4 fractions for cervix, fundus of uterus and upper third of vagina (HR-CTV1, and 22 Gy in 4 fractions to middle third of vagina and paraurethral region (HR-CTV2. D90 for whole treatment was 91.9 Gy and 86.0 Gy for HR-CTV1 and HR-CTV2, respectively. Patient remained 12-months disease-free without treatment related side effects.

  20. An on-site dosimetry audit for high-energy electron beams

    Directory of Open Access Journals (Sweden)

    Leon de Prez

    2018-01-01

    Full Text Available Background and purpose: External dosimetry audits are powerful quality assurance instruments for radiotherapy. The aim of this study was to implement an electron dosimetry audit based on a contemporary code of practice within the requirements for calibration laboratories performing proficiency tests. This involved the determination of suitable acceptance criteria based on thorough uncertainty analyses. Materials and methods: Subject of the audit was the determination of absorbed dose to water, Dw, and the beam quality specifier, R50,dos. Fifteen electron beams were measured in four institutes according to the Belgian-Dutch code of practice for high-energy electron beams. The expanded uncertainty (k = 2 for the Dw values was 3.6% for a Roos chamber calibrated in 60Co and 3.2% for a Roos chamber cross-calibrated against a Farmer chamber. The expanded uncertainty for the beam quality specifier, R50,dos, was 0.14 cm. The audit acceptance levels were based on the expanded uncertainties for the comparison results and estimated to be 2.4%. Results: The audit was implemented and validated successfully. All Dw audit results were satisfactory with differences in Dw values mostly smaller than 0.5% and always smaller than 1%. Except for one, differences in R50,dos were smaller than 0.2 cm and always smaller than 0.3 cm. Conclusions: An electron dosimetry audit based on absorbed dose to water and present-day requirements for calibration laboratories performing proficiency tests was successfully implemented. It proved international traceability of the participants value with an uncertainty better than 3.6% (k = 2. Keywords: Absorbed dose to water, Audit, Code of practice, Dosimetry, Electron beam, Radiation therapy

  1. SU-E-T-577: Commissioning of a Deterministic Algorithm for External Photon Beams

    International Nuclear Information System (INIS)

    Zhu, T; Finlay, J; Mesina, C; Liu, H

    2014-01-01

    Purpose: We report commissioning results for a deterministic algorithm for external photon beam treatment planning. A deterministic algorithm solves the radiation transport equations directly using a finite difference method, thus improve the accuracy of dose calculation, particularly under heterogeneous conditions with results similar to that of Monte Carlo (MC) simulation. Methods: Commissioning data for photon energies 6 – 15 MV includes the percentage depth dose (PDD) measured at SSD = 90 cm and output ratio in water (Spc), both normalized to 10 cm depth, for field sizes between 2 and 40 cm and depths between 0 and 40 cm. Off-axis ratio (OAR) for the same set of field sizes was used at 5 depths (dmax, 5, 10, 20, 30 cm). The final model was compared with the commissioning data as well as additional benchmark data. The benchmark data includes dose per MU determined for 17 points for SSD between 80 and 110 cm, depth between 5 and 20 cm, and lateral offset of up to 16.5 cm. Relative comparisons were made in a heterogeneous phantom made of cork and solid water. Results: Compared to the commissioning beam data, the agreement are generally better than 2% with large errors (up to 13%) observed in the buildup regions of the FDD and penumbra regions of the OAR profiles. The overall mean standard deviation is 0.04% when all data are taken into account. Compared to the benchmark data, the agreements are generally better than 2%. Relative comparison in heterogeneous phantom is in general better than 4%. Conclusion: A commercial deterministic algorithm was commissioned for megavoltage photon beams. In a homogeneous medium, the agreement between the algorithm and measurement at the benchmark points is generally better than 2%. The dose accuracy for a deterministic algorithm is better than a convolution algorithm in heterogeneous medium

  2. Dose calculations algorithm for narrow heavy charged-particle beams

    Energy Technology Data Exchange (ETDEWEB)

    Barna, E A; Kappas, C [Department of Medical Physics, School of Medicine, University of Patras (Greece); Scarlat, F [National Institute for Laser and Plasma Physics, Bucharest (Romania)

    1999-12-31

    The dose distributional advantages of the heavy charged-particles can be fully exploited by using very efficient and accurate dose calculation algorithms, which can generate optimal three-dimensional scanning patterns. An inverse therapy planning algorithm for dynamically scanned, narrow heavy charged-particle beams is presented in this paper. The irradiation `start point` is defined at the distal end of the target volume, right-down, in a beam`s eye view. The peak-dose of the first elementary beam is set to be equal to the prescribed dose in the target volume, and is defined as the reference dose. The weighting factor of any Bragg-peak is determined by the residual dose at the point of irradiation, calculated as the difference between the reference dose and the cumulative dose delivered at that point of irradiation by all the previous Bragg-peaks. The final pattern consists of the weighted Bragg-peaks irradiation density. Dose distributions were computed using two different scanning steps equal to 0.5 mm, and 1 mm respectively. Very accurate and precise localized dose distributions, conform to the target volume, were obtained. (authors) 6 refs., 3 figs.

  3. Dose distribution of chest wall electron beam radiotherapy for patients with breast cancer after radical mastectomy

    International Nuclear Information System (INIS)

    Cong Yetong; Chen Dawei; Bai Lan; Zhou Yinhang; Piao Yongfeng; Wang Xi; Qu Yaqin

    2006-01-01

    Objective: To study the dose distribution of different bolus after different energy electron beam irradiation to different chest wall radiotherapy for the patients with breast cancer. Methods: The paper simulated the dose distribution of women's left breast cancer after radical mastectomy by 6 and 9 MeV electron beam irradiation, and TLD was used to measure. Results: The dose of skin became higher and the dose of lung was less when 0.5 and 1.0 cm bolus were used on the body; with the increasing of the energy of electron beam, the high dose field became larger; and with the same energy of electron beam, the high dose field moved to surface of the body when the bolus was thicker. Conclusion: When different energy electron ray irradiates different thickness bolus, the dosage of skin surface increases and the dosage of anterior margin of lung reduces. With electron ray energy increasing, the high dosage field is widen, when the electron ray energy is identity, the high dosage field migrates to the surface after adding bolus. Using certain depth bolus may attain the therapeutical dose of target area. (authors)

  4. Transperineal high-dose-rate interstitial radiation therapy in the management of gynecologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Itami, Jun; Hara, Ryuseke; Kozuka, Takuyou; Yamashita, Hideomi; Nakajima, Kaori; Shibata, Kouji; Abe, Yoshihisa; Fuse, Masashi; Ito, Masashi [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy and Oncology

    2003-11-01

    Background: High-dose-rate interstitial radiation therapy is a newly introduced modality, and its role in the management of gynecologic malignancies remains to be studied. Clinical experience in high-dose-rate interstitial radiation therapy was retrospectively investigated. Patients and Methods: Eight patients with primary and nine with recurrent gynecologic malignancies underwent high-dose-rate interstitial radiation therapy with/without external-beam irradiation. Fractional dose of the high-dose-rate interstitial radiation therapy ranged between 4 and 6 Gy with total doses of 15-54 Gy. Interstitial irradiation was performed twice daily with an interval of > 6 h. Results: 2-year local control rate was 75% for primary treatment and 47% for treatment of recurrence (p = 0.46). Maximum tumor size had a statistically significant impact on local control (p < 0.002). Grade 2 and 4 late complications were seen in five patients, and the incidence was significantly higher in patients with a larger volume enclosed by the prescribed fractional dose of high-dose-rate interstitial radiation therapy. The incidence of grade 2 and 4 complications at 18 months was 78% and 0% with a volume > 100 cm{sup 3} and {<=} 100 cm{sup 3}, respectively (p < 0.04). Conclusion: Although high-dose-rate interstitial radiation therapy is a promising modality, it must be applied cautiously to patients with bulky tumors because of the high incidence of serious complications. (orig.)

  5. Levels of external natural radiation and doses to population in Heilongjiang province

    International Nuclear Information System (INIS)

    Liang Yicheng; He Yongjiang; Wang Lu

    1985-01-01

    The external natural radiation level in Heilongjiang Province was measured by using China-made FD-71 scintillation radiometers and RSS-111 high pressure ionization chambers. The doses of external radiation to population were also calculated. The population-weighted average value of the absorbed dose rate from terrestrial γ-radiation was 7.2 x 10 -8 Gy.h -1 for outdoors, and 10.8 x 10 -8 Gy.h -1 for indoors. The population-weighted average absorbed dose rate in air from cosmic rays was 3.3 x 10 -8 Gy.h -1 . The annual population-weighted average effective dose equivalent and the annual collective effective dose equivalent from the environmental γ-radiation were 620 μSv and 20.1 x 10 3 man.Sv, respectively. The corresponding figures from cosmic rays were 260 μSv and 8.7 x 10 3 man.Sv, respectively

  6. Effective dose equivalents from external radiation due to Chernobyl accident

    International Nuclear Information System (INIS)

    Erkin, V.G.; Debedev, O.V.; Balonov, M.I.; Parkhomenko, V.I.

    1992-01-01

    Summarized data on measurements of individual dose of external γ-sources in 1987-1990 of population of western areas of Bryansk region were presented. Type of distribution of effective dose equivalent, its significance for various professional and social groups of population depending on the type of the house was discussed. Dependences connecting surface soil activity in the populated locality with average dose of external radiation sources were presented. Tendency of dose variation in 1987-1990 was shown

  7. Cancer radiotherapy based on femtosecond IR laser-beam filamentation yielding ultra-high dose rates and zero entrance dose.

    Science.gov (United States)

    Meesat, Ridthee; Belmouaddine, Hakim; Allard, Jean-François; Tanguay-Renaud, Catherine; Lemay, Rosalie; Brastaviceanu, Tiberius; Tremblay, Luc; Paquette, Benoit; Wagner, J Richard; Jay-Gerin, Jean-Paul; Lepage, Martin; Huels, Michael A; Houde, Daniel

    2012-09-18

    Since the invention of cancer radiotherapy, its primary goal has been to maximize lethal radiation doses to the tumor volume while keeping the dose to surrounding healthy tissues at zero. Sadly, conventional radiation sources (γ or X rays, electrons) used for decades, including multiple or modulated beams, inevitably deposit the majority of their dose in front or behind the tumor, thus damaging healthy tissue and causing secondary cancers years after treatment. Even the most recent pioneering advances in costly proton or carbon ion therapies can not completely avoid dose buildup in front of the tumor volume. Here we show that this ultimate goal of radiotherapy is yet within our reach: Using intense ultra-short infrared laser pulses we can now deposit a very large energy dose at unprecedented microscopic dose rates (up to 10(11) Gy/s) deep inside an adjustable, well-controlled macroscopic volume, without any dose deposit in front or behind the target volume. Our infrared laser pulses produce high density avalanches of low energy electrons via laser filamentation, a phenomenon that results in a spatial energy density and temporal dose rate that both exceed by orders of magnitude any values previously reported even for the most intense clinical radiotherapy systems. Moreover, we show that (i) the type of final damage and its mechanisms in aqueous media, at the molecular and biomolecular level, is comparable to that of conventional ionizing radiation, and (ii) at the tumor tissue level in an animal cancer model, the laser irradiation method shows clear therapeutic benefits.

  8. External-beam PIXE analysis of small sculptures

    International Nuclear Information System (INIS)

    Gyodi, I.; Demeter, I.; Hollos-Nagy, K.; Kovacs, I.; Szokefalvi-Nagy, Z.

    1999-01-01

    Non-destructive analysis of precious art objects is an important tool to solve provenance problems or to facilitate restoration. External beam PIXE analysis is one of the most powerful and popular methods used in this respect. The paper summarises the external beam PIXE set-up at the Accelerator Laboratory in Budapest, and two selected applications are described. Different parts of a small Cambodian metal sculpture probably made in the 11th century were analysed. It was observed that the sculpture was composed of an iron core and an outer bronze shell. This sculptural technique was well known in the Middle-East but no indication has been found about its use in the Far-East, yet. Before its restoration paint traces on a wooden relief of St. Jerome made by an unknown artist in about 1600 were analysed. Different white and red paints were distinguished at selected points and the presence of titanium on a certain part of the relief was attributed to a repainting in modern times

  9. The assessment of personal dose due to external radiation

    International Nuclear Information System (INIS)

    Boas, J.F.; Young, J.G.

    1990-01-01

    The fundamental basis of thermoluminescent dosimetry (TLD) is discussed and a number of considerations in the measurement of thermoluminescence described, with particular reference to CaSO 4 :Dy. The steps taken to convert a thermoluminescence measurement to an exposure and then an absorbed dose are outlined. The calculation of effective dose equivalents due to external exposure to γ-radiation in a number of situations commonly encountered in a uranium mine is discussed. Factors which may affect the accuracy of external dose assessments are described

  10. SU-E-T-381: Evaluation of Calculated Dose Accuracy for Organs-At-Risk Located at Out-Of-Field in a Commercial Treatment Planning System for High Energy Photon Beams Produced From TrueBeam Accelerators

    International Nuclear Information System (INIS)

    Wang, L; Ding, G

    2015-01-01

    Purpose: Dose calculation accuracy for the out-of-field dose is important for predicting the dose to the organs-at-risk when they are located outside primary beams. The investigations on evaluating the calculation accuracy of treatment planning systems (TPS) on out-of-field dose in existing publications have focused on low energy (6MV) photon. This study evaluates out-of-field dose calculation accuracy of AAA algorithm for 15MV high energy photon beams. Methods: We used the EGSnrc Monte Carlo (MC) codes to evaluate the AAA algorithm in Varian Eclipse TPS (v.11). The incident beams start with validated Varian phase-space sources for a TrueBeam linac equipped with Millennium 120 MLC. Dose comparisons between using AAA and MC for CT based realistic patient treatment plans using VMAT techniques for prostate and lung were performed and uncertainties of organ dose predicted by AAA at out-of-field location were evaluated. Results: The results show that AAA calculations under-estimate doses at the dose level of 1% (or less) of prescribed dose for CT based patient treatment plans using VMAT techniques. In regions where dose is only 1% of prescribed dose, although AAA under-estimates the out-of-field dose by 30% relative to the local dose, it is only about 0.3% of prescribed dose. For example, the uncertainties of calculated organ dose to liver or kidney that is located out-of-field is <0.3% of prescribed dose. Conclusion: For 15MV high energy photon beams, very good agreements (<1%) in calculating dose distributions were obtained between AAA and MC. The uncertainty of out-of-field dose calculations predicted by the AAA algorithm for realistic patient VMAT plans is <0.3% of prescribed dose in regions where the dose relative to the prescribed dose is <1%, although the uncertainties can be much larger relative to local doses. For organs-at-risk located at out-of-field, the error of dose predicted by Eclipse using AAA is negligible. This work was conducted in part using the

  11. Prostate Specific Antigen (PSA) as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT) in Combination with Additional External Beam Radiation Therapy (EBRT) for High Risk Prostate Cancer.

    Science.gov (United States)

    Ecke, Thorsten H; Huang-Tiel, Hui-Juan; Golka, Klaus; Selinski, Silvia; Geis, Berit Christine; Koswig, Stephan; Bathe, Katrin; Hallmann, Steffen; Gerullis, Holger

    2016-11-10

    High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA) value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index), Gleason score, D'Amico risk classification for PCa, digital rectal examination (DRE), PSA value after one/three/five year(s) follow-up (FU), time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis ( p = 0.009), PSA on date of first HDR-BT ( p = 0.033), and PSA on date of first follow-up after one year ( p = 0.025) have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

  12. Out‐of‐field doses and neutron dose equivalents for electron beams from modern Varian and Elekta linear accelerators

    Science.gov (United States)

    Cardenas, Carlos E.; Nitsch, Paige L.; Kudchadker, Rajat J.; Howell, Rebecca M.

    2016-01-01

    Out‐of‐field doses from radiotherapy can cause harmful side effects or eventually lead to secondary cancers. Scattered doses outside the applicator field, neutron source strength values, and neutron dose equivalents have not been broadly investigated for high‐energy electron beams. To better understand the extent of these exposures, we measured out‐of‐field dose characteristics of electron applicators for high‐energy electron beams on two Varian 21iXs, a Varian TrueBeam, and an Elekta Versa HD operating at various energy levels. Out‐of‐field dose profiles and percent depth‐dose curves were measured in a Wellhofer water phantom using a Farmer ion chamber. Neutron dose was assessed using a combination of moderator buckets and gold activation foils placed on the treatment couch at various locations in the patient plane on both the Varian 21iX and Elekta Versa HD linear accelerators. Our findings showed that out‐of‐field electron doses were highest for the highest electron energies. These doses typically decreased with increasing distance from the field edge but showed substantial increases over some distance ranges. The Elekta linear accelerator had higher electron out‐of‐field doses than the Varian units examined, and the Elekta dose profiles exhibited a second dose peak about 20 to 30 cm from central‐axis, which was found to be higher than typical out‐of‐field doses from photon beams. Electron doses decreased sharply with depth before becoming nearly constant; the dose was found to decrease to a depth of approximately E(MeV)/4 in cm. With respect to neutron dosimetry, Q values and neutron dose equivalents increased with electron beam energy. Neutron contamination from electron beams was found to be much lower than that from photon beams. Even though the neutron dose equivalent for electron beams represented a small portion of neutron doses observed under photon beams, neutron doses from electron beams may need to be considered for

  13. External dose estimates for future Bikini Atoll inhabitants

    International Nuclear Information System (INIS)

    Gudiksen, P.H.; Crites, T.R.; Robison, W.L.

    1976-01-01

    To evaluate the potential radiation doses that may be received by the returning Bikinians, we surveyed the residual radioactivity on Bikini and Eneu Islands in June of 1975. An integral part of the survey included measurements of gamma-ray exposure rates which are used to estimate external gamma-ray doses. The survey showed that on Bikini Island the rates are highly variable: values near the shores are generally of the order of 10 to 20 μR/h, while those within the interior average about 40 μR/h with a range of roughly 30 to 100 μR/h. Eneu Island, however, is characterized by more or less uniformly distributed gamma radiation levels of less than 10 μR/h over the entire island. These data, in conjunction with population statistics and expected life styles, allowed us to estimate the potential external gamma-ray doses associated with proposed housing locations along the lagoon road and within the interior portions of Bikini Island as well as along the lagoon side of Eneu Island. As expected, living on Eneu Island results in the lowest doses: 0.12 rem during the first year and 2.9 rem during 30 years. The highest values, 0.28 rem during the first year and 5.9 rem over 30 years, may potentially be received by inhabitants living within the interior of Bikini Island. Other options under consideration produce intermediate values

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

    International Nuclear Information System (INIS)

    2007-06-01

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

  15. Comparison study of in vivo dose response to laser-driven versus conventional electron beam.

    Science.gov (United States)

    Oppelt, Melanie; Baumann, Michael; Bergmann, Ralf; Beyreuther, Elke; Brüchner, Kerstin; Hartmann, Josefin; Karsch, Leonhard; Krause, Mechthild; Laschinsky, Lydia; Leßmann, Elisabeth; Nicolai, Maria; Reuter, Maria; Richter, Christian; Sävert, Alexander; Schnell, Michael; Schürer, Michael; Woithe, Julia; Kaluza, Malte; Pawelke, Jörg

    2015-05-01

    The long-term goal to integrate laser-based particle accelerators into radiotherapy clinics not only requires technological development of high-intensity lasers and new techniques for beam detection and dose delivery, but also characterization of the biological consequences of this new particle beam quality, i.e. ultra-short, ultra-intense pulses. In the present work, we describe successful in vivo experiments with laser-driven electron pulses by utilization of a small tumour model on the mouse ear for the human squamous cell carcinoma model FaDu. The already established in vitro irradiation technology at the laser system JETI was further enhanced for 3D tumour irradiation in vivo in terms of beam transport, beam monitoring, dose delivery and dosimetry in order to precisely apply a prescribed dose to each tumour in full-scale radiobiological experiments. Tumour growth delay was determined after irradiation with doses of 3 and 6 Gy by laser-accelerated electrons. Reference irradiation was performed with continuous electron beams at a clinical linear accelerator in order to both validate the dedicated dosimetry employed for laser-accelerated JETI electrons and above all review the biological results. No significant difference in radiation-induced tumour growth delay was revealed for the two investigated electron beams. These data provide evidence that the ultra-high dose rate generated by laser acceleration does not impact the biological effectiveness of the particles.

  16. Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy (the ASCENDE-RT Trial): An Analysis of Survival Endpoints for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost to a Dose-Escalated External Beam Boost for High- and Intermediate-risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Morris, W. James, E-mail: jmorris@bccancer.bc.ca [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Tyldesley, Scott [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Rodda, Sree [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Halperin, Ross [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency–Centre for the Southern Interior, Vancouver, British Columbia (Canada); Pai, Howard [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency–Vancouver Island Centre, Vancouver, British Columbia (Canada); McKenzie, Michael; Duncan, Graeme [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Morton, Gerard [Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Hamm, Jeremy [Department of Population Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Murray, Nevin [BC Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Department of Medicine, University of British Columbia, Vancouver, British Columbia (Canada)

    2017-06-01

    Purpose: To report the primary endpoint of biochemical progression-free survival (b-PFS) and secondary survival endpoints from ASCENDE-RT, a randomized trial comparing 2 methods of dose escalation for intermediate- and high-risk prostate cancer. Methods and Materials: ASCENDE-RT enrolled 398 men, with a median age of 68 years; 69% (n=276) had high-risk disease. After stratification by risk group, the subjects were randomized to a standard arm with 12 months of androgen deprivation therapy, pelvic irradiation to 46 Gy, followed by a dose-escalated external beam radiation therapy (DE-EBRT) boost to 78 Gy, or an experimental arm that substituted a low-dose-rate prostate brachytherapy (LDR-PB) boost. Of the 398 trial subjects, 200 were assigned to DE-EBRT boost and 198 to LDR-PB boost. The median follow-up was 6.5 years. Results: In an intent-to-treat analysis, men randomized to DE-EBRT were twice as likely to experience biochemical failure (multivariable analysis [MVA] hazard ratio [HR] 2.04; P=.004). The 5-, 7-, and 9-year Kaplan-Meier b-PFS estimates were 89%, 86%, and 83% for the LDR-PB boost versus 84%, 75%, and 62% for the DE-EBRT boost (log-rank P<.001). The LDR-PB boost benefited both intermediate- and high-risk patients. Because the b-PFS curves for the treatment arms diverge sharply after 4 years, the relative advantage of the LDR-PB should increase with longer follow-up. On MVA, the only variables correlated with reduced overall survival were age (MVA HR 1.06/y; P=.004) and biochemical failure (MVA HR 6.30; P<.001). Although biochemical failure was associated with increased mortality and randomization to DE-EBRT doubled the rate of biochemical failure, no significant overall survival difference was observed between the treatment arms (MVA HR 1.13; P=.62). Conclusions: Compared with 78 Gy EBRT, men randomized to the LDR-PB boost were twice as likely to be free of biochemical failure at a median follow-up of 6.5 years.

  17. A comparative study of quality of life in patients with localized prostate cancer treated at a single institution: Stereotactic ablative radiotherapy or external beam + high dose rate brachytherapy boost

    International Nuclear Information System (INIS)

    Helou, Joelle; Morton, Gerard; Zhang, Liying; Deabreu, Andrea; D’Alimonte, Laura; Elias, Evelyn; Musunuru, Hima Bindu; Mamedov, Alexandre; Ravi, Ananth; Chung, Hans; Cheung, Patrick; Loblaw, Andrew

    2014-01-01

    Purpose: To compare the quality of life (QOL) in patients treated with stereotactic ablative radiation therapy (SABR) alone or high dose rate (HDR) brachytherapy + hypofractionated external beam radiotherapy (EBRT). Methods and materials: Patient self-reported QOL was prospectively measured among patients from two sequential phase 2 clinical trials: 1-SABR 35 Gy/5 fractions/5 weeks, 2–15 Gy HDR 1 fraction, followed by EBRT 37.5 Gy/15 fractions/3 weeks. The expanded prostate cancer index composite was assessed at baseline and q6 monthly up to 5 years. Urinary, bowel and sexual domains were analyzed. A minimally clinical important change (MCIC) was defined as 0.5*standard deviation of the baseline for each domain. Fisher exact test and general linear mixed model were used (p < 0.05). Results: 84 and 123 patients were treated on the SABR and HDR boost studies, with a median follow up of 51 and 61 months respectively. There was a significant difference in MCIC between treatments in the urinary function and bother (p < 0.0001), the bowel function (p = 0.0216) and the sexual function (p = 0.0419) and bother (p = 0.0290) domains in favor of the SABR group. Of patients who reported no problem with their sexual function at baseline, 7% and 23% respectively considered it to be a moderate to big problem on follow up (p = 0.0077). Conclusion: Patients treated with HDR-boost reported deterioration of QOL particularly in sexual domains in comparison with SABR

  18. Electron Beam Dose Distribution in the Presence of Non-Uniform Magnetic Field

    Directory of Open Access Journals (Sweden)

    Mohamad Javad Tahmasebi-Birgani

    2014-04-01

    Full Text Available Introduction Magnetic fields are capable of altering the trajectory of electron beams andcan be used in radiation therapy.Theaim of this study was to produce regions with dose enhancement and reduction in the medium. Materials and Methods The NdFeB permanent magnets were arranged on the electron applicator in several configurations. Then, after the passage of the electron beams (9 and 15 MeV Varian 2100C/D through the non-uniform magnetic field, the Percentage Depth Dose(PDDs on central axis and dose profiles in three depths for each energy were measured in a 3D water phantom. Results For all magnet arrangements and for two different energies, the surface dose increment and shift in depth of maximum dose (dmax were observed. In addition, the pattern of dose distribution in buildup region was changed. Measurement of dose profile showed dose localization and spreading in some other regions. Conclusion The results of this study confirms that using magnetic field can alter the dose deposition patterns and as a result can produce dose enhancement as well as dose reduction in the medium using high-energy electron beams. These effects provide dose distribution with arbitrary shapes for use in radiation therapy.

  19. Possibilities and conditions of applying PIXE analysis with external proton beam

    International Nuclear Information System (INIS)

    Potocek, V.

    1989-01-01

    The technical and methodological prerequisites are summed up for the use of the PIXE method with an external proton beam. The method is suitable for the preliminary analysis of unknown samples prior to the choice of the best suited analytical method, for the nondestructive analysis of rare samples such as unique works of art, of small amounts of materials which are difficult to access, etc., as well as for calibration and comparing analyses. As for the operators the application of the PIXE method with external proton beam assumes the availability of accelerator operating time, minimization of the length of exposure of the targets, optimization of parameters of the exciting beam and automation of the whole process. Attention is also devoted to technical provisions and organization of laboratory work. The design is described of an analytical unit using the PIXE method with external proton beam, and it is stated that the Van de Graaff accelerator at the Institute of Nuclear Physics in Rez near Prague could be used for the purpose. (Z.M.). 6 refs

  20. High intensity beam profile monitors for the LAMPF primary beam lines

    International Nuclear Information System (INIS)

    Hoffman, E.W.; Macek, R.J.; van Dyck, O.; Lee, D.; Harvey, A.; Bridge, J.; Cainet, J.

    1979-01-01

    Two types of beam profile monitors are in use at LAMPF to measure the properties of the 800 MeV, 500 μA proton beam external to the linac. Both types use secondary electron emission from a wire to produce a current signal proportional to the amount of proton beam that intercepts the wire. The wire scanner system uses a pair of orthogonal wires which are passed through the beam and the harp system uses two fixed planes of parallel wires. Most of the harps are not retractable and are exposed continuously to the primary beam. The high beam intensities available lead to a number of technical problems for instruments that intercept the beam or are close to primary beam targets. The thermal, electrical, radiation-damage, and material selection problems encountered, and some solutions which have been implemented are discussed

  1. Analysis of records of external occupational dose records in Brazil; Analise dos registros de dose ocupacional externa no Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Mauricio, Claudia L.P.; Silva, Herica L.R. da, E-mail: claudia@ird.gov.br, E-mail: herica@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ),Rio de Janeiro, RJ (Brazil); Silva, Claudio Ribeiro da, E-mail: claudio@cnen.gov.br [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil)

    2014-07-01

    Brazil, a continental country, with actually more than 150,000 workers under individual monitoring for ionizing radiation, has implemented in 1987 a centralized system for storage of external occupational dose. This database has been improved over the years and is now a web-based information system called Brazilian External Occupational Dose Management Database System - GDOSE. This paper presents an overview of the Brazilian external occupational dose over the years. The estimated annual average effective dose shows a decrease from 2.4 mSv in 1987 to about 0.6 mSv, having been a marked reduction from 1987 to 1990. Analyzing by type of controlled practice, one sees that the medical and dental radiology is the area with the largest number of users of individual monitors (70%); followed by education practices (8%) and the industrial radiography (7%). Additionally to photon whole body monitoring; neutron monitors are used in maintenance (36%), reactor (30%) and education (27%); and extremity monitors, in education (27%), nuclear medicine (22%) and radiology (19%). In terms of collective dose, the highest values are also found in conventional radiology, but the highest average dose values are those of interventional radiology. Nuclear medicine, R and D and radiotherapy also have average annual effective dose higher than 1 mSv. However, there is some very high dose values registered in GDOSE that give false information. This should be better analyzed in the future. Annual doses above 500 are certainly not realistic. (author)

  2. SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

    International Nuclear Information System (INIS)

    Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S

    2015-01-01

    Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream

  3. SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S [UC Davis Cancer Center, Sacramento, CA (United States)

    2015-06-15

    Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream

  4. Can high-dose fotemustine reverse MGMT resistance in glioblastoma multiforme?

    Science.gov (United States)

    Gallo, Chiara; Buonerba, Carlo; Di Lorenzo, Giuseppe; Romeo, Valeria; De Placido, Sabino; Marinelli, Alfredo

    2010-11-01

    Glioblastoma multiforme (GBM), the highest grade malignant glioma, is associated with a grim prognosis-median overall survival is in the range 12-15 months, despite optimum treatment. Surgery to the maximum possible extent, external beam radiotherapy, and systemic temozolomide chemotherapy are current standard treatments for newly diagnosed GBM, with intracerebral delivery of carmustine wafers (Gliadel). Unfortunately, the effectiveness of chemotherapy can be hampered by the DNA repair enzyme O6-methylguanine methyltransferase (MGMT), which confers resistance both to temozolomide and nitrosoureas, for example fotemustine and carmustine. MGMT activity can be measured by PCR and immunohistochemistry, with the former being the current validated technique. High-dose chemotherapy can deplete MGMT levels in GBM cells and has proved feasible in various trials on temozolomide, in both newly diagnosed and recurrent GBM. We here report the unique case of a GBM patient, with high MGMT expression by immunohistochemistry, who underwent an experimental, high-dose fotemustine schedule after surgery and radiotherapy. Although treatment caused two episodes of grade 3-4 thrombocytopenia, a complete response and survival of more than three years were achieved, with a 30% increase in dose intensity compared with the standard fotemustine schedule.

  5. Two-stream instability for a light ion beam-plasma system with external magnetic field

    International Nuclear Information System (INIS)

    Okada, T.; Tazawa, H.

    1992-12-01

    For inertial confinement fusion, a focused light ion beam (LIB) is required to propagate stably through a chamber to a target. We have pointed out that the applied external magnetic field is important for LIB propagation. To investigate the influence of the external magnetic field on the LIB propagation, we analysed the electrostatic dispersion relation of magnetized light ion beam-plasma system. The particle in-cell (PIC) simulation results are presented for a light ion beam-plasma system with external magnetic field. (author)

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  7. Dose error analysis for a scanned proton beam delivery system

    International Nuclear Information System (INIS)

    Coutrakon, G; Wang, N; Miller, D W; Yang, Y

    2010-01-01

    All particle beam scanning systems are subject to dose delivery errors due to errors in position, energy and intensity of the delivered beam. In addition, finite scan speeds, beam spill non-uniformities, and delays in detector, detector electronics and magnet responses will all contribute errors in delivery. In this paper, we present dose errors for an 8 x 10 x 8 cm 3 target of uniform water equivalent density with 8 cm spread out Bragg peak and a prescribed dose of 2 Gy. Lower doses are also analyzed and presented later in the paper. Beam energy errors and errors due to limitations of scanning system hardware have been included in the analysis. By using Gaussian shaped pencil beams derived from measurements in the research room of the James M Slater Proton Treatment and Research Center at Loma Linda, CA and executing treatment simulations multiple times, statistical dose errors have been calculated in each 2.5 mm cubic voxel in the target. These errors were calculated by delivering multiple treatments to the same volume and calculating the rms variation in delivered dose at each voxel in the target. The variations in dose were the result of random beam delivery errors such as proton energy, spot position and intensity fluctuations. The results show that with reasonable assumptions of random beam delivery errors, the spot scanning technique yielded an rms dose error in each voxel less than 2% or 3% of the 2 Gy prescribed dose. These calculated errors are within acceptable clinical limits for radiation therapy.

  8. External proton and Li beams; Haces externos de protones y litios

    Energy Technology Data Exchange (ETDEWEB)

    Schuff, Juan A; Burlon, Alejandro A; Debray, Mario E; Kesque, Jose M; Kreiner, Andres J; Stoliar, Pablo A; Naab, Fabian; Ozafran, Mabel J; Vazquez, Monica E [Comision Nacional de Energia Atomica, General San Martin (Argentina). Dept. de Fisica; Policastro, Lucia L; Duran, Hebe; Molinari, Beatriz L; O' Connor, Silvia E; Saint-Martin, Maria L.G.; Palmieri, Monica; Bernaola, Omar A; Opezzo, Oscar J [Comision Nacional de Energia Atomica, General San Martin (Argentina). Dept. de Radiobiologia; Mazal, A; Favaudon, F; Henry, Y [Institut Curie, 75 - Paris (France); Perez de la Hoz, A.; Somacal, Hector; Valda, Alejandro; Canevas, S; Ruffolo, M; Tasat, D R [Universidad Nacional de General San Martin, Villa Ballester (Argentina). Escuela de Ciencia y Tecnologia; Davidson, Miguel; Davidson, Jorge [Buenos Aires Univ. (Argentina). Dept. de Fisica; Delacroix, S; Nauraye, C; Brune, E; Gautier, C; Habrand, J L [Centre de Protontherapie, 91 - Orsay (France); Muhlmann, M C [Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Buenos Aires (Argentina)

    2000-07-01

    In the frame of a feasibility study to introduce proton therapy in Argentina in a collaborative agreement between the Physics and Radiobiology Departments of the National Atomic Energy Commission or Argentina and the Centre de Protontherapie de Orsay, France, external proton and Li beams were produced at the TANDAR accelerator in Buenos Aires. The specific aim of this work was to start radiobiology studies on cell cultures and small laboratory animals. In particular we seek to determine here the relative biological effectiveness, RBE, for proton and Li beams as a function of energy for different tumor and normal cell lines. The 24 MeV proton beam was diffused using a 25 {mu}m gold foil and extracted through a Kapton window to obtain a homogeneous field (constant to 95%) of about 7 cm in diameter. Measurements were carried out with quasi-monoenergetic beams (of 20.2 {+-} 0.07 MeV, 2.9 {+-} 0.10 MeV y 1.5 {+-} 0.1 MeV for protons and 21.4 {+-} 0.4 MeV for Lithium). Proton fluence and Bragg peaks were measured. The dose delivered in each case was monitored on-line with a calibrated transmission ionization chamber. Three cell lines PDV, PDVC 57 and V 79 (as a reference) were irradiated with {gamma}-rays, proton and lithium beams with linear energy transfer (LET) from 2 to 100 keV/{mu}m. RBE values in the range of 1.2-5.9 were obtained. In addition preliminary studies on chromosomal aberrations and viability of alveolar macrophages were carried out. (author)

  9. Absorbed dose calibration factors for parallel-plate chambers in high energy photon beams

    International Nuclear Information System (INIS)

    McEwen, M.R.; Duane, S.; Thomas, R.A.S.

    2002-01-01

    An investigation was carried out into the performance of parallel-plate chambers in 60 Co and MV photon beams. The aim was to derive calibration factors, investigate chamber-to-chamber variability and provide much-needed information on the use of parallel-plate chambers in high-energy X-ray beams. A set of NE2561/NE2611 reference chambers, calibrated against the primary standard graphite calorimeter is used for the dissemination of absorbed dose to water. The parallel-plate chambers were calibrated by comparison with the NPL reference chambers in a water phantom. Two types of parallel-plate chamber were investigated - the NACP -02 and Roos and measurements were made at 60 C0 and 6 linac photon energies (6-19 MV). Calibration factors were derived together with polarity corrections. The standard uncertainty in the calibration of a chamber in terms of absorbed dose to water is estimated to be ±0.75%. The results of the polarity measurements were somewhat confusing. One would expect the correction to be small and previous measurements in electron beams have indicated that there is little variation between chambers of these types. However, some chambers gave unexpectedly large polarity corrections, up to 0.8%. By contrast the measured polarity correction for a NE2611 chamber was less than 0.13% at all energies. The reason for these large polarity corrections is not clear, but experimental error and linac variations have been ruled out. By combining the calibration data for the different chambers it was possible to obtain experimental k Q factors for the two chamber types. It would appear from the data that the variations between chambers of the same type are random and one can therefore define a generic curve for each chamber type. These are presented in Figure 1, together with equivalent data for two cylindrical chamber types - NE2561/NE2611 and NE2571. As can be seen, there is a clear difference between the curves for the cylindrical chambers and those for the

  10. External Beam Boost for Cancer of the Cervix Uteri When Intracavitary Therapy Cannot Be Performed

    International Nuclear Information System (INIS)

    Barraclough, Lisa Helen; Swindell, Ric; Livsey, Jacqueline E.; Hunter, Robin D.; Davidson, Susan E.

    2008-01-01

    Purpose: To assess the outcome of patients treated with radical radiotherapy for cervical cancer who received an external beam boost, in place of intracavitary brachytherapy (ICT), after irradiation to the whole pelvis. Methods and Materials: Case notes were reviewed for all patients treated in this way in a single center between 1996 and 2004. Patient and tumor details, the reasons why ICT was not possible, and treatment outcome were documented. Results: Forty-four patients were identified. The mean age was 56.4 years (range, 26-88 years). Clinical International Federation of Gynecology and Obstetrics or radiologic stage for Stages I, II, III, and IV, respectively, was 16%, 48%, 27%, and 7%. A total radiation dose of 54-70 Gy was given (75% received ≥60 Gy). Reasons for ICT not being performed were technical limitations in 73%, comorbidity or isolation limitations in 23%, and patient choice in 4%. The median follow-up was 2.3 years. Recurrent disease was seen in 48%, with a median time to recurrence of 2.3 years. Central recurrence was seen in 16 of the 21 patients with recurrent disease. The 5-year overall survival rate was 49.3%. The 3-year cancer-specific survival rate by stage was 100%, 70%, and 42% for Stages I, II, and III, respectively. Late Grades 1 and 2 bowel, bladder, and vaginal toxicity were seen in 41%. Late Grade 3 toxicity was seen in 2%. Conclusion: An external beam boost is a reasonable option after external beam radiotherapy to the pelvis when it is not possible to perform ICT

  11. SU-F-T-420: Dosimetry Comparison of Advanced External Beam Radiation Treatment Modalities to Brachytherapy Treatments in Patients with Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mwidu, U; Devic, S [McGill University, Montreal, QC (Canada); Shehadeh, M; AlKafi, M; Mahmood, R; Moftah, B [King Faisal Specialist Hospital & Research Center, Riyadh, Riyadh (Saudi Arabia)

    2016-06-15

    Purpose: A retrospective comparison of dose distributions achievable by High dose rate brachytherapy (HDRBT), Helical TomoTherapy (TOMO), CyberKnife (CK) and RapidArc (RA) in locally advanced inoperable cervical cancer patients is presented. Methods: Five patients with advanced stage cervical carcinoma were selected for this study after a full course of external beam radiotherapy (EBRT), chemotherapy and HDR Brachytherapy. To highlight any significant similarities/differences in dose distributions, high-risk clinical target volume (HRCTV) coverage, organs at risk (OAR) sparing, and machine specific delivery limitations, we used D90 (dose received by 90% of the volume) as the parameter for HRCTV coverage as recommended by the GEC-ESTRO Working Group. We also compared both integral and differential dose volume histograms (DVH) between different dose distributions treatment modalities for HRCTV and OAR. Results: TOMO and RA provided the most conformal dose distributions to HRCTV. Median doses (in Gy) to organs at risk were; for rectal wall: 1.7±0.6, 2.5±0.6,1.2±0.3, and 1.5±0.6, and for bladder wall: 1.6±0.1, 2.4±0.4, 0.8±0.6, and 1.5±0.5, for HDRBT, TOMO, CK, and RA, respectively. Conclusion: Contemporary EBRT modalities might be able to replace brachytherapy treatments for cervix cancer. While brachytherapy dose distributions feature high dose gradients, EBRT modalities provide highly conformal dose distributions to the target. However, it is still not clear whether a highly conformal dose or high gradient dose is more clinically relevant for the HRCTV in cervix cancer patients.

  12. Surface dose measurements and comparison of unflattened and flattened photon beams

    Directory of Open Access Journals (Sweden)

    Ashokkumar Sigamani

    2016-01-01

    Full Text Available The purpose of this study was to evaluate the central axis dose in the build-up region and the surface dose of a 6 MV and 10 MV flattened photon beam (FB and flattening filter free (FFF therapeutic photon beam for different square field sizes (FSs for a Varian Truebeam linear accelerator using parallel-plate ionization chamber and Gafchromic film. Knowledge of dosimetric characteristics in the build-up region and surface dose of the FFF is essential for clinical care. The dose measurements were also obtained empirically using two different commonly used dosimeters: a p-type photon semiconductor dosimeter and a cylindrical ionization chamber. Surface dose increased linearly with FS for both FB and FFF photon beams. The surface dose values of FFF were higher than the FB FSs. The measured surface dose clearly increases with increasing FS. The FFF beams have a modestly higher surface dose in the build-up region than the FB. The dependence of source to skin distance (SSD is less significant in FFF beams when compared to the flattened beams at extended SSDs.

