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Sample records for internal radiation therapy

  1. Modeling Internal Radiation Therapy

    NARCIS (Netherlands)

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

    2011-01-01

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

  2. Internal radiation dosimetry in radionuclide therapy

    International Nuclear Information System (INIS)

    Kim, Kyeong Min; Lim, Sang Moo

    2006-01-01

    Radionuclide therapy has been continued for treatment of incurable diseases for past decades. Relevant evaluation of absorbed dose in radionuclide therapy in important to predict treatment output and essential for making treatment planning to prevent unexpected radiation toxicity. Many scientists in the field related with nuclear medicine have made effort to evolve concept and technique for internal radiation dosimetry. In this review, basic concept of internal radiation dosimetry if described and recent progress in method for dosimetry is introduced

  3. Nursing care update: Internal radiation therapy

    International Nuclear Information System (INIS)

    Lowdermilk, D.L.

    1990-01-01

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

  4. Selective internal radiation therapy for liver tumours.

    Science.gov (United States)

    Sundram, Francis X; Buscombe, John R

    2017-10-01

    Primary and secondary liver malignancies are common and associated with a poor prognosis. Surgical resection is the treatment of choice; however, many patients have unresectable disease. In these cases, several liver directed therapies are available, including selective internal radiation therapy (SIRT). SIRT is a multidisciplinary treatment involving nuclear medicine, interventional radiology and oncology. High doses of localised internal radiation are selectively delivered to liver tumour tissues, with relative sparing of adjacent normal liver parenchyma. Side effects are minimal and radiation protection measures following treatment are straightforward. In patients who have progressed following chemotherapy, clinical trials demonstrate prolonged liver progression-free survival. SIRT is offered at 10 centres in England via the NHS England Commissioning through Evaluation programme and is approved by the National Institute for Health and Care Excellence for certain liver malignancies. SIRT holds unique promise for personalised treatment of liver tumours. © Royal College of Physicians 2017. All rights reserved.

  5. Y90 selective internal radiation therapy.

    Science.gov (United States)

    Lee, Edward W; Thakor, Avnesh S; Tafti, Bashir A; Liu, David M

    2015-01-01

    Primary liver malignancies and liver metastases are affecting millions of individuals worldwide. Because of their late and advanced stage presentation, only 10% of patients can receive curative surgical treatment, including transplant or resection. Alternative treatments, such as systemic chemotherapy, ablative therapy, and chemoembolization, have been used with marginal survival benefits. Selective internal radiation therapy (SIRT), also known as radioembolization, is a compelling alternative treatment option for primary and metastatic liver malignancies with a growing body of evidence. In this article, an introduction to SIRT including background, techniques, clinical outcomes, and complications is reviewed. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Liver cancer and selective internal radiation therapy

    International Nuclear Information System (INIS)

    Sutton, C.

    2002-01-01

    Liver cancer is the biggest cancer-related killer of adults in the world. Liver cancer can be considered as two types: primary and secondary (metastatic). Selective Internal Radiation Therapy (SIRT) is a revolutionary treatment for advanced liver cancer that utilises new technologies designed to deliver radiation directly to the site of tumours. SIRT, on the other hand, involves the delivery of millions of microscopic radioactive spheres called SIR-Spheres directly to the site of the liver tumour/s, where they selectively irradiate the tumours. The anti-cancer effect is concentrated in the liver and there is little effect on cancer at other sites such as the lungs or bones. The SIR-Spheres are delivered through a catheter placed in the femoral artery of the upper thigh and threaded through the hepatic artery (the major blood vessel of the liver) to the site of the tumour. The microscopic spheres, each approximately 35 microns (the size of four red blood cells or one-third the diameter of a strand of hair), are bonded to yttrium-90 (Y-90), a pure beta emitter with a physical half-life of 64.1 hours (about 2.67 days). The microspheres are trapped in the tumour's vascular bed, where they destroy the tumour from inside. The average range of the radiation is only 2.5 mm, so it is wholly contained within the patient's body; after 14 days, only 2.5 percent of the radioactive activity remains. The microspheres are suspended in water for injection. The vials are shipped in lead shields for radiation protection. Treatment with SIR-Spheres is generally not regarded as a cure, but has been shown to shrink the cancer more than chemotherapy alone. This can increase life expectancy and improve quality of life. On occasion, patients treated with SIR-Spheres have had such marked shrinkage of the liver cancer that the cancer can be surgically removed at a later date. This has resulted in a long-term cure for some patients. SIRTeX Medical Limited has developed three separate cancer

  7. Selective internal radiation therapy for liver malignancies.

    Science.gov (United States)

    Moir, J A G; Burns, J; Barnes, J; Colgan, F; White, S A; Littler, P; Manas, D M; French, J J

    2015-11-01

    Selective internal radiation therapy (SIRT) is a non-ablative technique for the treatment of liver primaries and metastases, with the intention of reducing tumour bulk. This study aimed to determine optimal patient selection, and elucidate its role as a downsizing modality. Data were collected retrospectively on patients who underwent SIRT between 2011 and 2014. The procedure was performed percutaneously by an expert radiologist. Response was analysed in two categories, based on radiological (CT/MRI according to Response Evaluation Criteria In Solid Tumours (RECIST)) and biological (α-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9, chromogranin A) parameters. Forty-four patients were included. Liver metastases from colorectal cancer (22 patients) and hepatocellular carcinoma (HCC) (9) were the most common pathologies. Radiological response data were collected from 31 patients. A reduction in sum of diameters (SOD) was observed in patients with HCC (median -24.1 (95 per cent c.i. -43.4 to -3.8) per cent) and neuroendocrine tumours (-30.0 (-45.6 to -7.7) per cent), whereas a slight increase in SOD was seen in patients with colorectal cancer (4.9 (-10.6 to 55.3) per cent). Biological response was assessed in 17 patients, with a reduction in 12, a mixed response in two and no improvement in three. Six- and 12-month overall survival rates were 71 and 41 per cent respectively. There was no difference in overall survival between the RECIST response groups (median survival 375, 290 and 214 days for patients with a partial response, stable disease and progressive disease respectively; P = 0.130), or according to primary pathology (P = 0.063). Seven patients underwent liver resection with variable responses after SIRT. SIRT may be used to downsize tumours and may be used as a bridge to surgery in patients with tumours deemed borderline for resection. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  8. Radiation Therapy for Cancer

    Science.gov (United States)

    ... material placed in the body near cancer cells ( internal radiation therapy , also called brachytherapy ). Systemic radiation therapy uses radioactive ... material placed in the body near cancer cells (internal radiation therapy, more commonly called brachytherapy). Systemic radiation therapy uses ...

  9. An international intercomparison of absorbed dose measurements for radiation therapy

    International Nuclear Information System (INIS)

    Taiman Kadni; Noriah Mod Ali

    2002-01-01

    Dose intercomparison on an international basis has become an important component of quality assurance measurement i.e. to check the performance of absorbed dose measurements in radiation therapy. The absorbed dose to water measurements for radiation therapy at the SSDL, MINT have been regularly compared through international intercomparison programmes organised by the IAEA Dosimetry Laboratory, Seibersdorf, Austria such as IAEA/WHO TLD postal dose quality audits and the Intercomparison of therapy level ionisation chamber calibration factors in terms of air kerma and absorbed dose to water calibration factors. The results of these intercomparison in terms of percentage deviations for Cobalt 60 gamma radiation and megavoltage x-ray from medical linear accelerators participated by the SSDL-MINT during the year 1985-2001 are within the acceptance limit. (Author)

  10. Radiation therapy. 1990-2001. International Atomic Energy Agency publications

    International Nuclear Information System (INIS)

    2001-04-01

    This catalog lists all sales publications of the International Atomic Energy Agency dealing with Radiation Therapy, and issued during the period 1 January 1990 - 30 April 2001. Most publications are issued in English, though some are also available in other languages. These are noted in the catalogue

  11. Enhanced radiation therapy with internalized polyelectrolyte modified nanoparticles

    Science.gov (United States)

    Zhang, Peipei; Qiao, Yong; Wang, Chaoming; Ma, Liyuan; Su, Ming

    2014-08-01

    A challenge of X-ray radiation therapy is that high dose X-ray under therapeutic conditions damages normal cells. This paper describes a nanoparticle-based method to enhance X-ray radiation therapy by delivering radio-sensitizing gold nanoparticles into cancer cells. The nanoparticles have been modified with cationic polyelectrolytes to allow internalization. Upon X-ray irradiation of nanoparticles, more photoelectrons and Auger electrons are generated to cause water ionization, leading to formation of free radicals that damage DNA of cancer cells. The X-ray dose required for DNA damage and cell killing is reduced by delivering gold nanoparticles inside cancer cells.

  12. Radiation Therapy

    Science.gov (United States)

    ... radiation may be external, from special machines, or internal, from radioactive substances that a doctor places inside your body. The type of radiation therapy you receive depends on many factors, including The ...

  13. What to Know about Brachytherapy (A Type of Internal Radiation Therapy)

    Science.gov (United States)

    ... What To Know About Brachytherapy (A Type of Internal Radiation Therapy) “I asked questions. My doctor took the time ... most. Understanding Radiation Therapy: Brachytherapy (A Type of Internal Radiation Therapy) Types of brachytherapy: Low-dose rate (LDR) implants ...

  14. Internal radiation therapy: a neglected aspect of nuclear medicine in the molecular era.

    Science.gov (United States)

    Lin, Yansong

    2015-09-01

    With increasing evidence, internal radiation therapy, also known as brachytherapy, has become a neglected aspect of nuclear medicine in the molecular era. In this paper, recent developments regarding internal radiation therapy, including developments in radioiodine-131 ((131)I) and thyroid, radioimmunotherapy (RIT) for non-Hodgkin lymphoma (NHL), and radiopharmaceuticals for bone metastases. Relevant differences and status of their applications in China were mentioned as well. These molecular mediated internal radiation therapies are gaining increasing importance by providing palliative and curative treatments for an increasing number of diseases and becoming one of the important parts of molecular nuclear medicine.

  15. Combination of internal radiation therapy and hyperthermia to treat liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Grady, E.D.; McLaren, J.; Auda, S.P.; McGinley, P.H.

    1983-09-01

    Sixteen patients were treated for liver cancer (primary and metastatic) by a combination of internal radiation therapy with intra-arterial yttrium 90 microspheres and regional hyperthermia with electromagnetic radiation. Four patients have their liver disease apparently controlled; two had a partial regression of more than 50%; and two had a partial regression of less than 50%. The complications consisted of one case of radiation hepatitis and one of peptic ulcer.

  16. Prognostic factors for prediction of survival of hepatocellular cancer patients after selective internal radiation therapy.

    Science.gov (United States)

    Soydal, Cigdem; Keskin, Onur; Kucuk, Ozlem N; Ozkan, Elgin; Bilgic, Sadik; Idilman, Ramazan; Kir, Metin K

    2015-06-01

    In this study, it was aimed to explore the prognostic factors in patients who received selective internal radiation therapy for hepatocellular cancer. A retrospective evaluation was made of 28 (24 male, 4 female, mean age 65.4 ± 6.8 years) hepatocellular cancer patients who received selective internal radiation therapy with Y-90 resin microspheres. Using Cox proportional hazards regression analysis, the relationship between age, gender, MELD score, serum albumin and AFP levels, number of liver lesions, size of the largest lesion, absence of (18)F-FDG uptake, maximum standardized uptake value and overall survival times was analyzed. Treatment was applied to the right lobe in 22 and both in 6 patients. Mean treatment dose was 1.5 ± 0.2 GBq. Number of liver lesions were 1, internal radiation therapy.

  17. Prevention and treatment of complications of selective internal radiation therapy: Expert guidance and systematic review.

    Science.gov (United States)

    Sangro, Bruno; Martínez-Urbistondo, Diego; Bester, Lourens; Bilbao, Jose I; Coldwell, Douglas M; Flamen, Patrick; Kennedy, Andrew; Ricke, Jens; Sharma, Ricky A

    2017-09-01

    Selective internal radiation therapy (or radioembolization) by intra-arterial injection of radioactive yttrium-90-loaded microspheres is increasingly used for the treatment of patients with liver metastases or primary liver cancer. The high-dose beta-radiation penetrates an average of only 2.5 mm from the source, thus limiting its effects to the site of delivery. However, the off-target diversion of yttrium-90 microspheres to tissues other than the tumor may lead to complications. The most prominent of these complications include radiation gastritis and gastrointestinal ulcers, cholecystitis, radiation pneumonitis, and radioembolization-induced liver disease, which may occur despite careful pretreatment planning. Thus, selective internal radiation therapy demands an expert multidisciplinary team approach in order to provide comprehensive care for patients. This review provides recommendations to multidisciplinary teams on the optimal medical processes in order to ensure the safe delivery of selective internal radiation therapy. Based on the best available published evidence and expert opinion, we recommend the most appropriate strategies for the prevention, early diagnosis, and management of potential radiation injury to the liver and to other organs. (Hepatology 2017;66:969-982). © 2017 by the American Association for the Study of Liver Diseases.

  18. Influence of internal fixation systems on radiation therapy for spinal tumor.

    Science.gov (United States)

    Li, Jingfeng; Yan, Lei; Wang, Jianping; Cai, Lin; Hu, Dongcai

    2015-07-08

    In this study, the influence of internal fixation systems on radiation therapy for spinal tumor was investigated in order to derive a theoretical basis for adjustment of radiation dose for patients with spinal tumor and internal fixation. Based on a common method of internal fixation after resection of spinal tumor, different models of spinal internal fixation were constructed using the lumbar vertebra of fresh domestic pigs and titanium alloy as the internal fixation system. Variations in radiation dose in the vertebral body and partial spinal cord in different types of internal fixation were studied under the same radiation condition (6 MV and 600 mGy) in different fixation models and compared with those irradiated based on the treatment planning system (TPS). Our results showed that spinal internal fixation materials have great impact on the radiation dose absorbed by spinal tumors. Under the same radiation condition, the influence of anterior internal fixation material or combined anterior and posterior approach on radiation dose at the anterior border of the vertebral body was the greatest. Regardless of the kinds of internal fixation method employed, radiation dose at the anterior border of the vertebral body was significantly different from that at other positions. Notably, the influence of posterior internal fixation material on the anterior wall of the vertebral canal was the greatest. X-ray attenuation and scattering should be taken into consideration for most patients with bone metastasis that receive fixation of metal implants. Further evaluation should then be conducted with modified TPS in order to minimize the potentially harmful effects of inappropriate radiation dose.

  19. Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

    NARCIS (Netherlands)

    Lens, Eelco; van der Horst, Astrid; Versteijne, Eva; van Tienhoven, Geertjan; Bel, Arjan

    2015-01-01

    The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were

  20. Modern Radiation Therapy for Hodgkin Lymphoma: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

    Energy Technology Data Exchange (ETDEWEB)

    Specht, Lena, E-mail: lena.specht@regionh.dk [Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Yahalom, Joachim [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Illidge, Tim [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Christie Hospital NHS Trust, Manchester (United Kingdom); Berthelsen, Anne Kiil [Department of Radiation Oncology and PET Centre, Rigshospitalet, University of Copenhagen (Denmark); Constine, Louis S. [Department of Radiation Oncology and Pediatrics, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York (United States); Eich, Hans Theodor [Department of Radiation Oncology, University of Münster (Germany); Girinsky, Theodore [Department of Radiation Oncology, Institut Gustave-Roussy, Villejuif (France); Hoppe, Richard T. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Mauch, Peter [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States); Mikhaeel, N. George [Department of Clinical Oncology and Radiotherapy, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Ng, Andrea [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States)

    2014-07-15

    Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced volumes and doses is addressed, integrating modern imaging with 3-dimensional (3D) planning and advanced techniques of treatment delivery. The previously applied extended field (EF) and original involved field (IF) techniques, which treated larger volumes based on nodal stations, have now been replaced by the use of limited volumes, based solely on detectable nodal (and extranodal extension) involvement at presentation, using contrast-enhanced computed tomography, positron emission tomography/computed tomography, magnetic resonance imaging, or a combination of these techniques. The International Commission on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom optimal imaging is available, is explained. A new concept, involved site radiation therapy (ISRT), is introduced as the standard conformal therapy for the scenario, commonly encountered, wherein optimal imaging is not available. There is increasing evidence that RT doses used in the past are higher than necessary for disease control in this era of combined modality therapy. The use of INRT and of lower doses in early-stage HL is supported by available data. Although the

  1. Modern Radiation Therapy for Hodgkin Lymphoma: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

    International Nuclear Information System (INIS)

    Specht, Lena; Yahalom, Joachim; Illidge, Tim; Berthelsen, Anne Kiil; Constine, Louis S.; Eich, Hans Theodor; Girinsky, Theodore; Hoppe, Richard T.; Mauch, Peter; Mikhaeel, N. George; Ng, Andrea

    2014-01-01

    Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced volumes and doses is addressed, integrating modern imaging with 3-dimensional (3D) planning and advanced techniques of treatment delivery. The previously applied extended field (EF) and original involved field (IF) techniques, which treated larger volumes based on nodal stations, have now been replaced by the use of limited volumes, based solely on detectable nodal (and extranodal extension) involvement at presentation, using contrast-enhanced computed tomography, positron emission tomography/computed tomography, magnetic resonance imaging, or a combination of these techniques. The International Commission on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom optimal imaging is available, is explained. A new concept, involved site radiation therapy (ISRT), is introduced as the standard conformal therapy for the scenario, commonly encountered, wherein optimal imaging is not available. There is increasing evidence that RT doses used in the past are higher than necessary for disease control in this era of combined modality therapy. The use of INRT and of lower doses in early-stage HL is supported by available data. Although the

  2. Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG).

    Science.gov (United States)

    Specht, Lena; Yahalom, Joachim; Illidge, Tim; Berthelsen, Anne Kiil; Constine, Louis S; Eich, Hans Theodor; Girinsky, Theodore; Hoppe, Richard T; Mauch, Peter; Mikhaeel, N George; Ng, Andrea

    2014-07-15

    Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced volumes and doses is addressed, integrating modern imaging with 3-dimensional (3D) planning and advanced techniques of treatment delivery. The previously applied extended field (EF) and original involved field (IF) techniques, which treated larger volumes based on nodal stations, have now been replaced by the use of limited volumes, based solely on detectable nodal (and extranodal extension) involvement at presentation, using contrast-enhanced computed tomography, positron emission tomography/computed tomography, magnetic resonance imaging, or a combination of these techniques. The International Commission on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom optimal imaging is available, is explained. A new concept, involved site radiation therapy (ISRT), is introduced as the standard conformal therapy for the scenario, commonly encountered, wherein optimal imaging is not available. There is increasing evidence that RT doses used in the past are higher than necessary for disease control in this era of combined modality therapy. The use of INRT and of lower doses in early-stage HL is supported by available data. Although the

  3. Modern Radiation Therapy for Extranodal Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    International Nuclear Information System (INIS)

    Yahalom, Joachim; Illidge, Tim; Specht, Lena; Hoppe, Richard T.; Li, Ye-Xiong; Tsang, Richard; Wirth, Andrew

    2015-01-01

    Extranodal lymphomas (ENLs) comprise about a third of all non-Hodgkin lymphomas (NHL). Radiation therapy (RT) is frequently used as either primary therapy (particularly for indolent ENL), consolidation after systemic therapy, salvage treatment, or palliation. The wide range of presentations of ENL, involving any organ in the body and the spectrum of histological sub-types, poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies. This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians. Thus far there is a lack of guidelines for the use of RT in the management of ENL. This report presents an effort by the International Lymphoma Radiation Oncology Group (ILROG) to harmonize and standardize the principles of treatment of ENL, and to address the technical challenges of simulation, volume definition and treatment planning for the most frequently involved organs. Specifically, detailed recommendations for RT volumes are provided. We have applied the same modern principles of involved site radiation therapy as previously developed and published as guidelines for Hodgkin lymphoma and nodal NHL. We have adopted RT volume definitions based on the International Commission on Radiation Units and Measurements (ICRU), as has been widely adopted by the field of radiation oncology for solid tumors. Organ-specific recommendations take into account histological subtype, anatomy, the treatment intent, and other treatment modalities that may be have been used before RT

  4. International Patterns of Practice in the Management of Radiation Therapy-induced Nausea and Vomiting

    Energy Technology Data Exchange (ETDEWEB)

    Dennis, Kristopher; Zhang Liying [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Lutz, Stephen [Blanchard Valley Health Systems, Findlay, Ohio (United States); Baardwijk, Angela van [Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Linden, Yvette van der [Leiden University Medical Center, Leiden (Netherlands); Holt, Tanya [Radiation Oncology Mater Centre, Princess Alexandra Hospital, Brisbane (Australia); Arnalot, Palmira Foro [Parc de Salut Mar. Universitat Pompeu Fabra Barcelona (Spain); Lagrange, Jean-Leon [AP-HP Hopital Henri-Mondor, Universite Paris Est Creteil, Creteil (France); Maranzano, Ernesto [' S. Maria' Hospital, Terni (Italy); Liu, Rico [Queen Mary Hospital, Hong Kong (China); Wong, Kam-Hung [Queen Elizabeth Hospital, Hong Kong (Hong Kong); Wong, Lea-Choung [National University Cancer Institute (Singapore); Vassiliou, Vassilios [Bank of Cyprus Oncology Centre, Nicosia (Cyprus); Corn, Benjamin W. [Tel Aviv Medical Center, Tel Aviv (Israel); De Angelis, Carlo; Holden, Lori; Wong, C. Shun [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To investigate international patterns of practice in the management of radiation therapy-induced nausea and vomiting (RINV). Methods and Materials: Oncologists prescribing radiation therapy in the United States, Canada, The Netherlands, Australia, New Zealand, Spain, Italy, France, Hong Kong, Singapore, Cyprus, and Israel completed a Web-based survey that was based on 6 radiation therapy-only clinical cases modeled after the minimal-, low-, moderate-, and high-emetic risk levels defined in the antiemetic guidelines of the American Society of Clinical Oncology and the Multinational Association of Supportive Care in Cancer. For each case, respondents estimated the risks of nausea and vomiting separately and committed to an initial management approach. Results: In total, 1022 responses were received. Risk estimates and management decisions for the minimal- and high-risk cases varied little and were in line with guideline standards, whereas those for the low- and moderate-risk cases varied greatly. The most common initial management strategies were as follows: rescue therapy for a minimal-risk case (63% of respondents), 2 low-risk cases (56% and 80%), and 1 moderate-risk case (66%); and prophylactic therapy for a second moderate-risk case (75%) and a high-risk case (95%). The serotonin (5-HT){sub 3} receptor antagonists were the most commonly recommended prophylactic agents. On multivariate analysis, factors predictive of a decision for prophylactic or rescue therapy were risk estimates of nausea and vomiting, awareness of the American Society of Clinical Oncology antiemetic guideline, and European Society for Therapeutic Radiology and Oncology membership. Conclusions: Risk estimates and management strategies for RINV varied, especially for low- and moderate-risk radiation therapy cases. Radiation therapy-induced nausea and vomiting are under-studied treatment sequelae. New observational and translational studies are needed to allow for individual patient risk

  5. International Patterns of Practice in the Management of Radiation Therapy-induced Nausea and Vomiting

    International Nuclear Information System (INIS)

    Dennis, Kristopher; Zhang Liying; Lutz, Stephen; Baardwijk, Angela van; Linden, Yvette van der; Holt, Tanya; Arnalot, Palmira Foro; Lagrange, Jean-Léon; Maranzano, Ernesto; Liu, Rico; Wong, Kam-Hung; Wong, Lea-Choung; Vassiliou, Vassilios; Corn, Benjamin W.; De Angelis, Carlo; Holden, Lori; Wong, C. Shun; Chow, Edward

    2012-01-01

    Purpose: To investigate international patterns of practice in the management of radiation therapy-induced nausea and vomiting (RINV). Methods and Materials: Oncologists prescribing radiation therapy in the United States, Canada, The Netherlands, Australia, New Zealand, Spain, Italy, France, Hong Kong, Singapore, Cyprus, and Israel completed a Web-based survey that was based on 6 radiation therapy-only clinical cases modeled after the minimal-, low-, moderate-, and high-emetic risk levels defined in the antiemetic guidelines of the American Society of Clinical Oncology and the Multinational Association of Supportive Care in Cancer. For each case, respondents estimated the risks of nausea and vomiting separately and committed to an initial management approach. Results: In total, 1022 responses were received. Risk estimates and management decisions for the minimal- and high-risk cases varied little and were in line with guideline standards, whereas those for the low- and moderate-risk cases varied greatly. The most common initial management strategies were as follows: rescue therapy for a minimal-risk case (63% of respondents), 2 low-risk cases (56% and 80%), and 1 moderate-risk case (66%); and prophylactic therapy for a second moderate-risk case (75%) and a high-risk case (95%). The serotonin (5-HT) 3 receptor antagonists were the most commonly recommended prophylactic agents. On multivariate analysis, factors predictive of a decision for prophylactic or rescue therapy were risk estimates of nausea and vomiting, awareness of the American Society of Clinical Oncology antiemetic guideline, and European Society for Therapeutic Radiology and Oncology membership. Conclusions: Risk estimates and management strategies for RINV varied, especially for low- and moderate-risk radiation therapy cases. Radiation therapy-induced nausea and vomiting are under-studied treatment sequelae. New observational and translational studies are needed to allow for individual patient risk

  6. Radiation therapy

    International Nuclear Information System (INIS)

    Bader, J.L.; Glatstein, E.

    1987-01-01

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

  7. Radiation microsphere-induced GI ulcers after selective internal radiation therapy for hepatic tumors: an underrecognized clinical entity.

    Science.gov (United States)

    Konda, Amulya; Savin, Michael A; Cappell, Mitchell S; Duffy, Michael C

    2009-09-01

    Intra-arterial infusion of yttrium-90 (Y-90) microspheres is locoregional radiation therapy for unresectable hepatic neoplasms. Literature on GI complications of this novel therapy is sparse. Clinically and pictorially characterize selective internal radiation therapy (SIRT)-induced GI injury and review the published literature. Retrospective chart analysis. Single-center tertiary referral community hospital. One hundred three patients treated with SIRT for hepatic neoplasms between 2006 and 2008. SIRT for unresectable hepatic neoplasms followed by upper endoscopy with biopsy in symptomatic patients. GI ulcers after SIRT. Five patients with suspected GI injury after SIRT were identified. Significant postprocedural symptoms included nausea/vomiting, odynophagia, hematemesis, and melena. Radiation ulcers occurred mostly in the gastric antrum, pylorus, and duodenum. Biopsy specimens of ulcer margins in 4 patients showed pathognomonic radiation microspheres. Angiographic review of the fifth patient revealed a previously unrecognized arterial branch supplying the corresponding region of GI ulceration noted on endoscopy. Small retrospective study and follow-up limited by terminal disease states in most patients. The reported incidence of GI complications after SIRT for hepatic neoplasia varies from 3% to 24% of patients. Incidence can be minimized by strict adherence to published SIRT protocols. Diagnosis requires a high degree of clinical suspicion along with endoscopy and biopsy of ulcer margins. Characteristic radiation microspheres in biopsy specimens are pathognomonic. Gastroenterologists and pathologists must be cognizant of this complication.

  8. A Prospective Cohort Study of Gated Stereotactic Liver Radiation Therapy Using Continuous Internal Electromagnetic Motion Monitoring

    DEFF Research Database (Denmark)

    Worm, Esben S; Høyer, Morten; Hansen, Rune

    2018-01-01

    PURPOSE: Intrafraction motion can compromise the treatment accuracy in liver stereotactic body radiation therapy (SBRT). Respiratory gating can improve treatment delivery; however, gating based on external motion surrogates is inaccurate. The present study reports the use of Calypso-based internal.......0 percentage points (range 0.7-22.0) without gating and 0.8 percentage point (range 0.2-2.0) with gating. CONCLUSIONS: Gating using internal motion monitoring was successfully applied for liver SBRT. It markedly improved the geometric and dosimetric accuracy compared with nongated standard treatment....

  9. Radiation Therapy for Primary Cutaneous Anaplastic Large Cell Lymphoma: An International Lymphoma Radiation Oncology Group Multi-institutional Experience

    International Nuclear Information System (INIS)

    Million, Lynn; Yi, Esther J.; Wu, Frank; Von Eyben, Rie; Campbell, Belinda A.; Dabaja, Bouthaina; Tsang, Richard W.; Ng, Andrea; Wilson, Lynn D.; Ricardi, Umberto; Kirova, Youlia; Hoppe, Richard T.

    2016-01-01

    Purpose: To collect response rates of primary cutaneous anaplastic large cell lymphoma, a rare cutaneous T-cell lymphoma, to radiation therapy (RT), and to determine potential prognostic factors predictive of outcome. Methods and Materials: The study was a retrospective analysis of patients with primary cutaneous anaplastic large cell lymphoma who received RT as primary therapy or after surgical excision. Data collected include initial stage of disease, RT modality (electron/photon), total dose, fractionation, response to treatment, and local recurrence. Radiation therapy was delivered at 8 participating International Lymphoma Radiation Oncology Group institutions worldwide. Results: Fifty-six patients met the eligibility criteria, and 63 tumors were treated: head and neck (27%), trunk (14%), upper extremities (27%), and lower extremities (32%). Median tumor size was 2.25 cm (range, 0.6-12 cm). T classification included T1, 40 patients (71%); T2, 12 patients (21%); and T3, 4 patients (7%). The median radiation dose was 35 Gy (range, 6-45 Gy). Complete clinical response (CCR) was achieved in 60 of 63 tumors (95%) and partial response in 3 tumors (5%). After CCR, 1 tumor recurred locally (1.7%) after 36 Gy and 7 months after RT. This was the only patient to die of disease. Conclusions: Primary cutaneous anaplastic large cell lymphoma is a rare, indolent cutaneous lymphoma with a low death rate. This analysis, which was restricted to patients selected for treatment with radiation, indicates that achieving CCR was independent of radiation dose. Because there were too few failures (<2%) for statistical analysis on dose response, 30 Gy seems to be adequate for local control, and even lower doses may suffice.

  10. Current perspectives of radiation therapy. History of radiation therapy

    International Nuclear Information System (INIS)

    Itami, Jun

    2011-01-01

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

  11. Selective internal radiation therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma

    International Nuclear Information System (INIS)

    Welsh, James S.; Kennedy, Andrew S.; Thomadsen, Bruce

    2006-01-01

    Introduction: Selective internal radiation therapy (SIRT) is a relatively new commercially available microbrachytherapy technique for treatment of malignant hepatic lesions using 9 Y embedded in resin microspheres, which are infused directly into the hepatic arterial circulation. It is FDA approved for liver metastases secondary to colorectal carcinoma and is under investigation for treatment of other liver malignancies, such as hepatocellular carcinoma and neuroendocrine malignancies. Materials/Methods: A modest number of clinical trials, preclinical animal studies, and dosimetric studies have been reported. Here we review several of the more important results. Results: High doses of beta radiation can be selectively delivered to tumors, resulting in impressive local control and survival rates. Ex vivo analyses have shown that microspheres preferentially cluster around the periphery of tumor nodules with a high tumor:normal tissue ratio of up to 200:1. Toxicity is usually mild, featuring fatigue, anorexia, nausea, abdominal discomfort, and slight elevations of liver function tests. Conclusions: Selective internal radiation therapy represents an effective means of controlling liver metastases from colorectal adenocarcinoma. Clinical trials have demonstrated improved local control of disease and survival with relatively low toxicity. Investigations of SIRT for other hepatic malignancies and in combination with newer chemotherapy agents and targeted biologic therapies are under way or in planning. A well-integrated team involving interventional radiology, nuclear medicine, medical oncology, surgical oncology, medical physics, and radiation oncology is essential for a successful program. Careful selection of patients through the combined expertise of the team can maximize therapeutic efficacy and reduce the potential for adverse effects

  12. Enhancing Nanoparticle Accumulation and Retention in Desmoplastic Tumors via Vascular Disruption for Internal Radiation Therapy.

    Science.gov (United States)

    Satterlee, Andrew B; Rojas, Juan D; Dayton, Paul A; Huang, Leaf

    2017-01-01

    Aggressive, desmoplastic tumors are notoriously difficult to treat because of their extensive stroma, high interstitial pressure, and resistant tumor microenvironment. We have developed a combination therapy that can significantly slow the growth of large, stroma-rich tumors by causing massive apoptosis in the tumor center while simultaneously increasing nanoparticle uptake through a treatment-induced increase in the accumulation and retention of nanoparticles in the tumor. The vascular disrupting agent Combretastatin A-4 Phosphate (CA4P) is able to increase the accumulation of radiation-containing nanoparticles for internal radiation therapy, and the retention of these delivered radioisotopes is maintained over several days. We use ultrasound to measure the effect of CA4P in live tumor-bearing mice, and we encapsulate the radio-theranostic isotope 177 Lutetium as a therapeutic agent as well as a means to measure nanoparticle accumulation and retention in the tumor. This combination therapy induces prolonged apoptosis in the tumor, decreasing both the fibroblast and total cell density and allowing further tumor growth inhibition using a cisplatin-containing nanoparticle.

  13. Radiation therapy -- skin care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000735.htm Radiation therapy - skin care To use the sharing features on ... should treat your skin with care while receiving radiation therapy. Causes External radiation therapy uses high-powered x- ...

  14. Effects of Yttrium-90 selective internal radiation therapy on non-conventional liver tumors.

    Science.gov (United States)

    Kuei, Andrew; Saab, Sammy; Cho, Sung-Ki; Kee, Stephen T; Lee, Edward Wolfgang

    2015-07-21

    The liver is a common site of metastasis, with essentially all metastatic malignancies having been known to spread to the liver. Nearly half of all patients with extrahepatic primary cancer have hepatic metastases. The severe prognostic implications of hepatic metastases have made surgical resection an important first line treatment in management. However, limitations such as the presence of extrahepatic spread or poor functional hepatic reserve exclude the majority of patients as surgical candidates, leaving chemotherapy and locoregional therapies as next best options. Selective internal radiation therapy (SIRT) is a form of catheter-based locoregional cancer treatment modality for unresectable tumors, involving trans-arterial injection of microspheres embedded with a radio-isotope Yttrium-90. The therapeutic radiation dose is selectively delivered as the microspheres permanently embed themselves within the tumor vascular bed. Use of SIRT has been conventionally aimed at treating primary hepatic tumors (hepatocellular carcinoma) or colorectal and neuroendocrine metastases. Numerous reviews are available for these tumor types. However, little is known or reviewed on non-colorectal or non-neuroendocrine primaries. Therefore, the aim of this paper is to systematically review the current literature to evaluate the effects of Yttrium-90 radioembolization on non-conventional liver tumors including those secondary to breast cancer, cholangiocarcinoma, ocular and percutaneous melanoma, pancreatic cancer, renal cell carcinoma, and lung cancer.

  15. Oesophageal ulceration after selective internal radiation therapy in a patient with carcinoma of unknown primary.

    Science.gov (United States)

    Kubisch, C H; Beigel, F; Ihrler, S; Goke, B; Reiser, M F; Hoffmann, R T

    2010-05-01

    Cancer of unknown primary (CUP) is defined as histologically confirmed metastases in the absence of an identifiable primary tumor. Patients with solely liver metastases from adenocarinomas represent the most frequent subgroup with an unfavourable prognosis. The medium survival averages 6 to 9 months. No chemotherapheutic standard has been established. We present a patient with hepatic CUP. After cycles of chemotherapy and hemihepatectomy the tumor returned and showed hepatic progression. The patient was evaluated for selective internal radiation therapy (SIRT). Three years after diagnosis she is still alive and tumorfree. Despite a good result and disease control our patient suffered radiation-induced ulceration in the oesophagus, stomach, and duodenum. This side effect appears in up to 12 % of patients, often very late after treatment, is refractory to pharmacotherapy and persistent over a long time. SIRT is a new, effective treatment in patients with hepatic CUP. Because of the anticipated increase of this therapy, adverse side effects such as ulcerations in the upper-GI tract secondary to ectopic implantation of microspheres may be seen more commonly. Awareness of this and the recognition of microspheres in biopsies is cardinal for appropriate management and maintenance of the patient's quality of life.

  16. Radiation Therapy

    Science.gov (United States)

    ... kill any cancer cells that remain. Lifetime Dose Limits There is a limit to the amount of radiation an area of ... total dose of radiation more quickly or to limit damage to healthy cells. Different ways of delivering ...

  17. A computational tool for patient specific dosimetry and radiobiological modeling of selective internal radiation therapy with (90)Y microspheres.

    Science.gov (United States)

    Kalantzis, Georgios; Leventouri, Theodora; Apte, Aditiya; Shang, Charles

    2015-11-01

    In recent years we have witnessed tremendous progress in selective internal radiation therapy. In clinical practice, quite often, radionuclide therapy is planned using simple models based on standard activity values or activity administered per unit body weight or surface area in spite of the admission that radiation-dose methods provide more accurate dosimetric results. To address that issue, the authors developed a Matlab-based computational software, named Patient Specific Yttrium-90 Dosimetry Toolkit (PSYDT). PSYDT was designed for patient specific voxel-based dosimetric calculations and radiobiological modeling of selective internal radiation therapy with (90)Y microspheres. The developed toolkit is composed of three dimensional dose calculations for both bremsstrahlung and beta emissions. Subsequently, radiobiological modeling is performed on a per-voxel basis and cumulative dose volume histograms (DVHs) are generated. In this report we describe the functionality and visualization features of PSYDT. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Gaps in Radiation Therapy Awareness: Results From an Educational Multi-institutional Survey of US Internal Medicine Residents.

    Science.gov (United States)

    Shaverdian, Narek; Yoo, Sun Mi; Cook, Ryan; Chang, Eric M; Jiang, Naomi; Yuan, Ye; Sandler, Kiri; Steinberg, Michael; Lee, Percy

    2017-08-01

    Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents. A web-based institutional review board-approved multi-institutional survey was distributed to US internal medicine residency programs. The survey evaluated trainee demographic characteristics, baseline radiation oncology awareness, knowledge of the role of SBRT for early-stage NSCLC, and whether the survey successfully improved awareness. Thirty US internal medicine programs participated, with an overall participant response rate of 46% (1177 of 2551). Of the trainees, 93% (n=1076) reported no radiation oncology education in their residency, 39% (n=452) reported confidence in knowing when to consult radiation oncology in an oncologic emergency, and 26% (n=293) reported confidence in knowing when to consult radiation oncology in the setting of a newly diagnosed cancer. Of the participants, 76% (n=850) correctly identified that surgical resection is the standard treatment in operable early-stage NSCLC, but only 50% (n=559) of participants would recommend SBRT to a medically inoperable patient, followed by 31% of participants (n=347) who were unsure of the most appropriate treatment, and 10% (n=117) who recommended waiting to offer palliative therapy. Ninety percent of participants (n=1029) agreed that they would benefit from further training on when to consult radiation oncology. Overall, 96% (n=1072) indicated that the survey increased their knowledge and awareness of the role of SBRT. The majority of participating trainees received no education in radiation oncology in their residency, reported a lack of confidence regarding when to consult radiation oncology, and overwhelmingly agreed that they would benefit from further training. These findings

  19. [Radiation therapy for malignant tumors].

    Science.gov (United States)

    Murakami, Shumei; Konishi, Koji

    2008-04-01

    Radiation therapy uses ionizing radiation to kill cancer cells and shrink tumors, with consideration to minimize harmful damages to health tissues. About 30% of all people with cancer are treated with radiation therapy, either alone or in combination with chemotherapy. Radiation therapy may be internal or external. In brachytheraphy as the internal radiation therapy the radioisotope is implanted into or near the tumor by tubes as the container. And it is often used for patients with the tongue cancer. External radiation, the type most often used, comes from a machine outside the body. It is usually used for shrinking tumors with bony invasions such as gingival cancer and improving the pain in patients with bony metastasis. For the primary bone tumor the radiation therapy is not always used because the radiosensitivity of the almost primary bone tumor is low.

  20. Theranostic Nanoseeds for Efficacious Internal Radiation Therapy of Unresectable Solid Tumors

    Science.gov (United States)

    Moeendarbari, Sina; Tekade, Rakesh; Mulgaonkar, Aditi; Christensen, Preston; Ramezani, Saleh; Hassan, Gedaa; Jiang, Ruiqian; Öz, Orhan K.; Hao, Yaowu; Sun, Xiankai

    2016-02-01

    Malignant tumors are considered “unresectable” if they are adhere to vital structures or the surgery would cause irreversible damages to the patients. Though a variety of cytotoxic drugs and radiation therapies are currently available in clinical practice to treat such tumor masses, these therapeutic modalities are always associated with substantial side effects. Here, we report an injectable nanoparticle-based internal radiation source that potentially offers more efficacious treatment of unresectable solid tumors without significant adverse side effects. Using a highly efficient incorporation procedure, palladium-103, a brachytherapy radioisotope in clinical practice, was coated to monodispersed hollow gold nanoparticles with a diameter about 120 nm, to form 103Pd@Au nanoseeds. The therapeutic efficacy of 103Pd@Au nanoseeds were assessed when intratumorally injected into a prostate cancer xenograft model. Five weeks after a single-dose treatment, a significant tumor burden reduction (>80%) was observed without noticeable side effects on the liver, spleen and other organs. Impressively, >95% nanoseeds were retained inside the tumors as monitored by Single Photon Emission Computed Tomography (SPECT) with the gamma emissions of 103Pd. These findings show that this nanoseed-based brachytherapy has the potential to provide a theranostic solution to unresectable solid tumors.

  1. Selective internal radiation therapy in patients with progressive neuroendocrine liver metastases.

    Science.gov (United States)

    Barbier, Charlotte Ebeling; Garske-Román, Ulrike; Sandström, Mattias; Nyman, Rickard; Granberg, Dan

    2016-07-01

    To evaluate the safety and efficacy of selective internal radiation therapy (SIRT) in patients with unresectable liver metastases from neuroendocrine tumours (NETLMs). This retrospective study included 40 patients with progressive NETLMs (22 women, 18 men, mean age 61.6 years) who underwent SIRT with (90)Y-labelled resin microspheres. Tumour response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) on CT or MR images. Medical records were reviewed. In the 40 patients, 54 evaluable SIRT procedures were performed, 33 to the right liver lobe (mean activity 1.31 GBq), 13 to the left lobe (mean activity 0.85 GBq), and 8 to both lobes (mean activity 1.61 GBq). Late follow-up imaging (mean 20 months) was performed after 44 of the treatments. Objective tumour response and disease control rates were 54 % (29 of 54 treatments) and 94 % (51 treatments), respectively, at the early follow-up examination (mean 3 months) and 34 % (15 treatments) and 57 % (25 treatments), respectively at the late follow-up examination. Mean overall survival from the first SIRT was 34,8 months and survival rates at 1, 2, 3 and 5 years were 76 %, 59 %, 52 % and 35 % respectively. Adverse effects were generally mild and easily manageable, except in one patient who died from radiation-induced liver failure. Of the 45 patients, 18 (45 %) had received peptide receptor radionuclide therapy (PRRT) prior to SIRT. SIRT with (90)Y-labelled resin microspheres is a safe and effective treatment for patients with progressive NETLM, and also for those who have received prior PRRT.

  2. Radiation Therapy Planning for Early-Stage Hodgkin Lymphoma: Experience of the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Maraldo, Maja V., E-mail: dra.maraldo@gmail.com [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Dabaja, Bouthaina S. [Department of Radiation Oncology, MD Anderson Cancer Center, Texas (United States); Filippi, Andrea R. [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Illidge, Tim [Department of Oncology, Christie Hospital, Manchester (United Kingdom); Tsang, Richard [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ricardi, Umberto [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Petersen, Peter M.; Schut, Deborah A. [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Garcia, John [Department of Radiation Oncology, MD Anderson Cancer Center, Texas (United States); Headley, Jayne [Department of Oncology, Christie Hospital, Manchester (United Kingdom); Parent, Amy; Guibord, Benoit [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ragona, Riccardo [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Specht, Lena [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark)

    2015-05-01

    Purpose: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements, planning parameters, and estimated doses to the critical organs at risk (OARs). Methods: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30.6 Gy. A postchemotherapy computed tomography scan with precontoured clinical target volume (CTV) and OARs was provided for each patient. The treatment technique and planning methods were chosen according to each center's best practice in 2013. Results: Seven patients had mediastinal disease, 2 had axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3-dimensional conformal RT (2-4 fields). The variations in CTV-to-planning target volume margins (5-15 mm), maximum tolerated dose (31.4-40 Gy), and plan conformity (conformity index 0-3.6) were significant. However, estimated doses to OARs were comparable between centers for each patient. Conclusions: RT planning for HL is challenging because of the heterogeneity in size and location of disease and, additionally, to the variation in choice of treatment techniques and field arrangements. Adopting ILROG guidelines and implementing universal dose objectives could further standardize treatment techniques and contribute to lowering the dose to the surrounding OARs.

  3. Steps towards an individual treatment planning with the internal dosimetry of 18F-FDG as example for nuclear diagnostics and perspectives for internal radiation therapy

    International Nuclear Information System (INIS)

    Blaickner, M.

    2005-01-01

    Full text: Moving towards a more individual treatment planning, the studies below describe the perspectives and methods both in nuclear diagnostics and in internal radiation therapy. With 18 F-FDG as example in nuclear diagnostics, a more precise estimation of the effective dose to the patient is achieved by the calculation of physiognomy-dependent S-values. This project is a work in progress and the results are expected soon. Additionally the future possibilities of individual treatment planning in internal radiation therapy, such as the use of β-nuclide pairs and the potentials of combining CT and PET, are outlined. (author)

  4. XVII International Conference on the Use of Computers in Radiation Therapy (ICCR 2013)

    Science.gov (United States)

    2014-03-01

    Editorial Dear colleagues, From a professional perspective there is nothing quite as enjoyable as attending a good conference with colleagues that share not only interest for the same topic but also a similar vision for their field of work. Proceedings cannot replace the direct contact and lively conversations between participants who are at the same time at the same place sharing ideas and discussion. However, proceedings complement the actual conference by 1. giving the ideas, research findings and debates which characterise the conference lasting presence 2. giving participants an opportunity to refresh their memory about issues they would like to follow up on and 3. providing an opportunity for others who were not able to attend the meeting to share in the thoughts and issues discussed at the conference. For the proceedings of the International Conferences on the Use of Computers in Radiation Therapy (ICCR) all this has been important in the past as the high citation rates for ICCR proceedings show. We hope that also the present proceedings will appeal to participants and others who are interested in cancer and ways to treat patients affected by it. It is exciting to note that what sounded like a small niche field (''Computers in Radiation Therapy'') has become a very broad forum to discuss all aspects of cancer diagnosis and therapy. Of particular interest for the 17th ICCR have been data and how to collect, organise and use it effectively. This is relevant for most areas in medicine and we believe that radiation therapy with its focus on evidence based practice and measurable and standardised activities has an important and possibly leading role to play. The 100 manuscripts combined in the present proceedings can hopefully contribute to this. The proceedings are organised into five different streams which reflect the foci of the conference: • Dose Calculation • Imaging for treatment planning and Motion Management • Treatment planning and optimisation

  5. Conformal external beam radiation or selective internal radiation therapy-a comparison of treatment outcomes for hepatocellular carcinoma.

    Science.gov (United States)

    Oladeru, Oluwadamilola T; Miccio, Joseph A; Yang, Jie; Xue, Yaqi; Ryu, Samuel; Stessin, Alexander M

    2016-06-01

    Non-operative treatment for hepatocellular carcinoma (HCC) has expanded significantly with the use of selective internal radiotherapy (SIRT) mostly with yttrium 90 ((90)Y) tagged microspheres and highly conformal external beam radiation therapy such as stereotactic body radiotherapy (SBRT) to treat unresectable liver tumors for local tumor control. SBRT is a noninvasive procedure using external radiation source under image guidance, while SIRT delivers radioactive particles by transarterial radioembolization (TARE). However, the survival benefits of SBRT versus SIRT have never been compared. The aim of the present study is to compare the outcomes of overall and disease specific survival (DSS) using SIRT versus SBRT to treat HCC. The Surveillance, Epidemiology, and End Results (SEER) registry database [2004-2011] was queried for cases of unresectable HCC. Patients with missing data and those who received surgery were excluded from the study. A total of 189 patients with unresectable HCC were identified and used for statistical analysis, with 112 receiving SBRT and 77 receiving SIRT. Overall and disease-specific survival was compared using multivariable cox proportional hazard models. After adjusting for confounding factors (age at diagnosis, gender, race, grade, stage, AFP level and type of surgery), there were no significant difference in overall survival (OS) [hazard ratio (HR), 0.72; 95% confidence interval (CI), 0.49-1.07; P=0.1077] and DSS (HR, 0.70; 95% CI, 0.46-1.05; P=0.0880) for SIRT compared to SBRT. However, patients with elevated AFP level were associated with higher death risk (P=0.0459) and disease specific death risk (P=0.0233) than those with AFP within normal limits in both treatment groups. The retrospective analysis serves as the first comparison of SIRT to SBRT in treatment of unresectable HCC. Our findings suggest both treatment approaches result in similar outcomes in overall and disease-specific survival benefit. Future prospective randomized

  6. Basophilic round bodies in gastric biopsies little known by pathologists: iatrogenic yttrium 90 microspheres deriving from selective internal radiation therapy.

    Science.gov (United States)

    Luo, Dong-Lan; Chan, John K C

    2013-10-01

    Selective internal radiation therapy is a relatively new technique that irradiates primary and metastatic liver cancer using yttrium 90 microspheres. Increasing reports have shown this to be a useful treatment for unresectable primary hepatocellular carcinoma and others metastases from colon, lung, breast, sarcoma, and ocular melanoma. On the other hand, more and more therapy-related complications have been described. Since the morphologic description of injured organs are relatively uncommon, we report 2 cases of selective internal radiation therapy-related gastric injury, which represent basophilic round bodies in gastric biopsies little known by pathologists. The appearances in esophagogastroduodenoscopy include gastrointestinal ulcer, edema, and bleeding. Histological findings are mucosal atrophy, mild to moderate cytologic atypia, edema of the stroma, and inflammatory infiltration. The most characteristic feature is the presence of round blue and dark microspheres in the stromal blood vessels.

  7. Pilot randomized trial of selective internal radiation therapy vs. chemoembolization in unresectable hepatocellular carcinoma.