  13. Radiation dose in cone-beam computed tomography: myth or reality

    International Nuclear Information System (INIS)

    Madi, Medhini

    2013-01-01

    In the growing inventory of clinical computed tomography technologies, cone-beam X-ray computed tomography is a relatively recent instalment. It is an advancement in computed tomography imaging which is designed to provide relatively low-dose high-spatial-resolution visualization of high contrast structures in the head and neck and other anatomic areas. Comparatively low dosing requirements and relatively compact design has led to intense interest in surgical planning and intra-operative cone-beam computed tomography applications, particularly in head and neck, and also in spinal, thoracic, abdominal and orthopaedic procedures. The use of this emerging imaging technology, which has potential applications for imaging of high-contrast structures in the head and neck as well as dentomaxillofacial regions, has been the subject of criticism as well as acclaim. This paper envisages to discuss the state-of-the-art of the technique. (author)

  14. Assessment of population external irradiation doses with consideration of Rospotrebnadzor bodies equipment for monitoring of photon radiation dose

    Directory of Open Access Journals (Sweden)

    I. P. Stamat

    2016-01-01

    Full Text Available This paper provides review of equipment and methodology for measurement of photon radiation dose; analysis of possible reasons for considerable deviation between the Russian Federation population annual effective external irradiation doses and the relevant average global value. Data on Rospotrebnadzor bodies dosimetry equipment used for measurement of gamma radiation dose are collected and systematized. Over 60 kinds of dosimeters are used for monitoring of population external irradiation doses. Most of dosimeters used in the country have gas-discharge detectors (Geiger-Mueller counters, minor biochemical annunciators, etc. which have higher total values of own background level and of space radiation response than the modern dosimeters with scintillation detectors. This feature of dosimeters is apparently one of most plausible reasons of a bit overstating assessment of population external irradiation doses. The options for specification of population external irradiation doses assessment are: correction of gamma radiation dose measurement results with consideration of dosimeters own background level and space radiation response, introduction of more up-to-date dosimeters with scintillation detectors, etc. The most promising direction of research in verification of population external irradiation doses assessment is account of dosimetry equipment.

  15. A reviewed technique for total body electron therapy using a Varian Clinac 2100C/D high dose rate treatment beam facility

    International Nuclear Information System (INIS)

    Oliver, L.D.; Xuereb, E.M.A.; Last, V.; Hunt, P.B.; Wilfert, A.

    1996-01-01

    Our (Royal North Shore Hospital) most recent linear accelerator acquisition is a Varian Clinac 2100C/D which has a high dose rate (approximately 25Gy per minute at 1 metre) total body electron option. We investigated the physical characteristics of the electron beam to develop a suitable method of treatment for total body electron therapy. The useful electron beam width is defined as 80cm above and below the reference height. Measurements of the electron dose received from the two angled electron beams showed a critical dependence on the gantry angles. The treatment protocol uses ten different patient angles, fractionated into directly opposing fields and treated seuqentially each day. A full cycle of treatment is completed in five days. (author)

  16. External beam monitoring of the Cyclone 30 cyclotron of IPEN-CNEN-SP

    International Nuclear Information System (INIS)

    Matsuda, Hylton

    2002-01-01

    Due to the increasing demand for cyclotron radioisotopes and the high cost of equipment and materials involved in the process, it becomes evident the importance of external beam monitoring of the cyclotron. In this way, the beam of the Cyclone 30 cyclotron of IPEN-CNEN/S P was characterized throughout the evaluation of its current intensity, profile (position, focus and geometry), alignment and homogeneity, by measuring currents, temperatures and pressures of irradiation systems. For this purpose, techniques and conventional devices, thermocouples and pressure sensors associated to electronic of instrumentation, and technology and flexibility of micro controllers allowed observing the beam behavior during irradiations in real time. The ion beam energy was also evaluated using activation analysis technique of monitor reactions in nat Cu. The beam monitoring systems have been contributing to prevent material damages and they have already been used in routine irradiations, bringing important advantages in the process of beam optimization of the Cyclone 30. (author)

  17. Shielding for Critical Organs and Radiation Exposure Dose Distribution in Patients with High Energy Radiotherapy

    International Nuclear Information System (INIS)

    Chu, Sung Sil; Suh, Chang Ok; Kim, Gwi Eon

    2002-01-01

    High energy photon beams from medical linear accelerators produce large scattered radiation by various components of the treatment head, collimator and walls or objects in the treatment room including the patient. These scattered radiation do not provide therapeutic dose and are considered a hazard from the radiation safety perspective. Scattered dose of therapeutic high energy radiation beams are contributed significant unwanted dose to the patient. ICRP take the position that a dose of 500mGy may cause abortion at any stage of pregnancy and that radiation detriment to the fetus includes risk of mental retardation with a possible threshold in the dose response relationship around 100 mGy for the gestational period. The ICRP principle of As Low As Reasonably Achievable (ALARA) was recommended for protection of occupation upon the linear no-threshold dose response hypothesis for cancer induction. We suggest this ALARA principle be applied to the fetus and testicle in therapeutic treatment. Radiation dose outside a photon treatment filed is mostly due to scattered photons . This scattered dose is a function of the distance from the beam edge, treatment geometry, primary photon energy, and depth in the patient. The need for effective shielding of the fetus and testicle is reinforced when young patients are treated with external beam radiation therapy and then shielding designed to reduce the scattered photon dose to normal organs have to considered. Irradiation was performed in phantom using high energy photon beams produced by a Varian 2100C/D medical linear accelerator (Varian Oncology Systems, Polo Alto, CA) located at the Yonsei Cancer Center. The composite phantom used was comprised of a commercially available anthropomorphic Rando phantom (Phantom Laboratory Inc., Salem, YN) and a rectangular solid polystyrene phantom of dimensions 30cm x 30cm x 20cm. The anthropomorphic Rando phantom represents an average man made from tissue equivalent materials that is

  18. Shielding for Critical Organs and Radiation Exposure Dose Distribution in Patients with High Energy Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Chu, Sung Sil; Suh, Chang Ok; Kim, Gwi Eon [Yonsei Univ., Seoul (Korea, Republic of)

    2002-03-15

    High energy photon beams from medical linear accelerators produce large scattered radiation by various components of the treatment head, collimator and walls or objects in the treatment room including the patient. These scattered radiation do not provide therapeutic dose and are considered a hazard from the radiation safety perspective. Scattered dose of therapeutic high energy radiation beams are contributed significant unwanted dose to the patient. ICRP take the position that a dose of 500mGy may cause abortion at any stage of pregnancy and that radiation detriment to the fetus includes risk of mental retardation with a possible threshold in the dose response relationship around 100 mGy for the gestational period. The ICRP principle of As Low As Reasonably Achievable (ALARA) was recommended for protection of occupation upon the linear no-threshold dose response hypothesis for cancer induction. We suggest this ALARA principle be applied to the fetus and testicle in therapeutic treatment. Radiation dose outside a photon treatment filed is mostly due to scattered photons . This scattered dose is a function of the distance from the beam edge, treatment geometry, primary photon energy, and depth in the patient. The need for effective shielding of the fetus and testicle is reinforced when young patients are treated with external beam radiation therapy and then shielding designed to reduce the scattered photon dose to normal organs have to considered. Irradiation was performed in phantom using high energy photon beams produced by a Varian 2100C/D medical linear accelerator (Varian Oncology Systems, Polo Alto, CA) located at the Yonsei Cancer Center. The composite phantom used was comprised of a commercially available anthropomorphic Rando phantom (Phantom Laboratory Inc., Salem, YN) and a rectangular solid polystyrene phantom of dimensions 30cm x 30cm x 20cm. The anthropomorphic Rando phantom represents an average man made from tissue equivalent materials that is

  19. Structural stability of PAN fiber under high electron beam radiation doses

    International Nuclear Information System (INIS)

    Pino, Eddy S.; Machado, Luci D.B.; Arruda, Clarissa P. Zelinschi de; Carvalho, Alvaro A. Silva de; Giovedi, Claudia

    2009-01-01

    Fiber-reinforced composite are an important class of engineering material. A relevant task of composite technology in order to produce materials for structures of high mechanical performance is to obtain the best carbon fiber. One of the main ways to produce carbon fibers of high Young's modulus and tensile strength is to use as starting material polyacrylonitrile (PAN) fibers which after a rigorous and carefully thermal process become carbon fibers. Since some chemical modifications produced in the thermal treatment can be induced by ionizing radiation, the aim of this paper is to evaluate the effect of high electron beam (EB) doses on a commercial PAN fiber in order to evaluate the use of this technology as an alternative treatment to improve the properties and characteristics of the produced carbon fiber. The doses applied were: 0.2, 0.4, 0.6, 0.8, 1.0 and 1.2 MGy. The irradiation effects induced on the PAN fiber were evaluated by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and thermogravimetry (TG). FTIR obtained data have shown that the main functional groups remain practically unchanged in the non-irradiated and irradiated samples. The single DSC exothermic peak obtained for non-irradiated sample, becomes a double peak after the irradiation, presenting lower initial and higher final temperatures for exothermic DSC curves. The enthalpy involved in the chemical reaction decreases for irradiated samples as compared with the non-irradiated PAN fiber. TG data have shown that irradiated samples start a decomposition process at lower temperatures compared to the non-irradiated sample. (author)

  20. Radiotherapy in poor risk patients with stage I cancer of the endometrium: results of not giving external beam radiotherapy.

    Science.gov (United States)

    DeCruze, B; Guthrie, D

    1999-01-01

    Poor prognosis (poorly differentiated and/or deep myometrial invasion) Stage I endometrial cancer can have a relapse rate as high as 50%. Traditionally, most clinical oncologists treat these patients with external beam radiotherapy after surgery but there is no evidence to show that this improves survival. The retrospective study looks at the results of not giving external beam radiotherapy in 25 consecutive patients and compares the results with a group of 13 consecutive patients who did have such treatment. The two groups were comparable with regard to age, degree of differentiation and degree of invasion. Survival was comparable in the two groups. There is no evidence of any obvious decrease in survival from withholding external beam radiotherapy, but this was not a prospective randomized controlled trial. This study illustrates that it is essential that the Medical Research Council ASTEC trial should be supported because this will determine the true place of external beam radiotherapy in such patients.

  1. Hypofractionated High-Dose Proton Beam Therapy for Stage I Non-Small-Cell Lung Cancer: Preliminary Results of A Phase I/II Clinical Study

    International Nuclear Information System (INIS)

    Hata, Masaharu; Tokuuye, Koichi; Kagei, Kenji; Sugahara, Shinji; Nakayama, Hidetsugu; Fukumitsu, Nobuyoshi; Hashimoto, Takayuki; Mizumoto, Masashi; Ohara, Kiyoshi; Akine, Yasuyuki

    2007-01-01

    Purpose: To present treatment outcomes of hypofractionated high-dose proton beam therapy for Stage I non-small-cell lung cancer (NSCLC). Methods and Materials: Twenty-one patients with Stage I NSCLC (11 with Stage IA and 10 with Stage IB) underwent hypofractionated high-dose proton beam therapy. At the time of irradiation, patient age ranged from 51 to 85 years (median, 74 years). Nine patients were medically inoperable because of comorbidities, and 12 patients refused surgical resection. Histology was squamous cell carcinoma in 6 patients, adenocarcinoma in 14, and large cell carcinoma in 1. Tumor size ranged from 10 to 42 mm (median, 25 mm) in maximum diameter. Three and 18 patients received proton beam irradiation with total doses of 50 Gy and 60 Gy in 10 fractions, respectively, to primary tumor sites. Results: Of 21 patients, 2 died of cancer and 2 died of pneumonia at a median follow-up period of 25 months. The 2-year overall and cause-specific survival rates were 74% and 86%, respectively. All but one of the irradiated tumors were controlled during the follow-up period. Five patients showed recurrences 6-29 months after treatment, including local progression and new lung lesions outside of the irradiated volume in 1 and 4 patients, respectively. The local progression-free and disease-free rates were 95% and 79% at 2 years, respectively. No therapy-related toxicity of Grade ≥3 was observed. Conclusions: Hypofractionated high-dose proton beam therapy seems feasible and effective for Stage I NSCLC. Proton beams may contribute to enhanced efficacy and lower toxicity in the treatment of patients with Stage I NSCLC

  2. Dose perturbation effect of metallic spinal implants in proton beam therapy.

    Science.gov (United States)

    Jia, Yingcui; Zhao, Li; Cheng, Chee-Wai; McDonald, Mark W; Das, Indra J

    2015-09-08

    The purpose of this study was to investigate the effect of dose perturbations for two metallic spinal screw implants in proton beam therapy in the perpendicular and parallel beam geometry. A 5.5 mm (diameter) by 45 mm (length) stainless steel (SS) screw and a 5.5 mm by 35 mm titanium (Ti) screw commonly used for spinal fixation were CT-scanned in a hybrid phantom of water and solid water. The CT data were processed with an orthopedic metal artifact reduction (O-MAR) algorithm. Treatment plans were generated for each metal screw with a proton beam oriented, first parallel and then perpendicular, to the longitudinal axis of the screw. The calculated dose profiles were compared with measured results from a plane-parallel ion chamber and Gafchromic EBT2 films. For the perpendicular setup, the measured dose immediately downstream from the screw exhibited dose enhancement up to 12% for SS and 8% for Ti, respectively, but such dose perturbation was not observed outside the lateral edges of the screws. The TPS showed 5% and 2% dose reductions immediately at the interface for the SS nd Ti screws, respectively, and up to 9% dose enhancements within 1 cm outside of the lateral edges of the screws. The measured dose enhancement was only observed within 5 mm from the interface along the beam path. At deeper depths, the lateral dose profiles appeared to be similar between the measurement and TPS, with dose reduction in the screw shadow region and dose enhancement within 1-2 cm outside of the lateral edges of the metals. For the parallel setup, no significant dose perturbation was detected at lateral distance beyond 3 mm away from both screws. Significant dose discrepancies exist between TPS calculations and ion chamber and film measurements in close proximity of high-Z inhomogeneities. The observed dose enhancement effect with proton therapy is not correctly modeled by TPS. An extra measure of caution should be taken when evaluating dosimetry with spinal metallic implants.

  3. Calcium carbonate as a possible dosimeter for high irradiation doses

    International Nuclear Information System (INIS)

    Negron M, A.; Ramos B, S.; Camargo R, C.; Uribe, R. M.; Gomez V, V.; Kobayashi, K.

    2014-08-01

    The aim of this work is to analyze the interactions of 5 MeV electron beam radiation and a 290 MeV/u Carbon beam with calcium carbonate (powder) at 298 K and at different irradiation doses, for the potential use of calcium carbonate as a high-dose dosimeter. The irradiation doses with the electron beam were from 0.015 to 9 MGy, and with Carbon beam from 1.5 kGy to 8 kGy. High-energy radiation induces the formation of free radicals in solid calcium carbonate that can be detected and measured by electron paramagnetic resonance (EPR). An increase of the EPR response for some of the free radicals produced in the sample was observed as a function of the irradiation dose. The response of one of the radicals decreased with the dose. These measurements are reproducible; the preparation of the sample is simple and inexpensive; and the signal is stable for several months. The response curves show that the dosimeter tends to saturate at 10 MGy. Based on these properties, we propose this chemical compound as a high-dose dosimeter, mainly for electron irradiation. (author)

  4. Calcium carbonate as a possible dosimeter for high irradiation doses

    Energy Technology Data Exchange (ETDEWEB)

    Negron M, A.; Ramos B, S.; Camargo R, C. [UNAM, Instituto de Ciencias Nucleares, Ciudad Universitaria, 04510 Mexico D. F. (Mexico); Uribe, R. M. [Kent State University, College of Technology, Kent OH (United States); Gomez V, V. [UNAM, Instituto de Quimica, Ciudad Universitaria, 04510 Mexico D. F. (Mexico); Kobayashi, K., E-mail: negron@nucleares.unam.mx [Yokohama National University (Japan)

    2014-08-15

    The aim of this work is to analyze the interactions of 5 MeV electron beam radiation and a 290 MeV/u Carbon beam with calcium carbonate (powder) at 298 K and at different irradiation doses, for the potential use of calcium carbonate as a high-dose dosimeter. The irradiation doses with the electron beam were from 0.015 to 9 MGy, and with Carbon beam from 1.5 kGy to 8 kGy. High-energy radiation induces the formation of free radicals in solid calcium carbonate that can be detected and measured by electron paramagnetic resonance (EPR). An increase of the EPR response for some of the free radicals produced in the sample was observed as a function of the irradiation dose. The response of one of the radicals decreased with the dose. These measurements are reproducible; the preparation of the sample is simple and inexpensive; and the signal is stable for several months. The response curves show that the dosimeter tends to saturate at 10 MGy. Based on these properties, we propose this chemical compound as a high-dose dosimeter, mainly for electron irradiation. (author)

  5. Dosimetric accuracy at low monitor unit setting in electron beams at different dose rates

    International Nuclear Information System (INIS)

    Ravikumar, M.; Ravichandran, R.; Supe, Sanjay S.; Sharma, Anil K.

    1999-01-01

    As electron beam with low monitor unit (LMU) settings are used in some dosimetric studies, better understanding of accuracy in dose delivery at LMU setting is necessary. The dose measurements were carried out with 0.6 cm 3 farmer type ion chamber at d max in a polystyrene phantom. Measurements at different MUs show that the dose linearity ratio (DLR) increases as the MU setting decreases below 20 MU and DLRs are found to increase when the incident electron beams have higher energies. The increase in DLR is minimum for low dose rate setting for all five electron beam energies (6, 9, 12, 16 and 20 MeV). As the variation in dose delivery is machine-specific, a detailed study should be conducted before the low MU setting is implemented. Since errors in dose delivery are high at higher dose rates, low dose rate may be better at low MU unit setting. (author)

  6. Reproductive function of animals exposed to low-dose external γ-radiation

    International Nuclear Information System (INIS)

    Izhevskij, P.V.; Krupitskaya, L.I.; Startsev, N.V.

    1993-01-01

    Chronic external γ-radiation effects on the reproductive function were simulated in male rats at doses equivalent to the dose obtained by the persons who participated in the liquidation of the Chernobyl poer plant accident aftereffects and by the population. The incidence of the pre-and postimplantation deaths was found increased in the progeny of males exposed to chronic external γ-irradiation at total doses of 158 and 237 Gy, though no strict dose dependence was observed

  7. Asymmetric fan beams (AFB) for improvement of the craniocaudal dose distribution in helical tomotherapy delivery

    International Nuclear Information System (INIS)

    Gladwish, Adam; Kron, Tomas; McNiven, Andrea; Bauman, Glenn; Van Dyk, Jake

    2004-01-01

    Helical tomotherapy (HT) is a novel radiotherapy technique that utilizes intensity modulated fan beams that deliver highly conformal dose distributions in a helical beam trajectory. The most significant limitation in dose delivery with a constant fan beam thickness (FBT) is the penumbra width of the dose distribution in the craniocaudal direction, which is equivalent to the FBT. We propose to employ a half-blocked fan beam at start and stop location to reduce the penumbra width by half. By opening the jaw slowly during the helical delivery until the desired FBT is achieved it is possible to create a sharper edge in the superior and inferior direction from the target. The technique was studied using a tomotherapy beam model implemented on a commercial treatment planning system (Theraplan Plus V3.0). It was demonstrated that the dose distribution delivered using a 25 mm fan beam can be improved significantly, to reduce the dose to normal structures located superiorly and inferiorly of the target. Dosimetry for this technique is straightforward down to a FBT of 15 mm and implementation should be simple as no changes in couch movement are required compared to a standard HT delivery. We conclude that the use of asymmetric collimated fan beams for the start and stop of the helical tomotherapeutic dose delivery has the potential of significantly improving the dose distribution in helical tomotherapy

  8. Long term results of a prospective dose escalation phase-II trial: Interstitial pulsed-dose-rate brachytherapy as boost for intermediate- and high-risk prostate cancer

    International Nuclear Information System (INIS)

    Lettmaier, Sebastian; Lotter, Michael; Kreppner, Stephan; Strnad, Annedore; Fietkau, Rainer; Strnad, Vratislav

    2012-01-01

    Purpose: We reviewed our seven year single institution experience with pulsed dose rate brachytherapy dose escalation study in patients with intermediate and high risk prostate cancer. Materials and methods: We treated a total of 130 patients for intermediate and high risk prostate cancer at our institution between 2000 and 2007 using PDR-brachytherapy as a boost after conformal external beam radiation therapy to 50.4 Gy. The majority of patients had T2 disease (T1c 6%, T2 75%, T3 19%). Seventy three patients had intermediate-risk and 53 patients had high-risk disease according to the D’Amico classification. The dose of the brachytherapy boost was escalated from 25 to 35 Gy – 33 pts. received 25 Gy (total dose 75 Gy), 63 pts. 30 Gy (total dose 80 Gy) and 34 pts. 35 Gy, (total dose 85 Gy) given in one session (dose per pulse was 0.60 Gy or 0.70 Gy/h, 24 h per day, night and day, with a time interval of 1 h between two pulses). PSA-recurrence-free survival according to Kaplan–Meier using the Phoenix definition of biochemical failure was calculated and also late toxicities according to Common Toxicity Criteria scale were assessed. Results: At the time of analysis with a median follow-up of 60 months biochemical control was achieved by 88% of patients – only 16/130 patients (12.3%) developed a biochemical relapse. Biochemical relapse free survival calculated according to Kaplan–Meier for all patients at 5 years was 85.6% (83.9% for intermediate-risk patients and 84.2% for high-risk patients) and at 9 years’ follow up it was 79.0%. Analysing biochemical relapse free survival separately for different boost dose levels, at 5 years it was 97% for the 35 Gy boost dose and 82% for the 25 and 30 Gy dose levels. The side effects of therapy were negligible: There were 18 cases (15%) of grade 1/2 rectal proctitis, one case (0.8%) of grade 3 proctitis, 18 cases (15%) of grade 1/2 cystitis, and no cases (0%) with dysuria grade 3. No patient had a bulbourethral

  9. Comparison of measured with calculated dose distribution from a 120-MeV electron beam from a laser-plasma accelerator

    International Nuclear Information System (INIS)

    Lundh, O.; Rechatin, C.; Faure, J.; Ben-Ismaïl, A.; Lim, J.; De Wagter, C.; De Neve, W.; Malka, V.

    2012-01-01

    Purpose: To evaluate the dose distribution of a 120-MeV laser-plasma accelerated electron beam which may be of potential interest for high-energy electron radiation therapy. Methods: In the interaction between an intense laser pulse and a helium gas jet, a well collimated electron beam with very high energy is produced. A secondary laser beam is used to optically control and to tune the electron beam energy and charge. The potential use of this beam for radiation treatment is evaluated experimentally by measurements of dose deposition in a polystyrene phantom. The results are compared to Monte Carlo simulations using the geant4 code. Results: It has been shown that the laser-plasma accelerated electron beam can deliver a peak dose of more than 1 Gy at the entrance of the phantom in a single laser shot by direct irradiation, without the use of intermediate magnetic transport or focusing. The dose distribution is peaked on axis, with narrow lateral penumbra. Monte Carlo simulations of electron beam propagation and dose deposition indicate that the propagation of the intense electron beam (with large self-fields) can be described by standard models that exclude collective effects in the response of the material. Conclusions: The measurements show that the high-energy electron beams produced by an optically injected laser-plasma accelerator can deliver high enough dose at penetration depths of interest for electron beam radiotherapy of deep-seated tumors. Many engineering issues must be resolved before laser-accelerated electrons can be used for cancer therapy, but they also represent exciting challenges for future research.

  10. Off-axis dose equivalent due to secondary neutrons from uniform scanning proton beams during proton radiotherapy

    Science.gov (United States)

    Islam, M. R.; Collums, T. L.; Zheng, Y.; Monson, J.; Benton, E. R.

    2013-11-01

    The production of secondary neutrons is an undesirable byproduct of proton therapy and it is important to quantify the contribution from secondary neutrons to patient dose received outside the treatment volume. The purpose of this study is to investigate the off-axis dose equivalent from secondary neutrons experimentally using CR-39 plastic nuclear track detectors (PNTD) at ProCure Proton Therapy Center, Oklahoma City, OK. In this experiment, we placed several layers of CR-39 PNTD laterally outside the treatment volume inside a phantom and in air at various depths and angles with respect to the primary beam axis. Three different proton beams with max energies of 78, 162 and 226 MeV and 4 cm modulation width, a 5 cm diameter brass aperture, and a small snout located 38 cm from isocenter were used for the entire experiment. Monte Carlo simulations were also performed based on the experimental setup using a simplified snout configuration and the FLUKA Monte Carlo radiation transport code. The measured ratio of secondary neutron dose equivalent to therapeutic primary proton dose (H/D) ranged from 0.3 ± 0.08 mSv Gy-1 for 78 MeV proton beam to 37.4 ± 2.42 mSv Gy-1 for 226 MeV proton beam. Both experiment and simulation showed a similar decreasing trend in dose equivalent with distance to the central axis and the magnitude varied by a factor of about 2 in most locations. H/D was found to increase as the energy of the primary proton beam increased and higher H/D was observed at 135° compared to 45° and 90°. The overall higher H/D in air indicates the predominance of external neutrons produced in the nozzle rather than inside the body.

  11. Off-axis dose equivalent due to secondary neutrons from uniform scanning proton beams during proton radiotherapy

    International Nuclear Information System (INIS)

    Islam, M R; Collums, T L; Monson, J; Benton, E R; Zheng, Y

    2013-01-01

    The production of secondary neutrons is an undesirable byproduct of proton therapy and it is important to quantify the contribution from secondary neutrons to patient dose received outside the treatment volume. The purpose of this study is to investigate the off-axis dose equivalent from secondary neutrons experimentally using CR-39 plastic nuclear track detectors (PNTD) at ProCure Proton Therapy Center, Oklahoma City, OK. In this experiment, we placed several layers of CR-39 PNTD laterally outside the treatment volume inside a phantom and in air at various depths and angles with respect to the primary beam axis. Three different proton beams with max energies of 78, 162 and 226 MeV and 4 cm modulation width, a 5 cm diameter brass aperture, and a small snout located 38 cm from isocenter were used for the entire experiment. Monte Carlo simulations were also performed based on the experimental setup using a simplified snout configuration and the FLUKA Monte Carlo radiation transport code. The measured ratio of secondary neutron dose equivalent to therapeutic primary proton dose (H/D) ranged from 0.3 ± 0.08 mSv Gy −1  for 78 MeV proton beam to 37.4 ± 2.42 mSv Gy −1  for 226 MeV proton beam. Both experiment and simulation showed a similar decreasing trend in dose equivalent with distance to the central axis and the magnitude varied by a factor of about 2 in most locations. H/D was found to increase as the energy of the primary proton beam increased and higher H/D was observed at 135° compared to 45° and 90°. The overall higher H/D in air indicates the predominance of external neutrons produced in the nozzle rather than inside the body. (paper)

  12. Dose escalation using conformal high-dose-rate brachytherapy improves outcome in unfavorable prostate cancer

    International Nuclear Information System (INIS)

    Martinez, Alvaro A.; Gustafson, Gary; Gonzalez, Jose; Armour, Elwood; Mitchell, Chris; Edmundson, Gregory; Spencer, William; Stromberg, Jannifer; Huang, Raywin; Vicini, Frank

    2002-01-01

    Purpose: To overcome radioresistance for patients with unfavorable prostate cancer, a prospective trial of pelvic external beam irradiation (EBRT) interdigitated with dose-escalating conformal high-dose-rate (HDR) prostate brachytherapy was performed. Methods and Materials: Between November 1991 and August 2000, 207 patients were treated with 46 Gy pelvic EBRT and increasing HDR brachytherapy boost doses (5.50-11.5 Gy/fraction) during 5 weeks. The eligibility criteria were pretreatment prostate-specific antigen level ≥10.0 ng/mL, Gleason score ≥7, or clinical Stage T2b or higher. Patients were divided into 2 dose levels, low-dose biologically effective dose 93 Gy (149 patients). No patient received hormones. We used the American Society for Therapeutic Radiology and Oncology definition for biochemical failure. Results: The median age was 69 years. The mean follow-up for the group was 4.4 years, and for the low and high-dose levels, it was 7.0 and 3.4 years, respectively. The actuarial 5-year biochemical control rate was 74%, and the overall, cause-specific, and disease-free survival rate was 92%, 98%, and 68%, respectively. The 5-year biochemical control rate for the low-dose group was 52%; the rate for the high-dose group was 87% (p<0.001). Improvement occurred in the cause-specific survival in favor of the brachytherapy high-dose level (p=0.014). On multivariate analysis, a low-dose level, higher Gleason score, and higher nadir value were associated with increased biochemical failure. The Radiation Therapy Oncology Group Grade 3 gastrointestinal/genitourinary complications ranged from 0.5% to 9%. The actuarial 5-year impotency rate was 51%. Conclusion: Pelvic EBRT interdigitated with transrectal ultrasound-guided real-time conformal HDR prostate brachytherapy boost is both a precise dose delivery system and a very effective treatment for unfavorable prostate cancer. We demonstrated an incremental beneficial effect on biochemical control and cause

  13. Comparison of skin doses to large fields using tangential beams from cobalt-60 gamma rays and 4-MV x rays

    International Nuclear Information System (INIS)

    Gagnon, W.F.; Peterson, M.D.

    1978-01-01

    Excess radiation to the skin during external beam megavoltage radiation therapy has reportedly caused excessive erythema in patients treated with the Clinac 4 linear accelerator on sloping surfaces, but not for similar treatments with cobalt-60. Doses at the epidermal level were measured under geometries simulating sloping surfaces for a Clinac 4 and an Eldorado 8 cobalt-60 teletherapy machine. For equal doses to the axilla, doses to the epidermal layer were similar. When the tumor dose was calculated for the mediastinum, the dose to the skin in the axillary region was 12% higher for the Clinac 4

  14. A feasibility study for image guided radiotherapy using low dose, high speed, cone beam X-ray volumetric imaging

    International Nuclear Information System (INIS)

    Sykes, Jonathan R.; Amer, Ali; Czajka, Jadwiga; Moore, Christopher J.

    2005-01-01

    Background and purpose: Image Guidance of patient set-up for radiotherapy can be achieved by acquiring X-ray volumetric images (XVI) with Elekta Synergy and registering these to the planning CT scan. This enables full 3D registration of structures from similar 3D imaging modalities and offers superior image quality, rotational set-up information and a large field of view. This study uses the head section of the Rando phantom to demonstrate a new paradigm of faster, lower dose XVI that still allows registration to high precision. Materials and methods: One high exposure XVI scan and one low exposure XVI scan were performed with a Rando Head Phantom. The second scan was used to simulate ultra low dose, fast acquisition, full and half scans by discarding a large number of projections before reconstruction. Dose measurements were performed using Thermo Luminescent Dosimeters (TLD) and an ion chamber. The reconstructed XVI scans were automatically registered with a helical CT scan of the Rando Head using the volumetric, grey-level, cross-correlation algorithm implemented in the Syntegra software package (Philips Medical Systems). Reproducibility of the registration process was investigated. Results: In both XVI scans the body surface, bone-tissue and tissue air interfaces were clearly visible. Although the subjective image quality of the low dose cone beam scan was reduced, registration of both cone beam scans with the planning CT scan agreed within 0.1 mm and 0.1 deg. Dose to the patient was reduced from 28 mGy to less than 1 mGy and the equivalent scan speed reduced to one minute or less. Conclusions: Automatic 3D registration of high speed, ultra low dose XVI scans with the planning CT scan can be used for precision 3D patient set-up verification/image guidance on a daily basis with out loss of accuracy when compared to higher dose XVI scans

  15. 10 CFR 20.1202 - Compliance with requirements for summation of external and internal doses.

    Science.gov (United States)

    2010-01-01

    ... external and internal doses. (a) If the licensee is required to monitor under both §§ 20.1502 (a) and (b), the licensee shall demonstrate compliance with the dose limits by summing external and internal doses... compliance with the requirements for summation of external and internal doses by meeting one of the...

  16. Validation of an amino-acid-based radionuclide therapy plus external beam radiotherapy in heterotopic glioblastoma models

    Energy Technology Data Exchange (ETDEWEB)

    Israel, Ina [Department of Nuclear Medicine, University of Wuerzburg, D-97080 Wuerzburg (Germany); Blass, Georg [Department of Radiotherapy and Radiooncology, Saarland University Medical Center, Homburg (Germany); Reiners, Christoph [Department of Nuclear Medicine, University of Wuerzburg, D-97080 Wuerzburg (Germany); Samnick, Samuel, E-mail: samnick_s@klinik.uni-wuerzburg.d [Department of Nuclear Medicine, University of Wuerzburg, D-97080 Wuerzburg (Germany)

    2011-05-15

    of the initial tumor volume and an enhanced radiosensitivity in Tx3868 and A1207 glioblastoma xenografts in CD1 nu/nu mice and RNU rats. On day 90 after monotherapy with [{sup 131}I]IPA (20 MBq) or RT (20 Gy), 35%-50% of the treated rats were still alive. In comparison, up to 70%-80% survival rates were registered after combined [{sup 131}I]IPA/RT treatment on day 100 for all animal models. Conclusions: These preclinical data convincingly demonstrated that [{sup 131}I]IPA plus external beam photon radiotherapy is a safe and highly effective treatment for experimental gliomas, which may merit a clinical trial to ascertain its potential as a therapeutic approach in patients. As only a low [{sup 131}I]IPA activity and a low RT dose were applied, further optimization strategies should be pursued experimentally, including application of higher radiation doses and conventional fractionated regimens or use of methods aiming to increase target doses and maximize dose effects.

  17. External Beam Radiotherapy for Clinically Localized Hormone-Refractory Prostate Cancer: Clinical Significance of Nadir Prostate-Specific Antigen Value Within 12 Months

    International Nuclear Information System (INIS)

    Ogawa, Kazuhiko; Nakamura, Katsumasa; Sasaki, Tomonari; Onishi, Hiroshi; Koizumi, Masahiko; Shioyama, Yoshiyuki; Araya, Masayuki; Mukumoto, Nobutaka M.S.; Mitsumori, Michihide; Teshima, Teruki

    2009-01-01

    Purpose: To analyze retrospectively the results of external beam radiotherapy for clinically localized hormone-refractory prostate cancer and investigate the clinical significance of nadir prostate-specific antigen (PSA) value within 12 months (nPSA12) as an early estimate of clinical outcomes after radiotherapy. Methods and Materials: Eighty-four patients with localized hormone-refractory prostate cancer treated with external beam radiotherapy were retrospectively reviewed. The total radiation doses ranged from 30 to 76 Gy (median, 66 Gy), and the median follow-up period for all 84 patients was 26.9 months (range, 2.7-77.3 months). Results: The 3-year actuarial overall survival, progression-free survival (PFS), and local control rates in all 84 patients after radiotherapy were 67%, 61%, and 93%, respectively. Although distant metastases and/or regional lymph node metastases developed in 34 patients (40%) after radiotherapy, local progression was observed in only 5 patients (6%). Of all 84 patients, the median nPSA12 in patients with clinical failure and in patients without clinical failure was 3.1 ng/mL and 0.5 ng/mL, respectively. When dividing patients according to low (<0.5 ng/mL) and high (≥0.5 ng/mL) nPSA12 levels, the 3-year PFS rate in patients with low nPSA12 and in those with high nPSA12 was 96% and 44%, respectively (p < 0.0001). In univariate analysis, nPSA12 and pretreatment PSA value had a significant impact on PFS, and in multivariate analysis nPSA12 alone was an independent prognostic factor for PFS after radiotherapy. Conclusions: External beam radiotherapy had an excellent local control rate for clinically localized hormone-refractory prostate cancer, and nPSA12 was predictive of clinical outcomes after radiotherapy.

  18. The calculation of dose from external photon exposures using reference human phantoms and Monte Carlo methods. Pt. 7. Organ doses due to parallel and environmental exposure geometries

    Energy Technology Data Exchange (ETDEWEB)

    Zankl, M. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz; Drexler, G. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz; Petoussi-Henss, N. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz; Saito, K. [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan)

    1997-03-01

    This report presents a tabulation of organ and tissue equivalent dose as well as effective dose conversion coefficients, normalised to air kerma free in air, for occupational exposures and environmental exposures of the public to external photon radiation. For occupational exposures, whole-body irradiation with idealised geometries, i.e. broad parallel beams and fully isotropic radiation incidence, is considered. The directions of incidence for the parallel beams are anterior-posterior, posterior-anterior, left lateral, right lateral and a full 360 rotation around the body`s longitudinal axis. The influence of beam divergence on the body doses is also considered as well as the dependence of effective dose on the angle of radiation incidence. Regarding exposure of the public to environmental sources, three source geometries are considered: exposure from a radioactive cloud, from ground contamination and from the natural radionuclides distributed homogeneously in the ground. The precise angular and energy distributions of the gamma rays incident on the human body were taken into account. The organ dose conversion coefficients given in this catalogue were calculated using a Monte Carlo code simulating the photon transport in mathematical models of an adult male and an adult female, respectively. Conversion coefficients are given for the equivalent dose of 23 organs and tissues as well as for effective dose and the equivalent dose of the so-called `remainder`. The organ equivalent dose conversion coefficients are given separately for the adult male and female models and - as arithmetic mean of the conversion coefficients of both - for an average adult. Fitted data of the coefficients are presented in tables; the primary raw data as resulting from the Monte Carlo calculation are shown in figures together with the fitted data. (orig.)

  19. The calculation of dose from external photon exposures using reference human phantoms and Monte Carlo methods. Pt. 7. Organ doses due to parallel and environmental exposure geometries

    International Nuclear Information System (INIS)

    Zankl, M.

    1997-03-01

    This report presents a tabulation of organ and tissue equivalent dose as well as effective dose conversion coefficients, normalised to air kerma free in air, for occupational exposures and environmental exposures of the public to external photon radiation. For occupational exposures, whole-body irradiation with idealised geometries, i.e. broad parallel beams and fully isotropic radiation incidence, is considered. The directions of incidence for the parallel beams are anterior-posterior, posterior-anterior, left lateral, right lateral and a full 360 rotation around the body's longitudinal axis. The influence of beam divergence on the body doses is also considered as well as the dependence of effective dose on the angle of radiation incidence. Regarding exposure of the public to environmental sources, three source geometries are considered: exposure from a radioactive cloud, from ground contamination and from the natural radionuclides distributed homogeneously in the ground. The precise angular and energy distributions of the gamma rays incident on the human body were taken into account. The organ dose conversion coefficients given in this catalogue were calculated using a Monte Carlo code simulating the photon transport in mathematical models of an adult male and an adult female, respectively. Conversion coefficients are given for the equivalent dose of 23 organs and tissues as well as for effective dose and the equivalent dose of the so-called 'remainder'. The organ equivalent dose conversion coefficients are given separately for the adult male and female models and - as arithmetic mean of the conversion coefficients of both - for an average adult. Fitted data of the coefficients are presented in tables; the primary raw data as resulting from the Monte Carlo calculation are shown in figures together with the fitted data. (orig.)

  20. Phase II trial of combined surgical resection, high dose rate intraoperative radiation therapy, and external beam radiotherapy for malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Raben, A.; Rusch, V.; Mychalczak, B.; Ginsberg, R.; Burt, M.; Bains, M.; Francois, Damien; Harrison, L.B.

    1997-01-01

    Purpose: To determine the feasibility of combining extrapleural pneumonectomy (EPP) or pleurectomy / decortication (PD), high dose rate intraoperative radiation therapy (HDR-IORT) and postoperative external beam radiation hemithoracic radiation (EBHRT) to treat malignant pleural mesothelioma (MPM). Materials and Methods: From 3/94 through 9/94, 15 patients (pts) were enrolled on this trial. This included 3 females and 12 males with a median age of 59 (Range: 45-75). Eligibility criteria included biopsy proven MPM, no evidence of T4 or N3 disease by exam/CT/MRI, no evidence of metastatic disease, no previous treatment, and a Karnofsky performance status of ≥ 80%. Pts with pulmonary function tests permitting EPP, underwent EPP and HDR-IORT (N=7). The rest underwent PD/HDR-IORT (N=4). An intraoperative dose of 15 Gy was prescribed to a depth of 5 mm in tissue to the ipsilateral mediastinum, diaphragm, and chest wall. Postoperatively, 54 Gy of EBHRT was prescribed to the hemithorax, surgical scar and surgical drain site. The median surgical procedure time, median IORT time and median overall operating time was 554 minutes, 240 minutes, and 649 minutes respectively. The median dose of EBHRT was 50.4 Gy (Range 50-54 Gy). The median follow-up time is 8 months (Range: 3.5 to 28 months). Four of 15 pts had unresectable disease at the time of surgery and were taken off study. Results are presented in crude and actuarial analysis. Results: A complete resection of all visible gross disease was accomplished in 10 pts. One pt had a single focus of gross residual disease (less than 5 mm in size) left behind in the chest wall. The overall complication rate was 54%. Treatment related mortality occurred in 2 pts (18%) at 1 and 7 months respectively. This was attributed to ARDS in 1 pt (EPP/HDR-IORT) and radiation pneumonitis combined with a tracheoesophageal fistula in 1 pt (PD/HDR-IORT). Of the 6 remaining pts undergoing EPP/HDR-IORT, 2 pts developed a postoperative empyema with

  1. Electron beam dose measurements with alanine/ESR dosimeter

    International Nuclear Information System (INIS)

    Rodrigues, O. Jr.; Galante, O.L.; Campos, L.L.

    2001-01-01

    When the aminoacid alanine, CH 3 -CH(NH 2 )-COOH, is exposed to radiation field, stable free radicals are produced. The predominant paramagnetic specie found at room temperature is the CH 3 -CH-COOH. Electron Spin Resonance - ESR is a technique used for quantification and analysis of radicals in solid and liquid samples. The evaluation of the amount of produced radicals can be associated with the absorbed dose . The alanine/ESR is an established dosimetry method employed for high doses evaluation, it presents good performance for X-rays, gamma, electrons, and protons radiation detection. The High Doses Dosimetry Laboratory of Ipen developed a dosimetric system based on alanina/ESR that presents good characteristics for use in gamma fields such as: wide dose range from 10 to 10 5 Gy, low fading, low uncertainty (<5%), no dose rate dependence and non-destructive ESR single readout. The detector is encapsulated in a special polyethylene tube that reduces the humidity problems and improves the mechanical resistance. The IPEN dosimeter was investigated for application in electron beam fields dosimetry

  2. Tumor bed delineation for external beam accelerated partial breast irradiation: A systematic review

    International Nuclear Information System (INIS)

    Yang, T. Jonathan; Tao, Randa; Elkhuizen, Paula H.M.; Vliet-Vroegindeweij, Corine van; Li, Guang; Powell, Simon N.

    2013-01-01

    In recent years, accelerated partial breast irradiation (APBI) has been considered an alternative to whole breast irradiation for patients undergoing breast-conserving therapy. APBI delivers higher doses of radiation in fewer fractions to the post-lumpectomy tumor bed with a 1–2 cm margin, targeting the area at the highest risk of local recurrence while sparing normal breast tissue. However, there are inherent challenges in defining accurate target volumes for APBI. Studies have shown that significant interobserver variation exists among radiation oncologists defining the lumpectomy cavity, which raises the question of how to improve the accuracy and consistency in the delineation of tumor bed volumes. The combination of standardized guidelines and surgical clips significantly improves an observer’s ability in delineation, and it is the standard in multiple ongoing external-beam APBI trials. However, questions about the accuracy of the clips to mark the lumpectomy cavity remain, as clips only define a few points at the margin of the cavity. This paper reviews the techniques that have been developed so far to improve target delineation in APBI delivered by conformal external beam radiation therapy, including the use of standardized guidelines, surgical clips or fiducial markers, pre-operative computed tomography imaging, and additional imaging modalities, including magnetic resonance imaging, ultrasound imaging, and positron emission tomography/computed tomography. Alternatives to post-operative APBI, future directions, and clinical recommendations were also discussed

  3. High dose rate brachytherapy for superficial cancer of the esophagus

    International Nuclear Information System (INIS)

    Maingon, Philippe; D'Hombres, Anne; Truc, Gilles; Barillot, Isabelle; Michiels, Christophe; Bedenne, Laurent; Horiot, Jean Claude

    2000-01-01

    Purpose: We analyzed our experience with external radiotherapy, combined modality treatment, or HDR brachytherapy alone to limited esophageal cancers. Methods and Materials: From 1991 to 1996, 25 patients with limited superficial esophagus carcinomas were treated by high dose rate brachytherapy. The mean age was 63 years (43-86 years). Five patients showed superficial local recurrence after external radiotherapy. Eleven patients without invasion of the basal membrane were staged as Tis. Fourteen patients with tumors involving the submucosa without spreading to the muscle were staged as T1. Treatment consisted of HDR brachytherapy alone in 13 patients, external radiotherapy and brachytherapy in 8 cases, and concomitant chemo- and radiotherapy in 4 cases. External beam radiation was administered to a total dose of 50 Gy using 2 Gy daily fractions in 5 weeks. In cases of HDR brachytherapy alone (13 patients), 6 applications were performed once a week. Results: The mean follow-up is 31 months (range 24-96 months). Twelve patients received 2 applications and 13 patients received 6 applications. Twelve patients experienced a failure (48%), 11/12 located in the esophagus, all of them in the treated volume. One patient presented an isolated distant metastasis. In the patients treated for superficial recurrence, 4/5 were locally controlled (80%) by brachytherapy alone. After brachytherapy alone, 8/13 patients were controlled (61%). The mean disease-free survival is 14 months (1-36 months). Overall survival is 76% at 1 year, 37% at 2 years, and 14% at 3 years. Overall survival for Tis patients is 24% vs. 20% for T1 (p 0.83). Overall survival for patients treated by HDR brachytherapy alone is 43%. One patient presented with a fistula with local failure after external radiotherapy and brachytherapy. Four stenosis were registered, two were diagnosed on barium swallowing without symptoms, and two required dilatations. Conclusion: High dose rate brachytherapy permits the treating

  4. Two-dimensional pencil beam scaling: an improved proton dose algorithm for heterogeneous media

    International Nuclear Information System (INIS)

    Szymanowski, Hanitra; Oelfke, Uwe

    2002-01-01

    New dose delivery techniques with proton beams, such as beam spot scanning or raster scanning, require fast and accurate dose algorithms which can be applied for treatment plan optimization in clinically acceptable timescales. The clinically required accuracy is particularly difficult to achieve for the irradiation of complex, heterogeneous regions of the patient's anatomy. Currently applied fast pencil beam dose calculations based on the standard inhomogeneity correction of pathlength scaling often cannot provide the accuracy required for clinically acceptable dose distributions. This could be achieved with sophisticated Monte Carlo simulations which are still unacceptably time consuming for use as dose engines in optimization calculations. We therefore present a new algorithm for proton dose calculations which aims to resolve the inherent problem between calculation speed and required clinical accuracy. First, a detailed derivation of the new concept, which is based on an additional scaling of the lateral proton fluence is provided. Then, the newly devised two-dimensional (2D) scaling method is tested for various geometries of different phantom materials. These include standard biological tissues such as bone, muscle and fat as well as air. A detailed comparison of the new 2D pencil beam scaling with the current standard pencil beam approach and Monte Carlo simulations, performed with GEANT, is presented. It was found that the new concept proposed allows calculation of absorbed dose with an accuracy almost equal to that achievable with Monte Carlo simulations while requiring only modestly increased calculation times in comparison to the standard pencil beam approach. It is believed that this new proton dose algorithm has the potential to significantly improve the treatment planning outcome for many clinical cases encountered in highly conformal proton therapy. (author)

  5. High-dose-rate brachytherapy in uterine cervical carcinoma

    International Nuclear Information System (INIS)

    Patel, Firuza D.; Rai, Bhavana; Mallick, Indranil; Sharma, Suresh C.

    2005-01-01

    Purpose: High-dose-rate (HDR) brachytherapy is in wide use for curative treatment of cervical cancer. The American Brachytherapy Society has recommended that the individual fraction size be <7.5 Gy and the range of fractions should be four to eight; however, many fractionation schedules, varying from institution to institution, are in use. We use 9 Gy/fraction of HDR in two to five fractions in patients with carcinoma of the uterine cervix. We found that our results and toxicity were comparable to those reported in the literature and hereby present our experience with this fractionation schedule. Methods and Materials: A total of 121 patients with Stage I-III carcinoma of the uterine cervix were treated with HDR brachytherapy between 1996 and 2000. The total number of patients analyzed was 113. The median patient age was 53 years, and the histopathologic type was squamous cell carcinoma in 93% of patients. The patients were subdivided into Groups 1 and 2. In Group 1, 18 patients with Stage Ib-IIb disease, tumor size <4 cm, and preserved cervical anatomy underwent simultaneous external beam radiotherapy to the pelvis to a dose of 40 Gy in 20 fractions within 4 weeks with central shielding and HDR brachytherapy of 9 Gy/fraction, given weekly, and interdigitated with external beam radiotherapy. The 95 patients in Group 2, who had Stage IIb-IIIb disease underwent external beam radiotherapy to the pelvis to a dose of 46 Gy in 23 fractions within 4.5 weeks followed by two sessions of HDR intracavitary brachytherapy of 9 Gy each given 1 week apart. The follow-up range was 3-7 years (median, 36.4 months). Late toxicity was graded according to the Radiation Therapy Oncology Group criteria. Results: The 5-year actuarial local control and disease-free survival rate was 74.5% and 62.0%, respectively. The actuarial local control rate at 5 years was 100% for Stage I, 80% for Stage II, and 67.2% for Stage III patients. The 5-year actuarial disease-free survival rate was 88.8% for

  6. External dose assessment in the Ukraine following the Chernobyl accident

    Science.gov (United States)

    Frazier, Remi Jordan Lesartre

    While the physiological effects of radiation exposure have been well characterized in general, it remains unclear what the relationship is between large-scale radiological events and psychosocial behavior outcomes in individuals or populations. To investigate this, the National Science Foundation funded a research project in 2008 at the University of Colorado in collaboration with Colorado State University to expand the knowledge of complex interactions between radiation exposure, perception of risk, and psychosocial behavior outcomes by modeling outcomes for a representative sample of the population of the Ukraine which had been exposed to radiocontaminant materials released by the reactor accident at Chernobyl on 26 April 1986. In service of this project, a methodology (based substantially on previously published models specific to the Chernobyl disaster and the Ukrainian population) was developed for daily cumulative effective external dose and dose rate assessment for individuals in the Ukraine for as a result of the Chernobyl disaster. A software platform was designed and produced to estimate effective external dose and dose rate for individuals based on their age, occupation, and location of residence on each day between 26 April 1986 and 31 December 2009. A methodology was developed to transform published 137Cs soil deposition contour maps from the Comprehensive Atlas of Caesium Deposition on Europe after the Chernobyl Accident into a geospatial database to access these data as a radiological source term. Cumulative effective external dose and dose rate were computed for each individual in a 703-member cohort of Ukrainians randomly selected to be representative of the population of the country as a whole. Error was estimated for the resulting individual dose and dose rate values with Monte Carlo simulations. Distributions of input parameters for the dose assessment methodology were compared to computed dose and dose rate estimates to determine which

  7. Establishing the impact of temporary tissue expanders on electron and photon beam dose distributions.

    Science.gov (United States)

    Asena, A; Kairn, T; Crowe, S B; Trapp, J V

    2015-05-01

    This study investigates the effects of temporary tissue expanders (TTEs) on the dose distributions in breast cancer radiotherapy treatments under a variety of conditions. Using EBT2 radiochromic film, both electron and photon beam dose distribution measurements were made for different phantoms, and beam geometries. This was done to establish a more comprehensive understanding of the implant's perturbation effects under a wider variety of conditions. The magnetic disk present in a tissue expander causes a dose reduction of approximately 20% in a photon tangent treatment and 56% in electron boost fields immediately downstream of the implant. The effects of the silicon elastomer are also much more apparent in an electron beam than a photon beam. Evidently, each component of the TTE attenuates the radiation beam to different degrees. This study has demonstrated that the accuracy of photon and electron treatments of post-mastectomy patients is influenced by the presence of a tissue expander for various beam orientations. The impact of TTEs on dose distributions establishes the importance of an accurately modelled high-density implant in the treatment planning system for post-mastectomy patients. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  8. Effect of external magnetic field on critical current for the onset of virtual cathode oscillations in relativistic electron beams

    International Nuclear Information System (INIS)

    Hramov, Alexander; Koronovskii, Alexey; Morozov, Mikhail; Mushtakov, Alexander

    2008-01-01

    In this Letter we research the space charge limiting current value at which the oscillating virtual cathode is formed in the relativistic electron beam as a function of the external magnetic field guiding the beam electrons. It is shown that the space charge limiting (critical) current decreases with growth of the external magnetic field, and that there is an optimal induction value of the magnetic field at which the critical current for the onset of virtual cathode oscillations in the electron beam is minimum. For the strong external magnetic field the space charge limiting current corresponds to the analytical relation derived under the assumption that the motion of the electron beam is one-dimensional [D.J. Sullivan, J.E. Walsh, E. Coutsias, in: V.L. Granatstein, I. Alexeff (Eds.), Virtual Cathode Oscillator (Vircator) Theory, in: High Power Microwave Sources, vol. 13, Artech House Microwave Library, 1987, Chapter 13]. Such behavior is explained by the characteristic features of the dynamics of electron space charge in the longitudinal and radial directions in the drift space at the different external magnetic fields

  9. Comparison of measured with calculated dose distribution from a 120-MeV electron beam from a laser-plasma accelerator.

    Science.gov (United States)

    Lundh, O; Rechatin, C; Faure, J; Ben-Ismaïl, A; Lim, J; De Wagter, C; De Neve, W; Malka, V

    2012-06-01

    To evaluate the dose distribution of a 120-MeV laser-plasma accelerated electron beam which may be of potential interest for high-energy electron radiation therapy. In the interaction between an intense laser pulse and a helium gas jet, a well collimated electron beam with very high energy is produced. A secondary laser beam is used to optically control and to tune the electron beam energy and charge. The potential use of this beam for radiation treatment is evaluated experimentally by measurements of dose deposition in a polystyrene phantom. The results are compared to Monte Carlo simulations using the geant4 code. It has been shown that the laser-plasma accelerated electron beam can deliver a peak dose of more than 1 Gy at the entrance of the phantom in a single laser shot by direct irradiation, without the use of intermediate magnetic transport or focusing. The dose distribution is peaked on axis, with narrow lateral penumbra. Monte Carlo simulations of electron beam propagation and dose deposition indicate that the propagation of the intense electron beam (with large self-fields) can be described by standard models that exclude collective effects in the response of the material. The measurements show that the high-energy electron beams produced by an optically injected laser-plasma accelerator can deliver high enough dose at penetration depths of interest for electron beam radiotherapy of deep-seated tumors. Many engineering issues must be resolved before laser-accelerated electrons can be used for cancer therapy, but they also represent exciting challenges for future research. © 2012 American Association of Physicists in Medicine.

  10. SU-F-P-39: End-To-End Validation of a 6 MV High Dose Rate Photon Beam, Configured for Eclipse AAA Algorithm Using Golden Beam Data, for SBRT Treatments Using RapidArc

    Energy Technology Data Exchange (ETDEWEB)

    Ferreyra, M; Salinas Aranda, F; Dodat, D; Sansogne, R; Arbiser, S [Vidt Centro Medico, Ciudad Autonoma De Buenos Aires, Ciudad Autonoma de Buenos Aire (Argentina)

    2016-06-15

    Purpose: To use end-to-end testing to validate a 6 MV high dose rate photon beam, configured for Eclipse AAA algorithm using Golden Beam Data (GBD), for SBRT treatments using RapidArc. Methods: Beam data was configured for Varian Eclipse AAA algorithm using the GBD provided by the vendor. Transverse and diagonals dose profiles, PDDs and output factors down to a field size of 2×2 cm2 were measured on a Varian Trilogy Linac and compared with GBD library using 2% 2mm 1D gamma analysis. The MLC transmission factor and dosimetric leaf gap were determined to characterize the MLC in Eclipse. Mechanical and dosimetric tests were performed combining different gantry rotation speeds, dose rates and leaf speeds to evaluate the delivery system performance according to VMAT accuracy requirements. An end-to-end test was implemented planning several SBRT RapidArc treatments on a CIRS 002LFC IMRT Thorax Phantom. The CT scanner calibration curve was acquired and loaded in Eclipse. PTW 31013 ionization chamber was used with Keithley 35617EBS electrometer for absolute point dose measurements in water and lung equivalent inserts. TPS calculated planar dose distributions were compared to those measured using EPID and MapCheck, as an independent verification method. Results were evaluated with gamma criteria of 2% dose difference and 2mm DTA for 95% of points. Results: GBD set vs. measured data passed 2% 2mm 1D gamma analysis even for small fields. Machine performance tests show results are independent of machine delivery configuration, as expected. Absolute point dosimetry comparison resulted within 4% for the worst case scenario in lung. Over 97% of the points evaluated in dose distributions passed gamma index analysis. Conclusion: Eclipse AAA algorithm configuration of the 6 MV high dose rate photon beam using GBD proved efficient. End-to-end test dose calculation results indicate it can be used clinically for SBRT using RapidArc.

  11. New model for mines and transportation tunnels external dose calculation using Monte Carlo simulation

    International Nuclear Information System (INIS)

    Allam, Kh. A.

    2017-01-01

    In this work, a new methodology is developed based on Monte Carlo simulation for tunnels and mines external dose calculation. Tunnels external dose evaluation model of a cylindrical shape of finite thickness with an entrance and with or without exit. A photon transportation model was applied for exposure dose calculations. A new software based on Monte Carlo solution was designed and programmed using Delphi programming language. The variation of external dose due to radioactive nuclei in a mine tunnel and the corresponding experimental data lies in the range 7.3 19.9%. The variation of specific external dose rate with position in, tunnel building material density and composition were studied. The given new model has more flexible for real external dose in any cylindrical tunnel structure calculations. (authors)

  12. Intraoperative and external beam radiotherapy for pancreatic carcinoma; Intraoperative und perkutane Radiotherapie des Pankreaskarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Eble, M.J. [Abt. Klinische Radiologie, Radiologische Universitaetsklinik Heidelberg (Germany); Maurer, U. [Klinikum der Stadt Mannheim (Germany). Inst. fuer Radiologie

    1996-05-01

    Therapeutic strategies in the treatment of pancreatic carcinoma are based on the high number of non-resectable cancers, the high relative radioresistance and the high distant metastases rate. Even in curatively resected carcinomas, a locally effective treatment modality is needed because of the risk of microscopical residual disease in the peripancreatic tissue. The efficacy of radiotherapy is dose dependent. Based on an analysis of published data a dose of more than 50 Gy is recommended, resulting in a high morbidity rate with external beam radiotherapy alone. The use of intraoperative radiotherapy allows locally restricted dose escalation without increased perioperative morbidity. In adjuvant and in primary treatment, local tumor control was improved (70-90%). With palliative intent, pain relief was obtained rapidly in over 60% of patients and led to improved patient performance. As a result of the high distant metastases rate, even in curatively resected carcinomas, the overall prognosis could not be significantly improved. Further dose escalation is limited by the increasing incidence of upper gastrointestinal bleeding (20-30%). (orig.) [Deutsch] Therapiestrategien beim Pankreaskarzinom werden bestimmt durch den hohen Anteil primaer nicht resektabler Karzinome, der hohen relativen Strahlenresistenz und der hohen Fernmetastasierungsrate. Selbst kurativ resezierte Karzinome erfordern durch ihre hohe lokale Tumorzellpersistenz eine lokal effektive adjuvante Behandlungsmassnahme. Die Effektivitaet einer Radiotherapie ist dosisabhaengig. Aus der Analyse publizierter Daten wird eine Dosis von >50 Gy, welche bei der alleinigen perkutanen Bestrahlung mit einer hohen Morbiditaet verbunden ist, empfohlen. Mit der intraoperativen Radiotherapie ist eine lokal begrenzte Dosiseskalation ohne erhoehte perioperative Morbiditaet moeglich. Sowohl in der adjuvanten als auch in der primaeren Behandlung kann die lokale Tumorkontrolle deutlich verbessert werden (70-90%). Unter

  13. Calculation of dose conversion factors for doses in the fingernails to organ doses at external gamma irradiation in air

    International Nuclear Information System (INIS)

    Khailov, A.M.; Ivannikov, A.I.; Skvortsov, V.G.; Stepanenko, V.F.; Orlenko, S.P.; Flood, A.B.; Williams, B.B.; Swartz, H.M.

    2015-01-01

    Absorbed doses to fingernails and organs were calculated for a set of homogenous external gamma-ray irradiation geometries in air. The doses were obtained by stochastic modeling of the ionizing particle transport (Monte Carlo method) for a mathematical human phantom with arms and hands placed loosely along the sides of the body. The resulting dose conversion factors for absorbed doses in fingernails can be used to assess the dose distribution and magnitude in practical dose reconstruction problems. For purposes of estimating dose in a large population exposed to radiation in order to triage people for treatment of acute radiation syndrome, the calculated data for a range of energies having a width of from 0.05 to 3.5 MeV were used to convert absorbed doses in fingernails to corresponding doses in organs and the whole body as well as the effective dose. Doses were assessed based on assumed rates of radioactive fallout at different time periods following a nuclear explosion. - Highlights: • Elemental composition and density of nails were determined. • MIRD-type mathematical human phantom with arms and hands was created. • Organ doses and doses to nails were calculated for external photon exposure in air. • Effective dose and nail doses values are close for rotational and soil surface exposures.

  14. Time Course and Accumulated Risk of Severe Urinary Adverse Events After High- Versus Low-Dose-Rate Prostate Brachytherapy With or Without External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Tward, Jonathan D., E-mail: Jonathan.Tward@hci.utah.edu [Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah (United States); Jarosek, Stephanie; Chu, Haitao [University of Minnesota, Minneapolis, Minnesota (United States); Thorpe, Cameron; Shrieve, Dennis C. [Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah (United States); Elliott, Sean [University of Minnesota, Minneapolis, Minnesota (United States)

    2016-08-01

    Purpose: Severe urinary adverse events (UAEs) include surgical treatment of urethral stricture, urinary incontinence, and radiation cystitis. We compared the incidence of grade 3 UAEs, according to the Common Terminology Criteria for Adverse Events, after low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy, as well as after LDR plus external beam radiation therapy (EBRT) and HDR plus EBRT. Methods and Materials: Men aged >65 years with nonmetastatic prostate cancer were identified from the Surveillance, Epidemiology, and End Results–Medicare database who were treated with LDR (n=12,801), HDR (n=685), LDR plus EBRT (n=8518), or HDR plus EBRT (n=2392). The populations were balanced by propensity weighting, and the Kaplan-Meier incidence of severe UAEs was compared. Propensity-weighted Cox proportional hazards models were used to compare the adjusted hazard of UAEs. These UAEs were compared with those in a cohort of men not treated for prostate cancer. Results: Median follow-up was 4.3 years. At 8 years, the propensity-weighted cumulative UAE incidence was highest after HDR plus EBRT (26.6% [95% confidence interval, 23.8%-29.7%]) and lowest after LDR (15.7% [95% confidence interval, 14.8%-16.6%]). The absolute excess risk over nontreated controls at 8 years was 1.9%, 3.8%, 8.4%, and 12.9% for LDR, HDR, LDR plus EBRT, and HDR plus EBRT, respectively. These represent numbers needed to harm of 53, 26, 12, and 8 persons, respectively. The additional risk of development of a UAE related to treatment for LDR, LDR plus EBRT, and HDR plus EBRT was greatest within the 2 years after treatment and then continued to decline over time. Beyond 4 years, the risk of development of a new severe UAE matched the baseline risk of the control population for all treatments. Conclusions: Toxicity differences were observed between LDR and HDR, but the differences did not meet statistical significance. However, combination radiation therapy (either HDR plus EBRT or LDR plus

  15. Time Course and Accumulated Risk of Severe Urinary Adverse Events After High- Versus Low-Dose-Rate Prostate Brachytherapy With or Without External Beam Radiation Therapy

    International Nuclear Information System (INIS)

    Tward, Jonathan D.; Jarosek, Stephanie; Chu, Haitao; Thorpe, Cameron; Shrieve, Dennis C.; Elliott, Sean

    2016-01-01

    Purpose: Severe urinary adverse events (UAEs) include surgical treatment of urethral stricture, urinary incontinence, and radiation cystitis. We compared the incidence of grade 3 UAEs, according to the Common Terminology Criteria for Adverse Events, after low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy, as well as after LDR plus external beam radiation therapy (EBRT) and HDR plus EBRT. Methods and Materials: Men aged >65 years with nonmetastatic prostate cancer were identified from the Surveillance, Epidemiology, and End Results–Medicare database who were treated with LDR (n=12,801), HDR (n=685), LDR plus EBRT (n=8518), or HDR plus EBRT (n=2392). The populations were balanced by propensity weighting, and the Kaplan-Meier incidence of severe UAEs was compared. Propensity-weighted Cox proportional hazards models were used to compare the adjusted hazard of UAEs. These UAEs were compared with those in a cohort of men not treated for prostate cancer. Results: Median follow-up was 4.3 years. At 8 years, the propensity-weighted cumulative UAE incidence was highest after HDR plus EBRT (26.6% [95% confidence interval, 23.8%-29.7%]) and lowest after LDR (15.7% [95% confidence interval, 14.8%-16.6%]). The absolute excess risk over nontreated controls at 8 years was 1.9%, 3.8%, 8.4%, and 12.9% for LDR, HDR, LDR plus EBRT, and HDR plus EBRT, respectively. These represent numbers needed to harm of 53, 26, 12, and 8 persons, respectively. The additional risk of development of a UAE related to treatment for LDR, LDR plus EBRT, and HDR plus EBRT was greatest within the 2 years after treatment and then continued to decline over time. Beyond 4 years, the risk of development of a new severe UAE matched the baseline risk of the control population for all treatments. Conclusions: Toxicity differences were observed between LDR and HDR, but the differences did not meet statistical significance. However, combination radiation therapy (either HDR plus EBRT or LDR plus

  16. Time Course and Accumulated Risk of Severe Urinary Adverse Events After High- Versus Low-Dose-Rate Prostate Brachytherapy With or Without External Beam Radiation Therapy.

    Science.gov (United States)

    Tward, Jonathan D; Jarosek, Stephanie; Chu, Haitao; Thorpe, Cameron; Shrieve, Dennis C; Elliott, Sean

    2016-08-01

    Severe urinary adverse events (UAEs) include surgical treatment of urethral stricture, urinary incontinence, and radiation cystitis. We compared the incidence of grade 3 UAEs, according to the Common Terminology Criteria for Adverse Events, after low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy, as well as after LDR plus external beam radiation therapy (EBRT) and HDR plus EBRT. Men aged >65 years with nonmetastatic prostate cancer were identified from the Surveillance, Epidemiology, and End Results-Medicare database who were treated with LDR (n=12,801), HDR (n=685), LDR plus EBRT (n=8518), or HDR plus EBRT (n=2392). The populations were balanced by propensity weighting, and the Kaplan-Meier incidence of severe UAEs was compared. Propensity-weighted Cox proportional hazards models were used to compare the adjusted hazard of UAEs. These UAEs were compared with those in a cohort of men not treated for prostate cancer. Median follow-up was 4.3 years. At 8 years, the propensity-weighted cumulative UAE incidence was highest after HDR plus EBRT (26.6% [95% confidence interval, 23.8%-29.7%]) and lowest after LDR (15.7% [95% confidence interval, 14.8%-16.6%]). The absolute excess risk over nontreated controls at 8 years was 1.9%, 3.8%, 8.4%, and 12.9% for LDR, HDR, LDR plus EBRT, and HDR plus EBRT, respectively. These represent numbers needed to harm of 53, 26, 12, and 8 persons, respectively. The additional risk of development of a UAE related to treatment for LDR, LDR plus EBRT, and HDR plus EBRT was greatest within the 2 years after treatment and then continued to decline over time. Beyond 4 years, the risk of development of a new severe UAE matched the baseline risk of the control population for all treatments. Toxicity differences were observed between LDR and HDR, but the differences did not meet statistical significance. However, combination radiation therapy (either HDR plus EBRT or LDR plus EBRT) increases the risk of severe UAEs compared with HDR

  17. External dose reconstruction in tooth enamel of Techa riverside residents

    Energy Technology Data Exchange (ETDEWEB)

    Shishkina, E.A.; Volchkova, A.Yu.; Krivoschapov, V.A.; Degteva, M.O. [Urals Research Center for Radiation Medicine, Chelyabinsk (Russian Federation); Timofeev, Y.S.; Zalyapin, V.I. [Southern Urals State University, Chelyabinsk (Russian Federation); Fattibene, P.; Della Monaca, S.; De Coste, V. [Istituto Superiore di Sanita e Istituto Nazionale di Fisica Nucleare, Rome (Italy); Wieser, A. [Helmholtz Zentrum Muenchen, German Research Centre for Environmental Health, Neuherberg (Germany); Ivanov, D.V. [M.N. Mikheev Institute of Metal Physics, Ural Division of the Russian Academy of Sciences, Ekaterinburg (Russian Federation); Ural Federal University, Yekaterinburg (Russian Federation); Anspaugh, L.R. [University of Utah, Salt Lake City, UT (United States)

    2016-11-15

    This study summarizes the 20-year efforts for dose reconstruction in tooth enamel of the Techa riverside residents exposed to ionizing radiation as a result of radionuclide releases into the river in 1949-1956. It represents the first combined analysis of all the data available on EPR dosimetry with teeth of permanent residents of the Techa riverside territory. Results of electron paramagnetic resonance (EPR) measurements of 302 teeth donated by 173 individuals living permanently in Techa riverside settlements over the period of 1950-1952 were analyzed. These people were residents of villages located at the free-flowing river stream or at the banks of stagnant reservoirs such as ponds or blind river forks. Cumulative absorbed doses measured using EPR are from several sources of exposure, viz., background radiation, internal exposure due to bone-seeking radionuclides ({sup 89}Sr, {sup 90}Sr/{sup 90}Y), internal exposure due to {sup 137}Cs/{sup 137m}Ba incorporated in soft tissues, and anthropogenic external exposure. The purpose of the present study was to evaluate the contribution of different sources of enamel exposure and to deduce external doses to be used for validation of the Techa River Dosimetry System (TRDS). Since various EPR methods were used, harmonization of these methods was critical. Overall, the mean cumulative background dose was found to be 63 ± 47 mGy; cumulative internal doses due to {sup 89}Sr and {sup 90}Sr/{sup 90}Y were within the range of 10-110 mGy; cumulative internal doses due to {sup 137}Cs/{sup 137m}Ba depend on the distance from the site of releases and varied from 1 mGy up to 90 mGy; mean external doses were maximum for settlements located at the banks of stagnant reservoirs (∝500 mGy); in contrast, external doses for settlements located along the free-flowing river stream did not exceed 160 mGy and decreased downstream with increasing distance from the site of release. External enamel doses calculated using the TRDS code and

  18. Does prostate brachytherapy treat the seminal vesicles? A dose-volume histogram analysis of seminal vesicles in patients undergoing combined PD-103 prostate implantation and external beam irradiation

    International Nuclear Information System (INIS)

    Stock, Richard G.; Lo, Yeh-Chi; Gaildon, Mohamoud; Stone, Nelson N.

    1999-01-01

    Purpose: Combined brachytherapy of the prostate and external beam irradiation (EBRT) of the prostate and seminal vesicles (SV) is becoming a popular treatment for high-risk prostate cancer. Dose-volume histogram (DVH) analysis of the SV in patients undergoing this treatment was performed to determine the dose distribution to the SV and the adequacy of this treatment in patients with potential SV involvement. Methods and Materials: Twenty-five consecutive patients were treated with a Pd-103 implant of the prostate alone and 45 Gy of EBRT to the prostate and SV. Attempts were not made to implant the SV but seeds were routinely placed at the junction of the prostate and SV. All patients underwent CT-based post implant dosimetric analysis 1 month after implantation. As part of this analysis, DVH were generated for the prostate and total SV volume (SVT). In addition, the SV was divided into 6-mm-thick volumes identified as SV1, SV2, SV3, SV4, and SV5 starting from the junction of the prostate and SV and extending distally. DVH were also generated for these structures. Delivered dose was defined as the D90 (dose delivered to 90% of the organ on DVH). Results: The median volumes in cc of the prostate, SVT, SV1, SV2, SV3, SV4, and SV5 were 34.33, 9.75, 2.7, 3.48, 2.92, 3.18, and 1.96 respectively. The SVT contained from 0-9 seeds (median 2). There was little dose delivered to the SVT and SV volumes from the implanted prostate. The median D90 values for the prostate, SVT, SV1, SV2, SV3, SV4, and SV5 were 8615 cGy, 675 cGy, 3100 cGy, 1329 cGy, 553 cGy, 246 cGy, and 67 cGy, respectively. The dose delivered to the prostate covered small percentages of SV. The percents of SV volumes covered by the prostate D90 were 11, 35, 3.3, 0, 0, and 0 for SVT, SV1, SV2, SV3, SV4, and SV5, respectively. Conclusions: DVH analysis of the SV reveals that dose generated from an implanted prostate contributes little to the SV. Those patients at high risk for SV involvement may be under treated

  19. Estimation of individual doses from external exposures and dose-group classification of cohort members in high background radiation area in Yangjiang, China

    International Nuclear Information System (INIS)

    Yuan Yongling; Shen Hong; Sun Quanfu; Wei Luxin

    1999-01-01

    Objective: In order to estimate annual effective doses from external exposures in the high background radiation area (HBRA) and in the control area (CA) , the authors measured absorbed dose rates in air from terrestrial gamma radiation with different dosimeters. A dose group classification was an important step for analyzing the dose effects relationship among the cohort members in the investigated areas. The authors used the hamlet specific average annual effective doses of all the 526 hamlets in the investigated areas. A classification of four dose groups was made for the cohort members (high, moderate, low and control) . Methods: For the purpose of studying the dose effect relationships among the cohort members in HBRA and CA, it would be ideal that each subject has his own record of individual accumulated doses received before the evaluation. However, rt is difficult to realize it in practice (each of 106517 persons should wear TLD for a long time) . Thus the authors planned two sets of measurements. Firstly, to measure the environmental dose rates (outdoor, indoor, over the bed) in every hamlet of the investigated area (526 hamlets) , considering the occupancy factors for males and females of different age groups to convert to the annual effective dose from the data of dose rates. Secondly, to measure the individual cumulative dose with TLD for part of the subjects in the investigated areas. Results: Based on the two sets of measurements, the estimates of average annual effective doses in HBRA were 211.86 and 206.75 x 10 -5 Sv/a, respectively, 68.60 and 67.11 x 10 -5 Sv/a, respectively(gamma radiation only) . The intercomparison between these two sets of measurement showed that they were in good correlation. Thus the authors are able to yield the equations of linear regression: Y = 0.9937 + 6.0444, r = 0.9949. Conclusions: The authors took the value obtained from direct measurement as 'standard' , and 15 % for uncertainty of measurement. Since the estimates of

  20. SU-E-T-514: Investigating the Dose Distributions of Equiangular Spaced Noncoplanar Beams

    International Nuclear Information System (INIS)

    Mitchell, T; Maxim, P; Hadsell, M; Loo, B

    2015-01-01

    Purpose It has been demonstrated that the use of noncoplanar beams in radiation therapy may Result in dose distributions that are comparable or better than standard coplanar beams [Pugachev, 2001]. A radiation therapy system designed with a noncoplanar beam geometry could allow for a full ring diagnostic quality imaging system to be placed around the patient. Additionally, if the noncoplanar beams were fixed in number and in their angle with respect to the patient’s axial plane, then both treatment and imaging could be achieved concurrently without the need for moving parts, which could greatly reduce treatment times. For such a system to be designed, it is necessary to determine the appropriate number of beams and the beam angles to achieve optimal dose distributions. For simplicity, the beam angles are assumed to be equiangular in the patient’s axial plane, and only the beam angle with respect to the axial plane are varied. This study aims to investigate the dose distributions produced by equiangular noncoplanar beams for multiple beam numbers and beam angles, and to compare these dose distributions with distributions achieved in coplanar volumetric arc therapy (VMAT). Methods Dose distributions produced by noncoplanar beams were calculated using the Varian Eclipse treatment planning system by varying the gantry, collimator, and couch angles to simulate the noncoplanar delivery method. Noncoplanar intensity-modulated (NC-IMRT) beams using 8, 12, and 16 beams with angles varying from 45 degrees to 54 with respect to the patient’s axial plane were studied. Results The NC-IMRT beams produced dose distributions comparable to VMAT plans for a number of treatment sites, and were capable of meeting similar dose-volume histogram constraints. Conclusion This study has demonstrated that a noncoplanar beam delivery method with fixed beam numbers and beam angles is capable of delivering dose distributions comparable to VMAT plans currently in use

  1. Low grade gliomas: preliminary analysis of failure patterns among patients treated using 3D conformal external beam irradiation

    International Nuclear Information System (INIS)

    Pu, Anthony T.; Sandler, Howard M.; Radany, Eric H.; Blaivas, Mila; Page, Michaelyn A.; Greenberg, Harry S.; Junck, Larry; Ross, Donald A.

    1995-01-01

    Purpose: The pattern of failure of low grade gliomas following radiotherapy is less well known than that of the high grade gliomas. Stereotactic histologic studies have suggested that tumor cells extend beyond imaging abnormalities, and that large margins would be required for radiotherapy target volumes to encompass all of the neoplasm. Our experience using computerized tomography (CT)- and magnetic resonance (MR)-planned irradiation of low grade gliomas was reviewed to determine the pattern of tumor recurrence, in an effort to clinically define the minimum margin required. Methods and Materials: Forty-six patients with low grade supratentorial gliomas were treated between April 1985 and November 1992 using three-dimensional (3D) conformal CT- or MR-planned external beam radiotherapy. Fields were designed to encompass a target volume created by adding a margin to the tumor in three dimensions. Generally, patients were treated using shrinking fields with an initial target (tumor plus a 1 to 3 cm margin) treated to a dose of 45 to 50.4 (median 50.4) Gy, and a boost (tumor plus a 0 to 2 cm margin) treated to a total of 54 to 59.4 (median 59.4) Gy. Median follow-up was 32.9 months. Results: There have been 11 failures; all of these occurred within the radiographic abnormality (either T2 prolongation or CT hypodensity) visualized at the time of treatment planning (i.e., all failures were within the boost volume). Median time to failure was 53 months. Because all failures were local, there was no relationship between the amount by which the tumor volumes were expanded to create target volumes and the eventual outcome. Conclusion: Despite pathologic data suggesting that low grade glioma cells can be found outside the MR T2-signal abnormality in many cases, our results demonstrate that conformal external beam radiotherapy, in which the high dose volume is limited, does not result in increased marginal or out-of-field failures. Until control of tumor within the

  2. Late effects of post-high-dose-rate brachytherapy for oropharyngeal carcinoma: are they severer than post-low-dose-rate?

    International Nuclear Information System (INIS)

    Nose, T.; Koizumi, M.; Nishiyama, K.; Peiffert, D.; Lapeyre, M.; Hoffstetter, S.

    2004-01-01

    Background: late effects by high-dose-rate (HDR) brachytherapy have been believed severer than low-dose-rate (LDR) provided tumor control was constant. Local control of oropharyngeal carcinoma with HDR at Osaka Medical Center was comparable to LDR series from Centre Alexis Vautrin (82%, 79.5%, respectively). To assess the feasibility of HDR brachytherapy, the late effects were compared. Patients and methods: the data of 29 HDR and 24 LDR patients (median follow-up of 27 and 29.5 months, respectively; p = 0.89) were collected. The HDR schedule was 21 Gy/3.5 fractions/2 days following 46 Gy/23 fractions external beam, while 25 Gy/3 days following 50 Gy/25 fractions external beam was for LDR. Late changes were evaluated using RTOG/EORTC late morbidity scoring scheme. For subclinical late changes, mucosa chapter of Dische score was modified for brachytherapy. Scores were discussed through photos and were agreed on by authors. Late sequelae were estimated, by reviewing charts, concerning frequency, severity, and duration of mucosal damages (erosion and ulcer). Results: Late changes were of no difference (p = 0.12 for EORTC/RTOG, and p = 0.45, 0.47, 1.00, 0.12, 0.16, 0.95, 0.27, 0.21 for erythema, ulceration, edema, thinning, pallor, telangiectasia, mobility impairment of tongue/faucial pillars, respectively, of the modified Dische score). Late sequelae showed no differences (p = 0.90, 0.12, 0.40 for frequency, severity, duration, respectively, of mucosal damages). Conclusion: the late effects by HDR were not severer than by LDR. HDR oropharyngeal brachytherapy is as safe as LDR. (orig.)

  3. Wavelength beam combining of a 980-nm tapered diode laser bar in an external cavity

    DEFF Research Database (Denmark)

    Vijayakumar, Deepak; Jensen, Ole Bjarlin; Thestrup Nielsen, Birgitte

    2010-01-01

    solution for preserving the beam quality of the bar in the range of that of a single emitter and at the same time, enabling the power scaling. We report spectral beam combining applied to a 12 emitter tapered laser bar at 980 nm. The external cavity has been designed for a wavelength separation of 4.0 nm......High power diode lasers are used in a large number of applications. A limiting factor for more widespread use of broad area lasers is the poor beam quality. Gain guided tapered diode lasers are ideal candidates for industrial applications that demands watt level output power with good beam quality...

  4. High and low energy gamma beam dump designs for the gamma beam delivery system at ELI-NP

    International Nuclear Information System (INIS)

    Yasin, Zafar; Matei, Catalin; Ur, Calin A.; Mitu, Iani-Octavian; Udup, Emil; Petcu, Cristian

    2016-01-01

    The Extreme Light Infrastructure - Nuclear Physics (ELI-NP) is under construction in Magurele, Bucharest, Romania. The facility will use two 10 PW lasers and a high intensity, narrow bandwidth gamma beam for stand-alone and combined laser-gamma experiments. The accurate estimation of particle doses and their restriction within the limits for both personel and general public is very important in the design phase of any nuclear facility. In the present work, Monte Carlo simulations are performed using FLUKA and MCNPX to design 19.4 and 4 MeV gamma beam dumps along with shielding of experimental areas. Dose rate contour plots from both FLUKA and MCNPX along with numerical values of doses in experimental area E8 of the facility are performed. The calculated doses are within the permissible limits. Furthermore, a reasonable agreement between both codes enhances our confidence in using one or both of them for future calculations in beam dump designs, radiation shielding, radioactive inventory, and other calculations releated to radiation protection. Residual dose rates and residual activity calculations are also performed for high-energy beam dump and their effect is negligible in comparison to contributions from prompt radiation.

  5. High and low energy gamma beam dump designs for the gamma beam delivery system at ELI-NP

    Energy Technology Data Exchange (ETDEWEB)

    Yasin, Zafar, E-mail: zafar.yasin@eli-np.ro; Matei, Catalin; Ur, Calin A.; Mitu, Iani-Octavian; Udup, Emil; Petcu, Cristian [Extreme Light Infrastructure - Nuclear Physics / Horia Hulubei National Institute for R& D in Physics and Nuclear Engineering, Bucharest-Magurele (Romania)

    2016-03-25

    The Extreme Light Infrastructure - Nuclear Physics (ELI-NP) is under construction in Magurele, Bucharest, Romania. The facility will use two 10 PW lasers and a high intensity, narrow bandwidth gamma beam for stand-alone and combined laser-gamma experiments. The accurate estimation of particle doses and their restriction within the limits for both personel and general public is very important in the design phase of any nuclear facility. In the present work, Monte Carlo simulations are performed using FLUKA and MCNPX to design 19.4 and 4 MeV gamma beam dumps along with shielding of experimental areas. Dose rate contour plots from both FLUKA and MCNPX along with numerical values of doses in experimental area E8 of the facility are performed. The calculated doses are within the permissible limits. Furthermore, a reasonable agreement between both codes enhances our confidence in using one or both of them for future calculations in beam dump designs, radiation shielding, radioactive inventory, and other calculations releated to radiation protection. Residual dose rates and residual activity calculations are also performed for high-energy beam dump and their effect is negligible in comparison to contributions from prompt radiation.

  6. Novel high dose rate lip brachytherapy technique to improve dose homogeneity and reduce toxicity by customized mold

    International Nuclear Information System (INIS)

    Feldman, Jon; Appelbaum, Limor; Sela, Mordechay; Voskoboinik, Ninel; Kadouri, Sarit; Weinberger, Jeffrey; Orion, Itzhak; Meirovitz, Amichay

    2014-01-01

    The purpose of this study is to describe a novel brachytherapy technique for lip Squamous Cell Carcinoma, utilizing a customized mold with embedded brachytherapy sleeves, which separates the lip from the mandible, and improves dose homogeneity. Seven patients with T2 lip cancer treated with a “sandwich” technique of High Dose Rate (HDR) brachytherapy to the lip, consisting of interstitial catheters and a customized mold with embedded catheters, were reviewed for dosimetry and outcome using 3D planning. Dosimetric comparison was made between the “sandwich” technique to “classic” – interstitial catheters only plan. We compared dose volume histograms for Clinical Tumor Volume (CTV), normal tissue “hot spots” and mandible dose. We are reporting according to the ICRU 58 and calculated the Conformal Index (COIN) to show the advantage of our technique. The seven patients (ages 36–81 years, male) had median follow-up of 47 months. Four patients received Brachytherapy and External Beam Radiation Therapy, 3 patients received brachytherapy alone. All achieved local control, with excellent esthetic and functional results. All patients are disease free. The Customized Mold Sandwich technique (CMS) reduced the high dose region receiving 150% (V150) by an average of 20% (range 1–47%), The low dose region (les then 90% of the prescribed dose) improved by 73% in average by using the CMS technique. The COIN value for the CMS was in average 0.92 as opposed to 0.88 for the interstitial catheter only. All differences (excluding the low dose region) were statistically significant. The CMS technique significantly reduces the high dose volume and increases treatment homogeneity. This may reduce the potential toxicity to the lip and adjacent mandible, and results in excellent tumor control, cosmetic and functionality

  7. External contamination and skin dose. From ICRP and regulations to skin dose evaluation in practice

    International Nuclear Information System (INIS)

    Le Coulteulx, I.; Apretna, D.; Beaugerie, M.; Fenolland, J.; Frey, R.; Gonin, M.; Landry, B.; Laporte, E.; Le Guen, B.; Leval, D.