    Science.gov (United States)

    Kolligs, Frank T; Bilbao, Jose I; Jakobs, Tobias; Iñarrairaegui, Mercedes; Nagel, Jutta M; Rodriguez, Macarena; Haug, Alexander; D'Avola, Delia; op den Winkel, Mark; Martinez-Cuesta, Antonio; Trumm, Christoph; Benito, Alberto; Tatsch, Klaus; Zech, Christoph J; Hoffmann, Ralf-Thorsten; Sangro, Bruno

    2015-06-01

    To compare selective internal radiation therapy (SIRT) with transarterial chemoembolization (TACE), the standard-of-care for intermediate-stage unresectable, hepatocellular carcinoma (HCC), as first-line treatment. SIRTACE was an open-label multicenter randomized-controlled pilot study, which prospectively compared primarily safety and health-related quality of life (HRQoL) changes following TACE and SIRT. Patients with unresectable HCC, Child-Pugh ≤B7, ECOG performance status ≤2 and ≤5 liver lesions (≤20 cm total maximum diameter) without extrahepatic spread were randomized to receive either TACE (at 6-weekly intervals until tumour enhancement was not observed on MRI or disease progression) or single-session SIRT (yttrium-90 resin microspheres). Twenty-eight patients with BCLC stage A (32.1%), B (46.4%) or C (21.4%) received either a mean of 3.4 (median 2) TACE interventions (N = 15) or single SIRT (N = 13). Both treatments were well tolerated. Despite SIRT patients having significantly worse physical functioning at baseline, at week-12, neither treatment had a significantly different impact on HRQoL as measured by Functional Assessment of Cancer Therapy-Hepatobiliary total or its subscales. Both TACE and SIRT were effective for the local control of liver tumours. Best overall response-rate (RECIST 1.0) of target lesions were 13.3% and 30.8%, disease control rates were 73.3% and 76.9% for TACE and SIRT, respectively. Two patients in each group were down-staged for liver transplantation (N = 3) or radiofrequency ablation (N = 1). Single-session SIRT appeared to be as safe and had a similar impact on HRQoL as multiple sessions of TACE, suggesting that SIRT might be an alternative option for patients eligible for TACE. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Delineation of Internal Mammary Nodal Target Volumes in Breast Cancer Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jethwa, Krishan R.; Kahila, Mohamed M. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Hunt, Katie N. [Department of Radiology, Mayo Clinic, Rochester, Minnesota (United States); Brown, Lindsay C.; Corbin, Kimberly S.; Park, Sean S.; Yan, Elizabeth S. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Boughey, Judy C. [Department of Surgery, Mayo Clinic, Rochester, Minnesota (United States); Mutter, Robert W., E-mail: mutter.robert@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2017-03-15

    Purpose: The optimal clinical target volume for internal mammary (IM) node irradiation is uncertain in an era of increasingly conformal volume-based treatment planning for breast cancer. We mapped the location of gross internal mammary lymph node (IMN) metastases to identify areas at highest risk of harboring occult disease. Methods and Materials: Patients with axial imaging of IMN disease were identified from a breast cancer registry. The IMN location was transferred onto the corresponding anatomic position on representative axial computed tomography images of a patient in the treatment position and compared with consensus group guidelines of IMN target delineation. Results: The IMN location in 67 patients with 130 IMN metastases was mapped. The location was in the first 3 intercostal spaces in 102 of 130 nodal metastases (78%), whereas 18 of 130 IMNs (14%) were located caudal to the third intercostal space and 10 of 130 IMNs (8%) were located cranial to the first intercostal space. Of the 102 nodal metastases within the first 3 intercostal spaces, 54 (53%) were located within the Radiation Therapy Oncology Group consensus volume. Relative to the IM vessels, 19 nodal metastases (19%) were located medially with a mean distance of 2.2 mm (SD, 2.9 mm) whereas 29 (28%) were located laterally with a mean distance of 3.6 mm (SD, 2.5 mm). Ninety percent of lymph nodes within the first 3 intercostal spaces would have been encompassed within a 4-mm medial and lateral expansion on the IM vessels. Conclusions: In women with indications for elective IMN irradiation, a 4-mm medial and lateral expansion on the IM vessels may be appropriate. In women with known IMN involvement, cranial extension to the confluence of the IM vein with the brachiocephalic vein with or without caudal extension to the fourth or fifth interspace may be considered provided that normal tissue constraints are met.

  9. Delineation of Internal Mammary Nodal Target Volumes in Breast Cancer Radiation Therapy.

    Science.gov (United States)

    Jethwa, Krishan R; Kahila, Mohamed M; Hunt, Katie N; Brown, Lindsay C; Corbin, Kimberly S; Park, Sean S; Yan, Elizabeth S; Boughey, Judy C; Mutter, Robert W

    2017-03-15

    The optimal clinical target volume for internal mammary (IM) node irradiation is uncertain in an era of increasingly conformal volume-based treatment planning for breast cancer. We mapped the location of gross internal mammary lymph node (IMN) metastases to identify areas at highest risk of harboring occult disease. Patients with axial imaging of IMN disease were identified from a breast cancer registry. The IMN location was transferred onto the corresponding anatomic position on representative axial computed tomography images of a patient in the treatment position and compared with consensus group guidelines of IMN target delineation. The IMN location in 67 patients with 130 IMN metastases was mapped. The location was in the first 3 intercostal spaces in 102 of 130 nodal metastases (78%), whereas 18 of 130 IMNs (14%) were located caudal to the third intercostal space and 10 of 130 IMNs (8%) were located cranial to the first intercostal space. Of the 102 nodal metastases within the first 3 intercostal spaces, 54 (53%) were located within the Radiation Therapy Oncology Group consensus volume. Relative to the IM vessels, 19 nodal metastases (19%) were located medially with a mean distance of 2.2 mm (SD, 2.9 mm) whereas 29 (28%) were located laterally with a mean distance of 3.6 mm (SD, 2.5 mm). Ninety percent of lymph nodes within the first 3 intercostal spaces would have been encompassed within a 4-mm medial and lateral expansion on the IM vessels. In women with indications for elective IMN irradiation, a 4-mm medial and lateral expansion on the IM vessels may be appropriate. In women with known IMN involvement, cranial extension to the confluence of the IM vein with the brachiocephalic vein with or without caudal extension to the fourth or fifth interspace may be considered provided that normal tissue constraints are met. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Ra-224 for internal radiation therapy of spondylitis ankylosans (Bechterew's disease) - an alternative for chemotherapy

    International Nuclear Information System (INIS)

    Gloebel, B.

    1985-01-01

    For therapy of spondylitis ankylosans (Sp. a.) nowadays Ra-224 of high radionuclide purity in a dosage of 280 μCi total activity should be given a place beside the non-steroidal antirheumatic drugs. With comparable therapeutic efficacy and risk this substance has the advantage of improving the patients' quality of life without the relatively frequent and strained side effects of drug therapy. However, Ra-224 therapy has still a psychological disadvantage resulting from less positive experience with peteosthor therapy and application of external X-ray radiation. Ra-224 therapy is very safe concerning dosage by the physician, compared to drug therapy an overdosage by the patient is impossible. In future a comparison between Ra-224 therapy and peteosthor therapy performed with false indication and overdosage should be avoided. After careful examination of the type of the disease including a bone scan for evaluating the potential therapeutic success, up to now after application of Ra-224 of high radionuclide purity no severe side effects could be reported. (orig.) [de

  11. Hendee's radiation therapy physics

    CERN Document Server

    Pawlicki, Todd; Starkschall, George

    2016-01-01

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

  12. Intrahepatic cholangiocarcinoma in a transplant liver--selective internal radiation therapy followed by right hemihepatectomy: report of a case.

    Science.gov (United States)

    Sperling, Jens; Justinger, Christoph; Schuld, Jochen; Ziemann, Christian; Seidel, Roland; Kollmar, Otto

    2014-07-01

    Intra- or extrahepatic cholangiocarcinomas are the second most common primary liver malignancies behind hepatocellular carcinoma. Whereas the incidence for intrahepatic cholangiocarcinoma is rising, the occurrence of extrahepatic cholangiocarcinoma is trending downwards. The treatment of choice for intrahepatic cholangiocarcinoma remains liver resection. However, a case of liver resection after selective internal radiation therapy in order to treat a recurrent intrahepatic cholangiocarcinoma in a transplant liver is unknown in the literature so far. Herein, we present a case of a patient undergoing liver transplantation for Wilson's disease with an accidental finding of an intrahepatic cholangiocarcinoma within the explanted liver. Due to a recurrent intrahepatic cholangiocarcinoma after liver transplantation, a selective internal radiation therapy with yttrium-90 microspheres was performed followed by right hemihepatectomy. Four years later, the patient is tumor-free and in a healthy condition.

  13. A Report on Health Resource Use in Internal Radiation Therapy with Radium Chloride (223Ra) (2nd Survey).

    Science.gov (United States)

    Kinuya, Seigo; Kato, Katsuhiko; Kamioka, Takeshi; Shimmura, Toshiyuki; Matoba, Yoshinori; Ito, Kengo

    2017-01-01

    Internal radiation therapy using radium ( 223 Ra) chloride injection ( 223 Ra injection) is already being applied in actual clinical practice, however the NHI medical technical fee for the use of 223 Ra injection has not yet been set. The Japanese Society of Nuclear Medicine surveyed health resource use for internal radiation therapy using 223 Ra via questionnaires sent to medical institutions that have used 223 Ra injection. Results showed that the necessary cost per patient is 1,005,567 JPY, based on the Draft Proposal for Medical Examination Value (Ver. 7.1) of the Japanese Health Insurance Federation for Surgery. 223 Ra injection is supposed to be administered 6 times to each patient at 4-week intervals, and the fee per treatment was calculated to be 167,595 JPY. The appropriate NHI medical technical fee is thus considered to be 16,759 points per patient per treatment, which can be claimed 6 times per patient.

  14. Selective internal radiation therapy compared with sorafenib for hepatocellular carcinoma with portal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Edeline, Julien [Centre Eugene Marquis, Medical Oncology Department, Rennes (France); Inserm UMR991, Rennes (France); Crouzet, Laurence; Pracht, Marc; Boucher, Eveline [Centre Eugene Marquis, Medical Oncology Department, Rennes (France); Campillo-Gimenez, Boris [Centre Eugene Marquis, Clinical Research Department, Rennes (France); Rolland, Yan; Rohou, Tanguy [Centre Eugene Marquis, Imaging Department, Rennes (France); Guillygomarc' h, Anne [CHU Pontchaillou, Hepatology Department, Rennes (France); Boudjema, Karim [CHU Pontchaillou, Hepatobiliary Surgery, Rennes (France); Lenoir, Laurence [Centre Eugene Marquis, Nuclear Medicine Department, Rennes (France); Adhoute, Xavier [Hopital Saint-Joseph, Hepato-Gastroenterology Department, Marseille (France); Clement, Bruno [Inserm UMR991, Rennes (France); Blanc, Jean-Frederic [Hopital Saint-Andre, Hepato-Gastroenterology Department, Bordeaux (France); Garin, Etienne [Inserm UMR991, Rennes (France); Centre Eugene Marquis, Nuclear Medicine Department, Rennes (France)

    2016-04-15

    Tumoural portal vein thrombosis (PVT) is a major prognostic factor in hepatocellular carcinoma (HCC). The efficacy of sorafenib, the only treatment approved at an advanced stage, is limited. Based on previous data, selective internal radiation therapy (SIRT), or {sup 90}Y radioembolization, seems an interesting option. We aimed to compare both treatments in this population. We retrospectively compared patients treated in two centres for HCC with tumoural PVT. We compared overall survival (OS) between patients treated with SIRT and patients treated with sorafenib. Analyses were performed before and after 1:1 matching with a propensity score for controlling indication bias, using a Cox proportional hazards model. A total of 151 patients were analysed, 34 patients treated with SIRT and 117 patients treated with sorafenib only. In the whole population, SIRT was associated with a higher median OS as compared with sorafenib: 18.8 vs 6.5 months (log-rank p < 0.001). There was an imbalance of baseline characteristics between patients treated by SIRT and sorafenib, which justified patient matching with use of a propensity score: 24 patients treated with SIRT could be matched with 24 patients treated with sorafenib. OS was estimated with a median of 26.2 vs 8.7 months in patients treated with SIRT vs sorafenib, respectively (log-rank p = 0.054). Before and after patient matching, the adjusted hazard ratio related to treatment by SIRT was estimated at 0.62 [95 % confidence interval (CI) 0.39-0.97] (p = 0.037) and 0.40 (95 % CI 0.19-0.82) (p = 0.013), respectively. SIRT seems more effective than sorafenib in patients presenting with HCC and tumoural PVT. This hypothesis is being tested in prospective randomized trials. (orig.)

  15. Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer.

    Science.gov (United States)

    Lens, Eelco; van der Horst, Astrid; Versteijne, Eva; van Tienhoven, Geertjan; Bel, Arjan

    2015-07-01

    The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were investigated. For each of the 18 patients, 2 treatment plans (25 × 2.0 Gy) were created, 1 using an ITV and 1 using a midV approach. The midV dose distribution was blurred using the respiratory-induced motion from 4-dimensional computed tomography. The resulting planning target volume (PTV) coverage for this blurred dose distribution was analyzed; PTV coverage was required to be at least V95% >98%. In addition, the change in PTV size and the changes in V10Gy, V20Gy, V30Gy, V40Gy, Dmean and D2cc for the stomach and for the duodenum were analyzed; differences were tested for significance using the Wilcoxon signed-rank test. Using a midV approach resulted in sufficient target coverage. A highly significant PTV size reduction of 13.9% (P<.001) was observed. Also, all dose parameters for the stomach and duodenum, except the D2cc of the duodenum, improved significantly (P≤.002). By using the midV approach to account for respiratory-induced tumor motion, a significant PTV reduction and significant dose reductions to the stomach and to the duodenum can be achieved when irradiating pancreatic tumors. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Selective internal radiation therapy of hepatic tumours: is coiling of the gastroduodenal artery always beneficial?

    Science.gov (United States)

    Schelhorn, J; Theysohn, J; Ertle, J; Schlaak, J F; Mueller, S; Bockisch, A; Lauenstein, T

    2014-05-01

    To assess the effect of gastroduodenal artery (GDA) occlusion prior to selective internal radiation therapy (SIRT) with regards to arterial hepato-intestinal collateralization (HIC). Six hundred and six patients were scheduled for SIRT between 2006 and 2012 at University Hospital Essen, Germany. Digital subtraction angiography (DSA) followed by administration of 99m-technetium labelled human serum albumin microspheres ((99m)Tc-HSAM) and single-photon emission computed tomography combined with computed tomography (SPECT/CT) was initially performed. Depending on vascular anatomy and hepatic tumour load, GDA coil embolization was considered. In subsequent (99m)Tc-HSAM rescans or therapeutic DSA, HIC and its consequences for SIRT were analysed. The GDA was occluded in 86 of 606 patients (14%). Twenty-two of these 86 patients did not undergo SIRT due to the patients' clinical status or SIRT contraindications. In 28 of the remaining 64 patients, newly apparent or reopened HIC were seen either at the site of the proximal GDA (n = 21) or in the periphery of the hepatic arteries (n = 7). In 25 of these 28 patients, the HIC could be occluded or the catheter position could be changed achieving a safe (90)Y application. However, due to the newly visible HIC in three of 28 patients, SIRT was regarded as unsafe and was abandoned. Coil embolization of the GDA may induce arterial hepato-intestinal collaterals. Although most of these collaterals do not impede (90)Y administration, SIRT may become unfeasible in specific occasions. Hence, segmental or lobar SIRT instead of a whole-liver approach with coiling of the GDA is recommended. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Selective internal radiation therapy compared with sorafenib for hepatocellular carcinoma with portal vein thrombosis.

    Science.gov (United States)

    Edeline, Julien; Crouzet, Laurence; Campillo-Gimenez, Boris; Rolland, Yan; Pracht, Marc; Guillygomarc'h, Anne; Boudjema, Karim; Lenoir, Laurence; Adhoute, Xavier; Rohou, Tanguy; Boucher, Eveline; Clément, Bruno; Blanc, Jean-Frédéric; Garin, Etienne

    2016-04-01

    Tumoural portal vein thrombosis (PVT) is a major prognostic factor in hepatocellular carcinoma (HCC). The efficacy of sorafenib, the only treatment approved at an advanced stage, is limited. Based on previous data, selective internal radiation therapy (SIRT), or (90)Y radioembolization, seems an interesting option. We aimed to compare both treatments in this population. We retrospectively compared patients treated in two centres for HCC with tumoural PVT. We compared overall survival (OS) between patients treated with SIRT and patients treated with sorafenib. Analyses were performed before and after 1:1 matching with a propensity score for controlling indication bias, using a Cox proportional hazards model. A total of 151 patients were analysed, 34 patients treated with SIRT and 117 patients treated with sorafenib only. In the whole population, SIRT was associated with a higher median OS as compared with sorafenib: 18.8 vs 6.5 months (log-rank p < 0.001). There was an imbalance of baseline characteristics between patients treated by SIRT and sorafenib, which justified patient matching with use of a propensity score: 24 patients treated with SIRT could be matched with 24 patients treated with sorafenib. OS was estimated with a median of 26.2 vs 8.7 months in patients treated with SIRT vs sorafenib, respectively (log-rank p = 0.054). Before and after patient matching, the adjusted hazard ratio related to treatment by SIRT was estimated at 0.62 [95 % confidence interval (CI) 0.39-0.97] (p = 0.037) and 0.40 (95 % CI 0.19-0.82) (p = 0.013), respectively. SIRT seems more effective than sorafenib in patients presenting with HCC and tumoural PVT. This hypothesis is being tested in prospective randomized trials.

  18. Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

    International Nuclear Information System (INIS)

    Lens, Eelco; Horst, Astrid van der; Versteijne, Eva; Tienhoven, Geertjan van; Bel, Arjan

    2015-01-01

    Purpose: The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were investigated. Methods and Materials: For each of the 18 patients, 2 treatment plans (25 × 2.0 Gy) were created, 1 using an ITV and 1 using a midV approach. The midV dose distribution was blurred using the respiratory-induced motion from 4-dimensional computed tomography. The resulting planning target volume (PTV) coverage for this blurred dose distribution was analyzed; PTV coverage was required to be at least V 95% >98%. In addition, the change in PTV size and the changes in V 10Gy , V 20Gy , V 30Gy , V 40Gy , D mean and D 2cc for the stomach and for the duodenum were analyzed; differences were tested for significance using the Wilcoxon signed-rank test. Results: Using a midV approach resulted in sufficient target coverage. A highly significant PTV size reduction of 13.9% (P<.001) was observed. Also, all dose parameters for the stomach and duodenum, except the D 2cc of the duodenum, improved significantly (P≤.002). Conclusions: By using the midV approach to account for respiratory-induced tumor motion, a significant PTV reduction and significant dose reductions to the stomach and to the duodenum can be achieved when irradiating pancreatic tumors

  19. Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lens, Eelco, E-mail: e.lens@amc.uva.nl; Horst, Astrid van der; Versteijne, Eva; Tienhoven, Geertjan van; Bel, Arjan

    2015-07-01

    Purpose: The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were investigated. Methods and Materials: For each of the 18 patients, 2 treatment plans (25 × 2.0 Gy) were created, 1 using an ITV and 1 using a midV approach. The midV dose distribution was blurred using the respiratory-induced motion from 4-dimensional computed tomography. The resulting planning target volume (PTV) coverage for this blurred dose distribution was analyzed; PTV coverage was required to be at least V{sub 95%} >98%. In addition, the change in PTV size and the changes in V{sub 10Gy}, V{sub 20Gy}, V{sub 30Gy}, V{sub 40Gy}, D{sub mean} and D{sub 2cc} for the stomach and for the duodenum were analyzed; differences were tested for significance using the Wilcoxon signed-rank test. Results: Using a midV approach resulted in sufficient target coverage. A highly significant PTV size reduction of 13.9% (P<.001) was observed. Also, all dose parameters for the stomach and duodenum, except the D{sub 2cc} of the duodenum, improved significantly (P≤.002). Conclusions: By using the midV approach to account for respiratory-induced tumor motion, a significant PTV reduction and significant dose reductions to the stomach and to the duodenum can be achieved when irradiating pancreatic tumors.

  20. Gastric Perforation Following Prophylactic Embolization of Right Gastric and Gastroduodenal Arteries Prior to Selective Internal Radiation Therapy.

    Science.gov (United States)

    Shukla, Pratik A; Ahuja, Jitesh; Kurli, Vineel; Patel, Rajesh I; Kozuch, Peter S

    2015-12-01

    Prophylactic gastroduodenal artery (GDA) and right gastric artery (RGA) embolization for prevention of gastric ulceration in patients with hepatic metastases from colorectal cancer undergoing Selective Internal Radiation Therapy (SIRT) are relatively safe. Herein, we present a case of gastric perforation following prophylactic embolization of the GDA and RGA for SIRT in a 43-year-old male with sigmoid colon adenocarcinoma and multiple hepatic metastases.

  1. Radiation therapy of cancer

    International Nuclear Information System (INIS)

    Tomottogoo, G.

    1995-01-01

    The radiation therapy experienced at the hospital are classified into two sections:palliative and radically. A radically therapy can be done before or after surgery. Therapy after surgery is done when the results of the surgery have certain limits. The radiation therapy is accomplished within 2-3 weeks and 6 weeks at latest. A conclusion:1.To improving and increasing of radically radiation therapy method is necessary in the present time. 2.Monitoring, management and supervision capacity of the cancer radiation therapy for the nearest and future results should be strengthened

  2. Respiratory gating based on internal electromagnetic motion monitoring during stereotactic liver radiation therapy: First results.

    Science.gov (United States)

    Poulsen, Per Rugaard; Worm, Esben Schjødt; Hansen, Rune; Larsen, Lars Peter; Grau, Cai; Høyer, Morten

    2015-01-01

    Intrafraction motion may compromise the target dose in stereotactic body radiation therapy (SBRT) of tumors in the liver. Respiratory gating can improve the treatment delivery, but gating based on an external surrogate signal may be inaccurate. This is the first paper reporting on respiratory gating based on internal electromagnetic monitoring during liver SBRT. Two patients with solitary liver metastases were treated with respiratory-gated SBRT guided by three implanted electromagnetic transponders. The treatment was delivered in end-exhale with beam-on when the centroid of the three transponders deviated less than 3 mm [left-right (LR) and anterior-posterior (AP) directions] and 4mm [cranio-caudal (CC)] from the planned position. For each treatment fraction, log files were used to determine the transponder motion during beam-on in the actual gated treatments and in simulated treatments without gating. The motion was used to reconstruct the dose to the clinical target volume (CTV) with and without gating. The reduction in D95 (minimum dose to 95% of the CTV) relative to the plan was calculated for both treatment courses. With gating the maximum course mean (standard deviation) geometrical error in any direction was 1.2 mm (1.8 mm). Without gating the course mean error would mainly increase for Patient 1 [to -2.8 mm (1.6 mm) (LR), 7.1 mm (5.8 mm) (CC), -2.6 mm (2.8mm) (AP)] due to a large systematic cranial baseline drift at each fraction. The errors without gating increased only slightly for Patient 2. The reduction in CTV D95 was 0.5% (gating) and 12.1% (non-gating) for Patient 1 and 0.3% (gating) and 1.7% (non-gating) for Patient 2. The mean duty cycle was 55%. Respiratory gating based on internal electromagnetic motion monitoring was performed for two liver SBRT patients. The gating added robustness to the dose delivery and ensured a high CTV dose even in the presence of large intrafraction motion.

  3. A Prospective Cohort Study of Gated Stereotactic Liver Radiation Therapy Using Continuous Internal Electromagnetic Motion Monitoring.

    Science.gov (United States)

    Worm, Esben S; Høyer, Morten; Hansen, Rune; Larsen, Lars P; Weber, Britta; Grau, Cai; Poulsen, Per R

    2018-02-13

    Intrafraction motion can compromise the treatment accuracy in liver stereotactic body radiation therapy (SBRT). Respiratory gating can improve treatment delivery; however, gating based on external motion surrogates is inaccurate. The present study reports the use of Calypso-based internal electromagnetic motion monitoring for gated liver SBRT. Fifteen patients were included in a study of 3-fraction respiratory gated liver SBRT guided by 3 implanted electromagnetic transponders. The planning target volume was created by a 5-mm axial and 7-mm (n = 12) or 10-mm (n = 3) craniocaudal expansion of the clinical target volume (CTV) and covered with 67% of the prescribed CTV mean dose. Treatment was gated to the end-exhale phase of the respiratory cycle with beam-on when the target deviated 1 to 2 mm occurred. Log files of transponder motion were used to determine the geometric error and reconstruct the delivered CTV dose in the actual gated treatments and in simulated nongated treatments. No severe side effects were observed in relation to transponder implantation. All 45 treatment fractions were successfully guided using the Calypso system. The mean number of couch corrections during each gated fraction was 2.8 (range 0-7). The mean duty cycle during gated treatment was 62.5% (range 29.1%-84.9%). Without gating, the mean 3-dimensional geometric error during a fraction would have been 5.4 mm (range 2.7-12.1). Gating reduced this error to 2.0 mm (range 1.2-3.0). The patient mean reduction in minimum dose to 95% of the CTV relative to the planned dose was 6.0 percentage points (range 0.7-22.0) without gating and 0.8 percentage point (range 0.2-2.0) with gating. Gating using internal motion monitoring was successfully applied for liver SBRT. It markedly improved the geometric and dosimetric accuracy compared with nongated standard treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Synthesis and in vitro evaluation of radioiodinated indolequinones targeting NAD(P)H: quinone oxidoreductase 1 for internal radiation therapy.

    Science.gov (United States)

    Sasaki, Junichi; Sano, Kohei; Hagimori, Masayori; Yoshikawa, Mai; Maeda, Minoru; Mukai, Takahiro

    2014-11-01

    quinone oxidoreductase 1 (NQO1) is an obligate two-electron reductase and is highly expressed in many human solid cancers. Because NQO1 can be induced immediately after exposure to ionizing radiation, we aimed to develop an NQO1-targeted radiolabeled agent to establish a novel internal radiation therapy that amplifies the therapeutic effects when combined with external radiation therapy. We designed three NQO1-targeted radioiodinated compounds including two ether linkage compounds ([(125)I]1 and [(125)I]2) and a sulfide linkage compound ([(125)I]3) based on the selective binding of indolequinone analogs to the active site of NQO1 by the stacking effect. These compounds were successfully prepared using an oxidative iododestannylation reaction with high radiochemical yields and purity. In NQO1-expressing tumor cells, [(125)I]1 and [(125)I]2 were readily metabolized to p-[(125)I]iodophenol or m-[(125)I]iodophenol and [(125)I]I(-), whereas over 85% of the initial radioactivity of [(125)I]3 was observed as an intact form at 1h after incubation. The cellular uptake of [(125)I]3 was significantly higher than those of [(125)I]1 and [(125)I]2. The uptake of [(125)I]3 was specific and was dependent on the expression of NQO1. These data suggest that the novel NQO1-targeted radioiodinated compound [(125)I]3 could be used as a novel internal radiation agent for the treatment of cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    DEFF Research Database (Denmark)

    Illidge, Tim; Specht, Lena; Yahalom, Joachim

    2014-01-01

    Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning...... tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles...... of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT...

  6. Safety of selective internal radiation therapy (SIRT) with yttrium-90 microspheres combined with systemic anticancer agents: expert consensus.

    Science.gov (United States)

    Kennedy, Andrew; Brown, Daniel B; Feilchenfeldt, Jonas; Marshall, John; Wasan, Harpreet; Fakih, Marwan; Gibbs, Peter; Knuth, Alexander; Sangro, Bruno; Soulen, Michael C; Pittari, Gianfranco; Sharma, Ricky A

    2017-12-01

    Selective internal radiation therapy (SIRT) with microspheres labelled with the β-emitter yttrium-90 (Y-90) enables targeted delivery of radiation to hepatic tumors. SIRT is primarily used to treat inoperable primary or metastatic liver tumors. Eligible patients have usually been exposed to a variety of systemic anticancer therapies, including cytotoxic agents, targeted biologics, immunotherapy and peptide receptor radionuclide therapy (PRRT). All these treatments have potential interactions with SIRT; however, robust evidence on the safety of these potential combinations is lacking. This paper provides current clinical experiences and expert consensus guidelines for the use of SIRT in combination with the anticancer treatment agents likely to be encountered in clinical practice. It was agreed by the expert panel that precautions need to be taken with certain drugs, but that, in general, systemic therapies do not necessarily have to be stopped to perform SIRT. The authors recommend stopping vascular endothelial growth factor inhibitors 4-6 weeks before SIRT, and restart after the patient has recovered from the procedure. It may also be prudent to stop potent radiosensitizers such as gemcitabine therapy 4 weeks before SIRT, and restart treatment at least 2‒4 weeks later. Data from phase III studies combining SIRT with fluorouracil (5FU) or folinic acid/5FU/oxaliplatin (FOLFOX) suggest that hematological toxicity is more common from the combination than it is from chemotherapy without SIRT. There is no evidence to suggest that chemotherapy increases SIRT-specific gastro-intestinal or liver toxicities.

  7. Prospective study to determine early hypertrophy of the contra-lateral liver lobe after unilobar, Yttrium-90, selective internal radiation therapy in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Teo, Jin Yao; Allen, John Carson; Ng, David Chee Eng; Abdul Latiff, Julianah Bee; Choo, Su Pin; Tai, David Wai-Meng; Low, Albert Su Chong; Cheah, Foong Koon; Chang, Jason Pik Eu; Kam, Juinn Huar; Lee, Victor T W; Chung, Alexander Yaw Fui; Chan, Chung Yip; Chow, Pierce Kah Hoe; Goh, Brian K P

    2018-01-03

    Liver resection is a major curative option in patients presenting with hepatocellular carcinoma. An inadequate functional liver remnant is a major limiting factor precluding liver resection. In recent years, hypertrophy of the functional liver remnant after selective internal radiation therapy hypertrophy has been observed, but the degree of hypertrophy in the early postselective internal radiation therapy period has not been well studied. We conducted a prospective study on patients undergoing unilobar, Yttrium-90 selective internal radiation therapy for hepatocellular carcinoma to evaluate early hypertrophy at 4-6 weeks and 8-12 weeks after selective internal radiation therapy. In the study, 24 eligible patients were recruited and had serial volumetric measurements performed. The median age was 66 years (38-75 years). All patients were either Child-Pugh Class A or B, and 6/24 patients had documented, clinically relevant portal hypertension; 15 of the 24 patients were hepatitis B positive. At 4-6 weeks, modest hypertrophy was seen (median 3%; range -12 to 42%) and this increased at 8-12 weeks (median 9%; range -12 to 179%). No preprocedural factors predictive of hypertrophy were identified. Hypertrophy of the functional liver remnant after selective internal radiation therapy with Yttrium-90 occurred in a subset of patients but was modest and unpredictable in the early stages. Selective internal radiation therapy cannot be recommended as a standard treatment modality to induce early hypertrophy for patients with hepatocellular carcinoma. (Surgery 2017;160:XXX-XXX.). Copyright © 2017 Elsevier Inc. All rights reserved.

  8. A systematic review of contralateral liver lobe hypertrophy after unilobar selective internal radiation therapy with Y90.

    Science.gov (United States)

    Teo, Jin-Yao; Allen, John C; Ng, David C; Choo, Su-Pin; Tai, David W M; Chang, Jason P E; Cheah, Foong-Khoon; Chow, Pierce K H; Goh, Brian K P

    2016-01-01

    Curative liver resection is the treatment of choice for both primary and secondary liver malignancies. However, an inadequate future liver remnant (FLR) frequently precludes successful surgery. Portal vein embolization is the gold-standard modality for inducing hypertrophy of the FLR. In recent times, unilobar Yttrium-90 selective internal radiation therapy (SIRT) has been reported to induce hypertrophy of the contralateral, untreated liver lobe. The aim of this study is to review the current literature reporting on contralateral liver hypertrophy induced by unilobar SIRT. A systematic review of the English-language literature between 2000 and 2014 was performed using the search terms "Yttrium 90" OR "selective internal radiation therapy" OR "radioembolization" AND "hypertrophy". Seven studies, reporting on 312 patients, were included. Two hundred and eighty four patients (91.0%) received treatment to the right lobe. Two hundred and fifteen patients had hepatocellular carcinoma (HCC), 12 had intrahepatic cholangiocarcinoma, and 85 had liver metastases from mixed primaries. Y90 SIRT resulted in contralateral liver hypertrophy which ranged from 26 to 47% at 44 days-9 months. All studies were retrospective in nature, and heterogeneous, with substantial variations relative to pathology treated, underlying liver disease, dosage and delivery of Y90, number of treatment sessions and time to measurement of hypertrophy. Unilobar Y90 SIRT results in significant hypertrophy of the contralateral liver lobe. The rate of hypertrophy seems to be slower than that achieved by other methods. Copyright © 2015 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  9. Radiation Therapy - Multiple Languages

    Science.gov (United States)

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

  10. Radiation Dose to the Esophagus From Breast Cancer Radiation Therapy, 1943-1996: An International Population-Based Study of 414 Patients

    International Nuclear Information System (INIS)

    Lamart, Stephanie; Stovall, Marilyn; Simon, Steven L.; Smith, Susan A.; Weathers, Rita E.; Howell, Rebecca M.; Curtis, Rochelle E.; Aleman, Berthe M.P.; Travis, Lois; Kwon, Deukwoo; Morton, Lindsay M.

    2013-01-01

    Purpose: To provide dosimetric data for an epidemiologic study on the risk of second primary esophageal cancer among breast cancer survivors, by reconstructing the radiation dose incidentally delivered to the esophagus of 414 women treated with radiation therapy for breast cancer during 1943-1996 in North America and Europe. Methods and Materials: We abstracted the radiation therapy treatment parameters from each patient’s radiation therapy record. Treatment fields included direct chest wall (37% of patients), medial and lateral tangentials (45%), supraclavicular (SCV, 64%), internal mammary (IM, 44%), SCV and IM together (16%), axillary (52%), and breast/chest wall boosts (7%). The beam types used were 60 Co (45% of fields), orthovoltage (33%), megavoltage photons (11%), and electrons (10%). The population median prescribed dose to the target volume ranged from 21 Gy to 40 Gy. We reconstructed the doses over the length of the esophagus using abstracted patient data, water phantom measurements, and a computational model of the human body. Results: Fields that treated the SCV and/or IM lymph nodes were used for 85% of the patients and delivered the highest doses within 3 regions of the esophagus: cervical (population median 38 Gy), upper thoracic (32 Gy), and middle thoracic (25 Gy). Other fields (direct chest wall, tangential, and axillary) contributed substantially lower doses (approximately 2 Gy). The cervical to middle thoracic esophagus received the highest dose because of its close proximity to the SCV and IM fields and less overlying tissue in that part of the chest. The location of the SCV field border relative to the midline was one of the most important determinants of the dose to the esophagus. Conclusions: Breast cancer patients in this study received relatively high incidental radiation therapy doses to the esophagus when the SCV and/or IM lymph nodes were treated, whereas direct chest wall, tangentials, and axillary fields contributed lower doses

  11. SIRveNIB: Selective Internal Radiation Therapy Versus Sorafenib in Asia-Pacific Patients With Hepatocellular Carcinoma.

    Science.gov (United States)

    Chow, Pierce K H; Gandhi, Mihir; Tan, Say-Beng; Khin, Maung Win; Khasbazar, Ariunaa; Ong, Janus; Choo, Su Pin; Cheow, Peng Chung; Chotipanich, Chanisa; Lim, Kieron; Lesmana, Laurentius A; Manuaba, Tjakra W; Yoong, Boon Koon; Raj, Aloysius; Law, Chiong Soon; Cua, Ian H Y; Lobo, Rolley R; Teh, Catherine S C; Kim, Yun Hwan; Jong, Yun Won; Han, Ho-Seong; Bae, Si-Hyun; Yoon, Hyun-Ki; Lee, Rheun-Chuan; Hung, Chien-Fu; Peng, Cheng-Yuan; Liang, Po-Chin; Bartlett, Adam; Kok, Kenneth Y Y; Thng, Choon-Hua; Low, Albert Su-Chong; Goh, Anthony S W; Tay, Kiang Hiong; Lo, Richard H G; Goh, Brian K P; Ng, David C E; Lekurwale, Ganesh; Liew, Wei Ming; Gebski, Val; Mak, Kenneth S W; Soo, Khee Chee

    2018-03-02

    Purpose Selective internal radiation therapy or radioembolization (RE) shows efficacy in unresectable hepatocellular carcinoma (HCC) limited to the liver. This study compared the safety and efficacy of RE and sorafenib in patients with locally advanced HCC. Patients and Methods SIRveNIB (selective internal radiation therapy v sorafenib), an open-label, investigator-initiated, phase III trial, compared yttrium-90 ( 90 Y) resin microspheres RE with sorafenib 800 mg/d in patients with locally advanced HCC in a two-tailed study designed for superiority/detriment. Patients were randomly assigned 1:1 and stratified by center and presence of portal vein thrombosis. Primary end point was overall survival (OS). Efficacy analyses were performed in the intention-to-treat population and safety analyses in the treated population. Results A total of 360 patients were randomly assigned (RE, 182; sorafenib, 178) from 11 countries in the Asia-Pacific region. In the RE and sorafenib groups, 28.6% and 9.0%, respectively, failed to receive assigned therapy without significant cross-over to either group. Median OS was 8.8 and 10.0 months with RE and sorafenib, respectively (hazard ratio, 1.1; 95% CI, 0.9 to 1.4; P = .36). A total of 1,468 treatment-emergent adverse events (AEs) were reported (RE, 437; sorafenib, 1,031). Significantly fewer patients in the RE than sorafenib group had grade ≥ 3 AEs (36 of 130 [27.7%]) v 82 of 162 [50.6%]; P radiation hepatitis (two [1.5%] v zero [0%] patients). Fewer patients in the RE group (27 of 130 [20.8%]) than in the sorafenib group (57 of 162 [35.2%]) had serious AEs. Conclusion In patients with locally advanced HCC, OS did not differ significantly between RE and sorafenib. The improved toxicity profile of RE may inform treatment choice in selected patients.

  12. Yttrium-90 microsphere selective internal radiation therapy for liver metastases following systemic chemotherapy and surgical resection for metastatic adrenocortical carcinoma.

    Science.gov (United States)

    Makary, Mina S; Krishner, Lawrence S; Wuthrick, Evan J; Bloomston, Mark P; Dowell, Joshua D

    2018-02-10

    Adrenocortical carcinoma (ACC) is a rare malignancy with generally poor outcomes and limited treatment options. While surgical resection can be curative for early local disease, most patients present with advanced ACC owing to nonspecific symptoms. For those patients, treatment options include systemic chemotherapy and locoregional therapies including radiofrequency ablation and transarterial chemoembolization. We present the first reported case of utilizing yttrium-90 microsphere selective internal radiation therapy (SIRT) in combination with first line EDP-M (Etoposide, Doxorubicin, Cisplatin, Mitotane) chemotherapy and debulking surgical primary tumor resection for treatment of metastatic ACC. Stable complete radiologic response has been maintained after twelve months with resolution of clinical symptoms. These findings prompt the need for further consideration and studies to elucidate the role of SIRT in combination with systemic and surgical treatment for metastatic ACC.

  13. Yttrium-90 selective internal radiation therapy with glass microspheres for hepatocellular carcinoma: Current and updated literature review

    International Nuclear Information System (INIS)

    Lee, Edward Wolfgang; Alanic, Lourdes; Cho, Sung Ki; Saab, Sammy

    2016-01-01

    Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor. The liver tumor receives a highly concentrated radiation dose while sparing the healthy liver parenchyma due to its preferential blood supply from portal venous blood. There are two commercially available devices: TheraSphere® and SIR-Spheres®. Although, Y90-SIRT with glass microspheres improves median survival in patients with intermediate and advanced hepatocellular carcinoma and has the potential to downstage hepatocellular carcinoma so that the selected candidates meet the transplantable criteria, it has not gained widespread acceptance due to the lack of large randomized controlled trials. Currently, there are various clinical trials investigating the use of Y90-SIRT with glass microspheres for treatment of hepatocellular carcinoma and the outcomes of these trials may result in the incorporation of Y90-SIRT with glass microspheres into the treatment guidelines as a standard therapy option for patients with intermediate and advanced stage hepatocellular carcinoma

  14. Yttrium-90 Selective Internal Radiation Therapy with Glass Microspheres for Hepatocellular Carcinoma: Current and Updated Literature Review.

    Science.gov (United States)

    Lee, Edward Wolfgang; Alanis, Lourdes; Cho, Sung-Ki; Saab, Sammy

    2016-01-01

    Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor. The liver tumor receives a highly concentrated radiation dose while sparing the healthy liver parenchyma due to its preferential blood supply from portal venous blood. There are two commercially available devices: TheraSphere® and SIR-Spheres®. Although, Y90-SIRT with glass microspheres improves median survival in patients with intermediate and advanced hepatocellular carcinoma and has the potential to downstage hepatocellular carcinoma so that the selected candidates meet the transplantable criteria, it has not gained widespread acceptance due to the lack of large randomized controlled trials. Currently, there are various clinical trials investigating the use of Y90-SIRT with glass microspheres for treatment of hepatocellular carcinoma and the outcomes of these trials may result in the incorporation of Y90-SIRT with glass microspheres into the treatment guidelines as a standard therapy option for patients with intermediate and advanced stage hepatocellular carcinoma.

  15. Yttrium-90 Selective Internal Radiation Therapy with Glass Microspheres for Hepatocellular Carcinoma: Current and Updated Literature Review

    International Nuclear Information System (INIS)

    Lee, Edward Wolfgang; Alanis, Lourdes; Cho, Sung-Ki; Saab, Sammy

    2016-01-01

    Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor. The liver tumor receives a highly concentrated radiation dose while sparing the healthy liver parenchyma due to its preferential blood supply from portal venous blood. There are two commercially available devices: TheraSphere® and SIR-Spheres®. Although, Y90-SIRT with glass microspheres improves median survival in patients with intermediate and advanced hepatocellular carcinoma and has the potential to downstage hepatocellular carcinoma so that the selected candidates meet the transplantable criteria, it has not gained widespread acceptance due to the lack of large randomized controlled trials. Currently, there are various clinical trials investigating the use of Y90-SIRT with glass microspheres for treatment of hepatocellular carcinoma and the outcomes of these trials may result in the incorporation of Y90-SIRT with glass microspheres into the treatment guidelines as a standard therapy option for patients with intermediate and advanced stage hepatocellular carcinoma

  16. Yttrium-90 selective internal radiation therapy with glass microspheres for hepatocellular carcinoma: Current and updated literature review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Edward Wolfgang; Alanic, Lourdes [Div. of Interventional Radiology, Dept. of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles (United States); Cho, Sung Ki [Div. of Interventional Radiology, Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Saab, Sammy [Div. of Hepatology, Dept. of Medicine, Pfleger Liver Institute, University of California at Los Angeles, Los Angeles (United States)

    2016-07-15

    Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor. The liver tumor receives a highly concentrated radiation dose while sparing the healthy liver parenchyma due to its preferential blood supply from portal venous blood. There are two commercially available devices: TheraSphere® and SIR-Spheres®. Although, Y90-SIRT with glass microspheres improves median survival in patients with intermediate and advanced hepatocellular carcinoma and has the potential to downstage hepatocellular carcinoma so that the selected candidates meet the transplantable criteria, it has not gained widespread acceptance due to the lack of large randomized controlled trials. Currently, there are various clinical trials investigating the use of Y90-SIRT with glass microspheres for treatment of hepatocellular carcinoma and the outcomes of these trials may result in the incorporation of Y90-SIRT with glass microspheres into the treatment guidelines as a standard therapy option for patients with intermediate and advanced stage hepatocellular carcinoma.

  17. Yttrium-90 Selective Internal Radiation Therapy with Glass Microspheres for Hepatocellular Carcinoma: Current and Updated Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Edward Wolfgang; Alanis, Lourdes [Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095 (United States); Cho, Sung-Ki [Division of Interventional Radiology, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351 (Korea, Republic of); Saab, Sammy [Division of Hepatology, Department of Medicine, Pfleger Liver Institute, University of California at Los Angeles, Los Angeles, CA 90024 (United States)

    2016-11-01

    Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor. The liver tumor receives a highly concentrated radiation dose while sparing the healthy liver parenchyma due to its preferential blood supply from portal venous blood. There are two commercially available devices: TheraSphere® and SIR-Spheres®. Although, Y90-SIRT with glass microspheres improves median survival in patients with intermediate and advanced hepatocellular carcinoma and has the potential to downstage hepatocellular carcinoma so that the selected candidates meet the transplantable criteria, it has not gained widespread acceptance due to the lack of large randomized controlled trials. Currently, there are various clinical trials investigating the use of Y90-SIRT with glass microspheres for treatment of hepatocellular carcinoma and the outcomes of these trials may result in the incorporation of Y90-SIRT with glass microspheres into the treatment guidelines as a standard therapy option for patients with intermediate and advanced stage hepatocellular carcinoma.

  18. 3D dosimetry estimation for selective internal radiation therapy (SIRT) using SPECT/CT images: a phantom study

    Science.gov (United States)

    Debebe, Senait A.; Franquiz, Juan; McGoron, Anthony J.

    2015-03-01

    Selective Internal Radiation Therapy (SIRT) is a common way to treat liver cancer that cannot be treated surgically. SIRT involves administration of Yttrium - 90 (90Y) microspheres via the hepatic artery after a diagnostic procedure using 99mTechnetium (Tc)-macroaggregated albumin (MAA) to detect extrahepatic shunting to the lung or the gastrointestinal tract. Accurate quantification of radionuclide administered to patients and radiation dose absorbed by different organs is of importance in SIRT. Accurate dosimetry for SIRT allows optimization of dose delivery to the target tumor and may allow for the ability to assess the efficacy of the treatment. In this study, we proposed a method that can efficiently estimate radiation absorbed dose from 90Y bremsstrahlung SPECT/CT images of liver and the surrounding organs. Bremsstrahlung radiation from 90Y was simulated using the Compton window of 99mTc (78keV at 57%). 99mTc images acquired at the photopeak energy window were used as a standard to examine the accuracy of dosimetry prediction by the simulated bremsstrahlung images. A Liqui-Phil abdominal phantom with liver, stomach and two tumor inserts was imaged using a Philips SPECT/CT scanner. The Dose Point Kernel convolution method was used to find the radiation absorbed dose at a voxel level for a three dimensional dose distribution. This method will allow for a complete estimate of the distribution of radiation absorbed dose by tumors, liver, stomach and other surrounding organs at the voxel level. The method provides a quantitative predictive method for SIRT treatment outcome and administered dose response for patients who undergo the treatment.

  19. Estimated Internal and External Radiation Exposure of Caregivers of Patients With Pediatric Neuroblastoma Undergoing 131I Metaiodobenzylguanidine Therapy: A Prospective Pilot Study.

    Science.gov (United States)

    Han, Sangwon; Yoo, Seon Hee; Koh, Kyung-Nam; Lee, Jong Jin

    2017-04-01

    Current recommendations suggest that family members should participate in the care of children receiving in-hospital I metaiodobenzylguanidine (MIBG) therapy for neuroblastoma. The present study aimed to measure the external radiation exposure and estimate the internal radiation exposure of caregivers during the hospital stay for I MIBG therapy. Caregivers received radiation safety instructions and a potassium iodide solution for thyroid blockade before patient admission. External radiation exposure was determined using a personal pocket dosimeter. Serial 24-hour urine samples were collected from caregivers during the hospital stay. Estimated internal radiation exposure was calculated based on the urine activity. Twelve cases (mean age, 6.2 ± 3.5 years; range, 2-13 years) were enrolled. The mean administered activity was 233.3 ± 74.9 (range, 150.0-350.0) mCi. The mean external radiation dose was 5.8 ± 7.2 (range, 0.8-19.9) mSv. Caregivers of children older than 4 years had significantly less external radiation exposure than those of children younger than 4 years (1.9 ± 1.0 vs 16.4 ± 5.0 mSv; P = 0.012). The mean estimated internal radiation dose was 11.3 ± 10.2 (range, 1.0-29.8) μSv. Caregivers receive both external and internal radiation exposure while providing in-hospital care to children receiving I MIBG therapy for neuroblastoma. However, the internal radiation exposure was negligible compared with the external radiation exposure.

  20. Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Illidge, Tim, E-mail: Tim.Illidge@ics.manchester.ac.uk [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, The Christie National Health Service Foundation Trust, Manchester (United Kingdom); Specht, Lena [Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Yahalom, Joachim [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Aleman, Berthe [Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Berthelsen, Anne Kiil [Department of Radiation Oncology and PET Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Constine, Louis [Departments of Radiation Oncology and Pediatrics, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York (United States); Dabaja, Bouthaina [Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dharmarajan, Kavita [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Ng, Andrea [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States); Ricardi, Umberto [Radiation Oncology Unit, Department of Oncology, University of Torino, Torino (Italy); Wirth, Andrew [Division of Radiation Oncology, Peter MacCallum Cancer Institute, St. Andrews Place, East Melbourne (Australia)

    2014-05-01

    Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. A new concept, involved-site RT, defines the clinical target volume. For indolent NHL, often treated with RT alone, larger fields should be considered. Newer treatment techniques, including intensity modulated RT, breath holding, image guided RT, and 4-dimensional imaging, should be implemented, and their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control.

  1. Adjuvant therapy of Dukes' C colon cancer by intra-arterial P-32 colloid for internal radiation therapy of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Grady, E.D.

    1984-09-01

    To prevent probable occult metastatic liver cancer from progressing to clinical disease, the author used internal radiation therapy as an effective adjuvant to surgical excision of primary Dukes' C colonic cancer. A calculated radiation dose of 5000 rads was delivered to the liver by injecting radioactive 32-P chromic phosphate colloid through the superior mesenteric and celiac arteries. When this was done, the colloid passed through the intestines and was mixed thoroughly with the blood and delivered to the liver by the portal vein. The Kupffer cells in the liver trapped the colloid, and a minimum amount passed through the liver and got into the general circulation. This kept the amount of colloid deposited in the bone marrow to a minimum. In a phase-I pilot study in which nine patients were treated, no serious side effects were noted. In eight patients, the liver has remained free of cancer for more than 1 year.