    2006-01-01

    Dose limitation to the skin is an objective of radiation protection. Our aim is to propose in case of skin contamination in EDF NPPs a simply, quickly and reproducible procedure for evaluating skin dose. French regulation admit an annual limit for skin dose over one square centimeter equal to 500 mSv. ICRP Publication 26 and 60 recommend that dose assessment be performed only if skin dose might be equal to or more than 50 mSv at basal cells. To respect this recommendation, an alert value (A) must be determined. This value is the lowest value of measurement from which dose assessment has to be made, based on the hypothesis that uninterrupted work time in controlled area is no more than four hours. This alert value (A) has been established for three external detection equipments, and for the ten radionuclides commonly detected. In case of external contamination, a first measurement is performed. If the value exceeds value (A), other measurements are instituted because skin dose evaluation needs to know other parameters as: - the radioactivity of the most contaminated square centimeter of the skin, - the identity of the radionuclides and their relative proportion. At the same time, we have to evaluate the length of the exposure. At last, we use different compiled results in a program developed from excel software which allow to calculate automatically the skin dose. This work has allowed us to publish an occupational health guideline about the assessment of skin dose in case of external contamination in EDF NPPs and to create an information booklet for workers. The authors propose to examine used methodology and to demonstrate the software. (authors)

  8. Dosimetric comparison of partial and whole breast external beam irradiation in the treatment of early stage breast cancer

    International Nuclear Information System (INIS)

    Kim, Yongbok; Parda, David S.; Trombetta, Mark G.; Colonias, Athanasios; Werts, E. Day; Miller, Linda; Miften, Moyed

    2007-01-01

    A dosimetric comparison was performed on external-beam three-dimensional conformal partial breast irradiation (PBI) and whole breast irradiation (WBI) plans for patients enrolled in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 protocol at our institution. Twenty-four consecutive patients were treated with either PBI (12 patients) or WBI (12 patients). In the PBI arm, the lumpectomy cavity was treated to a total dose of 38.5 Gy at 3.85 Gy per fraction twice daily using a four-field noncoplanar beam setup. A minimum 6 h interval was required between fractions. In the WBI arm, the whole breast including the entirety of the lumpectomy cavity was treated to a total dose of 50.4 Gy at 1.8 Gy per fraction daily using opposed tangential beams. The lumpectomy cavity volume, planning target volume for evaluation (PTV E VAL), and critical structure volumes were contoured for both the PBI and WBI patients. Dosimetric parameters, dose volume histograms (DVHs), and generalized equivalent uniform dose (gEUD) for target and critical structures were compared. Dosimetric results show the PBI plans, compared to the WBI plans, have smaller hot spots in the PTV E VAL (maximum dose: 104.2% versus 110.9%) and reduced dose to the ipsilateral breast (V50: 48.6% versus 92.1% and V100: 10.2% versus 50.5%), contralateral breast (V3: 0.16% versus 2.04%), ipsilateral lung (V30: 5.8% versus 12.7%), and thyroid (maximum dose: 0.5% versus 2.0%) with p values ≤0.01. However, similar dose coverage of the PTV E VAL (98% for PBI and 99% for WBI, on average) was observed and the dose difference for other critical structures was clinically insignificant in both arms. The gEUD data analysis showed the reduction of dose to the ipsilateral breast and lung, contralateral breast and thyroid. In addition, preliminary dermatologic adverse event assessment data suggested reduced skin toxicity for patients treated with the PBI technique

  9. Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

    International Nuclear Information System (INIS)

    Lee, Sung Uk; Cho, Kwan Ho; Moon, Sung Ho; Choi, Sung Weon; Park, Joo Yong; Yun, Tak; Lee, Sang Hyun; Lim, Young Kyung; Jeong, Chi Young

    2014-01-01

    To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

  10. Diamond detector in absorbed dose measurements in high-energy linear accelerator photon and electron beams.

    Science.gov (United States)

    Ravichandran, Ramamoorthy; Binukumar, John Pichy; Al Amri, Iqbal; Davis, Cheriyathmanjiyil Antony

    2016-03-08

    Diamond detectors (DD) are preferred in small field dosimetry of radiation beams because of small dose profile penumbras, better spatial resolution, and tissue-equivalent properties. We investigated a commercially available 'microdiamond' detector in realizing absorbed dose from first principles. A microdiamond detector, type TM 60019 with tandem electrometer is used to measure absorbed doses in water, nylon, and PMMA phantoms. With sensitive volume 0.004 mm3, radius 1.1mm, thickness 1 x10(-3) mm, the nominal response is 1 nC/Gy. It is assumed that the diamond detector could collect total electric charge (nC) developed during irradiation at 0 V bias. We found that dose rate effect is less than 0.7% for changing dose rate by 500 MU/min. The reproducibility in obtaining readings with diamond detector is found to be ± 0.17% (1 SD) (n = 11). The measured absorbed doses for 6 MV and 15 MV photons arrived at using mass energy absorption coefficients and stop-ping power ratios compared well with Nd, water calibrated ion chamber measured absorbed doses within 3% in water, PMMA, and nylon media. The calibration factor obtained for diamond detector confirmed response variation is due to sensitivity due to difference in manufacturing process. For electron beams, we had to apply ratio of electron densities of water to carbon. Our results qualify diamond dosimeter as a transfer standard, based on long-term stability and reproducibility. Based on micro-dimensions, we recommend these detectors for pretreatment dose verifications in small field irradiations like stereotactic treatments with image guidance.

  11. External-beam boost prior to total-body irradiation in relapsed NHL transplant patients

    Energy Technology Data Exchange (ETDEWEB)

    Monson, Jedidiah M; Neuberg, Donna; Freedman, Arnold S; Tarbell, Nancy J; Nadler, Lee M; Mauch, Peter

    1995-07-01

    irradiation; of these 22 patients had {>=} 25% of one lung, or {>=} 15% of both lungs irradiated. Median EBB dose to the partially irradiated lung was 37.2 Gy (range, 16-63). Seven of the 26 patients receiving thoracic radiation (27%) developed symptomatic radiation pneumonitis. Symptoms have resolved in 4 patients and 3 patients have died of pulmonary complications. A total of 21 patients had abdominal radiation; 9 of these patients had direct kidney irradiation, defined as 10% or greater of total kidney volume. The median EBB dose to the partially treated kidney was 24 Gy. None of the 9 patients who received direct kidney irradiation have developed signs of kidney injury, although 1 of the 21 patients who received abdominal radiation developed a hemolytic uremia syndrome. Six patients had {>=} 50% of the heart irradiated to a median EBB dose of 37.8 Gy (range, 32-47.8). One patient developed a pericardial effusion and constrictive pericarditis after BMT while on IL-2 therapy; this patient died of respiratory causes (included in the pulmonary complication group above). CONCLUSIONS: Patients with recurrent lymphoma with gross residual disease after reinduction chemotherapy (defined as {>=} 2cm in size in this study) have a poor prognosis following BMT. In an attempt to improve the outcome of these patients, an external beam boost was given to sites of residual gross disease prior to BMT. The efficacy of this treatment remains uncertain. Caution must be exercised when using this approach to treat residual thoracic disease, as there is a high risk of associated radiation pneumonitis. However, for patients with resistant thoracic disease, external beam boost followed by BMT may offer the only potential for cure.

  12. Bilateral Rhegmatogenous Retinal Detachment during External Beam Radiotherapy

    Directory of Open Access Journals (Sweden)

    Takako Hidaka

    2016-06-01

    Full Text Available Herein, we report a case of nontraumatic bilateral rhegmatogenous retinal detachment (RRD during external beam radiotherapy for nonocular tumor, presented as an observational case study in conjunction with a review of the relevant literature. A 65-year-old male was referred to our hospital due to bilateral RRD. He underwent a biopsy for a tumor of the left frontal lobe 4 months prior to presentation, and the tumor had been diagnosed as primary central nerve system B-cell type lymphoma. He received chemotherapy and external beam radiotherapy for 1 month. There were no traumatic episodes. Bilateral retinal detachment occurred during a series of radiotherapies. Simultaneous nontraumatic bilateral retinal detachment is rare. The effects of radiotherapy on ocular functionality, particularly in cases involving retinal adhesion and vitreous contraction, may include RRD. Thus, it is necessary to closely monitor the eyes of patients undergoing radiotherapy, particularly those undergoing surgery for retinal detachment and those with a history of photocoagulation for retinal tears, a relevant family history, or risk factors known to be associated with RRD.

  13. Outline of manual on measurement and assessment of doses from external radiation

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizawa, Michio [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Tsujimura, Norio

    2001-03-01

    The external exposure part in the manual for measurement and assessment of doses from external radiation is described since the part is changed in accordance with the revision of the Law Concerning Prevention from Radiation Hazard due to Radioisotopes, Etc. The manual contains general remarks, control of external exposure and its methods, person monitoring, site monitoring, correction of instruments and storage of records. The 2nd and 3rd chapters are described in details, because which are considerably changed together with appendices concerning the operational quantity for measuring external dose, conversion coefficients, and correlations of 3 mm, 1 cm and 70 {mu}m dose equivalents. Making manuals unique to the individual offices, etc. is recommended in compliance with the above manual.(K.H.)

  14. Microdosimetry of high LET therapeutic beams

    International Nuclear Information System (INIS)

    Ito, Akira

    1980-01-01

    Experimental microdosimetry of high LET therapeutic beams were presented. The cyclotron produced fast neutron beams at IMS, TAMVEC and NRL, a reactor fast neutron at YAYOI, a proctor beam at Harvard and a pion beam at TRIUMF are included. Measurements were performed with a conventional tissue equivalent spherical proportional counter with a logarithmic amplifier which made the recording and analysis quite simple. All the energy deposition spectra were analysed in the conventional manner and anti y F, anti y D as well as anti y D* were calculated. The spectra and their mean lineal energies showed wide variations, depending on the particle type, energy, position in phantom. Fractional contribution of elemental particles ( electron, muon, pion, proton, alpha and so on) to the total dose were analysed. For fast neutron beams, the y spectra stayed almost constant at any depth along the central axis in the phantom. The y spectra of proton beam changed slightly along the depth. On the other side, the y spectra of pion beam change drastically in the phantom between plateau and dose peak region. A novel technique of time-of-flight microdosimetry was employed, which made it possible to separate the fractional contribution of contaminant electrons and muons out of pions. Finally, a map of the radiation quality for all the beams is presented and its significances are discussed. (author)

  15. Estimate on external effective doses received by the Iranian population from environmental gamma radiation sources

    Energy Technology Data Exchange (ETDEWEB)

    Roozitalab, J.; Reza deevband, M.; Rastkhah, N. [National Radiation Protection Dept. Atomic Energy Organization (Iran, Islamic Republic of); Sohrabi, M. [Intenatinal atomic Energy Agency, Vienna (Austria)

    2006-07-01

    Concentration of natural radioactive materials, especially available U 238, Ra 226, Th 232, and K 40 in construction materials and soil, as well as absorb dose from cosmic rays, is the most important source of the people for effective doses from the environment radiation. In order to evaluate external effective dose, it has been carried out more than 1000 measurements in 36 cities by sensitive dosimeters to environmental gamma radiation for indoor and outdoor conditions in residential areas; which its results show that range of gamma exposure for inside of buildings in Iran is 8.7-20.5 {mu}R/h, and outdoor environments of different cities is 7.9-20.6 {mu}R/h, which their mean value are 14.33 and 12.62 {mu}R/h respectively. Meanwhile, it has been estimated that beam-absorbing ratio between indoor and outdoor in measured environments is 1.55, except contribution of cosmic rays. This studies show that average effective dose for each Iranian person from environmental gamma is 96.9 n Sv/h, and annually effective dose for every person is 0.848 mSv. (authors)

  16. Estimate on external effective doses received by the Iranian population from environmental gamma radiation sources

    International Nuclear Information System (INIS)

    Roozitalab, J.; Reza deevband, M.; Rastkhah, N.; Sohrabi, M.

    2006-01-01

    Concentration of natural radioactive materials, especially available U 238, Ra 226, Th 232, and K 40 in construction materials and soil, as well as absorb dose from cosmic rays, is the most important source of the people for effective doses from the environment radiation. In order to evaluate external effective dose, it has been carried out more than 1000 measurements in 36 cities by sensitive dosimeters to environmental gamma radiation for indoor and outdoor conditions in residential areas; which its results show that range of gamma exposure for inside of buildings in Iran is 8.7-20.5 μR/h, and outdoor environments of different cities is 7.9-20.6 μR/h, which their mean value are 14.33 and 12.62 μR/h respectively. Meanwhile, it has been estimated that beam-absorbing ratio between indoor and outdoor in measured environments is 1.55, except contribution of cosmic rays. This studies show that average effective dose for each Iranian person from environmental gamma is 96.9 n Sv/h, and annually effective dose for every person is 0.848 mSv. (authors)

  17. External post-operational checks for the LHC beam dumping system

    International Nuclear Information System (INIS)

    Magnin, N.; Baggiolini, V.; Carlier, E.; Goddard, B.; Gorbonosov, R.; Khasbulatov, D.; Uythoven, J.; Zerlauth, M.

    2012-01-01

    The LHC Beam Dumping System (LBDS) is a critical part of the LHC machine protection system. After every LHC beam dump action the various signals and transient data recordings of the beam dumping control systems and beam instrumentation measurements are automatically analysed by the external Post-Operational Checks (XPOC) system to verify the correct execution of the dump action and the integrity of the related equipment. This software system complements the LHC machine protection hardware, and has to ascertain that the beam dumping system is 'as good as new' before the start of the next operational cycle. This is the only way by which the stringent reliability requirements can be met. The XPOC system has been developed within the framework of the LHC 'Post-Mortem' system, allowing highly dependable data acquisition, data archiving, live analysis of acquired data and replay of previously recorded events. It is composed of various analysis modules, each one dedicated to the analysis of measurements coming from specific equipment. This paper describes the global architecture of the XPOC system and gives examples of the analyses performed by some of the most important analysis modules. It explains the integration of the XPOC into the LHC control infrastructure along with its integration into the decision chain to allow proceeding with beam operation. Finally, it discusses the operational experience with the XPOC system acquired during the first years of LHC operation, and illustrates examples of internal system faults or abnormal beam dump executions which it has detected. (authors)

  18. Acute genitourinary toxicity after high-dose-rate (HDR) brachytherapy combined with hypofractionated external-beam radiation therapy for localized prostate cancer: Correlation between the urethral dose in HDR brachytherapy and the severity of acute genitourinary toxicity

    International Nuclear Information System (INIS)

    Akimoto, Tetsuo; Ito, Kazuto; Saitoh, Jun-ichi; Noda, Shin-ei; Harashima, Koichi; Sakurai, Hideyuki; Nakayama, Yuko; Yamamoto, Takumi; Suzuki, Kazuhiro; Nakano, Takashi; Niibe, Hideo

    2005-01-01

    Purpose: Several investigations have revealed that the α/β ratio for prostate cancer is atypically low, and that hypofractionation or high-dose-rate (HDR) brachytherapy regimens using appropriate radiation doses may be expected to yield tumor control and late sequelae rates that are better or at least as favorable as those achieved with conventional radiation therapy. In this setting, we attempted treating localized prostate cancer patients with HDR brachytherapy combined with hypofractionated external beam radiation therapy (EBRT). The purpose of this study was to evaluate the feasibility of using this approach, with special emphasis on the relationship between the severity of acute genitourinary (GU) toxicity and the urethral dose calculated from the dose-volume histogram (DVH) of HDR brachytherapy. Methods and Materials: Between September 2000 and December 2003, 70 patients with localized prostate cancer were treated by iridium-192 HDR brachytherapy combined with hypofractionated EBRT at the Gunma University Hospital. Hypofractionated EBRT was administered in fraction doses of 3 Gy, three times per week; a total dose of 51 Gy was delivered to the prostate gland and the seminal vesicles using the four-field technique. No elective pelvic irradiation was performed. After the completion of EBRT, all the patients additionally received transrectal ultrasonography (TRUS)-guided HDR brachytherapy. The fraction size and the number of fractions in HDR brachytherapy were prospectively changed, whereas the total radiation dose for EBRT was fixed at 51 Gy. The fractionation in HDR brachytherapy was as follows: 5 Gy x 5, 7 Gy x 3, 9 Gy x 2, administered twice per day, although the biologic effective dose (BED) for HDR brachytherapy combined with EBRT, assuming that the α/β ratio is 3, was almost equal to 138 in each fractionation group. The planning target volume was defined as the prostate gland with 5-mm margin all around, and the planning was conducted based on

  19. High electron beam dosimetry using ZrO2

    International Nuclear Information System (INIS)

    Lueza M, F.; Rivera M, T.; Azorin N, J.; Garcia H, M.

    2009-10-01

    This paper reports the experimental results of studying the thermoluminescent (Tl) properties of ZrO 2 powder embedded in polytetrafluorethylene (PTFE) exposed to high energy electron beam from linear accelerators (Linac). Structural and morphological characteristics were also reported. Irradiations were conducted using high energy electrons beams in the range from 2 to 18 MeV. Pellets of ZrO 2 +PTFE were produced using polycrystalline powder grown by the precipitation method. These pellets presented a Tl glow curve exhibiting an intense glow peak centered at around 235 C. Tl response as a function of high electron absorbed dose was linear in the range from 2 to 30 Gy. Repeatability determined by exposing a set of pellets repeatedly to the same electron absorbed dose was 0.5%. Fading along 30 days was about 50%. Then, results obtained in this study suggest than ZrO 2 +PTFE pellets could be used for high energy electron beam dosimetry provided fading correction is accounted for. (Author)

  20. An investigation of dose changes for therapeutic kilovoltage x-ray beams with underlying lead shielding

    International Nuclear Information System (INIS)

    Hill, Robin; Healy, Brendan; Holloway, Lois; Baldock, Clive

    2007-01-01

    Kilovoltage x-ray beams are used to treat cancer on or close to the skin surface. Many clinical cases use high atomic number materials as shielding to reduce dose to underlying healthy tissues. In this work, we have investigated the effect on both the surface dose and depth doses in a water phantom with lead shielding at depth in the phantom. The EGSnrc Monte Carlo code was used to simulate the water phantom and to calculate the surface doses and depth doses using primary x-ray beam spectra derived from an analytical model. The x-ray beams were in the energy range of 75-135 kVp with field sizes of 2, 5 and 8 cm diameter. The lead sheet was located beneath the water surface at depths ranging from 0.5-7.5 cm. The surface dose decreased as the lead was positioned closer to the water surface and as the field size was increased. The variation in surface dose as a function of x-ray beam energy was only small but the maximum reduction occurred for the 100 kVp x-ray beam. For the 8 cm diameter field with the lead at 1 cm depth and using the 100 kVp x-ray beam, the surface dose was reduced to 0.898 of the surface dose in the water phantom only. Measured surface dose changes, using a Farmer-type ionization chamber, agreed with the Monte Carlo calculated doses. Calculated depth doses in water with a lead sheet positioned below the surface showed that the dose fall-off increased as the lead was positioned closer to the water surface as compared to the depth dose in the water phantom only. Monte Carlo calculations of the total x-ray beam spectrum at the water surface showed that the total fluence decreased due to a reduction in backscatter from within the water and very little backscatter from the lead. The mean energy of the x-ray spectrum varied less than 1 keV, with the lead at 1 cm beneath the water phantom surface. As the Monte Carlo calculations showed good agreement with the measured results, this method can be used to verify surface dose changes in clinical situations

  1. Integral dose investigation of non-coplanar treatment beam geometries in radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Dan; Dong, Peng; Ruan, Dan; Low, Daniel A.; Sheng, Ke, E-mail: ksheng@mednet.ucla.edu [Department of Radiation Oncology, University of California, Los Angeles, California 90095 (United States); Long, Troy; Romeijn, Edwin [Department of Industrial and Operations, University of Michigan, Ann Arbor, Michigan 48109 (United States)

    2014-01-15

    Purpose: Automated planning and delivery of non-coplanar plans such as 4π radiotherapy involving a large number of fields have been developed to take advantage of the newly available automated couch and gantry on C-arm gantry linacs. However, there is an increasing concern regarding the potential changes in the integral dose that needs to be investigated. Methods: A digital torso phantom and 22 lung and liver stereotactic body radiation therapy (SBRT) patients were included in the study. The digital phantom was constructed as a water equivalent elliptical cylinder with a major axis length of 35.4 cm and minor axis of 23.6 cm. A 4.5 cm diameter target was positioned at varying depths along the major axis. Integral doses from intensity modulated, non-coplanar beams forming a conical pattern were compared against the equally spaced coplanar beam plans. Integral dose dependence on the phantom geometry and the beam number was also quantified. For the patient plans, the non-coplanar and coplanar beams and fluences were optimized using a column generation and pricing approach and compared against clinical VMAT plans using two full (lung) or partial coplanar arcs (liver) entering at the side proximal to the tumor. Both the average dose to the normal tissue volume and the total volumes receiving greater than 2 Gy (V2) and 5 Gy (V5) were evaluated and compared. Results: The ratio of integral dose from the non-coplanar and coplanar plans depended on the tumor depth for the phantom; for tumors shallower than 10 cm, the non-coplanar integral doses were lower than coplanar integral doses for non-coplanar angles less than 60°. Similar patterns were observed in the patient plans. The smallest non-coplanar integral doses were observed for tumor 6–8 cm deep. For the phantom, the integral dose was independent of the number of beams, consistent with the liver SBRT patients but the lung SBRT patients showed slight increase in the integral dose when more beams were used. Larger

  2. Unresectable Retiform Hemangioendothelioma Treated with External Beam Radiation Therapy and Chemotherapy: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Alina Z. Hirsh

    2010-01-01

    Full Text Available Retiform hemangioendothelioma (RH is an infrequently encountered vascular neoplasm of intermediate or borderline malignancy. Treatment of RH is controversial. We present a case of a 44-year-old Asian male presenting with an unresectable RH of the pelvis. The patient was treated with concurrent low-dose Cisplatin and External beam Radiation (4140cGy in 180cGy per fraction. This is the first report of a clinical complete response and a long-term local control of this rare tumor. This has significant clinical implication, since it gives the first evidence of treatment of this rare tumor using concurrent low-dose chemotherapy and radiation.

  3. A scintillating gas detector for 2D dose measurements in clinical carbon beams.

    Science.gov (United States)

    Seravalli, E; de Boer, M; Geurink, F; Huizenga, J; Kreuger, R; Schippers, J M; van Eijk, C W E; Voss, B

    2008-09-07

    A two-dimensional position sensitive dosimetry system based on a scintillating gas detector has been developed for pre-treatment verification of dose distributions in hadron therapy. The dosimetry system consists of a chamber filled with an Ar/CF4 scintillating gas mixture, inside which two cascaded gas electron multipliers (GEMs) are mounted. A GEM is a thin kapton foil with copper cladding structured with a regular pattern of sub-mm holes. The primary electrons, created in the detector's sensitive volume by the incoming beam, drift in an electric field towards the GEMs and undergo gas multiplication in the GEM holes. During this process, photons are emitted by the excited Ar/CF4 gas molecules and detected by a mirror-lens-CCD camera system. Since the amount of emitted light is proportional to the dose deposited in the sensitive volume of the detector by the incoming beam, the intensity distribution of the measured light spot is proportional to the 2D hadron dose distribution. For a measurement of a 3D dose distribution, the scintillating gas detector is mounted at the beam exit side of a water-bellows phantom, whose thickness can be varied in steps. In this work, the energy dependence of the output signal of the scintillating gas detector has been verified in a 250 MeV/u clinical 12C ion beam by means of a depth-dose curve measurement. The underestimation of the measured signal at the Bragg peak depth is only 9% with respect to an air-filled ionization chamber. This is much smaller than the underestimation found for a scintillating Gd2O2S:Tb ('Lanex') screen under the same measurement conditions (43%). Consequently, the scintillating gas detector is a promising device for verifying dose distributions in high LET beams, for example to check hadron therapy treatment plans which comprise beams with different energies.

  4. High Contrast Internal and External Coronagraph Masks Produced by Various Techniques

    Science.gov (United States)

    Balasubramanian, Kunjithapatha; Wilson, Daniel; White, Victor; Muller, Richard; Dickie, Matthew; Yee, Karl; Ruiz, Ronald; Shaklan, Stuart; Cady, Eric; Kern, Brian; hide

    2013-01-01

    Masks for high contrast internal and external coronagraphic imaging require a variety of masks depending on different architectures to suppress star light. Various fabrication technologies are required to address a wide range of needs including gradient amplitude transmission, tunable phase profiles, ultra-low reflectivity, precise small scale features, and low-chromaticity. We present the approaches employed at JPL to produce pupil plane and image plane coronagraph masks, and lab-scale external occulter type masks by various techniques including electron beam, ion beam, deep reactive ion etching, and black silicon technologies with illustrative examples of each. Further development is in progress to produce circular masks of various kinds for obscured aperture telescopes.

  5. Muscle-invasive bladder cancer treated with external beam radiation: influence of total dose, overall treatment time, and treatment interruption on local control

    International Nuclear Information System (INIS)

    Moonen, L.; Voet, H. van der; Nijs, R. de; Horenblas, S.; Hart, A.A.M.; Bartelink, H.

    1998-01-01

    Purpose: To evaluate and eventually quantify a possible influence of tumor proliferation during the external radiation course on local control in muscle invasive bladder cancer. Methods and Materials: The influence of total dose, overall treatment time, and treatment interruption has retrospectively been analyzed in a series of 379 patients with nonmetastasized, muscle-invasive transitional cell carcinoma of the urinary bladder. All patients received external beam radiotherapy at the Netherlands Cancer Institute between 1977 and 1990. Total dose varied between 50 and 75 Gy with a mean of 60.5 Gy and a median of 60.4 Gy. Overall treatment time varied between 20 and 270 days with a mean of 49 days and a median of 41 days. Number of fractions varied between 17 and 36 with a mean of 27 and a median of 26. Two hundred and forty-four patients had a continuous radiation course, whereas 135 had an intended split course or an unintended treatment interruption. Median follow-up was 22 months for all patients and 82 months for the 30 patients still alive at last follow-up. A stepwise procedure using proportional hazard regression has been used to identify prognostic treatment factors with respect to local recurrence as sole first recurrence. Results: One hundred and thirty-six patients experienced a local recurrence and 120 of these occurred before regional or distant metastases. The actuarial local control rate was 40.3% at 5 years and 32.3% at 10 years. In a multivariate analysis total dose showed a significant association with local control (p 0.0039), however in a markedly nonlinear way. In fact only those patients treated with a dose below 57.5 Gy had a significant higher bladder relapse rate, whereas no difference in relapse rate was found among patients treated with doses above 57.5 Gy. This remained the case even after adjustment for overall treatment time and all significant tumor and patient characteristics. The Normalized Tumor Dose (NTD) (α/β = 10) and NTD (

  6. Robotic stereotactic radioablation of breast tumors: Influence of beam size on the absorbed dose distributions

    International Nuclear Information System (INIS)

    Garnica-Garza, H.M.

    2016-01-01

    Robotic stereotactic radioablation (RSR) therapy for breast tumors has been shown to be an effective treatment strategy when applied concomitantly with chemotherapy, with the purpose of reducing the tumor volume thus making it more amenable for breast conserving surgery. In this paper we used Monte Carlo simulation within a realistic patient model to determine the influence that the variation in beam collimation radius has on the resultant absorbed dose distributions for this type of treatment. Separate optimized plans were obtained for treatments using 300 circular beams with radii of 0.5 cm, 0.75 cm, 1.0 cm and 1.5 cm. Cumulative dose volume histograms were obtained for the gross, clinical and planning target volumes as well as for eight organs and structures at risk. Target coverage improves as the collimator size is increased, at the expense of increasing the volume of healthy tissue receiving mid-level absorbed doses. Interestingly, it is found that the maximum dose imparted to the skin is highly dependent on collimator size, while the dosimetry of other structures, such as both the ipsilateral and contralateral lung tissue are basically unaffected by a change in beam size. - Highlights: • Stereotactic body radiation therapy of breast tumors is analyzed using Monte Carlo simulation. • The influence of beam collimation on the absorbed dose distributions is determined. • Large field sizes increase target dose uniformity and midlevel doses to healthy structures. • Skin dose is greatly affected by changes in beam collimation.

  7. Radiographic film dosimetry of proton beams for depth‐dose constancy check and beam profile measurement

    Science.gov (United States)

    Teran, Anthony; Ghebremedhin, Abiel; Johnson, Matt; Patyal, Baldev

    2015-01-01

    Radiographic film dosimetry suffers from its energy dependence in proton dosimetry. This study sought to develop a method of measuring proton beams by the film and to evaluate film response to proton beams for the constancy check of depth dose (DD). It also evaluated the film for profile measurements. To achieve this goal, from DDs measured by film and ion chamber (IC), calibration factors (ratios of dose measured by IC to film responses) as a function of depth in a phantom were obtained. These factors imply variable slopes (with proton energy and depth) of linear characteristic curves that relate film response to dose. We derived a calibration method that enables utilization of the factors for acquisition of dose from film density measured at later dates by adapting to a potentially altered processor condition. To test this model, the characteristic curve was obtained by using EDR2 film and in‐phantom film dosimetry in parallel with a 149.65 MeV proton beam, using the method. An additional validation of the model was performed by concurrent film and IC measurement perpendicular to the beam at various depths. Beam profile measurements by the film were also evaluated at the center of beam modulation. In order to interpret and ascertain the film dosimetry, Monte Carlos simulation of the beam was performed, calculating the proton fluence spectrum along depths and off‐axis distances. By multiplying respective stopping powers to the spectrum, doses to film and water were calculated. The ratio of film dose to water dose was evaluated. Results are as follows. The characteristic curve proved the assumed linearity. The measured DD approached that of IC, but near the end of the spread‐out Bragg peak (SOBP), a spurious peak was observed due to the mismatch of distal edge between the calibration and measurement films. The width of SOBP and the proximal edge were both reproducible within a maximum of 5 mm; the distal edge was reproducible within 1 mm. At 5 cm depth, the

  8. Dose-volume based ranking of incident beam direction and its utility in facilitating IMRT beam placement

    International Nuclear Information System (INIS)

    Schreibmann, Eduard; Xing Lei

    2005-01-01

    Purpose: Beam orientation optimization in intensity-modulated radiation therapy (IMRT) is computationally intensive, and various single beam ranking techniques have been proposed to reduce the search space. Up to this point, none of the existing ranking techniques considers the clinically important dose-volume effects of the involved structures, which may lead to clinically irrelevant angular ranking. The purpose of this work is to develop a clinically sensible angular ranking model with incorporation of dose-volume effects and to show its utility for IMRT beam placement. Methods and Materials: The general consideration in constructing this angular ranking function is that a beamlet/beam is preferable if it can deliver a higher dose to the target without exceeding the tolerance of the sensitive structures located on the path of the beamlet/beam. In the previously proposed dose-based approach, the beamlets are treated independently and, to compute the maximally deliverable dose to the target volume, the intensity of each beamlet is pushed to its maximum intensity without considering the values of other beamlets. When volumetric structures are involved, the complication arises from the fact that there are numerous dose distributions corresponding to the same dose-volume tolerance. In this situation, the beamlets are not independent and an optimization algorithm is required to find the intensity profile that delivers the maximum target dose while satisfying the volumetric constraints. In this study, the behavior of a volumetric organ was modeled by using the equivalent uniform dose (EUD). A constrained sequential quadratic programming algorithm (CFSQP) was used to find the beam profile that delivers the maximum dose to the target volume without violating the EUD constraint or constraints. To assess the utility of the proposed technique, we planned a head-and-neck and abdominal case with and without the guidance of the angular ranking information. The qualities of the

  9. Sub-second pencil beam dose calculation on GPU for adaptive proton therapy.

    Science.gov (United States)

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

    2015-06-21

    Although proton therapy delivered using scanned pencil beams has the potential to produce better dose conformity than conventional radiotherapy, the created dose distributions are more sensitive to anatomical changes and patient motion. Therefore, the introduction of adaptive treatment techniques where the dose can be monitored as it is being delivered is highly desirable. We present a GPU-based dose calculation engine relying on the widely used pencil beam algorithm, developed for on-line dose calculation. The calculation engine was implemented from scratch, with each step of the algorithm parallelized and adapted to run efficiently on the GPU architecture. To ensure fast calculation, it employs several application-specific modifications and simplifications, and a fast scatter-based implementation of the computationally expensive kernel superposition step. The calculation time for a skull base treatment plan using two beam directions was 0.22 s on an Nvidia Tesla K40 GPU, whereas a test case of a cubic target in water from the literature took 0.14 s to calculate. The accuracy of the patient dose distributions was assessed by calculating the γ-index with respect to a gold standard Monte Carlo simulation. The passing rates were 99.2% and 96.7%, respectively, for the 3%/3 mm and 2%/2 mm criteria, matching those produced by a clinical treatment planning system.

  10. The effect of a metal hip prosthesis on the radiation dose in therapeutic photon beam irradiations

    International Nuclear Information System (INIS)

    Lin, S.-Y.; Chu, T.-C.; Lin, J.-P.; Liu, M.-T.

    2002-01-01

    Prostate and cervical cancer patients are often treated with external X-ray beams of bi-lateral incidence. Such treatment may incur some dose effect that cannot be predicted precisely in commercial treatment planning systems (TPS) for patients having undergone total hip replacement. This study performs a Monte Carlo (MC) simulation and an analytical calculation (convolution superposition algorithm which is implemented in ADAC TPS) of a 6 MV, 5x5 cm 2 X-ray beam incident into water with the existence of hip prosthesis, e.g. Ti6Al4V and CoCrMo alloy. The results indicate that ADAC TPS cannot precisely account for the scatter and backscatter radiation that a metal hip prosthesis causes. For percent depth dose (PDD) curves, the maximum underdosage of ADAC TPS up to 5 mm above the interface between dense material and water is 5%, 20% and 27% for PDD Bone , PDD Ti and PDD Co , respectively. The dose re-buildup, which occurs behind the hip region, becomes more and more obvious for denser medium existed in water. Increasing inhomogeneity also enhances the underdosage of ADAC for greater depth (>10 cm), as the figures of nearly 2% in PDD Bone , PDD Ti and 4-5% in PDD Co reveal. Overestimating the attenuated power of high-density non-water material in ADAC TPS causes this underdosage. For dose profiles, no significant differences were found in Profile Bone at any depth. Profile Ti reveals that MC slightly exceeds ADAC at off-axis position 1.0-2.0 cm. Profile Co reveals this more obviously. This finding means that scatter radiation from these denser materials is significant and cannot be predicted precisely in ADAC

  11. External Beam Radiotherapy in Metastatic Bone Pain from Solid ...

    African Journals Online (AJOL)

    Key Words: Bone, metastasis, radiotherapy, pain, control randomized ... described the efficacy of external beam radiotherapy in pain .... life of patients with multiple myeloma. Eur. J. ... Rades D, Jeremic B, Hoskin PJ: The Role of ... randomised multicenter trial on single fraction ... "The subjective experience of acute pain. An.

  12. Study of External Radiation Expose Dose on Hands of Nuclear Medicine Workers

    International Nuclear Information System (INIS)

    Park, Jun Chul; Pyo, Sung Jae

    2012-01-01

    The aims of this study are to assess external radiation exposed doses of body and hands of nuclear medicine workers who handle radiation sources, and to measure radiation exposed doses of the hands induced by a whole body bone scan with high frequency and handling a radioactive sources like 99m Tc-HDP and 18 F-FDG in the PET/CT examination. Skillful workers, who directly dispense and inject from radiation sources, were asked to wear a TLD on the chest and ring finger. Then, radiation exposed dose and duration exposed from daily radiation sources for each section were measured by using a pocket dosimeter for the accumulated external doses and the absorbed dose to the hands. In the survey of four medical institutions in Incheon Metropolitan City, only one of four institutions has a radiation dosimeter for local area like hands. Most of institutions uses radiation shielding devices for the purpose of protecting the body trunk, not local area. Even some institutions were revealed not to use such a shielding device. The exposed doses on the hands of nuclear medicine workers who directly handles radioactive sources were approximately twice as much as those on the body. The radiation exposure level for each section of the whole body bone scan with high frequency and that of the PET/CT examination showed that radiation doses were revealed in decreasing order of synthesis of radioactive medicine and installation to a dispensing container, dispensing, administering and transferring. Furthermore, there were statistically significant differences of radiation exposure doses of the hands before and after wearing a syringe shielder in administration of a radioactive sources. In this study, although it did not reach the permissible effective dose for nuclear medicine, the occupational workers were exposed by relatively higher dose level than the non-occupational workers. Therefore, the workers, who closely exposed to radioactive sources should be in compliance with safety

  13. High-quality laser-accelerated ion beams for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Harman, Zoltan; Keitel, Christoph H. [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany); Salamin, Yousef I. [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany); American University of Sharjah (United Arab Emirates)

    2009-07-01

    Cancer radiation therapy requires accelerated ion beams of high energy sharpness and a narrow spatial profile. As shown recently, linearly and radially polarized, tightly focused and thus extremely strong laser beams should permit the direct acceleration of light atomic nuclei up to energies that may offer the potentiality for medical applications. Radially polarized beams have better emittance than their linearly polarized counterparts. We put forward the direct laser acceleration of ions, once the refocusing of ion beams by external fields is solved or radially polarized laser pulses of sufficient power can be generated.

  14. External beam pixe programs at the University of California, Davis

    International Nuclear Information System (INIS)

    Eldred, R.A.

    1983-01-01

    A PIXE system in which large or delicate samples are excited by a low-current external proton beam is described. This system has been used to analyze historical printed books and manuscripts, as well as a large variety of archeological artifacts. The steps used to protect the sample from unnecessary beam current are examined. A recent thorough study of the first volume of the Gutenberg 42-line Bible is described in some detail

  15. Dosimetric characterization of VIPARnd gel by optical analysis to high-energy photon beam used in external radiotherapy

    International Nuclear Information System (INIS)

    Dias, Juliana R.; Lima, Renata S.; Lopes, Roseany de V. Vieira; Ceschin, Artemis Marti

    2015-01-01

    Polymer gel dosimetry has been proposed as a possibility for measurements of dose distribution in radiotherapy. This work aims to evaluate the dosimetric characteristics of a VIPARnd for 6 MV photon beam used in radiotherapy using optical investigations. The absorbance spectrum of irradiated gel dosimeter was optical evaluated with spectrophotometer techniques and with CMOS camera readout for dose range of 0 to 50 Gy. Data shows that the VIPARnd has a maximum absorbance at 300 to 320 nm depending on the absorbed dose. The CMOS camera readouts were obtained in RGB color, the absorbance measurements suggest a major response of dose for blue matrix verified with data. The dose-response curve for blue component showed interval of linearity from 1 Gy to 20 Gy. (author)

  16. High intensity beam dump for the Tevatron beam abort system

    International Nuclear Information System (INIS)

    Kidd, J.; Mokhov, N.; Murphy, T.; Palmer, M.; Toohig, T.; Turkot, F.; VanGinneken, A.

    1981-01-01

    The beam abort system proposed for the Fermilab Tevatron Accelerator will extract the proton beam from the ring in a single turn (approximately 20/mu/s) and direct it to an external beam dump. It is the function of the beam dump to absorb the unwanted beam and limit the escaping radiation to levels that are acceptable to the surrounding populace and apparatus. A beam dump that is expected to meet these requirements has been designed and constructed. Detailed design of the dump, including considerations leading to the choice of materials, are given. 6 refs

  17. Determination of dose factors for external gamma radiation in dwellings

    International Nuclear Information System (INIS)

    Maduar, M.F.; Hiromoto, G.

    2000-01-01

    A significant contribution to the global population exposure to ionizing radiation arises from natural sources, especially from radionuclides present in terrestrial crust. Human activities can eventually increase that exposure to significant levels, from the point of view of radiological protection. The presence of natural radionuclides in building materials may lead to an increment of both external and internal radiation exposure of the population. External exposure in dwellings arises from gamma-emitter radionuclides existing in the walls, floor and ceiling of their rooms. Mathematical models can be used to predict external dose rates inside the room, known the radionuclide concentration activities in dwelling constituents. This paper presents a methodology for theoretical evaluation of external gamma doses due to radionuclides present in the walls of an hypothetical standard room. The room is modeled as three pairs of rectangular sheets with finite thickness. Assessment of doses was performed through the application of photon transport model, taking in account self-absorption and radiation buildup. As the external dose due to a particular radionuclide is proportional to its activity concentration, results are presented as dose factors, defined as a ratio of absorbed dose (nGy.h -1 ) to the activity concentration (Bq.kg -1 ), for each radionuclide. The radionuclides were assumed to be uniformly distributed in the building materials. Calculations were performed for concrete walls and results are presented for 40 K, 226 Ra, and 232 Th, taking in account, for dose calculations, all gamma emitters from 226 Ra and 232 Th decay chains. Sensitivity of the model was estimated by varying four of its input parameters within a reasonable range of applicability, while leaving all other parameters at fixed selected values. The parameters studied and respective ranges of variation were: for thickness, 5 to 60 cm; for density, 0.5 to 4 g.cm -3 ; for the room length, 1.5 to 10 m

  18. Fluence-convolution broad-beam (FCBB) dose calculation

    Energy Technology Data Exchange (ETDEWEB)

    Lu Weiguo; Chen Mingli, E-mail: wlu@tomotherapy.co [TomoTherapy Inc., 1240 Deming Way, Madison, WI 53717 (United States)

    2010-12-07

    IMRT optimization requires a fast yet relatively accurate algorithm to calculate the iteration dose with small memory demand. In this paper, we present a dose calculation algorithm that approaches these goals. By decomposing the infinitesimal pencil beam (IPB) kernel into the central axis (CAX) component and lateral spread function (LSF) and taking the beam's eye view (BEV), we established a non-voxel and non-beamlet-based dose calculation formula. Both LSF and CAX are determined by a commissioning procedure using the collapsed-cone convolution/superposition (CCCS) method as the standard dose engine. The proposed dose calculation involves a 2D convolution of a fluence map with LSF followed by ray tracing based on the CAX lookup table with radiological distance and divergence correction, resulting in complexity of O(N{sup 3}) both spatially and temporally. This simple algorithm is orders of magnitude faster than the CCCS method. Without pre-calculation of beamlets, its implementation is also orders of magnitude smaller than the conventional voxel-based beamlet-superposition (VBS) approach. We compared the presented algorithm with the CCCS method using simulated and clinical cases. The agreement was generally within 3% for a homogeneous phantom and 5% for heterogeneous and clinical cases. Combined with the 'adaptive full dose correction', the algorithm is well suitable for calculating the iteration dose during IMRT optimization.

  19. External radiation dose from patients received diagnostic doses of 201 T1-Chloride and 99 Tc-MIBI

    International Nuclear Information System (INIS)

    Dadashzadeh, S.; Sattari, A.; Nasiroghli, G.A.

    2002-01-01

    Patients receiving diagnostic doses of radiopharmaceuticals become a source of contamination and exposure for those who come in contact with them, such as nuclear medicine technologists, relatives and nurses. Therefore, the measurement of external radiation dose from these patients is necessary. In this study, the dose rates at distances of 10, 50 and 100 cm from 70 patients who received diagnostic amounts of 201 T1-Chloride and 99 Tc-MIBI was measures. The results showed that the maximum external radiation dose rates for 201 T1 and 99 Tc-MIBI were 18.4 and 75.0 μ Sv.h -1 , respectively, at 5 cm distance from the patients. The average radiation dose received by nuclear medicine technologists, considering their close contact during one working day was 12.5 ± 3.4μ Sv. The highest received dose was 22.7 μSv, which was well below the acceptable dose limit

  20. Dose and volume specification for reporting interstitial therapy

    International Nuclear Information System (INIS)

    1997-01-01

    The ICRU has previously published reports dealing with Dose Specification for Reporting External Beam Therapy with Photons and Electrons (ICRU Report 29, ICRU, 1978), Dose Specification for Reporting External Beam Therapy (ICRU Report 50, ICRU, 1993) and Dose and Volume Specification for Reporting Intracavitary Therapy in Gynecology (ICRU Report 38, ICRU, 1985). The present report addresses the problem of absorbed dose specification for report interstitial therapy. Although specific to interstitial therapy, many of the concepts developed in this report are also applicable to certain other kinds of brachytherapy applications. In particular, special cases of intraluminal brachytherapy and plesio-brachytherapy via surface molds employing x or gamma emitters are addressed in this report

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

    International Nuclear Information System (INIS)

    Dupin, Charles; Lang, Philippe; Dessard-Diana, Bernadette; Simon, Jean-Marc; Cuenca, Xavier; Mazeron, Jean-Jacques; Feuvret, Loïc

    2014-01-01

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

  2. Trace element fingerprinting of jewellery rubies by external beam PIXE

    International Nuclear Information System (INIS)

    Calligaro, T.; Poirot, J.-P.; Querre, G.

    1999-01-01

    External beam PIXE analysis allows the non-destructive in situ characterisation of gemstones mounted on jewellery pieces. This technique was used for the determination of the geographical origin of 64 rubies set on a high-valued necklace. The trace element content of these gemstones was measured and compared to that of a set of rubies of known sources. Multivariate statistical processing of the results allowed us to infer the provenance of rubies: one comes from Thailand/Cambodia deposit while the remaining are attributed to Burma. This highlights the complementary capabilities of PIXE and conventional geological observations

  3. Trace element fingerprinting of jewellery rubies by external beam PIXE

    Energy Technology Data Exchange (ETDEWEB)

    Calligaro, T. E-mail: calli@culture.nl; Poirot, J.-P.; Querre, G

    1999-04-02

    External beam PIXE analysis allows the non-destructive in situ characterisation of gemstones mounted on jewellery pieces. This technique was used for the determination of the geographical origin of 64 rubies set on a high-valued necklace. The trace element content of these gemstones was measured and compared to that of a set of rubies of known sources. Multivariate statistical processing of the results allowed us to infer the provenance of rubies: one comes from Thailand/Cambodia deposit while the remaining are attributed to Burma. This highlights the complementary capabilities of PIXE and conventional geological observations.

  4. Estimation of deep, eye lens and skin doses for high energy electron beams for dosimetry and protection purpose

    International Nuclear Information System (INIS)

    Reena Kumari; Rakesh, R.B.

    2018-01-01

    In the radiological protection especially for individual as well as area monitoring, it is generally considered that beta sources deposit skin and eye lens doses only as they do not have enough energy for depositing doses at 10 mm depth. Also, the skin and eye lens doses differ substantially due to attenuation of beta particles at 0.07 mm (skin) and 3 mm (eye lens) depths and the surface doses are always greater than eye lens doses even for the highest energy beta source used in brachytherapy applications. However, worldwide increase in the use of high energy electron accelerators, new challenges are being posed for radiological protection and the operational quantities defined previously by ICRU are being reviewed. In view of these developments, studies have been performed for different electron beams in the energy range from (4 - 20) MeV generated using a medical linear accelerator. The aim of the study is to measure doses deposited at various depths as defined by ICRU 39 for individual and area monitoring purposes

  5. Dose characteristics of total-skin electron-beam irradiation with six-dual electron fields

    International Nuclear Information System (INIS)

    Choi, Tae Jin; Kim, Jin Hee; Kim, Ok Bae

    1998-01-01

    To obtain the uniform dose at limited depth to entire surface of the body, the dose characteristics of degraded electron beam of the large target-skin distance and the dose distribution of the six-dual electron fields were investigated. The experimental dose distributions included the depth dose curve, spatial dose and attenuated electron beam were determined with 300 cm of Target-Skin Distance (TSD) and full collimator size (35x35 cm 2 on TSD 100 cm) in 4 MeV electron beam energy. Actual collimated field size of 105 cmx105 cm at the distance of 300 cm could include entire hemibody. A patient was standing on step board with hands up and holding the pole to stabilize his/her positions for the six-dual fields technique. As a scatter-degrader, 0.5 cm of acrylic plate was inserted at 20 cm from the body surface on the electron beam path to induce ray scattering and to increase the skin dose. The Full Width at Half Maximum(FWHM) of dose profile was 130 cm in large field of 105x105 cm 2 . The width of 100±10% of the resultant dose from two adjacent fields which were separated at 25 cm from field edge for obtaining the dose uniformity was extended to 186 cm. The depth of maximum dose lies at 5 mm and the 80% depth dose lies between 7 and 8 mm for the degraded electron beam by using the 0.5 cm thickness of acrylic absorber. Total skin electron beam irradiation (TSEBI) was carried out using the six dual fields has been developed at Stanford University. The dose distribution in TSEBI showed relatively uniform around the flat region of skin except the protruding and deeply curvatured portion of the body, which showed excess of dose at the former and less dose at the latter. The percent depth dose, profile curves and superimposed dose distribution were investigated using the degraded using the degraded electron beam through the beam absorber. The dose distribution obtained by experiments of TSEBI showed within±10% difference excepts the protruding area of skin which needs a

  6. Simulation and radiation treatment in external radiotherapy

    International Nuclear Information System (INIS)

    Singer, E.

    1996-01-01

    It is well known that in order to obtain a uniform dose in the treated volume as defined in ICRU 50, there should be a 10% maximum difference between maximum and minimum dose values in treatment planning. Clinical target volume (CTV) should be related to external areas of body sections where tumour is located. These areas are important because different radiation beams enter through them. Therefore, verification of the planning target volume (PTV) through the external areas is highly significant. In this work we point out the importance of controlling that PTV is irradiated as planned considering some error sources usually found in radiotherapy practice with equipment that has been intensively used for a long time. Moreover, I think this experience will be helpful for those centers around the world where radiation treatment is carried out with reconditioned units. (author)

  7. Simulation and radiation treatment in external radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Singer, E [Mevaterapia Medical Center, Buenos Aires (Argentina)

    1996-08-01

    It is well known that in order to obtain a uniform dose in the treated volume as defined in ICRU 50, there should be a 10% maximum difference between maximum and minimum dose values in treatment planning. Clinical target volume (CTV) should be related to external areas of body sections where tumour is located. These areas are important because different radiation beams enter through them. Therefore, verification of the planning target volume (PTV) through the external areas is highly significant. In this work we point out the importance of controlling that PTV is irradiated as planned considering some error sources usually found in radiotherapy practice with equipment that has been intensively used for a long time. Moreover, I think this experience will be helpful for those centers around the world where radiation treatment is carried out with reconditioned units. (author).

  8. External beam radiotherapy for rectal adenocarcinoma

    International Nuclear Information System (INIS)

    Taylor, R.E.; Kerr, G.R.; Arnott, S.J.

    1987-01-01

    A series of 243 patients with adenocarcinoma of the rectum treated with radiotherapy is presented. Radiotherapy was combined with 5-fluorouracil, or given alone. Seventy-four patients were treated with radical external beam radiotherapy for recurrent or inoperable rectal adenocarcinoma. One hundred and forty-five patients with advanced pelvic tumours or metastases were treated with palliative pelvic radiotherapy. Twenty-four patients with small-volume residual pelvic tumour or who were felt to be at high risk of pelvic recurrence following radical resection received postoperative radiotherapy. Complete tumour regression was seen in 38% of radically treated patients, and 24% of palliatively treated patients. Partial regression was observed in 56% of radically treated patients, and 58% of palliatively treated patients. Long-term local tumour control was more commonly observed for small tumours (< 5 cm diameter). Fifty-eight % of patients treated with postoperative radiotherapy remained free of local recurrence. Survival was significantly better with small tumours. The addition of 5FU did not appear to improve survival or tumour control. (author)

  9. Radiation dosimetry at the BNL High Flux Beam Reactor

    International Nuclear Information System (INIS)

    Holden, N.E.; Hu, J.P.; Reciniello, R.N.

    1998-02-01

    The HFBR is a heavy water, D 2 O, cooled and moderated reactor with twenty-eight fuel elements containing a maximum of 9.8 kilograms of 235 U. The core is 53 cm high and 48 cm in diameter and has an active volume of 97 liters. The HFBR, which was designed to operate at forty mega-watts, 40 NW, was upgraded to operate at 60 NW. Since 1991, it has operated at 30 MW. In a normal 30 MW operating cycle the HFBR operates 24 hours a day for thirty days, with a six to fourteen day shutdown period for refueling and maintenance work. While most reactors attempts to minimize the escape of neutrons from the core, the HFBR's D 2 O design allows the thermal neutron flux to peak in the reflector region and maximizes the number of thermal neutrons available to nine horizontal external beams, H-1 to H-9. The HFBR neutron dosimetry effort described here compares measured and calculated energy dependent neutron and gamma ray flux densities and/or dose rates at horizontal beam lines and vertical irradiation thimbles

  10. Can we avoid high levels of dose escalation for high-risk prostate cancer in the setting of androgen deprivation?

    Science.gov (United States)

    Shakespeare, Thomas P; Wilcox, Shea W; Aherne, Noel J

    2016-01-01

    Both dose-escalated external beam radiotherapy (DE-EBRT) and androgen deprivation therapy (ADT) improve outcomes in patients with high-risk prostate cancer. However, there is little evidence specifically evaluating DE-EBRT for patients with high-risk prostate cancer receiving ADT, particularly for EBRT doses >74 Gy. We aimed to determine whether DE-EBRT >74 Gy improves outcomes for patients with high-risk prostate cancer receiving long-term ADT. Patients with high-risk prostate cancer were treated on an institutional protocol prescribing 3-6 months neoadjuvant ADT and DE-EBRT, followed by 2 years of adjuvant ADT. Between 2006 and 2012, EBRT doses were escalated from 74 Gy to 76 Gy and then to 78 Gy. We interrogated our electronic medical record to identify these patients and analyzed our results by comparing dose levels. In all, 479 patients were treated with a 68-month median follow-up. The 5-year biochemical disease-free survivals for the 74 Gy, 76 Gy, and 78 Gy groups were 87.8%, 86.9%, and 91.6%, respectively. The metastasis-free survivals were 95.5%, 94.5%, and 93.9%, respectively, and the prostate cancer-specific survivals were 100%, 94.4%, and 98.1%, respectively. Dose escalation had no impact on any outcome in either univariate or multivariate analysis. There was no benefit of DE-EBRT >74 Gy in our cohort of high-risk prostate patients treated with long-term ADT. As dose escalation has higher risks of radiotherapy-induced toxicity, it may be feasible to omit dose escalation beyond 74 Gy in this group of patients. Randomized studies evaluating dose escalation for high-risk patients receiving ADT should be considered.

  11. Non-rigid CT/CBCT to CBCT registration for online external beam radiotherapy guidance

    Science.gov (United States)

    Zachiu, Cornel; de Senneville, Baudouin Denis; Tijssen, Rob H. N.; Kotte, Alexis N. T. J.; Houweling, Antonetta C.; Kerkmeijer, Linda G. W.; Lagendijk, Jan J. W.; Moonen, Chrit T. W.; Ries, Mario

    2018-01-01

    Image-guided external beam radiotherapy (EBRT) allows radiation dose deposition with a high degree of accuracy and precision. Guidance is usually achieved by estimating the displacements, via image registration, between cone beam computed tomography (CBCT) and computed tomography (CT) images acquired at different stages of the therapy. The resulting displacements are then used to reposition the patient such that the location of the tumor at the time of treatment matches its position during planning. Moreover, ongoing research aims to use CBCT-CT image registration for online plan adaptation. However, CBCT images are usually acquired using a small number of x-ray projections and/or low beam intensities. This often leads to the images being subject to low contrast, low signal-to-noise ratio and artifacts, which ends-up hampering the image registration process. Previous studies addressed this by integrating additional image processing steps into the registration procedure. However, these steps are usually designed for particular image acquisition schemes, therefore limiting their use on a case-by-case basis. In the current study we address CT to CBCT and CBCT to CBCT registration by the means of the recently proposed EVolution registration algorithm. Contrary to previous approaches, EVolution does not require the integration of additional image processing steps in the registration scheme. Moreover, the algorithm requires a low number of input parameters, is easily parallelizable and provides an elastic deformation on a point-by-point basis. Results have shown that relative to a pure CT-based registration, the intrinsic artifacts present in typical CBCT images only have a sub-millimeter impact on the accuracy and precision of the estimated deformation. In addition, the algorithm has low computational requirements, which are compatible with online image-based guidance of EBRT treatments.

  12. WE-D-210-04: Radiation-Induced Polymerization of Ultrasound Contrast Agents in View of Non-Invasive Dosimetry in External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Callens, M; Verboven, E; Van Den Abeele, K [Department of Physics, Wave Propagation and Signal Processing, KU Leuven KULAK, Kortrijk (Belgium); D’Agostino, E [DoseVue NV, Hasselt (Belgium); Pfeiffer, H [Department of Materials Engineering, KU Leuven, Leuven (Belgium); D’hooge, J [Department of Cardiovascular Sciences, Bio-Medical Science Group, KU Leuven, Leuven (Belgium)

    2015-06-15

    Purpose: Ultrasound contrast agents (UCA’s) based on gas-filled microbubbles encapsulated by an amphiphilic shell are well established as safe and effective echo-enhancers in diagnostic imaging. In view of an alternative application of UCA’s, we investigated the use of targeted microbubbles as radiation sensors for external beam radiation therapy. As radiation induces permanent changes in the microbubble’s physico-chemical properties, a robust measure of these changes can provide a direct or indirect estimate of the applied radiation dose. For instance, by analyzing the ultrasonic dispersion characteristics of microbubble distributions before and after radiation treatment, an estimate of the radiation dose at the location of the irradiated volume can be made. To increase the radiation sensitivity of microbubbles, polymerizable diacetylene molecules can be incorporated into the shell. This study focuses on characterizing the acoustic response and quantifying the chemical modifications as a function of radiation dose. Methods: Lipid/diacetylene microbubbles were irradiated with a 6 MV photon beam using dose levels in the range of 0–150 Gy. The acoustic response of the microbubbles was monitored by ultrasonic through-transmission measurements in the range of 500 kHz to 20 MHz, thereby providing the dispersion relations of the phase velocity, attenuation and nonlinear coefficient. In addition, the radiation-induced chemical modifications were quantified using UV-VIS spectroscopy. Results: UV-VIS spectroscopy measurements indicate that ionizing radiation induces the polymerization of diacetylenes incorporated in the microbubble shell. The polymer yield strongly depends on the shell composition and the radiation-dose. The acoustic response is inherently related to the visco-elastic properties of the shell and is strongly influenced by the shell composition and the physico-chemical changes in the environment. Conclusion: Diacetylene-containing microbubbles are

  13. Improving anatomical mapping of complexly deformed anatomy for external beam radiotherapy and brachytherapy dose accumulation in cervical cancer

    International Nuclear Information System (INIS)

    Vásquez Osorio, Eliana M.; Kolkman-Deurloo, Inger-Karine K.; Schuring-Pereira, Monica; Zolnay, András; Heijmen, Ben J. M.; Hoogeman, Mischa S.

    2015-01-01

    Purpose: In the treatment of cervical cancer, large anatomical deformations, caused by, e.g., tumor shrinkage, bladder and rectum filling changes, organ sliding, and the presence of the brachytherapy (BT) applicator, prohibit the accumulation of external beam radiotherapy (EBRT) and BT dose distributions. This work proposes a structure-wise registration with vector field integration (SW+VF) to map the largely deformed anatomies between EBRT and BT, paving the way for 3D dose accumulation between EBRT and BT. Methods: T2w-MRIs acquired before EBRT and as a part of the MRI-guided BT procedure for 12 cervical cancer patients, along with the manual delineations of the bladder, cervix-uterus, and rectum-sigmoid, were used for this study. A rigid transformation was used to align the bony anatomy in the MRIs. The proposed SW+VF method starts by automatically segmenting features in the area surrounding the delineated organs. Then, each organ and feature pair is registered independently using a feature-based nonrigid registration algorithm developed in-house. Additionally, a background transformation is calculated to account for areas far from all organs and features. In order to obtain one transformation that can be used for dose accumulation, the organ-based, feature-based, and the background transformations are combined into one vector field using a weighted sum, where the contribution of each transformation can be directly controlled by its extent of influence (scope size). The optimal scope sizes for organ-based and feature-based transformations were found by an exhaustive analysis. The anatomical correctness of the mapping was independently validated by measuring the residual distances after transformation for delineated structures inside the cervix-uterus (inner anatomical correctness), and for anatomical landmarks outside the organs in the surrounding region (outer anatomical correctness). The results of the proposed method were compared with the results of the

  14. Improving anatomical mapping of complexly deformed anatomy for external beam radiotherapy and brachytherapy dose accumulation in cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vásquez Osorio, Eliana M., E-mail: e.vasquezosorio@erasmusmc.nl; Kolkman-Deurloo, Inger-Karine K.; Schuring-Pereira, Monica; Zolnay, András; Heijmen, Ben J. M.; Hoogeman, Mischa S. [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam 3075 (Netherlands)

    2015-01-15

    Purpose: In the treatment of cervical cancer, large anatomical deformations, caused by, e.g., tumor shrinkage, bladder and rectum filling changes, organ sliding, and the presence of the brachytherapy (BT) applicator, prohibit the accumulation of external beam radiotherapy (EBRT) and BT dose distributions. This work proposes a structure-wise registration with vector field integration (SW+VF) to map the largely deformed anatomies between EBRT and BT, paving the way for 3D dose accumulation between EBRT and BT. Methods: T2w-MRIs acquired before EBRT and as a part of the MRI-guided BT procedure for 12 cervical cancer patients, along with the manual delineations of the bladder, cervix-uterus, and rectum-sigmoid, were used for this study. A rigid transformation was used to align the bony anatomy in the MRIs. The proposed SW+VF method starts by automatically segmenting features in the area surrounding the delineated organs. Then, each organ and feature pair is registered independently using a feature-based nonrigid registration algorithm developed in-house. Additionally, a background transformation is calculated to account for areas far from all organs and features. In order to obtain one transformation that can be used for dose accumulation, the organ-based, feature-based, and the background transformations are combined into one vector field using a weighted sum, where the contribution of each transformation can be directly controlled by its extent of influence (scope size). The optimal scope sizes for organ-based and feature-based transformations were found by an exhaustive analysis. The anatomical correctness of the mapping was independently validated by measuring the residual distances after transformation for delineated structures inside the cervix-uterus (inner anatomical correctness), and for anatomical landmarks outside the organs in the surrounding region (outer anatomical correctness). The results of the proposed method were compared with the results of the

  15. Neutron dose to patients treated with high-energy medical accelerators

    International Nuclear Information System (INIS)

    McGinley, P.H.

    2001-01-01

    The neutron dose equivalent received by patients treated with high energy x-ray beams was measured in this research. A total of 13 different medical accelerators were evaluated in terms of the neutron dose equivalent in the patient plane and at the beam center. The neutron dose equivalent at the beam center was found to ranged from 0.02 to 9.4 mSv per Sv of x-ray dose and values from 0.029 to 2.58 mSv per Sv of x-ray were measured in the patient plane. It was concluded that the neutron levels meet the International Electrotechnical Commission standard for the patient plane. It was also concluded that when intensity modulated radiation treatment is conducted the neutron dose equivalent received by the patient will increase by a factor of 2 to 10. (author)

  16. Variations of dose distribution in high energy electron beams as a function of geometrical parameters of irradiation. Application to computer calculation

    International Nuclear Information System (INIS)

    Villeret, O.

    1985-04-01

    An algorithm is developed for the purpose of compter treatment planning of electron therapy. The method uses experimental absorbed dose distribution data in the irradiated medium for electron beams in the 8-20 MeV range delivered by the Sagittaire linear accelerator (study of central axis depth dose, beam profiles) in various geometrical conditions. Experimental verification of the computer program showed agreement with 2% between dose measurement and computer calculation [fr

  17. Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Ping, E-mail: ping.jiang@uksh.de [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Baumann, René [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Dunst, Juergen [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Department of Radiation Oncology, University of Copenhagen, Copenhagen (Denmark); Geenen, Matthias [Department of Reconstructive Surgery, Lubinus Clinic Kiel, Kiel (Germany); Siebert, Frank-André [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Niehoff, Peter [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Department of Radiation Oncology, Community Clinic Köln, Köln (Germany); Department of Radiation Oncology, University Witten/Herdecke, Witten (Germany); Bertolini, Julia; Druecke, Daniel [Department of Reconstructive Surgery, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany)

    2016-03-01

    Purpose: To prospectively evaluate high-dose-rate brachytherapy in the treatment of therapy-resistant keloids and report first results, with emphasis on feasibility and early treatment outcome. Methods and Materials: From 2009 to 2014, 24 patients with 32 recurrent keloids were treated with immediate perioperative high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiation therapy and presented with recurrences in the pretreated areas. Two or more different treatment modalities had been tried in all patients and had failed to achieve remission. After (re-)excision of the keloids, a single brachytherapy tube was placed subcutaneously before closing the wound. The target volume covered the scar in total length. Brachytherapy was given in 3 fractions with a single dose of 6 Gy in 5 mm tissue depth. The first fraction was given within 6 hours after surgery, the other 2 fractions on the first postoperative day. Thus, a total dose of 18 Gy in 3 fractions was administered within 36 hours after the resection. Results: The treatment was feasible in all patients. No procedure-related complications (eg, secondary infections) occurred. Nineteen patients had keloid-related symptoms before treatment like pain and pruritus; disappearance of symptoms was noticed in all patients after treatment. After a median follow-up of 29.4 months (range, 7.9-72.4 months), 2 keloid recurrences and 2 mildly hypertrophied scars were observed. The local control rate was 94%. Pigmentary abnormalities were detected in 3 patients, and an additional 6 patients had a mild delay in the wound-healing process. Conclusions: The early results of this study prove the feasibility and the efficacy of brachytherapy for the prevention of keloids. The results also suggest that brachytherapy may be advantageous in the management of high-risk keloids or as salvage treatment for failure after external beam therapy.

  18. Radiolysis products and sensory properties of electron-beam-irradiated high-barrier food-packaging films containing a buried layer of recycled low-density polyethylene.

    Science.gov (United States)

    Chytiri, S D; Badeka, A V; Riganakos, K A; Kontominas, M G

    2010-04-01

    The aim was to study the effect of electron-beam irradiation on the production of radiolysis products and sensory changes in experimental high-barrier packaging films composed of polyamide (PA), ethylene-vinyl alcohol (EVOH) and low-density polyethylene (LDPE). Films contained a middle buried layer of recycled LDPE, while films containing 100% virgin LDPE as the middle buried layer were taken as controls. Irradiation doses ranged between zero and 60 kGy. Generally, a large number of radiolysis products were produced during electron-beam irradiation, even at the lower absorbed doses of 5 and 10 kGy (approved doses for food 'cold pasteurization'). The quantity of radiolysis products increased with irradiation dose. There were no significant differences in radiolysis products identified between samples containing a recycled layer of LDPE and those containing virgin LDPE (all absorbed doses), indicating the 'functional barrier' properties of external virgin polymer layers. Sensory properties (mainly taste) of potable water were affected after contact with irradiated as low as 5 kGy packaging films. This effect increased with increasing irradiation dose.

  19. A practical method to calculate head scatter factors in wedged rectangular and irregular MLC shaped beams for external and internal wedges

    International Nuclear Information System (INIS)

    Georg, Dietmar; Olofsson, Joergen; Kuenzler, Thomas; Aiginger, Hannes; Karlsson, Mikael

    2004-01-01

    Factor based methods for absorbed dose or monitor unit calculations are often based on separate data sets for open and wedged beams. The determination of basic beam parameters can be rather time consuming, unless equivalent square methods are applied. When considering irregular wedged beams shaped with a multileaf collimator, parametrization methods for dosimetric quantities, e.g. output ratios or wedge factors as a function of field size and shape, become even more important. A practical method is presented to derive wedged output ratios in air (S c,w ) for any rectangular field and for any irregular MLC shaped beam. This method was based on open field output ratios in air (S c ) for a field with the same collimator setting, and a relation f w between S c,w and S c . The relation f w can be determined from measured output ratios in air for a few open and wedged fields including the maximum wedged field size. The function f w and its parametrization were dependent on wedge angle and treatment head design, i.e. they were different for internal and external wedges. The proposed method was tested for rectangular wedged fields on three accelerators with internal wedges (GE, Elekta, BBC) and two accelerators with external wedges (Varian). For symmetric regular beams the average deviation between calculated and measured S c,w /S c ratios was 0.3% for external wedges and about 0.6% for internal wedges. Maximum deviations of 1.8% were obtained for elongated rectangular fields on the GE and ELEKTA linacs with an internal wedge. The same accuracy was achieved for irregular MLC shaped wedged beams on the accelerators with MLC and internal wedges (GE and Elekta), with an average deviation <1% for the fields tested. The proposed method to determine output ratios in air for wedged beams from output ratios of open beams, combined with equivalent square approaches, can be easily integrated in empirical or semi-empirical methods for monitor unit calculations

  20. Comparison of surface doses from spot scanning and passively scattered proton therapy beams

    International Nuclear Information System (INIS)

    Arjomandy, Bijan; Sahoo, Narayan; Gillin, Michael; Cox, James; Lee, Andrew

    2009-01-01

    Proton therapy for the treatment of cancer is delivered using either passively scattered or scanning beams. Each technique delivers a different amount of dose to the skin, because of the specific feature of their delivery system. The amount of dose delivered to the skin can play an important role in choosing the delivery technique for a specific site. To assess the differences in skin doses, we measured the surface doses associated with these two techniques. For the purpose of this investigation, the surface doses in a phantom were measured for ten prostate treatment fields planned with passively scattered proton beams and ten patients planned with spot scanning proton beams. The measured doses were compared to evaluate the differences in the amount of skin dose delivered by using these techniques. The results indicate that, on average, the patients treated with spot scanning proton beams received lower skin doses by an amount of 11.8% ± 0.3% than did the patients treated with passively scattered proton beams. That difference could amount to 4 CGE per field for a prescribed dose of 76 CGE in 38 fractions treated with two equally weighted parallel opposed fields. (note)

  1. Beam intensity scanner system for three dimensional dose verification of IMRT

    International Nuclear Information System (INIS)

    Vahc, Young W.; Kwon, Ohyun; Park, Kwangyl; Park, Kyung R.; Yi, Byung Y.; Kim, Keun M.

    2003-01-01

    Patient dose verification is clinically one of the most important parts in the treatment delivery of radiation therapy. The three dimensional (3D) reconstruction of dose distribution delivered to target volume helps to verify patient dose and determine the physical characteristics of beams used in IMRT. Here we present beam intensity scanner (BInS) system for the pre-treatment dosimetric verification of two dimensional photon intensity. The BInS is a radiation detector with a custom-made software for dose conversion of fluorescence signals from scintillator. The scintillator is used to produce fluorescence from the irradiation of 6 MV photons on a Varian Clinac 21EX. The digitized fluoroscopic signals obtained by digital video camera-based scintillator (DVCS) will be processed by our custom made software to reproduce 3D- relative dose distribution. For the intensity modulated beam (IMB), the BInS calculates absorbed dose in absolute beam fluence which is used for the patient dose distribution. Using BInS, we performed various measurements related to IMRT and found the following: (1) The 3D-dose profiles of the IMBs measured by the BInS demonstrate good agreement with radiographic film, pin type ionization chamber and Monte Carlo simulation. (2) The delivered beam intensity is altered by the mechanical and dosimetric properties of the collimation of dynamic and/or step MLC system. This is mostly due to leaf transmission, leaf penumbra scattered photons from the round edges of leaves, and geometry of leaf. (3) The delivered dose depends on the operational detail of how to make multi leaf opening. These phenomena result in a fluence distribution that can be substantially different from the initial and calculated intensity modulation and therefore, should be taken into account by the treatment planning for accurate dose calculations delivered to the target volume in IMRT. (author)

  2. Prospective survey of erectile dysfunction after external beam radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Kikuchi, Eiji; Ando, Toshiyuki; Nagata, Hirohiko; Miyajima, Akira; Nakagawa, Ken; Oya, Mototsugu; Nakashima, Jun; Marumo, Ken

    2011-01-01

    We prospectively evaluated the effect of external beam radiotherapy on erectile function in patients with localized or locally advanced prostate cancer using the Japanese version of the International Index of Erectile Function (IIEF) survey. From 2000 to 2007, we identified 55 patients who underwent external beam radiotherapy at our institution for localized or locally advanced prostate cancer and could respond to the IIEF survey. The patients did not receive neo- and/or adjuvant hormone therapy and they were followed-up for at least 12 months after radiotherapy. Mean patient age was 69 years and the mean prostate specific antigen (PSA) level before radiotherapy was 24.9 ng/ml. First we evaluated the change of the erectile function domain score over time before and after radiotherapy. The population of severe erectile dysfunction (ED) increased while those with no or mild ED decreased after radiotherapy. The erectile function and intercourse satisfaction domain score of the IIEF declined significantly after radiotherapy, however, the orgasmic function, sexual desire, and overall satisfaction domain scores did not change after external beam radiation. Of the 34 patients who had erectile function at baseline, 10 patients could maintain erectile function 12 months after radiotherapy. Though there were no significant differences in clinical features between patients who could maintain erectile function and those who had worsening erectile function 12 months after radiotherapy, the sexual desire domain score before radiotherapy was significantly higher in patients who could maintain erectile function than their counterparts. Using the IIEF survey, external beam radiation was found to affect erectile function in patients with localized or locally advanced prostate cancer. (author)

  3. Dose and energy dependence of response of Gafchromic XR-QA film for kilovoltage x-ray beams.

    Science.gov (United States)

    Rampado, O; Garelli, E; Deagostini, S; Ropolo, R

    2006-06-07

    There is a growing interest in Gafchromic films for patient dosimetry in radiotherapy and in radiology. A new model (XR-QA) with high sensitivity to low dose was tested in this study. The response of the film to different x-ray beam energies (range 28-145 kVp with various filtrations, dose range 0-100 mGy) and to visible light was investigated, together with the after exposure darkening properties. Exposed films were digitized with a commercially available, optical flatbed scanner. A single functional form for dose versus net pixel value variation has been determined for all the obtained calibration curves, with a unique fit parameter different for each of the used x-ray beams. The film response was dependent on beam energy, with higher colour variations for the beams in the range 80-140 kVp. Different sources of uncertainties in dose measurements, governed by the digitalization process, the film response uniformity and the calibration curve fit procedure, have been considered. The overall one-sigma dose measurement uncertainty depended on the beam energy and decreased with increasing absorbed dose. For doses above 10 mGy and beam energies in the range 80-140 kVp the total uncertainty was less than 5%, whereas for the 28 kVp beam the total uncertainty at 10 mGy was about 10%. The post-exposure colour variation was not negligible in the first 24 h after the exposure, with a consequent increase in the calculated dose of about 10%. Results of the analysis of the sensitivity to visible light indicated that a short exposure of this film to ambient and scanner light during the measurements will not have a significant impact on the radiation dosimetry.

  4. Interstitial high-dose rate brachytherapy as boost for anal canal cancer

    International Nuclear Information System (INIS)

    Falk, Alexander Tuan; Claren, Audrey; Benezery, Karen; François, Eric; Gautier, Mathieu; Gerard, Jean-Pierre; Hannoun-Levi, Jean-Michel

    2014-01-01

    To assess clinical outcomes of patients treated with a high-dose rate brachytherapy boost for anal canal cancer (ACC). From August 2005 to February 2013, 28 patients presenting an ACC treated by split-course external beam radiotherapy (EBRT) and HDR brachytherapy with or without chemotherapy in a French regional cancer center in Nice were retrospectively analyzed. Median age was 60.6 years [34 – 83], 25 patients presented a squamous cell carcinoma and 3 an adenocarcinoma; 21 received chemotherapy. Median dose of EBRT was 45 Gy [43.2 – 52]. Median dose of HDR brachytherapy was 12 Gy [10 - 15] with a median duration of 2 days. Median overall treatment time was 63 days and median delay between EBRT and brachytherapy was 20 days. Two-year local relapse free, metastatic free, disease free and overall survivals were 83%, 81.9%, 71.8% and 87.7% respectively. Acute toxicities were frequent but not severe with mostly grade 1 toxicities: 37% of genito-urinary, 40.7% of gastro-intestinal and 3.7% of cutaneous toxicities. Late toxicities were mainly G1 (43.1%) and G2 (22%). Two-year colostomy-free survival was 75.1%, one patient had a definitive sphincter amputation. High-dose rate brachytherapy for anal canal carcinoma as boost represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time

  5. Post operative high dose rate intravaginal irradiation in endometrial cancer: a safe and effective outpatient treatment

    International Nuclear Information System (INIS)

    Chen, Peter; Gibbons, Susan; Vicini, Frank; Weiner, Sheldon; Dmuchowski, Carl; Mele, Beth; Brabbins, Donald; Jennings, John; Gustafson, Gary; Martinez, Alvaro

    1995-01-01

    Purpose: We reviewed our experience with out patient high dose rate (HDR) intravaginal irradiation given post-operatively in endometrial cancer to assess local control, survival, and toxicity when used alone or in combination with external beam irradiation. Methods and Materials: From (12(88)) to (12(92)), 78 patients underwent TAH/BSO and received post-operative HDR intravaginal irradiation for endometrial cancer. Pathologic stage distribution was IB/IC: 56%, II: 22%, III: 22%. Adjuvant therapy was given in one of three schemes: HDR vaginal radiation alone (6 weekly fractions of 500 cGy prescribed 5 mm from the applicator surface treating the upper 4 cm of the vagina), pelvic irradiation with vaginal HDR (500 cGy x 4 weekly fractions) or whole abdomen/pelvic irradiation (WAPI) with vaginal HDR treatment (500 cGy x 3 weekly fractions). Prior to the first HDR vaginal treatment, a simulation with placement of vaginal apex metallic markers was performed to assure proper positioning of the intravaginal cylinders. Pelvic midline blocking was designed from the HDR intravaginal simulation films. The 55 patients who underwent combined external beam irradiation/brachytherapy received a median dose to the pelvis of 5040 cGy (range 25.2-51.6 Gy), and a median total vaginal dose of 5060 cGy (range 30.0-57.6 Gy). Results: Median follow-up is 37 months (range 6-73 months). Local control (vaginally) is 98.7%. The one vaginal failure was in the distal vagina, outside the treatment volume. All other failures (4) were distant with the vagina controlled [3 intra-abdominal and one bone/intra-abdominal]. For stages I and II, the disease free survival is 92.8%. For stage III the disease free survival is 86.5%. Median overall time to failure is 14.3 months (range 8.5-18.6 months). In terms of acute toxicity, no grade 3-4 acute toxicity of the vagina or bladder was seen. However, 9% acute GI toxicity was encountered. Chronic grade 1-2 toxicities included: vaginal 21.8% (foreshortening and

  6. Assessment of protocols in cone beam CT with symmetric and asymmetric beam using effective dose and Pka

    International Nuclear Information System (INIS)

    Batista, W. O.; Linhares de O, M. V.; Soares, M. R.; Maia, A. F.; Caldas, L. V. E.

    2014-08-01

    The cone beam CT is an emerging technology in dental radiology with significant differences the point of view of design technology between the various manufacturers on the world market. This study aims to evaluate and compare protocols with similar purposes in a cone beam CT scanner using TLDs and air kerma - area product (P ka ) as kerma index. Measurements were performed on two protocols used to obtain the image the maxilla-mandible in equipment Gendex GXCB 500: Protocol [GX1] extended diameter and asymmetric beam (14 cm x 8.5 cm - maxilla / mandible) and protocol [GX2] symmetrical beam (8.5 cm x 8.5 cm - maxillary / mandible). Was used LiF dosimeters (TLD 100) inserted into a female anthropomorphic phantom manufactured by Radiology Support Devices. For all protocols evaluated the value of P ka using a meter Diamentor E2 and PTW system Radcal Rapidose. The results obtained for Effective Dose / P ka these measurements were separated by protocol image. Protocol [GX1]: 44.5 μSv/478 mGy cm 2 ; protocol [GX2]: 54.8 μSv/507 mGy cm 2 . These values indicate that the relationship between the diameter of the image acquired in the protocol [GX1] and the diameter of the image in the protocol [GX2] is equal to 1.65, the Effective Dose for the first protocol has lower value at 18%. P ka values reveal very similar results between the two protocols, although, common sense leads to the interpretation that imaging protocols with field of view (Fov) of large diameters imply high values of effective dose when compared to small diameters. However, in this particular case, this is not true due to the asymmetrical beam technology. Conclude that for the cases where the scanner uses asymmetric beam to obtain images with large diameters that cover the entire face there are advantages from the point of view of reducing the exposure of patients with respect to the use of symmetrical beam and / or to Fov images with a smaller diameter. (Author)

  7. The effects of high dose and highly fractionated radiation on distraction osteogenesis in the murine mandible

    International Nuclear Information System (INIS)

    Monson, Laura A; Cavaliere, Christi M; Deshpande, Sagar S; Ayzengart, Alexander L; Buchman, Steven R

    2012-01-01

    The ability of irradiated tissue to support bony growth remains poorly defined, although there are anecdotal cases reported showing mixed results for the use of mandibular distraction osteogenesis after radiation for head and neck cancer. Many of these reports lack objective measures that would allow adequate analysis of outcomes or efficacy. The purpose of this experiment was to utilize a rat model of mandibular distraction osteogenesis after high dose and highly fractionated radiation therapy and to evaluate and quantify distracted bone formation under these conditions. Male Sprague–Dawley rats underwent 12 fractions of external beam radiation (48 Gray) of the left mandible. Following a two week recovery period, an external frame distractor was applied and gradual distraction of the mandible was performed. Tissue was harvested after a twenty-eight day consolidation period. Gross, radiologic and histological evaluations were undertaken. Those animals subjected to pre-operative radiation showed severe attenuation of bone formation including bone atrophy, incomplete bridging of the distraction gap, and gross bony defects or non-union. Although physical lengthening was achieved, the irradiated bone consistently demonstrated marked damaging effects on the normal process of distraction osteogenesis. This murine model has provided reliable evidence of the injurious effects of high dose radiation on bone repair and regeneration in distraction osteogenesis utilizing accurate and reproducible metrics. These results can now be used to assist in the development of therapies directed at mitigating the adverse consequences of radiation on the regeneration of bone and to optimize distraction osteogenesis so it can be successfully applied to post-oncologic reconstruction

  8. HIGH-DOSE RATE BRACHYTHERAPY IN CARCINOMA CERVIX STAGE IIIB

    Directory of Open Access Journals (Sweden)

    Sathya Maruthavanan

    2016-07-01

    Full Text Available INTRODUCTION Radiotherapy is the standard treatment in locally advanced (IIB-IVA and early inoperable cases. The current standard of practice with curable intent is concurrent chemoradiation in which intracavitary brachytherapy is an integral component of radiotherapy. This study aims at assessing the efficacy of HDR ICBT (High-dose rate intracavitary brachytherapy in terms local response, normal tissue reactions, and feasibility. METHODS AND MATERIALS A total of 20 patients of stage IIIB cancer of the uterine cervix were enrolled in the study and were planned to receive concurrent chemotherapy weekly along with EBRT (external beam radiotherapy to a dose of 50 Gy/25 Fr. Suitability for ICBT was assessed at 40 Gy/20 Fr. 6/20 patients were suitable at 40 Gy and received HDR ICBT with a dose of 5.5 Gy to point A in 4 sessions (5.5 Gy/4 Fr. The remaining 14/20 patients completed 50 Gy and received HDR ICBT with a dose of 6 Gy to point A in 3 sessions (6 Gy/3 Fr. RESULTS A total of 66 intracavitary applications were done and only one application required dose modification due to high bladder dose, the pelvic control rate was 85% (17/20. 10% (2/20 had stable disease and 5% (1/20 had progressive disease at one year of follow up. When toxicity was considered only 15% developed grade I and grade II rectal complications. Patient compliance and acceptability was 100%. Patients were very comfortable with the short treatment time as compared with patients on LDR ICBT (low-dose rate intracavitary brachytherapy treatment interviewed during the same period. CONCLUSION This study proves that HDR brachytherapy is efficacious and feasible in carcinoma of cervix stage IIIB. It also proves that good dose distribution can be achieved with HDR intracavitary facility by the use of dose optimization. The short treatment time in HDR ICBT makes it possible to maintain this optimised dose distribution throughout the treatment providing a gain in the therapeutic ratio and

  9. Dose distributions in thorax inhomogeneity for fast neutron beam from NIRS cyclotron

    International Nuclear Information System (INIS)

    Kutsutani-Nakamura, Yuzuru; Furukawa, Shigeo; Iinuma, T.A.; Kawashima, Katsuhiro; Hoshino, Kazuo; Hiraoka, Takeshi; Maruyama, Takashi; Sakashita, Kunio; Tsunemoto, Hiroshi

    1990-01-01

    The power law tissue-air ratio (TAR) method developed by Batho appears to be practical use for inhomogeneity corrections to the dose calculated in a layered media for photon beam therapy. The validity was examined in applying the modified power law TAR and the isodose shift methods to the dose calculation in thorax tissue inhomogeneity containing the boundary region for fast neutron beam. The neutron beam is produced by bombarding a thick beryllium target with 30 MeV deuterons. Lung phantom was made of granulated tissue equivalent plastic, which resulted in density of 0.30 and 0.60 g/cm 3 . Depth dose distributions for neutron beam were measured in thorax phantom by an air-filled cylindrical ionization chamber with TE plastic wall. The power law TAR method considering TAR of zero depth at boundary was compared with the measured data and a good result was obtained that the calculated dose was within ±3 % against the measured. But the isodose shift method is not so good for dose calculation in thorax tissue inhomogeneity using fast neutron beam. (author)

  10. Low-dose external beam radiotherapy for greater trochanteric pain syndrome. Target volume definition and treatment outcome

    International Nuclear Information System (INIS)

    Kaltenborn, Alexander; Carl, Ulrich Martin; Hinsche, Tanja; Nitsche, Mirko; Hermann, Robert Michael

    2017-01-01

    Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [de

  11. The effect of a metal hip prosthesis on the radiation dose in therapeutic photon beam irradiations

    Energy Technology Data Exchange (ETDEWEB)

    Lin, S.-Y.; Chu, T.-C. E-mail: tcchu@mx.nthu.edu.tw; Lin, J.-P.; Liu, M.-T

    2002-07-01

    Prostate and cervical cancer patients are often treated with external X-ray beams of bi-lateral incidence. Such treatment may incur some dose effect that cannot be predicted precisely in commercial treatment planning systems (TPS) for patients having undergone total hip replacement. This study performs a Monte Carlo (MC) simulation and an analytical calculation (convolution superposition algorithm which is implemented in ADAC TPS) of a 6 MV, 5x5 cm{sup 2} X-ray beam incident into water with the existence of hip prosthesis, e.g. Ti6Al4V and CoCrMo alloy. The results indicate that ADAC TPS cannot precisely account for the scatter and backscatter radiation that a metal hip prosthesis causes. For percent depth dose (PDD) curves, the maximum underdosage of ADAC TPS up to 5 mm above the interface between dense material and water is 5%, 20% and 27% for PDD{sub Bone}, PDD{sub Ti} and PDD{sub Co}, respectively. The dose re-buildup, which occurs behind the hip region, becomes more and more obvious for denser medium existed in water. Increasing inhomogeneity also enhances the underdosage of ADAC for greater depth (>10 cm), as the figures of nearly 2% in PDD{sub Bone}, PDD{sub Ti} and 4-5% in PDD{sub Co} reveal. Overestimating the attenuated power of high-density non-water material in ADAC TPS causes this underdosage. For dose profiles, no significant differences were found in Profile{sub Bone} at any depth. Profile{sub Ti} reveals that MC slightly exceeds ADAC at off-axis position 1.0-2.0 cm. Profile{sub Co} reveals this more obviously. This finding means that scatter radiation from these denser materials is significant and cannot be predicted precisely in ADAC.