  2. Role of Internal Mammary Node Radiation as a Part of Modern Breast Cancer Radiation Therapy: A Systematic Review

    International Nuclear Information System (INIS)

    Verma, Vivek; Vicini, Frank; Tendulkar, Rahul D.; Khan, Atif J.; Wobb, Jessica; Edwards-Bennett, Sophia; Desai, Anand; Shah, Chirag

    2016-01-01

    Purpose: Despite data from multiple randomized trials, the role of internal mammary lymph node irradiation as a part of regional nodal irradiation (IMLN RT–RNI) remains unanswered. Recent noteworthy data and modern RT techniques might identify a subset of patients who will benefit from IMLN RT–RNI, lending insight into the balance between improved outcomes and acceptable toxicity. We evaluated the current role of IMLN RT–RNI by analyzing randomized, prospective, and retrospective data. Methods and Materials: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a review of the published data was performed using PubMed to evaluate published studies from 1994 to 2015. The information evaluated included the number of patients, follow-up period, technical aspects of RT, and outcomes (clinical outcomes, complications/toxicity). Results: We included 16 studies (4 randomized, 4 nonrandomized, 7 retrospective, and 1 meta-analysis). Although older randomized trials failed to show differences in clinical outcomes or toxicity with IMLN RT–RNI, recent randomized data suggest the potential for improved outcomes, including overall survival, with IMLN RT–RNI. Furthermore, nonrandomized data have suggested a potential benefit for central tumors with IMLN RT–RNI. Although recent data have suggested a potential increase in pulmonary complications with IMLN RT–RNI with the use of advanced radiation techniques, toxicity rates remain low with limited cardiac toxicity data available. Conclusions: Increasing data from recent randomized trials support the use of IMLN RT–RNI. IMLN RT can be considered based on the inclusion of IMLN RT as a part of RNI in recent trials and the inclusion criteria from IMLN RT–RNI trials and for patients with central or medial tumors and axillary disease.

  3. Role of Internal Mammary Node Radiation as a Part of Modern Breast Cancer Radiation Therapy: A Systematic Review.

    Science.gov (United States)

    Verma, Vivek; Vicini, Frank; Tendulkar, Rahul D; Khan, Atif J; Wobb, Jessica; Edwards-Bennett, Sophia; Desai, Anand; Shah, Chirag

    2016-06-01

    Despite data from multiple randomized trials, the role of internal mammary lymph node irradiation as a part of regional nodal irradiation (IMLN RT-RNI) remains unanswered. Recent noteworthy data and modern RT techniques might identify a subset of patients who will benefit from IMLN RT-RNI, lending insight into the balance between improved outcomes and acceptable toxicity. We evaluated the current role of IMLN RT-RNI by analyzing randomized, prospective, and retrospective data. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a review of the published data was performed using PubMed to evaluate published studies from 1994 to 2015. The information evaluated included the number of patients, follow-up period, technical aspects of RT, and outcomes (clinical outcomes, complications/toxicity). We included 16 studies (4 randomized, 4 nonrandomized, 7 retrospective, and 1 meta-analysis). Although older randomized trials failed to show differences in clinical outcomes or toxicity with IMLN RT-RNI, recent randomized data suggest the potential for improved outcomes, including overall survival, with IMLN RT-RNI. Furthermore, nonrandomized data have suggested a potential benefit for central tumors with IMLN RT-RNI. Although recent data have suggested a potential increase in pulmonary complications with IMLN RT-RNI with the use of advanced radiation techniques, toxicity rates remain low with limited cardiac toxicity data available. Increasing data from recent randomized trials support the use of IMLN RT-RNI. IMLN RT can be considered based on the inclusion of IMLN RT as a part of RNI in recent trials and the inclusion criteria from IMLN RT-RNI trials and for patients with central or medial tumors and axillary disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Role of Internal Mammary Node Radiation as a Part of Modern Breast Cancer Radiation Therapy: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Vicini, Frank [Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States); Tendulkar, Rahul D. [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Khan, Atif J. [Department of Radiation Oncology, Rutgers Robert Wood Johnson Medical School and the Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Wobb, Jessica [Department of Radiation Oncology, Ohio State University, Columbus, Ohio (United States); Edwards-Bennett, Sophia [21st Century Oncology, Myrtle Beach, South Carolina (United States); Desai, Anand [Department of Radiation Oncology, Summa Health System, Akron, Ohio (United States); Shah, Chirag, E-mail: csshah27@hotmail.com [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2016-06-01

    Purpose: Despite data from multiple randomized trials, the role of internal mammary lymph node irradiation as a part of regional nodal irradiation (IMLN RT–RNI) remains unanswered. Recent noteworthy data and modern RT techniques might identify a subset of patients who will benefit from IMLN RT–RNI, lending insight into the balance between improved outcomes and acceptable toxicity. We evaluated the current role of IMLN RT–RNI by analyzing randomized, prospective, and retrospective data. Methods and Materials: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a review of the published data was performed using PubMed to evaluate published studies from 1994 to 2015. The information evaluated included the number of patients, follow-up period, technical aspects of RT, and outcomes (clinical outcomes, complications/toxicity). Results: We included 16 studies (4 randomized, 4 nonrandomized, 7 retrospective, and 1 meta-analysis). Although older randomized trials failed to show differences in clinical outcomes or toxicity with IMLN RT–RNI, recent randomized data suggest the potential for improved outcomes, including overall survival, with IMLN RT–RNI. Furthermore, nonrandomized data have suggested a potential benefit for central tumors with IMLN RT–RNI. Although recent data have suggested a potential increase in pulmonary complications with IMLN RT–RNI with the use of advanced radiation techniques, toxicity rates remain low with limited cardiac toxicity data available. Conclusions: Increasing data from recent randomized trials support the use of IMLN RT–RNI. IMLN RT can be considered based on the inclusion of IMLN RT as a part of RNI in recent trials and the inclusion criteria from IMLN RT–RNI trials and for patients with central or medial tumors and axillary disease.

  5. Radiation Therapy for Lung Cancer

    Science.gov (United States)

    ... of the lung cancer and your overall health. Radiation Therapy Radiation is a high-energy X-ray that ... surgery, chemotherapy or both depending upon the circumstances. Radiation therapy works within cancer cells by damaging their ability ...

  6. Serious hepatic complications of selective internal radiation therapy with yttrium-90 microsphere radioembolization for unresectable liver tumors.

    Science.gov (United States)

    Kuo, James C; Tazbirkova, Andrea; Allen, Robert; Kosmider, Suzanne; Gibbs, Peter; Yip, Desmond

    2014-09-01

    Selective internal radiation therapy with yttrium-90 microsphere radioembolization has been used to treat unresectable liver tumors and its acute toxicity has been well described. Subacute and long-term hepatic complications related to radioembolization however may be underreported in the literature. This retrospective study describes the incidence and sequelae of serious hepatic complications in patients who underwent radioembolization for unresectable liver tumors. A retrospective review of clinical notes of patients who received radioembolization for unresectable liver tumors from 2001 to 2011 at two Australian institutions was performed to identify those who developed clinically significant hepatic complications. Relevant clinical data were obtained and analyzed to determine their incidence and sequelae. A total of 205 patients were identified, of whom 10 (4.9%) developed serious hepatic complications with 7 (3.4%) attributable to radioembolization-induced liver disease. None had preexisting underlying liver disease or progressive hepatic metastases at the time of developing hepatic complication. The median time to the onset of hepatic complications was 3.5 months (range 1-67 months); six patients had a complete resolution eventually, including one patient who subsequently underwent hepatic metastasectomy safely. Three patients died as a result of fulminant hepatic failure. Selective internal radiation therapy with radioembolization was associated with serious hepatic complications with an incidence of 4.9% and a mortality rate of 1.5% in 205 patients from two Australian institutions. The risk of serious hepatic toxicity therefore needs to be discussed when counseling patients regarding this potential treatment option. © 2014 Wiley Publishing Asia Pty Ltd.

  7. Glass Microspheres 90Y Selective Internal Radiation Therapy and Chemotherapy as First-Line Treatment of Intrahepatic Cholangiocarcinoma.

    Science.gov (United States)

    Edeline, Julien; Du, Fanny Le; Rayar, Michel; Rolland, Yan; Beuzit, Luc; Boudjema, Karim; Rohou, Tanguy; Latournerie, Marianne; Campillo-Gimenez, Boris; Garin, Etienne; Boucher, Eveline

    2015-11-01

    Intrahepatic cholangiocarcinoma's incidence is increasing. We studied the efficacy of Y selective internal radiation therapy (SIRT) as first-line treatment, with chemotherapy, and compared with the results of chemotherapy alone. We retrospectively studied data from patients treated at our institution with glass microspheres SIRT for intrahepatic cholangiocarcinoma as part of first-line treatment in combination with chemotherapy. We compared results with those of similar patients treated in the ABC-02 study (a study in advanced biliary tract cancer that defined the current standard chemotherapy), assessed as not progressing after the first evaluation. We assessed progression-free survival (PFS) and overall survival (OS). Twenty-four patients were treated with SIRT. Chemotherapy was given concomitantly in 10 (42%), as induction before SIRT in 13 (54%) or after SIRT in 1 (4%). Grade 3 adverse events were reported in 1 (4%). Median PFS after SIRT was 10.3 months. Longer PFS was observed when chemotherapy was given concomitantly than when chemotherapy was given before SIRT, with respective median of 20.0 versus 8.8 months (P = 0.001). Median OS after SIRT was not reached. Eleven patients went to surgery (46%). Thirty-three patients in ABC-02 had locally advanced nonextrahepatic cholangiocarcinoma, not progressing after first evaluation. From the start of any treatment, the median PFS was 16.0 months in our cohort versus 11.3 months in ABC-02 (P = 0.25), whereas the median OS was significantly higher in our cohort, not reached versus 17.9 months, respectively (P = 0.026). Selective internal radiation therapy combined with concomitant chemotherapy seems a promising strategy as first-line treatment for unresectable intrahepatic cholangiocarcinoma.

  8. Radiation Therapy: Additional Treatment Options

    Science.gov (United States)

    ... novel targeted therapies can act as radiosensitizers. Systemic Radiation Therapy Certain cancers may be treated with radioactive drugs ... intravenous). This type of treatment is called systemic radiation therapy because the medicine goes to the entire body. ...

  9. Correlation between patients' anatomical characteristics and interfractional internal prostate motion during intensity modulated radiation therapy for prostate cancer.

    Science.gov (United States)

    Maruoka, Shintaroh; Yoshioka, Yasuo; Isohashi, Fumiaki; Suzuki, Osamu; Seo, Yuji; Otani, Yuki; Akino, Yuichi; Takahashi, Yutaka; Sumida, Iori; Ogawa, Kazuhiko

    2015-01-01

    Intensity modulated radiation therapy (IMRT) is one of a standard treatment for localized prostate cancer. Although lower complication is expected for smaller target margin, determination of optimal margin is important. For bony-structure based registration, internal prostate motion is the main factor determining the margin from clinical target volume to planning target volume. The purpose of this study was to measure interfractional internal motion of the prostate and to identity the factors which enlarge or reduce the margin, with special focus on patients' anatomical characteristics. The 586 image sets of 16 patients acquired with megavoltage cone beam computed tomography were analyzed. For each patient, prostate shift in three directions was recorded for each fraction to calculate the required margin. Correlations between these values and patients' anatomical characteristics were evaluated. The posteriorly required margin correlated positively with rectal volume and rectal mean area (p = 0.015 and p = 0.008), while random error in lateral, craniocaudal and anteroposterior direction correlated negatively (p = 0.014, 0.04 and 0.0026, respectively) with body mass index (BMI). In addition to the previously identified factor of distended rectum, BMI was newly identified as another significant factor influencing interfractional internal prostate motion.

  10. The effect of selective internal radiation therapy with yttrium-90 resin microspheres on lung carbon monoxide diffusion capacity.

    Science.gov (United States)

    Ones, Tunc; Eryuksel, Emel; Baltacioglu, Feyyaz; Ceyhan, Berrin; Erdil, Tanju Yusuf

    2017-12-29

    Selective internal radiation therapy (SIRT) with embolization of branches of the hepatic artery is a valuable therapeutic tool for patients with hepatic malignancies; however, it is also associated with lung injury risk due to shunting. Diffusion capacity of the lungs for carbon monoxide (DLCO) is a clinically significant lung function test, and worsening in DLCO is suggested to reflect a limited gas exchange reserve caused by the potential toxicity of chemoradiotherapy or it may be a marker of related lung injury. This study aimed to examine the changes in DLCO during SIRT with resin microspheres in newly treated and retreated patients. Forty consecutive patients who received SIRT for a variety of malignant conditions were included. All subjects were treated with Yttrium-90 labelled resin microspheres. DLCO tests were performed after the procedures. In addition, patients were specifically followed for radiation pneumonitis. The mean DLCO did not significantly change after the first (82.8 ± 19.4 vs. 83.1 ± 20.9, p = 0.921) and the second treatments (87.4 ± 19.7 vs. 88.6 ± 23.2, p = 0.256). Proportion of patients with impaired DLCO at baseline was not altered significantly after the first (37.5 vs. 45.0%, p = 0.581) and the second treatments (27.3 vs. 27.3%, p = 1.000). Also, percent change in DLCO values did not correlate with radiation dose, lung shunt fraction, or lung exposure dose (p > 0.05 for all comparisons). None of the patients developed radiation pneumonitis. Our results suggest that no significant change in DLCO in association with SIRT occurs, both after the first or the second treatment sessions. Further larger studies possibly with different protocols are warranted to better delineate DLCO changes after SIRT in a larger spectrum of patients.

  11. External Validation and Optimization of International Consensus Clinical Target Volumes for Adjuvant Radiation Therapy in Bladder Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Abhinav V. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Christodouleas, John P. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Wu, Tianming [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Smith, Norman D.; Steinberg, Gary D. [Section of Urology, Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Liauw, Stanley L., E-mail: sliauw@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States)

    2017-03-15

    Purpose: International consensus (IC) clinical target volumes (CTVs) have been proposed to standardize radiation field design in the treatment of patients at high risk of locoregional failure (LRF) after radical cystectomy. The purpose of this study was to externally validate the IC CTVs in a cohort of postsurgical patients followed up for LRF and identify revisions that might improve the IC CTVs' performance. Methods and Materials: Among 334 patients with pT3 to pT4 bladder cancer treated with radical cystectomy, LRF developed in 58 (17%), of whom 52 had computed tomography scans available for review. Images with LRF were exported into a treatment planning system, and IC CTVs were contoured and evaluated for adequacy of coverage of each LRF with respect to both the patient and each of 6 pelvic subsites: common iliac (CI) region, obturator region (OR), external and internal iliac region, presacral region, cystectomy bed, or other pelvic site. Revisions to the IC contours were proposed based on the findings. Results: Of the 52 patients with documented LRF, 13 (25%) had LRFs that were outside of the IC CTV involving 17 pelvic subsites: 5 near the CI CTV, 5 near the OR CTV, 1 near the external and internal iliac region, and 6 near the cystectomy bed. The 5 CI failures were located superior to the CTV, and the 5 OR failures were located medial to the CTV. Increasing the superior boundary of the CI to a vessel-based definition of the aortic bifurcation, as well as increasing the medial extension of the OR by an additional 9 mm, decreased the number of patients with LRF outside of the IC CTV to 7 (13%). Conclusions: Modified IC CTVs inclusive of a slight adjustment superiorly for the CI region and medially for the OR may reduce the risk of pelvic failure in patients treated with adjuvant radiation therapy.

  12. Involved Node Radiation Therapy

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  13. Radiation therapy physics

    CERN Document Server

    1995-01-01

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

  14. Internal and external validation of an ESTRO delineation guideline - dependent automated segmentation tool for loco-regional radiation therapy of early breast cancer

    NARCIS (Netherlands)

    Eldesoky, A.R.; Yates, E.S.; Nyeng, T.B.; Thomsen, M.S.; Nielsen, H.M.; Poortmans, P.; Kirkove, C.; Krause, M.; Kamby, C.; Mjaaland, I.; Blix, E.S.; Jensen, I.; Berg, M; Lorenzen, E.L.; Taheri-Kadkhoda, Z.; Offersen, B.V.

    2016-01-01

    BACKGROUND AND PURPOSE: To internally and externally validate an atlas based automated segmentation (ABAS) in loco-regional radiation therapy of breast cancer. MATERIALS AND METHODS: Structures of 60 patients delineated according to the ESTRO consensus guideline were included in four categorized

  15. Liver Resection After Selective Internal Radiation Therapy with Yttrium-90 is Safe and Feasible: A Bi-institutional Analysis.

    Science.gov (United States)

    Wright, G Paul; Marsh, J Wallis; Varma, Manish K; Doherty, Michael G; Bartlett, David L; Chung, Mathew H

    2017-04-01

    Treatment with yttrium-90 (Y90) microspheres has emerged as a viable liver-directed therapy for patients with unresectable tumors and those outside transplantation criteria. A select number of patients demonstrate a favorable response and become candidates for surgical resection. Patients who underwent selective internal radiation therapy (SIRT) with Y90 microspheres at two institutions were reviewed. Patients who underwent liver resection were included in the study. The data gathered included demographics, tumor characteristics, response to Y90, surgical details, perioperative outcomes, and survival. The inclusion criteria were met by 12 patients. The diagnoses included metastatic disease from colorectal adenocarcinoma (n = 6), neuroendocrine tumor (n = 1), and ocular melanoma (n = 1) in addition to hepatocellular carcinoma (n = 4). The median time from liver disease diagnosis to Y90 treatment was 5.5 months (range 2-92 months). The median time from Y90 treatment to surgery was 9.5 months (range 3-20 months). The surgical approach included right hepatectomy (n = 3), extended right hepatectomy (n = 5), extended left hepatectomy (n = 1), segmentectomy with ablation (n = 2), and segmentectomy with isolated liver perfusion (n = 1). The hospital stay was 7 days (range 4-31 days), and 67% of the patients were discharged home. The readmission rate was 42%. The 90-day morbidity and mortality rates were respectively 42 and 8%. At this writing, the median overall survival has not been reached at 25 months. Liver resection after Y90 SIRT is a challenging surgical procedure with high rates of perioperative morbidity and hospital readmission. However, for properly selected patients, potential exists for extending disease-free and overall survival in the current era of multimodal therapy for malignant liver disease.

  16. Improving patient selection for selective internal radiation therapy of intra-hepatic cholangiocarcinoma: A meta-regression study.

    Science.gov (United States)

    Cucchetti, Alessandro; Cappelli, Alberta; Mosconi, Cristina; Zhong, Jian-Hong; Cescon, Matteo; Pinna, Antonio D; Golfieri, Rita

    2017-07-01

    Selective internal radiation therapy (SIRT) is emerging as a potential therapy for unresectable intra-hepatic cholangiocarcinoma (iCCA) able to prolong life-expectancy. Aim of this study was to collect available literature meta-analyse data and results and investigate sources of heterogeneity through a meta-regression approach before suggesting SIRT as a valuable option. A systematic review of studies published until 1 September 2016 in PubMed and Scopus databases was performed. Patient survival was the primary outcome measure. Meta-analysis was performed using a random-effects model. Meta-regression was applied to investigate relationships existing between clinical and tumour features and the primary outcome. Nine observational studies were included in the analysis involving 224 patients. The 1-, 2- and 3-year pooled survival estimates were 55.7%, 33.1% and 20.2%. Clinical and tumour characteristics showed medium-to-considerable heterogeneity (I 2 >50%). Meta-regression analysis showed that determinants of best survivals were the presence of mass-forming iCCA type (median survival=19.9 months vs 8.1 months for the infiltrative type; P=.002) that also accounted for most of the heterogeneity between included studies (residual I 2 =0); SIRT as first-line therapy (median survival=24 months vs 11.5 months for non-naïve patients; P=.048) and the adoption of concomitant chemotherapy (median survival 19.5 months vs 5.5 months in patients not receiving chemotherapy; P=.042). There is considerable heterogeneity between studies highlighting that indications for SIRT are extremely varied. To ameliorate SIRT results naïve patients with mass-forming iCCA should be selected as the best candidates with the possibility of adding concomitant standard chemotherapy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Prognostic significance of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients treated with selective internal radiation therapy.

    Science.gov (United States)

    D'Emic, Nicole; Engelman, Alexander; Molitoris, Jason; Hanlon, Alexandra; Sharma, Navesh K; Moeslein, Fred M; Chuong, Michael D

    2016-04-01

    Elevated neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte ratios (PLR) may represent markers of a suboptimal host immune response to cancer and have been shown to correlate with prognosis in multiple tumor types across different treatment modalities, including radiation therapy. Limited data suggest that NLR may predict for survival and disease control in patients receiving selective internal radiation therapy (SIRT). The correlation between clinical outcomes and change in NLR and PLR after SIRT has not been evaluated. We retrospectively reviewed 339 consecutive patients with primary (n=37) or metastatic (n=79) liver cancer treated with SIRT from 2006 to 2014. Complete blood counts with differential were available for 116 patients both before and after (median, 29 and 20 days, respectively) SIRT. Survival and progression were calculated from date of initial SIRT. Patient and tumor characteristics evaluated for ability to predict overall survival (OS) and progression free survival (PFS) included pre- and post-treatment neutrophil, platelet, and lymphocyte counts (LCs), as well as NLR, PLR, and relative change in NLR and PLR. Cutoff values were determined for variables that were significant on multivariate analysis (MVA) for OS and/or PFS. Median follow-up of surviving patients was 12 months. Median OS was 8 months from SIRT and 20 months from date of liver metastasis diagnosis. Significant factors on univariate analysis (UVA) for both lower OS and PFS included higher post-treatment neutrophil count (NC), higher post-treatment NLR, higher liver tumor volume, higher percentage liver tumor burden, and worse Eastern Cooperative Oncology Group (ECOG) performance status. Significant factors on MVA for lower OS and PFS were ECOG performance status ≥2, higher liver tumor volume, higher pretreatment PLR, and increase in PLR after SIRT. Post-treatment increase in PLR >3-fold was the most predictive early marker for increased risk of death when compared with those

  18. Radiation Therapy for Skin Cancer

    Science.gov (United States)

    ... make sure they are safe to use during radiation therapy. • Eat a balanced diet. If food tastes funny ... melanoma.org Skin Cancer Foundation www.skincancer.org Radiation Therapy Answers www.rtanswers.org LEARNING ABOUT CLINICAL TRIALS ...

  19. Advances in radiation therapy dosimetry

    OpenAIRE

    Paliwal, Bhudatt; Tewatia, Dinesh

    2009-01-01

    During the last decade, there has been an explosion of new radiation therapy planning and delivery tools. We went through a rapid transition from conventional three-dimensional (3D) conformal radiation therapy to intensity-modulated radiation therapy (IMRT) treatments, and additional new techniques for motion-adaptive radiation therapy are being introduced. These advances push the frontiers in our effort to provide better patient care; and with the addition of IMRT, temporal dimensions are ma...

  20. Guidelines on the medical therapy of persons accidentally overexposed to ionizing radiations. Internal contamination

    International Nuclear Information System (INIS)

    Di Trano, J.L.; Perez, M.R.; Gisone, P.

    1999-01-01

    This work represent a guide for the treatment of accidental intakes of radionuclides. The different phases of radioactive contamination, the transfer and non-transfer of radioisotopes, the general principles in the treatment of internal contamination and the follow-up are determined. The in vivo monitoring and the evaluation of activity level are specified in this document. The applied treatment depends on the via of intake, that is: inhalation, ingestion, and through skin. The decontamination procedures that reduce the radionuclide transfer are specified. The different drugs, used to enhance radionuclides elimination, are enumerated in this work. Considerations about the iodine prophylaxis in radiologic als accidents are considered. (author)

  1. Single-institution experience with selective internal radiation therapy (SIRT) for the treatment of unresectable colorectal liver metastases.

    Science.gov (United States)

    O'Leary, Cathal; Greally, Megan; McCaffrey, John; Hughes, Peter; Lawler, Leo L P; O'Connell, Martin; Geoghegan, Tony; Farrelly, Cormac

    2018-03-06

    Liver metastases are the commonest cause of death for patients with colorectal cancer. Growing evidence supports the use of selective internal radiation therapy (SIRT) in combination with conventional chemotherapy regimens for liver-only or liver-dominant unresectable metastatic colorectal cancer. To measure and evaluate outcomes of the first 20 consecutive patients with unresectable colorectal liver metastasis selected for SIRT in addition to their chemotherapy at a single Irish institution. Retrospective case series was performed. Patient charts and medical records were reviewed. All 20 patients (100%) selected for angiographic workup were subsequently successfully treated with radioembolization. All patients were discharged 1 day post-SIRT. At initial imaging evaluation, 12 (60%) had a partial response in their liver, 2 (10%) had stable disease, and 6 (30%) had liver-specific progressive disease. Median follow up was 10 months (range 6-26). At last follow up, 14 (70%) patients were alive and 6 (30%) deceased. Most recent imaging demonstrated 2 (10%) with a complete response, 7 (35%) had a partial response, 2 (10%) had stable disease, and 9 (45%) had progressive disease within their liver. One patient was downstaged to hepatic resection, and one with a complete hepatic response had his primary sigmoid tumor resected 11 months post-SIRT. SIRT is a safe and effective therapy for certain patients with unresectable colorectal liver metastases. This case series supports our opinion that selected patients should be offered SIRT in concert with their medical oncologist, concomitant with their chemotherapy. Larger multi-center studies are required to more clearly define the patient groups that will derive most benefit from SIRT.

  2. Principles of radiation therapy

    International Nuclear Information System (INIS)

    Richter, M.P.; Share, F.S.; Goodman, R.L.

    1985-01-01

    Radiation oncology now represents the integration of knowledge obtained over an 80-year period from the physics and biology laboratories and the medical clinic. Such integration is recent; until the supervoltage era following World War II, the chief developments in these three areas for the most part were realized independently. The physics and engineering laboratories have now developed a dependable family of sources of ionizing radiations that can be precisely directed at tumor volumes at various depths within the body. The biology laboratory has provided the basic scientific support underlying the intensive clinical experience and currently is suggesting ways of using ionizing radiations more effectively, such as modified fractionation schedules relating to cell cycle kinetics and the use of drugs and chemicals as modifiers of radiation response and normal tissue reaction. The radiation therapy clinic has provided the patient stratum on which the acute and chronic effects of irradiation have been assessed, and the patterns of treatment success and failure identified. The radiation therapist has shared with the surgeon and medical oncologist the responsibility for clarifying the natural history of a large number of human neoplasms, and through such clarifications, has developed more effective treatment strategies. Several examples of this include the improved results in the treatment of Hodgkin's disease, squamous cell carcinoma of the cervix, seminoma, and epithelial neoplasms of the upper aerodigestive tract

  3. [Cardiac effects of radiation therapy].

    Science.gov (United States)

    Tuohinen, Suvi; Turpeinen, Anu; Skyttä, Tanja; Kellokumpu-Lehtinen, Pirkko-Liisa

    2015-01-01

    Because of increased life-expentancy cancer patients having undergone radiation therapy nowadays live longer, and late-appearing adverse effects are therefore playing a more significant role. Radiation therapy given to the chest is known to approximately double the risk of heart disease, the cumulative total radiation dose being the most important risk-increasing factor. The most significant adverse effects appear only years after the treatment. The mortality from late manifestations reduces the total benefit of radiation therapy. Patients with radiation therapy due to a cancer of the left breast or Hodgkin's lymphoma are particularly susceptible to cardiac effects. A safe radiation dose is not known.

  4. Image-based dosimetry for selective internal radiation therapy (SIRT) using yttrium-90 microspheres

    Science.gov (United States)

    Selwyn, Reed G.

    present a new PET-labeled microsphere for pre- and post-treatment assessment, two new beta dosimetry protocols along with validation studies, a new positron branching ratio for 90Y that led to formation of an accurate non-destructive assay, and the first successful experimental validation of a computer generated internal dose distribution using dose kernel convolution.

  5. Radiation therapy for digestive tumors

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  6. nano-particles in radiation therapy

    International Nuclear Information System (INIS)

    Billotey, Claire; Bourhis, Jean; Levy, Laurent

    2012-01-01

    After a recall of the history of radiation therapy this article outlines that the presence of a high electronic density material within a tumour can artificially and locally increase the radiation absorption. It outlines the benefit of the elaboration of nano-particles from such a material for the case of external radiation therapy (increase of material density and bioavailability of nano-particles) where nano-particles can even be introduced by intravenous injection. It describes the various possibility of using nano-particles in the case of internal radiation therapy or Curie therapy. It allows a much less invasive process, the possibility of direct injection into a tumour or a cavity, and the possibility of an increase of the dose received by cells. Other topics are briefly evoked: subcellular targeting by high atomic number nano-particles, and the radiation therapy approach by Nanobiotix

  7. Simultaneous occurrence of subarachnoid hemorrhage and epistaxis due to ruptured petrous internal carotid artery aneurysm. Association with transsphenoidal surgery and radiation therapy. Case report

    International Nuclear Information System (INIS)

    Endo, Hidenori; Fujimura, Miki; Inoue, Takashi; Matsumoto, Yasushi; Ogawa, Yoshikazu; Kawagishi, Jun; Jokura, Hidefumi; Shimizu, Hiroaki; Tominaga, Teiji

    2011-01-01

    A 62-year-old woman presented with simultaneous subarachnoid hemorrhage (SAH) and massive epistaxis. The patient had been treated for pituitary prolactinoma by two transsphenoidal surgeries, gamma knife radiosurgery, and conventional radiation therapy since age 43 years. Cerebral angiography showed left petrous internal carotid artery (ICA) aneurysm with slight stenosis on the adjacent left petrous ICA. She underwent superficial temporal artery-middle cerebral artery (STA-MCA) double anastomosis with endovascular internal trapping without complication the day after onset. Postoperative course was uneventful; the patient did not develop symptomatic vasospasm, recurrent epistaxis, or cerebrospinal fluid rhinorrhea. Postoperative angiography demonstrated complete disappearance of the aneurysm with patent STA-MCA anastomosis. The patient was discharged 2 months after surgery without neurological deficit. The present case is extremely rare with simultaneous onset of SAH and epistaxis caused by ruptured petrous ICA aneurysm. The transsphenoidal surgeries and radiation therapies might have been critical in the formation of the petrous ICA aneurysm. (author)

  8. Technical advances in radiation therapy

    International Nuclear Information System (INIS)

    Sause, W.T.

    1986-01-01

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

  9. Liver Selective Internal Radiation Therapy with (90)Y resin microspheres: comparison between pre-treatment activity calculation methods.

    Science.gov (United States)

    Bernardini, M; Smadja, C; Faraggi, M; Orio, S; Petitguillaume, A; Desbrée, A; Ghazzar, N

    2014-11-01

    Different methods to calculate (90)Y resin microspheres activity for Selective Internal Radiation Therapy (SIRT) were compared. Such comparison is not yet available and is needed in clinical practice to optimize patient specific treatment planning. 32 (99m)Tc-macroagregates (MAA) evaluations were performed, followed by 26 treatments. Four methods to calculate (90)Y-activity were applied retrospectively: three based on Body Surface Area and one based on MIRD formalism, partition model (PM). Relationships between calculated activities, lung breakthrough (LB), the activity concentration ratio between lesions and healthy liver (T/N) and tumour involvement were investigated, where lobar and whole liver treatments were analysed separately. Without attenuation correction, overestimation of LB was 65%. In any case, the estimated lungs' doses remained below 30 Gy. Thus, the maximal injectable activity (MIA) is not limited by lungs' irradiation. Moreover, LB was not significantly related to T/N, neither to tumour involvement nor radiochemical purity (RP). Differences in calculated activity with the four methods were extremely large, in particular they were greater between BSA-based and PM activities for lobar treatments (from -85% to 417%) compared to whole liver treatments (from -49% to 61%). Two values of T/N ratio were identified as thresholds: for BSA-based methods, healthy liver doses are much higher than 30 Gy when T/N  4. As PM accounts for uptake ratio between normal and tumour liver, this method should be employed over BSA-based methods. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  10. Splenomegaly and tumor marker response following selective internal radiation therapy for non-resectable liver metastases from neuroendocrine tumor

    International Nuclear Information System (INIS)

    Shehata, M.; Yan, K.; Itoh, Seiji; King, J.; Glenn, D.; Quinn, R.; Morris, D.L.

    2009-01-01

    The aim of this study was to investigate changes in spleen size, the level of chromogranin A as a tumor marker, and the relationship between these two parameters before and 3 months after selective internal radiation therapy (SIRT) for non-resectable liver metastases from neuroendocrine tumor (NET). Our first serious adverse event with this relatively new treatment is also discussed. A retrospective review of a prospective database identified patients with non-resectable liver metastases from NET who underwent SIRT between 2003 and 2007. Patients who underwent CT scans before and 3 months after treatment were included. The patients were divided into two groups: those with and without a 20% or more increase in splenic volume on the CT scans. The percentages of patients showing a tumor marker response in the two groups were then compared. Fourteen patients were included in the present analysis. A tumor marker response was seen in 6 of 7 patients (85.7%) who showed an increase in splenic volume of >20%, and in 3 of 7 patients (42.9%) without an increase in splenic volume (p=0.266). There was one death as a result of oesophageal variceal bleeding due to portal hypertension at 9 months after treatment. Splenic enlargement after SIRT may be associated with tumor marker response, although this could not be confirmed statistically in this study due to the small number of patients. Long-term splenomegaly and portal hypertension may be important complications of SIRT. This issue needs to be investigated further using a larger number of patients and longer follow-up. (author)

  11. Selective Internal Radiation Therapy With Yttrium-90 Glass Microspheres: Biases and Uncertainties in Absorbed Dose Calculations Between Clinical Dosimetry Models.

    Science.gov (United States)

    Mikell, Justin K; Mahvash, Armeen; Siman, Wendy; Baladandayuthapani, Veera; Mourtada, Firas; Kappadath, S Cheenu

    2016-11-15

    To quantify differences that exist between dosimetry models used for 90 Y selective internal radiation therapy (SIRT). Retrospectively, 37 tumors were delineated on 19 post-therapy quantitative 90 Y single photon emission computed tomography/computed tomography scans. Using matched volumes of interest (VOIs), absorbed doses were reported using 3 dosimetry models: glass microsphere package insert standard model (SM), partition model (PM), and Monte Carlo (MC). Univariate linear regressions were performed to predict mean MC from SM and PM. Analysis was performed for 2 subsets: cases with a single tumor delineated (best case for PM), and cases with multiple tumors delineated (typical clinical scenario). Variability in PM from the ad hoc placement of a single spherical VOI to estimate the entire normal liver activity concentration for tumor (T) to nontumoral liver (NL) ratios (TNR) was investigated. We interpreted the slope of the resulting regression as bias and the 95% prediction interval (95%PI) as uncertainty. MC NL single represents MC absorbed doses to the NL for the single tumor patient subset; other combinations of calculations follow a similar naming convention. SM was unable to predict MC T single or MC T multiple (p>.12, 95%PI >±177 Gy). However, SM single was able to predict (p<.012) MC NL single , albeit with large uncertainties; SM single and SM multiple yielded biases of 0.62 and 0.71, and 95%PI of ±40 and ± 32 Gy, respectively. PM T single and PM T multiple predicted (p<2E-6) MC T single and MC T multiple with biases of 0.52 and 0.54, and 95%PI of ±38 and ± 111 Gy, respectively. The TNR variability in PM T single increased the 95%PI for predicting MC T single (bias = 0.46 and 95%PI = ±103 Gy). The TNR variability in PM T multiple modified the bias when predicting MC T multiple (bias = 0.32 and 95%PI = ±110 Gy). The SM is unable to predict mean MC tumor absorbed dose. The PM is statistically correlated with mean MC, but the

  12. Phase II trial of selective internal radiation therapy and systemic chemotherapy for liver-predominant metastases from pancreatic adenocarcinoma.

    Science.gov (United States)

    Gibbs, Peter; Do, Cuong; Lipton, Lara; Cade, David N; Tapner, Michael J; Price, David; Bower, Geoff D; Dowling, Richard; Lichtenstein, Meir; van Hazel, Guy A

    2015-10-26

    This prospective, open-label phase II study assessed the impact of liver-directed therapy with selective internal radiation therapy (SIRT) and systemic chemotherapy on progression-free survival (PFS) in liver-dominant metastatic pancreatic adenocarcinoma. Patients received yttrium-90-labelled ((90)Y) resin microspheres (SIR-Spheres; Sirtex Medical Limited, Sydney, Australia) as a single procedure on day 2 of the first weekly cycle of 5-fluorouracil (5FU; 600 mg/m(2)) with the option to switch to gemcitabine (1000 mg/m(2)) after 8 weeks of 5FU. Statistical analysis was conducted using Microsoft Excel (Microsoft Corporation, Redmond, Washington, USA). The primary endpoint of the study was PFS in the liver, with a median of ≥ 16 weeks defined as the threshold for clinical significance. PFS and overall survival (OS) were summarised by the Kaplan-Meier method using non-parametric estimates of the survivor function. Fourteen eligible patients were enrolled; ten had primary tumour in situ and eight had liver-only metastases. Patients received a median (90)Y activity of 1.1 GBq and 8 weekly doses of 5FU; seven patients received a median of two doses of gemcitabine. Disease control in the liver was 93% (two confirmed partial responses [PR], one unconfirmed PR, ten stable disease). Median reduction in cancer antigen 19-9 was 72%. Median PFS was 5.2 months in the liver, which met the primary endpoint of the study, and 4.4 months at any site. PFS was prolonged in those with a resected primary compared with patients with primary in situ (median 7.8 vs. 3.4 months; p = 0.017). Median OS was 5.5 months overall and 13.6 months in patients with a resected primary. Grade 3/4 adverse events occurred in eight (57%) patients during days 0-60. There was one sudden death and another patient who died from possible treatment-related liver failure 7.0 months after SIRT. SIRT and chemotherapy appears to be an effective treatment for liver metastases from pancreatic cancer, likely to be of

  13. International Conference Medical Radiations

    International Nuclear Information System (INIS)

    2010-01-01

    Full text : The second edition of the international conference Medical radiation : research and applications which took place in Marrakech (Morocco) from 7 to 9 April 2010, was designed to bring together researchers and physicians from different countries who dedicated their talents and time to this endeavour. The conference's program defined goals were is to identify the most reliable techniques among the several tested so far and to establish the most practical standardized methodologies, taking into account such recent technological development in radiation medical research. The scientific objectives of this conference are as follows : present the state of the art of the various topics of the congress, give a progress report on the impact of the interaction of the various scientific and technical disciplinary fields (Medicine, Biology, Mathematics, Physics,..) on the applications of radiations in medicine, promote the interdisciplinary efforts of research among researchers, present new technologies and research and development tasks prepared in the field of medical radiations, contribute to the emergence of new ideas of research and development of new collaborations [fr

  14. Modern radiation therapy for primary cutaneous lymphomas

    DEFF Research Database (Denmark)

    Specht, Lena; Dabaja, Bouthaina; Illidge, Tim

    2015-01-01

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

  15. Radiation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Nakamura, Katsumasa

    2001-01-01

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

  16. Smart Radiation Therapy Biomaterials.

    Science.gov (United States)

    Ngwa, Wilfred; Boateng, Francis; Kumar, Rajiv; Irvine, Darrell J; Formenti, Silvia; Ngoma, Twalib; Herskind, Carsten; Veldwijk, Marlon R; Hildenbrand, Georg Lars; Hausmann, Michael; Wenz, Frederik; Hesser, Juergen

    2017-03-01

    Radiation therapy (RT) is a crucial component of cancer care, used in the treatment of over 50% of cancer patients. Patients undergoing image guided RT or brachytherapy routinely have inert RT biomaterials implanted into their tumors. The single function of these RT biomaterials is to ensure geometric accuracy during treatment. Recent studies have proposed that the inert biomaterials could be upgraded to "smart" RT biomaterials, designed to do more than 1 function. Such smart biomaterials include next-generation fiducial markers, brachytherapy spacers, and balloon applicators, designed to respond to stimuli and perform additional desirable functions like controlled delivery of therapy-enhancing payloads directly into the tumor subvolume while minimizing normal tissue toxicities. More broadly, smart RT biomaterials may include functionalized nanoparticles that can be activated to boost RT efficacy. This work reviews the rationale for smart RT biomaterials, the state of the art in this emerging cross-disciplinary research area, challenges and opportunities for further research and development, and a purview of potential clinical applications. Applications covered include using smart RT biomaterials for boosting cancer therapy with minimal side effects, combining RT with immunotherapy or chemotherapy, reducing treatment time or health care costs, and other incipient applications. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Radiation Therapy: Professions in Radiation Therapy

    Science.gov (United States)

    ... measurements of radiation beam characteristics and do other safety tests on a regular basis. Therapeutic medical physicists have doctorates or master's degrees and have completed four years of college, two to four years of graduate school and typically one to two years of clinical ...

  18. The physics of radiation therapy

    CERN Document Server

    Khan, Faiz M

    2009-01-01

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

  19. Outcomes and predictors of toxicity after selective internal radiation therapy using yttrium-90 resin microspheres for unresectable hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Andrew eGabrielson

    2015-12-01

    Full Text Available Purpose: We sought to report outcomes and toxicity in patients with hepatocellular carcinoma (HCC who received resin Yttrium-90 Selective Internal Radiation Therapy (90Y-SIRT, and to identify factors associated with declining liver function.Methods: Patients treated with 90Y-SIRT were retrospectively evaluated. Radiographic response was assessed using RECIST 1.1. Median liver progression-free survival (LPFS and overall survival (OS were calculated using the Kaplan-Meier method. Bivariate analysis was used to examine associations between change in Child-Pugh (CP score/class and patient characteristics and treatment parameters.Results: Twenty-seven patients with unresectable HCC underwent SIRT, 52% were CP Class A, 48% were Class B; 11% were BCLC stage B, 89% were stage C. Forty-four percent of patients had portal vein thrombus at baseline. One-third of patients received bilobar treatment. Median activity was 32.1 mCi (range 9.18 – 43.25 and median absorbed dose to the liver was 39.6 Gy (range 13.54 – 67.70. Median LPFS and OS were 2.5 and 11.7 months, respectively. Three-month disease control rate was 63% and 52% in the target lesions and whole liver, respectively.New onset or worsened from baseline clinical toxicities were confined to Grade 1-2 events. However, new or worsened Grade 3-4 laboratory toxicities occurred in 38% of patients at 3 months and 43% of patients at 6 months following SIRT (6 had lymphocytopenia, 3 had hypoalbuminemia, 2 had transaminasemia. After 3 months, 6 patients had worsened in CP score and 5 had worsened in class from baseline. After 6 months, 4 patients had worsened in CP score and 1 had worsened in class from baseline. Pretreatment bilirubinemia was associated with a 2+ increase in CP score within 3 months (P = 0.001 and 6 months (P = 0.039 of 90Y-SIRT. Pretreatment transaminasemia and bilirubinemia were associated with increased CP class within 3 months of SIRT (P = 0.021 and 0.009 respectively.Conclusions: 90Y

  20. Dosimetric effect of internal metallic ports in temporary tissue expanders on postmastectomy radiation therapy: a Monte Carlo study

    Science.gov (United States)

    Park, Jong Min; Kim, Kyubo; In Park, Jong; Shin, Kyung Hwan; Jin, Ung Sik; Kim, Jung-in

    2017-06-01

    To investigate the dosimetric effect of the internal metallic port (IMP) in a tissue expander (TE) on the dose distribution of postmastectomy radiation therapy (PMRT). A total of 10 patients who have received PMRT with a TE were selected retrospectively. For each patient, the dose distributions of treatment plans with a 10 MV photon beam were calculated using the Monte Carlo (MC) method with CT images. The dose distributions without the TE were also calculated by designating the mass densities of the TE including the IMP as those of tissue. From the MC calculations, the dose-volumetric parameters were calculated and analyzed for several structures: the planning target volume (PTV) including the TE, the PTV excluding the TE (PTVreal), the TE alone, heart, and lungs. For the PTV and PTVreal, dose-volumetric parameters did not appear to depend on the IMP. Within the TE volume, the maximum dose and D 1% were higher with the IMP than without the IMP (62.8  ±  1.4 Gy versus 57.9  ±  1.3 Gy with p  <  0.001 and 58.6  ±  1.6 Gy versus 57.0  ±  1.2 Gy with p  =  0.035). The values of V 100% and V 95% were lower with the IMP than without the IMP (77.9%  ±  7.6% versus 87.2%  ±  5.3% with p  =  0.008 and 89.5%  ±  5.6% versus 94.6%  ±  2.9% with p  =  0.027). The IMP did not affect dose-volumetric parameters of heart and lungs. Dosimetric changes due to the IMP occurred mainly within the TE, and not in the target volume, heart, and lungs.

  1. Basic physics of radiation therapy

    International Nuclear Information System (INIS)

    Selman, J.

    1976-01-01

    The subject is discussed under the following chapter headings: simple mathematics gradiation therapy; matter and energy; the nature of radiation;reactions between radiation and matter; x-ray production and control; high-energy therapy units and particle accelerators; quantity of x rays and γ rays; x-ray quality; dosage in x-ray and γ-ray therapy; therapy planning; radioactivity and nuclear physics; implant therapy with radium, radon, and artificial radionuclides; surface therapy with β particles; medical use of radionuclides; radiobiology; radiotherapy with heavy particles; and protection in radiotherapy-health physics

  2. Modern Radiation Therapy for Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    Specht, Lena; Yahalom, Joachim; Illidge, Tim

    2014-01-01

    on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy...... optimal imaging is available, is explained. A new concept, involved site radiation therapy (ISRT), is introduced as the standard conformal therapy for the scenario, commonly encountered, wherein optimal imaging is not available. There is increasing evidence that RT doses used in the past are higher than...... (ILROG) Steering Committee regarding the modern approach to RT in the treatment of HL, outlining a new concept of ISRT in which reduced treatment volumes are planned for the effective control of involved sites of HL. Nodal and extranodal non-Hodgkin lymphomas (NHL) are covered separately by ILROG...

  3. Radiation therapy in palliative care

    International Nuclear Information System (INIS)

    Ikushima, Hitoshi; Nishitani, Hiromu

    2005-01-01

    Radiation therapy is a valuable treatment for palliation of local symptoms with consistently high response rates in the relief and control of bone pain, neurological symptom, obstructive symptoms, and tumor hemorrhage. Over than 80% of patients who developed bone metastasis and superior vena cava syndrome obtained symptom relief by radiation therapy. Radiation therapy is also well established as an effective treatment for brain metastasis, improving symptoms and preventing progressive neurological deficits, and recently stereotactic irradiation had became a alternative treatment of surgery for small metastatic brain tumors. Both radiation therapy and surgery are effective in the initial treatment of malignant spinal cord compression syndrome, and no advantages of surgery over radiation therapy has been demonstrated in published series when patients have a previously conformed diagnosis of malignant disease and no evidence of vertebral collapse. The outcome of treatment depends primarily upon the speed of diagnosis and neurological status at initiation of treatment. It is very important to start radiation therapy before patient become non-ambulant. Low irradiation dose and short treatment period of palliative radiation therapy can minimize disruption and acute morbidity for the patients with advanced cancer with enabling control of symptoms and palliative radiation therapy is applicable to the patient even in poor general condition. (author)

  4. Optimization of radiation therapy

    International Nuclear Information System (INIS)

    Ohtsubo, Masaaki

    1990-01-01

    In radiotherapy, dose optimization is to give adequate dose uniformly over target volume and minimize the dose to normal and adjacent critical organs. Therefore, it is necessary to analyze dose distribution in detail. This paper presents a method for quantitatively assessing treatment planning by analysis of dose distribution. For this purpose, several parameters were introduced, such as D T, min (minimum target absorbed dose), NUF (nonuniformity factor), volume rate of damaged lung and spinal cord, R T/T (ratio of target volume to treatment volume), LE (local efficiency), integral dose, etc. And some criteria were made using these parameters, and were applied to evaluate various plans in external beam radiation therapy for lung and esophagus cancer. In these parameters, NUF was especially useful to obtain three-dimensional dose information of target volume, and value of NUF was in agreement with the information provided by dose volume histogram. AP-PA parallel opposed fields technique was inferior in D T,min and NUF. In lung cancer, there was no spinal cord injury in oblique parallel opposed fields technique, and this technique is particularly useful when target volume is in posterior. In these two techniques, R T/T was small and hot spots were frequently observed. R T/T was largest in oblique wedged two-fields technique, but this technique was inferior in D T, min and NUF. About D T, min and NUF, four fields technique was the best, but in this technique spinal cord complication often occurred in case that target volume was in the middle. In moving beam technique (360deg rotation or arc), integral dose is large, and the more target volume is in posterior, the more often spinal cord complication occurs. In esophageal cancer, three fields technique was the best to avoid spinal cord injury. It seems that this method is very useful for optimization in radiation treatment planning. (author)

  5. Development and Internal Validation of a Clinical Risk Score to Predict Pain Response After Palliative Radiation Therapy in Patients With Bone Metastases.

    Science.gov (United States)

    van der Velden, Joanne M; Peters, Max; Verlaan, Jorrit-Jan; Versteeg, Anne L; Zhang, Liying; Tsao, May; Danjoux, Cyril; Barnes, Elizabeth; van Vulpen, Marco; Chow, Edward; Verkooijen, Helena M

    2017-11-15

    To investigate the relationship between patient and tumor characteristics and pain response in patients with metastatic bone disease, and construct and internally validate a clinical prediction model for pain response to guide individualized treatment decision making. A total of 965 patients with painful bone metastases undergoing palliative radiation therapy at a tertiary referral center between 1999 and 2007 were identified. Pain scores were measured at 1, 2, and 3 months after radiation therapy. Pain response was defined as at least a 2-point decrease on a pain score scale of 0-10, without increase in analgesics, or an analgesic decrease of at least 25% without an increase in pain score. Thirteen candidate predictors were identified from the literature and expert experience. After multiple imputation, final predictors were selected using stepwise regression and collapsed into a prediction model. Model performance was evaluated by calibration and discrimination and corrected for optimism. Overall 462 patients (47.9%) showed a response. Primary tumor site, performance status, and baseline pain score were predictive for pain response, with a corrected c-statistic of 0.63. The predicted response rates after radiation therapy increased from 37.5% for patients with the highest risk score to 79.8% for patients with the lowest risk score and were in good agreement with the observed response rates. A prediction score for pain response after palliative radiation therapy was developed. The model performance was moderate, showing that prediction of pain response is difficult. New biomarkers and predictors may lead to improved identification of the large group of patients who are unlikely to respond and who may benefit from other or innovative treatment options. Copyright © 2017. Published by Elsevier Inc.

  6. Radiation safety: New international standards

    International Nuclear Information System (INIS)

    Gonzalez, A.J.

    1994-01-01

    This article highlights an important result of this work for the international harmonization of radiation safety: specifically, it present an overview of the forthcoming International Basic Safety Standards for Protection Against Ionizing Radiation and for the Safety of Radiation Sources - the so-called BSS. They have been jointly developed by six organizations - the Food and Agriculture Organization of the United Nations (FAO), the International Atomic Energy Agency (IAEA), the International Labour Organization (ILO), the Nuclear Energy Agency of the Organization for Economic Co-operation and Development (NEA/OECD), the Pan American Health Organization (PAHO), and the World Health Organization (WHO)

  7. Radiation therapy in the neonate

    International Nuclear Information System (INIS)

    Littman, P.; D'Angio, G.J.