  12. Californium-252 Brachytherapy Combined With External-Beam Radiotherapy for Cervical Cancer: Long-Term Treatment Results

    International Nuclear Information System (INIS)

    Lei Xin; Qian Chengyuan; Qing Yi; Zhao Kewei; Yang Zhengzhou; Dai Nan; Zhong Zhaoyang; Tang Cheng; Li Zheng; Gu Xianqing; Zhou Qian; Feng Yan; Xiong Yanli; Shan Jinlu; Wang Dong

    2011-01-01

    Purpose: To observe, by retrospective analysis, the curative effects and complications due to californium-252 ( 252 Cf) neutron intracavitary brachytherapy (ICBT) combined with external-beam radiotherapy (EBRT) in the treatment of cervical cancer. Methods and Materials: From February 1999 to December 2007, 696 patients with cervical cancer (Stages IB to IIIB) were treated with 252 Cf-ICBT in combination of EBRT. Of all, 31 patients were at Stage IB, 104 at IIA, 363 at IIB, 64 at IIIA, and 134 at IIIB. Californium-252 ICBT was delivered at 7–12 Gy per insertion per week, with a total dose of 29–45 Gy to reference point A in three to five insertions. The whole pelvic cavity was treated with 8-MV X-ray external irradiation at 2 Gy per fraction, four times per week. After 16–38 Gy of external irradiation, the center of the whole pelvic field was blocked with a 4-cm-wide lead shield, with a total external irradiation dose of 44–56 Gy. The total treatment course was 5 to 6 weeks. Results: Overall survival rate at 3 and 5 years for all patients was 76.0% and 64.9%, respectively. Disease-free 3- and 5-year survival rates of patients were 71.2% and 58.4%, respectively. Late complications included vaginal contracture and adhesion, radiation proctitis, radiation cystitis, and inflammatory bowel, which accounted for 5.8%, 7.1%, 6.2%, and 4.9%, respectively. Univariate analysis results showed significant correlation of stage, age, histopathologic grade, and lymph node status with overall survival. Cox multiple regression analysis showed that the independent variables were stage, histopathologic grade, tumor size, and lymphatic metastasis in all patients. Conclusion: Results of this series suggest that the combined use of 252 Cf-ICBT with EBRT is an effective method for treatment of cervical cancer.

  13. Low-dose ion-based transmission radiography and tomography for optimization of carbon ion-beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Magallanes Hernandez, Lorena

    2017-02-21

    In the last few decades, ion-beam radiotherapy has emerged as a highly effective tumor treatment modality. Its success relies on the capability to precisely confine the prescribed dose within the target volume, due to the inverted depth-dose profile and the finite range featured by charged particles. However, to fully exploit the physical and biological advantages of ion-beams, it is necessary to prioritize on innovative imaging techniques to monitor the ion-range inside the patient. Main range uncertainties result from X-ray-based calibration of the ion relative Water Equivalent Path Length (rWEPL) during the planning phase, and patient anatomical or positioning variation during the treatment. In this thesis, low-dose carbon-ion transmissionimaging performed with a Residual Range Detector (RRD) is proposed as imaging strategy for actively scanned beam delivery facilities. It enables the verification of the beam range and the patient positioning with ion-radiographies (iRAD), and ion computed tomographies (iCT) can directly provide the ion stopping-power of the traversed tissue for treatment planning purposes. First experimental investigations aiming to minimize the imaging dose to the object are presented. The performance of the integration-mode multi-channel array of 61 parallel-plate ionization chambers (PPICs), interleaved with 3 mm thickness PMMA slabs, was thoroughly investigated for low-fluence irradiation. This characterization has been pursued in terms of beam-monitoring performance at the Heidelberg Ion-beam Therapy Center (HIT, Heidelberg, Germany), RRD signal-to-noise ratio (SNR), RRD charge-collection efficiency and drift voltage applied to the PPICs. Pixel-wise metrics for signal quality evaluation based on specific channel-charge features have been developed to support the visual assessment of the acquired images. Phantoms of different complexity and tissue-equivalent composition were imaged with high (5000 primaries per raster-scanning point (RP

  14. Low-dose ion-based transmission radiography and tomography for optimization of carbon ion-beam therapy

    International Nuclear Information System (INIS)

    Magallanes Hernandez, Lorena

    2017-01-01

    In the last few decades, ion-beam radiotherapy has emerged as a highly effective tumor treatment modality. Its success relies on the capability to precisely confine the prescribed dose within the target volume, due to the inverted depth-dose profile and the finite range featured by charged particles. However, to fully exploit the physical and biological advantages of ion-beams, it is necessary to prioritize on innovative imaging techniques to monitor the ion-range inside the patient. Main range uncertainties result from X-ray-based calibration of the ion relative Water Equivalent Path Length (rWEPL) during the planning phase, and patient anatomical or positioning variation during the treatment. In this thesis, low-dose carbon-ion transmissionimaging performed with a Residual Range Detector (RRD) is proposed as imaging strategy for actively scanned beam delivery facilities. It enables the verification of the beam range and the patient positioning with ion-radiographies (iRAD), and ion computed tomographies (iCT) can directly provide the ion stopping-power of the traversed tissue for treatment planning purposes. First experimental investigations aiming to minimize the imaging dose to the object are presented. The performance of the integration-mode multi-channel array of 61 parallel-plate ionization chambers (PPICs), interleaved with 3 mm thickness PMMA slabs, was thoroughly investigated for low-fluence irradiation. This characterization has been pursued in terms of beam-monitoring performance at the Heidelberg Ion-beam Therapy Center (HIT, Heidelberg, Germany), RRD signal-to-noise ratio (SNR), RRD charge-collection efficiency and drift voltage applied to the PPICs. Pixel-wise metrics for signal quality evaluation based on specific channel-charge features have been developed to support the visual assessment of the acquired images. Phantoms of different complexity and tissue-equivalent composition were imaged with high (5000 primaries per raster-scanning point (RP

  15. Generating AN Optimum Treatment Plan for External Beam Radiation Therapy.

    Science.gov (United States)

    Kabus, Irwin

    1990-01-01

    The application of linear programming to the generation of an optimum external beam radiation treatment plan is investigated. MPSX, an IBM linear programming software package was used. All data originated from the CAT scan of an actual patient who was treated for a pancreatic malignant tumor before this study began. An examination of several alternatives for representing the cross section of the patient showed that it was sufficient to use a set of strategically placed points in the vital organs and tumor and a grid of points spaced about one half inch apart for the healthy tissue. Optimum treatment plans were generated from objective functions representing various treatment philosophies. The optimum plans were based on allowing for 216 external radiation beams which accounted for wedges of any size. A beam reduction scheme then reduced the number of beams in the optimum plan to a number of beams small enough for implementation. Regardless of the objective function, the linear programming treatment plan preserved about 95% of the patient's right kidney vs. 59% for the plan the hospital actually administered to the patient. The clinician, on the case, found most of the linear programming treatment plans to be superior to the hospital plan. An investigation was made, using parametric linear programming, concerning any possible benefits derived from generating treatment plans based on objective functions made up of convex combinations of two objective functions, however, this proved to have only limited value. This study also found, through dual variable analysis, that there was no benefit gained from relaxing some of the constraints on the healthy regions of the anatomy. This conclusion was supported by the clinician. Finally several schemes were found that, under certain conditions, can further reduce the number of beams in the final linear programming treatment plan.

  16. Suppression of beam-excited electron waves by an externally applied RF signal

    International Nuclear Information System (INIS)

    Fukumasa, Osamu; Itatani, Ryohei

    1980-11-01

    Suppression of the beam-excited electron wave in a bounded system is investigated in connection with the beam distribution function. Wave suppression has two different processes depending on whether injected beams are reflected at the other end or not. In the absence of reflected beam electrons, deformation of the beam distribution function is observed in relation to the suppression of the electron wave. However, when beam electrons are reflected, the external wave suppresses the electron wave but distribution function shows no appreciable change. These experimental results show that nonlinear behaviors of beam electrons, namely behaviors of reflected beams, are quite important for wave suppression. By using the method of partial simulation, interaction between two waves in the bounded system including nonlinear motions of beam electrons is studied numerically. Qualitative agreement between experimental and numerical results is obtained. (author)

  17. Interaction of 2-Gy Equivalent Dose and Margin Status in Perioperative High-Dose-Rate Brachytherapy

    International Nuclear Information System (INIS)

    Martinez-Monge, Rafael; Cambeiro, Mauricio; Moreno, Marta; Gaztanaga, Miren; San Julian, Mikel; Alcalde, Juan; Jurado, Matias

    2011-01-01

    Purpose: To determine patient, tumor, and treatment factors predictive of local control (LC) in a series of patients treated with either perioperative high-dose-rate brachytherapy (PHDRB) alone (Group 1) or with PHDRB combined with external-beam radiotherapy (EBRT) (Group 2). Patient and Methods: Patients (n = 312) enrolled in several PHDRB prospective Phase I-II studies conducted at the Clinica Universidad de Navarra were analyzed. Treatment with PHDRB alone, mainly because of prior irradiation, was used in 126 patients to total doses of 32 Gy/8 b.i.d. or 40 Gy/10 b.i.d. treatments after R0 or R1 resections. Treatment with PHDRB plus EBRT was used in 186 patients to total doses of 16 Gy/4 b.i.d. or 24 Gy/6 b.i.d. treatments after R0 or R1 resections along with 45 Gy of EBRT with or without concomitant chemotherapy. Results: No dose-margin interaction was observed in Group 1 patients. In Group 2 patients there was a significant interaction between margin status and 2-Gy equivalent (Eq2Gy) dose (p = 0.002): (1) patients with negative margins had 9-year LC of 95.7% at Eq2Gy = 62.9Gy; (2) patients with close margins of >1 mm had 9-year LC of 92.4% at Eq2Gy = 72.2Gy, and (3) patients with positive/close <1-mm margins had 9-year LC of 68.0% at Eq2Gy = 72.2Gy. Conclusions: Two-gray equivalent doses ≥70 Gy may compensate the effect of close margins ≥1 mm but do not counterbalance the detrimental effect of unfavorable (positive/close <1 mm) resection margins. No dose-margin interaction is observed in patients treated at lower Eq2Gy doses ≤50 Gy with PHDRB alone.

  18. Urinary incontinence in prostate cancer patients treated with external beam radiotherapy

    International Nuclear Information System (INIS)

    Liu, Mitchell; Pickles, Tom; Berthelet, Eric; Agranovich, Alexander; Kwan, Winkle; Tyldesley, Scott; McKenzie, Michael; Keyes, Mira; Morris, James; Pai, Howard

    2005-01-01

    Background and purpose: To describe the incidence of urinary incontinence among prostate cancer patients treated with external beam radiotherapy (RT) and to investigate associated risk factors. Patients and methods: One thousand and hundred ninety-two patients with ≥24 months follow-up were the subjects of this series. All patients received between 50 and 72 Gy in 20-37 fractions (median 66 Gy/33). Post-RT urinary incontinence was scored by direct patient interviewing according to the modified RTOG/SOMA scale: Grade 1-occasional use of incontinence pads, Grade 2-intermittent use of incontinence pads, Grade 3-persistent use of incontinence pads, and Grade 4-permanent catheter. Risk-factors investigated were: age, diabetes, TURP prior to RT, elapsed time from TURP to RT, clinical stage, RT dose and presence of Grade ≥2 acute GU and GI toxicity. Non-parametric, actuarial univariate (Kaplan-Meier) and multivariate tests (MVA, Cox regression) were performed. Results: Median follow-up for the group is 52 months (24-109). Thirty-four patients (2.9%) had incontinence prior to RT, which was more common in TURP patients (7.8% vs 1.6% P<0.001). These are excluded from further analysis. Fifty-seven patients (4.9%) developed Grade 1 incontinence, 7 (0.6%) Grade 2, and 7 (0.6%) Grade 3. There was no Grade 4 incontinence. Actuarial rates for Grade ≥1 and ≥2 incontinence at 5 years are 7 and 1.7%, respectively. Risk factors on MVA associated with the development of Grade 1 or worse incontinence are pre-RT TURP (5-year rates 10% vs 6%, P=0.026), presence of Grade ≥2 acute GU toxicity (5-year rates 11% vs 5%, P=0.002). Age, diabetes, clinical stage, elapsed time from TURP to RT, RT dose or fraction size, acute GI toxicity were not significant. Patients who underwent post-RT TURP or dilatation for obstructive symptoms (4.3%), were more likely to develop Grade 2-3 incontinence (5-year rate 8 vs 1.5%, P=0.0015). Conclusions: Grade 2 or greater urinary incontinence is rare

  19. Fast IMRT with narrow high energy scanned photon beams

    Energy Technology Data Exchange (ETDEWEB)

    Andreassen, Bjoern; Straaring t, Sara Janek; Holmberg, Rickard; Naefstadius, Peder; Brahme, Anders [Department of Medical Radiation Physics, Karolinska Institutet and Stockholm University, P.O. Box 260, SE-171 76 Stockholm (Sweden); Department of Hospital Physics, Karolinska University Hospital, SE-171 76 Stockholm (Sweden); Department of Medical Radiation Physics, Karolinska Institutet and Stockholm University, P.O. Box 260, SE-171 76 Stockholm, Sweden and Department of Hospital Physics, Karolinska University Hospital, SE-171 76 Stockholm (Sweden)

    2011-08-15

    Purpose: Since the first publications on intensity modulated radiation therapy (IMRT) in the early 1980s almost all efforts have been focused on fairly time consuming dynamic or segmental multileaf collimation. With narrow fast scanned photon beams, the flexibility and accuracy in beam shaping increases, not least in combination with fast penumbra trimming multileaf collimators. Previously, experiments have been performed with full range targets, generating a broad bremsstrahlung beam, in combination with multileaf collimators or material compensators. In the present publication, the first measurements with fast narrow high energy (50 MV) scanned photon beams are presented indicating an interesting performance increase even though some of the hardware used were suboptimal. Methods: Inverse therapy planning was used to calculate optimal scanning patterns to generate dose distributions with interesting properties for fast IMRT. To fully utilize the dose distributional advantages with scanned beams, it is necessary to use narrow high energy beams from a thin bremsstrahlung target and a powerful purging magnet capable of deflecting the transmitted electron beam away from the generated photons onto a dedicated electron collector. During the present measurements the scanning system, purging magnet, and electron collimator in the treatment head of the MM50 racetrack accelerator was used with 3-6 mm thick bremsstrahlung targets of beryllium. The dose distributions were measured with diodes in water and with EDR2 film in PMMA. Monte Carlo simulations with geant4 were used to study the influence of the electrons transmitted through the target on the photon pencil beam kernel. Results: The full width at half-maximum (FWHM) of the scanned photon beam was 34 mm measured at isocenter, below 9.5 cm of water, 1 m from the 3 mm Be bremsstrahlung target. To generate a homogeneous dose distribution in a 10 x 10 cm{sup 2} field, the authors used a spot matrix of 100 equal intensity

  20. Estimates of external dose-rate conversion factors and internal dose conversion factors for selected radionuclides released from fusion facilities

    Energy Technology Data Exchange (ETDEWEB)

    Homma, Toshimitsu; Togawa, Orihiko [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1996-11-01

    This report provides a tabulation of both external dose-rate conversion factors and internal dose conversion factors using radioactive decay data in the updated Evaluated Nuclear Structure Data File (ENSDF) for selected 26 radionuclides and all their daughter radionuclides of potential importance in safety assessments of fusion facilities. The external dose-rate conversion factors for 21 target organs are tabulated for three exposure modes that are immersion in contaminated air, irradiation at a height of 1 m above a contaminated ground surface and immersion contaminated water. For internal exposure, committed dose equivalents, based on the methodology of ICRP Publication 30, in the same target organs per intake of unit activity are given for the inhalation and ingestion exposure pathways. The data presented here is intended to be generally used for safety assessments of fusion reactors. Comparisons of external effective dose-rate conversion factors and committed effective dose equivalents are made with the previous data from the independent data bases to provide quality assurance on our calculated results. There is generally good agreement among data from the independent data bases. The differences in the values of both effective dose-rate and dose conversion factors appeared are primarily due to differences in calculational methodology, the use of different radioactive decay data, and compilation errors. (author)

  1. Age-dependent conversion coefficients for organ doses and effective doses for external neutron irradiation

    International Nuclear Information System (INIS)

    Nishizaki, Chihiro; Endo, Akira; Takahashi, Fumiaki

    2006-06-01

    To utilize dose assessment of the public for external neutron irradiation, conversion coefficients of absorbed doses of organs and effective doses were calculated using the numerical simulation technique for six different ages (adult, 15, 10, 5 and 1 years and newborn), which represent the member of the public. Calculations were performed using six age-specific anthropomorphic phantoms and a Monte Carlo radiation transport code for two irradiation geometries, anterior-posterior and rotational geometries, for 20 incident energies from thermal to 20 MeV. Effective doses defined by the 1990 Recommendation of ICRP were calculated from the absorbed doses in 21 organs. The calculated results were tabulated in the form of absorbed doses and effective doses per unit neutron fluence. The calculated conversion coefficients are used for dose assessment of the public around nuclear facilities and accelerator facilities. (author)

  2. Dose Response of Alanine Detectors Irradiated with Carbon Ion Beams

    DEFF Research Database (Denmark)

    Herrmann, Rochus; Jäkel, Oliver; Palmans, Hugo

    2011-01-01

    Purpose: The dose response of the alanine detector shows a dependence on particle energy and type, when irradiated with ion beams. The purpose of this study is to investigate the response behaviour of the alanine detector in clinical carbon ion beams and compare the results with model predictions......-dose curves deviate from predictions in the peak region, most pronounced at the distal edge of the peak. Conclusions: The used model and its implementation show a good overall agreement for quasi mono energetic measurements. Deviations in depth-dose measurements are mainly attributed to uncertainties...

  3. Characteristics of therapeutic electron beams and their determination from depth dose curves

    Energy Technology Data Exchange (ETDEWEB)

    Novotny, J; Pernicka, F [Ceskoslovenska Akademie Ved, Prague. Ustav Dozimetrie Zareni

    1980-09-01

    The distribution of absorbed dose in the environment irradiated with broad beams of high-energy electrons is analyzed physically and therapeutically. A number of parameters are defined with the aid of which the beams of electrons may be characterized in great detail and compared. The theoretical calculations of individual parameters are compared with the values measured using the Ostron betatron in the central axis of the beam at a distance of 65 cm from the target; the differences found are ascribed to the spectrum of electrons, the scattering of electrons on the homogenizing foils, collimators, monitoring chambers, etc.

  4. Narrow beam dosimetry for high-energy hadrons and electrons

    CERN Document Server

    Pelliccioni, M; Ulrici, Luisa

    2001-01-01

    Organ doses and effective dose were calculated with the latest version of the Monte Carlo transport code FLUKA in the case of an anthropomorphic mathematical model exposed to monoenergetic narrow beams of protons, pions and electrons in the energy range 10°— 400 GeV. The target organs considered were right eye, thyroid, thymus, lung and breast. Simple scaling laws to the calculated values are given. The present data and formula should prove useful for dosimetric estimations in case of accidental exposures to high-energy beams.

  5. Fluence-to-absorbed-dose conversion coefficients for neutron beams from 0.001 eV to 100 GeV calculated for a set of pregnant female and fetus models

    International Nuclear Information System (INIS)

    Taranenko, Valery; Xu, X George

    2008-01-01

    Protection of fetuses against external neutron exposure is an important task. This paper reports a set of absorbed dose conversion coefficients for fetal and maternal organs for external neutron beams using the RPI-P pregnant female models and the MCNPX code. The newly developed pregnant female models represent an adult female with a fetus including its brain and skeleton at the end of each trimester. The organ masses were adjusted to match the reference values within 1%. For the 3 mm cubic voxel size, the models consist of 10-15 million voxels for 35 organs. External monoenergetic neutron beams of six standard configurations (AP, PA, LLAT, RLAT, ROT and ISO) and source energies 0.001 eV-100 GeV were considered. The results are compared with previous data that are based on simplified anatomical models. The differences in dose depend on source geometry, energy and gestation periods: from 20% up to 140% for the whole fetus, and up to 100% for the fetal brain. Anatomical differences are primarily responsible for the discrepancies in the organ doses. For the first time, the dependence of mother organ doses upon anatomical changes during pregnancy was studied. A maximum of 220% increase in dose was observed for the placenta in the nine months model compared to three months, whereas dose to the pancreas, small and large intestines decreases by 60% for the AP source for the same models. Tabulated dose conversion coefficients for the fetus and 27 maternal organs are provided

  6. Experimental characterization and physical modelling of the dose distribution of scanned proton pencil beams

    International Nuclear Information System (INIS)

    Pedroni, E; Scheib, S; Boehringer, T; Coray, A; Grossmann, M; Lin, S; Lomax, A

    2005-01-01

    In this paper we present the pencil beam dose model used for treatment planning at the PSI proton gantry, the only system presently applying proton therapy with a beam scanning technique. The scope of the paper is to give a general overview on the various components of the dose model, on the related measurements and on the practical parametrization of the results. The physical model estimates from first physical principles absolute dose normalized to the number of incident protons. The proton beam flux is measured in practice by plane-parallel ionization chambers (ICs) normalized to protons via Faraday-cup measurements. It is therefore possible to predict and deliver absolute dose directly from this model without other means. The dose predicted in this way agrees very well with the results obtained with ICs calibrated in a cobalt beam. Emphasis is given in this paper to the characterization of nuclear interaction effects, which play a significant role in the model and are the major source of uncertainty in the direct estimation of the absolute dose. Nuclear interactions attenuate the primary proton flux, they modify the shape of the depth-dose curve and produce a faint beam halo of secondary dose around the primary proton pencil beam in water. A very simple beam halo model has been developed and used at PSI to eliminate the systematic dependences of the dose observed as a function of the size of the target volume. We show typical results for the relative (using a CCD system) and absolute (using calibrated ICs) dosimetry, routinely applied for the verification of patient plans. With the dose model including the nuclear beam halo we can predict quite precisely the dose directly from treatment planning without renormalization measurements, independently of the dose, shape and size of the dose fields. This applies also to the complex non-homogeneous dose distributions required for the delivery of range-intensity-modulated proton therapy, a novel therapy technique

  7. Cervix Regression and Motion During the Course of External Beam Chemoradiation for Cervical Cancer

    International Nuclear Information System (INIS)

    Beadle, Beth M.; Jhingran, Anuja; Salehpour, Mohammad; Sam, Marianne; Iyer, Revathy B.; Eifel, Patricia J.

    2009-01-01

    Purpose: To evaluate the magnitude of cervix regression and motion during external beam chemoradiation for cervical cancer. Methods and Materials: Sixteen patients with cervical cancer underwent computed tomography scanning before, weekly during, and after conventional chemoradiation. Cervix volumes were calculated to determine the extent of cervix regression. Changes in the center of mass and perimeter of the cervix between scans were used to determine the magnitude of cervix motion. Maximum cervix position changes were calculated for each patient, and mean maximum changes were calculated for the group. Results: Mean cervical volumes before and after 45 Gy of external beam irradiation were 97.0 and 31.9 cc, respectively; mean volume reduction was 62.3%. Mean maximum changes in the center of mass of the cervix were 2.1, 1.6, and 0.82 cm in the superior-inferior, anterior-posterior, and right-left lateral dimensions, respectively. Mean maximum changes in the perimeter of the cervix were 2.3 and 1.3 cm in the superior and inferior, 1.7 and 1.8 cm in the anterior and posterior, and 0.76 and 0.94 cm in the right and left lateral directions, respectively. Conclusions: Cervix regression and internal organ motion contribute to marked interfraction variations in the intrapelvic position of the cervical target in patients receiving chemoradiation for cervical cancer. Failure to take these variations into account during the application of highly conformal external beam radiation techniques poses a theoretical risk of underdosing the target or overdosing adjacent critical structures

  8. Mobilizing peripheral blood stem cells with high-dose G-CSF alone is as effective as with Dexa-BEAM plus G-CSF in lymphoma patients.

    Science.gov (United States)

    Kröger, N; Zeller, W; Fehse, N; Hassan, H T; Krüger, W; Gutensohn, K; Lölliger, C; Zander, A R

    1998-09-01

    We compared retrospectively the efficacy of granulocyte colony stimulating factor (G-CSF) alone with chemotherapy plus G-CSF in mobilizing CD34-positive cells in patients with malignant lymphoma. 35 patients underwent peripheral blood stem cell (PBSC) collection following mobilization either with 24 microg/kg G-CSF for 4 consecutive days (n = 18) or Dexa-BEAM chemotherapy plus 5 microg/kg G-CSF (n = 17). High-dose G-CSF was well tolerated with only slight bone pain and/or myalgia. The Dexa-BEAM therapy required hospitalization with a median duration of 21 d. The median number of apheresis procedures in both groups was two (range two to four), resulting in a median of 5.3 and 5.1 x 10(6) CD34+ cells/kg. No patients in the G-CSF group, but one in the Dexa-BEAM group, failed to reach the target of collecting >2.0 x 10(6) CD34+ cells/kg. The number of CFU-GM (10.4 v 6.0 x 10(5)/kg) and of BFU-E (10.6 v 4.5 x 10(5)/kg; P = 0.04) was higher in the G-CSF group than in the Dexa-BEAM group. A subset analysis of CD34+ cells was performed in 16 patients showing a higher mean of Thy-1 (CD90w) coexpression in the G-CSF than in the Dexa-BEAM group (4.8 v 1.8%, P = 0.12). Additionally the percentage of CD34+/CD38- cells was higher in the G-CSF group (10.66% v 8.8%). However, these differences were not statistically significant. The median time to leucocyte and platelet engraftment after high-dose chemotherapy was slightly shorter in the G-CSF than in the Dexa-BEAM group (9 v 10 and 12 v 13.5 d, respectively). These results demonstrate that high-dose G-CSF is as effective as Dexa-BEAM plus G-CSF in mobilizing peripheral blood stem cells and produces prompt engraftment. The major advantages of G-CSF mobilization were the safe outpatient self-application and the fixed-day apheresis.

  9. External beam PIXE analysis of painting

    International Nuclear Information System (INIS)

    Pascholati, Paulo R.; Rizzutto, Marcia A.; Barbosa, Marcel D.L.; Albuquerque, Cindy

    2005-01-01

    The preservation and conservation of mankind cultural heritage has become an important issue worldwide. Non-destructive analytical techniques are suitable, for example, to analyze precious and unique objects of art and archaeology. Among those techniques Particle Induced X-Ray Emission (PIXE) has good advantage to identify elemental composition present in these kinds of objects. The Laboratorio de Analise de Materiais por Feixes Ionicos-LAMFI of the Institute of Physics of the University of Sao Paulo has been installed an external beam facility for PIXE analysis. This new setup is being used for the analysis of archaeological pottery artifacts, paintings and biological tissues (teeth and bones), which are not compatible with the high vacuum of the regular PIXE target chamber. In addition most art and archaeological objects are too large for the evacuated analysis chamber. Applications of this facility will be presented in the analysis of one painting of the beginning of the last century. The chemical elements identified in the painting were Ca, Ti, Cr, Cu, Fe, Zn, Pb and Ba. The PIXE measurements were done non-destructively and no visible damage was observed on the irradiated object. (author)

  10. Study of effective dose of various protocols in equipment cone beam CT

    International Nuclear Information System (INIS)

    Soares, M. R.; Maia, A. F.; Batista, W. O.; Caldas, L. V. E.; Lara, P. A.

    2014-08-01

    Currently the cone beam computed tomography is widely used in various procedures of dental radiology. Although the doses values associated with the procedures of cone beam CT are low compared to typical values associated with dental radiology procedure in multi slices CT. However can be high compared to typical values of other techniques commonly used in dental radiology. The present scenario is a very wide range of designs of equipment and, consequently, lack of uniformity in all parameters associated with x-ray generation and geometry. In this context, this study aimed to evaluate and calculate the absorbed dose in organs and tissues relevant and estimate effective dose for different protocols with different geometries of exposure in five cone beam CT equipment. For this, a female Alderson anthropomorphic phantom, manufactured by Radiology Support Devices was used. The phantom was irradiated with 26 dosimeters LiF: Mg, Ti (TLD-100), inserted in organs and tissues along the layers forming the head and neck of the phantom. The equipment used, in this present assessment, was: i-CAT Classical, Kodak 9000 3D, Gendex GXCB 500, Sirona Orthophos X G 3D and Planmeca Pro Max 3D. The effective doses were be determined by the ICRP 103 weighting factors. The values were between 7.0 and 111.5 micro Sv, confirming the broad dose range expected due to the diversity of equipment and protocols used in each equipment. The values of effective dose per Fov size were: between 7 and 51.2 micro Sv for located Fov; between 17.6 and 52.0 micro Sv for medium Fov; and between 11.5 and 43.1 micro Sv to large Fov (maxillofacial). In obtaining the effective dose the measurements highlighted a relevance contribution of dose absorbed by the remaining organs (36%), Salivary glands (30%), thyroid (12%) and bone marrow (12%). (Author)

  11. Study of effective dose of various protocols in equipment cone beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Soares, M. R.; Maia, A. F. [Universidade Federale de Sergipe, Departamento de Fisica, Cidade Universitaria Prof. Jose Aloisio de Campos, Marechal Rondon s/n, Jardim Rosa Elze, 49-100000 Sao Cristovao, Sergipe (Brazil); Batista, W. O. [Instituto Federal da Bahia, Rua Emidio dos Santos s/n, Barbalho, Salvador, 40301015 Bahia (Brazil); Caldas, L. V. E.; Lara, P. A., E-mail: mrs2206@gmail.com [Instituto de Pesquisas Energeticas e Nucleares / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil)

    2014-08-15

    Currently the cone beam computed tomography is widely used in various procedures of dental radiology. Although the doses values associated with the procedures of cone beam CT are low compared to typical values associated with dental radiology procedure in multi slices CT. However can be high compared to typical values of other techniques commonly used in dental radiology. The present scenario is a very wide range of designs of equipment and, consequently, lack of uniformity in all parameters associated with x-ray generation and geometry. In this context, this study aimed to evaluate and calculate the absorbed dose in organs and tissues relevant and estimate effective dose for different protocols with different geometries of exposure in five cone beam CT equipment. For this, a female Alderson anthropomorphic phantom, manufactured by Radiology Support Devices was used. The phantom was irradiated with 26 dosimeters LiF: Mg, Ti (TLD-100), inserted in organs and tissues along the layers forming the head and neck of the phantom. The equipment used, in this present assessment, was: i-CAT Classical, Kodak 9000 3D, Gendex GXCB 500, Sirona Orthophos X G 3D and Planmeca Pro Max 3D. The effective doses were be determined by the ICRP 103 weighting factors. The values were between 7.0 and 111.5 micro Sv, confirming the broad dose range expected due to the diversity of equipment and protocols used in each equipment. The values of effective dose per Fov size were: between 7 and 51.2 micro Sv for located Fov; between 17.6 and 52.0 micro Sv for medium Fov; and between 11.5 and 43.1 micro Sv to large Fov (maxillofacial). In obtaining the effective dose the measurements highlighted a relevance contribution of dose absorbed by the remaining organs (36%), Salivary glands (30%), thyroid (12%) and bone marrow (12%). (Author)

  12. Application of Electron Dose Kernels to account for heterogeneities in voxelized phantoms

    International Nuclear Information System (INIS)

    Al-Basheer, A. K.; Sjoden, G. E.; Ghita, M.; Bolch, W.

    2009-01-01

    In this paper, we present work on the application of the Electron Dose Kernel discrete ordinates method (EDK-S N ) to compute doses and account for material heterogeneities using high energy external photon beam irradiations in voxelized human phantoms. EDKs are pre-computed using photon pencil 'beamlets' that lead to dose delivery in tissue using highly converged Monte Carlo. Coupling the EDKs to accumulate dose scaled by integral photon fluences computed using S N methods in dose driving voxels (DDVs) allows for the full charged particle physics computed dose to be accumulated throughout the voxelized phantom, and is the basis of the EDK-S N method, which is fully parallelized. For material heterogeneities, a density scaling correction factor is required to yield good agreement. In a fully voxelized phantom, all doses were in agreement with those determined by independent Monte Carlo computations. We are continuing to expand upon the development of this robust approach for rapid and accurate determination of whole body and out of field organ doses due to high energy x-ray beams. (authors)

  13. Dose and energy dependence of response of Gafchromic (registered) XR-QA film for kilovoltage x-ray beams

    Energy Technology Data Exchange (ETDEWEB)

    Rampado, O; Garelli, E; Deagostini, S; Ropolo, R [Struttura Complessa fisica Sanitaria, Azienda Ospedaliera San Giovanni Battista, Corso Bramante 88, 10126 Turin (Italy)

    2006-06-07

    There is a growing interest in Gafchromic (registered) films for patient dosimetry in radiotherapy and in radiology. A new model (XR-QA) with high sensitivity to low dose was tested in this study. The response of the film to different x-ray beam energies (range 28-145 kVp with various filtrations, dose range 0-100 mGy) and to visible light was investigated, together with the after exposure darkening properties. Exposed films were digitized with a commercially available, optical flatbed scanner. A single functional form for dose versus net pixel value variation has been determined for all the obtained calibration curves, with a unique fit parameter different for each of the used x-ray beams. The film response was dependent on beam energy, with higher colour variations for the beams in the range 80-140 kVp. Different sources of uncertainties in dose measurements, governed by the digitalization process, the film response uniformity and the calibration curve fit procedure, have been considered. The overall one-sigma dose measurement uncertainty depended on the beam energy and decreased with increasing absorbed dose. For doses above 10 mGy and beam energies in the range 80-140 kVp the total uncertainty was less than 5%, whereas for the 28 kVp beam the total uncertainty at 10 mGy was about 10%. The post-exposure colour variation was not negligible in the first 24 h after the exposure, with a consequent increase in the calculated dose of about 10%. Results of the analysis of the sensitivity to visible light indicated that a short exposure of this film to ambient and scanner light during the measurements will not have a significant impact on the radiation dosimetry.

  14. Conformal Brachytherapy Boost To External Beam Irradiation For Clinically Localized High Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dattoli, Michael J; Wasserman, Stuart G; Koval, John M; Sorace, Richard A; Cash, Jennifer; Wallner, Kent E

    1995-07-01

    Purpose: To evaluate the efficacy of using a Pd-103 implant as a boost in conjunction with external beam radiotherapy (EBRT) in patients having prostate cancer associated with adverse features. Materials and Methods: 114 consecutive high risk patients have been treated with combination EBRT and Pd-103 implant. 70 patients with follow-up range of 12-42 months (median 24 months) form the basis of this report. Each patient had at least one of the following risk factors for extra-capsular disease extension: Stage T2b or greater ((66(70))), Gleason score {>=} 7 ((38(70))), significantly elevated PSA (typically > 15 ng/ml)((30(70))) or elevated serum prostatic acid phosphatase (SPAP)((17(70))). Patients received median 4140 cGy EBRT to a limited pelvic field followed by a Pd-103 boost (median prescription dose: 8000 cGy). All patients have been followed in a prospective fashion with respect to PSA response, clinical evidence of disease progression and complications. Criteria for biochemical failure was relatively strict, and was analyzed using both, PSA > 2.0 and PSA > 1.0 as end points. Patients whose PSA was still decreasing at last follow-up were censored at that time. Freedom from failure rates were calculated by the method of Kaplan and Meier. Differences between groups were determined by the Log-rank method. Sexual potency was defined as the ability to attain and maintain an erection sufficient for intercourse. Results: Actuarial freedom from biochemical failure at 3 years after treatment was 90% and 78%, when PSA > 2 and PSA > 1 were used, respectively. There are no documented local relapses. 4 patients failed distantly, and all other failures are based solely on rising PSA values. Biochemical failure was higher in patients having Gleason score {>=} 7 (p=0.001), those with PSA >20 (p=0.014) and in those with elevated SPAP (p=0.007). The primary treatment related morbity was temporary, Grade 1-2 urinary symptoms. No patient developed rectal ulceration or prostatic

  15. Conformal Brachytherapy Boost To External Beam Irradiation For Clinically Localized High Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Dattoli, Michael J.; Wasserman, Stuart G.; Koval, John M.; Sorace, Richard A.; Cash, Jennifer; Wallner, Kent E.

    1995-01-01

    Purpose: To evaluate the efficacy of using a Pd-103 implant as a boost in conjunction with external beam radiotherapy (EBRT) in patients having prostate cancer associated with adverse features. Materials and Methods: 114 consecutive high risk patients have been treated with combination EBRT and Pd-103 implant. 70 patients with follow-up range of 12-42 months (median 24 months) form the basis of this report. Each patient had at least one of the following risk factors for extra-capsular disease extension: Stage T2b or greater ((66(70))), Gleason score ≥ 7 ((38(70))), significantly elevated PSA (typically > 15 ng/ml)((30(70))) or elevated serum prostatic acid phosphatase (SPAP)((17(70))). Patients received median 4140 cGy EBRT to a limited pelvic field followed by a Pd-103 boost (median prescription dose: 8000 cGy). All patients have been followed in a prospective fashion with respect to PSA response, clinical evidence of disease progression and complications. Criteria for biochemical failure was relatively strict, and was analyzed using both, PSA > 2.0 and PSA > 1.0 as end points. Patients whose PSA was still decreasing at last follow-up were censored at that time. Freedom from failure rates were calculated by the method of Kaplan and Meier. Differences between groups were determined by the Log-rank method. Sexual potency was defined as the ability to attain and maintain an erection sufficient for intercourse. Results: Actuarial freedom from biochemical failure at 3 years after treatment was 90% and 78%, when PSA > 2 and PSA > 1 were used, respectively. There are no documented local relapses. 4 patients failed distantly, and all other failures are based solely on rising PSA values. Biochemical failure was higher in patients having Gleason score ≥ 7 (p=0.001), those with PSA >20 (p=0.014) and in those with elevated SPAP (p=0.007). The primary treatment related morbity was temporary, Grade 1-2 urinary symptoms. No patient developed rectal ulceration or prostatic

  16. Elemental analysis with external-beam PIXE

    Science.gov (United States)

    Lin, E. K.; Wang, C. W.; Teng, P. K.; Huang, Y. M.; Chen, C. Y.

    1992-05-01

    A beamline system and experimental setup has been established for elemental analysis using PIXE with an external beam. Experiments for the study of the elemental composition of ancient Chinese potsherds (the Min and Ching ages) were performed. Continuum X-ray spectra from the samples bombarded by 3 MeV protons have been measured with a Si(Li) detector. From the analysis of PIXE data, the concentration of the main elements (Al, Si, K, and Ca) and of more than ten trace elements in the matrices and glazed surfaces were determined. Results for two different potsherds are presented, and those obtained from the glaze colorants are compared with the results of measurements on a Ching blue-and-white porcelain vase.

  17. Measurement of the primary and scatter dose in high energy photon beams

    Energy Technology Data Exchange (ETDEWEB)

    Van der Linden, P M [Catharina Ziekenhuis, Eindhoven (Netherlands). Radiotherapy Dept.; Tiourina, T B; Dries, W

    1995-12-01

    A method is presented to measure the primary and scatter components separately in a water tank using a small cylindrical absorber. Results from this experiment are compared with Monte Carlo calculations. The measurement setup consists of a small cylindrical absorber placed on a central axis of the beam a few centimetres above the radiation detector. Both absorber and detector move along the central axis while absorbed dose is registered. As the primary radiation is fully blocked, only scatter component is measured when a cylindrical absorber is used. Measurements in open fields result in the total absorbed dose being the sum of primary and scatter components. The primary dose component can be derived by substraction. Absorbers with different diameters are used. With decreasing dimensions the relative contribution of the dose due to scatter radiation increases. A steep increase is observed when the range of laterally scattered electrons becomes comparable with the radius of the absorber. Two different Monte Carlo simulations have been performed: with and without secondary electron transport. The data obtained for the former case perfectly agrees with the experiment. The situation where the secondary electron is assumed zero (i.e. local energy deposition) simulates the Cunningham model. Our results show that the Cunningham model predicts lower scatter component under the block edge which can be important for these applications.

  18. Combination of peptide receptor radionuclide therapy with fractionated external beam radiotherapy for treatment of advanced symptomatic meningioma

    International Nuclear Information System (INIS)

    Kreissl, Michael C; Flentje, Michael; Sweeney, Reinhart A; Hänscheid, Heribert; Löhr, Mario; Verburg, Frederik A; Schiller, Markus; Lassmann, Michael; Reiners, Christoph; Samnick, Samuel S; Buck, Andreas K

    2012-01-01

    External beam radiotherapy (EBRT) is the treatment of choice for irresectable meningioma. Due to the strong expression of somatostatin receptors, peptide receptor radionuclide therapy (PRRT) has been used in advanced cases. We assessed the feasibility and tolerability of a combination of both treatment modalities in advanced symptomatic meningioma. 10 patients with irresectable meningioma were treated with PRRT ( 177 Lu-DOTA0,Tyr3 octreotate or - DOTA0,Tyr3 octreotide) followed by external beam radiotherapy (EBRT). EBRT performed after PRRT was continued over 5–6 weeks in IMRT technique (median dose: 53.0 Gy). All patients were assessed morphologically and by positron emission tomography (PET) before therapy and were restaged after 3–6 months. Side effects were evaluated according to CTCAE 4.0. Median tumor dose achieved by PRRT was 7.2 Gy. During PRRT and EBRT, no side effects > CTCAE grade 2 were noted. All patients reported stabilization or improvement of tumor-associated symptoms, no morphologic tumor progression was observed in MR-imaging (median follow-up: 13.4 months). The median pre-therapeutic SUV max in the meningiomas was 14.2 (range: 4.3–68.7). All patients with a second PET after combined PRRT + EBRT showed an increase in SUV max (median: 37%; range: 15%–46%) to a median value of 23.7 (range: 8.0–119.0; 7 patients) while PET-estimated volume generally decreased to 81 ± 21% of the initial volume. The combination of PRRT and EBRT is feasible and well tolerated. This approach represents an attractive strategy for the treatment of recurring or progressive symptomatic meningioma, which should be further evaluated

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  20. Quality assurance technique for absorbed dose distribution in external radiation therapy with non-physical wedges in consideration of the character of the imaging plate

    International Nuclear Information System (INIS)

    Fujibuchi, Toshioh; Fujisaki, Tatsuya; Kurokawa, Masayuki; Sakae, Takeji

    2011-01-01

    The film dose distribution method is used for profile measurements of non-physical wedges, because three-dimensional automatic control water phantoms cannot be used. Recently, many hospitals have adopted computed radiography (CR) systems in preference to automatic developing processors and films. This may allow use of automatic processors to be discontinued. In this study, a beam was irradiated to an Imaging Plate (IP), and then IP was exposed to a fixed amount of light with fading, and we then measured the off-center ratio (OCR) absorbed dose distribution in external radiation therapy with non-physical wedge. This was compared with the OCR measured with an ionization chamber dosimeter. It was consequently possible for IP to approximate the value measured by the ionization chamber dosimeter by using a metal filter. This method offers a simple quality assurance technique for absorbed dose distribution in external radiation therapy with non-physical wedges in consideration of the character of the IP. (author)

  1. Benchmark measurements and simulations of dose perturbations due to metallic spheres in proton beams

    International Nuclear Information System (INIS)

    Newhauser, Wayne D.; Rechner, Laura; Mirkovic, Dragan; Yepes, Pablo; Koch, Nicholas C.; Titt, Uwe; Fontenot, Jonas D.; Zhang, Rui

    2013-01-01

    Monte Carlo simulations are increasingly used for dose calculations in proton therapy due to its inherent accuracy. However, dosimetric deviations have been found using Monte Carlo code when high density materials are present in the proton beamline. The purpose of this work was to quantify the magnitude of dose perturbation caused by metal objects. We did this by comparing measurements and Monte Carlo predictions of dose perturbations caused by the presence of small metal spheres in several clinical proton therapy beams as functions of proton beam range and drift space. Monte Carlo codes MCNPX, GEANT4 and Fast Dose Calculator (FDC) were used. Generally good agreement was found between measurements and Monte Carlo predictions, with the average difference within 5% and maximum difference within 17%. The modification of multiple Coulomb scattering model in MCNPX code yielded improvement in accuracy and provided the best overall agreement with measurements. Our results confirmed that Monte Carlo codes are well suited for predicting multiple Coulomb scattering in proton therapy beams when short drift spaces are involved. - Highlights: • We compared measurements and Monte Carlo predictions of dose perturbations caused by the metal objects in proton beams. • Different Monte Carlo codes were used, including MCNPX, GEANT4 and Fast Dose Calculator. • Good agreement was found between measurements and Monte Carlo simulations. • The modification of multiple Coulomb scattering model in MCNPX code yielded improved accuracy. • Our results confirmed that Monte Carlo codes are well suited for predicting multiple Coulomb scattering in proton therapy

  2. Production of a high-current microsecond electron beam with a large cross section

    International Nuclear Information System (INIS)

    Abdullin, E.N.; Belomytsev, S.Ya.; Bugaev, S.P.; Gorbachev, S.I.; Zaslavskii, V.M.; Zorin, V.P.; Koval'chuk, B.M.; Loginov, S.V.; Matyukov, Yu.N.; Rasputin, R.M.; Tolkachev, V.S.; Shchanin, P.M.

    1991-01-01

    Obtaining high-current wide-aperture electron beams is an important problem in the development of laser technology for controlled nuclear fusion and for solving ecological and technological problems. The main scheme for producing such beams involves the use of generators with intermediate energy storage devices and burst-emission vacuum diodes. Beam pinching is prevented by using an external magnetic field or sectioning the diode into magnetically insulated diodes with currents lower than the limiting current. The length of the electron-current pulse varies from tens to hundreds of nano-seconds and is limited by the parameters of the intermediate storage device. Here the authors study the formation of a high-current electron beam with a square cross section and a current of the order of the limiting current of the diode in the absence of an external magnetic field as well as a 'fast' storage device in the power supply circuit. These conditions as a whole correspond to a simpler electron-source circuit, but the beam forming becomes more complicated. The reason for this is that there is no external magnetic field and that the role of plasma processes in the diode is enhanced by the greater length of the electron-current pulses

  3. The quality of high-energy X-ray beams

    International Nuclear Information System (INIS)

    LaRiviere, P.D.

    1989-01-01

    Supplement 17 of the British Journal of Radiology is a survey of central-axis depth doses for radiotherapy machines, patterned largely on BJR Supplement 11 (1972). Inspection of high-energy X-ray depth doses for a 10 x 10 cm field at an SSD of 100 cm disclosed large differences between the two sets of data, especially for qualities above 8 MV, e.g. a depth dose of 80% at 10 cm is rated at about 19 MV according to BJR Supplement 11, and 23 MV according to BJR Supplement 17. It was found that Supplement 17 depth-dose data above 8 MV were erratic, but Supplement 11 data could be represented by an analytical expression, providing a unique means of assigning MV quality. It was also found that dose-weighted average energy of the filtered beam plotted smoothly against depth dose. For dosimetric purposes, it is suggested that this parameter be used as a true measure of beam quality, removing discrepancies introduced by the use of nominal MV for this purpose. (author)

  4. A light-weight compact proton gantry design with a novel dose delivery system for broad-energetic laser-accelerated beams.

    Science.gov (United States)

    Masood, U; Cowan, T E; Enghardt, W; Hofmann, K M; Karsch, L; Kroll, F; Schramm, U; Wilkens, J J; Pawelke, J

    2017-07-07

    Proton beams may provide superior dose-conformity in radiation therapy. However, the large sizes and costs limit the widespread use of proton therapy (PT). The recent progress in proton acceleration via high-power laser systems has made it a compelling alternative to conventional accelerators, as it could potentially reduce the overall size and cost of the PT facilities. However, the laser-accelerated beams exhibit different characteristics than conventionally accelerated beams, i.e. very intense proton bunches with large divergences and broad-energy spectra. For the application of laser-driven beams in PT, new solutions for beam transport, such as beam capture, integrated energy selection, beam shaping and delivery systems are required due to the specific beam parameters. The generation of these beams are limited by the low repetition rate of high-power lasers and this limitation would require alternative solutions for tumour irradiation which can efficiently utilize the available high proton fluence and broad-energy spectra per proton bunch to keep treatment times short. This demands new dose delivery system and irradiation field formation schemes. In this paper, we present a multi-functional light-weight and compact proton gantry design for laser-driven sources based on iron-less pulsed high-field magnets. This achromatic design includes improved beam capturing and energy selection systems, with a novel beam shaping and dose delivery system, so-called ELPIS. ELPIS system utilizes magnetic fields, instead of physical scatterers, for broadening the spot-size of broad-energetic beams while capable of simultaneously scanning them in lateral directions. To investigate the clinical feasibility of this gantry design, we conducted a treatment planning study with a 3D treatment planning system augmented for the pulsed beams with optimizable broad-energetic widths and selectable beam spot sizes. High quality treatment plans could be achieved with such unconventional beam

  5. A light-weight compact proton gantry design with a novel dose delivery system for broad-energetic laser-accelerated beams

    Science.gov (United States)

    Masood, U.; Cowan, T. E.; Enghardt, W.; Hofmann, K. M.; Karsch, L.; Kroll, F.; Schramm, U.; Wilkens, J. J.; Pawelke, J.

    2017-07-01

    Proton beams may provide superior dose-conformity in radiation therapy. However, the large sizes and costs limit the widespread use of proton therapy (PT). The recent progress in proton acceleration via high-power laser systems has made it a compelling alternative to conventional accelerators, as it could potentially reduce the overall size and cost of the PT facilities. However, the laser-accelerated beams exhibit different characteristics than conventionally accelerated beams, i.e. very intense proton bunches with large divergences and broad-energy spectra. For the application of laser-driven beams in PT, new solutions for beam transport, such as beam capture, integrated energy selection, beam shaping and delivery systems are required due to the specific beam parameters. The generation of these beams are limited by the low repetition rate of high-power lasers and this limitation would require alternative solutions for tumour irradiation which can efficiently utilize the available high proton fluence and broad-energy spectra per proton bunch to keep treatment times short. This demands new dose delivery system and irradiation field formation schemes. In this paper, we present a multi-functional light-weight and compact proton gantry design for laser-driven sources based on iron-less pulsed high-field magnets. This achromatic design includes improved beam capturing and energy selection systems, with a novel beam shaping and dose delivery system, so-called ELPIS. ELPIS system utilizes magnetic fields, instead of physical scatterers, for broadening the spot-size of broad-energetic beams while capable of simultaneously scanning them in lateral directions. To investigate the clinical feasibility of this gantry design, we conducted a treatment planning study with a 3D treatment planning system augmented for the pulsed beams with optimizable broad-energetic widths and selectable beam spot sizes. High quality treatment plans could be achieved with such unconventional beam

  6. Surface dose measurements in and out of field. Implications for breast radiotherapy with megavoltage photon beams

    Energy Technology Data Exchange (ETDEWEB)

    Lonski, Peta; Kron, Tomas [Peter MacCallum Cancer Centre, Melbourne (Australia); RMIT Univ., Melbourne (Australia); Ramachandran, Prabhakar; Franich, Rick [Peter MacCallum Cancer Centre, Melbourne (Australia)

    2017-07-01

    This study examines the difference in surface dose between flat and flattening filter free (FFF) photon beams in the context of breast radiotherapy. The surface dose was measured for 6 MV, 6 MV FFF, 10 MV, 10 MV FFF and 18 MV photon beams using a thin window ionisation chamber for various field sizes. Profiles were acquired to ascertain the change in surface dose off-axis. Out-of-field measurements were included in a clinically representative half beam block tangential breast field. In the field centres of FFF beams the surface dose was found to be increased for small fields and decreased for large fields compared to flat beams. For FFF beams, surface dose was found to decrease off-axis and resulted in lower surface dose out-of-field compared to flat beams.

  7. Estimation of delivered doses to the fetus in a external radiation therapy treatment of megavoltage

    International Nuclear Information System (INIS)

    Ruggeri, Ricardo M.; Mairal, Liliana; Scarabino, Mara L.; Colombo, Soledad; Sardi, Mabel

    2013-01-01

    This work, stimulated by the entrance to our radiotherapy service several cases of central nervous system injury in pregnant patients, involves the estimation of doses to the fetus from the comparative analysis and verification of theoretical and experimental data. Um phantom was designed with the pregnant morphology about 28 weeks gestation, with inserts for waterproof ionization chamber in the head and abdominal area. From the scan of the anthropomorphic phantom were reproduced in 3D planner treatments comprised of pregnant patients, estimating the dose in the lesion and at different points in the abdominal area. With the phantom in the beam of radiation treatment conditions were measured with the camera dose at the same points of the abdomen mentioned and the isocenter of the injury. The dose was also measured on surface of the abdominal area with diode array to establish correlation with the measured dose ionization chamber calibrated with water. The work provided medical radiotherapists fundamental experimental data for elevated risk assessment framework for radiation protection of the fetus. It also set the reference calibration for in vivo dosimetry in the abdominal area in pregnant patients treated for external radiotherapy. The results obtained with the implemented dosimetry design will determine the procedures that will form the operating rules institution and thus how professionals working within it

  8. 10 CFR 20.1502 - Conditions requiring individual monitoring of external and internal occupational dose.

    Science.gov (United States)

    2010-01-01

    ... external and internal occupational dose. Each licensee shall monitor exposures to radiation and radioactive... 10 Energy 1 2010-01-01 2010-01-01 false Conditions requiring individual monitoring of external and internal occupational dose. 20.1502 Section 20.1502 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR...

  9. Benchmarking the minimum Electron Beam (eBeam) dose required for the sterilization of space foods

    Science.gov (United States)

    Bhatia, Sohini S.; Wall, Kayley R.; Kerth, Chris R.; Pillai, Suresh D.

    2018-02-01

    As manned space missions extend in length, the safety, nutrition, acceptability, and shelf life of space foods are of paramount importance to NASA. Since food and mealtimes play a key role in reducing stress and boredom of prolonged missions, the quality of food in terms of appearance, flavor, texture, and aroma can have significant psychological ramifications on astronaut performance. The FDA, which oversees space foods, currently requires a minimum dose of 44 kGy for irradiated space foods. The underlying hypothesis was that commercial sterility of space foods could be achieved at a significantly lower dose, and this lowered dose would positively affect the shelf life of the product. Electron beam processed beef fajitas were used as an example NASA space food to benchmark the minimum eBeam dose required for sterility. A 15 kGy dose was able to achieve an approximately 10 log reduction in Shiga-toxin-producing Escherichia coli bacteria, and a 5 log reduction in Clostridium sporogenes spores. Furthermore, accelerated shelf life testing (ASLT) to determine sensory and quality characteristics under various conditions was conducted. Using Multidimensional gas-chromatography-olfactometry-mass spectrometry (MDGC-O-MS), numerous volatiles were shown to be dependent on the dose applied to the product. Furthermore, concentrations of off -flavor aroma compounds such as dimethyl sulfide were decreased at the reduced 15 kGy dose. The results suggest that the combination of conventional cooking combined with eBeam processing (15 kGy) can achieve the safety and shelf-life objectives needed for long duration space-foods.

  10. Relationship between Individual External Doses, Ambient Dose Rates and Individuals' Activity-Patterns in Affected Areas in Fukushima following the Fukushima Daiichi Nuclear Power Plant Accident.

    Directory of Open Access Journals (Sweden)

    Wataru Naito

    Full Text Available The accident at Fukushima Daiichi Nuclear Power Plant on March 11, 2011, released radioactive material into the atmosphere and contaminated the land in Fukushima and several neighboring prefectures. Five years after the nuclear disaster, the radiation levels have greatly decreased due to physical decay, weathering, and decontamination operations in Fukushima. The populations of 12 communities were forced to evacuate after the accident; as of March 2016, the evacuation order has been lifted in only a limited area, and permanent habitation is still prohibited in most of the areas. In order for the government to lift the evacuation order and for individuals to return to their original residential areas, it is important to assess current and future realistic individual external doses. Here, we used personal dosimeters along with the Global Positioning System and Geographic Information System to understand realistic individual external doses and to relate individual external doses, ambient doses, and activity-patterns of individuals in the affected areas in Fukushima. The results showed that the additional individual external doses were well correlated to the additional ambient doses based on the airborne monitoring survey. The results of linear regression analysis suggested that the additional individual external doses were on average about one-fifth that of the additional ambient doses. The reduction factors, which are defined as the ratios of the additional individual external doses to the additional ambient doses, were calculated to be on average 0.14 and 0.32 for time spent at home and outdoors, respectively. Analysis of the contribution of various activity patterns to the total individual external dose demonstrated good agreement with the average fraction of time spent daily in each activity, but the contribution due to being outdoors varied widely. These results are a valuable contribution to understanding realistic individual external doses

  11. Radiation hygienization of cattle and swine slurry with high energy electron beam

    International Nuclear Information System (INIS)

    Skowron, Krzysztof; Olszewska, Halina; Paluszak, Zbigniew; Zimek, Zbigniew; Kałuska, Iwona; Skowron, Karolina Jadwiga

    2013-01-01

    The research was carried out to assess the efficiency of radiation hygienization of cattle and swine slurry of different density using the high energy electron beam based on the inactivation rate of Salmonella ssp, Escherichia coli, Enterococcus spp and Ascaris suum eggs. The experiment was conducted with use of the linear electron accelerator Elektronika 10/10 in Institute of Nuclear Chemistry and Technology in Warsaw. The inoculated slurry samples underwent hygienization with high energy electron beam of 1, 3, 5, 7 and 10 kGy. Numbers of reisolated bacteria were determined according to the MPN method, using typical microbiological media. Theoretical lethal doses, D 90 doses and hygienization efficiency of high energy electron beam were determined. The theoretical lethal doses for all tested bacteria ranged from 3.63 to 8.84 kGy and for A. suum eggs from 4.07 to 5.83 kGy. Salmonella rods turned out to be the most sensitive and Enterococcus spp were the most resistant to electron beam hygienization. The effectiveness or radiation hygienization was lower in cattle than in swine slurry and in thick than in thin one. Also the species or even the serotype of bacteria determined the dose needed to inactivation of microorganisms. - Highlights: ► The hygienic efficiency of electron beam against slurry was researched. ► The hygienization efficiency depended on the slurry characteristics and microorganism species. ► In most of the cases 7 kGy dose was sufficient for slurry hygienization. ► Dose below 1 kGy allowed for 90% elimination of microorganism population. ► The radiation hygienization is a good alternative for typical slurry treatment methods

  12. Defining a dose-response relationship for prostate external beam radiotherapy

    International Nuclear Information System (INIS)

    Trada, Yuvnik; Plank, Ash; Martin, Jarad

    2013-01-01

    We aimed to quantify a relationship between radiotherapy dose and freedom from biochemical failure (FFBF) in low- and intermediate-risk prostate cancer. To reduce confounding we used data with a standardised end–point, mature follow-up, low competing risk of metastatic failure, conventional fractionation and separate reporting for outcomes with hormonal therapy (HT). A systematic review of the literature was carried out. Studies that reported the use of radiotherapy alone in 1.8–2Gy fractions in low- and intermediate-risk prostate cancer were included. The primary end–point was Phoenix definition 5-year FFBF. A logistic regression was used to quantify the dose–response relationship. Data from eight studies with 3037 patients met the inclusion criteria. The data from 810 low-risk patients and 2245 intermediate-risk patients were analysed. A strong association between radiotherapy dose and FFBF was found in low- and intermediate-risk patients managed with radiotherapy alone. In low-risk patients not treated with HT the dose required to achieve 50% biochemical tumour control (TCD 50 ) is 52.0 Gy and the slope of the dose–response curve at TCD 50 (γ 50 ) is 2.1%/Gy. At 78Gy this represented a FFBF of 90.3%. In intermediate-risk patients not treated with HT the TCD 50 is 64.7Gy and γ 50 is 3.2%/Gy. At 78 Gy this translated into a FFBF of 84.3%. HT had a small effect for low-risk patients and an inconsistent effect for intermediate-risk men. A strong association was found between radiation dose and biochemical outcome in both low- and intermediate-risk patients. Standardised reporting of results from future studies will make future analyses more robust.

  13. External radiotherapy for bone and lymph-node metastases from thyroid cancer

    International Nuclear Information System (INIS)

    Niunoya, Koichiro; Kusakabe, Kiyoko; Obara, Takao; Ito, Yukio; Fujimoto, Yoshihide

    2002-01-01

    The therapeutic effects of external beam radiation to bone or lymph-node metastatic lesions of thyroid cancer were evaluated in 11 patients. These 11 cases included four male and seven female patients ranging in age from 44 to 69 years (mean age 54 years), were treated by 4MV-Xray irradiation. Thyroid surgery had been performed in all patients. The thyroid tumors were classified histologically as papillary carcinoma in 3 patients and follicular carcinoma in 8. Following surgical total thyroidectomy, thyroid ablation and/or therapy with I-131 was performed in 8 patients with follicular carcinoma. Using a 4MV-Xray external beam, a total dose of 54 to 68 Gy (mean dose 62 Gy) was delivered to 28 metastatic lesions including 2 lymph nodes and 26 bones, although an 82-Gy total dose was used for one lymph node. All patients underwent follow-up for more than 8 years. Ten of the 11 patients died, 6 of thyroid cancer and 4 of other diseases. Two of them suffered anaplastic transformation of differentiated thyroid carcinoma and died. The survival term was 0.2 to 8.6 years (mean 4.9 years) after initial external radiotherapy. Local irradiation with a curative dose was able to control most of the lesions in the 11 patients (29 lesions with the exception of 2 cases showing anaplastic transformation). In some patients, pain relief was obtained although tumor size measured by CT did not reveal marked regression. External beam radiation therapy with a curative dose was thought to be beneficial for patients with metastatic lesions of thyroid cancer as slow-growing and having relatively long survival period of patients. (author)

  14. 3D FE Analysis of RC Beams Externally Strengthened with SRG/SRP Systems

    Directory of Open Access Journals (Sweden)

    Francesco Bencardino

    2016-05-01

    Full Text Available The purpose of this study is to evaluate, through a nonlinear Finite Element (FE analysis, the structural behavior of Reinforced Concrete (RC beams externally strengthened by using Steel Reinforced Grout (SRG and Steel Reinforced Polymer (SRP systems. The parameters taken into account were the external strengthening configuration, with or without U-wrap end anchorages, as well as the strengthening materials. The numerical simulations were carried out by using a three-dimensional (3D FE model. The linear and nonlinear behavior of all materials was modeled by appropriate constitutive laws and the connection between concrete substrate and external reinforcing layer was simulated by means of cohesive surfaces with appropriate bond-slip laws. In order to overcome convergence difficulties, to simulate the quasi-static response of the strengthened RC beams, a dynamic approach was adopted. The numerical results in terms of load-displacement curves, failure modes, and load and strain values at critical stages were validated against some experimental data. As a result, the proposed 3D FE model can be used to predict the structural behavior up to ultimate stage of similar strengthened beams without carrying out experimental tests.

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

    International Nuclear Information System (INIS)

    Sutlief, S.

    2015-01-01

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

  16. Radiophotoluminescence light scope for high-dose dosimetry

    International Nuclear Information System (INIS)

    Sato, Fuminobu; Zushi, Naoki; Sakiyama, Tomoki; Kato, Yushi; Murata, Isao; Shimizu, Kikuo; Yamamoto, Takayoshi; Iida, Toshiyuki

    2015-01-01

    A radiophotoluminescence (RPL) light scope is a remote-sensing technique for measuring in situ the radiation dose in an RPL detector placed at a distance. The RPL light scope is mainly composed of an ultraviolet (UV) pulse laser, telescopic lenses, a photomultiplier tube, and camera modules. In a performance test, some RPL detectors were placed at distances up to 30 m and were illuminated with a pulsed UV laser beam. The photoluminescence responses of the RPL detectors were analyzed using this scope. Their radiation doses were determined from the amplitude of the given component of the photoluminescence responses. The RPL readout could be repeated without fading, and its amplitude exhibited good linearity at a dose ranging from 0.1 to 60 Gy. Furthermore, a two-dimensional distribution of radiation dose was obtained by laser scanning on an RPL detector. It was confirmed that the RPL light scope was a useful remote-sensing tool for high-dose dosimetry. - Highlights: • A radiophotoluminescence (RPL) light scope was developed for high-dose dosimetry. • The RPL light scope has high sensitivity and accuracy in high-dose dosimetry. • Two-dimensional radiation dose distribution was obtained by the RPL light scope.

  17. Dose calculation methods in photon beam therapy using energy deposition kernels

    International Nuclear Information System (INIS)

    Ahnesjoe, A.

    1991-01-01

    The problem of calculating accurate dose distributions in treatment planning of megavoltage photon radiation therapy has been studied. New dose calculation algorithms using energy deposition kernels have been developed. The kernels describe the transfer of energy by secondary particles from a primary photon interaction site to its surroundings. Monte Carlo simulations of particle transport have been used for derivation of kernels for primary photon energies form 0.1 MeV to 50 MeV. The trade off between accuracy and calculational speed has been addressed by the development of two algorithms; one point oriented with low computional overhead for interactive use and one for fast and accurate calculation of dose distributions in a 3-dimensional lattice. The latter algorithm models secondary particle transport in heterogeneous tissue by scaling energy deposition kernels with the electron density of the tissue. The accuracy of the methods has been tested using full Monte Carlo simulations for different geometries, and found to be superior to conventional algorithms based on scaling of broad beam dose distributions. Methods have also been developed for characterization of clinical photon beams in entities appropriate for kernel based calculation models. By approximating the spectrum as laterally invariant, an effective spectrum and dose distribution for contaminating charge particles are derived form depth dose distributions measured in water, using analytical constraints. The spectrum is used to calculate kernels by superposition of monoenergetic kernels. The lateral energy fluence distribution is determined by deconvolving measured lateral dose distributions by a corresponding pencil beam kernel. Dose distributions for contaminating photons are described using two different methods, one for estimation of the dose outside of the collimated beam, and the other for calibration of output factors derived from kernel based dose calculations. (au)

  18. Energy and integrated dose dependence of MOSFET dosimeter for clinical electron beams

    International Nuclear Information System (INIS)

    Manigandan, D.; Bharanidharan, G.; Aruna, P.; Ganesan, S.; Tamil Kumar, T.; Rai

    2008-01-01

    In this study, the sensitivity (mV/cGy) and integral dose dependence of a MOSFET detector for different clinical electron beams was studied. Calibrated clinical electron beams (Varian 2100) were used for the exposure. A Markus type parallel plate chamber was used for the absolute dose measurements. In order to study the sensitivity of a MOSFET, the response of the ion chamber and MOSFET for the absorbed dose of 100 cGy was measured. The sensitivity of the MOSFET was then expressed as mV/cGy. Sensitivity was measured for 4-18 MeV electron beams. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-01

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

  20. Measuring uncertainty in dose delivered to the cochlea due to setup error during external beam treatment of patients with cancer of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Yan, M.; Lovelock, D.; Hunt, M.; Mechalakos, J.; Hu, Y.; Pham, H.; Jackson, A., E-mail: jacksona@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065 (United States)

    2013-12-15

    Purpose: To use Cone Beam CT scans obtained just prior to treatments of head and neck cancer patients to measure the setup error and cumulative dose uncertainty of the cochlea. Methods: Data from 10 head and neck patients with 10 planning CTs and 52 Cone Beam CTs taken at time of treatment were used in this study. Patients were treated with conventional fractionation using an IMRT dose painting technique, most with 33 fractions. Weekly radiographic imaging was used to correct the patient setup. The authors used rigid registration of the planning CT and Cone Beam CT scans to find the translational and rotational setup errors, and the spatial setup errors of the cochlea. The planning CT was rotated and translated such that the cochlea positions match those seen in the cone beam scans, cochlea doses were recalculated and fractional doses accumulated. Uncertainties in the positions and cumulative doses of the cochlea were calculated with and without setup adjustments from radiographic imaging. Results: The mean setup error of the cochlea was 0.04 ± 0.33 or 0.06 ± 0.43 cm for RL, 0.09 ± 0.27 or 0.07 ± 0.48 cm for AP, and 0.00 ± 0.21 or −0.24 ± 0.45 cm for SI with and without radiographic imaging, respectively. Setup with radiographic imaging reduced the standard deviation of the setup error by roughly 1–2 mm. The uncertainty of the cochlea dose depends on the treatment plan and the relative positions of the cochlea and target volumes. Combining results for the left and right cochlea, the authors found the accumulated uncertainty of the cochlea dose per fraction was 4.82 (0.39–16.8) cGy, or 10.1 (0.8–32.4) cGy, with and without radiographic imaging, respectively; the percentage uncertainties relative to the planned doses were 4.32% (0.28%–9.06%) and 10.2% (0.7%–63.6%), respectively. Conclusions: Patient setup error introduces uncertainty in the position of the cochlea during radiation treatment. With the assistance of radiographic imaging during setup

  1. Characterisation of a MOSFET-based detector for dose measurement under megavoltage electron beam radiotherapy

    Science.gov (United States)

    Jong, W. L.; Ung, N. M.; Tiong, A. H. L.; Rosenfeld, A. B.; Wong, J. H. D.

    2018-03-01

    The aim of this study is to investigate the fundamental dosimetric characteristics of the MOSkin detector for megavoltage electron beam dosimetry. The reproducibility, linearity, energy dependence, dose rate dependence, depth dose measurement, output factor measurement, and surface dose measurement under megavoltage electron beam were tested. The MOSkin detector showed excellent reproducibility (>98%) and linearity (R2= 1.00) up to 2000 cGy for 4-20 MeV electron beams. The MOSkin detector also showed minimal dose rate dependence (within ±3%) and energy dependence (within ±2%) over the clinical range of electron beams, except for an energy dependence at 4 MeV electron beam. An energy dependence correction factor of 1.075 is needed when the MOSkin detector is used for 4 MeV electron beam. The output factors measured by the MOSkin detector were within ±2% compared to those measured with the EBT3 film and CC13 chamber. The measured depth doses using the MOSkin detector agreed with those measured using the CC13 chamber, except at the build-up region due to the dose volume averaging effect of the CC13 chamber. For surface dose measurements, MOSkin measurements were in agreement within ±3% to those measured using EBT3 film. Measurements using the MOSkin detector were also compared to electron dose calculation algorithms namely the GGPB and eMC algorithms. Both algorithms were in agreement with measurements to within ±2% and ±4% for output factor (except for the 4 × 4 cm2 field size) and surface dose, respectively. With the uncertainties taken into account, the MOSkin detector was found to be a suitable detector for dose measurement under megavoltage electron beam. This has been demonstrated in the in vivo skin dose measurement on patients during electron boost to the breast tumour bed.

  2. Clinical dosimetry with plastic scintillators - Almost energy independent, direct absorbed dose reading with high resolution

    Energy Technology Data Exchange (ETDEWEB)

    Quast, U; Fluehs, D [Department of Radiotherapy, Essen (Germany). Div. of Clinical Radiation Physics; Fluehs, D; Kolanoski, H [Dortmund Univ. (Germany). Inst. fuer Physik

    1996-08-01

    Clinical dosimetry is still far behind the goal to measure any spatial or temporal distribution of absorbed dose fast and precise without disturbing the physical situation by the dosimetry procedure. NE 102A plastic scintillators overcome this border. These tissue substituting dosemeter probes open a wide range of new clinical applications of dosimetry. This versatile new dosimetry system enables fast measurement of the absorbed dose to water in water also in regions with a steep dose gradient, close to interfaces, or in partly shielded regions. It allows direct reading dosimetry in the energy range of all clinically used external photon and electron beams, or around all branchytherapy sources. Thin detector arrays permit fast and high resolution measurements in quality assurance, such as in-vivo dosimetry or even afterloading dose monitoring. A main field of application is the dosimetric treatment planning, the individual optimization of brachytherapy applicators. Thus, plastic scintillator dosemeters cover optimally all difficult fields of clinical dosimetry. An overview about its characteristics and applications is given here. 20 refs, 1 fig.

  3. Influence of bone and fat on dose distribution in electron beams in a semi-infinite medium

    International Nuclear Information System (INIS)

    Sordo, A.

    1983-12-01

    Hitherto, physical and theoretical aspects of the influence of heterogeneities in radiotherapy by electron beams had not been enough considered. We have developped an experimental method which permitted us to analyze the effect of the hard bone and the fat on the depth dose distributions when an infinite medium is irradiated by high energy electron beams. We have incorporated the KR. HOGSTROM's algorithm in a treatment planning system (TP11; AECL). This algorithm sums the dose distribution of individual pencil beams. A comparison between calculated and measured isodose lines obtained in a heterogeneous medium, shows us the performance and limits of this algorithm [fr

  4. Gafchromic EBT-XD film: Dosimetry characterization in high-dose, volumetric-modulated arc therapy.

    Science.gov (United States)

    Miura, Hideharu; Ozawa, Shuichi; Hosono, Fumika; Sumida, Naoki; Okazue, Toshiya; Yamada, Kiyoshi; Nagata, Yasushi

    2016-11-08

    Radiochromic films are important tools for assessing complex dose distributions. Gafchromic EBT-XD films have been designed for optimal performance in the 40-4,000 cGy dose range. We investigated the dosimetric characteristics of these films, including their dose-response, postexposure density growth, and dependence on scanner orientation, beam energy, and dose rate with applications to high-dose volumetric-modulated arc therapy (VMAT) verification. A 10 MV beam from a TrueBeam STx linear accelerator was used to irradiate the films with doses in the 0-4,000 cGy range. Postexposure coloration was analyzed at postirradiation times ranging from several minutes to 48 h. The films were also irradiated with 6 MV (dose rate (DR): 600 MU/min), 6 MV flattening filter-free (FFF) (DR: 1,400 MU/ min), and 10 MV FFF (DR: 2,400 MU/min) beams to determine the energy and dose-rate dependence. For clinical examinations, we compared the dose distribu-tion measured with EBT-XD films and calculated by the planning system for four VMAT cases. The red channel of the EBT-XD film exhibited a wider dynamic range than the green and blue channels. Scanner orientation yielded a variation of ~ 3% in the net optical density (OD). The difference between the film front and back scan orientations was negligible, with variation of ~ 1.3% in the net OD. The net OD increased sharply within the first 6 hrs after irradiation and gradually afterwards. No significant difference was observed for the beam energy and dose rate, with a variation of ~ 1.5% in the net OD. The gamma passing rates (at 3%, 3 mm) between the film- measured and treatment planning system (TPS)-calculated dose distributions under a high dose VMAT plan in the absolute dose mode were more than 98.9%. © 2016 The Authors.

  5. Salvage external beam radiotherapy for clinical failure after cryosurgery for prostate cancer

    International Nuclear Information System (INIS)

    McDonough, Michael J.; Feldmeier, John J.; Parsai, Ishmael; Dobelbower, Ralph R.; Selman, Steven H.

    2001-01-01

    Purpose: To investigate the role of external beam radiotherapy (EBRT) as salvage treatment of prostate cancer after cryosurgery failure. Methods and Materials: Between 1993 and 1998, 6 patients underwent EBRT with curative intent for local recurrence of prostate cancer after cryosurgery. All 6 patients had biopsy-proven recurrence and palpable disease on digital rectal examination at the time of EBRT. The median follow-up was 34 months (range 8-46). The median prostate-specific antigen level was 2.3 ng/mL (range 0.8-4.1). No patient had evidence of metastatic disease. Two patients received hormonal therapy before beginning EBRT. No patient received hormonal therapy after EBRT completion. The median elapsed time between cryosurgery and EBRT was 3 years (range 1.5-4). The median delivered dose was 66 Gy (range 62-70.2) using a 10-MeV photon beam. An in-house-developed three-dimensional treatment planning system was used to plan delivery of the prescribed dose with conformal radiotherapy techniques. Results: After EBRT, all patients had complete resolution of palpable disease. Four patients (66%) were disease free at the time of the last follow-up. Two patients developed biochemical failure as defined by the American Society for Therapeutic Radiology and Oncology consensus definition. One of these patients had a prostate-specific antigen level of 97 ng/mL before cryosurgery. No patient developed distant metastasis during follow-up. Two patients (33%) developed proctitis; 1 case resolved with Rowasa suppositories and 1 required blood transfusion. Conclusions: Our preliminary results suggest that EBRT can render a significant number of patients biochemically free of disease and can cause complete resolution of clinically palpable disease after initial cryosurgery. The results also showed that EBRT can be given without excessive morbidity. EBRT should be considered as a treatment option in these potentially curable cases

  6. Evaluation of various approaches for assessing dose indicators and patient organ doses resulting from radiotherapy cone-beam CT

    International Nuclear Information System (INIS)

    Rampado, Osvaldo; Giglioli, Francesca Romana; Rossetti, Veronica; Ropolo, Roberto; Fiandra, Christian; Ragona, Riccardo

    2016-01-01

    Purpose: The aim of this study was to evaluate various approaches for assessing patient organ doses resulting from radiotherapy cone-beam CT (CBCT), by the use of thermoluminescent dosimeter (TLD) measurements in anthropomorphic phantoms, a Monte Carlo based dose calculation software, and different dose indicators as presently defined. Methods: Dose evaluations were performed on a CBCT Elekta XVI (Elekta, Crawley, UK) for different protocols and anatomical regions. The first part of the study focuses on using PCXMC software (PCXMC 2.0, STUK, Helsinki, Finland) for calculating organ doses, adapting the input parameters to simulate the exposure geometry, and beam dose distribution in an appropriate way. The calculated doses were compared to readouts of TLDs placed in an anthropomorphic Rando phantom. After this validation, the software was used for analyzing organ dose variability associated with patients’ differences in size and gender. At the same time, various dose indicators were evaluated: kerma area product (KAP), cumulative air-kerma at the isocenter (K_a_i_r), cone-beam dose index, and central cumulative dose. The latter was evaluated in a single phantom and in a stack of three adjacent computed tomography dose index phantoms. Based on the different dose indicators, a set of coefficients was calculated to estimate organ doses for a range of patient morphologies, using their equivalent diameters. Results: Maximum organ doses were about 1 mGy for head and neck and 25 mGy for chest and pelvis protocols. The differences between PCXMC and TLDs doses were generally below 10% for organs within the field of view and approximately 15% for organs at the boundaries of the radiation beam. When considering patient size and gender variability, differences in organ doses up to 40% were observed especially in the pelvic region; for the organs in the thorax, the maximum differences ranged between 20% and 30%. Phantom dose indexes provided better correlation with organ doses

  7. Calculating external doses from contaminated soil with the computer model SOILD

    International Nuclear Information System (INIS)

    Chen, Y.; LePoire, D.; Yu, C.

    1991-01-01

    The SOILD computer model was developed for calculating the effective dose equivalent from external exposure to distributed gamma sources in soil. It is designed to assess external doses under various exposure scenarios that may be encountered in environmental restoration programs. The model's four major functional features address (a) dose versus source depth in soil, (b) shielding of clean cover soil, (c) area of contamination, and (d) nonuniform distribution of sources. The model can also adjust doses when there are variations in soil densities for both source and cover soils. It is supported by a data base of ∼500 radionuclides. A sample calculation was performed by SOILD to determine the effective dose equivalent for a uniform source distribution in soil. The soil density was assumed to be 1.6 g/cm 3 , and the source strength was assumed to be 1 pCi/cm 3 . The following radionuclides were studied: 60 C, 131 I, 137+D Cs, 238+D U, and 226+D Ra ('+D' denotes the parent nuclide and daughters)

  8. Analysis of Surface Dose Refer to Distance between Beam Spoiler and Patient in Total Body Irradiation

    International Nuclear Information System (INIS)

    Choi, Jong Hwan; Kim, Jong Sik; Choi, Ji Min; Shin, Eun Hyuk; Song, Ki Won; Park, Young Hwan

    2007-01-01

    Total body irradiation is used to kill the total malignant cell and for immunosuppression component of preparatory regimens for bone-marrow restitution of patients. Beam spoiler is used to increase the dose to the superficial tissues. This paper finds the property of the distance between beam spoiler and patient. Set-up conditions are 6 MV-Xray, 300 MU, SAD = 400 cm, field size = 40 x 40 cm 2 . The parallel plate chamber located in surface, midpoint and exit of solid water phantom. The surface dose is measured while the distance between beam spoiler and patient is altered. Because it should be found proper distance. The solid water phantom is fixer and beam spoiler is moving. Central dose of phantom is 10.7 cGy and exit dose is 6.7 cGy. In case of distance of 50 cm to 60 cm between beam spoiler and solid water phantom, incidence dose is 14.58-14.92 cGy. Therefore, The surface dose was measured 99.4-101% with got near most to the prescription dose. In clinical case, distance between beam spoiler and patient affect surface dose. If once 50-60 cm of distance between beam spoiler and patient, surface dose of patient got near prescription dose. It would be taken distance between beam spoiler and patient into account in clinical therapy.

  9. Locally advanced prostatic cancer: experience with combined pelvic external beam irradiation and interstitial thermobrachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Hancock, Steven L; Kapp, Daniel S; Goffinet, Don R; Prionas, Stavros; Cox, Richard S; Bagshaw, Malcolm A

    1995-07-01

    Purpose: Recurrence of prostatic carcinoma within the prostate gland remains a significant problem for patients who present with locally advanced disease. In an attempt to improve the local control of such tumors, an iridium-192 transperineal, template-guided prostatic implant was combined wit radiofrequency-induced hyperthermia after external beam irradiation of the pelvic lymph nodes and prostate gland. This study evaluates the influence of pre-treatment patient characteristics and treatment parameters upon outcome. Materials and Methods: Between July 1987 and April 1992 33 patients with adenocarcinoma of the prostate were selected for treatment: 28 of these patients had extensive local disease on clinical examination (AJCC-4 stages T2b or c: 9 patients; T3: 19 patients); two patients with T2a tumors had Gleason grade 5 + 4 disease or disproportionately high prostate specific antigen (PSA) values and a mass encroaching upon the bladder on computerized tomographic scan. Three patients with more clinically limited T2a or T2b involvement elected implantation in lieu of an external beam irradiation boost. The mean pre-treatment serum PSA value was 25.6 ng/ml (Hybritech scale), with values of above 19 ng/ml for 17 of the patients. Treatment consisted of 50 Gy of external beam irradiation to the prostate and pelvic lymph nodes followed by a transperineal needle implant of the prostate gland. Thirty-two patients had no evidence of pelvic nodal involvement during exploration at laparotomy performed after external irradiation, and 25 of these had lymph node samplings that were histologically negative for metastasis. Perineal template oriented needles were placed by inspection and palpation at laparotomy; 2 were performed closed under ultrasound guidance. Needles were afterloaded with {sup 192}Ir to provide a dose of 30 Gy to the periphery of the prostate gland. Interstitial radiofrequency-induced hyperthermia treatments were given in conjunction with the implant, one just

  10. Implementation of an algorithm for absorbed dose calculation in high energy photon beams at off axis points

    International Nuclear Information System (INIS)

    Matos, M.F.; Alvarez, G.D.; Sanz, D.E.