    1981-01-01

    Radiation therapy (RT) is frequently used in the management of children with cancer, but neonatal neoplasms are rare. Newborns represent 1.5% of the children with malignant diseases in the Tumor Registry at the Children's Hospital of Philadelphia over the last 30 years. Thus, occasionally the pediatrics radiation therapist must consider treating the very young infant. The specific radiation effects on growth and development must be weighed in reaching a therapeutic decision. All children are vulnerable to the late effects of radiation therapy, but the neonates may be more susceptible because of the immaturity of important organs such as the brain, lung, liver, kidney, and bone. In general, radiation therapy, should be avoided during the first several weeks of life because of the potential increased sensitivity of the liver and kidneys during that period. If radiation therapy is used at all during infancy, the benefits must be weighed against the possibility of significant late effects. Increasing knowledge of pediatric neoplasms has shown that some tumors (such as mesoblastic nephroma) require no treatment except for surgical excision; and other tumors, such as Stage IV-S neuroblastoma, may require very little treatment. In those tumors that require radiation therapy, the use of chemotherapy may allow reduction of the radiation dose. Furthermore, alterations of time-dose-fractionation schemes and careful attention to tumor volume with the use of special techniques, such as ''shrinking fields,'' may decrease the late adverse effects of treatment

  8. Radiation Therapy for Gynecologic Cancers

    Science.gov (United States)

    ... with some form of gynecologic cancer this year. Cancers of the uterus and cervix are most common gynecologic cancers treated ... detected or removed by surgery. Radiation therapy kills ... of the uterus and cervix, called a hysterectomy. The surgeon may ...

  9. Malignant mesothelioma following radiation therapy.

    Science.gov (United States)

    Hofmann, J; Mintzer, D; Warhol, M J

    1994-10-01

    Studies of the growing population of long-term survivors of cancer have led to increased recognition of the neoplastic complications of therapy. The causes of secondary malignancies are probably multifactorial, but radiation therapy and chemotherapy have certainly been implicated in the development of posttherapy neoplasia. A case of pleural mesothelioma after successful radiation therapy for Hodgkin's disease is described with a review of radiation-associated mesotheliomas reported in the literature. In Hodgkin's disease, patients may receive radiation, chemotherapy, or combined treatment; the most common secondary malignancy is acute nonlymphocytic leukemia while sarcomas are the second most common solid tumors. Although mesothelioma is an uncommon sarcoma, its occurrence has been documented numerous times after exposure to diagnostic or therapeutic radiation.

  10. Internal and external validation of an ESTRO delineation guideline - dependent automated segmentation tool for loco-regional radiation therapy of early breast cancer.

    Science.gov (United States)

    Eldesoky, Ahmed R; Yates, Esben S; Nyeng, Tine B; Thomsen, Mette S; Nielsen, Hanne M; Poortmans, Philip; Kirkove, Carine; Krause, Mechthild; Kamby, Claus; Mjaaland, Ingvil; Blix, Egil S; Jensen, Ingelise; Berg, Martin; Lorenzen, Ebbe L; Taheri-Kadkhoda, Zahra; Offersen, Birgitte V

    2016-12-01

    To internally and externally validate an atlas based automated segmentation (ABAS) in loco-regional radiation therapy of breast cancer. Structures of 60 patients delineated according to the ESTRO consensus guideline were included in four categorized multi-atlas libraries using MIM Maestro™ software. These libraries were used for auto-segmentation in two different patient groups (50 patients from the local institution and 40 patients from other institutions). Dice Similarity Coefficient, Average Hausdorff Distance, difference in volume and time were computed to compare ABAS before and after correction against a gold standard manual segmentation (MS). ABAS reduced the time of MS before and after correction by 93% and 32%, respectively. ABAS showed high agreement for lung, heart, breast and humeral head, moderate agreement for chest wall and axillary nodal levels and poor agreement for interpectoral, internal mammary nodal regions and LADCA. Correcting ABAS significantly improved all the results. External validation of ABAS showed comparable results. ABAS is a clinically useful tool for segmenting structures in breast cancer loco-regional radiation therapy in a multi-institutional setting. However, manual correction of some structures is important before clinical use. The ABAS is now available for routine clinical use in Danish patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Role and liabilities of the medical physicist in the validation of oncologic treatments in internal vectorized radiation therapy. S.F.P.M. report nr 31, June 2015

    International Nuclear Information System (INIS)

    Farman, Bardia; Defez, Didier; Martineau, Antoine; Vrigneaud, Jean-Marc; Dieudonne, Arnaud; Giraud, Fabienne; Divry, Guillaume; Bardies, Manuel; Laffont, Sophie; Santoro, Lore; Ferrer, Ludovic; Guilhem, Marie-Therese; Meyer, Philippe; Simon, Luc

    2015-06-01

    According to legal arrangements and decrees, the medical physicist must validate the preparation of each treatment based on the use of radio-elements in non-sealed sources. As the medical physicist is therefore liable of this validation, this report addresses the approach to be followed to comply with the law. The authors first outline that this report only concerns oncologic internal vectorized radiation therapy, and does not address the dosimetric aspect of these treatments. After having recalled the principles of internal vectorized radiography, they describe the role of the different actors: nuclear physician, medical physicist, radio-pharmacist, radio-pharmacy dispenser, medical electro-radiology operator, state nurse. They address the various aspects of the process of validation of a treatment preparation: technical prerequisites, organisational prerequisite, validation process, traceability, dosimetry. Several examples are proposed in appendix regarding traceability, dosimetry software, examples of PRM files

  12. International radiation protection standards

    International Nuclear Information System (INIS)

    Aghayev, J.A.

    2009-01-01

    Full text: Today the recommendations of ICRP have a profound influence on radiation protection all over the world. The latest recommendations were issued as publication no 60 (ICRP 60 1991). This document elaborated a conceptual framework for radiation protection based on ethics, experimental work, and risk assessment. The justification principle prohibits practices involving additional radiation exposures unless they produce sufficient societal benefits. The three main principles of the ICRP for proposed or continuing radiation-protection practices are: 1) the justification principle; 2)the optimization principle; 3) the dose limitation principle.The optimization principle requires managers to keep radiation exposures as low as reasonably achievable (ALARA), taking into account economic and social factors. the dose-limitation principle limits exposure of individuals to radiation. The system of radiological protection recommended by CRP for intervention is based on two additional principles: the proposed intervention should do more good than harm; one should optimize the form, scale and duration of intervention. Although the ICRP does not employ the term precautionary principle it does use the concept, at least implicitly

  13. Partial breast radiation therapy - external beam

    Science.gov (United States)

    Carcinoma of the breast - partial radiation therapy; Partial external beam radiation - breast; Intensity-modulated radiation therapy - breast cancer; IMRT - breast cancer WBRT; Adjuvant partial breast - IMRT; APBI - IMRT; ...

  14. Monte Carlo techniques in radiation therapy

    CERN Document Server

    Verhaegen, Frank

    2013-01-01

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

  15. Radiation Therapy of Pituitary Tumors

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-12-15

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

  16. Radiation Therapy of Pituitary Tumors

    International Nuclear Information System (INIS)

    Park, Moon Baik; Hong, Seong Eong

    1989-01-01

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

  17. Advances in radiation therapy dosimetry

    Directory of Open Access Journals (Sweden)

    Paliwal Bhudatt

    2009-01-01

    Full Text Available During the last decade, there has been an explosion of new radiation therapy planning and delivery tools. We went through a rapid transition from conventional three-dimensional (3D conformal radiation therapy to intensity-modulated radiation therapy (IMRT treatments, and additional new techniques for motion-adaptive radiation therapy are being introduced. These advances push the frontiers in our effort to provide better patient care; and with the addition of IMRT, temporal dimensions are major challenges for the radiotherapy patient dosimetry and delivery verification. Advanced techniques are less tolerant to poor implementation than are standard techniques. Mis-administrations are more difficult to detect and can possibly lead to poor outcomes for some patients. Instead of presenting a manual on quality assurance for radiation therapy, this manuscript provides an overview of dosimetry verification tools and a focused discussion on breath holding, respiratory gating and the applications of four-dimensional computed tomography in motion management. Some of the major challenges in the above areas are discussed.

  18. International standards for radiation protection

    International Nuclear Information System (INIS)

    Ambrosi, P.

    2011-01-01

    International standards for radiation protection are issued by many bodies. These bodies differ to a large extent in their organisation, in the way the members are designated and in the way the international standards are authorised by the issuing body. Large differences also exist in the relevance of the international standards. One extreme is that the international standards are mandatory in the sense that no conflicting national standard may exist, the other extreme is that national and international standards conflict and there is no need to resolve that conflict. Between these extremes there are some standards or documents of relevance, which are not binding by any formal law or contract but are de facto binding due to the scientific reputation of the issuing body. This paper gives, for radiation protection, an overview of the main standards issuing bodies, the international standards or documents of relevance issued by them and the relevance of these documents. (authors)

  19. Radiation therapy of nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Nho, Y. J.; Cho, J. G.; Ahn, S. D.; Choi, E. K.; Kim, J. H.; Kang, O. C.; Chang, H. S.

    1997-01-01

    This is a retrospective study to evaluate the results of radiation therapy and prognostic factors influencing the results in nasopharyngeal carcinoma. From October 1989 to May 1996, 56 patients were treated for nasopharyngeal carcinoma at Department of Radiation Oncology. According to stage, patients were distributed as follows: stage I (2), II (13), III (11), IV (30). Twenty-eight patients were treated with radiation therapy and weekly CDDP. After external beam radiotherapy of 60Gy, 46 patients received boost dose with intracavitary radiation and 9 patients with 3D conformal therapy. One patient received boost dose with 2 dimensional photon beam therapy. The tumor dose ranged from 69.4Gy to 86.2Gy with median dose of 74.4Gy. The follow-up period ranged from 5 months to 92 months with a median of 34 months. Forty-seven patients achieved complete response and 8 patients showed partial response. One patient showed minimal response. Patterns of failure were as follows: locoregional recurrence (8) and distant metastasis (18). Among these patients, 2 patients failed locoregionally and distantly, The sites of distant metastasis were bone (8), lung (8) and liver (4). Five years survival rate was 67.2% and 5 years disease-free survival rate was 53.6%. KPS (P=0.005) and response of radiation therapy (P=0.0001) were significant prognostic factors for overall survival. KPS (P=0.02) and response of radiation therapy (P=0.005) were significant prognostic factors for disease-free survival. This retrospective study showed that distant metastasis was the predominant pattern of relapse in nasopharyngeal cancer. Neoadjuvant chemotherapy or weekly CDDP did not influence the distant metastasis-free survival. For advanced T stage, 3D conformal therapy provided an improved dose coverage compared to ICR. But further follow-up was needed in patients with 3D conformal therapy to assess the efficacy of this therapy. Development of techniques of radiation therapy to improve locoregional

  20. Three-dimensional personalized dosimetry for 188Re liver selective internal radiation therapy based on quantitative post-treatment SPECT studies

    Science.gov (United States)

    Shcherbinin, S.; Grimes, J.; Bator, A.; Cwikla, J. B.; Celler, A.

    2014-01-01

    We demonstrate that accurate patient-specific distributions of microspheres labeled with 188Re and resulting absorbed doses can be obtained from single-photon emission computed tomography (SPECT) studies performed after 188Re selective internal radiation therapy when accurate correction methods are employed in image reconstruction. Our quantitative image reconstruction algorithm includes corrections for attenuation, resolution degradations and scatter as well as a window-based compensation for contamination. The procedure has been validated using four phantom experiments containing an 18 ml cylindrical source (82-93 MBq of 188Re activity) simulating a liver tumor. In addition, we applied our approach to post-therapy SPECT studies of ten patients with progressive primary or metastatic liver carcinomas. Our quantitative algorithm accurately (within 9%) recovered 188Re activity from four phantom experiments. In addition, for two patients that received three scans, deviations remained consistent between the measured and the reconstructed activities that were determined from studies with differing severity of the dead-time effect. The analysis of absorbed doses for patient studies allowed us to hypothesize that D90 (the minimum dose received by 90% of the tumor volume) may be a reliable metric relating therapy outcomes to the calculated doses. Among several considered metrics, only D90 showed statistically significant correlation with the overall survival.

  1. Radiation therapy in pseudotumour haemarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Lal, P.; Biswal, B.M.; Thulkar, S.; Patel, A.K.; Venkatesh, R.; Julka, P.K. [Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi (India). Departments of Radiation Oncology, Radiodiagnosis and Haematology

    1998-11-01

    Total or partial deficiency of factor VIII and IX in the coagulation cascade leads to haemophilia. Haemophilia affecting weight-bearing joints gives a `pseudotumour` or haemarthrosis-like condition. Surgery and cryoprecipitate infusions have been the treatment for this condition. Radiocolloids and radiation therapy have been used with some benefit. One case of ankle pseudotumour which was treated by low-dose external beam radiation is presented here. Copyright (1998) Blackwell Science Pty Ltd 14 refs., 2 figs.

  2. Radiation therapy in pseudotumour haemarthrosis

    International Nuclear Information System (INIS)

    Lal, P.; Biswal, B.M.; Thulkar, S.; Patel, A.K.; Venkatesh, R.; Julka, P.K.

    1998-01-01

    Total or partial deficiency of factor VIII and IX in the coagulation cascade leads to haemophilia. Haemophilia affecting weight-bearing joints gives a 'pseudotumour' or haemarthrosis-like condition. Surgery and cryoprecipitate infusions have been the treatment for this condition. Radiocolloids and radiation therapy have been used with some benefit. One case of ankle pseudotumour which was treated by low-dose external beam radiation is presented here. Copyright (1998) Blackwell Science Pty Ltd

  3. Integration of real-time internal electromagnetic position monitoring coupled with dynamic multileaf collimator tracking: an intensity-modulated radiation therapy feasibility study.

    Science.gov (United States)

    Smith, Ryan L; Sawant, Amit; Santanam, Lakshmi; Venkat, Raghu B; Newell, Laurence J; Cho, Byung-Chul; Poulsen, Per; Catell, Herbert; Keall, Paul J; Parikh, Parag J

    2009-07-01

    Continuous tumor position measurement coupled with a tumor tracking system would result in a highly accurate radiation therapy system. Previous internal position monitoring systems have been limited by fluoroscopic radiation dose and low delivery efficiency. We aimed to incorporate a continuous, electromagnetic, three-dimensional position tracking system (Calypso 4D Localization System) with a dynamic multileaf collimator (DMLC)-based dose delivery system. A research version of the Calypso System provided real-time position of three Beacon transponders. These real-time three-dimensional positions were sent to research MLC controller with a motion-tracking algorithm that changed the planned leaf sequence. Electromagnetic transponders were embedded in a solid water film phantom that moved with patient lung trajectories while being irradiated with two different plans: a step-and-shoot intensity-modulated radiation therapy (S-IMRT) field and a dynamic IMRT (D-IMRT) field. Dosimetric results were recorded under three conditions: no intervention, DMLC tracking, and a spatial gating system. Dosimetric accuracy was comparable for gating and DMLC tracking. Failure rates for gating/DMLC tracking are as follows: +/-3 cGy 10.9/ 7.5% for S-IMRT, 3.3/7.2% for D-IMRT; gamma (3mm/3%) 0.2/1.2% for S-IMRT, 0.2/0.2% for D-IMRT. DMLC tracking proved to be as efficient as standard delivery, with a two- to fivefold efficiency increase over gating. Real-time target position information was successfully integrated into a DMLC effector system to modify dose delivery. Experimental results show both comparable dosimetric accuracy as well as improved efficiency compared with spatial gating.

  4. Laparoscopic parenchymal preserving liver resections for colorectal liver metastases in the era of highly effective systemic therapy and selective internal radiation therapy can often prevent a hemihepatectomy. (With video).

    Science.gov (United States)

    D'Hondt, Mathieu; Ververken, Frédéric; Nuytens, Frederiek

    2017-12-01

    Preservation of hepatic parenchyma is important in liver surgery to prevent postoperative liver failure and according to some reports it could offer a prolonged survival and lower recurrence rates compared to major hepatectomies in patients with colorectal liver metastases. However, laparoscopic parenchyma-preserving liver resections can be technically challenging. The aim of this video is to illustrate the concept of laparoscopic parenchymal-preserving liver resections after conversion chemotherapy with targeted therapy. In this video we present three cases in which a laparoscopic parenchymal-preserving liver resection was performed after neo-adjuvant therapy: the first patient had a giant solitary colorectal metastasis in segment V and VIII. Neoadjuvant chemotherapy was given, resulting in a 30% volume reduction of the lesion after which a laparoscopic anterior sectionectomy was successfully performed. The second patient had five colorectal liver metastases. After conversion chemotherapy, four remaining metastases were resected by laparoscopic surgery. The last patient had 7 colorectal liver metastases. After 18 cycles of neo-adjuvant chemotherapy and a good response to selective internal radiation therapy, a laparoscopic liver resection of six metastases and radiofrequency ablation of 1 central lesion were performed. The video of these three cases shows that laparoscopic parenchymal-preserving liver surgery is feasible after neo-adjuvant systemic therapy and selective internal radiation therapy. The emergence of more effective systemic chemotherapies with biologicals and SIRT for the treatment of colorectal liver metastases often creates a possibility for parenchymal-preserving liver resections to achieve an R0 resection. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Radiation therapy and herpes zoster

    International Nuclear Information System (INIS)

    Kaneko, Itsuo; Matsushima, Hideno; Yamada, Teruyo; Moriya, Hiroshi

    1975-01-01

    The relationship between herpes zoster and radiation therapy was discussed and the combination of herpes zoster with malignancies was observed. Reported were five cases of herpes zoster (four breast and one lung carcinoma) out of 317 cases of malignancies which were irradiated in our clinic and include considerations about the etiologic relationship. (J.P.N.)

  6. Radiation dosimetry for radionuclide therapy

    International Nuclear Information System (INIS)

    Kim, Eun Hee

    2001-01-01

    The radionuclide therapy is a protocol for tumor control by administering radionuclides as the cytotoxic agents. Radionuclides concentrated at the site of cancerous lesion are expected to kill the cancerous cells with minimal injury to the normal tissue. The efficacy of every radionuclide treatment can be evaluated by examining the toxicity to the lesion differentiated from that to the normal tissue. Radiation dosimerty is the procedure of quantitating the energy absorbed by target volumes of interest. Dosimetric information plays an indicator of the expected radiation damage and thus the therapeutic efficacy. This paper summarizes the dosimetric aspects in radionuclide therapy in terms of radionuclides of use, radionuclides of use, radiation dosimetry methodology and considerations for each treatment in practical use

  7. Diffusion-weighted magnetic resonance imaging predicts survival in patients with liver-predominant metastatic colorectal cancer shortly after selective internal radiation therapy.

    Science.gov (United States)

    Schmeel, Frederic Carsten; Simon, Birgit; Sabet, Amir; Luetkens, Julian Alexander; Träber, Frank; Schmeel, Leonard Christopher; Ezziddin, Samer; Schild, Hans Heinz; Hadizadeh, Dariusch Reza

    2017-03-01

    To investigate whether quantifications of apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) can predict overall survival (OS) in patients with liver-predominant metastatic colorectal cancer (CRC) following selective internal radiation therapy with 90 Yttrium-microspheres (SIRT). Forty-four patients underwent DWI 19 ± 16 days before and 36 ± 10 days after SIRT. Tumour-size and intratumoral minimal ADC (minADC) values were measured for 132 liver metastases on baseline and follow-up DWI. Optimal functional imaging response to treatment was determined by receiver operating characteristics and defined as ≥22 % increase in post-therapeutic minADC. Survival analysis was performed with the Kaplan-Meier method and Cox-regression comparing various variables with potential impact on OS. Median OS was 8 months. The following parameters were significantly associated with median OS: optimal functional imaging response (18 vs. 5 months; p therapy management in sequential lobar radioembolization approaches.

  8. Phase I trial of selective internal radiation therapy for chemorefractory colorectal cancer liver metastases progressing after hepatic arterial pump and systemic chemotherapy.

    Science.gov (United States)

    Sofocleous, Constantinos T; Garcia, Alessandra R; Pandit-Taskar, Neeta; Do, Kinh G; Brody, Lynn A; Petre, Elena N; Capanu, Marinela; Longing, Anne P; Chou, Joanne F; Carrasquillo, Jorge A; Kemeny, Nancy E

    2014-03-01

    This prospective study assessed the safety and outcomes of selective internal radiation therapy (SIRT) using yttrium-90 ((90)Y) resin microspheres as a salvage therapy for liver-predominant metastases of colorectal cancer in patients with documented progression after hepatic arterial chemotherapy (HAC) and systemic chemotherapy. We recruited 19 patients who had received a mean of 2.9 prior lines of chemotherapy and ≥ 1 line of HAC. Dose-limiting toxicities (grade 3 or higher) were catalogued using Common Terminology Criteria for Adverse Events version 3.0. At 4 to 8 weeks and 3 to 4 months post SIRT, responses were assessed by carcinoembryonic antigen (CEA), and quantitative imaging using Response Evaluation Criteria in Solid Tumors (RECIST) and PET Response Criteria in Solid Tumors (PERCIST). Liver progression-free survival (LPFS), progression-free survival (PFS), and overall survival (OS) were calculated using Kaplan-Meier methodology. Median follow-up was 31.2 months after SIRT. Within 6 weeks of SIRT, 3 patients (15.8%) experienced grade 3 toxicity. There was no incidence of radiation-induced liver disease. Responses by RECIST, PERCIST, and CEA were, respectively, 0%, 20%, and 32% at 4 to 8 weeks and 5%, 33%, and 21% at 3 to 4 months post SIRT; 53% of patients had stable disease (by RECIST) at 3 to 4 months. Of 19 patients, 4 (21.1%) had liver ablation, 9 (47%) received additional HAC, and 17 (89%) received systemic chemotherapy after SIRT. Median LPFS, PFS, and OS after SIRT were 5.2 months, 2.0 months, and 14.9 months, respectively. SIRT was well tolerated and did not prohibit subsequent treatment, resulting in a median OS of 14.9 months in this heavily pretreated population. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Radiation therapy - questions to ask your doctor

    Science.gov (United States)

    What to ask your doctor about radiation therapy ... National Cancer Institute website. Radiation therapy and you: support for people with cancer. www.cancer.gov/publications/patient-education/radiationttherapy.pdf . Updated May 2007. Accessed December ...

  10. International Occupational Therapy Research Priorities.

    Science.gov (United States)

    Mackenzie, Lynette; Coppola, Susan; Alvarez, Liliana; Cibule, Lolita; Maltsev, Sergey; Loh, Siew Yim; Mlambo, Tecla; Ikiugu, Moses N; Pihlar, Zdenka; Sriphetcharawut, Sarinya; Baptiste, Sue; Ledgerd, Richard

    2017-04-01

    Occupational therapy is a global profession represented by the World Federation of Occupational Therapists (WFOT). International research priorities are needed for strategic guidance on global occupational therapy practice. The objective of this study was to develop international research priorities to reflect global occupational therapy practice. A Delphi study using three rounds of electronic surveys, distributed to WFOT member organizations and WFOT accredited universities, was conducted. Data were analyzed after each round, and priorities were presented for rating and ranking in order of importance. Forty-six (53%) out of 87 WFOT member countries participated in the Delphi process. Eight research priorities were confirmed by the final electronic survey round. Differences were observed in rankings given by member organizations and university respondents. Despite attrition at Round 3, the final research priorities will help to focus research efforts in occupational therapy globally. Follow-up research is needed to determine how the research priorities are being adopted internationally.

  11. Results of a Quality Assurance Review of External Beam Radiation Therapy in the International Society of Paediatric Oncology (Europe) Neuroblastoma Group's High-risk Neuroblastoma Trial: A SIOPEN Study

    International Nuclear Information System (INIS)

    Gaze, Mark N.; Boterberg, Tom; Dieckmann, Karin; Hörmann, Marcus; Gains, Jennifer E.; Sullivan, Kevin P.; Ladenstein, Ruth

    2013-01-01

    Purpose: Radiation therapy is important for local control in neuroblastoma. This study reviewed the compliance of plans with the radiation therapy guidelines of the International Society of Paediatric Oncology (Europe) Neuroblastoma Group (SIOPEN) High-Risk Trial protocol. Methods and Materials: The SIOPEN trial central electronic database has sections to record diagnostic imaging and radiation therapy planning data. Individual centers may upload data remotely, but not all centers involved in the trial chose to use this system. A quality scoring system was devised based on how well the radiation therapy plan matched the protocol guidelines, to what extent deviations were justified, and whether adverse effects may result. Central review of radiation therapy planning was undertaken retrospectively in 100 patients for whom complete diagnostic and treatment sets were available. Data were reviewed and compared against protocol guidelines by an international team of radiation oncologists and radiologists. For each patient in the sample, the central review team assigned a quality assurance score. Results: It was found that in 48% of patients there was full compliance with protocol requirements. In 29%, there were deviations for justifiable reasons with no likely long-term adverse effects resulting. In 5%, deviations had occurred for justifiable reasons, but that might result in adverse effects. In 1%, there was a deviation with no discernible justification, which would not lead to long-term adverse events. In 17%, unjustified deviations were noted, with a risk of an adverse outcome resulting. Conclusions: Owing to concern over the proportion of patients in whom unjustified deviations were observed, a protocol amendment has been issued. This offers the opportunity for central review of radiation therapy plans before the start of treatment and the treating clinician a chance to modify plans.

  12. Results of a quality assurance review of external beam radiation therapy in the International Society of Paediatric Oncology (Europe) Neuroblastoma Group's High-risk Neuroblastoma Trial: a SIOPEN study.

    Science.gov (United States)

    Gaze, Mark N; Boterberg, Tom; Dieckmann, Karin; Hörmann, Marcus; Gains, Jennifer E; Sullivan, Kevin P; Ladenstein, Ruth

    2013-01-01

    Radiation therapy is important for local control in neuroblastoma. This study reviewed the compliance of plans with the radiation therapy guidelines of the International Society of Paediatric Oncology (Europe) Neuroblastoma Group (SIOPEN) High-Risk Trial protocol. The SIOPEN trial central electronic database has sections to record diagnostic imaging and radiation therapy planning data. Individual centers may upload data remotely, but not all centers involved in the trial chose to use this system. A quality scoring system was devised based on how well the radiation therapy plan matched the protocol guidelines, to what extent deviations were justified, and whether adverse effects may result. Central review of radiation therapy planning was undertaken retrospectively in 100 patients for whom complete diagnostic and treatment sets were available. Data were reviewed and compared against protocol guidelines by an international team of radiation oncologists and radiologists. For each patient in the sample, the central review team assigned a quality assurance score. It was found that in 48% of patients there was full compliance with protocol requirements. In 29%, there were deviations for justifiable reasons with no likely long-term adverse effects resulting. In 5%, deviations had occurred for justifiable reasons, but that might result in adverse effects. In 1%, there was a deviation with no discernible justification, which would not lead to long-term adverse events. In 17%, unjustified deviations were noted, with a risk of an adverse outcome resulting. Owing to concern over the proportion of patients in whom unjustified deviations were observed, a protocol amendment has been issued. This offers the opportunity for central review of radiation therapy plans before the start of treatment and the treating clinician a chance to modify plans. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Results of a Quality Assurance Review of External Beam Radiation Therapy in the International Society of Paediatric Oncology (Europe) Neuroblastoma Group's High-risk Neuroblastoma Trial: A SIOPEN Study

    Energy Technology Data Exchange (ETDEWEB)

    Gaze, Mark N., E-mail: mark.gaze@uclh.nhs.uk [Department of Oncology, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Boterberg, Tom [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Dieckmann, Karin; Hoermann, Marcus [General Hospital Vienna, Medical University Vienna (Austria); Gains, Jennifer E.; Sullivan, Kevin P. [Department of Oncology, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Ladenstein, Ruth [Children' s Cancer Research Institute, St. Anna Children' s Hospital, Vienna (Austria)

    2013-01-01

    Purpose: Radiation therapy is important for local control in neuroblastoma. This study reviewed the compliance of plans with the radiation therapy guidelines of the International Society of Paediatric Oncology (Europe) Neuroblastoma Group (SIOPEN) High-Risk Trial protocol. Methods and Materials: The SIOPEN trial central electronic database has sections to record diagnostic imaging and radiation therapy planning data. Individual centers may upload data remotely, but not all centers involved in the trial chose to use this system. A quality scoring system was devised based on how well the radiation therapy plan matched the protocol guidelines, to what extent deviations were justified, and whether adverse effects may result. Central review of radiation therapy planning was undertaken retrospectively in 100 patients for whom complete diagnostic and treatment sets were available. Data were reviewed and compared against protocol guidelines by an international team of radiation oncologists and radiologists. For each patient in the sample, the central review team assigned a quality assurance score. Results: It was found that in 48% of patients there was full compliance with protocol requirements. In 29%, there were deviations for justifiable reasons with no likely long-term adverse effects resulting. In 5%, deviations had occurred for justifiable reasons, but that might result in adverse effects. In 1%, there was a deviation with no discernible justification, which would not lead to long-term adverse events. In 17%, unjustified deviations were noted, with a risk of an adverse outcome resulting. Conclusions: Owing to concern over the proportion of patients in whom unjustified deviations were observed, a protocol amendment has been issued. This offers the opportunity for central review of radiation therapy plans before the start of treatment and the treating clinician a chance to modify plans.

  14. Radiation Therapy and Hearing Loss

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  15. Radiation therapy for carcinoma of the endometrium

    International Nuclear Information System (INIS)

    Potish, R.A.

    1987-01-01

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

  16. Radiation therapy of gynecological cancer

    International Nuclear Information System (INIS)

    Nori, D.; Hilaris, B.S.

    1987-01-01

    This book consists of three parts: General Principles; Clinical Applications; and Special Topics. Some of the papers are: Introduction to Basic Radiobiology; Staging and Work-up Procedures for Patients with Gynecological Cancers; Radiation Therapy in the Treatment of Cancer of the Cervix; Role of Interstitial Implantation in Gynecological Cancer; Role of Radiocolloids in Gynecological Cancer; Radiosensitizers and Protectors; and Management of Lymphoma Associated with Pregnancy

  17. Registration accuracy and possible migration of internal fiducial gold marker implanted in prostate and liver treated with real-time tumor-tracking radiation therapy (RTRT)

    International Nuclear Information System (INIS)

    Kitamura, Kei; Shirato, Hiroki; Shimizu, Shinichi; Shinohara, Nobuo; Harabayashi, Toru; Shimizu, Tadashi; Kodama, Yoshihisa; Endo, Hideho; Onimaru, Rikiya; Nishioka, Seiko; Aoyama, Hidefumi; Tsuchiya, Kazuhiko; Miyasaka, Kazuo

    2002-01-01

    Background and purpose: We have developed a linear accelerator synchronized with a fluoroscopic real-time tumor-tracking system to reduce errors due to setup and organ motion. In the real-time tumor-tracking radiation therapy (RTRT) system, the accuracy of tumor tracking depends on the registration of the marker's coordinates. The registration accuracy and possible migration of the internal fiducial gold marker implanted into prostate and liver was investigated. Materials and methods: Internal fiducial gold markers were implanted in 14 patients with prostate cancer and four patients with liver tumors. Computed tomography (CT) was carried out as a part of treatment planning in the 18 patients. A total of 72 follow-up CT scans were taken. We calculated the relative relationship between the coordinates of the center of mass (CM) of the organs and those of the marker. The discrepancy in the CM coordinates during a follow-up CT compared to those recorded during the planning CT was used to study possible marker migration. Results: The standard deviation (SD) of interobserver variations in the CM coordinates was within 2.0 and 0.4 mm for the organ and the marker, respectively, in seven observers. Assuming that organs do not shrink, grow, or rotate, the maximum SD of migration error in each direction was estimated to be less than 2.5 and 2.0 mm for liver and prostate, respectively. There was no correlation between the marker position and the time after implantation. Conclusion: The degree of possible migration of the internal fiducial marker was within the limits of accuracy of the CT measurement. Most of the marker movement can be attributed to the measurement uncertainty, which also influences registration in actual treatment planning. Thus, even with the gold marker and RTRT system, a planning target volume margin should be used to account for registration uncertainty

  18. Treatment charts in radiation therapy

    International Nuclear Information System (INIS)

    Macia, M.; De Blas, R.; Monfa, C.; Bonet, A.; Rubio, A.M.

    1993-01-01

    The radiotherapy treatment chart (dose prescription, set-up parameters, dose computation and daily dose recording form) represents an important working tool in radiotherapy, not only as a compilation of data, but also as a method of communication among physicians, physicists and technicians. In addition to administrative and medical data, physical and simulation data that are indispensable for the daily accurate reproduction of the therapy procedures should be recorded, as well as accurate daily entries of the fractional and cumulative absorbed doses. Moreover, any radiation therapy quality assurance programme must rely on the accessibility of the radiation treatment history and a correct record of the therapy protocol in order to be verifiable. We have analysed the treatment charts of 92 European Departments of Radiation Oncology, with the aim of identifying their salient characteristics and data recorded. The study shows strong differences among the charts analysed, not only in the amount of information recorded, but also in the kind of data and concepts used. (author) 6 refs., 1 fig

  19. Multibeam radiation therapy treatment application

    International Nuclear Information System (INIS)

    Manens, J.P.; Le Gall, G.; Chenal, C.; Ben Hassel, M.; Fresne, F.; Barillot, C.; Gibaud, B.; Lemoine, D.; Bouliou, A.; Scarabin, J.M.

    1991-01-01

    A software package has been developed for multibeam radiation therapy treatment application. We present in this study a computer-assisted dosimetric planning procedure which includes: i), an analytical stage for setting up the large volume via 2D and 3D displays; ii), a planning stage for issue of a treatment strategy including dosimetric simulations; and iii), a treatment stage to drive the target volume to the radiation unit isocenter. The combined use of stereotactic methods and multimodality imagery ensures spatial coherence and makes target definition and cognition of structure environment more accurate. The dosimetric planning suited to the spatial reference (the stereotactic frame) guarantees optimal distribution of the dose, computed by the original 3D volumetric algorithm. A computer-driven chair-framework cluster was designed to position the target volume at the radiation unit isocenter [fr

  20. Late complications of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-03-01

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

  1. Late complications of radiation therapy

    International Nuclear Information System (INIS)

    Masaki, Norie

    1998-01-01

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

  2. Development of local radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-04-01

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

  3. Development of local radiation therapy

    International Nuclear Information System (INIS)

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

    1999-04-01

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

  4. Applications of Machine Learning for Radiation Therapy.

    Science.gov (United States)

    Arimura, Hidetaka; Nakamoto, Takahiro

    2016-01-01

    Radiation therapy has been highly advanced as image guided radiation therapy (IGRT) by making advantage of image engineering technologies. Recently, novel frameworks based on image engineering technologies as well as machine learning technologies have been studied for sophisticating the radiation therapy. In this review paper, the author introduces several researches of applications of machine learning for radiation therapy. For examples, a method to determine the threshold values for standardized uptake value (SUV) for estimation of gross tumor volume (GTV) in positron emission tomography (PET) images, an approach to estimate the multileaf collimator (MLC) position errors between treatment plans and radiation delivery time, and prediction frameworks for esophageal stenosis and radiation pneumonitis risk after radiation therapy are described. Finally, the author introduces seven issues that one should consider when applying machine learning models to radiation therapy.

  5. Radiation therapy of psoriasis and parapsoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Wiskemann, A.

    1982-09-15

    Selective UV-Phototherapy with lambda 300-320 nm (SUP) as well as oral photochemotherapy with 8-methoxy-psoralen plus UVA-radiation (PUVA intern) are very effective in clearing the lesions of the generalized psoriasis and those of the chronic forms of parapsoriasis. Being treated with 4 suberythemal doses per week psoriasis patients are free or nearly free of symptoms after averagely 6.3 weeks of SUP-therapy or after 5.3 weeks of PUVA orally. The PUVA-therapy is mainly indicated in pustular, inverse and erythrodermic psoriasis as well as in parapsoriasis en plaques and variegata. In all other forms of psoriasis and in pityriasis lichenoides-chronica, we prefer the SUP-therapy because of less acute or chronic side effects, and because of its better practicability. X-rays are indicated in psoriais of nails, grenz-rays in superficial psoriatic lesions of the face, the armpits, the genitals and the anal region.

  6. Connecting cancer biology and clinical outcomes to imaging in KRAS mutant and wild-type colorectal cancer liver tumors following selective internal radiation therapy with yttrium-90.

    Science.gov (United States)

    Magnetta, Michael J; Ghodadra, Anish; Lahti, Steven J; Xing, Minzhi; Zhang, Di; Kim, Hyun S

    2017-02-01

    To determine whether pathologic colorectal tumor KRAS mutation status is correlated with progression-free survival (PFS) by imaging after selective internal radiation therapy with Yttrium-90 (SIRT Y90) for metastatic colorectal cancer in the liver (mCRC). This was an IRB approved, HIPAA compliant retrospective cohort study. Consecutive patients with unresectable mCRC with documented KRAS mutation status treated at a single center from 2002 to 2013 with SIRT Y90 were investigated. Treatment response was compared between KRAS wild-type (wt) and mutant (mut) using an anatomic tumor response criteria based on RECIST 1.0. Kaplan-Meier estimation and Cox regression analysis were used to measure progression-free survival (PFS) and to assess independent prognostic factors for PFS. 82 of 186 patients met review criteria. 33 (40.2%) patients were identified as KRAS mut. PFS was longer in KRAS wt (median 166 days [95% CI 96-258 days]) vs. mut (median 91 days [95% CI 79-104 days], p = 0.002). KRAS mut patients were 1.48 times more likely to progress at first follow-up imaging than wt (95% CI 1.06-2.08, p = 0.024). Univariate analysis identified high pre-SIRT Y90 INR, KRAS wt, any use of anti-EGFR therapy, and post-SIRT Y90 chemotherapy as prognostic factors for longer PFS. In multivariate analysis, only KRAS wt was an independent prognostic factor for longer PFS (RR: 1.80 [95% CI 1.08-2.99], p = 0.024). Longer PFS is associated with KRAS wt vs. mut following SIRT Y90.

  7. Potential dosimetric benefits of adaptive tumor tracking over the internal target volume concept for stereotactic body radiation therapy of pancreatic cancer.

    Science.gov (United States)

    Karava, Konstantina; Ehrbar, Stefanie; Riesterer, Oliver; Roesch, Johannes; Glatz, Stefan; Klöck, Stephan; Guckenberger, Matthias; Tanadini-Lang, Stephanie

    2017-11-09

    Radiotherapy for pancreatic cancer has two major challenges: (I) the tumor is adjacent to several critical organs and, (II) the mobility of both, the tumor and its surrounding organs at risk (OARs). A treatment planning study simulating stereotactic body radiation therapy (SBRT) for pancreatic tumors with both the internal target volume (ITV) concept and the tumor tracking approach was performed. The two respiratory motion-management techniques were compared in terms of doses to the target volume and organs at risk. Two volumetric-modulated arc therapy (VMAT) treatment plans (5 × 5 Gy) were created for each of the 12 previously treated pancreatic cancer patients, one using the ITV concept and one the tumor tracking approach. To better evaluate the overall dose delivered to the moving tumor volume, 4D dose calculations were performed on four-dimensional computed tomography (4DCT) scans. The resulting planning target volume (PTV) size for each technique was analyzed. Target and OAR dose parameters were reported and analyzed for both 3D and 4D dose calculation. Tumor motion ranged from 1.3 to 11.2 mm. Tracking led to a reduction of PTV size (max. 39.2%) accompanied with significant better tumor coverage (p<0.05, paired Wilcoxon signed rank test) both in 3D and 4D dose calculations and improved organ at risk sparing. Especially for duodenum, stomach and liver, the mean dose was significantly reduced (p<0.05) with tracking for 3D and 4D dose calculations. By using an adaptive tumor tracking approach for respiratory-induced pancreatic motion management, a significant reduction in PTV size can be achieved, which subsequently facilitates treatment planning, and improves organ dose sparing. The dosimetric benefit of tumor tracking is organ and patient-specific.

  8. Diffusion-weighted magnetic resonance imaging predicts survival in patients with liver-predominant metastatic colorectal cancer shortly after selective internal radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schmeel, Frederic Carsten; Simon, Birgit; Luetkens, Julian Alexander; Traeber, Frank; Schmeel, Leonard Christopher; Schild, Hans Heinz; Hadizadeh, Dariusch Reza [University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universitaet Bonn, Department of Radiology, Bonn (Germany); Sabet, Amir [University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universitaet Bonn, Department of Nuclear Medicine, Bonn (Germany); University Hospital Essen, Universitaet Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany); Ezziddin, Samer [University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universitaet Bonn, Department of Nuclear Medicine, Bonn (Germany); University Hospital Saarland, Universitaet des Saarlandes, Department of Nuclear Medicine, Homburg (Germany)

    2017-03-15

    To investigate whether quantifications of apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) can predict overall survival (OS) in patients with liver-predominant metastatic colorectal cancer (CRC) following selective internal radiation therapy with {sup 90}Yttrium-microspheres (SIRT). Forty-four patients underwent DWI 19 ± 16 days before and 36 ± 10 days after SIRT. Tumour-size and intratumoral minimal ADC (minADC) values were measured for 132 liver metastases on baseline and follow-up DWI. Optimal functional imaging response to treatment was determined by receiver operating characteristics and defined as ≥22 % increase in post-therapeutic minADC. Survival analysis was performed with the Kaplan-Meier method and Cox-regression comparing various variables with potential impact on OS. Median OS was 8 months. The following parameters were significantly associated with median OS: optimal functional imaging response (18 vs. 5 months; p < 0.001), hepatic tumour burden <50 % (8 vs. 5 months; p = 0.018), Eastern Cooperative Oncology Group performance scale <1 (10 vs. 4 months; p = 0.012) and progressive disease according to Response and Evaluation Criteria in Solid Tumours (8 vs. 3 months; p = 0.001). On multivariate analysis, optimal functional imaging response and hepatic tumour burden remained independent predictors of OS. Functional imaging response assessment using minADC changes on DWI may predict survival in CRC shortly after SIRT. (orig.)

  9. Comparison of Choi criteria and Response Evaluation Criteria in Solid Tumors (RECIST) for intrahepatic cholangiocarcinoma treated with glass-microspheres Yttrium-90 selective internal radiation therapy (SIRT).

    Science.gov (United States)

    Beuzit, Luc; Edeline, Julien; Brun, Vanessa; Ronot, Maxime; Guillygomarc'h, Anne; Boudjema, Karim; Gandon, Yves; Garin, Etienne; Rolland, Yan

    2016-08-01

    To compare Choi criteria with Response Evaluation Criteria in Solid Tumors (RECIST) for the prediction of overall survival (OS) in patients treated with glass-microspheres, Yttrium-90 selective internal radiation therapy (SIRT) for intrahepatic cholangiocarcinoma (ICC). Between 2010 and 2014, 45 adult patients with locally advanced ICC treated with SIRT were retrospectively analyzed. Computed tomography scans performed before and after treatment were analyzed using both RECIST 1.1 and Choi criteria. Response was correlated with survival. Patients who achieved an objective response according to Choi had a longer OS than non-responders (median OS 19.9 months [95% CI, 1.1-38.7 months] vs. 7.5 months if stable disease [uncountable CI] and 3 months if progressive disease [95% CI, 0-6.2 months], log-rank test: p=0.003) whereas there was no significant survival difference according to the RECIST response (p=0.339). Among the 39 RECIST non-responding patients, those identified as responders by Choi (n=31) had significantly better OS than Choi non-responders (median OS 19.9 months (95% CI, 5.1-34.7 months) and 5.4 months (95% CI, 0-11.6 months), p=0.005). Choi criteria appear more appropriate than RECIST to identify responders with long survival among patients who received SIRT for ICC. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Prognostic Importance of the Presence of Early Metabolic Response and Absence of Extrahepatic Metastasis After Selective Internal Radiation Therapy in Colorectal Cancer Liver Metastasis.

    Science.gov (United States)

    Soydal, Cigdem; Kucuk, Nuriye Ozlem; Balci, Deniz; Gecim, Ethem; Bilgic, Sadik; Elhan, Atilla Halil

    2016-11-01

    In this study, the authors aimed to identify prognostic factors after selective internal radiation therapy (SIRT) for colorectal cancer (CRC) liver metastasis. Forty-nine (28 male, 21 female; mean age: 64.6 ± 10.8) patients who received SIRT for CRC liver metastasis were studied. Effects of number (<5 vs. ≥5), maximum dimension, and standardized uptake value (SUV) of liver metastases, liver tumor load (<25% vs. 26%-50% vs. 51%-75%), presence of extrahepatic disease, and metabolic early response on overall survival were analyzed. Mean follow-up time was 44.1 ± 27.5 months. Overall survival time was calculated as 10.03 ± 1.61 (95% CI; 6.86-13.20) months. SUV (0.004) of liver metastases, early metabolic response (p = 0.015), and presence of extrahepatic metastasis (p = 0.001) were identified as significant factors influencing overall survival. The hazard ratio was 1:2.3 for the presence of extrahepatic metastasis and 1:2.7 for the absence of early metabolic response. These findings suggest that patients with CRC liver metastasis who have lower SUV at presentation and early metabolic response have better outcomes after SIRT.

  11. Radiofrequency ablation after selective internal radiation therapy with Yttrium90 microspheres in metastatic liver disease-Is it feasible?

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, R.T. [Institute of Clinical Radiology, Ludwig Maximilians-University - Campus Grosshadern, Marchioninstr. 15, 81377 Munich (Germany)], E-mail: rthoffma@med.uni-muenchen.de; Jakobs, T.F. [Institute of Clinical Radiology, Ludwig Maximilians-University - Campus Grosshadern, Marchioninstr. 15, 81377 Munich (Germany); Kubisch, C.H. [Department of Medicine/Gastroenterology, Ludwig Maximilians-University - Campus Grosshadern, Munich (Germany); Stemmler, H.J. [Department of Internal Medicine III/Haematology and Oncology, Ludwig Maximilians-University - Campus Grosshadern, Munich (Germany); Trumm, C. [Institute of Clinical Radiology, Ludwig Maximilians-University - Campus Grosshadern, Marchioninstr. 15, 81377 Munich (Germany); Tatsch, K. [Department of Nuclear Medicine, Ludwig Maximilians-University - Campus Grosshadern, Munich (Germany); Helmberger, T.K. [Institute of Clinical and Diagnostic Radiology and Nuclear Medicine, Munich - Bogenhausen, Munich (Germany); Reiser, M.F. [Institute of Clinical Radiology, Ludwig Maximilians-University - Campus Grosshadern, Marchioninstr. 15, 81377 Munich (Germany)

    2010-04-15

    This retrospective study analyzes, whether patients suffering from extensive hepatic metastatic disease treated with SIRT can become suitable candidates for RFA.Within 38 months 46 patients (26 female, 20 male; age 32-75 years) bearing an extensive hepatic metastatic disease were treated with SIRT. Patients suffered from metastases of breast cancer (16/46), colorectal cancer (CRC) (21/46), neuroendocrine (3/46), and other primary carcinomas (6/46). The indication for SIRT was otherwise untreatable metastases confined to the liver. Forty-three patients received single-session whole-liver radioembolization treatment using Yttrium90 resin microspheres with a mean activity of 2.13 GBq. In 1 patient SIRT was confined to the left and in 2 patients to the right liver lobe. In 3 patients major complications (2/3 gastric ulceration and 1/3 oedematous pancreatitis) and in 24 patients minor complications occurred (acute abdominal/epigastric pain and/or nausea). Follow-up CT and/or MRI were obtained in 44 of 46 patients. In 5 of 44 patients tumor load decreased substantially (3/5 breast cancer, 1/5 CRC and 1/5 pancreatic cancer) making RFA feasible. The patients were referred for RFA after the first 3-month follow-up. RFA of the liver was successful in all cases in terms of complete ablation. In selected patients radioembolization is able to downstage liver metastases to an extent making a subsequent RFA suitable and therefore allows increasing the number of patients with a 'complete response' after a minimally invasive therapy.

  12. Basal cell carcinoma after radiation therapy

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  13. Radiation therapy of the uterine cancer

    International Nuclear Information System (INIS)

    Noguchi, Hiroshi

    1999-01-01

    Cervical and endometrial cancer of the uterus, and ovarian cancer are three major malignant diseases in gynecology in Japan. These diagnosis and therapy are almost established. In uterine cervical cancer, radiation therapy and surgery of these diseases are two main treatment methods, and both treatment results are almost the same. And radiation therapy is also used as postoperative treatment to patients with high risk factors. In endometrial cancer, surgery is main therapy. Radiation therapy is undergone only to medically inoperable cases preoperative radiation is widely carried out in Europe and America, but almost none in Japan. Postoperative irradiation is adapted to the cases with high risk factors. But recent advance of chemotherapy changes the importance of radiation therapy in such patients. I review the literatures of radiation therapy of uterine cervical cancer and of endometrial cancer. (author)

  14. Radiation therapy system and its accuracy

    International Nuclear Information System (INIS)

    Nakamura, Yuzuru

    1990-01-01

    Three prerequisites for increasing accuracy of radiation therapy are considered. Firstly, every irradiation must be performed without errors according to irradiation conditions. Secondly, accurate quality assurance of equipments for radiation, diagnosis, radiation planning, and dosimetry must be maintained. Thirdly, new radiation planning system and treatment equipments with the introduction of computers are required. The purpose of this report is to discuss accuracy of radiation therapy, focusing on (I) the current status of radiation therapy system developed at the National Institute of Radiation Sciences (NIRS) in Japan and on (II) basic items and quality assurance for increasing accuracy of radiation therapy. Fast neutron therapy has been started with the NIRS cyclotron collimator in November 1975. The advent of X-ray CT has contributed to radiation therapy planning, in that it visualizes the inside structure of the patient stereoscopically. An optical positioning apparatus with CT scanner and a dedicated CT simulator have been developed, allowing the realization of more accurate conformation radiotherapy. Error or uncertainty poses a problem in radiation therapy and treatment system. The ICRU Report 24 describes that standard errors for biological changes in tolerance radiation doses should be within ±5%. The AAPM Report 13 describes that uncertainty for dosimetry with phantoms or dose distribution computation must be less than 2.5% and 4.2%, respectively. It is recommended that quality assurance program be introduced to decrease errors in radiation therapy. (N.K.)

  15. DNA repair related to radiation therapy

    International Nuclear Information System (INIS)

    Klein, W.

    1979-01-01

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

  16. Evaluation of dual energy quantitative CT for determining the spatial distributions of red marrow and bone for dosimetry in internal emitter radiation therapy.

    Science.gov (United States)

    Goodsitt, Mitchell M; Shenoy, Apeksha; Shen, Jincheng; Howard, David; Schipper, Matthew J; Wilderman, Scott; Christodoulou, Emmanuel; Chun, Se Young; Dewaraja, Yuni K

    2014-05-01

    To evaluate a three-equation three-unknown dual-energy quantitative CT (DEQCT) technique for determining region specific variations in bone spongiosa composition for improved red marrow dose estimation in radionuclide therapy. The DEQCT method was applied to 80/140 kVp images of patient-simulating lumbar sectional body phantoms of three sizes (small, medium, and large). External calibration rods of bone, red marrow, and fat-simulating materials were placed beneath the body phantoms. Similar internal calibration inserts were placed at vertebral locations within the body phantoms. Six test inserts of known volume fractions of bone, fat, and red marrow were also scanned. External-to-internal calibration correction factors were derived. The effects of body phantom size, radiation dose, spongiosa region segmentation granularity [single (∼17 × 17 mm) region of interest (ROI), 2 × 2, and 3 × 3 segmentation of that single ROI], and calibration method on the accuracy of the calculated volume fractions of red marrow (cellularity) and trabecular bone were evaluated. For standard low dose DEQCT x-ray technique factors and the internal calibration method, the RMS errors of the estimated volume fractions of red marrow of the test inserts were 1.2-1.3 times greater in the medium body than in the small body phantom and 1.3-1.5 times greater in the large body than in the small body phantom. RMS errors of the calculated volume fractions of red marrow within 2 × 2 segmented subregions of the ROIs were 1.6-1.9 times greater than for no segmentation, and RMS errors for 3 × 3 segmented subregions were 2.3-2.7 times greater than those for no segmentation. Increasing the dose by a factor of 2 reduced the RMS errors of all constituent volume fractions by an average factor of 1.40 ± 0.29 for all segmentation schemes and body phantom sizes; increasing the dose by a factor of 4 reduced those RMS errors by an average factor of 1.71 ± 0.25. Results for external calibrations exhibited

  17. Combined Yttrium-90 microsphere selective internal radiation therapy and external beam radiotherapy in patients with hepatocellular carcinoma: From clinical aspects to dosimetry.

    Directory of Open Access Journals (Sweden)

    Ti-Hao Wang

    Full Text Available Selective internal radiation therapy (SIRT is an effective treatment strategy for unresectable hepatocellular carcinoma (HCC patients. However, the prognoses of patients with portal vein thrombosis, extra-hepatic metastases, or residual tumors remain poor when treated with SIRT alone. In these patients, sequential external beam radiotherapy (EBRT may offer a chance of salvage. Here, we reported the clinical outcomes and the detailed dosimetry analysis of 22 patients treated with combination therapy.Between October 2011 and May 2015, 22 consecutive patients who underwent EBRT after yttrium-90 (90Y SIRT were included in this study. The post-SIRT 90Y bremsstrahlung SPECT/CT of each patient was transferred to dose distribution by adopting the local deposition hypothesis. The patient-specific 3-dimensional biological effective dose distribution of combined SIRT and EBRT was generated. The overall survival and safety were evaluated. The relationship between dosimetric parameters and liver toxicity was analyzed.The mean administered activity of SIRT was 1.50 GBq (range: 0.5-2.8. The mean prescribed dose of EBRT was 42.3 Gy (range: 15-63 in 14 fractions (range: 5-15 and was targeted to the residual liver tumor in 12 patients (55%, portal vein thrombosis in 11 patients (50%, and perihilar lymphadenopathies in 4 patients (18%. The overall 1-, 2-, and 3-year survival rates were 59.8%, 47.9%, and 47.9%, respectively. Overall, 8 patients (36% developed > grade 2 liver toxicities, and the Child-Pugh score prior to EBRT strongly affected the toxicity risk. A dosimetry analysis restricted to 18 Child-Pugh A/B patients showed that the V100 (The fraction of normal liver exposed to more than 100 Gy to V140 significance differed between patients who did or did not experience hepatotoxicity. The V110 was the strongest predictor of hepatotoxicity (18.6±11.6% vs 29.5±5.8%; P = 0.030.Combined therapy is feasible and safe if patients are carefully selected

  18. Combined Yttrium-90 microsphere selective internal radiation therapy and external beam radiotherapy in patients with hepatocellular carcinoma: From clinical aspects to dosimetry.

    Science.gov (United States)

    Wang, Ti-Hao; Huang, Pin-I; Hu, Yu-Wen; Lin, Ko-Han; Liu, Ching-Sheng; Lin, Yi-Yang; Liu, Chien-An; Tseng, Hsiou-Shan; Liu, Yu-Ming; Lee, Rheun-Chuan

    2018-01-01

    Selective internal radiation therapy (SIRT) is an effective treatment strategy for unresectable hepatocellular carcinoma (HCC) patients. However, the prognoses of patients with portal vein thrombosis, extra-hepatic metastases, or residual tumors remain poor when treated with SIRT alone. In these patients, sequential external beam radiotherapy (EBRT) may offer a chance of salvage. Here, we reported the clinical outcomes and the detailed dosimetry analysis of 22 patients treated with combination therapy. Between October 2011 and May 2015, 22 consecutive patients who underwent EBRT after yttrium-90 (90Y) SIRT were included in this study. The post-SIRT 90Y bremsstrahlung SPECT/CT of each patient was transferred to dose distribution by adopting the local deposition hypothesis. The patient-specific 3-dimensional biological effective dose distribution of combined SIRT and EBRT was generated. The overall survival and safety were evaluated. The relationship between dosimetric parameters and liver toxicity was analyzed. The mean administered activity of SIRT was 1.50 GBq (range: 0.5-2.8). The mean prescribed dose of EBRT was 42.3 Gy (range: 15-63) in 14 fractions (range: 5-15) and was targeted to the residual liver tumor in 12 patients (55%), portal vein thrombosis in 11 patients (50%), and perihilar lymphadenopathies in 4 patients (18%). The overall 1-, 2-, and 3-year survival rates were 59.8%, 47.9%, and 47.9%, respectively. Overall, 8 patients (36%) developed > grade 2 liver toxicities, and the Child-Pugh score prior to EBRT strongly affected the toxicity risk. A dosimetry analysis restricted to 18 Child-Pugh A/B patients showed that the V100 (The fraction of normal liver exposed to more than 100 Gy) to V140 significance differed between patients who did or did not experience hepatotoxicity. The V110 was the strongest predictor of hepatotoxicity (18.6±11.6% vs 29.5±5.8%; P = 0.030). Combined therapy is feasible and safe if patients are carefully selected. Specifically

  19. Radiation Litigation and Internal Dosimetry

    International Nuclear Information System (INIS)

    Jose, D.E.

    1987-01-01

    Radiation Litigation refers to those lawsuits filed by individuals who claim to have been injured by some past exposure to ionizing radiation. Law classifies these cases as personal injury or tort cases. However, they are a new breed of such cases and the law is presently struggling with whether these cases can be resolved using the traditional methods of legal analysis or whether new forms of analysis, such as probability of causation, need to be applied. There are no absolutely certain rules concerning how these particular lawsuits will be tried and analyzed. The United States presently is defending cases filed by approximately 7000 plaintiffs. The private nuclear industry is defending cases filed by over 2000 plaintiffs. While not all of these cases will actually be tried on their merits, at least some will and internal dosimetry will play a very important part in many of these trials

  20. Radiation therapy of thoracic and abdominal tumors

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  1. Radiation therapy for operable rectal cancer

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  2. Radiation Therapy and You: Support for People with Cancer

    Science.gov (United States)

    ... Terms Blogs and Newsletters Health Communications Publications Reports Radiation Therapy and You: Support for People With Cancer Radiation ... Copy This booklet covers: Questions and Answers About Radiation Therapy. Answers common questions, such as what radiation therapy ...

  3. Radiation therapy of peritoneal mesothelioma

    International Nuclear Information System (INIS)

    Lederman, G.; Recht, A.

    1986-01-01

    The role of radiation therapy in the treatment of peritoneal mesotheliomas remains ill-defined despite its association with the few long-term survivals reported for this disease. The rationale for local therapy is clear as the disease most often is confined to the peritoneal cavity at the time of initial diagnosis and remains there for much of the subsequent course. Effective local treatment of this intra-abdominal disease would likely improve survival. The absence of randomized studies has made analysis of the various treatments of the disease and the few reported success difficult. Nonetheless, scrutiny of the available data may offer insights and guide future clinical trials, as well as the clinician responsible for the treatment of current patients with peritoneal mesothelioma. The radiotherapeutic approach to oncology stresses anatomic considerations in an attempt to understand the patterns of spread of the primary tumor. The observed location and bulk of disease by clinical examination, radiologic study, surgical exploration, and autopsy suggest mechanisms of metastases (direct extension, lymphatic or hematogenous). This dictates the administration of radiation that best achieves a successful outcome

  4. Missed Radiation Therapy and Cancer Recurrence

    Science.gov (United States)

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

  5. Radiation therapy services in South Africa

    African Journals Online (AJOL)

    combined with the components of adequate RT: localis- ing systems (computed tomography (CT) scanners and simulators), planning equipment, radiation machines for both teletherapy and brachytherapy, skilled therapy radiographers, physicists and radiation therapists. A survey was undertaken to determine the adequacy.

  6. Risk analysis of external radiation therapy

    International Nuclear Information System (INIS)

    Arvidsson, Marcus

    2011-09-01

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

  7. The impact of active breathing control on internal mammary lymph node coverage and normal tissue exposure in breast cancer patients planned for left-sided postmastectomy radiation therapy.

    Science.gov (United States)

    Barry, Aisling; Rock, Kathy; Sole, Claudio; Rahman, Mohammad; Pintilie, Melania; Lee, Grace; Fyles, Anthony; Koch, C Anne

    The purpose of this study was to evaluate the impact of the active breathing control (ABC) technique on IMN coverage and organs at risk in patients planned for postmastectomy radiation therapy (PMRT), with the inclusion of the internal mammary lymph nodes (IMNs). The effect of body mass index (BMI) on recorded dosimetric parameters was examined in the same patient cohort. Fifty left-sided postmastectomy patients with breast cancer who underwent free-breathing (FB) and ABC-Elekta CT simulation scans were selected at random from an institutional breast cancer database between 2008 and 2014. The ABC plans were directly compared with FB plans from the same patient. The IMN planning target volume coverage met dosimetric criteria for coverage of receiving more than 90% of the prescribed dose (V90) >90%, although it decreased with ABC compared with FB (94.5% vs 98%, P < .001). Overall, ABC significantly reduced doses to all measured heart and left anterior descending coronary artery parameters, ipsilateral lung V20, and mean lung dose compared with FB (P < .001). There was no difference seen between the ABC and FB plans with respect to the dose to contralateral lung or contralateral breast. There was no correlation identified between BMI and any of the dosimetric parameters recorded from the ABC and FB plans. Our results suggest that ABC reduces IMN coverage in left-sided breast cancer patients planned for PMRT; however, dosimetric criteria for IMN coverage were still met, suggesting that this is not likely to be clinically significant. ABC led to significant sparing of organs at risk compared with FB conditions and was not affected by BMI. Collectively, the results support the use of ABC for breast cancer patients undergoing left-sided PMRT requiring regional nodal irradiation that includes the IMNs. Further prospective clinical studies are required to determine the impact of these results on late normal tissue effects. Crown Copyright © 2016. Published by Elsevier Inc

  8. Boosted selective internal radiation therapy with 90Y-loaded glass microspheres (B-SIRT) for hepatocellular carcinoma patients: a new personalized promising concept

    International Nuclear Information System (INIS)

    Garin, E.; Lenoir, L.; Edeline, J.; Laffont, S.; Mesbah, H.; Poree, P.; Sulpice, L.; Boudjema, K.; Mesbah, M.; Guillygomarc'h, A.; Quehen, E.; Pracht, M.; Raoul, J.L.; Clement, B.; Rolland, Y.; Boucher, E.

    2013-01-01

    To evaluate the impact of dosimetry based on MAA SPECT/CT for the prediction of response, toxicity and survival, and for treatment planning in patients with hepatocellular carcinoma (HCC) treated with 90 Y-loaded glass microspheres (TheraSphere registered). TheraSphere registered was administered to 71 patients with inoperable HCC. MAA SPECT/CT quantitative analysis was used for the calculation of the tumour dose (TD), healthy injected liver dose (HILD), and total injected liver dose. Response was evaluated at 3 months using EASL criteria. Time to progression (TTP) and overall survival (OS) were evaluated using the Kaplan-Meier method. Factors potentially associated with liver toxicity were combined to construct a liver toxicity score (LTS). The response rate was 78.8 %. Median TD were 342 Gy for responding lesions and 191 Gy for nonresponding lesions (p 205 Gy (p = 0.0015 and not significant). Among patients with portal vein thrombosis (PVT) (n = 33), the median TTP and OS were 4.5 months (2-7 months) and 5 months (2-8 months), respectively, in patients with TD 205 Gy (p = 0.039 and 0.005). The median OS was 24.5 months (18-28.5 months) in PVT patients with TD >205 Gy and good PVT targeting on MAA SPECT/CT. The LTS was able to detect severe liver toxicity (n = 6) with a sensitivity of 83 % and overall accuracy of 97 %. Dosimetry based on MAA SPECT/CT was able to accurately predict response and survival in patients treated with glass microspheres. This method can be used to adapt the injected activity without increasing liver toxicity, thus defining a new concept of boosted selective internal radiation therapy (B-SIRT). This new concept and LTS enable fully personalized treatment planning with glass microspheres to be achieved. (orig.)

  9. Boosted selective internal radiation therapy with 90Y-loaded glass microspheres (B-SIRT) for hepatocellular carcinoma patients: a new personalized promising concept.

    Science.gov (United States)

    Garin, E; Lenoir, L; Edeline, J; Laffont, S; Mesbah, H; Porée, P; Sulpice, L; Boudjema, K; Mesbah, M; Guillygomarc'h, A; Quehen, E; Pracht, M; Raoul, J L; Clement, B; Rolland, Y; Boucher, E

    2013-07-01

    To evaluate the impact of dosimetry based on MAA SPECT/CT for the prediction of response, toxicity and survival, and for treatment planning in patients with hepatocellular carcinoma (HCC) treated with (90)Y-loaded glass microspheres (TheraSphere®). TheraSphere® was administered to 71 patients with inoperable HCC. MAA SPECT/CT quantitative analysis was used for the calculation of the tumour dose (TD), healthy injected liver dose (HILD), and total injected liver dose. Response was evaluated at 3 months using EASL criteria. Time to progression (TTP) and overall survival (OS) were evaluated using the Kaplan-Meier method. Factors potentially associated with liver toxicity were combined to construct a liver toxicity score (LTS). The response rate was 78.8%. Median TD were 342 Gy for responding lesions and 191 Gy for nonresponding lesions (p 205 Gy (p = 0.0015 and not significant). Among patients with portal vein thrombosis (PVT) (n = 33), the median TTP and OS were 4.5 months (2-7 months) and 5 months (2-8 months), respectively, in patients with TD 205 Gy (p = 0.039 and 0.005). The median OS was 24.5 months (18-28.5 months) in PVT patients with TD >205 Gy and good PVT targeting on MAA SPECT/CT. The LTS was able to detect severe liver toxicity (n = 6) with a sensitivity of 83% and overall accuracy of 97%. Dosimetry based on MAA SPECT/CT was able to accurately predict response and survival in patients treated with glass microspheres. This method can be used to adapt the injected activity without increasing liver toxicity, thus defining a new concept of boosted selective internal radiation therapy (B-SIRT). This new concept and LTS enable fully personalized treatment planning with glass microspheres to be achieved.

  10. Radiation therapy for prostatic cancer

    International Nuclear Information System (INIS)

    Kimura, Akira; Minowada, Shigeru; Tomoishi, Junzo; Kinoshita, Kenji; Matsuda, Tadayoshi

    1983-01-01

    A conformation radiotherapy system with collimators, whose openings can be controlled symmetrically by computerized techniques during rotational irradiation by a linear accelerator, has been developed for routine use in our hospital. Forty-four patients underwent radiation therapy, including this particular modality of radiotherapy, for prostatic cancer during the period of July 1976 through December 1981. Eight patients were classified as stage A, 10 stage B, 10 stage C, and 16 as stage D. Twenty-nine patients underwent conformation radiotherapy, two rotation radiotherapy, eight 2-port opposing technique radiotherapy, one 4-field radiotherapy, and four underwent a combination of 2-port opposing technique and conformation radiotherapy. Transient mild side effects such as diarrhea occurred in seven cases, while severe side effects such as rectal stricture or contracted bladder occurred in three cases. The latter occurred only in one case among 29 of conformation radiotherapy and in two among eight of 2-port opposing technique radiotherapy. The results of the treatment of short intervals in stage B, C, and D are as follows: prostatic size was reduced in 26 cases among 36, serum acid phosphatase level was reduced in 15 among 18 who had showed high acid phosphatase levels before treatment, although almost all cases underwent simultaneous hormonal therapy. The effects of radiotherapy alone were verified in two cases of stage B in which radiotherapy preceded hormonal therapy. Prostatic size and serum acid phosphatase level were reduced by radiotherapy alone. (author)

  11. Optical Tracking Technology in Stereotactic Radiation Therapy

    International Nuclear Information System (INIS)

    Wagner, Thomas H.; Meeks, Sanford L.; Bova, Frank J.; Friedman, William A.; Willoughby, Twyla R.; Kupelian, Patrick A.; Tome, Wolfgang

    2007-01-01

    The last decade has seen the introduction of advanced technologies that have enabled much more precise application of therapeutic radiation. These relatively new technologies include multileaf collimators, 3-dimensional conformal radiotherapy planning, and intensity modulated radiotherapy in radiotherapy. Therapeutic dose distributions have become more conformal to volumes of disease, sometimes utilizing sharp dose gradients to deliver high doses to target volumes while sparing nearby radiosensitive structures. Thus, accurate patient positioning has become even more important, so that the treatment delivered to the patient matches the virtual treatment plan in the computer treatment planning system. Optical and image-guided radiation therapy systems offer the potential to improve the precision of patient treatment by providing a more robust fiducial system than is typically used in conventional radiotherapy. The ability to accurately position internal targets relative to the linac isocenter and to provide real-time patient tracking theoretically enables significant reductions in the amount of normal tissue irradiated. This report reviews the concepts, technology, and clinical applications of optical tracking systems currently in use for stereotactic radiation therapy. Applications of radiotherapy optical tracking technology to respiratory gating and the monitoring of implanted fiducial markers are also discussed

  12. Radiation dosimetry in radiotherapy with internal emitters

    International Nuclear Information System (INIS)

    Stabin, Michael G.

    1997-01-01

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

  13. Radiation therapy sources, equipment and installations

    International Nuclear Information System (INIS)

    2011-03-01

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

  14. SU-F-J-137: Intrafractional Change of the Relationship Between Internal Fiducials and External Breathing Signal in Pancreatic Cancer Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pettersson, N; Murphy, J; Simpson, D; Cervino, L [University of California, San Diego, La Jolla, CA (United States)

    2016-06-15

    Purpose: The use of respiratory gating for management of breathing motion during stereotactic body radiation therapy (SBRT) relies on a consistent relationship between the breathing signal and the actual position of the internal target. This relationship was investigated in patients treated for pancreatic cancer. Methods: Four patients with pancreatic cancer undergoing SBRT that had implanted fiducials in the tumor were included in this study. Treatment plans were generated based on the exhale phases (30–70%) from the pre-treatment 4DCT. The margin between the internal target volume (ITV) and the planning target volume was three mm. After patient setup using cone-beam CT, simultaneous fluoroscopic imaging and breathing motion monitoring were used during at least three breathing cycles to verify the fiducial position and to optimize the gating window. After treatment, fluoroscopic images were acquired for verification purposes and exported for retrospective analyses. Fiducial positions were determined using a template-matching algorithm. For each dataset, we established a linear relationship between the fiducial position and the anterior-posterior (AP) breathing signal. The relationships before and after treatment were compared and the dose distribution impact evaluated. Results: Seven pre- and post-treatment fluoroscopic pairs were available for fiducial position analyses in the superior-inferior (SI) and left-right (LR) directions, and five in the AP direction. Time between image acquisitions was typically six to eight minutes. An average absolute change of 1.2±0.7 mm (range: 0.1–1.7) of the SI fiducial position relative to the external signal was found. Corresponding numbers for the LR and AP fiducial positions were 0.9±1.0 mm (range: 0.2–3.0) and 0.5±0.4 mm (range: 0.2–1.2), respectively. The dose distribution impact was small in both the ITV and organs-at-risk. Conclusion: The relationship change between fiducial position and external breathing

  15. SU-F-J-137: Intrafractional Change of the Relationship Between Internal Fiducials and External Breathing Signal in Pancreatic Cancer Stereotactic Body Radiation Therapy

    International Nuclear Information System (INIS)

    Pettersson, N; Murphy, J; Simpson, D; Cervino, L

    2016-01-01

    Purpose: The use of respiratory gating for management of breathing motion during stereotactic body radiation therapy (SBRT) relies on a consistent relationship between the breathing signal and the actual position of the internal target. This relationship was investigated in patients treated for pancreatic cancer. Methods: Four patients with pancreatic cancer undergoing SBRT that had implanted fiducials in the tumor were included in this study. Treatment plans were generated based on the exhale phases (30–70%) from the pre-treatment 4DCT. The margin between the internal target volume (ITV) and the planning target volume was three mm. After patient setup using cone-beam CT, simultaneous fluoroscopic imaging and breathing motion monitoring were used during at least three breathing cycles to verify the fiducial position and to optimize the gating window. After treatment, fluoroscopic images were acquired for verification purposes and exported for retrospective analyses. Fiducial positions were determined using a template-matching algorithm. For each dataset, we established a linear relationship between the fiducial position and the anterior-posterior (AP) breathing signal. The relationships before and after treatment were compared and the dose distribution impact evaluated. Results: Seven pre- and post-treatment fluoroscopic pairs were available for fiducial position analyses in the superior-inferior (SI) and left-right (LR) directions, and five in the AP direction. Time between image acquisitions was typically six to eight minutes. An average absolute change of 1.2±0.7 mm (range: 0.1–1.7) of the SI fiducial position relative to the external signal was found. Corresponding numbers for the LR and AP fiducial positions were 0.9±1.0 mm (range: 0.2–3.0) and 0.5±0.4 mm (range: 0.2–1.2), respectively. The dose distribution impact was small in both the ITV and organs-at-risk. Conclusion: The relationship change between fiducial position and external breathing

  16. Melioidosis: reactivation during radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jegasothy, B.V.; Goslen, J.B.; Salvatore, M.A.

    1980-05-01

    Melioidosis is caused by Pseudomonas pseudomallei, a gram-negative, motile bacillus which is a naturally occurring soil saprophyte. The organism is endemic in Southeast Asia, the Philippines, Australia, and parts of Central and South America. Most human disease occurs from infection acquired in these countries. Infection with P pseudomallei may produce no apparent clinical disease. Acute pneumonitis or septicemia may result from inhalation of the organism, and inoculation into sites of trauma may cause localized skin abscesses, or the disease may remain latent and be reactivated months or years later by trauma, burns, or pneumococcal pneumonia, diabetic ketoacidosis, influenza, or bronchogenic carcinoma. The last is probably the commonest form of melioidosis seen in the United States. We present the first case of reactivation of melioidosis after radiation therapy for carcinoma of the lung, again emphasizing the need to consider melioidosis in a septic patient with a history of travel, especially to Southeast Asia.

  17. Melioidosis: reactivation during radiation therapy

    International Nuclear Information System (INIS)

    Jegasothy, B.V.; Goslen, J.B.; Salvatore, M.A.

    1980-01-01

    Melioidosis is caused by Pseudomonas pseudomallei, a gram-negative, motile bacillus which is a naturally occurring soil saprophyte. The organism is endemic in Southeast Asia, the Philippines, Australia, and parts of Central and South America. Most human disease occurs from infection acquired in these countries. Infection with P pseudomallei may produce no apparent clinical disease. Acute pneumonitis or septicemia may result from inhalation of the organism, and inoculation into sites of trauma may cause localized skin abscesses, or the disease may remain latent and be reactivated months or years later by trauma, burns, or pneumococcal pneumonia, diabetic ketoacidosis, influenza, or bronchogenic carcinoma. The last is probably the commonest form of melioidosis seen in the United States. We present the first case of reactivation of melioidosis after radiation therapy for carcinoma of the lung, again emphasizing the need to consider melioidosis in a septic patient with a history of travel, especially to Southeast Asia

  18. Neutron-Activatable Nanoparticles for Intraperitoneal Radiation Therapy.

    Science.gov (United States)

    Hargrove, Derek; Lu, Xiuling

    2017-01-01

    Intraperitoneal internal radiation therapy is a cancer treatment option that is employed in situations where surgical resection, systemic chemotherapy, and external beam radiotherapy are not amenable for patients. However, exposure of noncancerous tissues to radiation continues to be a hindrance to safe and effective treatment of patients. In addition, reducing prolonged radiation exposure of personnel during preparation of internal radiation therapy agents makes their manufacture complicated and hazardous. Developments in nanotechnology have provided a platform for targeted treatments that combine dual imaging and treatment capabilities all in one package, while also being robust enough to withstand the intense stresses faced during neutron activation. Here, we describe a method for synthesizing neutron activatable mesoporous silica nanoparticles for use in radiotherapy of metastatic peritoneal cancers while limiting personal exposure to radioactive materials, limiting the leakage of radioactive isotopes caused by nanoparticle degradation during neutron activation, and increasing cancer tissue specificity of radiation.

  19. The carcinogenicity of radiation therapy

    International Nuclear Information System (INIS)

    Pizzarello, D.J.; Roses, D.F.; Newall, J.; Barish, R.J.

    1984-01-01

    Ionizing radiation as used for therapy for cancer is probably weakly carcinogenic at worst. The probability that cancers will be induced at a distance from the treatment volume is so small that it can only be inferred from experiences with large populations exposed to much higher radiation doses. The risk of cancer in and adjacent to the treatment volume also appears to be small, especially in adults. Intensive radiotherapy or radiotherapy of children 20 to 30 years ago appears to have induced secondary cancers in about 3 to 4 per cent of those treated, but modern practice has every expectation of reducing this incidence. No precise risk factor can be offered, but it seems likely that less than 3 to 4 per cent is a reasonable projection. The reason for the low carcinogenicity in the treatment volume probably lies in the fact that the irradiation dose is high and many cells are killed rather than transformed. The frequency of the induction of radiogenic cancer adjacent to or near the treatment volume is expected to vary according to the tissue exposed. It is not estimated to exceed a few per cent in the worst instances (for example, breast and thyroid gland) and is much less than 1 per cent in most tissues

  20. Targeted drugs in radiation therapy

    International Nuclear Information System (INIS)

    Favaudon, V.; Hennequin, C.; Hennequin, C.

    2004-01-01

    New drugs aiming at the development of targeted therapies have been assayed in combination with ionizing radiation over the past few years. The rationale of this concept comes from the fact that the cytotoxic potential of targeted drugs is limited, thus requiring concomitant association with a cytotoxic agent for the eradication of tumor cells. Conversely a low level of cumulative toxicity is expected from targeted drugs. Most targeted drugs act through inhibition of post-translational modifications of proteins, such as dimerization of growth factor receptors, prenylation reactions, or phosphorylation of tyrosine or serine-threonine residues. Many systems involving the proteasome, neo-angiogenesis promoters, TGF-β, cyclooxygenase or the transcription factor NF-κB, are currently under investigation in hopes they will allow a control of cell proliferation, apoptosis, cell cycle progression, tumor angiogenesis and inflammation. A few drugs have demonstrated an antitumor potential in particular phenotypes. In most instances, however, radiation-drug interactions proved to be strictly additive in terms of cell growth inhibition or induced cell death. Strong potentiation of the response to radiotherapy is expected to require interaction with DNA repair mechanisms. (authors)

  1. Job satisfaction among radiation therapy educators.

    Science.gov (United States)

    Swafford, Larry G; Legg, Jeffrey S

    2007-01-01

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

  2. Nonsurgical treatment for cancer using radiation therapy

    International Nuclear Information System (INIS)

    Ogi, Yasuo

    2012-01-01

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

  3. Radiation therapy facilities in the United States

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  4. Chemotherapy and molecular target therapy combined with radiation therapy

    International Nuclear Information System (INIS)

    Akimoto, Tetsuo

    2012-01-01

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

  5. Is a Technetium-99m Macroaggregated Albumin Scan Essential in the Workup for Selective Internal Radiation Therapy with Yttrium-90? An Analysis of 532 Patients.

    Science.gov (United States)

    Sancho, Lidia; Rodriguez-Fraile, Macarena; Bilbao, Jose Ignacio; Beorlegui Arteta, Carmen; Iñarrairaegui, Mercedes; Moran, Veronica; Sangro, Bruno

    2017-11-01

    To determine if baseline patient, tumor, and pretreatment evaluation characteristics could help identify patients who require technetium-99m ( 99m Tc) macroaggregated albumin ( 99m Tc MAA) imaging before selective internal radiation therapy (SIRT). In this retrospective analysis, 532 consecutive patients with primary (n = 248) or metastatic (n = 284) liver tumors were evaluated between 2006 and 2015. Variables were compared between patients in whom 99m Tc MAA imaging results contraindicated/modified SIRT administration with yttrium-90 ( 90 Y) resin microspheres and those who were treated as initially planned. The 99m Tc MAA findings that contraindicated/modified SIRT were a lung shunt fraction (LSF) > 20%, gastrointestinal 99m Tc MAA uptake, or a mismatch between 99m Tc MAA uptake and intrahepatic tumor distribution. LSF > 20% and gastrointestinal MAA uptake were observed in 7.5% and 3.9% of patients, respectively, and 11% presented a mismatch. Presence of a single lesion (odds ratio [OR] = 2.4) and vascular invasion (OR = 5.5) predicted LSF > 20%, and GI MAA uptake was predicted by the presence of liver metastases (OR = 3.7) and 99m Tc MAA injection through the common/proper hepatic artery (OR = 4.7). Vascular invasion (OR = 4.1) was the only predictor of LSF > 20% and/or GI MAA uptake (sensitivity = 49.2%, specificity = 80.3%, negative predictive value = 92.4%). Previous antiangiogenic treatment (OR = 2.4) and presence of a single lesion (OR = 2.6) predicted mismatch. Imaging with 99m Tc MAA is essential in SIRT workup because baseline characteristics may not adequately predict 99m Tc MAA results. Nevertheless, the absence of vascular invasion potentially identifies a group of patients at low risk of SIRT contraindication/modification in whom performing SIRT in a single session (ie, pretreatment evaluation and SIRT on the same day) should be explored. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  6. Boosted selective internal radiation therapy with {sup 90}Y-loaded glass microspheres (B-SIRT) for hepatocellular carcinoma patients: a new personalized promising concept

    Energy Technology Data Exchange (ETDEWEB)

    Garin, E.; Lenoir, L. [Comprehensive Cancer Center, Institute Eugene Marquis, Department of Nuclear Medicine, CS 44229, Rennes (France); University of Rennes 1, Rennes (France); INSERM, U-991, Liver Metabolisms and Cancer, Rennes (France); Edeline, J. [University of Rennes 1, Rennes (France); Comprehensive Cancer Center, Institute Eugene Marquis, Department of Medical Oncology, CS 44229, Rennes (France); Laffont, S. [Comprehensive Cancer Center, Institute Eugene Marquis, Department of Nuclear Medicine, CS 44229, Rennes (France); Mesbah, H.; Poree, P. [Comprehensive Cancer Center, Institute Eugene Marquis, Department of Medical Informatics, CS 44229, Rennes (France); Sulpice, L. [INSERM, U-991, Liver Metabolisms and Cancer, Rennes (France); Centre Hospitalier Universitaire Pontchaillou, Department of Digestive Surgery, Rennes (France); Boudjema, K. [University of Rennes 1, Rennes (France); INSERM, U-991, Liver Metabolisms and Cancer, Rennes (France); Centre Hospitalier Universitaire Pontchaillou, Department of Digestive Surgery, Rennes (France); Mesbah, M. [University of Pierre et Marie Curie, Paris (France); Guillygomarc' h, A. [Centre Hospitalier Universitaire Pontchaillou, Department of Hepatology, Rennes (France); Quehen, E. [Centre Hospitalier Universitaire Pontchaillou, Department of Radiology, Rennes (France); Pracht, M. [Comprehensive Cancer Center, Institute Eugene Marquis, Department of Medical Oncology, CS 44229, Rennes (France); Raoul, J.L. [Comprehensive Cancer Center, Institute Paoli Calmette, Department of Medical Oncology, Marseille (France); Clement, B. [INSERM, U-991, Liver Metabolisms and Cancer, Rennes (France); Rolland, Y. [Comprehensive Cancer Center, Institute Eugene Marquis, Department of Medical Imaging, CS 44229, Rennes (France); Boucher, E. [INSERM, U-991, Liver Metabolisms and Cancer, Rennes (France); Comprehensive Cancer Center, Institute Eugene Marquis, Department of Medical Oncology, CS 44229, Rennes (France)

    2013-07-15

    able to accurately predict response and survival in patients treated with glass microspheres. This method can be used to adapt the injected activity without increasing liver toxicity, thus defining a new concept of boosted selective internal radiation therapy (B-SIRT). This new concept and LTS enable fully personalized treatment planning with glass microspheres to be achieved. (orig.)

  7. Booted selective internal radiation therapy (B-SIRT) using 90Y-loaded glass microspheres induces prolonged overall survival for PVT patients

    International Nuclear Information System (INIS)

    Garin, E.; Lenoir, L.; Edeline, J.; Laffont, S.; Mesbah, H.; Poree, P.; Boucher, E.; Rolland, Y.

    2015-01-01

    Full text of publication follows. Goal: evaluation of the response rate and survival of hepatocellular carcinoma PVT patients treated with Therasphere using the boost concept. Material and methods: Therasphere was administered in 40 PVT hepatocellular carcinoma patients (main = 11, lobar = 23, segmental = 6). MAA SPECT/CT quantitative analysis was used for the calculation of the tumour dose (TD), the healthy injected liver dose (HLD) and the injected liver dose (LD). Response was evaluated at 3 months using EASL criterion. OS was evaluated using Kaplan and Meyer tests. Results: Mean 90 Y-loaded microspheres injected activity was 3.1 ± 1.5 GBq. Mean LD was 143 ± 49 Gy. Median TD was 316 Gy for responding lesions versus 133 Gy for non responding lesion (p<0.0001). With a threshold TD of 205 Gy, MAA-SPECT/CT was predictive of response with a sensibility of 100%, and an overall accuracy of 90% (0FN, 4FP). Knowing the TD and the HLD, 40% of the patients received an intensification of the treatment (increase of the injected activity with the goal to achieve a TD> 205 Gy with a LD > 150 Gy and a HLD<120 Gy) with a good response rate (81%) and without increased liver grade III toxicity (6.2% as against 12.5% in the non boosted patients, ns). 6 patients were put aside, 5 received a lobar hepatectomy. Median OS was 18.2 months [12-27]. It was 4 m [12-27] for patients with a TD < 205 Gy versus 21.5 m [12-28.5] for patients with a TD > 205 Gy. OS was 12 m [3-∞] for patients with main PVT versus 21.5 m [12-28.7] for patients segmental or lobar PVT (ns). Finally Os was 23.2 m for patients with a TD > 205 Gy and a good PVT targeting (n = 34). Conclusion: boosted selective internal radiation therapy using 90 Y-loaded glass microspheres induces prolonged overall survival for PVT patients without increasing liver toxicity. (authors)

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  9. New modalities in radiation therapy for treatment of cancer

    International Nuclear Information System (INIS)

    Kumar, Deepak

    2013-01-01

    -RAY used). Stereotactic radiation type of external beam radiation therapy, is focused radiation beam targeting a well-defined tumor, these treatment include gamma knife surgery. Intensity-modulated radiation therapy (IMRT) is an advanced type of high-precision radiation which improves the treatment volume to concave tumor shapes. In 3-dimensional conformal radiation therapy (3DCRT), the profile of each radiation beam is shaped to fit the profile of the target using a multi leaf collimator (MLC) and a variable number of beams. In image-guided radiation therapy (IGRT) or four-dimensional radiation therapy, real time imaging combined with real time adjustment of the therapeutic beams use. Brachytherapy (internal radiation therapy) is an effective treatment for cervical, prostate, breast, and skin cancer and can also be used to treat tumors in many other body sites. Radioisotopes therapy (RIT) is a form of targeted therapy which is used for the treatment of certain specific types of tumors. (author)

  10. Study on external beam radiation therapy

    International Nuclear Information System (INIS)

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

    1999-04-01

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

  11. Study on external beam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-04-01

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

  12. Cardiovascular effects of radiation therapy

    International Nuclear Information System (INIS)

    Alvarez, Jose A.G.; Leiva, Gustavo

    2001-01-01

    Therapeutic mediastinal irradiation can induce heart disease with variable degree of cardiac engagement. Heart disease manifestations depend on the grade of involvement of the different cardiac structures. During the first two years following irradiation, pericarditis with or without pericardial effusion is the most common manifestation of toxicity related to radiation therapy. Later on, after a latency period of five to ten years, a constrictive pericarditis may develop. Other type of late cardiac toxicities due to irradiation are restrictive cardiomyopathy, multiple valvular disease, coronary artery disease and different atrioventricular conduction disturbances. The therapeutic approach to this kind of heart disease has to be focused on its progressive course and in the possibility of a global involvement of all the cardiac structures. Pericardiectomy is strongly recommended for recurrent pericardial effusion with cardiac tamponade. Cardiac surgery for myocardial revascularization or valvular disease can be performed with variable results; the presence of myocardial fibrosis can significantly affect perioperative management and long-term results. Cardiac transplantation is a promissory option for those patients with end-stage cardiac failure. Immunosuppressive regimens are not associated with recurrence of malignancy. (author) [es

  13. Radiation therapy of psoriasis and parapsoriasis

    International Nuclear Information System (INIS)

    Wiskemann, A.

    1982-01-01

    Selective UV-Phototherapy with lambda 300-320 nm (SUP) as well as oral photochemotherapy with 8-methoxy-psoralen plus UVA-radiation (PUVA intern) are very effective in clearing the lesions of the generalized psoriasis and those of the chronic forms of parapsoriasis. Being treated with 4 suberythemal doses per week psoriasis patients are free or nearly free of symptoms after averagely 6.3 weeks of SUP-therapy or after 5.3 weeks of PUVA orally. The PUVA-therapy is mainly indicated in pustular, inverse and erythrodermic psoriasis as well as in parapsoriasis en plaques and variegata. In all other forms of psoriasis and in pityriasis lichenoides-chronica, we prefer the SUP-therapy because of less acute or chronic side effects, and because of its better practicability. X-rays are indicated in psoriais of nails, grenz-rays in superficial psoriatic lesions of the face, the armpits, the genitals and the anal region. (orig.) [de

  14. Extramammary Paget's disease: role of radiation therapy

    International Nuclear Information System (INIS)

    Guerrieri, M.; Back, M.F.

    2002-01-01

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

  15. Radiation therapy in elderly patients

    International Nuclear Information System (INIS)

    Terradas, M.; Santini, A.; Mara, C.

    2004-01-01

    Elderly patients, or those individuals over 65 or 70 depending on the different authors, represent the majority of cancer patients who treated with radiation therapy (RT), however there are very few publications that we provide information needed to evaluate the use of RT in the treatment elders regarding: indication of dose, tissue tolerance, toxicity and association with other therapeutic modalities. In the treatment process must take into account RT radiobiology Clinical applied to each patient and is more relevant in the elderly in which often are comorbid conditions and functional limitations normal tissues increases with age and disease coexisting vascular and connective influencing RT treatment. Chronological age does not correlate with the biological age for tolerance normal tissue, however frequently refers to healthy tissue in the elderly are less tolerant than healthy tissue RT adults young but no data in the literature to support it and perhaps those claims probably based on the presence of comorbid conditions or diseases associated or previous surgeries that influence the risk of tissue damage healthy. Studies conducted by the EORTC not show differences in toxicity acute and late age-related. Elderly patients tolerate RT like younger patients with comparable side effects. In the case of concurrent chronic diseases should take into account a possible modification of the dose and volume irradiated to prevent the risk develop permanent damage or sector body lest un irradiated able to compensate for the loss of function of the irradiated tissue; but we should always note that the dose reduction while reducing the risk of complications also decreases the chance of cure

  16. Intensity-Modulated Radiation Therapy (IMRT)

    Science.gov (United States)

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

  17. Preoperative breast radiation therapy: Indications and perspectives

    DEFF Research Database (Denmark)

    Lightowlers, S V; Boersma, L J; Fourquet, A

    2017-01-01

    Preoperative breast radiation therapy (RT) is not a new concept, but older studies failed to change practice. More recently, there has been interest in revisiting preoperative RT using modern techniques. This current perspective discusses the indications, summarises the published literature...

  18. Pediatric radiation therapy. A Japanese nationwide survey

    International Nuclear Information System (INIS)

    Nemoto, Kenji; Nagata, Yasushi; Hirokawa, Yutaka

    2006-01-01

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

  19. Effect of radiation therapy against intracranial hemangiopericytoma

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  20. Care of the patient receiving radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yasko, J.M.

    1982-12-01

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

  1. Care of the patient receiving radiation therapy

    International Nuclear Information System (INIS)

    Yasko, J.M.

    1982-01-01

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

  2. Role of the International Radiation Protection Association.

    Science.gov (United States)

    Kase, Kenneth R; Metcalf, Phil

    2011-01-01

    Global concerns over energy supply and climate change have given rise to an increase in uranium prospecting, mining and extraction. The changing world economy is spreading the use of advanced nuclear and radiation-related technologies to many parts of the world, giving rise to global initiatives on nuclear energy and operation of nuclear fuel cycle facilities. The emerging global nuclear safety regime promotes and encourages high standards of radiation safety worldwide. These developments call for increasing capacity and capabilities in radiation protection expertise and continue to present both challenges and opportunities to the International Radiation Protection Association (IRPA), an association of 46 societies representing 58 countries with an individual membership of approximately 17,000. IRPA's objectives include: (1) assisting the development of competent radiation protection programs; (2) fostering the exchange of scientific and technical information through its international and regional congresses; (3) promoting the scientific and professional recognition of the radiation protection expert; and (4) supporting continuing education programs at each IRPA congress. IRPA has adopted a Code of Ethics and Guiding Principles for the Conduct of Stakeholder Engagement. Recently work began to develop guidance for maintaining and improving current levels of radiation protection and transferring this culture to future radiation protection professionals. These IRPA projects are developed through the Associate Society Forum discussions that are held at each IRPA international and regional congress. Finally, IRPA maintains a close working relationship with various international organizations and is also represented on the Inter-Agency Committee on Radiation Safety. Copyright © 2010 Health Physics Society

  3. Radiation therapy apparatus having retractable beam stopper

    International Nuclear Information System (INIS)

    Coad, G.L.

    1983-01-01

    This invention relates to a radiation therapy apparatus which utilized a linear translation mechanism for positioning a beam stopper. An apparatus is described wherein the beam stopper is pivotally attached to the therapy machine with an associated drive motor in such a way that the beam stopper retracts linearly

  4. 42 CFR 410.35 - X-ray therapy and other radiation therapy services: Scope.

    Science.gov (United States)

    2010-10-01

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

  5. Use of 18F-FDG PET-CT imaging to determine internal mammary lymph node location for radiation therapy treatment planning in breast cancer patients.

    Science.gov (United States)

    Davidson, Tima; Ben-David, Merav; Galper, Shira; Haskin, Tess; Howes, Megan; Scaife, Roland; Kanana, Nayroz; Amit, Uri; Weizman, Noam; Chikman, Bar; Goshen, Elinor; Ben-Haim, Simona; Symon, Zvi; Goldstein, Jeffrey

    Adjuvant internal mammary lymph node (IMN) radiation is often delivered with 2-dimensional techniques that use anatomic landmarks and predetermined depths for field placement and dose specification. In contrast, 3-dimensional planning uses the internal mammary vessels (IMVs) to localize the IMNs for planning. Our purpose was to determine if localization of the involved IMN (i-IMN) by 18 F-labeled fluorodeoxyglucose positron emission tomography-computed tomography ( 18 F-FDG PET-CT) offers opportunities to improve treatment. Breast cancer patients (n = 80) who had i-IMNs (n = 112) on PET-CT for initial staging (n = 40) or recurrence (n = 40) were studied. Size, intercostal space (IC), and distance from skin, sternum, and IMVs were recorded. Effects on 2- and 3-dimensional planning were evaluated. Most i-IMNs (94.6%) were in the first to third ICs. Few were in the fourth (4.5%) or fifth (0.9%) IC. Mean i-IMN depth was 3.4 cm (range, 1.1-7.3 cm). Prescriptive depths of 4, 5, and 6 cm would result in undertreatment of 25%, 10.7%, and 5.3% of IMNs, respectively. Most IMNs (86.6%) were lateral or adjacent to the sternal edge. Only 13.4% of IMNs were posterior to the sternum. Use of the ipsilateral or contralateral sternal edge for field placement increases the risk of geographic miss or excess normal tissue exposure. Most i-IMNs were adjacent to (83%) or ≤0.5 cm (14%) from the IMV edge. Three (3%) were >0.5 cm beyond the IMV edge. The clinical target volume (CTV) defined by the first to third ICs encompassed 78% of i-IMNs. IMN-CTV coverage of i-IMNs increased with inclusion of the fourth IC (82%), 0.5 cm medial and lateral margin expansion (93%), or both (96.5%). Two-dimensional treatment techniques risk geographic miss of IMNs and exposure of excess normal tissue to radiation. An IMN-CTV defined by the IMVs from the first to third ICs with 0.5-cm medial and lateral margin expansion encompasses almost all i-IMNs identified on PET-CT imaging. Inclusion of the fourth IC

  6. Internal conversion of gamma radiation

    International Nuclear Information System (INIS)

    Dragoun, O.

    1982-01-01

    The process of the gamma-ray internal conversion is reviewed. The principle of the calculations of the internal conversion coefficients is outlined and methods of conversion electron measurements are described. The extensive utilization of internal conversion in nuclear physics, as well as several applications in chemistry and solid state physics are also discussed. (author)

  7. Evolution of radiation therapy: technology of today

    International Nuclear Information System (INIS)

    Shrivastava, S.K.; Mishra, Shagun

    2013-01-01

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

  8. Protective prostheses during radiation therapy

    International Nuclear Information System (INIS)

    Poole, T.S.; Flaxman, N.A.

    1986-01-01

    Current applications and complications in the use of radiotherapy for the treatment of oral malignancy are reviewed. Prostheses are used for decreasing radiation to vital structures not involved with the lesion but located in the field of radiation. With a program of oral hygiene and proper dental care, protective prostheses can help decrease greatly the morbidity seen with existing radiotherapy regimens

  9. Radiation Complications Following Breast Conserving Therapy.

    Science.gov (United States)

    Ikushima; Takegawa; Yasuda; Makimoto; Matsuzaki; Kashihara; Ueno; Sasa; Morimoto; Nishitani

    1998-10-25

    BACKGROUND: Breast conserving therapy is being established as a standard therapeutic procedure for early breast cancer in Japan. However, the indications of radiotherapy and a standardized therapeutic procedure have not been established yet. In this study, complications following radiotherapy were evaluated in patients who had previously undergone breast conserving therapy at Tokushima University Hospital. METHODS From October 1989 to March 1996, 60 women with stage I or II breast cancer underwent radiation therapy after breast conserving surgery, and all patients were followed-up for a median of 27 months. Radiation morbidity scoring of the breast and adjacent organs was performed using the toxity criteria of the Radiation Therapy Oncology Group (RTOG) and European Organization for Research andTreatment of Cancer (EORTC). RESULTS: Only 1 patient developed local recurrence, and no distant metastasisor death was observed. The cause of recurrence in 1 case was considered to be due to extended intraductal component. Although transient dermal reaction was induced by irradiation of the breast, no side effects that may cause cosmetic problems were found. No serious radiation complications were found in the lungs, ribs, heart or other adjacent organs. CONCLUSION: The adverse reactions caused by irradiation does not reduce the merit of combined use of radiation therapy in breast conserving therapy, and therefore, are not the hesitation factor in application of radiotherapy.

  10. Radiation therapy for metastatic spinal tumors

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  11. Radiation therapy for cancer patients

    International Nuclear Information System (INIS)

    Mileikowsky, C.

    1987-01-01

    This patent describes an apparatus for irradiating a patient comprising: a source of a radiation beam directed along a radiation axis; means mounting the source for pivotal movement about a first horizontal axis which intersects the source, is stationary with respect to the apparatus, and extends in a direction substantially normal to the radiation axis, whereby the beam is capable of an angular scan in a vertical plane; table means adapted to support a patient to be irradiated; and suspension means mounted the table means for arcuate movement to any positions angularly spaced about the first horizontal axis and for pivoting movement about a second horizontal axis displacement from and substantially parallel to the first horizontal axis. The suspension means maintain the second horizontal axis in substantially intersecting relation to the radiation axis in each of the positions while maintaining a fixed angular position of the table means with respect to the environment

  12. Radiation therapy of benign diseases

    International Nuclear Information System (INIS)

    Order, S.E.; Donaldson, S.

    1990-01-01

    This book reports on the evaluation and treatment of benign disease. The text begins with a chapter concerning standards of practice by an eminent malpractice lawyer, thereby clarifying the medical-legal implications of the radiation treatment of benign disease. The text then lists, in alphabetic order, those benign diseases which have been or are currently treated with radiotherapy for each disease entity. A feature is the survey of current radiation practice in the United States

  13. Guidelines for safe practice of stereotactic body (ablative) radiation therapy

    International Nuclear Information System (INIS)

    Foote, Matthew; Barry, Tamara; Bailey, Michael; Smith, Leigh; Seeley, Anna; Siva, Shankar; Hegi-Johnson, Fiona; Booth, Jeremy; Ball, David; Thwaites, David

    2015-01-01

    The uptake of stereotactic ablative body radiation therapy (SABR) / stereotactic body radiation therapy (SBRT) worldwide has been rapid. The Australian and New Zealand Faculty of Radiation Oncology (FRO) assembled an expert panel of radiation oncologists, radiation oncology medical physicists and radiation therapists to establish guidelines for safe practice of SABR. Draft guidelines were reviewed by a number of international experts in the field and then distributed through the membership of the FRO. Members of the Australian Institute of Radiography and the Australasian College of Physical Scientists and Engineers in Medicine were also asked to comment on the draft. Evidence-based recommendations (where applicable) address aspects of departmental staffing, procedures and equipment, quality assurance measures, as well as organisational considerations for delivery of SABR treatments. Central to the guidelines is a set of key recommendations for departments undertaking SABR. These guidelines were developed collaboratively to provide an educational guide and reference for radiation therapy service providers to ensure appropriate care of patients receiving SABR.