    2008-01-01

    Full text: A semiempirical algorithm for absorbed dose calculation at off-axis points in irregular beams was implemented. It is well known that semiempirical methods are very useful because of their easy implementation and its helpfulness in dose calculation in the clinic. These methods can be used as independent tools for dosimetric calculation in many applications of quality assurance. However, the applicability of such methods has some limitations, even in homogeneous media, specially at off axis points, near beam fringes or outside the beam. Only methods derived from tissue-air-ratio (TAR) or scatter-maximum-ratio (SMR) have been devised for those situations, many years ago. Despite there have been improvements for these manual methods, like the Sc-Sp ones, no attempt has been made to extend their usage at off axis points. In this work, a semiempirical formalism was introduced, based on the works of Venselaar et al. (1999) and Sanz et al. (2004), aimed to the Sc-Sp separation. This new formalism relies on the separation of primary and secondary components of the beam although in a relative way. The data required by the algorithm are reduced to a minimal, allowing for experimental easy. According to modern recommendations, reference measurements in water phantom are performed at 10 cm depth, keeping away electron contamination. Air measurements are done using a mini phantom instead of the old equilibrium caps. Finally, the calculation at off-axis points are done using data measured on the central beam axis; but correcting the results with the introduction of a measured function which depends on the location of the off axis point. The measurements for testing the algorithm were performed in our Siemens MXE linear accelerator. The algorithm was used to determine specific dose profiles for a great number of different beam configurations, and the results were compared with direct measurements to validate the accuracy of the algorithm. Additionally, the results were

  11. Procedure on reconstruction of external dose to evacuees at Chernobyl accident

    International Nuclear Information System (INIS)

    Nakajima, T.; Likhtariov, I.; Repin, V.S.

    1992-01-01

    An external dose estimation on the Chernobyl accident was carried out using sugar left in two houses at Pripyat-city from before the accident. The external dose to the people evacuated from Pripyat-city after the Chernobyl accident has been estimated using both a data from the sugar-electron spin resonance (ESR) dosimeter and information on the type of buildings and the exposure rates there. In this work, the procedure of the dose estimation for the evacuees in Pripyat-city be reported. Furthermore, the sugar-ESR method will be discussed. The present result good agree with one reported from USSR to IAEA. It has been certified that small crystalline sugar such as granulated sugar is one of the most useful dosimeter in the emergency for the public. (author)

  12. External beam irradiation of craniopharyngiomas: long-term analysis of tumor control and morbidity

    International Nuclear Information System (INIS)

    Varlotto, John M.; Flickinger, John C.; Kondziolka, Douglas; Lunsford, L.D.; Deutsch, Melvin

    2002-01-01

    Purpose: To delineate the long-term control and morbidity with external beam radiotherapy (EBRT) of craniopharyngiomas. Methods and Materials: Between 1971 and 1992, 24 craniopharyngioma patients underwent EBRT at the University of Pittsburgh. Most (19 of 24) were treated within 1-3 months after subtotal resection. The other prior surgical procedures were biopsy (n = 2) and gross total resection (n = 1); 2 patients did not undergo any surgical procedure. The median follow-up was 12.1 years. The median patient age was 29 years (range 5-69). The total radiation doses varied from 36 to 70 Gy (median 59.75). The normalized total dose (NTD, biologically equivalent dose given in 2 Gy/fraction [α/β ratio = 2]) varied from 28 to 83 Gy (median 55.35). Results: The actuarial survival rate at 10 and 20 years was 100% and 92.3%, respectively. The actuarial local control rate at 10 and 20 years was 89.1% and 54.0%, respectively. No local failures occurred with doses ≥60 Gy (n=12) or NTDs ≥55 Gy. The complication-free survival rate at 10 and 20 years was 80.1% and 72.1%, respectively. No complications were noted with an NTD of ≤55 Gy. The actuarial survival free from any adverse outcome (recurrence or complication) was 70.1% and 31.8% at 10 and 20 years, respectively. The adverse outcome-free survival appeared optimized (at 73%) with an NTD of 55-63 Gy. Multivariate analysis found that tumor control correlated significantly with the total dose (p=0.02), treatment complications with NTD (p=0.008), and adverse outcome with hypopituitarism on presentation (p=0.03). Conclusion: We recommend treating craniopharyngioma with 1.6-1.7-Gy dose fractions to 60 Gy to optimize outcome from EBRT

  13. Performance on a CT Scanner. Application for the dose correction in the presence of heterogeneities, experimental study using high energy photon beams

    International Nuclear Information System (INIS)

    Hanna, Therese.

    1979-01-01

    The purpose of this work is the physical analysis of a second generation C T scanner: the A C T A Scanner 0200 FS (PFIZER) used at the 'Institut Gustave Roussy, Villejuif' and its application in radiotherapy. The first part of the study specifically concerns the physical performance of the C T Scanner, and, the evaluation of the doses, delivered to patients during tomodensitometric examinations. The second part envisages the possibilities of the application of C T scanning in radiotherapy. A particular study is established for the utilization of the physical characteristics, furnished by the C T Scanner, concerning different organs, in dose calculations, in the presence of heterogeneities. An experimental study using high energy photon beams more particularly 25 MV X ray beams produced by a linear accelerator (type Sagittaire) has been realized with materials, simulating different human tissues. Consequently, the validity of different correction methods proposed in the literature has been tested for the soft tissues and bone as for the lungs. Modifications are suggested to allow the use of these methods for the photons of very high energy [fr

  14. The peripheral dose outside the applicator in electron beams of Oncor linear accelerator

    International Nuclear Information System (INIS)

    Iktueren, B.; Bilge, H.; Karacam, S.; Atkovar, G.

    2012-01-01

    In this study, the peripheral dose outside the applicator was measured using electron beams produced by an Oncor linear accelerator and compared with the data of the treatment planning system (TPS). The dose profiles have been measured, by using a water-equivalent slab phantom and a parallel plate ionisation chamber, at 6, 9 and 15 MeV energy levels in 5 x 5, 10 x 10, 15 x 15, 20 x 20 and 25 x 25 cm 2 applicators and at 0, 10 and 20 deg. gantry angles; and at the surface, 0.2, 0.5, 1 cm and d max depth for each electron energy level. The peripheral dose has been determined with these profiles by normalisation at the field central beam axis (CAX). It has been noticed that, using a 10 x 10 cm 2 applicator, there is a 1.4 % dose peak on the surface 6 cm away from the field edge where the field CAX is at 100 %, at a gantry angle of 0 deg. with 6 and 9 MeV electron beams; also for the 15 MeV electron beam there is a 2.3 % dose peak. It has been discovered that the peak dose approaches a minimum depending on the increase in depth and reaches 2.5-4 % depending on the growth of the field dimension. At gantry angles of 10 and 20 deg., 6 and 9 MeV electron beams created small peaks and a maximum dose could be reached at 0.2 and 1 cm depth. Electron beam of 15 MeV did not peak at depths of 0.2 and 1 cm at gantry angles of 10 and 20 deg.. The measured peripheral dose outside the applicators has been compared with the data from a TPS's computer using the Pencil Beam algorithm; it has been stated that dose calculations can be made as far as 3 cm outside the field. In conclusion, the TPS is not sufficient to measure the peripheral dose outside the applicators, and this dose can only be determined by direct measurement. (authors)

  15. The peripheral dose outside the applicator in electron beams of Oncor linear accelerator.

    Science.gov (United States)

    Iktueren, Basak; Bilge, Hatice; Karacam, Songul; Atkovar, Gulyuz

    2012-06-01

    In this study, the peripheral dose outside the applicator was measured using electron beams produced by an Oncor linear accelerator and compared with the data of the treatment planning system (TPS). The dose profiles have been measured, by using a water-equivalent slab phantom and a parallel plate ionisation chamber, at 6, 9 and 15 MeV energy levels in 5×5, 10×10, 15×15, 20×20 and 25×25 cm(2) applicators and at 0, 10 and 20° gantry angles; and at the surface, 0.2, 0.5, 1 cm and d(max) depth for each electron energy level. The peripheral dose has been determined with these profiles by normalisation at the field central beam axis (CAX). It has been noticed that, using a 10×10 cm(2) applicator, there is a 1.4 % dose peak on the surface 6 cm away from the field edge where the field CAX is at 100 %, at a gantry angle of 0° with 6 and 9 MeV electron beams; also for the 15 MeV electron beam there is a 2.3 % dose peak. It has been discovered that the peak dose approaches a minimum depending on the increase in depth and reaches 2.5-4 % depending on the growth of the field dimension. At gantry angles of 10 and 20°, 6 and 9 MeV electron beams created small peaks and a maximum dose could be reached at 0.2 and 1 cm depth. Electron beam of 15 MeV did not peak at depths of 0.2 and 1 cm at gantry angles of 10 and 20°. The measured peripheral dose outside the applicators has been compared with the data from a TPS's computer using the Pencil Beam algorithm; it has been stated that dose calculations can be made as far as 3 cm outside the field. In conclusion, the TPS is not sufficient to measure the peripheral dose outside the applicators, and this dose can only be determined by direct measurement.

  16. Reconstruction of the external dose of evacuees from the contaminated areas based on simulation modelling

    International Nuclear Information System (INIS)

    Meckbach, R.; Chumak, V.V.

    1996-01-01

    Model calculations are being performed for the reconstruction of individual external gamma doses of population evacuated during the Chernobyl accident from the city of Pripyat and other settlements of the 30-km zone. The models are based on sets of dose rate measurements performed during the accident, on individual behavior histories of more than 30000 evacuees obtained by questionnaire survey and on location factors determined for characteristic housing buildings. Location factors were calculated by Monte Carlo simulations of photon transport for a typical housing block and village houses. Stochastic models for individual external dose reconstruction are described. Using Monte Carlo methods, frequency distributions representing the uncertainty of doses are calculated from an assessment of the uncertainty of the data. The determination of dose rate distributions in Pripyat is discussed. Exemplary results for individual external doses are presented

  17. Metallization of ion beam synthesized Si/3C-SiC/Si layer systems by high-dose implantation of transition metal ions

    International Nuclear Information System (INIS)

    Lindner, J.K.N.; Wenzel, S.; Stritzker, B.

    2001-01-01

    The formation of metal silicide layers contacting an ion beam synthesized buried 3C-SiC layer in silicon by means of high-dose titanium and molybdenum implantations is reported. Two different strategies to form such contact layers are explored. The titanium implantation aims to convert the Si top layer of an epitaxial Si/SiC/Si layer sequence into TiSi 2 , while Mo implantations were performed directly into the SiC layer after selectively etching off all capping layers. Textured and high-temperature stable C54-TiSi 2 layers with small additions of more metal-rich silicides are obtained in the case of the Ti implantations. Mo implantations result in the formation of the high-temperature phase β-MoSi 2 , which also grows textured on the substrate. The formation of cavities in the silicon substrate at the lower SiC/Si interface due to the Si consumption by the growing silicide phase is observed in both cases. It probably constitutes a problem, occurring whenever thin SiC films on silicon have to be contacted by silicide forming metals independent of the deposition technique used. It is shown that this problem can be solved with ion beam synthesized contact layers by proper adjustment of the metal ion dose

  18. Clinical implementation of full Monte Carlo dose calculation in proton beam therapy

    International Nuclear Information System (INIS)

    Paganetti, Harald; Jiang, Hongyu; Parodi, Katia; Slopsema, Roelf; Engelsman, Martijn

    2008-01-01

    The goal of this work was to facilitate the clinical use of Monte Carlo proton dose calculation to support routine treatment planning and delivery. The Monte Carlo code Geant4 was used to simulate the treatment head setup, including a time-dependent simulation of modulator wheels (for broad beam modulation) and magnetic field settings (for beam scanning). Any patient-field-specific setup can be modeled according to the treatment control system of the facility. The code was benchmarked against phantom measurements. Using a simulation of the ionization chamber reading in the treatment head allows the Monte Carlo dose to be specified in absolute units (Gy per ionization chamber reading). Next, the capability of reading CT data information was implemented into the Monte Carlo code to model patient anatomy. To allow time-efficient dose calculation, the standard Geant4 tracking algorithm was modified. Finally, a software link of the Monte Carlo dose engine to the patient database and the commercial planning system was established to allow data exchange, thus completing the implementation of the proton Monte Carlo dose calculation engine ('DoC++'). Monte Carlo re-calculated plans are a valuable tool to revisit decisions in the planning process. Identification of clinically significant differences between Monte Carlo and pencil-beam-based dose calculations may also drive improvements of current pencil-beam methods. As an example, four patients (29 fields in total) with tumors in the head and neck regions were analyzed. Differences between the pencil-beam algorithm and Monte Carlo were identified in particular near the end of range, both due to dose degradation and overall differences in range prediction due to bony anatomy in the beam path. Further, the Monte Carlo reports dose-to-tissue as compared to dose-to-water by the planning system. Our implementation is tailored to a specific Monte Carlo code and the treatment planning system XiO (Computerized Medical Systems Inc

  19. Prediction of in-phantom dose distribution using in-air neutron beam characteristics for BNCS

    International Nuclear Information System (INIS)

    Verbeke, Jerome M.

    1999-01-01

    A monoenergetic neutron beam simulation study is carried out to determine the optimal neutron energy range for treatment of rheumatoid arthritis using radiation synovectomy. The goal of the treatment is the ablation of diseased synovial membranes in joints, such as knees and fingers. This study focuses on human knee joints. Two figures-of-merit are used to measure the neutron beam quality, the ratio of the synovium absorbed dose to the skin absorbed dose, and the ratio of the synovium absorbed dose to the bone absorbed dose. It was found that (a) thermal neutron beams are optimal for treatment, (b) similar absorbed dose rates and therapeutic ratios are obtained with monodirectional and isotropic neutron beams. Computation of the dose distribution in a human knee requires the simulation of particle transport from the neutron source to the knee phantom through the moderator. A method was developed to predict the dose distribution in a knee phantom from any neutron and photon beam spectra incident on the knee. This method was revealed to be reasonably accurate and enabled one to reduce by a factor of 10 the particle transport simulation time by modeling the moderator only

  20. Prediction of in-phantom dose distribution using in-air neutron beam characteristics for BNCS

    Energy Technology Data Exchange (ETDEWEB)

    Verbeke, Jerome M.

    1999-12-14

    A monoenergetic neutron beam simulation study is carried out to determine the optimal neutron energy range for treatment of rheumatoid arthritis using radiation synovectomy. The goal of the treatment is the ablation of diseased synovial membranes in joints, such as knees and fingers. This study focuses on human knee joints. Two figures-of-merit are used to measure the neutron beam quality, the ratio of the synovium absorbed dose to the skin absorbed dose, and the ratio of the synovium absorbed dose to the bone absorbed dose. It was found that (a) thermal neutron beams are optimal for treatment, (b) similar absorbed dose rates and therapeutic ratios are obtained with monodirectional and isotropic neutron beams. Computation of the dose distribution in a human knee requires the simulation of particle transport from the neutron source to the knee phantom through the moderator. A method was developed to predict the dose distribution in a knee phantom from any neutron and photon beam spectra incident on the knee. This method was revealed to be reasonably accurate and enabled one to reduce by a factor of 10 the particle transport simulation time by modeling the moderator only.

  1. A TCP model for external beam treatment of intermediate-risk prostate cancer.

    LENUS (Irish Health Repository)

    Walsh, Seán

    2013-03-01

    Biological models offer the ability to predict clinical outcomes. The authors describe a model to predict the clinical response of intermediate-risk prostate cancer to external beam radiotherapy for a variety of fractionation regimes.

  2. Remanent dose rates around the collimators of the LHC beam cleaning insertions

    International Nuclear Information System (INIS)

    Brugger, M.; Roesler, S.

    2005-01-01

    The LHC will require an extremely powerful and unprecedented collimation system. As ∼30% of the LHC beam is lost in the cleaning insertions, these will become some of the most radioactive locations around the entire LHC ring. Thus, remanent dose rates to be expected during later repair or maintenance interventions must be considered in the design phase itself. As a consequence, the beam cleaning insertions form a unique test bed for a recently developed approach to calculate remanent dose rates. A set of simulations, different in complexity, is used in order to evaluate methods for the estimation of remanent dose rates. The scope, as well as the restrictions, of the omega-factor method are shown and compared with the explicit simulation approach. The latter is then used to calculate remanent dose rates in the beam cleaning insertions. Furthermore, a detailed example for maintenance dose planning is given. (authors)

  3. Remanent dose rates around the collimators of the LHC beam cleaning insertions.

    Science.gov (United States)

    Brugger, M; Roesler, S

    2005-01-01

    The LHC will require an extremely powerful and unprecedented collimation system. As approximately 30% of the LHC beam is lost in the cleaning insertions, these will become some of the most radioactive locations around the entire LHC ring. Thus, remanent dose rates to be expected during later repair or maintenance interventions must be considered in the design phase itself. As a consequence, the beam cleaning insertions form a unique test bed for a recently developed approach to calculate remanent dose rates. A set of simulations, different in complexity, is used in order to evaluate methods for the estimation of remanent dose rates. The scope, as well as the restrictions, of the omega-factor method are shown and compared with the explicit simulation approach. The latter is then used to calculate remanent dose rates in the beam cleaning insertions. Furthermore, a detailed example for maintenance dose planning is given.

  4. Photon beam dose distributions for patients with implanted temporary tissue expanders

    Science.gov (United States)

    Asena, A.; Kairn, T.; Crowe, S. B.; Trapp, J. V.

    2015-01-01

    This study examines the effects of temporary tissue expanders (TTEs) on the dose distributions of photon beams in breast cancer radiotherapy treatments. EBT2 radiochromic film and ion chamber measurements were taken to quantify the attenuation and backscatter effects of the inhomogeneity. Results illustrate that the internal magnetic port present in a tissue expander causes a dose reduction of approximately 25% in photon tangent fields immediately downstream of the implant. It was also shown that the silicone elastomer shell of the tissue expander reduced the dose to the target volume by as much as 8%. This work demonstrates the importance for an accurately modelled high-density implant in the treatment planning system for post-mastectomy breast cancer patients.

  5. External beam radiotherapy for head and neck carcinomas with preservation of parotid function: indications, techniques and long term results

    International Nuclear Information System (INIS)

    Ding-Jen, Lee; Fairbanks, Robert; Lee, Frank C.

    1995-01-01

    Purpose/Objective: To reduce the incidence of radiotherapy induced xerostomia, we developed techniques of external beam irradiation with preservation of parotid function for patients with early to intermediate stage carcinomas of the head and neck. This analysis reports the efficacy of our methods. Materials and Methods: From 1985 to 1993, 42 patients with early to intermediate stage (T 1-3 N 0-2 M 0 ) head and neck carcinomas received a course of external beam radiotherapy. There were 13 patients with carcinoma of the oropharynx, 26 with carcinomas of the oral cavity and 3 with carcinomas of the hypopharynx (lateral wall). 7 patients received a course of definitive radiotherapy (66 to 72 Gy), while 35 patients received a course of postoperative radiotherapy (60-66 Gy). The fraction size was 2 Gy per day. In terms of treatment planning, the primary site (plus a margin) and the ipsilateral neck were covered by the irradiation volume. The ipsilateral parotid gland was within the treatment volume while the contralateral parotid gland was not. The most frequently used field arrangement was a paired wedge fields with an AP (medially just across the mid-line) and an ipsilateral posterior oblique field (usually 30 deg. off vertical axis with a spinal cord block). Multiple level of contours were taken and transmission blocks were used to improve dose homogeneity. In all patients, the ipsilateral parotid gland (and the neck) was irradiated while the contralateral parotid gland (and the neck) was not. Results: With a median follow up of 4 years (ranged from 1.5 to 9 years), only one patient developed symptomatic xerostomia. None had radiation induced dental caries. No patient developed recurrent disease in the contralateral neck. The local control rate was (38(42)) (90%) in the primary site and(41(42)) (98%) in the ipsilateral neck. Conclusion: With appropriate treatment planning, external beam irradiation with parotid function preservation can be achieved. Our results

  6. Endobronchial and endoesophageal high dose rate brachytherapy for malignant airway and digestive tract obstructions

    International Nuclear Information System (INIS)

    Mehta, Minesh P.

    1996-01-01

    With an annual incidence of more than 160,000 cases and a local failure rate between 30-50%, endobronchial occlusion seen with lung cancer is a common and potentially life-threatening complication. Several methods of managing this exist and recently endobronchial brachytherapy has been used extensively as a consequence of the development of fiberoptic bronchoscopy and high dose rate remote afterloading technology. Procedurally, one or more afterloading catheters are inserted in the involved portions of the tracheobronchial tree through fiberoptic guidance. Treatment techniques range from 1-4 applications fractionated over several weeks or given over 2 days with a single insertion procedure. Almost all procedures are currently performed in the outpatient setting. The major application of this technology is in the palliation of occlusive symptomatology. Clinical improvement ranges from 50-100%, radiographic reaeration ranges from 46-88% and bronchoscopic responses ranges from 59-100%. Symptomatic relief is usually quite durable with more than 70% of the patients' remaining life-time rendered symptom-free and symptom-improved. Recently, this modality has been explored for its curative potential as a boost following external beam radiotherapy. It is clear from these series, that in selected patients, endobronchial boost produces significant reaeration and sparing of lung volume from subsequent external radiation, and a few cases may even become resectable. Demonstration of the survival advantage will, however, require larger clinical trials with adequate controls. Some reports have suggested an unacceptably high rate of fatal hemoptysis following HDR endobronchial brachytherapy. Review of the world literature suggests that fatal hemoptysis rates range from 0-50% with an average of about 8%, comparable to an average of 5% with low dose rate brachytherapy. Other recognized complications include fistulae and radiation bronchitis. Because the majority of patients with

  7. 3D Dose Reconstruction to Insure Correct External Beam Treatment of Patients

    International Nuclear Information System (INIS)

    Renner, Wendel Dean

    2007-01-01

    Radiation therapy treatments have become increasingly more complicated. There are multiple opportunities for humans, machines, software, and combinations thereof to result in a treatment error that could be of significance. Current methods for quality assurance are often abstract in nature and may have unclear underlying assumptions as to what is assumed to be working correctly, or may depend upon the diligence of persons to discover errors from a review of the treatment plan. Here, an example will be shown of a direct method to reconstruct and demonstrate the dose and the dose distribution delivered to a particular patient. By measuring the radiation fields that come out of the accelerator, and using the measurement as input to a 3-dimensional (3D) dose algorithm, the delivered patient dose is determined and presented in a manner similar to the treatment plan. The intended treatment plan dose may be directly compared. Using this feedback mechanism, there is less abstraction and dependence upon the diligence of individuals checking multiple steps in a treatment process, and assumptions can be clearly stated. With this system, the dose is determined and presented minimizing assumptions and dependence upon other systems

  8. Absorbed dose determination in high energy photon beams using new IAEA TRS - 398 Code of Practice

    International Nuclear Information System (INIS)

    Suriyapee, S.; Srimanoroath, S.; Jumpangern, C.

    2002-01-01

    The absorbed dose calibration of 6 and 10 MV X-ray beams from Varian Clinac 1800 at King Chulalongkorn Memorial Hospital Bangkok, Thailand were performed using cylindrical chamber 0.6 cc NE2571 Serial No. 1633 with graphite wall and Delrin build up cap and lonex Dosemaster NE 2590 Serial No. 223. The absorbed dose determination followed the IAEA code of practice TRS-277. The new IAEA code of practice TRS-398 have been studied to compare the result with the IAEA TRS-277

  9. MO-C-17A-10: Comparison of Dose Deformable Accumulation by Using Parallel and Serial Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Z; Li, M; Wong, J [Morristown Medical Center, Morristown, NJ (United States)

    2014-06-15

    Purpose: The uncertainty of dose accumulation over multiple CT datasets with deformable fusion may have significant impact on clinical decisions. In this study, we investigate the difference of two dose summation approaches involving deformable fusion. Methods: Five patients, four external beam and one brachytherapy(BT), were chosen for the study. The BT patient was treated with CT-based HDR. The CT image sets acquired in the imageguidance process (8-11 CTs/patient) were used to determine the dose delivered to the four external beam patients. (prostate, pelvis, lung and head and neck). For the HDR patient (cervix), five CT image sets and the corresponding BT plans were used. In total 44 CT datasets and RT dose/plans were imported into the image fusion software MiM (6.0.4) for analysis.For each of the five clinical cases, the dose from each fraction was accumulated into the primary CT dataset by using both Parallel and Serial approaches. The dose-volume histogram (DVH) for CTV and selected organs-at-risks (OAR) were generated. The D95(CTV), OAR(mean) and OAR(max) for the four external beam cases the D90(CTV), and the max dose to bladder and rectum for the BT case were compared. Results: For the four external beam patients, the difference in D95(CTV) were <1.2% PD between the parallel and the serial approaches. The differences of the OAR(mean) and the OAR(max ) range from 0 to 3.7% and <1% PD respectively. For the HDR patient, the dose difference for D90 is 11% PD while that of the max dose to bladder and rectum were 11.5% and 23.3% respectively. Conclusion: For external beam treatments, the parallel and serial approaches have <5% difference probably because tumor volume and OAR have less changes from fraction to fraction. For the brachytherapy case, >10% dose difference between the two approaches was observed as significant volume changes of tumor and OAR were observed among treatment fractions.

  10. Dose distribution considerations of medium energy electron beams at extended source-to-surface distance

    International Nuclear Information System (INIS)

    Saw, Cheng B.; Ayyangar, Komanduri M.; Pawlicki, Todd; Korb, Leroy J.

    1995-01-01

    Purpose: To determine the effects of extended source-to-surface distance (SSD) on dose distributions for a range of medium energy electron beams and cone sizes. Methods and Materials: The depth-dose curves and isodose distributions of 6 MeV, 10 MeV, and 14 MeV electron beams from a dual photon and multielectron energies linear accelerator were studied. To examine the influence of cone size, the smallest and the largest cone sizes available were used. Measurements were carried out in a water phantom with the water surface set at three different SSDs from 101 to 116 cm. Results: In the region between the phantom surface and the depth of maximum dose, the depth-dose decreases as the SSD increases for all electron beam energies. The effects of extended SSD in the region beyond the depth of maximum dose are unobservable and, hence, considered minimal. Extended SSD effects are apparent for higher electron beam energy with small cone size causing the depth of maximum dose and the rapid dose fall-off region to shift deeper into the phantom. However, the change in the depth-dose curve is small. On the other hand, the rapid dose fall-off region is essentially unaltered when the large cone is used. The penumbra enlarges and electron beam flatness deteriorates with increasing SSD

  11. Probabilistic approach to external cloud dose calculations using onsite meteorological data

    International Nuclear Information System (INIS)

    Strenge, D.L.; Watson, E.C.; Bander, T.J.; Kennedy, W.E.

    1976-01-01

    A method is described for calculation of external total body and skin doses from accidental atmospheric releases of radionuclides based on hourly onsite meteorological data. The method involves calculation of dose values from a finite size cloud for each hourly observation for a given radionuclide inventory. These values are then used to determine the probability of occurrence of dose levels for specified release times ranging from one hour to 30 days

  12. Intercomparison of absorbed dose to water and air-kerma based dosimetry protocols for photon and electron beams

    International Nuclear Information System (INIS)

    Huq, M.S.

    2002-01-01

    Full text: During the last three decades the International Atomic Energy Agency (IAEA), the American Association of Physicists in Medicine (AAPM) and organizations from various countries have published Codes of Practice (CoP) and dosimetry protocols for the calibration of high-energy photon and electron beams. They are based on the air-kerma or exposure calibration factor of an ionization chamber in a 60 Co gamma ray beam and formalism for the determination of absorbed dose to water in reference conditions. In recent years, the IAEA (IAEA TRS-398) and the AAPM (AAPM TG-51) have published new external beam dosimetry protocols that are based on the use of an ionization chamber calibrated in terms of absorbed dose to water in a standards laboratory's reference quality beam. These two new protocols follow those by the German Standard DIN, the British IPSM and the IAEA CoP for plane-parallel chambers, which have discussed and implemented the procedures for the determination of absorbed dose-to-water based on standards of absorbed dose-to-water. Since the publication of these protocols and CoPs, many comparisons, theoretical as well as experimental, between them have been published in the literature providing valuable information about the sources of similarities and discrepancies that exist among them. For example, the differences in the basic data for photon and electron beams included in the various IAEA CoPs are very small for the second edition of TRS-277 for photons, TRS-381 for electrons and TRS-398. In these cases the data changes posed by the adoption of TRS-398 are within about ±0.3% for the most commonly used energies. When implementing TRS-398 in these cases, the main difference will arise from the transition from K air to D w standards. For example, experimental comparison of absorbed doses between TRS-398 and TRS-277 for photons show an average difference of about 0.3% for most commonly used energies with a maximum difference of about 1% at a TPR 20

  13. SU-F-T-506: Development and Commissioning of the Effective and Efficient Grid Therapy Using High Dose Rate Flattening Filter Free Beam and Multileaf Collimator

    Energy Technology Data Exchange (ETDEWEB)

    Liu, M; Wen, N; Beyer, C; Siddiqui, F; Chetty, I; Zhao, B [Henry Ford Health System, Detroit, MI (United States)

    2016-06-15

    Purpose: Treating bulky tumors with grid therapy (GT) has demonstrated high response rates. Long delivery time (∼15min), with consequent increased risk of intrafraction motion, is a major disadvantage of conventional MLC-based GT (MLC-GT). The goal of this study was to develop and commission a MLC-GT technique with similar dosimetric characteristics, but more efficient delivery. Methods: Grid plan was designed with 10X-FFF (2400MU/min) beam and MLC in a commercial treatment planning system (TPS). Grid size was 1cm by 1cm and grid-to-grid distance was 2cm. Field-in-field technique was used to flatten the dose profile at depth of 10cm. Prescription was 15Gy at 1.5cm depth. Doses were verified at depths of 1.5cm, 5cm and 10cm. Point dose was measured with a plastic scintillator detector (PSD) while the planar dose was measured with calibrated Gafchromic EBT3 films in a 20cm think, 30cmx30cm solid water phantom. The measured doses were compared to the doses calculated in the treatment planning system. Percent depth dose (PDD) within the grid was also measured using EBT3 film. Five clinical cases were planned to compare beam-on time. Results: The valley-to-peak dose ratio at the 3 depths was approximately 10–15%, which is very similar to published result. The average point dose difference between the PSD measurements and TPS calculation is 2.1±0.6%. Film dosimetry revealed good agreement between the delivered and calculated dose. The average gamma passing rates at the 3 depths were 95% (3%, 1mm). The average percent difference between the measured PDD and calculated PDD was 2.1% within the depth of 20cm. The phantom plan delivery time was 3.6 min. Average beam-on time was reduced by 66.1±5.6% for the 5 clinical cases. Conclusion: An effective and efficient GT technique was developed and commissioned for the treatment of bulky tumors using FFF beam combined with MLC and automation. The Department of Radiation Oncology at Henry Ford Health System receives research

  14. CRionScan: A stand-alone real time controller designed to perform ion beam imaging, dose controlled irradiation and proton beam writing

    Science.gov (United States)

    Daudin, L.; Barberet, Ph.; Serani, L.; Moretto, Ph.

    2013-07-01

    High resolution ion microbeams, usually used to perform elemental mapping, low dose targeted irradiation or ion beam lithography needs a very flexible beam control system. For this purpose, we have developed a dedicated system (called “CRionScan”), on the AIFIRA facility (Applications Interdisciplinaires des Faisceaux d'Ions en Région Aquitaine). It consists of a stand-alone real-time scanning and imaging instrument based on a Compact Reconfigurable Input/Output (Compact RIO) device from National Instruments™. It is based on a real-time controller, a Field Programmable Gate Array (FPGA), input/output modules and Ethernet connectivity. We have implemented a fast and deterministic beam scanning system interfaced with our commercial data acquisition system without any hardware development. CRionScan is built under LabVIEW™ and has been used on AIFIRA's nanobeam line since 2009 (Barberet et al., 2009, 2011) [1,2]. A Graphical User Interface (GUI) embedded in the Compact RIO as a web page is used to control the scanning parameters. In addition, a fast electrostatic beam blanking trigger has been included in the FPGA and high speed counters (15 MHz) have been implemented to perform dose controlled irradiation and on-line images on the GUI. Analog to Digital converters are used for the beam current measurement and in the near future for secondary electrons imaging. Other functionalities have been integrated in this controller like LED lighting using Pulse Width Modulation and a “NIM Wilkinson ADC” data acquisition.

  15. CRionScan: A stand-alone real time controller designed to perform ion beam imaging, dose controlled irradiation and proton beam writing

    Energy Technology Data Exchange (ETDEWEB)

    Daudin, L., E-mail: daudin@cenbg.in2p3.fr [Université Bordeaux, CENBG, UMR 5797, F-33170 Gradignan (France); CNRS, IN2P3, CENBG, UMR 5797, F-33170 Gradignan (France); Barberet, Ph.; Serani, L.; Moretto, Ph. [Université Bordeaux, CENBG, UMR 5797, F-33170 Gradignan (France); CNRS, IN2P3, CENBG, UMR 5797, F-33170 Gradignan (France)

    2013-07-01

    High resolution ion microbeams, usually used to perform elemental mapping, low dose targeted irradiation or ion beam lithography needs a very flexible beam control system. For this purpose, we have developed a dedicated system (called “CRionScan”), on the AIFIRA facility (Applications Interdisciplinaires des Faisceaux d’Ions en Région Aquitaine). It consists of a stand-alone real-time scanning and imaging instrument based on a Compact Reconfigurable Input/Output (Compact RIO) device from National Instruments™. It is based on a real-time controller, a Field Programmable Gate Array (FPGA), input/output modules and Ethernet connectivity. We have implemented a fast and deterministic beam scanning system interfaced with our commercial data acquisition system without any hardware development. CRionScan is built under LabVIEW™ and has been used on AIFIRA’s nanobeam line since 2009 (Barberet et al., 2009, 2011) [1,2]. A Graphical User Interface (GUI) embedded in the Compact RIO as a web page is used to control the scanning parameters. In addition, a fast electrostatic beam blanking trigger has been included in the FPGA and high speed counters (15 MHz) have been implemented to perform dose controlled irradiation and on-line images on the GUI. Analog to Digital converters are used for the beam current measurement and in the near future for secondary electrons imaging. Other functionalities have been integrated in this controller like LED lighting using Pulse Width Modulation and a “NIM Wilkinson ADC” data acquisition.

  16. Acute genitourinary toxicity after high dose rate (HDR) brachytherapy combined with hypofractionated external-beam radiation therapy for localized prostate cancer: Second analysis to determine the correlation between the urethral dose in HDR brachytherapy and the severity of acute genitourinary toxicity

    International Nuclear Information System (INIS)

    Akimoto, Tetsuo; Katoh, Hiroyuki; Noda, Shin-ei; Ito, Kazuto; Yamamoto, Takumi; Kashiwagi, Bunzo; Nakano, Takashi

    2005-01-01

    Purpose: We have been treating localized prostate cancer with high-dose-rate (HDR) brachytherapy combined with hypofractionated external beam radiation therapy (EBRT) at our institution. We recently reported the existence of a correlation between the severity of acute genitourinary (GU) toxicity and the urethral radiation dose in HDR brachytherapy by using different fractionation schema. The purpose of this study was to evaluate the role of the urethral dose in the development of acute GU toxicity more closely than in previous studies. For this purpose, we conducted an analysis of patients who had undergone HDR brachytherapy with a fixed fractionation schema combined with hypofractionated EBRT. Methods and Materials: Among the patients with localized prostate cancer who were treated by 192-iridium HDR brachytherapy combined with hypofractionated EBRT at Gunma University Hospital between August 2000 and November 2004, we analyzed 67 patients who were treated by HDR brachytherapy with the fractionation schema of 9 Gy x two times combined with hypofractionated EBRT. Hypofractionated EBRT was administered at a fraction dose of 3 Gy three times weekly, and a total dose of 51 Gy was delivered to the prostate gland and seminal vesicles using the four-field technique. No elective pelvic irradiation was performed. After the completion of EBRT, all the patients additionally received transrectal ultrasonography-guided HDR brachytherapy. The planning target volume was defined as the prostate gland with a 5-mm margin all around, and the planning was conducted based on computed tomography images. The tumor stage was T1c in 13 patients, T2 in 31 patients, and T3 in 23 patients. The Gleason score was 2-6 in 12 patients, 7 in 34 patients, and 8-10 in 21 patients. Androgen ablation was performed in all the patients. The median follow-up duration was 11 months (range 3-24 months). The toxicities were graded based on the Radiation Therapy Oncology Group and the European Organization

  17. External beam irradiation inhibits neointimal hyperplasia after injury-induced arterial smooth muscle cell proliferation

    International Nuclear Information System (INIS)

    Schaefer, U.; Micke, O.; Dorszewski, A.; Breithardt, G.; Willich, N.

    1996-01-01

    Purpose/Objective: Restenosis after catheter-based revascularization has been demonstrated to be primarily caused by smooth muscle cell proliferation. This study examines the effects of external beam irradiation on neointimal proliferation after external injury to the central artery of the rabbit ear. Materials and Methods: 30 male New Zealand White rabbits were used in this study. Crush lesions were performed on each ear under general anesthesia and bilateral auricular nerve blockade. A single dose of 12 Gy (n=10), 16 Gy (n=10), or 20 Gy (n=10) gamma radiation was delivered to the left or right central artery of the ear 24 hours after injury; the contralateral central artery served as control. All rabbits were sacrificed after twenty-one days and the central arteries of the ear were fixed for morphometric measurements. Results: Mean (± SD) neointimal area was 0.062 ± 0.005 mm 2 (12 Gy), 0.022 ± 0.005 mm 2 (16 Gy) and 0.028 ± 0.006 mm 2 in irradiated arteries compared with 0.081 ± 0.009 mm 2 in the control group. Mean (± SD) luminal area was 0.049 ± 0.004 mm 2 (12 Gy), 0.059 ± 0.002 mm 2 (16 Gy) and 0.072 ± 0.006 mm 2 (24 Gy) in irradiated arteries compared with 0.043 ± 0.008 mm 2 in the control group. The difference in neointimal and luminal area between control and irradiated arteries was significant (p<0.05) only for the 16 and 20 Gy group compared to control. Conclusion: We conclude that in this model, external beam X-ray irradiation was successful in reducing neointimal proliferation after injury of the central artery of the rabbit ear. Marked reductions in neointimal proliferation were demonstrated in vessels subjected to 16 and 20 Gy radiation, a less prominent effect was noted for 12 Gy. Whether this approach can be used successfully to inhibit restenosis in the clinical setting requires further investigation

  18. Influence of boost technique (external beam radiotherapy or brachytherapy) on the outcome of patients with carcinoma of the base of the tongue

    International Nuclear Information System (INIS)

    Regueiro, C.A.; Millan, I.; Torre, A. de la; Valcarcel, F.J.; Magallon, R.; Fernandez, E.; Aragon, G.

    1995-01-01

    We reviewed 90 patients with squamous cell carcinoma of the base of the tongue. Fifty-three patients were treated with external beam radiotherapy alone (3 T1, 11 T2, 21 T3, and 18 T4 tumors) and thirty-seven patients were treated with external beam radiotherapy plus brachytherapy boost (4 T1, 15 T2, 11 T3, and 7 T4 tumors). For patients with T1, T2 and T3 primaries, the actuarial 3-year local relapse-free survival was 42% following external beam radiotherapy alone and 67% following external beam radiotherapy plus brachytherapy (p<0.05). The actuarial 3-year cause specific survival for these T-stages was 37% for patients treated with external beam radiotherapy alone and 53% for patients treated with external beam radiotherapy plus brachytherapy (p=0.1). In the Cox multivariate analyses restricted patients with T1, T2 and T3 staged tumors, treatment modality was the only predictor for local control but no influence on specific survival was found. The trend towards significant differences in specific survival found in the univariate comparison of both treatment modalities was probably due to the significantly higher number of N-positive patients treated with external beam radiotherapy alone. When all stages were included in the Cox analysis, low hemoglobin level, invasion of deep muscle, number of palpable nodes, and history of weight loss significantly influenced the outcome. Soft tissue necrosis occurred more frequently in patients treated with external beam radiotherapy plus brachytherapy (33% vs. 10%, p=0.52). (orig.)

  19. Target volume delineation in external beam partial breast irradiation: less inter-observer variation with preoperative- compared to postoperative delineation

    NARCIS (Netherlands)

    Leij, F. van der; Elkhuizen, P.H.M.; Janssen, T.M.; Poortmans, P.M.P.; Sangen, M. van der; Scholten, A.N.; Vliet-Vroegindeweij, C. van; Boersma, L.J.

    2014-01-01

    The challenge of adequate target volume definition in external beam partial breast irradiation (PBI) could be overcome with preoperative irradiation, due to less inter-observer variation. We compared the target volume delineation for external beam PBI on preoperative versus postoperative CT scans of

  20. Biological effective doses in the intracavitary high dose rate brachytherapy of cervical cancer

    Directory of Open Access Journals (Sweden)

    Y. Sobita Devi

    2011-12-01

    Full Text Available Purpose: The aim of this study is to evaluate the decrease of biological equivalent dose and its correlation withlocal/loco-regional control of tumour in the treatment of cervical cancer when the strength of the Ir-192 high dose rate(HDR brachytherapy (BT source is reduced to single, double and triple half life in relation to original strength of10 Ci (~ 4.081 cGy x m2 x h–1. Material and methods: A retrospective study was carried out on 52 cervical cancer patients with stage II and IIItreated with fractionated HDR-BT following external beam radiation therapy (EBRT. International Commission onRadiation Units and Measurement (ICRU points were defined according to ICRU Report 38, using two orthogonal radiographimages taken by Simulator (Simulix HQ. Biologically effective dose (BED was calculated at point A for diffe -rent Ir-192 source strength and its possible correlation with local/loco-regional tumour control was discussed. Result: The increase of treatment time per fraction of dose due to the fall of dose rate especially in HDR-BT of cervicalcancer results in reduction in BED of 2.59%, 7.02% and 13.68% with single, double and triple half life reduction ofsource strength, respectively. The probabilities of disease recurrence (local/loco-regional within 26 months are expectedas 0.12, 0.12, 0.16, 0.39 and 0.80 for source strength of 4.081, 2.041, 1.020, 0.510 and 0.347 cGy x m2 x h–1, respectively.The percentages of dose increase required to maintain the same BED with respect to initial BED were estimated as1.71, 5.00, 11.00 and 15.86 for the dose rate of 24.7, 12.4, 6.2 and 4.2 Gy/hr at point A, respectively. Conclusions: This retrospective study of cervical cancer patients treated with HDR-BT at different Ir-192 sourcestrength shows reduction in disease free survival according to the increase in treatment time duration per fraction.The probable result could be associated with the decrease of biological equivalent dose to point A. Clinical