  14. Impact of radiation therapy on sexual life

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  15. Cancer of the larynx: radiation therapy. III

    International Nuclear Information System (INIS)

    Wang, C.C.

    1976-01-01

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

  16. Current trends in nuclear medicine metabolic therapy - international experience

    International Nuclear Information System (INIS)

    Chavdarova, L.; Tsonevska, A.; Piperkova, E.

    2013-01-01

    Full text: Introduction: Modern nuclear medicine (NM) metabolic therapy involves treatment with radionuclides sources mainly β-, and lately more often and α- rays and aims target specificity to the disease process with minimal damage to healthy surrounding tissues. Materials and Methods: We present some of the most important clinically significant contemporary trends in metabolic therapy in the light of international experience, including low-known in Bulgaria peptide radioreceptor therapy, radioimmunotherapy and so called SIRT (Selective internal radiation therapy) for liver metastases. Results: The ability of NM therapy range from definitive treatment of benign thyroid disease and differentiated thyroid cancer by achieving partial response or complete remission to a temporary palliative analgesic and symptom reducing effect in different, mainly cancer, diseases. Conclusion: The principle of 'terradiagnostic' - the interdependence of diagnostic and therapeutic nuclear medicine approaches is crucial for individualizing treatment and achieving better results in extending survival and improving the quality of life of patients

  17. Radiation therapy of gastric carcinoma

    International Nuclear Information System (INIS)

    Asakawa, Hiroshi; Yamada, Shogo

    1980-01-01

    A total of 136 cases with gastric cancer was treated with radiation and some anti-cancer drugs. The tumor responded markedly to radiation in 37% of 92 cases, irradiated more than 5000 rad and regressed completely in only 5% of them. Out of them, the permanent cure was achieved in 3% of T2-4 M0 cases. Serious complications, such as hemorrhagic gastritis, massive bleeding, chronic ulcer of the stomach and perforation, were also observed in a few per cent of them. It was suggested that in the treatment of inoperable gastric cancer, the combination treatment of radiation and chemotherapy should be chosen as a valuable therapeutic procedure to get a good palliation. (author)

  18. Role of the ICRU in quality assurance in radiation therapy

    International Nuclear Information System (INIS)

    Wambersie, A.

    1984-01-01

    A short history of the International Commission on Radiation Units and Measurements (ICRU) and its main objectives are presented. They now include the development of internationally acceptable recommendations regarding: (1) quantities and units; (2) procedures suitable for the measurement and application of these quantities (as well as the associated uncertainties); (3) physical data needed in the application of these procedures; and (4) definition of terms and concepts used in radiation therapy. One of the most important actions of the ICRU during the last two decades was its recommendation in favor of the introduction of the SI units (International System of Units) in the field of ionizing radiation. Recently published ICRU reports in the field of radiation therapy are reviewed. Reports 23 and 24 provide recommendations for determining the absorbed dose in a patient irradiated with X or gamma ray beams. High energy electron and neutron beams have been considered in Reports 21 and 26 respectively. Report 31 provides a survey of the available anti W values and Report 29 makes recommendations on dose specification for reporting therapeutic irradiation in external beam therapy

  19. Results of radiation therapy in periarthritis humeroscapularis

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  20. Advanced Small Animal Conformal Radiation Therapy Device.

    Science.gov (United States)

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

    2017-02-01

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

  1. Radiation Therapy of Suprasellar Germ Cell Tumors

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  2. Radiation therapy for resistant sternal hydatid disease

    International Nuclear Information System (INIS)

    Ulger, S.; Barut, H.; Tunc, M.; Aydinkarahaliloglu, E.; Aydin, E.; Karaoglanoglu, N.; Gokcek, A.

    2013-01-01

    Hydatid disease is a zoonotic infectious disease for which there are known treatment procedures and effective antibiotics; however, there are resistant cases that do not respond to medication or surgery. We report a case diagnosed as hydatid disease of the chest wall and treated with radiation therapy (RT) after medical and surgical therapy had failed. In conclusion, RT represents an alternative treatment modality in resistant cases. (orig.)

  3. 21 CFR 892.5300 - Medical neutron radiation therapy system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical neutron radiation therapy system. 892.5300... therapy system. (a) Identification. A medical neutron radiation therapy system is a device intended to generate high-energy neutrons for radiation therapy. This generic type of device may include signal...

  4. History of international symbol for ionizing radiation

    International Nuclear Information System (INIS)

    Franic, Z.

    1996-01-01

    The year 1996 marks the 50th anniversary of the radiation warning symbol as we currently know it. It was (except the colours used) doodled out at the University of California, Berkeley, sometime in 1946 by a small group of people. The key guy responsible was Nelson Garden, then the head of the Health Chemistry Group, at the Radiation Laboratory. The radiation warning symbol should not be confused with the civil defence symbol (circle divided into six equal sections, three of these being black and three yellow), designed to identify fallout shelters. The basic radiation symbol was eventually internationally standardized by ISO code: 361-1975 (E). Variations of this symbol are frequently used in logotypes radiation protection organizations or associations. Particularly nice are those of International Radiation Protection Association (IRPA) and Croatian Radiation Protection Association (CRPA) that combines traditional Croatian motives with high technology. However, apart from speculations, there is no definite answer why did the Berkeley people chose this particular symbol. Whatever the reason was, it was very good choice because the ionizing radiation symbol is simple, readily identifiable, i.e., not similar to other warning symbols, and discernible at a large distance. (author)

  5. Single administration of Selective Internal Radiation Therapy versus continuous treatment with sorafeNIB in locally advanced hepatocellular carcinoma (SIRveNIB): study protocol for a phase iii randomized controlled trial

    International Nuclear Information System (INIS)

    Gandhi, Mihir; Choo, Su Pin; Thng, Choon Hua; Tan, Say Beng; Low, Albert Su Chong; Cheow, Peng Chung; Goh, Anthony Soon Whatt; Tay, Kiang Hiong; Lo, Richard Hoau Gong; Goh, Brian Kim Poh; Wong, Jen San; Ng, David Chee Eng; Soo, Khee Chee; Liew, Wei Ming; Chow, Pierce K. H.

    2016-01-01

    Approximately 20 % of hepatocellular carcinoma (HCC) patients diagnosed in the early stages may benefit from potentially curative ablative therapies such as surgical resection, transplantation or radiofrequency ablation. For patients not eligible for such options, prognosis is poor. Sorafenib and Selective Internal Radiation Therapy (SIRT) are clinically proven treatment options in patients with unresectable HCC, and this study aims to assess overall survival following either SIRT or Sorafenib therapy for locally advanced HCC patients. This investigator-initiated, multi-centre, open-label, randomized, controlled trial will enrol 360 patients with locally advanced HCC, as defined by Barcelona Clinic Liver Cancer stage B or stage C, without distant metastases, and which is not amenable to immediate curative treatment. Exclusion criteria include previous systemic therapy, metastatic disease, complete occlusion of the main portal vein, or a Child-Pugh score of >7. Eligible patients will be randomised 1:1 and stratified by centre and presence or absence of portal vein thrombosis to receive either a single administration of SIRT using yttrium-90 resin microspheres (SIR-Spheres®, Sirtex Medical Limited, Sydney, Australia) targeted at HCC in the liver by the trans-arterial route or continuous oral Sorafenib (Nexavar®, Bayer Pharma AG, Berlin, Germany) at a dose of 400 mg twice daily until disease progression, no further response, complete regression or unacceptable toxicity. Patients for both the Sorafenib and SIRT arms will be followed-up every 4 weeks for the first 3 months and 12 weekly thereafter. Overall survival is the primary endpoint, assessed for the intention-to-treat population. Secondary endpoints are tumour response rate, time-to-tumour progression, progression free survival, quality of life and down-staging to receive potentially curative therapy. Definitive data comparing these two therapies will help to determine clinical practice in the large group of

  6. Postoperative radiation therapy for adenoid cystic carcinoma

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  7. Quality of Life After Palliative Radiation Therapy for Patients With Painful Bone Metastases: Results of an International Study Validating the EORTC QLQ-BM22

    Energy Technology Data Exchange (ETDEWEB)

    Zeng Liang [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: edward.chow@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Bedard, Gillian; Zhang, Liying [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Fairchild, Alysa [Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Vassiliou, Vassilios [Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia (Cyprus); Alm El-Din, Mohamed A. [Department of Clinical Oncology, Tanta University Hospital, Tanta Faculty of Medicine, Tanta (Egypt); Jesus-Garcia, Reynaldo [Department of Orthopedic Oncology, Federal University of Sao Paulo, Sao Paulo (Brazil); Kumar, Aswin [Division of Gynaecology and Genitourinary Oncology, Department of Radiation Oncology, Regional Cancer Center, Trivandrum (India); Forges, Fabien [Inserm CIE3, Saint Etienne University Hospital, Saint-Etienne (France); Unit of Clinical Research, Innovation, and Pharmacology, Saint Etienne University Hospital, Saint-Etienne (France); Tseng, Ling-Ming [Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan (China); Hou, Ming-Feng [Department of Gastroenterologic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (China); Chie, Wei-Chu [Department of Public Health and Institute of Epidemiology and Preventative Medicine, National Taiwan University, Taipei, Taiwan (China); Bottomley, Andrew [European Organisation for Research and Treatment of Cancer, EORTC Headquarters, Brussels (Belgium)

    2012-11-01

    Purpose: Radiation therapy (RT) is an effective method of palliating painful bone metastases and can improve function and reduce analgesic requirements. In advanced cancer patients, quality of life (QOL) is the primary outcome of interest over traditional endpoints such as survival. The purpose of our study was to compare bone metastasis-specific QOL scores among patients who responded differently to palliative RT. Methods and Materials: Patients receiving RT for bone metastases across 6 countries were prospectively enrolled from March 2010-January 2011 in a trial validating the QLQ-BM22 and completed the QLQ-BM22 and the core measure (QLQ-C30) at baseline and after 1 month. Pain scores and analgesic intake were recorded, and response to RT was determined according to the latest published guidelines. The Kruskal-Wallis nonparametric and Wilcoxon rank sum tests compared changes in QOL among response groups. A Bonferroni-adjusted P<.003 indicated statistical significance. Results: Of 79 patients who received palliative RT, 59 were assessable. Partial response, pain progression, and indeterminate response were observed in 22, 8, and 29 patients, respectively; there were no patients with a complete response. Patients across all groups had similar baseline QOL scores apart from physical functioning (patients who progressed had better initial functioning). One month after RT, patients who responded had significant improvements in 3 of 4 QLQ-BM22 domains (painful site, P<.0001; painful characteristic, P<.0001; and functional interference, P<.0001) and 3 QLQ-C30 domains (physical functioning, P=.0006; role functioning, P=.0026; and pain, P<.0001). Patients with progression in pain had significantly worse functional interference (P=.0007) and pain (P=.0019). Conclusions: Patients who report pain relief after palliative RT also have better QOL with respect to bone metastasis-specific issues. The QLQ-BM22 and QLQ-C30 are able to discriminate among patients with varying

  8. Bullous pemphigoid after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Duschet, P.; Schwarz, T.; Gschnait, F.

    1988-02-01

    Electron beam therapy applied to a lymph node metastasis from a squamous cell carcinoma was followed by the development of histologically and immunologically typical bullous pemphigoid, the lesions being initially strictly confined to the irradiation area. This observation suggests that the bullous pemphigoid antigen may be altered or unmasked by electron beam radiotherapy, leading subsequently to the production of autoantibodies. The disease in this case effectively responded to the administration of tetracycline and niacinamide, a therapeutic regimen described recently.

  9. Radiation Therapy for Carcinoma of the Oropharynx

    Energy Technology Data Exchange (ETDEWEB)

    Park, In Kyu; Kim, Jae Choel [Kyungpook National University College of Medicine, Taegu (Korea, Republic of)

    1996-06-15

    Purpose : A retrospective analysis for patients with oropharyngeal carcinoma who were treated with radiation was performed to assess the results of treatment and patterns of failure, and to identify the factors that might influence survival. Methods and Materials : From March 1985 through June 1993, 53 patients with oropharyngeal carcinoma were treated with either radiation therapy alone or combination of neoadjuvant chemotherapy and radiation therapy at the Department of Radiation Oncology, Kyungpook National University Hospital. Patients' ages ranged from 31 to 73 years with a median age of 54 years. There were 47 men and 6 women. Forty-two patients (79.2%) had squamous cell carcinoma, 10 patients (18.9%) had undifferentiated carcinoma and 1 patient (1.9%) had adenoid cystic carcinoma. There were 2 patients with stage I 12 patients with stage II, 12 patients with stage III and 27 patients with stage IV. According to the TNM classification, patients were distributed as follows: T1 7, T2 2, T3 10, T4 7, TX 1, and N0 17, N1 13, N2 21, N3 2. The primary tumor sites were tonsillar region in 36 patients (67.9%) base of the tongue in 12 patients (22.6%), and soft palate in 5 patients (9.4%). Twenty-five patients were treated with radiation therapy alone and twenty-eight patients were treated with one to three courses of chemotherapy followed by radiation therapy. Chemotherapeutic regimens used were either CF (cisplatin and 5-fluorouracil) or CVB (cisplatin, vincristine and bleomycin), Radiation therapy was delivered 180-200 cGy daily,five times a week using 6 MV X-ray with or without 8-10 MeV electron beams. A tumor dose ranged from 4500 cGy to 7740 cGy with a median dose of 7100 cGy. The follow-up time ranged from 4months to 99 months with a median of 21 months. Results : Thrity-seven patients (69.8%) achieved a CR (complete response) and PR (partial response) in 16 patients (30.2%) after radiation therapy. The overall survival rates were 47% at 2 years and 42% at

  10. PET/CT in Radiation Therapy Planning

    DEFF Research Database (Denmark)

    Specht, Lena; Berthelsen, Anne Kiil

    2018-01-01

    Radiation therapy (RT) is an important component of the management of lymphoma patients. Most lymphomas are metabolically active and accumulate 18F-fluorodeoxyglucose (FDG). Positron emission tomography with computer tomography (PET/CT) imaging using FDG is used routinely in staging and treatment...

  11. Electron beams in radiation therapy

    International Nuclear Information System (INIS)

    Bruinvis, I.A.D.

    1987-01-01

    Clinical electron beams in interaction with beam flattening and collimating devices are studied, in order to obtain the means for adequate electron therapy. A treatment planning method for arbitrary field shapes is developed that takes the properties of the collimated electron beams into account. An electron multiple-scattering model is extended to incorporate a model for the loss of electrons with depth, in order to improve electron beam dose planning. A study of ionisation measurements in two different phantom materials yields correction factors for electron beam dosimetry. (Auth.)

  12. Radiation therapy for esophageal carcinoma

    International Nuclear Information System (INIS)

    Chatani, Masashi; Matayoshi, Yoshinobu; Masaki, Norie

    1992-01-01

    From 1977 through 1989, 149 patients with esophageal carcinoma were treated with external irradiation (EI) with or without high-dose rate intraluminal irradiation (HDRII) using remote afterloading system. Concerning complete response group EI alone showed higher local control rate than EI + HDRII, especially in ulcerative type. Another problem is the EI field. Fourteen of 22 patients who were salvaged by surgery due to local recurrence after EI showed marginal or out-field metastasis of the lymph node. These preliminary results suggest that HDRII is not effective for the local control of the ulcerative lesion as a boost therapy, EI should be given for the entire regional lymph nodes. (author)

  13. Underlying liver disease influences volumetric changes in the spared hemiliver after selective internal radiation therapy with 90Y in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Teo, Jin Yao; Goh, Brian Kim Poh; Cheah, Foong Koon; Allen, John Carson; Lo, Richard Hoau Gong; Ng, David Chee Eng; Goh, Anthony Soon Whatt; Khor, Andrew Yu Keat; Sim, Hui Shan; Ng, Jia Jun; Chow, Pierce Kah-Hoe

    2014-08-01

    Hypertrophy of the contralateral liver lobe after treatment with yttrium-90 ((90)Y) microspheres has recently been reported. This study aimed to quantify left hepatic lobe hypertrophy after right-sided radioembolization for hepatocellular carcinoma (HCC) and to identify pretreatment predictive factors of hypertrophy in an Asian population. A retrospective review of patients with inoperable HCC undergoing selective internal radiation treatment (SIRT) with (90)Y microspheres at a single institution from January 2008 to January 2012 was performed. Only patients who had treatment delivered via the right hepatic artery alone were included. In all, 17 patients fulfilling the study criteria were identified. The mean percentage of left-lobe hypertrophy was 34.2% ± 34.9% (range 19.0-106.5%) during a median of 5-month follow-up. Patients with hepatitis B were found to experience a significantly greater degree of hypertrophy than those with hepatitis C or alcoholic liver cirrhosis. There were no cases of acute liver failure after the administration of SIRT in this study and none of the patients developed disease in the contralateral lobe over the study period. Administration of unilobar SIRT to the right liver lobe in patients with HCC resulted in a significant degree of contralateral left lobe hypertrophy. Patients with hepatitis B experienced a greater degree of hypertrophy than those with hepatitis C or alcoholic liver cirrhosis. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  14. Drug delivery system and radiation therapy

    International Nuclear Information System (INIS)

    Shibata, Tokushi

    2005-01-01

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

  15. Combined therapy of urinary bladder radiation injury

    International Nuclear Information System (INIS)

    Zaderin, V.P.; Polyanichko, M.F.

    1982-01-01

    A scheme of therapy of radiation cystitis is suggested. It was developed on the basis of evaluation of literature data and clinical of 205 patients with radiation injury of the urinary bladder. The method is based on general and local therapy of damaged tissues by antiinflammatory drugs, anesthetics and stimulators of reparative regeneration. Severe ulcerative and incrustation cystites, refractory to conservative therapy, were treated by surgery, using antiseptics and reparation stimulators before, during and after operation. As a result, there were hardly any complications after reconstruction of the bladder with intestinal and peritoneal tissues. 104 patients (96.1%) were cured completely and ability to work was restored in 70 patients (76.9%) [ru

  16. Radiation therapy of Graves' ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-01-01

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

  17. Computer models for optimizing radiation therapy

    International Nuclear Information System (INIS)

    Duechting, W.

    1998-01-01

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

  18. Database for radiation therapy images

    International Nuclear Information System (INIS)

    Shalev, S.; Cosby, S.; Leszczynski, K.; Chu, T.

    1989-01-01

    The authors have developed a database for images acquired during simulation and verification of radiation treatments. Simulation images originate as planning films that are digitized with a video camera, or through direct digitization of fluoroscopic images. Verification images may also be digitized from portal films or acquired with an on-line portal imaging system. Images are classified by the patient, the fraction, the field direction, static or dynamic (movie) sequences, and the type of processing applied. Additional parameters indicate whether the source is a simulation or treatment, whether images are digitized film or real-time acquisitions, and whether treatment is portal or double exposure for beam localization. Examples are presented for images acquired, processed, stored, and displayed with on-line portal imaging system (OPIUM) and digital simulation system (FLIP)

  19. Electron wedges for radiation therapy

    International Nuclear Information System (INIS)

    Lief, Eugene P.; Lo, Y.-C.; Humm, John L.

    1998-01-01

    Purpose: Brain tumors can be advantageously treated with electron over photon radiation, by exploiting the rapid fall-off in dose with depth. This advantage could be further enhanced by utilizing multiple electron beams. However, in some beam configurations, wedged dose profiles would be necessary for the dose uniformity. Unlike photons, shaped pieces of material placed in electron beam severely degrade the energy, give additional scattering and, therefore, are suboptimal. The purpose of this study was to create wedged electron fields, using intensity modulation. The combination of electron wedges enables a more uniform coverage of brain tumors with a reduced dose to normal tissue. Methods and Materials: Intensity modulation was performed for 10 to 50 MeV electrons using a narrow scanning elementary beam of a racetrack Microtron accelerator, delivering radiation pulses with coordinates and intensities prescribed by a custom scan matrix. Dispensing more pulses (or longer pulses) within the field to increase the local dose, one can sharpen the penumbra at depth and generate wedged dose distributions of arbitrary angle as well as many other desired profiles. We modulated the electron beams, measured dose distributions using film in an anthropomorphic phantom, and compared the results with conventional techniques. Results: Intensity modulation of electron beams decreases the 50-90% penumbra at depth by 40% and increases the flatness by 80%. Wedged profiles at depth can be created for any angle up to about 70 deg. , depending on the beam energy. Multiple modulated electron beams give smaller 20-70% but larger 70-100% isodose regions than photon beams. Conclusions: Electron beams can improve dose distributions in brain compared to the same number of photon beams, reducing the 20-70% isodoses region in normal tissue by 30%. Intensity modulation significantly improves the dose distribution from combined electron beams providing a sharper penumbra, better conformity, and

  20. International regulations for radiation protection

    International Nuclear Information System (INIS)

    Daw, H.T.

    1982-01-01

    A review of the development of the IAEA Radiological Protection standards is given. The basic features of the latest revision recently adopted by the governing bodies of the sponsoring organizations, i.e. IAEA, WHO, ILO, NEA/OECD are discussed and some of the features of the future Agency programme for its implementation will be outlined. In particular, attention will be given to development of the basic principles for setting release limits of radioactive materials into the environment. An important aspect of this is when the release of radioactive materials into the environment crosses international boundaries. The Agency is best suited to try to reach a consensus on the minimum monetary value for the unit collective dose. (orig./RW)

  1. The Role of 18F-FDG-PET and PET/CT in Patients with Colorectal Liver Metastases Undergoing Selective Internal Radiation Therapy with Yttrium-90: A First Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Salvatore Annunziata

    2014-01-01

    tomography/computed tomography (FDG-PET and PET/CT in patients with colorectal liver metastases (CRLM undergoing selective internal radiation therapy (SIRT with yttrium-90 (90Y microspheres. Methods. A comprehensive computer literature search was conducted to find relevant published articles on whole-body FDG-PET or PET/CT in patients with CRLM undergoing SIRT. Results. We identified 19 studies including 833 patients with CRLM undergoing SIRT. The role of FDG-PET or PET/CT was analysed in treatment planning, treatment response evaluation, and as prognostic tool. Conclusion. FDG-PET and PET/CT provide additional information in treatment evaluation of CRLM patients treated with SIRT and may have a role in treatment planning and patient selection. FDG-PET/CT is emerging as good prognostic tool in these patients.

  2. Studying the efficacy of escalated dose conformal radiation therapy in prostate carcinoma – Pakistan experience

    Directory of Open Access Journals (Sweden)

    Asad Zamir

    2017-11-01

    Conclusion: Our data were comparable to international studies of dose escalation using 3D and beneficial as compared to conventional radiation therapy delivered by 2D in terms of biochemical failure rate and treatment related toxicity.

  3. Contemporary radiation therapy in combined modality therapy for Hodgkin lymphoma.

    Science.gov (United States)

    Narang, Amol K; Terezakis, Stephanie A

    2015-05-01

    The advent of effective combination chemotherapy markedly changed the management of Hodgkin lymphoma, establishing combined modality therapy as the standard of care for most patients with this disease. In response, significant interest has been shown in refining the delivery of radiation in the combined modality setting such that toxicity is minimized while still preserving disease control. An understanding of the way in which radiation treatment fields, prescription dose, and advanced technology have evolved to accomplish these goals is critical. Moreover, fluency in the clinical literature exploring contemporary questions, such as the omission of radiation and response-based treatment, is equally important. Knowledge of these topics will yield both an appreciation of the value of radiation in the combined modality setting and the ability to better customize treatment regimens to individual patients. Copyright © 2015 by the National Comprehensive Cancer Network.

  4. Timing of Radiation Therapy and Chemotherapy After Breast-Conserving Surgery for Node-Positive Breast Cancer: Long-Term Results From International Breast Cancer Study Group Trials VI and VII

    International Nuclear Information System (INIS)

    Karlsson, Per; Cole, Bernard F.; Price, Karen N.; Gelber, Richard D.; Coates, Alan S.; Goldhirsch, Aron; Castiglione, Monica; Colleoni, Marco; Gruber, Günther

    2016-01-01

    Purpose: To update the previous report from 2 randomized clinical trials, now with a median follow-up of 16 years, to analyze the effect of radiation therapy timing on local failure and disease-free survival. Patients and Methods: From July 1986 to April 1993, International Breast Cancer Study Group trial VI randomly assigned 1475 pre-/perimenopausal women with node-positive breast cancer to receive 3 or 6 cycles of initial chemotherapy (CT). International Breast Cancer Study Group trial VII randomly assigned 1212 postmenopausal women with node-positive breast cancer to receive tamoxifen for 5 years, or tamoxifen for 5 years with 3 early cycles of initial CT. For patients who received breast-conserving surgery (BCS), radiation therapy (RT) was delayed until initial CT was completed; 4 or 7 months after BCS for trial VI and 2 or 4 months for trial VII. We compared RT timing groups among 433 patients on trial VI and 285 patients on trial VII who received BCS plus RT. Endpoints were local failure, regional/distant failure, and disease-free survival (DFS). Results: Among pre-/perimenopausal patients there were no significant differences in disease-related outcomes. The 15-year DFS was 48.2% in the group allocated 3 months initial CT and 44.9% in the group allocated 6 months initial CT (hazard ratio [HR] 1.12; 95% confidence interval [CI] 0.87-1.45). Among postmenopausal patients, the 15-year DFS was 46.1% in the no-initial-CT group and 43.3% in the group allocated 3 months initial CT (HR 1.11; 95% CI 0.82-1.51). Corresponding HRs for local failures were 0.94 (95% CI 0.61-1.46) in trial VI and 1.51 (95% CI 0.77-2.97) in trial VII. For regional/distant failures, the respective HRs were 1.15 (95% CI 0.80-1.63) and 1.08 (95% CI 0.69-1.68). Conclusions: This study confirms that, after more than 15 years of follow-up, it is reasonable to delay radiation therapy until after the completion of standard CT.

  5. Pulsed laser radiation therapy of skin tumors

    International Nuclear Information System (INIS)

    Kozlov, A.P.; Moskalik, K.G.

    1980-01-01

    Radiation from a neodymium laser was used to treat 846 patients with 687 precancerous lesions or benign tumors of the skin, 516 cutaneous carcinomas, 33 recurrences of cancer, 51 melanomas, and 508 metastatic melanomas in the skin. The patients have been followed for three months to 6.5 years. No relapses have been observed during this period. Metastases to regional lymph nodes were found in five patients with skin melanoma. Pulsed laser radiation may be successfully used in the treatment of precancerous lesions and benign tumors as well as for skin carcinoma and its recurrences, and for skin melanoma. Laser radiation is more effective in the treatment of tumors inaccessible to radiation therapy and better in those cases in which surgery may have a bad cosmetic or even mutilating effect. Laser beams can be employed in conjunction with chemo- or immunotherapy

  6. 7. international congress of radiation research

    International Nuclear Information System (INIS)

    Musilek, L.

    1984-01-01

    The congress was held in Amsterdam on July 3 to 8, 1983, with the participation of 1305 specialists from 44 countries. The number of papers came close to one thousand, most of them being posters. The congress met in 44 sessions grouped by problem areas of which there were five: A. Chemistry and Physics; B. Biology; C. Somatic and genetic effects; D. Biology and therapy of tumours; E. Dosimetry, radionuclides and technology. The congress brought out the immense quantitative growth of knowledge in the field of radiation biology and biochemistry. A general idea of the effects of radiation on organisms is yet to be attained. (Ha)

  7. External beam radiation therapy for recurrent sigmoid colorectal cancer. Retrospective analysis by group comparison between the radiation therapy alone and the radiation therapy combined with other therapies

    International Nuclear Information System (INIS)

    Churei, Hisahiko; Takeshita, Tsuyoshi; Hiraki, Yoshiyuki; Baba, Yasutaka; Hokotate, Hirohumi; Nakajo, Masayuki; Ohkubo, Kouichi; Miyaji, Noriaki

    1999-01-01

    The purpose of this study is to evaluate retrospectively clinical efficacy of curativeintent external beam radiation therapy for recurrent sigmoid colorectal cancer. As the radiation therapy of higher dose level combined with other therapies might improve pain control, tumor response, and prognosis, the total dose over 60 Gy was delivered except cases that were received surgery for the recurrent tumor. The study population consisted of 25 patients received the radiation therapy alone (RTA) and 24 patients received the radiation therapy combined with other one or two treatment modalities (RTC), which included surgery (tumor resection) in 15 cases, chemotherapy (low dose daily CDDP) in 13 cases, and hyperthermia in 6 cases. They received the radiation therapy from January, 1989 to June, 1996. Data on pain relief and tumor response were compared between the groups of RTA and RTC. The effect on pain relief was not different between the two groups. Tumor response appeared to be high in the patients combined with chemotherapy, but the difference was not statistically significant between the groups. There were no differences in the prognosis by the recurrent tumor size, the pain relief, and the tumor response. There was a statistically significant difference in the prognosis between the groups with and without extrapelvic distant metastases. A more effective treatment modality combined with the external radiation therapy is necessary to improve the clinical efficacy for the recurrent sigmoid colorectal cancer. (author)

  8. 21 CFR 892.5840 - Radiation therapy simulation system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiation therapy simulation system. 892.5840... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5840 Radiation therapy simulation system. (a) Identification. A radiation therapy simulation system is a fluoroscopic or radiographic x-ray...

  9. 21 CFR 892.5750 - Radionuclide radiation therapy system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radionuclide radiation therapy system. 892.5750... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5750 Radionuclide radiation therapy system. (a) Identification. A radionuclide radiation therapy system is a device intended to permit an...

  10. Radiation therapy with fast neutrons: A review

    International Nuclear Information System (INIS)

    Jones, D.T.L.; Wambersie, A.

    2007-01-01

    Because of their biological effects fast neutrons are most effective in treating large, slow-growing tumours which are resistant to conventional X-radiation. Patients are treated typically 3-4 times per week for 4-5 weeks (sometimes in combination with X-radiation) for a variety of conditions such as carcinomas of the head and neck, salivary gland, paranasal sinus and breast; soft tissue, bone and uterine sarcomas and malignant melanomas. It is estimated that about 27,000 patients have undergone fast neutron therapy to date

  11. Radiation Therapy in Elderly Skin Cancer

    International Nuclear Information System (INIS)

    Kim, Jin Hee

    2008-01-01

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

  12. Radiation therapy for head and neck cancers

    International Nuclear Information System (INIS)

    Gillette, S.M.; Gillette, E.L.

    1995-01-01

    Radiation therapy may be indicated for larger invasive tumors of the head and neck that may be difficult to surgically excise or for which surgery would be significantly disfiguring. Previous studies of oral squamous cell carcinomas indicate that it should be possible to control approximately 80% of all but the most advanced local or locoregional tumors. Aggressive radiation therapy to total doses of 56 Gy or greater may be required. That can be done by using smaller doses per fraction and gradually reducing the size of the field so that the highest dose is given only to the tumor with a relatively tight margin. Malignant melanomas can be controlled locally apparently with a few large fractions. Metastatic disease limits survival; therefore, some type of systemic therapy seems to be needed to improve survival of those patients. Canine oral fibrosarcomas require a very high dose for a reasonable probability of control. It seems that a dose of 56 Gy given in 3.3 Gy fractions might provide local control of 50% of the tumors. It is likely that a combination of surgery and radiation would significantly improve the probability for control. Oral squamous cell carcinomas of cats must also be treated very aggressively to improve local control. Tumors of the nasal cavity are usually very large and invasive at the time of diagnosis. Radiation therapy has been shown to be effective in some instances. It is possible that with better definition of the tumor through computerized tomography imaging and improved treatment planning, control of these difficult to manage nasal tumors can be improved

  13. Targeted Radiation Therapy for Cancer Initiative

    Science.gov (United States)

    2017-11-01

    CONTRACTING ORGANIZATION: The Geneva Foundation , Tacoma, WA 98402 REPORT DATE: November 2017 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical...ADDRESS. 1. REPORT DATE November 2017 2. REPORT TYPE Final 3. DATES COVERED 08/04/2008 - 08/03/2017 4. TITLE AND SUBTITLE Targeted Radiation Therapy...REPORT NUMBER The Geneva Foundation 917 Pacific Ave, Suite 600 Tacoma, WA 98402 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR

  14. Radiation therapy planning for early-stage Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Maraldo, Maja V; Dabaja, Bouthaina S; Filippi, Andrea R

    2015-01-01

    PURPOSE: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements......, planning parameters, and estimated doses to the critical organs at risk (OARs). METHODS: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30...... axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3...

  15. Chronic neuroendocrinological sequelae of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sklar, C.A. [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Constine, L.S. [Univ. of Rochester Medical Center, Rochester, NY (United States)

    1995-03-30

    A variety of neuroendocrine disturbances are observed following treatment with external radiation therapy when the hypothalamic-pituitary axis (HPA) is included in the treatment field. Radiation-induced abnormalities are generally dose dependent and may develop many years after irradiation. Growth hormone deficiency and premature sexual development can occur following doses as low as 18 Gy fractionated radiation and are the most common neuroendocrine problems noted in children. Deficiency of gonadotropins, thyroid stimulating hormone, and adrenocorticotropin are seen primarily in individuals treated with > 40 Gy HPA irradiation. Hyperprolactinemia can be seen following high-dose radiotherapy (>40 Gy), especially among young women. Most neuroendocrine disturbances that develop as a result of HPA irradiation are treatable; patients at risk require long-term endocrine follow-up. 23 refs., 6 figs., 2 tabs.

  16. Generalized Morphea after Breast Cancer Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Jonathan Kushi

    2011-01-01

    Full Text Available We present a case of a 69-year-old woman who received external beam radiation for the treatment of breast cancer. Seven months later, she developed generalized morphea involving the area of irradiated skin of the breast as well as distant sites of the groin and distal lower extremity. Postirradiation morphea is an uncommon yet well-documented phenomenon, usually confined to the radiated site and the immediate surrounding tissue. To our knowledge, this is only the fourth reported case of morphea occurring distant from the radiation field. While most cases of postirradiation morphea have been shown to either resolve spontaneously or respond to topical corticosteroids, our patient required systemic therapy with methotrexate, which resulted in clinical improvement. With this paper, we hope to bring further awareness to this phenomenon and demonstrate a successful treatment response with the use of methotrexate in postirradiation generalized morphea.

  17. Fiber-optic dosimeters for radiation therapy

    Science.gov (United States)

    Li, Enbang; Archer, James

    2017-10-01

    According to the figures provided by the World Health Organization, cancer is a leading cause of death worldwide, accounting for 8.8 million deaths in 2015. Radiation therapy, which uses x-rays to destroy or injure cancer cells, has become one of the most important modalities to treat the primary cancer or advanced cancer. The newly developed microbeam radiation therapy (MRT), which uses highly collimated, quasi-parallel arrays of x-ray microbeams (typically 50 μm wide and separated by 400 μm) produced by synchrotron sources, represents a new paradigm in radiotherapy and has shown great promise in pre-clinical studies on different animal models. Measurements of the absorbed dose distribution of microbeams are vitally important for clinical acceptance of MRT and for developing quality assurance systems for MRT, hence are a challenging and important task for radiation dosimetry. On the other hand, during the traditional LINAC based radiotherapy and breast cancer brachytherapy, skin dose measurements and treatment planning also require a high spatial resolution, tissue equivalent, on-line dosimeter that is both economical and highly reliable. Such a dosimeter currently does not exist and remains a challenge in the development of radiation dosimetry. High resolution, water equivalent, optical and passive x-ray dosimeters have been developed and constructed by using plastic scintillators and optical fibers. The dosimeters have peak edge-on spatial resolutions ranging from 50 to 500 microns in one dimension, with a 10 micron resolution dosimeter under development. The developed fiber-optic dosimeters have been test with both LINAC and synchrotron x-ray beams. This work demonstrates that water-equivalent and high spatial resolution radiation detection can be achieved with scintillators and optical fiber systems. Among other advantages, the developed fiber-optic probes are also passive, energy independent, and radiation hard.

  18. Image-guided radiation therapy: physician's perspectives

    International Nuclear Information System (INIS)

    Gupta, T.; Anand Narayan, C.

    2012-01-01

    The evolution of radiotherapy has been ontogenetically linked to medical imaging. Over the years, major technological innovations have resulted in substantial improvements in radiotherapy planning, delivery, and verification. The increasing use of computed tomography imaging for target volume delineation coupled with availability of computer-controlled treatment planning and delivery systems have progressively led to conformation of radiation dose to the target tissues while sparing surrounding normal tissues. Recent advances in imaging technology coupled with improved treatment delivery allow near-simultaneous soft-tissue localization of tumor and repositioning of patient. The integration of various imaging modalities within the treatment room for guiding radiation delivery has vastly improved the management of geometric uncertainties in contemporary radiotherapy practice ushering in the paradigm of image-guided radiation therapy (IGRT). Image-guidance should be considered a necessary and natural corollary to high-precision radiotherapy that was long overdue. Image-guided radiation therapy not only provides accurate information on patient and tumor position on a quantitative scale, it also gives an opportunity to verify consistency of planned and actual treatment geometry including adaptation to daily variations resulting in improved dose delivery. The two main concerns with IGRT are resource-intensive nature of delivery and increasing dose from additional imaging. However, increasing the precision and accuracy of radiation delivery through IGRT is likely to reduce toxicity with potential for dose escalation and improved tumor control resulting in favourable therapeutic index. The radiation oncology community needs to leverage this technology to generate high-quality evidence to support widespread adoption of IGRT in contemporary radiotherapy practice. (author)

  19. Single administration of Selective Internal Radiation Therapy versus continuous treatment with sorafeNIB in locally advanced hepatocellular carcinoma (SIRveNIB): study protocol for a phase iii randomized controlled trial.

    Science.gov (United States)

    Gandhi, Mihir; Choo, Su Pin; Thng, Choon Hua; Tan, Say Beng; Low, Albert Su Chong; Cheow, Peng Chung; Goh, Anthony Soon Whatt; Tay, Kiang Hiong; Lo, Richard Hoau Gong; Goh, Brian Kim Poh; Wong, Jen San; Ng, David Chee Eng; Soo, Khee Chee; Liew, Wei Ming; Chow, Pierce K H

    2016-11-07

    Approximately 20 % of hepatocellular carcinoma (HCC) patients diagnosed in the early stages may benefit from potentially curative ablative therapies such as surgical resection, transplantation or radiofrequency ablation. For patients not eligible for such options, prognosis is poor. Sorafenib and Selective Internal Radiation Therapy (SIRT) are clinically proven treatment options in patients with unresectable HCC, and this study aims to assess overall survival following either SIRT or Sorafenib therapy for locally advanced HCC patients. This investigator-initiated, multi-centre, open-label, randomized, controlled trial will enrol 360 patients with locally advanced HCC, as defined by Barcelona Clinic Liver Cancer stage B or stage C, without distant metastases, and which is not amenable to immediate curative treatment. Exclusion criteria include previous systemic therapy, metastatic disease, complete occlusion of the main portal vein, or a Child-Pugh score of >7. Eligible patients will be randomised 1:1 and stratified by centre and presence or absence of portal vein thrombosis to receive either a single administration of SIRT using yttrium-90 resin microspheres (SIR-Spheres®, Sirtex Medical Limited, Sydney, Australia) targeted at HCC in the liver by the trans-arterial route or continuous oral Sorafenib (Nexavar®, Bayer Pharma AG, Berlin, Germany) at a dose of 400 mg twice daily until disease progression, no further response, complete regression or unacceptable toxicity. Patients for both the Sorafenib and SIRT arms will be followed-up every 4 weeks for the first 3 months and 12 weekly thereafter. Overall survival is the primary endpoint, assessed for the intention-to-treat population. Secondary endpoints are tumour response rate, time-to-tumour progression, progression free survival, quality of life and down-staging to receive potentially curative therapy. Definitive data comparing these two therapies will help to determine clinical practice in the large group

  20. Modern radiation therapy for extranodal lymphomas

    DEFF Research Database (Denmark)

    Yahalom, Joachim; Illidge, Tim; Specht, Lena

    2015-01-01

    , involving any organ in the body and the spectrum of histological sub-types, poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies. This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians. Thus far...... adopted RT volume definitions based on the International Commission on Radiation Units and Measurements (ICRU), as has been widely adopted by the field of radiation oncology for solid tumors. Organ-specific recommendations take into account histological subtype, anatomy, the treatment intent, and other...

  1. International Radiation Monitoring and Information System (IRMIS)

    Science.gov (United States)

    Mukhopadhyay, Sanjoy; Baciu, Florian; Stowisek, Jan; Saluja, Gurdeep; Kenny, Patrick; Albinet, Franck

    2017-09-01

    This article describes the International Radiation Monitoring Information System (IRMIS) which was developed by the International Atomic Energy Agency (IAEA) with the goal to provide Competent Authorities, the IAEA and other international organizations with a client server based web application to share and visualize large quantities of radiation monitoring data. The data maps the areas of potential impact that can assist countries to take appropriate protective actions in an emergency. Ever since the Chernobyl nuclear power plant accident in April of 19861 European Community (EC) has worked towards collecting routine environmental radiological monitoring data from national networked monitoring systems. European Radiological Data Exchange Platform (EURDEP) was created in 19952 to that end - to provide radiation monitoring data from most European countries reported in nearly real-time. During the response operations for the Fukushima Dai-ichi nuclear power plant accident (March 2011) the IAEA Incident and Emergency Centre (IEC) managed, harmonized and shared the large amount of data that was being generated from different organizations. This task underscored the need for a system which allows sharing large volumes of radiation monitoring data in an emergency. In 2014 EURDEP started the submission of the European radiological data to the International Radiation Monitoring Information System (IRMIS) as a European Regional HUB for IRMIS. IRMIS supports the implementation of the Convention on Early Notification of a Nuclear Accident by providing a web application for the reporting, sharing, visualizing and analysing of large quantities of environmental radiation monitoring data during nuclear or radiological emergencies. IRMIS is not an early warning system that automatically reports when there are significant deviations in radiation levels or when values are detected above certain levels. However, the configuration of the visualization features offered by IRMIS may

  2. International Society of Radiology and Radiation Protection

    International Nuclear Information System (INIS)

    Standertskjoeld-Nordenstam, C.G.

    2001-01-01

    The purpose of the International Society of Radiology (ISR), as being the global organization of radiologists, is to promote and help co-ordinate the progress of radiology throughout the world. In this capacity and as a co-operating organization of the IAEA, the ISR has a specific responsibility in the global radiological protection of patients. Globally, there are many users of medical radiation, and radiology may be practised in the most awkward circumstances. The individuals performing X ray studies as well as those interpreting them may be well trained, as in industrialized parts of the world, but also less knowledgeable, as in developing areas. The problems of radiological protection, both of patients and of radiation workers, still exist, and radiation equipment is largely diffused throughout the world. That is why a conference like this is today as important as ever. Radiation protection is achieved through education, on the one hand, and legislation, on the other. Legislation and regulation are the instruments of national authorities. The means of the ISR are education and information. Good radiological practice is something that can be taught. The ISR is doing this mainly through the biannual International Congress of Radiology (ICR), now arranged in an area of radiological need; the three previous ICRs were in China, in India and in South America; the next one is going to be in Mexico in 2002. The goal of the ICR is mainly to be an instructive and educational event, especially designed for the needs of its surrounding region. The ISR is aiming at producing educational material. The International Commission on Radiological Education (ICRE), as part of the ISR, is launching the production of a series of educational booklets, which also include radiation protection. The ICRE is actively involved in shaping and organizing the educational and scientific programme of the ICRs

  3. Radiation therapy in Africa: distribution and equipment

    International Nuclear Information System (INIS)

    Levin, C.V.; Meghzifene, A.; Gueddari, B. el

    1999-01-01

    Africa is the least developed continent as regards radiation oncology resources. The documented ASR of cancer is of the order of 1 to 2 per 1000. With improving health care this is becoming more significant. This review was undertaken to help develop priorities for the region. Radiation Oncology departments in Africa were identified and a survey of their equipment performed. These were compared to the reported situation in 1991. Population tables for the year 2000 were compared to available megavoltage machines. Of 56 countries in Africa, only 22 are confidently known to have megavoltage therapy concentrated in the southern and northern extremes of the continent. The 155 megavoltage machines operating represents over 100% increase over the past 8 years. The population served by each megavoltage machine ranges from 0.6 million to 70 million per machine. Overall, only 50% of the population have some access to Radiation Oncology services. Progress has been made in initiating radiation oncology in Ghana, Ethiopia and Namibia. There has been some increase in machines in Algeria, Egypt, Libya, Morocco and Tunisia. However, a large backlog exists for basic radiation services. (author.)

  4. Effect of respiratory motion on internal radiation dosimetry

    NARCIS (Netherlands)

    Xie, Tianwu; Zaidi, Habib

    2014-01-01

    Purpose: Estimation of the radiation dose to internal organs is essential for the assessment of radiation risks and benefits to patients undergoing diagnostic and therapeutic nuclear medicine procedures including PET. Respiratory motion induces notable internal organ displacement, which influences

  5. Radiation therapy for superior vena cava syndrome

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-06-15

    We studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS). From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-ray and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy. The follow-up periods were from 1 to 180 months with a median of 5.6 months. The main clinical manifestations were dyspnea (84.7%), facial edema (81.9%), arm edema (22.2%), neck vein distension (25%), hoarseness (12.5%) and facial plethora (5.6%). Eighty percent of patients achieved excellent to good symptom improvement and 19.4% experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were 17.7% at 2 years (2YOS) and 14.8% at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, 16.7% and 13.4% for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR; > 30 Gy, 25.6%, {<=} 30 Gy 6.7%, {rho} < 0.01). On the multivariated analysis, a higher total tumor dose ({rho} < 0.01) and younger age ({rho} < 0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant ({rho} > 0.05). Radiation therapy for the patients with SVCS due to

  6. Quantification of late complications after radiation therapy

    International Nuclear Information System (INIS)

    Jung, Horst; Beck-Bornholdt, Hans-Peter; Svoboda, Vladimir; Alberti, Winfried; Herrmann, Thomas

    2001-01-01

    Background: An increasing number of patients survive cancer after having received radiation therapy. Therefore, the occurrence of late normal tissue complications among long-term survivors is of particular concern. Methods: Sixty-three patients treated by radical surgery and irradiation for rectal carcinoma were subjected to an unconventional sandwich therapy. Preoperative irradiation was given in four fractions of 5 Gy each applied within 2 or 3 days; postoperative irradiation consisted mostly of 15x2 Gy (range, 20-40 Gy). A considerable proportion of these patients developed severe late complications (Radiother Oncol 53 (1999) 177). The data allowed a detailed analysis of complication kinetics, leading to a new model which was tested using data from the literature. Results: Data on late complications were obtained for eight different organs with a follow-up of up to 10 years. For the various organs, the percentage of patients being free from late complications, plotted as a function of time after start of radiation therapy, was adequately described by exponential regression. From the fit, the parameter p a was obtained, which is the percentage of patients at risk in a given year of developing a complication in a given organ during that year. The rate p a remained about constant with time. Following sandwich therapy, the annual incidence of complications in the bladder, ileum, lymphatic and soft tissue, and ureters was about the same (p a =10-14%/year), whereas complications in bone or dermis occurred at lower rates (4.7 or 7.5%/year, respectively). Discussion: Numerous data sets collected from published reports were analyzed in the same way. Many of the data sets studied were from patients in a series where there was a high incidence of late effects. Three types of kinetics for the occurrence of late effects after radiotherapy were identified: Type 1, purely exponential kinetics; Type 2, exponential kinetics, the slope of which decreased exponentially with time

  7. External beam radiation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Forman, Jeffrey D.

    1996-01-01

    Purpose/Objectives: The intent of this course is to review the issues involved in the management of non-metastatic adenocarcinoma of the prostate. -- The value of pre-treatment prognostic factors including stage, grade and PSA value will be presented, and their value in determining therapeutic strategies will be discussed. -- Controversies involving the simulation process and treatment design will be presented. The value of CT scanning, Beams-Eye View, 3-D planning, intravesicle, intraurethral and rectal contrast will be presented. The significance of prostate and patient movement and strategies for dealing with them will be presented. -- The management of low stage, low to intermediate grade prostate cancer will be discussed. The dose, volume and timing of irradiation will be discussed as will the role of neo-adjuvant hormonal therapy, neutron irradiation and brachytherapy. The current status of radical prostatectomy and cryotherapy will be summarized. Treatment of locally advanced, poorly differentiated prostate cancer will be presented including a discussion of neo-adjuvant and adjuvant hormones, dose-escalation and neutron irradiation. -- Strategies for post-radiation failures will be presented including data on cryotherapy, salvage prostatectomy and hormonal therapy (immediate, delayed and/or intermittent). New areas for investigation will be reviewed. -- The management of patients post prostatectomy will be reviewed. Data on adjuvant radiation and therapeutic radiation for biochemical or clinically relapsed patients will be presented. This course hopes to present a realistic and pragmatic overview for treating patients with non-metastatic prostatic cancer

  8. Long term nuclear data needs for internal radiation dosimetry

    International Nuclear Information System (INIS)

    Burrows, T.W.

    2001-01-01

    The Evaluated Nuclear Structure Data File (ENSDF) is the principle source of nuclear data for internal radiation dosimetry and is, therefore, described briefly. Nuclear data needs and accuracy requirements for internal radiation dosimetry are summarized. Currently available sources of internal radiation dosimetry data are outlined and the need for traceability and documentation of these data is discussed. (author)

  9. Cone-beam computed tomography internal motion tracking should be used to validate 4-dimensional computed tomography for abdominal radiation therapy patients

    DEFF Research Database (Denmark)

    Rankine, Leith; Wan, Hanlin; Parikh, Parag

    2016-01-01

    and implanted fiducial markers, tumor motion was measured daily with CBCT and fluoroscopy for 202 treatment fractions. Fiducial tracking and maximum-likelihood algorithms extracted 3-dimensional fiducial trajectories from CBCT projections. The daily internal margin (IM) (ie, range of fiducial motion...

  10. Development and Internal Validation of a Clinical Risk Score to Predict Pain Response After Palliative Radiation Therapy in Patients With Bone Metastases

    NARCIS (Netherlands)

    van der Velden, JM; Peters, Max; Verlaan, Jorrit Jan; Versteeg, Anne L.; Zhang, Liying; Tsao, May; Danjoux, Cyril; Barnes, Elizabeth; van Vulpen, Marco; Chow, Edward; Verkooijen, Helena M.

    2017-01-01

    Purpose To investigate the relationship between patient and tumor characteristics and pain response in patients with metastatic bone disease, and construct and internally validate a clinical prediction model for pain response to guide individualized treatment decision making. Material and Methods A

  11. Phantom dosimetry at 15 MV conformal radiation therapy

    International Nuclear Information System (INIS)

    Thompson, Larissa; Campos, Tarcisio P.R.

    2015-01-01

    The main goal of this work was to evaluate the spatial dose distribution into a tumor simulator inside a head phantom exposed to a 15MV 3D conformal radiation therapy in order to validate internal doses. A head and neck phantom developed by the Ionizing Radiation Research Group (NRI) was used on the experiments. Therapy Radiation planning (TPS) was performed based on those CT images, satisfying a 200 cGy prescribed dose split in three irradiation fields. The TPS assumed 97% of prescribed dose cover the prescribed treatment volume (PTV). Radiochromic films in a solid water phantom provided dose response as a function of optical density. Spatial dosimetric distribution was generated by radiochromic film samples inserted into tumor simulator and brain. The spatial dose profiles held 70 to 120% of the prescribed dose. In spite of the stratified profile, as opposed to the smooth dose profile from TPS, the tumor internal doses were within a 5% deviation from 214.4 cGy evaluated by TPS. 83.2% of the points with a gamma value of less than 1 (3%/3mm) for TPS and experimental values, respectively. At the tumor, a few dark spots in the film caused the appearance of outlier points in 13-15% of dose deviation percentage. As final conclusion, such dosimeter choice and the physical anthropomorphic and anthropometric phantom provided an efficient method for validating radiotherapy protocols. (author)

  12. Phantom dosimetry at 15 MV conformal radiation therapy

    International Nuclear Information System (INIS)

    Thompson, Larissa; Campos, Tarcisio P.R.; Dias, Humberto G.

    2013-01-01

    The main goal of this work was to evaluate the spatial dose distribution into a tumor simulator inside a head phantom exposed to a 15MV 3D conformal radiation therapy in order to validate internal doses. A head and neck phantom developed by the Ionizing Radiation Research Group (NRI) was used on the experiments. Therapy Radiation planning (TPS) was performed based on those CT images, satisfying a 200 cGy prescribed dose split in three irradiation fields. The TPS assumed 97% of prescribed dose cover the prescribed treatment volume (PTV). Radiochromic films in a solid water phantom provided dose response as a function of optical density. Spatial dosimetric distribution was generated by radiochromic film samples inserted into tumor simulator and brain. The spatial dose profiles held 70 to 120% of the prescribed dose. In spite of the stratified profile, as opposed to the smooth dose profile from TPS, the tumor internal doses were within a 5% deviation from 214.4 cGy evaluated by TPS. 83.2% of the points with a gamma value of less than 1 (3%/3mm) for TPS and experimental values, respectively. At the tumor, a few dark spots in the film caused the appearance of outlier points in 13-15% of dose deviation percentage. As final conclusion, such dosimeter choice and the physical anthropomorphic and anthropometric phantom provided an efficient method for validating radiotherapy protocols. (author)

  13. Phantom dosimetry at 15 MV conformal radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, Larissa; Campos, Tarcisio P.R., E-mail: larissathompson@hotmail.com, E-mail: tprcampos@yahoo.com.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Dias, Humberto G., E-mail: fisicamedica.hl@mariopenna.org.br [Luxemburgo Hospital, Mario Penna Institute, Belo Horizonte, MG (Brazil)

    2015-07-01

    The main goal of this work was to evaluate the spatial dose distribution into a tumor simulator inside a head phantom exposed to a 15MV 3D conformal radiation therapy in order to validate internal doses. A head and neck phantom developed by the Ionizing Radiation Research Group (NRI) was used on the experiments. Therapy Radiation planning (TPS) was performed based on those CT images, satisfying a 200 cGy prescribed dose split in three irradiation fields. The TPS assumed 97% of prescribed dose cover the prescribed treatment volume (PTV). Radiochromic films in a solid water phantom provided dose response as a function of optical density. Spatial dosimetric distribution was generated by radiochromic film samples inserted into tumor simulator and brain. The spatial dose profiles held 70 to 120% of the prescribed dose. In spite of the stratified profile, as opposed to the smooth dose profile from TPS, the tumor internal doses were within a 5% deviation from 214.4 cGy evaluated by TPS. 83.2% of the points with a gamma value of less than 1 (3%/3mm) for TPS and experimental values, respectively. At the tumor, a few dark spots in the film caused the appearance of outlier points in 13-15% of dose deviation percentage. As final conclusion, such dosimeter choice and the physical anthropomorphic and anthropometric phantom provided an efficient method for validating radiotherapy protocols. (author)

  14. Phantom dosimetry at 15 MV conformal radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, Larissa; Campos, Tarcisio P.R., E-mail: larissathompson@hotmail.com, E-mail: tprcampos@yahoo.com.br [Universidade Federal de Minas Gerais (UFMG), Minas Gerais, MG (Brazil). Dept. de Engenharia Nuclear; Dias, Humberto G., E-mail: fisicamedica.hl@mariopenna.org.br [Instituto Mario Penna, Minas Gerais, MG (Brazil). Hospital Luxemburgo

    2013-07-01

    The main goal of this work was to evaluate the spatial dose distribution into a tumor simulator inside a head phantom exposed to a 15MV 3D conformal radiation therapy in order to validate internal doses. A head and neck phantom developed by the Ionizing Radiation Research Group (NRI) was used on the experiments. Therapy Radiation planning (TPS) was performed based on those CT images, satisfying a 200 cGy prescribed dose split in three irradiation fields. The TPS assumed 97% of prescribed dose cover the prescribed treatment volume (PTV). Radiochromic films in a solid water phantom provided dose response as a function of optical density. Spatial dosimetric distribution was generated by radiochromic film samples inserted into tumor simulator and brain. The spatial dose profiles held 70 to 120% of the prescribed dose. In spite of the stratified profile, as opposed to the smooth dose profile from TPS, the tumor internal doses were within a 5% deviation from 214.4 cGy evaluated by TPS. 83.2% of the points with a gamma value of less than 1 (3%/3mm) for TPS and experimental values, respectively. At the tumor, a few dark spots in the film caused the appearance of outlier points in 13-15% of dose deviation percentage. As final conclusion, such dosimeter choice and the physical anthropomorphic and anthropometric phantom provided an efficient method for validating radiotherapy protocols. (author)

  15. Radiation and society: Comprehending radiation risk. V. 2. Poster papers. Proceedings of an international conference

    International Nuclear Information System (INIS)

    1996-01-01

    This IAEA international conference on Radiation and Society was the first major international meeting devoted to the comprehension of radiation risk, public attitude towards radiation risk and hazards encountered by the general public in contaminated areas. Volume two of the proceedings mainly deals with assessment of radiation exposure levels, radiation health effects, impact of radiation on the environment, perception of and managing radiation risk. Refs, figs, tabs

  16. Why do patients drop out during radiation therapy?

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  17. Oral care of the cancer patient receiving radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-07-01

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

  18. Oral care of the cancer patient receiving radiation therapy

    International Nuclear Information System (INIS)

    Holtzhausen, T.

    1982-01-01

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

  19. Recommendations of International Commission of Radiation Protection 1990

    International Nuclear Information System (INIS)

    1995-01-01

    The book summarizes the recommendations on radiation protection of International of Radiation Protection. The main chapters are: 1.- Rates in radiation protection 2.- Biological aspects of radiation protection 3.- Framework of radiation protection. 4.- System of protection. 5.- Implantation of commission's recommendations. 6.- Summary of recommendations

  20. Two component-theory and radiation therapy

    International Nuclear Information System (INIS)

    Wideroee, R.

    1990-01-01

    The two component theory which describes the biological effect of X-ray and particle irradiation divides radiation into densely ionizing radiation (ion density in water greater than four ions per 100 A, i.e. LET>12 keV/μm) und loosely ionizing radiation with low ion densities. In case of densely ionizing radiation, the ions can produce breaks of both cords of DNA thus causing the death of the cell (α effect). Lower ion densities will produce only slight damages which are possibly lethal but can be partly repaired (β effect). If the cell parameters are known (L. Cohen 1983), the number of surviving cells after an irradiation can be calculated. The surviving lung cells and tumor cells (squamous cell carcinoma) have been calculated for a pulmonary irradiation with 30 MeV electrons and 200 keV X-rays (single doses of 2 and 5 Gy), respectively. The electron irradiation with single doses of 5 Gy turned out to be the most favorable therapy sparing the greatest number of lung cells and reducing the tumor cells in the most effective way (down to 1.6x10 -10 ). (orig.) [de

  1. Imaging after radiation therapy of thoracic tumors

    International Nuclear Information System (INIS)

    Ghaye, B.; Wanet, M.; El Hajjam, M.

    2016-01-01

    Radiation-induced lung disease (RILD) is frequent after therapeutic irradiation of thoracic malignancies. Many technique-, treatment-, tumor- and patient-related factors influence the degree of injury sustained by the lung after irradiation. Based on the time interval after the completion of the treatment RILD presents as early and late features characterized by inflammatory and fibrotic changes, respectively. They are usually confined to the radiation port. Though the typical pattern of RILD is easily recognized after conventional two-dimensional radiation therapy (RT), RILD may present with atypical patterns after more recent types of three or four-dimensional RT treatment. Three atypical patterns are reported: the modified conventional, the mass-like and the scar-like patterns. Knowledge of the various features and patterns of RILD is important for correct diagnosis and appropriate treatment. RILD should be differentiated from recurrent tumoral disease, infection and radiation-induced tumors. Due to RILD, the follow-up after RT may be difficult as response evaluation criteria in solid tumours (RECIST) criteria may be unreliable to assess tumor control particularly after stereotactic ablation RT (SABR). Long-term follow-up should be based on clinical examination and morphological and/or functional investigations including CT, PET-CT, pulmonary functional tests, MRI and PET-MRI. (authors)

  2. Radiation therapy in the treatment of hilar cholangiocarcinoma

    International Nuclear Information System (INIS)

    Jing Jin; Zhai Renyou

    2007-01-01

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

  3. Treatment of arterial lesions after radiation therapy

    International Nuclear Information System (INIS)

    Bergqvist, D.; Jonsson, K.; Nilsson, M.; Takolander, R.

    1987-01-01

    Of 1,724 patients who underwent peripheral vascular operation, 12 (0.7 per cent) underwent radiation therapy of the areas including the relevant arteries one and one-half to 28 years (a mean of 15 years) previously; one patient had carcinoma of the breast, three had tumors of the neck and eight patients had malignant gynecologic disease. One patient with an occluded carotid artery was not actively treated, two underwent percutaneous transluminal angioplasty and the remaining patients underwent different types of vascular reconstructions. These patients frequently have other radiation lesions as well with involvement of the skin, bladder or intestine, which may make them problematic from a surgical point of view. Extra-anatomic reconstructions or percutaneous transluminal angioplasty can be recommended. One patient died of malignant disease three years after arterial operation. Otherwise, the results of follow-up study for these patients did not differ from other patients who underwent arterial reconstruction

  4. Radiation therapy for carcinoma of the eyelid

    International Nuclear Information System (INIS)

    Tsuchiya, Miwako; Takahashi, Mitsuhiro; Shinozaki, Jun; Kaneda, Koichi; Oda, Norio; Tabuchi, Yoshiko

    1987-01-01

    Between 1969 and 1985, 30 patients with carcinomas of the eyelid were treated by radiation, including 19 primary cases and 11 secondary cases. The latter were less controlable than the former. According to histology, there were 21 squamous cell carcinomas, 6 basal cell carcinomas and 3 adenocarcinomas. Among the 21 patients with squamous cell carcinomas, 5 had local recurrences, 10 had lymph node metastasis and 3 had distant metastasis. Patients with other histological classifications had no local recurrences, except for one who received incomplete therapy due to diabetes. Almost all of the controlled patients with squamous cell carcinomas were treated with a TDF value greater than 90. Although the visual function was damaged by irradiation in seven patients, the lesions of 6 of them were too advanced to avoid radiation injuries. (author)

  5. The situation of computer utilization in radiation therapy in Japan and other countries and problems

    International Nuclear Information System (INIS)

    Onai, Yoshio

    1981-01-01

    The uses of computers in radiation therapy are various, such as radiation dose calculation, clinical history management, radiotherapeutical instrument automation and biological model. To grasp the situation in this field, a survey by questionnaire was carried out internationally at the time of the 7th International Conference on the Use of Computers in Radiation Therapy held in Kawasaki and Tokyo in September, 1980. The surveyed nations totaled 21 including Japan; the number of facilities answered were 203 in Japan and 111 in other countries, and the period concerned is December, 1979, to September, 1980. The results of the survey are described as follows: areas of use of computers in hospitals, computer utilization in radiation department, computer uses in radiation therapy, and evaluation of radiotherapeutical computer uses and problems. (J.P.N.)

  6. Impact of radiation therapy for benign diseases

    International Nuclear Information System (INIS)

    Kantor, G.; Van Houtte, P.; Beauvois, S.; Roelandts, M.

    1997-01-01

    Radiation therapy of benign diseases represent a wide panel of indications. Some indications are clearly identified as treatment of arteriovenous malformations (AVM), hyperthyroid ophthalmopathy, postoperative heterotopic bone formations or keloid scars. Some indications are under evaluation as complications induced by neo-vessels of age-related macular degeneration or coronary restenosis after angioplasty. Some indications remain controversial with poor evidence of efficiency as treatment of bursitis, tendinitis or Dupuytren's disease. Some indications are now obsolete such as warts, or contra-indicated as treatment of infant and children. (authors)

  7. Radiation therapy following targeted therapy in oligometastatic renal cell carcinoma.

    Science.gov (United States)

    Gravis, Gwenaelle; Faure, Marjorie; Rybikowski, Stanislas; Dermeche, Slimane; Tyran, Marguerite; Calderon, Benoit; Thomassin, Jeanne; Walz, Jochen; Salem, Naji

    2015-11-01

    Up to 40% of patients with renal cell carcinoma (RCC) with initially localized disease eventually develop metastasis following nephrectomy. The current standard of care for metastatic RCC (mRCC) is targeted therapy. However, complete response remains rare. A state of oligometastatic disease may exist, in which metastases are present in a limited number of locations; such cases may benefit from metastasis-directed local therapy, based on the evidence supporting resection of limited-volume metastases, allowing for improved disease control. We retrospectively analyzed 7 cases of response of RCC metastases, in patients treated with targeted therapies followed by radiation therapy (RT) of residual metastatic lesions in Paoli-Calmettes Institute (Marseille, France). We analyzed disease response rates, response to sequential strategy, relapse at the irradiated locations and disease evolution. The median follow-up was 34.1 months (range, 19.2-54.5 months). No progression at the irradiated sites was observed. A total of 5 patients had stable disease at the irradiated locations at the last follow-up; 3 remained in complete remission at the assessment, and 2 were stable. Excellent local response and clinical benefit may be achieved without added toxicity. In conclusion, sequential therapeutic strategies with RT following systemic treatment using sunitinib appear to be highly effective in patients with progressive mRCC and prompt the conduction of further confirmatory trials.

  8. Results of radiation therapy on cervical cancer

    International Nuclear Information System (INIS)

    Mitsuhashi, Norio; Nagai, Teruo; Yamakawa, Michitaka; Tsuchiya, Miwako; Takahashi, Mitsuhiro; Niibe, Hideo

    1989-01-01

    Between 1969 and 1985, a total of 298 patients with cervical cancer were treated by radiation therapy at the Department of Radiology, Gunma University Hospital. Another 111 patients were treated with irradiation as a follow up to surgery; 69 for prophylactic reasons and 42 to treat residual tumors. Patients treated with irradiation alone were given a combination of external irradiation to the pelvis and low dose rate intracavitary irradiation. Patients treated post-operatively were given intracavitary electron beam irradiation of the resected end of the vagina, and external irradiation of the entire pelvis. The following results were obtained: In patients treated by radiation therapy alone, the relative 5-year survival rates according to clinical stage were: 108% for patients with stage I cancer, 90% for stage II, 62% for stage III, and 31% for stage IV. Stage IV patients with no evidence of hematogenous metastasis could be candidates for radical therapy. Local recurrence was observed in 13% of stage II and III patients, attributed to inadequate intracavitary treatment and the histological diagnosis of adenocarcinoma. Severe complications occurred in only 12 (4%) of the 298 patients treated with irradiation alone. The relative 5-year survival rates for patients treated with post-operative irradiation were 91% for patients treated prophylactically and 49% for patients treated for residual tumor. Patients treated with post-operative irradiation for residual tumor at the resected end of the vagina showed a high cumulative survival rate of 77%. Since urinary sequelae developed in only 4 patients, it would seem that electron beam irradiation of the resected end of the vagina is a safe and effective method of therapy. (author)

  9. Memory and survival after microbeam radiation therapy

    International Nuclear Information System (INIS)

    Schueltke, Elisabeth; Juurlink, Bernhard H.J.; Ataelmannan, Khalid; Laissue, Jean; Blattmann, Hans; Braeuer-Krisch, Elke; Bravin, Alberto; Minczewska, Joanna; Crosbie, Jeffrey; Taherian, Hadi; Frangou, Evan; Wysokinsky, Tomasz; Chapman, L. Dean; Griebel, Robert; Fourney, Daryl

    2008-01-01

    Background: Disturbances of memory function are frequently observed in patients with malignant brain tumours and as adverse effects after radiotherapy to the brain. Experiments in small animal models of malignant brain tumour using synchrotron-based microbeam radiation therapy (MRT) have shown a promising prolongation of survival times. Materials and methods: Two animal models of malignant brain tumour were used to study survival and memory development after MRT. Thirteen days after implantation of tumour cells, animals were submitted to MRT either with or without adjuvant therapy (buthionine-SR-sulfoximine = BSO or glutamine). We used two orthogonal 1-cm wide arrays of 50 microplanar quasiparallel microbeams of 25 μm width and a center-to-center distance of about 200 μm, created by a multislit collimator, with a skin entrance dose of 350 Gy for each direction. Object recognition tests were performed at day 13 after tumour cell implantation and in monthly intervals up to 1 year after tumour cell implantation. Results: In both animal models, MRT with and without adjuvant therapy significantly increased survival times. BSO had detrimental effects on memory function early after therapy, while administration of glutamine resulted in improved memory

  10. The prognostic value of pimonidazole and tumour pO2 in human cervix carcinomas after radiation therapy: a prospective international multi-center study

    DEFF Research Database (Denmark)

    Nordsmark, Marianne; Loncaster, Julie; Aquino-Parsons, Christina

    2006-01-01

    BACKGROUND AND PURPOSE: Hypoxia adversely affects treatment outcome in human uterine cervical cancer. Here, we present the results of a prospective international multi-centre study evaluating the prognostic value of pre-treatment tumour oxygen partial pressure (pO(2)) and the hypoxia marker pimon...... pimonidazole (pimo). MATERIALS AND METHODS: One hundred and twenty-seven patients with primary cervix cancer were entered. Pre-treatment tumour pO(2) measurements were obtained, and reported by the median tumour pO(2), the fraction of pO(2) values...

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  12. Clinical applications of continuous infusion chemotherapy ahd concomitant radiation therapy

    International Nuclear Information System (INIS)

    Rosenthal, C.J.; Rotman, M.

    1986-01-01

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

  13. Criteria and standards for radiation therapy (megavoltage) in southeastern Michigan

    International Nuclear Information System (INIS)

    1979-01-01

    The criteria and standards presented in this document provide the basis for the review of proposals to establish, expand or alter institutionally-based radiation therapy services, the criteria developed should provide sufficient guidance to the Plan Implementation Committee of CHPC-SEM to enable it to accomplish the following: Assure the existence of sufficient treatment capacity to serve the identified radiation therapy needs of the Southeastern Michigan community; Assure the residents of Southeastern Michigan of reasonable access to radiation therapy services; Assure that the radiation therapy services offered are of good quality; Avoid unnecessary and wasteful duplication of radiation therapy equipment and services; and promote the effective operation of the health care system in Southeastern Michigan. These criteria and standards also should provide guidance to providers who may consider initiating a new radiation therapy service or altering an existing service or program

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

    International Nuclear Information System (INIS)

    Webb, S.

    1998-01-01

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

  15. Mapping the literature of radiation therapy.

    Science.gov (United States)

    Delwiche, Frances A

    2013-04-01

    This study characterizes the literature of the radiation therapy profession, identifies the journals most frequently cited by authors writing in this discipline, and determines the level of coverage of these journals by major bibliographic indexes. Cited references from three discipline-specific source journals were analyzed according to the Mapping the Literature of Allied Health Project Protocol of the Nursing and Allied Health Resources Section of the Medical Library Association. Bradford's Law of Scattering was applied to all journal references to identify the most frequently cited journal titles. Journal references constituted 77.8% of the total, with books, government documents, Internet sites, and miscellaneous sources making up the remainder. Although a total of 908 journal titles were cited overall, approximately one-third of the journal citations came from just 11 journals. MEDLINE and Scopus provided the most comprehensive indexing of the journal titles in Zones 1 and 2. The source journals were indexed only by CINAHL and Scopus. The knowledgebase of radiation therapy draws heavily from the fields of oncology, radiology, medical physics, and nursing. Discipline-specific publications are not currently well covered by major indexing services, and those wishing to conduct comprehensive literature searches should search multiple resources.

  16. Image Guidance and Assessment of Radiation Induced Gene Therapy

    National Research Council Canada - National Science Library

    Pelizzari, Charles

    2004-01-01

    Image guidance and assessment techniques are being developed for combined radiation/gene therapy, which utilizes a radiation-inducible gene promoter to cause expression of tumor necrosis factor alpha...

  17. Selective use of adjuvant radiation therapy in resectable colorectal adenocarcinoma

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  18. Percutaneous radiation therapy of peyronie's disease with 137cesium

    International Nuclear Information System (INIS)

    Schreiber, B.; Rossbach, T.; Schmitt, G.; Essen Univ.

    1978-01-01

    From 1966 to 1977, 49 patients suffering from Peyronie's disease received percutaneous radiation treatment with 137 Cesium ( 137 Cs). Therapy results were followed up for a period of from 2 months to 11 years. The method of 137 Cs radiation is described and the results compared with other forms of therapy. Percutaneous radiation therapy with 137 Cs seems to be the preferred treatment of Peyronie's disease because of its few side effects, rapid effectiveness, and low cost. (orig.) [de

  19. Internal dose assessment in radiation accidents

    International Nuclear Information System (INIS)

    Toohey, R.E.

    2003-01-01

    Although numerous models have been developed for occupational and medical internal dosimetry, they may not be applicable to an accident situation. Published dose coefficients relate effective dose to intake, but if acute deterministic effects are possible, effective dose is not a useful parameter. Consequently, dose rates to the organs of interest need to be computed from first principles. Standard bioassay methods may be used to assess body contents, but, again, the standard models for bioassay interpretation may not be applicable because of the circumstances of the accident and the prompt initiation of decorporation therapy. Examples of modifications to the standard methodologies include adjustment of biological half-times under therapy, such as in the Goiania accident, and the same effect, complicated by continued input from contaminated wounds, in the Hanford 241 Am accident. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-08-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  2. Potential for heavy particle radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Raju, M.R.; Phillips, T.L.

    1977-03-01

    Radiation therapy remains one of the major forms of cancer treatment. When x rays are used in radiotherapy, there are large variations in radiation sensitivity among tumors because of the possible differences in the presence of hypoxic but viable tumor cells, differences in reoxygenation during treatment, differences in distribution of the tumor cells in their cell cycle, and differences in repair of sublethal damage. When high-LET particles are used, depending upon the LET distribution, these differences are reduced considerably. Because of these differences between x rays and high-LET particle effects, the high-LET particles may be more effective on tumor cells for a given effect on normal cells. Heavy particles have potential application in improving radiotherapy because of improved dose localization and possible advantages of high-LET particles due to their radiobiological characteristics. Protons, because of their defined range, Bragg peak, and small effects of scattering, have good dose localization characteristics. The use of protons in radiotherapy minimizes the morbidity of radiotherapy treatment and is very effective in treating deep tumors located near vital structures. Fast neutrons have no physical advantages over /sup 60/Co gamma rays but, because of their high-LET component, could be very effective in treating tumors that are resistant to conventional radiations. Negative pions and heavy ions combine some of the advantages of protons and fast neutrons.

  3. Potential for heavy particle radiation therapy

    International Nuclear Information System (INIS)

    Raju, M.R.; Phillips, T.L.

    1977-03-01

    Radiation therapy remains one of the major forms of cancer treatment. When x rays are used in radiotherapy, there are large variations in radiation sensitivity among tumors because of the possible differences in the presence of hypoxic but viable tumor cells, differences in reoxygenation during treatment, differences in distribution of the tumor cells in their cell cycle, and differences in repair of sublethal damage. When high-LET particles are used, depending upon the LET distribution, these differences are reduced considerably. Because of these differences between x rays and high-LET particle effects, the high-LET particles may be more effective on tumor cells for a given effect on normal cells. Heavy particles have potential application in improving radiotherapy because of improved dose localization and possible advantages of high-LET particles due to their radiobiological characteristics. Protons, because of their defined range, Bragg peak, and small effects of scattering, have good dose localization characteristics. The use of protons in radiotherapy minimizes the morbidity of radiotherapy treatment and is very effective in treating deep tumors located near vital structures. Fast neutrons have no physical advantages over 60 Co gamma rays but, because of their high-LET component, could be very effective in treating tumors that are resistant to conventional radiations. Negative pions and heavy ions combine some of the advantages of protons and fast neutrons

  4. Film Dosimetry for Intensity Modulated Radiation Therapy

    International Nuclear Information System (INIS)

    Benites-Rengifo, J.; Martinez-Davalos, A.; Celis, M.; Larraga, J.

    2004-01-01

    Intensity Modulated Radiation Therapy (IMRT) is an oncology treatment technique that employs non-uniform beam intensities to deliver highly conformal radiation to the targets while minimizing doses to normal tissues and critical organs. A key element for a successful clinical implementation of IMRT is establishing a dosimetric verification process that can ensure that delivered doses are consistent with calculated ones for each patient. To this end we are developing a fast quality control procedure, based on film dosimetry techniques, to be applied to the 6 MV Novalis linear accelerator for IMRT of the Instituto Nacional de Neurologia y Neurocirugia (INNN) in Mexico City. The procedure includes measurements of individual fluence maps for a limited number of fields and dose distributions in 3D using extended dose-range radiographic film. However, the film response to radiation might depend on depth, energy and field size, and therefore compromise the accuracy of measurements. In this work we present a study of the dependence of Kodak EDR2 film's response on the depth, field size and energy, compared with those of Kodak XV2 film. The first aim is to devise a fast and accurate method to determine the calibration curve of film (optical density vs. doses) commonly called a sensitometric curve. This was accomplished by using three types of irradiation techniques: Step-and-shoot, dynamic and static fields

  5. Radiation therapy for advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kosaka, Takeo; Sejima, Teruhiro; Sugaya, Jun-ichi [Kanazawa Medical Univ. (Japan)] [and others

    1997-09-01

    Thirteen patients with advanced gastric cancer treated by palliative radiotherapy were retrospectively analyzed. The radiation sites were abdominal cavities in 8 cases, superficial masses in 5 and lung metastasis in one. The purposes were to diminish mass size in 5 cases, to relieve pain in 3 and to reduce stenosis in 6. The total doses were more than 40 Gy in 10 patients. In 2 cases, the intracavitary irradiation was performed using {sup 192}Ir. In one case, radiation had to be stopped at the dose of 22.5 Gy because of poor general condition. Partial response was obtained in 6 of 12 cases (RP, 50%). The sites of responders were superficial lesions in 4 and hepatic hilar mass in 2, which were given intracavitary as well as external radiation. Pain relief was achieved in all patients suffering from it. One of 3 cases with esophageal stenosis showed marked improvement in swallowing. Two patients showed a decrease in the levels of tumor markers. Five patients had side effects of more than grade 2. Two of them were grade 3, one thrombocytopenia and one diarrhea. The median survival time of all cases was 9 months, and 5 patients could shift to home care. These results suggest that palliative radiotherapy could be one of the most useful locoregional therapies for advanced gastric cancer, in the aspect of improvement of patient`s QOL. (author)

  6. Radiation therapy for advanced gastric cancer

    International Nuclear Information System (INIS)

    Kosaka, Takeo; Sejima, Teruhiro; Sugaya, Jun-ichi

    1997-01-01

    Thirteen patients with advanced gastric cancer treated by palliative radiotherapy were retrospectively analyzed. The radiation sites were abdominal cavities in 8 cases, superficial masses in 5 and lung metastasis in one. The purposes were to diminish mass size in 5 cases, to relieve pain in 3 and to reduce stenosis in 6. The total doses were more than 40 Gy in 10 patients. In 2 cases, the intracavitary irradiation was performed using 192 Ir. In one case, radiation had to be stopped at the dose of 22.5 Gy because of poor general condition. Partial response was obtained in 6 of 12 cases (RP, 50%). The sites of responders were superficial lesions in 4 and hepatic hilar mass in 2, which were given intracavitary as well as external radiation. Pain relief was achieved in all patients suffering from it. One of 3 cases with esophageal stenosis showed marked improvement in swallowing. Two patients showed a decrease in the levels of tumor markers. Five patients had side effects of more than grade 2. Two of them were grade 3, one thrombocytopenia and one diarrhea. The median survival time of all cases was 9 months, and 5 patients could shift to home care. These results suggest that palliative radiotherapy could be one of the most useful locoregional therapies for advanced gastric cancer, in the aspect of improvement of patient's QOL. (author)

  7. Image-Guided Radiation Therapy for Muscle-Invasive Carcinoma of the Urinary Bladder with Cone Beam CT Scan: Use of Individualized Internal Target Volumes for a Single Patient

    Directory of Open Access Journals (Sweden)

    Gagan Saini

    2012-09-01

    Full Text Available Introduction: While planning radiation therapy (RT for a carcinoma of the urinary bladder (CaUB, the intra-fractional variation of the urinary bladder (UB volume due to filling-up needs to be accounted for. This internal target volume (ITV is obtained by adding internal margins (IM to the contoured bladder. This study was planned to propose a method of acquiring individualized ITVs for each patient and to verify their reproducibility. Methods: One patient with CaUB underwent simulation with the proposed ‘bladder protocol’. After immobilization, a planning CT scan on empty bladder was done. He was then given 300 ml of water to drink and the time (T was noted. Planning CT scans were performed after 20 min (T+20, 30 min (T+30 and 40 min (T+40. The CT scan at T+20 was co-registered with the T+30 and T+40 scans. The bladder volumes at 20, 30 and 40 min were then contoured as CTV20, CTV30 and CTV40 to obtain an individualized ITV for our patient. For daily treatment, he was instructed to drink water as above, and the time was noted; treatment was started after 20 min. Daily pre- and post-treatment cone beam CT (CBCT scans were done. The bladder visualized on the pre-treatment CBCT scan was compared with CTV20 and on the post-treatment CBCT scan with CTV30. Results: In total, there were 65 CBCT scans (36 pre- and 29 post-treatment. Individualized ITVs were found to be reproducible in 93.85% of all instances and fell outside in 4 instances. Conclusions: The proposed bladder protocol can yield a reproducible estimation of the ITV during treatment; this can obviate the need for taking standard IMs.

  8. Postoperative Radiation Therapy Is Associated with Longer Overall Survival in Completely Resected Stage II and III Thymoma-An Analysis of the International Thymic Malignancies Interest Group Retrospective Database.

    Science.gov (United States)

    Rimner, Andreas; Yao, Xiaopan; Huang, James; Antonicelli, Alberto; Ahmad, Usman; Korst, Robert J; Detterbeck, Frank; Gomez, Daniel R

    2016-10-01

    The aim of this study was to determine whether postoperative radiation therapy (PORT) is associated with an overall survival (OS) benefit in patients with completely resected Masaoka or Masaoka-Koga stage II and III thymoma. All patients with completely resected (R0) stage II or III thymoma were identified in a large database of the International Thymic Malignancy Interest Group. Clinical, pathologic, treatment, and follow-up information were extracted. OS was the primary end point. A univariate analysis using the log-rank test was performed, and a multivariate Cox model was created to identify factors associated with OS. Of 1263 patients meeting the selection criteria, 870 (69%) had stage II thymoma. The WHO histologic subtype was A/AB in 360 patients (30%) and B1/B2/B3 in 827 (70%). PORT was given to 55% of patients (n = 689), 15% (n = 180) received chemotherapy, and 10% (n = 122) received both. The 5- and 10-year OS rates for patients having undergone an operation plus PORT were 95% and 86%, respectively, compared with 90% and 79% for patients receiving an operation alone (p = 0.002). This OS benefit remained significant when patients with stage II (p = 0.02) and stage III thymoma (p = 0.0005) were analyzed separately. On multivariate analysis, earlier stage, younger age, absence of paraneoplastic syndrome, and PORT were significantly associated with improved OS. We observed an OS benefit with the use of PORT in completely resected stage II and III thymoma. In the absence of a randomized trial, this represents the most comprehensive analysis of individual patient data and strong evidence in favor of PORT in this patient population. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  9. A Patterns of Care Study of the Various Radiation Therapies for Prostate Cancer among Korean Radiation Oncologists in 2006

    International Nuclear Information System (INIS)

    Kim, Jin Hee; Kim, Jae Sung; Ha, Sung Whan

    2008-01-01

    To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites (mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy (dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles (54.0∼73.8 Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide (60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost (SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer

  10. International symposium on radiative heat transfer: Book of abstracts

    International Nuclear Information System (INIS)

    1995-01-01

    The international symposium on radiative heat transfer was held on 14-18 August 1995 Turkey. The specialists discussed radiation transfer in materials processing and manufacturing, solution of radiative heat transfer equation, transient radiation problem and radiation-turbulence interactions, raditive properties of gases, atmospheric and stellar radiative transfer , radiative transfer and its applications, optical and radiative properties of soot particles, inverse radiation problems, partticles, fibres,thermophoresis and waves and modelling of comprehensive systems at the meeting. Almost 79 papers were presented in the meeting

  11. The prognostic value of pimonidazole and tumour pO2 in human cervix carcinomas after radiation therapy: A prospective international multi-center study

    International Nuclear Information System (INIS)

    Nordsmark, Marianne; Loncaster, Julie; Aquino-Parsons, Christina; Chou, S.-C.; Gebski, Val; West, Catharine; Lindegaard, Jacob C.; Havsteen, Hanne; Davidson, Susan E.; Hunter, Robin; Raleigh, James A.; Overgaard, Jens

    2006-01-01

    Background and purpose: Hypoxia adversely affects treatment outcome in human uterine cervical cancer. Here, we present the results of a prospective international multi-centre study evaluating the prognostic value of pre-treatment tumour oxygen partial pressure (pO 2 ) and the hypoxia marker pimonidazole (pimo). Materials and methods: One hundred and twenty-seven patients with primary cervix cancer were entered. Pre-treatment tumour pO 2 measurements were obtained, and reported by the median tumour pO 2 , the fraction of pO 2 values ≤10 mmHg (HP 1 ), ≤5 mmHg (HP 5 ) and ≤2.5 mmHg (HP 2.5 ). Following intravenous pimonidazole administration, biopsies were taken, stained for pimonidazole adducts, and scored for the area of labelled tumour cells on a scale from 0 to 4. Treatment modalities were surgery (11%), radiotherapy (98%), chemotherapy (33%) and carbogen (14%). Results: None of the hypoxia descriptors were statistically significant prognostic factors for loco-regional tumour control or overall survival when analyzed as continuous variables or divided by the sample median. By univariate analysis only tumour size and nodal status were significant prognostic factors for local control. Tumour size and FIGO stage were significant for overall survival. In a multivariate analysis stratified by centre, only tumour size above 5 cm and lower pre-treatment haemoglobin predicted poorer overall survival among FIGO stage, nodal involvement, tumour size, pre-treatment haemoglobin dichotomized at 12 g/dl and pimo 1, pimo 4 and HP 5 as continuous variables. Conclusion: Neither Eppendorf nor pimonidazole should be dismissed based on the current results. However, further investigations are needed to readdress the hypotheses of the current study having optimized statistical designs, and a population of sufficient size treated more homogenously following rigorous protocols

  12. External radiation therapy in early stage prostate cancer

    International Nuclear Information System (INIS)

    Sandler, Howard M.

    1996-01-01

    Optimal therapy for adenocarcinoma of the prostate is controversial. Numerous options are available, however, comparison of results is difficult in view of the insufficiency of phase III randomized trials comparing alternative treatment strategies. These options include such strategies as no curative therapy (so-called watchful waiting), radiotherapy (external and/or internal), cryotherapy, or radical prostatectomy. Clearly, a broad spectrum of clinical approaches. When reported experiences involving radiation therapy and radical prostatectomy are compared, surgical patients tend to be younger, of earlier stage, of higher performance status, and have lower pre-therapy PSA. These prognostic factors influence the probability of disease control, and since patient selection can have a profound impact on results reporting, these issues need to be carefully controlled. A review of patients who are potentially candidates for surgery at the University of Michigan treated with conformal therapy external beam treatment, indicates that these relatively early patients are doing well. These issues will be elaborated upon further during the presentation

  13. Cone-Beam Computed Tomography Internal Motion Tracking Should Be Used to Validate 4-Dimensional Computed Tomography for Abdominal Radiation Therapy Patients

    Energy Technology Data Exchange (ETDEWEB)

    Rankine, Leith; Wan, Hanlin; Parikh, Parag; Maughan, Nichole [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Poulsen, Per [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); DeWees, Todd; Klein, Eric [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Santanam, Lakshmi, E-mail: lsantanam@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)

    2016-06-01

    Purpose: To demonstrate that fiducial tracking during pretreatment Cone-Beam CT (CBCT) can accurately measure tumor motion and that this method should be used to validate 4-dimensional CT (4DCT) margins before each treatment fraction. Methods and Materials: For 31 patients with abdominal tumors and implanted fiducial markers, tumor motion was measured daily with CBCT and fluoroscopy for 202 treatment fractions. Fiducial tracking and maximum-likelihood algorithms extracted 3-dimensional fiducial trajectories from CBCT projections. The daily internal margin (IM) (ie, range of fiducial motion) was calculated for CBCT and fluoroscopy as the 5th-95th percentiles of displacement in each cardinal direction. The planning IM from simulation 4DCT (IM{sub 4DCT}) was considered adequate when within ±1.2 mm (anterior–posterior, left–right) and ±3 mm (superior–inferior) of the daily measured IM. We validated CBCT fiducial tracking as an accurate predictive measure of intrafraction motion by comparing the daily measured IM{sub CBCT} with the daily IM measured by pretreatment fluoroscopy (IM{sub pre-fluoro}); these were compared with pre- and posttreatment fluoroscopy (IM{sub fluoro}) to identify those patients who could benefit from imaging during treatment. Results: Four-dimensional CT could not accurately predict intrafractional tumor motion for ≥80% of fractions in 94% (IM{sub CBCT}), 97% (IM{sub pre-fluoro}), and 100% (IM{sub fluoro}) of patients. The IM{sub CBCT} was significantly closer to IM{sub pre-fluoro} than IM{sub 4DCT} (P<.01). For patients with median treatment time t < 7.5 minutes, IM{sub CBCT} was in agreement with IM{sub fluoro} for 93% of fractions (superior–inferior), compared with 63% for the t > 7.5 minutes group, demonstrating the need for patient-specific intratreatment imaging. Conclusions: Tumor motion determined from 4DCT simulation does not accurately predict the daily motion observed on CBCT or fluoroscopy. Cone-beam CT could

  14. Exposure Risks Among Children Undergoing Radiation Therapy: Considerations in the Era of Image Guided Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hess, Clayton B. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Thompson, Holly M. [Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento, California (United States); Benedict, Stanley H. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Seibert, J. Anthony [Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento, California (United States); Wong, Kenneth [Department of Radiation Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, University of California David Geffen School of Medicine, Los Angeles, California (United States); Vaughan, Andrew T. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Chen, Allen M., E-mail: allenmchen@yahoo.com [Department of Radiation Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, University of California David Geffen School of Medicine, Los Angeles, California (United States)

    2016-04-01

    Recent improvements in toxicity profiles of pediatric oncology patients are attributable, in part, to advances in the field of radiation oncology such as intensity modulated radiation (IMRT) and proton therapy (IMPT). While IMRT and IMPT deliver highly conformal dose to targeted volumes, they commonly demand the addition of 2- or 3-dimensional imaging for precise positioning—a technique known as image guided radiation therapy (IGRT). In this manuscript we address strategies to further minimize exposure risk in children by reducing effective IGRT dose. Portal X rays and cone beam computed tomography (CBCT) are commonly used to verify patient position during IGRT and, because their relative radiation exposure is far less than the radiation absorbed from therapeutic treatment beams, their sometimes significant contribution to cumulative risk can be easily overlooked. Optimizing the conformality of IMRT/IMPT while simultaneously ignoring IGRT dose may result in organs at risk being exposed to a greater proportion of radiation from IGRT than from therapeutic beams. Over a treatment course, cumulative central-axis CBCT effective dose can approach or supersede the amount of radiation absorbed from a single treatment fraction, a theoretical increase of 3% to 5% in mutagenic risk. In select scenarios, this may result in the underprediction of acute and late toxicity risk (such as azoospermia, ovarian dysfunction, or increased lifetime mutagenic risk) in radiation-sensitive organs and patients. Although dependent on variables such as patient age, gender, weight, body habitus, anatomic location, and dose-toxicity thresholds, modifying IGRT use and acquisition parameters such as frequency, imaging modality, beam energy, current, voltage, rotational degree, collimation, field size, reconstruction algorithm, and documentation can reduce exposure, avoid unnecessary toxicity, and achieve doses as low as reasonably achievable, promoting a culture and practice of “gentle IGRT.”.

  15. Definitive radiation therapy for squamous cell carcinoma of the vagina

    International Nuclear Information System (INIS)

    Frank, Steven J.; Jhingran, Anuja; Levenback, Charles; Eifel, Patricia J.

    2005-01-01

    Purpose: To evaluate outcome and describe clinical treatment guidelines for patients with primary squamous cell carcinoma of the vagina treated with definitive radiation therapy. Methods and Materials: Between 1970 and 2000, a total of 193 patients were treated with definitive radiation therapy for squamous cell carcinoma of the vagina at The University of Texas M. D. Anderson Cancer Center. The patients' medical records were reviewed to obtain information about patient, tumor, and treatment characteristics, as well as outcome and patterns of recurrence. Surviving patients were followed for a median of 137 months. Survival rates were calculated using the Kaplan-Meier method, with differences assessed using log-rank tests. Results: Disease-specific survival (DSS) and pelvic disease control rates correlated with International Federation of Gynecology and Obstetrics (FIGO) stage and tumor size. At 5 years, DSS rates were 85% for the 50 patients with Stage I, 78% for the 97 patients with Stage II, and 58% for the 46 patients with Stage III-IVA disease (p = 0.0013). Five-year DSS rates were 82% and 60% for patients with tumors ≤4 cm or >4 cm, respectively (p = 0.0001). At 5 years, pelvic disease control rates were 86% for Stage I, 84% for Stage II, and 71% for Stage III-IVA (p = 0.027). The predominant mode of relapse after definitive radiation therapy was local-regional (68% and 83%, respectively, for patients with stages I-II or III-IVA disease). The incidence of major complications was correlated with FIGO stage; at 5 years, the rates of major complications were 4% for Stage I, 9% for Stage II, and 21% for Stage III-IVA (p < 0.01). Conclusions: Excellent outcomes can be achieved with definitive radiation therapy for invasive squamous cell carcinoma of the vagina. However, to achieve these results, treatment must be individualized according to the site and size of the tumor at presentation and the response to initial external-beam radiation therapy. Brachytherapy

  16. Radiation therapy in extrahepatic bile duct carcinoma

    International Nuclear Information System (INIS)

    Mahe, Marc; Romestaing, Pascale; Talon, Bernard; Ardiet, J.M.; Salerno, Nathalie; Sentenac, Irenee; Gerard, J.P.

    1991-01-01

    Fifty-one patients with carcinoma of the extrahepatic bile ducts (EHBD) received radiation therapy between Jan 1980-Dec 1988. The location of the tumors was: proximal third, 20 patients; middle third, 23; distal third, 3; diffuse, 5 patients. Thirty-six patients underwent surgery with complete gross resection in 14 (10/14 with positive margins), incomplete gross resection in 12 and only biopsy in 10. Fifteen patients had only biliary drainage without laparotomy after cytologic diagnosis of malignancy in 11/15. Radiation therapy was done with curative intent after complete or incomplete resection (n=26) and it was palliative in patients who had no resection or only biliary drainage (n=25). Twenty-five patients received external radiation-therapy (ERT) alone to the tumor and lymph nodes (mean dose 45 Gy/2Gy per fraction for cure, 35 Gy/10 fractions for palliation), 8 patients had only iridium-192 ( 192 Ir) implant (50-60 Gy at a 1 cm radius for cure, 30 Gy for palliation), 17 patients had both ERT + 192 Ir(ERT 42.5 Gy + 192 Ir 10-15 Gy for cure; ERT 20 Gy/5 fractions + 192 Ir 20-30 Gy for palliation) and one intra-operative irradiation + ERT. The overall survival rate for the entire group was 55, 28.5 and 15 percent at 12, 24, 36 months and median survival 12 months. Median survival was 22 months in patients treated with curative intent and only 10 months after palliative treatment (p0.03). Among patients who had curative treatment, median survival was 27.5 months after complete gross resection and 13 months after incomplete gross resection (p0.045). After complete gross resection 5/14 patients were alive without evolutive disease at 11, 19, 20, 23 and 41 months, 2 were alive with metastases at 25 and 27 months and 7/14 died of cancer from 7 to 59 months. The rate of complications was low: 3 cholangitis responsive to antibiotics, 1 hemobilia and 2 gastric ulcers. These results are encouraging especially for patients with complete gross resection but they must be

  17. Abstracts of 20. International Symposium Radiation Protection Physics

    International Nuclear Information System (INIS)

    1988-01-01

    51 papers are presented as titles with abstracts which are processed individually for the INIS data base. They deal with general aspects of radiation protection physics, international activities in radiation protection, solid state dosimetry, models and calculation methods in radiation protection, and measuring techniques in radiation protection

  18. Quality assurance study for dosimetry of Radiation Therapy equipment in Saudi Arabia

    International Nuclear Information System (INIS)

    Al-Mokhlef, Jazi M.; Nabaz, Noori

    2003-01-01

    International standards address the accuracy of dose delivery for radiation therapy machines as well as quality assurance and staffing levels for radiation therapy centers. We performed absolute calibrations of gamma ,X-ray and electron radiotherapy beams in all radiation therapy centers in Saudi Arabia. We also assessed quality assurance and staffing levels Dosimetric measurements were made with a portable dosimetry system, which consisted of a calibrated Farmer ionization chamber and an electrometer, small water phantom, barometer and thermometer. Differences between the measured and the expected output (c Gy/MU or c Gy/min) were found to be in the range of -11%+5%. About 17% of radiotherapy beams were not within the acceptable tolerance level (+/-3%). Quality assurance in some radiation centers was poor and staffing levels were inadequate. We found poor compliance with internationally accepted tolerance levels for dose calibration of radiotherapy beams at radiation therapy centers in Saudi Arabia. Analysis of medical physics staffing revealed severe discrepancies from those recommended by international guidelines .We recommend that radiation therapy centers be adequately staffed with qualified medical physics personnel and that periodic audit programs be required a governmental body. (author)

  19. Method of radiation therapy treatment planning

    International Nuclear Information System (INIS)

    Hodes, L.

    1976-01-01

    A technique of radiation therapy treatment planning designed to allow the assignment of dosage limits directly to chosen points in the computer-displayed cross-section of the patient. These dosage limits are used as constraints in a linear programming attempt to solve for beam strengths, minimizing integral dosage. If a feasible plan exists, the optimized plan will be displayed for approval as an isodose pattern. If there is no feasible plan, the operator/therapist can designate some of the point dosage constraints as ''relaxed.'' Linear programming will then optimize for minimum deviation at the relaxed points. This process can be iterated and new points selected until an acceptable plan is realized. In this manner the plan is optimized for uniformity as well as overall low dosage. 6 claims, 6 drawing figures

  20. Radiation protection at hadron therapy facilities

    International Nuclear Information System (INIS)

    Pelliccioni, M.

    2011-01-01

    The Italian National Centre for Oncological Hadron-therapy is currently under construction in Pavia. It is designed for the treatment of deep-seated tumours (up to a depth of 27 cm of water equivalent) with proton and C-ion beams as well as for both clinical and radio-biological research. The particles will be accelerated by a 7-MeV u -1 LINAC injector and a 400-MeV u -1 synchrotron. In the first phase of the project, three treatment rooms will be in operation, equipped with four fixed beams, three horizontal and one vertical. The accelerators are currently undergoing commissioning. The main radiation protection problems encountered (shielding, activation, etc.) are hereby illustrated and discussed in relation to the constraints set by the Italian national authorities. (authors)

  1. Clinical results of radiation therapy for thymoma

    Energy Technology Data Exchange (ETDEWEB)

    Masunaga, Shin-ichiro; Ono, Koji; Hiraoka, Masahiro; Sasai, Keisuke; Kitakabu, Yoshizumi; Abe, Mitsuyuki (Kyoto Univ. (Japan). Faculty of Medicine); Takahashi, Masaji; Tsutsui, Kazushige; Fushiki, Masato

    1992-05-01

    From August 1968 to December 1989, 58 patients with thymoma were treated by radiotherapy using cobalt-60 gamma ray. Eleven cases were treated by radiothrapy alone, 1 by preoperative radiotheapy, 43 by postoperative radiotherapy, and 3 in combination with intraoperative radiotherapy. The following points were clarified: (a) Postoperative and intraoperative radiotherapy were effective; (b) For postoperative radiotherapy, operability was the major factor influencing survival and local control, and Stage I and II tumors resected totally or subtotally as well as Stage III tumors resected totally were good indications for such therapy; (c) The patients with complicating myasthenia gravis had a longer survival time and better local control rate than those without it. Radiation pneumonitis was observed in 17 patients, and none of them died of this complication. In all cases in combination with intraoperative radiotherapy, dry desquamation was observed within the irradiated field. (author).

  2. Radiation therapy for intrahepatic recurrence after hepatectomy for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Otsuka, Masaaki; Ohara, Kiyosi; Takada, Yasutsugu; Ueda, Takanori; Murata, Souichirou; Ushijima, Ryou; Adachi, Shinya; Todoroki, Takesi

    2003-01-01

    The intrahepatic recurrence rate after curative hepatectomy for hepatocellular carcinoma (HCC) is high, and management of recurrence is thus important for long-term survival. The use of radiation therapy has been relatively uncommon in the treatment of recurrent HCC. Eight patients underwent radiation therapy for recurrent HCC 12-98 months after hepatectomy. Five of them were treated with protons (250 MeV; 68.8-84.5 Gy), and three were treated with X-rays (6 MV; 60 or 70 Gy). One patient received radiation therapy twice for another lesion with a 79-month interval. The target tumors were 1.2-4.5 cm. All patients also underwent transcatheter arterial embolization or other regional therapy. Although transient ascites was found in three patients after radiation therapy, no patient died as a result of the irradiation. Seven patients died 9 months to 4 years (median 1 year 6 months) after radiation therapy. Re-recurrence was observed in the irradiated liver in two patients (local control 78%). Four patients died of lung metastasis after radiation therapy. The median survival time was 3 years 3 months (range 1 year 1 month to 8 years 6 months) after recurrence. Multimodality therapy is necessary for the management of recurrence. Radiation therapy could be beneficial when other therapies present some difficulty regarding application or are performed incompletely. It must be emphasized that radiation therapy should be considered in addition to other regional therapies for the treatment of recurrent or re-recurrent HCC, and that radiation therapy can be repeated in selected patients. (author)

  3. The international implementation of multisystemic therapy.

    Science.gov (United States)

    Schoenwald, Sonja K; Heiblum, Naamith; Saldana, Lisa; Henggeler, Scott W

    2008-06-01

    The purpose of this article is to consider, through the lenses of theory and research on technology transfer and the adoption and implementation of innovation, the international transport of evidence-based psychosocial treatments for youth, using Multisystemic Therapy (MST) as an example. MST is a well-validated family and community-based approach originally developed in the United States to treat serious juvenile offenders. This article describes challenges to MST transport internationally by virtue of the political, legal, economic, and cultural contexts in different nations. Modifications used to address these challenges and facilitate the international implementation of MST are described and pertain to pre-implementation processes, clinical staff, training materials and procedures, and clinical service delivery.

  4. Definition of treatment geometry in radiation therapy

    International Nuclear Information System (INIS)

    Aaltonen, P.

    1996-01-01

    When accurate systems for quality assurance and treatment optimization are employed, a precise system for fixation and dosimetric and portal verification are as important as a continued and standardized code of practice for dosimetry and patient follow-up, including registration of tumour responses and acute and late normal tissue reactions. To improve the accuracy of existing dose response relations in order to improve future therapy the treatment geometry and dose delivery concepts have to be accurately defined and uniformly employed. A Nordic working group was set up in 1991 (by Nordic Association of Clinica Physics) to standardize the concepts and quantities used during the whole radiotherapy process in the Nordic countries. Now the group is finalizing its report ''Specification of Dose Delivery in Radiation Therapy''. The report emphasizes that the treatment geometry shall be consistent with the geometry used during the diagnostic work up. The patient fixation is of importance early in the diagnostic phase to ensure that the same reference points and patients position will be used both during the diagnostic work up, simulation and treatment execution. Reference Coordinate System of the patient is a concept based on defined anatomic reference points. This Patient Reference System is a local system which has validity for the tissues, organs and volumes defined during radiotherapy. The reference points of the Patient Reference System should in turn be used for beam set-up. The treatment geometry is then defined by using different concepts describing tissues which are mobile in the Patient Reference System, and finally, volumes which are fixed in this coordinate system. A Set-up Margin has to be considered for movements of the volumes defined in the Reference Coordinate System of the Patient in relation to the radiation beam. The Set-up Margin is dependent on the treatment technique and it is needed in the treatment planning procedure to ensure that the prescribed

  5. Radiation Therapy in Peru: Achievements and Challenges

    International Nuclear Information System (INIS)

    Guerrero, P.; Má, C.; Venegas, D.; Bustamante, R.

    2015-01-01

    Peru is the fastest growing economy in Latin America (sustained increase in GDP, low inflation and poverty reduction). The health system is fragmented and until 2012, almost half of the population had no health insurance. The current government poses: Improved access to health and education, employment and social security, reducing extreme poverty, within a context of social inclusion. The Plan for Prevention and Control of Cancer (“Plan Esperanza”) was established in 2012 in order to reduce cancer mortality and morbidity, with greater access to oncology services (promotion, prevention, early diagnosis, treatment and palliative care). With an area of 1 285 216 square kilometers and almost 30 million inhabitants, cancer treatment resources are scarce. Regarding Radiation Therapy, until 2007, it existed only in Lima, the capital city (over 9 million inhabitants). Later, another services were established in two more regions. At present, there is 23 radiotherapy machines in whole country. In this regard, Plan Esperanza is working on strengthening Radiation Therapy Services nationwide. Considering the population demand and availability of other cancer services (chemotherapy, oncologic surgery), the regions where need create new radiotherapy services were identified: 3 Hospitals in Lima (in peripheral areas: Cayetano Heredia at the North, Hipólito Unanue at East and Maria Auxiliadora at South). Also, other Regions of the country: Piura, Lambayeque, La Libertad at North; Junín in the Central Highland, Cusco in the Southern Highland, and Loreto in the Northern Forest. Each with 2 linear accelerators, except Loreto, where they will consider two 60 Cobalt bomb instead, due to the geographical conditions. Moreover, one linear accelerator in Arequipa Region will be acquired. In Lima, the Hospitals are projected to become operational in 2016, while in the Regions, the Ministry of Health is providing them technical assistance in needs identification, planning and

  6. Managing radiation therapy side effects with complementary medicine.

    Science.gov (United States)

    Thomas, Jerah; Beinhorn, Curtiss; Norton, Dena; Richardson, Michael; Sumler, Sat-Siri; Frenkel, Moshe

    2010-01-01

    Over one-third of Americans use complementary and alternative medicine (CAM). The prevalence among cancer patients may even be higher. Complementary therapies may reduce possible symptom burdens caused by conventional cancer treatments. Integrating CAM therapies has become more common and more accepted in clinical oncology. However, little research is available on beneficial CAM therapies for radiation therapy patients. This article reviews potential CAM therapies that have been shown to be effective in decreasing the symptom burden related to radiation therapy treatments and includes clinical observations from CAM practitioners in a comprehensive cancer center.

  7. Proposed Lymph Node Staging System Using the International Consensus Guidelines for Lymph Node Levels Is Predictive for Nasopharyngeal Carcinoma Patients From Endemic Areas Treated With Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Li, Wen-Fei; Sun, Ying; Mao, Yan-Ping; Chen, Lei; Chen, Yuan-Yuan; Chen, Mo [Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Liu, Li-Zhi [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Lin, Ai-Hua [Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou (China); Li, Li [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Ma, Jun, E-mail: majun2@mail.sysu.edu.cn [Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China)

    2013-06-01

    Purpose: To propose a lymph node (N) staging system for nasopharyngeal carcinoma (NPC) based on the International Consensus Guidelines for lymph node (LN) levels and MRI-determined nodal variables. Methods and Materials: The MRI scans and medical records of 749 NPC patients receiving intensity modulated radiation therapy with or without chemotherapy were retrospectively reviewed. The prognostic significance of nodal level, laterality, maximal axial diameter, extracapsular spread, necrosis, and Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) size criteria were analyzed. Results: Nodal level and laterality were the only independent prognostic factors for distant failure and disease failure in multivariate analysis. Compared with unilateral levels Ib, II, III, and/or Va involvement (hazard ratio [HR] 1), retropharyngeal lymph node involvement alone had a similar prognostic value (HR 0.71; 95% confidence interval [CI] 0.43-1.17; P=.17), whereas bilateral levels Ib, II, III, and/or Va involvement (HR 1.65; 95% CI 1.06-2.58; P=.03) and levels IV, Vb, and/or supraclavicular fossa involvement (HR 3.47; 95% CI 1.92-6.29; P<.01) both significantly increased the HR for distant failure. Thus we propose that the N category criteria could be revised as follows: N0, no regional LN metastasis; N1, retropharyngeal lymph node involvement, and/or unilateral levels Ib, II, III, and/or Va involvement; N2, bilateral levels Ib, II, III, and/or Va involvement; N3, levels IV, Vb, and/or supraclavicular fossa involvement. Compared with the 7th edition of the UICC/AJCC criteria, the proposed N staging system provides a more satisfactory distinction between the HRs for regional failure, distant failure, and disease failure in each N category. Conclusions: The proposed N staging system defined by the International Consensus Guidelines and laterality is predictive and practical. However, because of no measurements of the maximal nodal diameter on MRI slices

  8. Diagnostic imaging and radiation therapy equipment

    International Nuclear Information System (INIS)

    1990-05-01

    This is the third edition of CSA Standard C22.2 No. 114 (now CAN/CSA-C22.2 No. 114), which is one of a series of standards issued by the Canadian Standards Association under Part II of the Canadian Electrical Code. This edition marks an important shift towards harmonization of Canadian requirements with those of the European community and the United States. Also important to this edition is the expansion of its scope to include the complete range of diagnostic imaging and radiation therapy equipment, rather than solely radiation-emitting equipment. In so doing, equipment previously addressed by CSA Standard C22.2 No. 125, Electromedical Equipment, specifically lasers for medical applications and diagnostic ultrasound units, is now dealt with in the new edition. By virtue of this expanded scope, many of the technical requirements in the electromedical equipment standard have been introduced to the new edition, thereby bringing CSA Standard C22.2 No. 114 up to date. 14 tabs., 16 figs

  9. Coronary artery disease following mediastinal radiation therapy

    International Nuclear Information System (INIS)

    Annest, L.S.; Anderson, R.P.; Li, W.; Hafermann, M.D.

    1983-01-01

    Coronary artery disease occurred in four young men (mean age 41 years) who had received curative irradiation therapy for mediastinal malignancies 12 to 18 (mean 15) years previously. None was at high risk for developing coronary artery disease by Framingham criteria. Angiography demonstrated proximal coronary artery disease with normal distal vessels. Distribution of the lesions correlated with radiation dosimetry in that vessels exposed to higher radiation intensity were more frequently diseased. Three patients had coronary bypass grafting for intractable angina and are asymptomatic at 10 to 43 months. A total of 163 patients underwent mediastinal irradiation for lymphoma or thymoma between 1959 and 1980. Among the 29 who survived 10 or more years, five (18%) developed severe coronary artery disease, implicating thoracic radiotherapy as an important risk factor. Because of the importance of mantle irradiation in the treatment of lymphomas, the prevalence of these neoplasms, and the survival patterns following treatment, many long-term survivors may be at increased risk for the development of coronary artery disease. Recognition of the relationship between radiotherapy and coronary artery disease may lead to earlier diagnosis and more timely intervention. Standard surgical treatment may be particularly beneficial because of the relative youth of most of these patients and because the proximal distribution of typical lesions increases the likelihood of complete revascularization

  10. Experimental frontiers in radiation therapy of cancer

    International Nuclear Information System (INIS)

    Kaplan, H.S.

    1979-01-01

    Eighty years of the history of radiation therapy are reviewed. Discovery of X-ray, radioactivity and radium was made at the end of the 19th Century. The products of nuclear fission reactions such as 60 Co and the high-energy beam generated by megavoltage devices are used as effective tools to ionize beneath the skin surface where cancerous change is present. Development of more selective devices was performed from both the irradiating means and chemically sensitive and selective sensitizers. Differential radioprotection is also a valid means to improve therapeutic gain. The radiosensitivity of mammalian cells is reduced approximately 3-fold when they are irradiated in nitrogen atmosphere rather than in air or in oxygen. As the differential modification of radiosensitivity currently used, the following means are practiced: (a) increased yield of irreversible radiation lesions, (b) increased intrinsic sensitivity of target DNA, (c) inhibition of repair, (d) optimization of dose fractionation schedules and (e) differential radioprotection of normal tumors. With 156 references up to 1978. (Yamashita, S.)

  11. Virtual reality in radiation therapy training.

    Science.gov (United States)

    Boejen, Annette; Grau, Cai

    2011-09-01

    Integration of virtual reality (VR) in clinical training programs is a novel tool in radiotherapy. This paper presents a review of the experience with VR and Immersive visualization in 3D perspective for planning and delivery of external radiotherapy. Planning and delivering radiation therapy is a complex process involving physicians, physicists, radiographers and radiation therapists/nurses (RTT's). The specialists must be able to understand spatial relationships in the patient anatomy. Although still in its infancy, VR tools have become available for radiotherapy training, enabling students to simulate and train clinical situations without interfering with the clinical workflow, and without the risk of making errors. Immersive tools like a 3D linear accelerator and 3D display of dose distributions have been integrated into training, together with IT-labs with clinical software. Training in a VR environment seems to be cost-effective for the clinic. Initial reports suggest that 3D display of dose distributions may improve treatment planning and decision making. Whether VR training qualifies the students better than conventional training is still unsettled, but the first results are encouraging. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. The Effect of Therapy Oriented CT in Radiation Therapy Planning

    International Nuclear Information System (INIS)

    Kim, Sung Kyu; Shin, Sei One; Kim, Myung Se

    1987-01-01

    The success of radiation therapy depends on exact treatment of the tumor with significant high dose for maximizing local control and excluding the normal tissues for minimizing unwanted complications. To achieve these goals, correct estimation of target volume in three dimension, exact dose distribution in tumor and normal critical structures and correction of tissue inhomogeneity are required. The effect of therapy oriented CT (planning CT) were compared with conventional simulation method in necessity of planning change, set dose, and proper distribution of tumor dose. Of 365 new patients examined, planning CT was performed in 104 patients (28%). Treatment planning was changed in 47% of head and neck tumor, 79% of intrathoracic tumor and 63% of abdominal tumor. In breast cancer and musculoskeletal tumors, planning CT was recommended for selection of adequate energy and calculation of exact dose to critical structures such as kidney or spinal cord. The average difference of tumor doses between CT planning and conventional simulation was 10% in intrathoracic and intra-abdominal tumors but 20% in head and neck tumors which suggested that tumor dose may be overestimated in conventional simulation. Although some limitations and disadvantages including the cost and irradiation during CT are still criticizing, our study showed that CT planning is very helpful in radiotherapy planning

  13. Physics fundamentals and biological effects of synchrotron radiation therapy

    International Nuclear Information System (INIS)

    Prezado, Y.

    2010-01-01

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

  14. Precise positioning of patients for radiation therapy

    International Nuclear Information System (INIS)

    Verhey, L.J.; Goitein, M.; McNulty, P.; Munzenrider, J.E.; Suit, H.D.

    1982-01-01

    A number of immobilization schemes which permit precise daily positioning of patients for radiation therapy are discussed. Pretreatment and post-treatment radiographs have been taken with the patient in the treatment position and analyzed to determine the amount of intratreatment movement. Studies of patients in the supine, seated and decubitus positions indicate mean movements of less than 1 mm with a standard deviation of less than 1 mm. Patients immobilized in the seated position with a bite block and a mask have a mean movement of about 0.5 mm +/- 0.3 mm (s.d.), and patients immobilized in the supine position with their necks hyperextended for submental therapy evidence a mean movement of about 1.4 mm +/- 0.9 mm (s.d.). With the exception of those used for the decubitus position, the immobilization devices are simply fabricated out of thermoplastic casting materials readily available from orthopedic supply houses. A study of day-to-day reproducibility of patient position using laser alignment and pretreatment radiographs for final verification of position indicates that the initial laser alignment can be used to position a patient within 2.2 mm +/- 1.4 mm (s.d.) of the intended position. These results indicate that rigid immobilization devices can improve the precision of radiotherapy, which would be advantageous with respect to both tumor and normal tissue coverage in certain situations

  15. Radiation therapy for malignant lid tumor

    International Nuclear Information System (INIS)

    Totsuka, Seiichi; Itsuno, Hajime

    1991-01-01

    The case of a 42-year-old man with Meibomian gland carcinoma in his right lower lid is reported. The tumor found in the nasal part of the lower lid, was 12 mm x 13 mm in size. First, surgical resection was performed. The pathological diagnosis of the frozen section was 'undifferentiated basal cell epithelioma'. Second, cryotherapy was performed all over the cut surface. Later, the permanent section was pathologically diagnosed as 'undifferentiated Meibomian gland carcinoma'. Total 50 Gy irradiation therapy was therefore performed using a 9 Mev Linac electron beam, 25 x 20 mm field, with a lead protector for the cornea and lens. A lead contact lens did not afford good results because it was too easily shifted on the cornea, owing to its weight. Therefore, we made a racket-shaped lead protector. Fixed well with tape, this protector afforded good protective effect. Three years after treatment, the patient has good visual function, with no recurrence. This racket-shaped lead protector is thought to be useful in radiation therapy for malignant lid tumors. (author)

  16. Influence of radiation therapy on T-lymphocyte subpopulations

    International Nuclear Information System (INIS)

    Job, G.

    1984-01-01

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

  17. Source book of educational materials for radiation therapy. Final report

    International Nuclear Information System (INIS)

    Pijar, M.L.

    1979-08-01

    The Source Book is a listing of educational materials in radiation therapy technology. The first 17 sections correspond to the subjects identified in the ASRT Curriculum Guide for schools of radiation therapy. Each section is divided into publications and in some sections audiovisuals and training aids. Entries are listed without endorsement

  18. The role of radiation therapy in bone metastases management

    OpenAIRE

    Felice, Francesca De; Piccioli, Andrea; Musio, Daniela; Tombolini, Vincenzo

    2017-01-01

    Bone metastases represent an important complication of malignant tumours. Despite improvement in surgical techniques and advances in systemic therapies, management of patients with bone metastatic disease remains a powerful cornerstone for the radiation oncologist. The primary goal of radiation therapy is to provide pain relief, preserving patients quality of life.

  19. Stereotactic radiation therapy combined with immunotherapy: augmenting the role of radiation in local and systemic treatment.

    Science.gov (United States)

    Sharabi, Andrew B; Tran, Phuoc T; Lim, Michael; Drake, Charles G; Deweese, Theodore L

    2015-05-01

    Stereotactic radiosurgery and stereotactic body radiation therapy are two contemporary radiation modalities that can treat tumors in any area of the body using highly focused radiation. Recently, immunotherapy has established itself as a viable and powerful anticancer treatment. In this review we detail the rationale supporting a combination of immunotherapy and stereotactic radiation. Additionally, we discuss the evidence for the immune stimulatory effects of focused radiation and the role that radiation may play in enhancing the systemic treatment effects of immunotherapy.

  20. Radiation therapy among atomic bomb survivors, Hiroshima and Nagasaki

    International Nuclear Information System (INIS)

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

    1980-10-01

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

  1. Laryngeal necrosis after combined chemotherapy and radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Miyaguchi, Mamoru; Kubo, Takeshi [Osaka Univ., Suita (Japan). School of Medicine; Takashima, Hitoshi [Kagawa Medical School (Japan)

    1997-08-01

    Post-radiation necrosis of the larynx is a major complication after irradiation and has become rare. Recently, combined chemotherapy and radiation therapy has been introduced for head and neck tumours. The authors report a case of laryngeal necrosis after combination therapy for a patient with cervical lymph node metastases of nasopharyngeal carcinoma and review the literature on late laryngeal necrosis. Although radiation-induced laryngeal necrosis has become a rare complication, the combination of chemotherapy and radiation therapy may increase its incidence. (author).

  2. SIRFLOX: Randomized Phase III Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients With Metastatic Colorectal Cancer.

    Science.gov (United States)

    van Hazel, Guy A; Heinemann, Volker; Sharma, Navesh K; Findlay, Michael P N; Ricke, Jens; Peeters, Marc; Perez, David; Robinson, Bridget A; Strickland, Andrew H; Ferguson, Tom; Rodríguez, Javier; Kröning, Hendrik; Wolf, Ido; Ganju, Vinod; Walpole, Euan; Boucher, Eveline; Tichler, Thomas; Shacham-Shmueli, Einat; Powell, Alex; Eliadis, Paul; Isaacs, Richard; Price, David; Moeslein, Fred; Taieb, Julien; Bower, Geoff; Gebski, Val; Van Buskirk, Mark; Cade, David N; Thurston, Kenneth; Gibbs, Peter

    2016-05-20

    SIRFLOX was a randomized, multicenter trial designed to assess the efficacy and safety of adding selective internal radiation therapy (SIRT) using yttrium-90 resin microspheres to standard fluorouracil, leucovorin, and oxaliplatin (FOLFOX)-based chemotherapy in patients with previously untreated metastatic colorectal cancer. Chemotherapy-naïve patients with liver metastases plus or minus limited extrahepatic metastases were randomly assigned to receive either modified FOLFOX (mFOLFOX6; control) or mFOLFOX6 plus SIRT (SIRT) plus or minus bevacizumab. The primary end point was progression-free survival (PFS) at any site as assessed by independent centralized radiology review blinded to study arm. Between October 2006 and April 2013, 530 patients were randomly assigned to treatment (control, 263; SIRT, 267). Median PFS at any site was 10.2 v 10.7 months in control versus SIRT (hazard ratio, 0.93; 95% CI, 0.77 to 1.12; P = .43). Median PFS in the liver by competing risk analysis was 12.6 v 20.5 months in control versus SIRT (hazard ratio, 0.69; 95% CI, 0.55 to 0.90; P = .002). Objective response rates (ORRs) at any site were similar (68.1% v 76.4% in control v SIRT; P = .113). ORR in the liver was improved with the addition of SIRT (68.8% v 78.7% in control v SIRT; P = .042). Grade ≥ 3 adverse events, including recognized SIRT-related effects, were reported in 73.4% and 85.4% of patients in control versus SIRT. The addition of SIRT to FOLFOX-based first-line chemotherapy in patients with liver-dominant or liver-only metastatic colorectal cancer did not improve PFS at any site but significantly delayed disease progression in the liver. The safety profile was as expected and was consistent with previous studies. © 2016 by American Society of Clinical Oncology.

  3. Postoperative Radiation Therapy is Associated with Longer Overall Survival in Completely Resected Stage II and III Thymoma – An Analysis of the International Thymic Malignancies Interest Group (ITMIG) Retrospective Database

    Science.gov (United States)

    Rimner, Andreas; Yao, Xiaopan; Huang, James; Antonicelli, Alberto; Ahmad, Usman; Korst, Robert J.; Detterbeck, Frank; Gomez, Daniel R.

    2017-01-01

    Purpose To determine whether postoperative radiation therapy (PORT) is associated with an overall survival benefit in patients with completely resected Masaoka or Masaoka-Koga stage II and III thymoma. Patients and Methods All patients with completely resected (R0) stage II–III thymoma were identified in a large database of the International Thymic Malignancy Interest Group (ITMIG). Clinical, pathologic, treatment, and follow up information were extracted. Overall survival (OS) was the primary endpoint. A univariate analysis using log-rank test and a multivariate Cox model were created to identify factors associated with OS. Results In 1263 patients meeting the selection criteria 870 (69%) patients had stage II thymoma. The WHO histologic subtype was A/AB in 360 (30%) and B1/B2/B3 in 827 (70%) patients. PORT was given to 55% (n=689) of patients, 15% (n=180) received chemotherapy, and 10% (n=122) both. The 5- and 10-year OS rates for patients having undergone surgery + PORT were 95% and 86%, respectively, compared to 90% and 79% for patients with surgery alone(p = 0.002). This OS benefit remained significant when separately analyzing patients with stage II (p= 0.02) and stage III thymoma (p=0.0005). On multivariate analysis, earlier stage, younger age, absence of paraneoplastic syndrome and PORT were significantly associated with improved OS. Conclusions We observed an OS benefit with the use of PORT in completely resected stage II and III thymoma. In the absence of a randomized trial, this represents the most comprehensive individual patient data analysis and strong evidence in favor of PORT in this patient population. PMID:27346413

  4. Optimisation of reconstruction, volumetry and dosimetry for 99mTc-SPECT and 90Y-PET images: Towards reliable dose-volume histograms for selective internal radiation therapy with 90Y-microspheres.

    Science.gov (United States)

    Bernardini, M; Thevenet, H; Berthold, C; Desbrée, A; Smadja, C; Desiré, C; Bianciardi, M; Ghazzar, N

    2017-07-01

    In Selective Internal Radiation Therapy (SIRT), 99m Tc-MAA SPECT images are commonly used to predict microspheres distribution but recent works used 90 Y-microspheres PET images. Nevertheless, evaluation of the predictive power of 99m Tc-MAA has been hampered by the lack of reliable comparisons between 99m Tc-SPECT and 90 Y-PET images. Our aim was to determine the "in situ" optimisation procedure in order to reliably compare 99m Tc-SPECT and 90 Y-PET images and achieve optimal personal dosimetry. We acquired 99m Tc-SPECT/CT and 90 Y-PET/CT images of NEMA and Jaszczak phantoms. We found the best reconstruction parameters for quantification and for volume estimations. We determined adaptive threshold curves on the volumetric reconstruction. We copied the optimised volumes on the quantitative reconstruction, named here the "cross volumes" technique. Finally, we compared 99m Tc-SPECT and 90 Y-PET Dose Volume Histograms. Our "in situ" optimisation procedure decreased errors on volumes and quantification (from -44.2% and -15.8% to -3.4% and -3.28%, respectively, for the 26.5mL PET phantom sphere). Moreover, 99m Tc-SPECT and 90 Y-PET DVHs were equivalent only after the optimisation procedure (difference in mean dose PET images and allowed to achieve a reliable comparison between patient treatment planning and post implant dosimetry, notably by the use of the "cross volumes" technique. Methodology developed in this work will enable robust evaluations of the predictive power of 99m Tc-SPECT, as well as dose-response relationship and side effects in SIRT treatments. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  5. International radiation commissions 1896 to 2008. Research into atmospheric radiation from IMO to IAMAS

    Energy Technology Data Exchange (ETDEWEB)

    Bolle, H.J. (comp.); Moeller, F.; London, J.

    2008-05-15

    The document covers a historical compilation on research into atmospheric radiation from 1896 to 2008. The first part is a brief history of the radiation commissions of IMO (International Meteorological Organization) and IUGG (International Union of Geodesy and Geophysics) for the period 1824 to 1948. Part 2 Covers the International Radiation Commission (IRC) of IAM (International Association of Meteorology)/IAMAS (International Association of Meteorology and Atmospheric Sciences)/IAMAP (International Association of Meteorology and Atmospheric Physics); the Re-constitution of the IUGG Radiation Commision, the Officers of the International Radiation Commission of IUUG 1948-2008, and the activities of the Radiation Commision of the IUGG 1948-2008. The appendices include the Radiation Commission Members, the summaries of presented papers from 1954 and 1957, the IRC publications, and acronyms.

  6. International radiation commissions 1896 to 2008. Research into atmospheric radiation from IMO to IAMAS

    International Nuclear Information System (INIS)

    Bolle, H.J.; Moeller, F.; London, J.

    2008-01-01

    The document covers a historical compilation on research into atmospheric radiation from 1896 to 2008. The first part is a brief history of the radiation commissions of IMO (International Meteorological Organization) and IUGG (International Union of Geodesy and Geophysics) for the period 1824 to 1948. Part 2 Covers the International Radiation Commission (IRC) of IAM (International Association of Meteorology)/IAMAS (International Association of Meteorology and Atmospheric Sciences)/IAMAP (International Association of Meteorology and Atmospheric Physics); the Re-constitution of the IUGG Radiation Commision, the Officers of the International Radiation Commission of IUUG 1948-2008, and the activities of the Radiation Commision of the IUGG 1948-2008. The appendices include the Radiation Commission Members, the summaries of presented papers from 1954 and 1957, the IRC publications, and acronyms

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-09-15

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

  8. Radionuclide Therapy a Targeted Internal Radiotherapy Method Currently Growing

    International Nuclear Information System (INIS)

    Kebbou, Mohammed

    2010-01-01

    Full text: The internal radionuclide therapy is a therapeutic means intended to deliver adequate radiation doses to the target and as low as possible dose to non targeted tissues. Iodine 131 is the oldest element used in benign and malignant thyroid diseases due to its uptake by thyroid cells. Iodine 131 follows the same metabolic pathway than natural iodine. The metabolic process of organification begins after transfer of iodide (negative ion) inside the cell by the Nis symporter (Na+/I-). Iodine 131 being a mixed emitter beta and gamma, its therapeutic action is due to the beta particles whereas the gamma rays allow its localization by external detectors. Other proceedings of targeting were then developed, using labelled agents such as peptides, ligands targeting receptors or antibodies targeting specific antigens. The MIBG labelled with iodine 131 was introduced for the treatment of tumours up taking this agent. The somatostatin (sms) analogues are used for the treatment of the endocrine tumours expressing the sms receptor. Antigen expressed by lymphomas or other tumours have been targeted using specific antibodies or their conjugates. The same agents can be labelled by radionuclides with low dose rates, to study the quality of uptake before considering the treatment. The internal radionuclide therapy requires good radiation protection measures. Dosimetry procedures allow better management of this therapeutic method. The fields of application are widely spreading currently. In oncology, radionuclide therapies include curative and palliative procedures. In addition to beta emitters, the use of alpha emitters is expected to grow due to dosimetric reasons. Also, new agents and combination with other therapeutic procedures are under development. High cost of the majority of radionuclide therapies constitutes currently the principal limitation of their growth in several developing countries [fr

  9. A Method for Evaluating Quality Assurance Needs in Radiation Therapy

    International Nuclear Information System (INIS)

    Huq, M. Saiful; Fraass, Benedick A.; Dunscombe, Peter B.; Gibbons, John P.; Ibbott, Geoffrey S.; Medin, Paul M.; Mundt, Arno; Mutic, Sassa; Palta, Jatinder R.; Thomadsen, Bruce R.; Williamson, Jeffrey F.; Yorke, Ellen D.

    2008-01-01

    The increasing complexity of modern radiation therapy planning and delivery techniques challenges traditional prescriptive quality control and quality assurance programs that ensure safety and reliability of treatment planning and delivery systems under all clinical scenarios. Until now quality management (QM) guidelines published by concerned organizations (e.g., American Association of Physicists in Medicine [AAPM], European Society for Therapeutic Radiology and Oncology [ESTRO], International Atomic Energy Agency [IAEA]) have focused on monitoring functional performance of radiotherapy equipment by measurable parameters, with tolerances set at strict but achievable values. In the modern environment, however, the number and sophistication of possible tests and measurements have increased dramatically. There is a need to prioritize QM activities in a way that will strike a balance between being reasonably achievable and optimally beneficial to patients. A systematic understanding of possible errors over the course of a radiation therapy treatment and the potential clinical impact of each is needed to direct limited resources in such a way to produce maximal benefit to the quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and is developing a framework for designing QM activities, and hence allocating resources, based on estimates of clinical outcome, risk assessment, and failure modes. The report will provide guidelines on risk assessment approaches with emphasis on failure mode and effect analysis (FMEA) and an achievable QM program based on risk analysis. Examples of FMEA to intensity-modulated radiation therapy and high-dose-rate brachytherapy are presented. Recommendations on how to apply this new approach to individual clinics and further research and development will also be discussed

  10. Space Radiation Research Unit, International Open Laboratory in NIRS

    OpenAIRE

    Uchihori, Yukio; Hei, Tom K.; Konishi, Teruaki; Kobayashi, Alisa; Kitamura, Hisashi; Kodaira, Satoshi; Kobayashi, Shingo

    2014-01-01

    The radiation environment encountered by astronauts during spaceflight is far more complex than any radiation field existed on Earth. Space crew living and working in the International Space Station (ISS) are exposed to a mixed radiation field comprises primary high-energy cosmic rays, including energetic protons and heavy ions, and to secondary radiations, including energetic neutrons, produced when the primary radiation interacts with the mass of the space station and its contents. The dose...

  11. Radiation doses and risks from internal emitters

    International Nuclear Information System (INIS)

    Harrison, John; Day, Philip

    2008-01-01

    This review updates material prepared for the UK Government Committee Examining Radiation Risks from Internal Emitters (CERRIE) and also refers to the new recommendations of the International Commission on Radiological Protection (ICRP) and other recent developments. Two conclusions from CERRIE were that ICRP should clarify and elaborate its advice on the use of its dose quantities, equivalent and effective dose, and that more attention should be paid to uncertainties in dose and risk estimates and their implications. The new ICRP recommendations provide explanations of the calculation and intended purpose of the protection quantities, but further advice on their use would be helpful. The new recommendations refer to the importance of understanding uncertainties in estimates of dose and risk, although methods for doing this are not suggested. Dose coefficients (Sv per Bq intake) for the inhalation or ingestion of radionuclides are published as reference values without uncertainty. The primary purpose of equivalent and effective dose is to enable the summation of doses from different radionuclides and from external sources for comparison with dose limits, constraints and reference levels that relate to stochastic risks of whole-body radiation exposure. Doses are calculated using defined biokinetic and dosimetric models, including reference anatomical data for the organs and tissues of the human body. Radiation weighting factors are used to adjust for the different effectiveness of different radiation types, per unit absorbed dose (Gy), in causing stochastic effects at low doses and dose rates. Tissue weighting factors are used to take account of the contribution of individual organs and tissues to overall detriment from cancer and hereditary effects, providing a simple set of rounded values chosen on the basis of age- and sex-averaged values of relative detriment. While the definition of absorbed dose has the scientific rigour required of a basic physical quantity

  12. Modern role and issues of radiation therapy for benign diseases

    International Nuclear Information System (INIS)

    Miyashita, Tsuguhiro; Tateno, Atsushi; Kumazaki, Tatsuo

    1999-01-01

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

  13. VESPRO: An Individual Patient Data Prospective Meta-Analysis of Selective Internal Radiation Therapy Versus Sorafenib for Advanced, Locally Advanced, or Recurrent Hepatocellular Carcinoma of the SARAH and SIRveNIB Trials.

    Science.gov (United States)

    Gebski, Val; Gibbs, Emma; Gandhi, Mihir; Chatellier, Gilles; Dinut, Aurelia; Pereira, Helena; Chow, Pierce Kh; Vilgrain, Valérie

    2017-02-15

    Untreated advanced hepatocellular carcinoma (HCC) has an overall poor prognosis. Currently there are 2 ongoing prospective randomized controlled trials that are evaluating the efficacy and safety of sorafenib and selective internal radiation therapy (SIRT) with yttrium-90 resin microspheres in patients with advanced HCC. The SorAfenib versus Radioembolisation in Advanced Hepatocellular carcinoma (SARAH; 459 patients) trial is being performed in Europe and the SIRt VErsus SorafeNIB (SIRveNIB; 360 patients) trial in the Asia Pacific region. Prospectively combining the results, these trials will not only allow for increased precision to estimate efficacy (in terms of survival), but will also provide increased statistical power for subgroup analyses. To ensure the prospectivity and transparency of the meta-analysis. The sirVEnib and SARAH merge PROject (VESPRO) is an individual, patient-data prospective meta-analysis of the SIRveNIB and SARAH randomized trials. The VESPRO protocol includes prespecified hypotheses, inclusion criteria, and outcome measures. The primary outcome measure is overall survival and secondary outcomes include tumor response rate, progression-free survival, progression in the liver as first event, and disease control in the liver. Pooling of toxicity results will allow for robust safety profiles to be established for both therapies, and provides increased statistical power to investigate treatment effects in key subgroups. Analyses will be performed in the intent-to-treat population stratified by trial. Both studies are expected to demonstrate a survival benefit for SIRT together with a better toxicity profile compared with sorafenib. It is also anticipated that liver progression as the first event would be longer in the intervention compared with the control. As the results of the 2 trials are not yet known, the methodological strength is enhanced, as biases inherent in conventional meta-analyses are avoided. This has the effect of providing

  14. Using Oxygen “Microbubbles” To Improve Radiation Therapy

    Science.gov (United States)

    Oxygen-carrying “microbubbles” could potentially improve the effectiveness of radiation therapy in the treatment of breast cancer, findings from a study in mice suggest. Using the bubbles along with radiation slowed tumor growth more than radiation alone, as this NCI Cancer Currents post reports.

  15. Occurrence of BOOP outside radiation field after radiation therapy for small cell lung cancer

    International Nuclear Information System (INIS)

    Hamanishi, Tohru; Oida, Kazukiyo; Morimatu, Takafumi

    2001-01-01

    We report a case of bronchiolitis obliterans organizing pneumonia (BOOP) that occurred outside the radiation field after radiation therapy for small cell lung cancer. A 74-year-old woman received chemotherapy and a total of 60 Gy of radiation therapy to the right hilum and mediastinum for small cell carcinoma of the suprahilar area of the right lung. Radiation pneumonitis developed within the radiation port 3 months after the completion of radiation therapy. She complained of cough and was admitted 7 months after completion of the radiation therapy. Chest radiography and computed tomography demonstrated peripheral alveolar opacities outside the radiation field on the side contralateral to that receiving the radiation therapy. Bronchoalveolar lavage showed that the total cell count was increased, with a markedly increased percentage of lymphocytes. Transbronchial lung biopsy revealed a histologic pattern consistent with BOOP. Treatment with corticosteroids resulted in rapid improvement of the symptoms and complete resolution of the radiographic abnormalities of the left lung. Although some cases of BOOP following radiation therapy for breast cancer have been reported, none of BOOP after radiation therapy for lung cancer have appeared in the literature. (author)

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating (60)Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. METHODS AND MATERIALS...

  17. Cancer and Radiation Therapy: Current Advances and Future Directions

    Science.gov (United States)

    Baskar, Rajamanickam; Lee, Kuo Ann; Yeo, Richard; Yeoh, Kheng-Wei

    2012-01-01

    In recent years remarkable progress has been made towards the understanding of proposed hallmarks of cancer development and treatment. However with its increasing incidence, the clinical management of cancer continues to be a challenge for the 21st century. Treatment modalities comprise of radiation therapy, surgery, chemotherapy, immunotherapy and hormonal therapy. Radiation therapy remains an important component of cancer treatment with approximately 50% of all cancer patients receiving radiation therapy during their course of illness; it contributes towards 40% of curative treatment for cancer. The main goal of radiation therapy is to deprive cancer cells of their multiplication (cell division) potential. Celebrating a century of advances since Marie Curie won her second Nobel Prize for her research into radium, 2011 has been designated the Year of Radiation therapy in the UK. Over the last 100 years, ongoing advances in the techniques of radiation treatment and progress made in understanding the biology of cancer cell responses to radiation will endeavor to increase the survival and reduce treatment side effects for cancer patients. In this review, principles, application and advances in radiation therapy with their biological end points are discussed. PMID:22408567

  18. CT follow-up after radiation therapy for pituitary adenomas

    International Nuclear Information System (INIS)

    Rush, S.C.; Newall, J.

    1988-01-01

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

  19. Polymer gel dosimetry system for radiation therapy

    International Nuclear Information System (INIS)

    Maryanski, M.J.; Schulz, R.J.; Gignac, C.; Eastman, P.; Gore, J.C.

    1995-01-01

    Purpose/Objective: Recently developed treatment modalities such as stereotactic and conformal radiation therapy produce complex dose distributions which are difficult or impractical to measure with conventional dosimetry instrumentation. Three-dimensional treatment planning systems which purport to calculate these complex dose distributions should be compared to experimental results before being routinely applied to clinical problems. There is a need for a new class of tissue-equivalent dosimeters capable of providing accurate, high resolution, time-integrated and three dimensional dose distributions. The recently developed BANG polymer gel dosimetry system (MGS Research, Inc., Guilford, CT) is ideally suited for the task described above. Physico-chemical principles of the polymer gel dosimetry are presented, together with examples of its application to radiation therapy. Data analysis and display program, written for Macintosh computer, is demonstrated. Materials and Methods: Radiation-induced polymerization of acrylic monomers, which are dispersed in tissue-equivalent gelatin, has been shown to be dependent on the dose, but independent of the dose rate or photon energy. Therefore, the spatial distribution of polymer in the gel is precisely representative of the dose distribution. As the polymeric microparticles reduce the water proton NMR relaxation times in the gel, the dose distribution can be measured with high resolution and accuracy using magnetic resonance imaging. Also, as these microparticles cannot diffuse through the gelatin matrix, their distribution is permanent. An improved formulation of the BANG dosimeter consists of 3% w/v acrylic acid, 3% N,N'-methylene-bis-acrylamide, 1% sodium hydroxide, 5% gelatin, and 88% water. MR images are transferred via a local network to a Macintosh computer, and R2 maps constructed on the basis of multiple TE images, using a non-linear least squares fit based on the Levenberg-Marquardt algorithm. A dose-to-R2

  20. Computed Tomography Density Change in the Thyroid Gland Before and After Radiation Therapy.

    Science.gov (United States)

    Ishibashi, Naoya; Maebayashi, Toshiya; Aizawa, Takuya; Sakaguchi, Masakuni; Okada, Masahiro; Matsushita, Junichi

    2018-01-01

    Hypothyroidism is an established adverse effect of radiation therapy for head and neck cancer, and computed tomography (CT) density of the thyroid gland is lower in hypothyroid than euthyroid individuals. No previous studies have evaluated changes in CT densities of the thyroid gland caused by radiation therapy. The aim was to investigate the relationship between the change in CT density of the thyroid gland before and after radiation therapy for head and neck cancer and hypothyroidism. This retrospective study analyzed data of 24 patients treated by radiation therapy for head and neck cancers. After dosimetric analysis of received radiation therapy, a Picture Archiving and Communication System was used to manually contour the thyroid on pre-treatment CT images to enable determination of mean thyroid gland CT densities and received radiation doses. Pre- and post-treatment thyroid function was assessed on the basis of serum TSH concentrations. Multivariate and univariate analyses were used to determine what clinical factors are associated with post-radiation therapy decrease in CT density of the thyroid and Pearson's χ 2 test was used to assess correlations between these densities and TSH concentrations. Mean CT densities of the thyroid gland decreased from before to after radiation therapy in 73.9% of our patients (median decrease 16.8 HU). Serum TSH concentrations were significantly higher in patients with greater then median decreases in CT density than in those with lesser or no decreases. Post-radiation therapy hypothyroidism may be predicted by significant decreases in CT density of the thyroid gland. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  1. Explanation of diagnosis criteria for radiation sickness from internal exposure

    International Nuclear Information System (INIS)

    Xing Zhiwei; Jiang Enhai; Du Jianying; Bai Guang

    2012-01-01

    A revised edition of the Diagnostic Criteria for Radiation Sickness from Internal Exposure has been approved and issued by the Ministry of Health. It is necessary to research the internal radiation sickness to adapt to the current serious anti-terrorism situation. This standard was enacted based on the extensive research of related literature, from which 12 cases with internal radiation sickness and screened out were involving 7 types of radionuclide. The Development of Emergency Response Standard Extension Framework: Midterm Evaluation Report is the main reference which approved by the International Atomic Energy Agency and World Health Organization. This amendment contains many new provisions such as internal radiation sickness effects models and threshold dose, and the appendix added threshold dose of serious deterministic effects induced by radionuclide intake and radiotoxicology parameters of some radionuclides. In order to understand and implement this standard, and to diagnose and treat the internal radiation sickness correctly, the contents of this standard were interpreted in this article. (authors)

  2. Postoperative radiation therapy for lung cancer

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  3. Scatter factors assessment in microbeam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Prezado, Y.; Martinez-Rovira, I.; Sanchez, M. [Laboratoire Imagerie et Modelisation en Neurobiologie et Cancerologie IMNC-UMR 8165, Centre National de la Recherche Scientifique (CNRS), Campus Universitaire, Bat. 440, 15 rue Georges Clemenceau, 91406 Orsay Cedex (France); Institut de Tecniques Energetiques, Universitat Politecnica de Catalunya, Diagonal 647, E-08028 Barcelona (Spain) and ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz, B.P. 220, 38043 Grenoble Cedex (France); Servicio de Radiofisica, Complejo Hospitalario de Santiago de Compostela, Rua Choupana S/N, 15706 Santiago de Compostela (Spain)

    2012-03-15

    Purpose: The success of the preclinical studies in Microbeam Radiation Therapy (MRT) paved the way to the clinical trials under preparation at the Biomedical Beamline of the European Synchrotron Radiation Facility. Within this framework, an accurate determination of the deposited dose is crucial. With that aim, the scatter factors, which translate the absolute dose measured in reference conditions (2 x 2 cm{sup 2} field size at 2 cm-depth in water) to peak doses, were assessed. Methods: Monte Carlo (MC) simulations were performed with two different widely used codes, PENELOPE and GEANT4, for the sake of safety. The scatter factors were obtained as the ratio of the doses that are deposited by a microbeam and by a field of reference size, at the reference depth. The calculated values were compared with the experimental data obtained by radiochromic (ISP HD-810) films and a PTW 34070 large area chamber. Results: The scatter factors for different microbeam field sizes assessed by the two MC codes were in agreement and reproduced the experimental data within uncertainty bars. Those correction factors were shown to be non-negligible for the future MRT clinical settings: an average 30% lower dose was deposited by a 50 {mu}m microbeam with respect to the reference conditions. Conclusions: For the first time, the scatter factors in MRT were systematically studied. They constitute an essential key to deposit accurate doses in the forthcoming clinical trials in MRT. The good agreement between the different calculations and the experimental data confirms the reliability of this challenging micrometric dose estimation.

  4. A virtual radiation therapy workflow training simulation

    International Nuclear Information System (INIS)

    Bridge, P.; Crowe, S.B.; Gibson, G.; Ellemor, N.J.; Hargrave, C.; Carmichael, M.

    2016-01-01

    Aim: Simulation forms an increasingly vital component of clinical skills development in a wide range of professional disciplines. Simulation of clinical techniques and equipment is designed to better prepare students for placement by providing an opportunity to learn technical skills in a “safe” academic environment. In radiotherapy training over the last decade or so this has predominantly comprised treatment planning software and small ancillary equipment such as mould room apparatus. Recent virtual reality developments have dramatically changed this approach. Innovative new simulation applications and file processing and interrogation software have helped to fill in the gaps to provide a streamlined virtual workflow solution. This paper outlines the innovations that have enabled this, along with an evaluation of the impact on students and educators. Method: Virtual reality software and workflow applications have been developed to enable the following steps of radiation therapy to be simulated in an academic environment: CT scanning using a 3D virtual CT scanner simulation; batch CT duplication; treatment planning; 3D plan evaluation using a virtual linear accelerator; quantitative plan assessment, patient setup with lasers; and image guided radiotherapy software. Results: Evaluation of the impact of the virtual reality workflow system highlighted substantial time saving for academic staff as well as positive feedback from students relating to preparation for clinical placements. Students valued practice in the “safe” environment and the opportunity to understand the clinical workflow ahead of clinical department experience. Conclusion: Simulation of most of the radiation therapy workflow and tasks is feasible using a raft of virtual reality simulation applications and supporting software. Benefits of this approach include time-saving, embedding of a case-study based approach, increased student confidence, and optimal use of the clinical environment

  5. On probabilistically defined margins in radiation therapy

    International Nuclear Information System (INIS)

    Papiez, Lech; Langer, Mark

    2006-01-01

    Margins about a target volume subject to external beam radiation therapy are designed to assure that the target volume of tissue to be sterilized by treatment is adequately covered by a lethal dose. Thus, margins are meant to guarantee that all potential variation in tumour position relative to beams allows the tumour to stay within the margin. Variation in tumour position can be broken into two types of dislocations, reducible and irreducible. Reducible variations in tumour position are those that can be accommodated with the use of modern image-guided techniques that derive parameters for compensating motions of patient bodies and/or motions of beams relative to patient bodies. Irreducible variations in tumour position are those random dislocations of a target that are related to errors intrinsic in the design and performance limitations of the software and hardware, as well as limitations of human perception and decision making. Thus, margins in the era of image-guided treatments will need to accommodate only random errors residual in patient setup accuracy (after image-guided setup corrections) and in the accuracy of systems designed to track moving and deforming tissues of the targeted regions of the patient's body. Therefore, construction of these margins will have to be based on purely statistical data. The characteristics of these data have to be determined through the central limit theorem and Gaussian properties of limiting error distributions. In this paper, we show how statistically determined margins are to be designed in the general case of correlated distributions of position errors in three-dimensional space. In particular, we show how the minimal margins for a given level of statistical confidence are found. Then, how they are to be used to determine geometrically minimal PTV that provides coverage of GTV at the assumed level of statistical confidence. Our results generalize earlier recommendations for statistical, central limit theorem

  6. On probabilistically defined margins in radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Papiez, Lech; Langer, Mark [Department of Radiation Oncology, Indiana University, Indianapolis, IN (United States)

    2006-08-21

    Margins about a target volume subject to external beam radiation therapy are designed to assure that the target volume of tissue to be sterilized by treatment is adequately covered by a lethal dose. Thus, margins are meant to guarantee that all potential variation in tumour position relative to beams allows the tumour to stay within the margin. Variation in tumour position can be broken into two types of dislocations, reducible and irreducible. Reducible variations in tumour position are those that can be accommodated with the use of modern image-guided techniques that derive parameters for compensating motions of patient bodies and/or motions of beams relative to patient bodies. Irreducible variations in tumour position are those random dislocations of a target that are related to errors intrinsic in the design and performance limitations of the software and hardware, as well as limitations of human perception and decision making. Thus, margins in the era of image-guided treatments will need to accommodate only random errors residual in patient setup accuracy (after image-guided setup corrections) and in the accuracy of systems designed to track moving and deforming tissues of the targeted regions of the patient's body. Therefore, construction of these margins will have to be based on purely statistical data. The characteristics of these data have to be determined through the central limit theorem and Gaussian properties of limiting error distributions. In this paper, we show how statistically determined margins are to be designed in the general case of correlated distributions of position errors in three-dimensional space. In particular, we show how the minimal margins for a given level of statistical confidence are found. Then, how they are to be used to determine geometrically minimal PTV that provides coverage of GTV at the assumed level of statistical confidence. Our results generalize earlier recommendations for statistical, central limit theorem

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-04-01

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

  8. Two case reports of a cerebrovascular disorder after radiation therapy

    International Nuclear Information System (INIS)

    Ono, Jiro; Mimaki, Takashi; Tagawa, Tetsuzo

    1985-01-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  10. Cost-containment in hypofractionated radiation therapy: a literature review.

    Science.gov (United States)

    Hunter, Darren; Mauldon, Emily; Anderson, Nigel

    2018-03-13

    Recent technological advances in radiation therapy have allowed for greater accuracy in planning and treatment delivery. The development of hypofractionated radiation treatment regimens is an example, and has the potential to decrease the cost per episode of care, relative to conventional treatments. Our aim was to analyse published literature on the cost-effectiveness and budgetary implications of hypofractionated radiation therapy. As such, this article will quantify the projected health care cost savings and address the optimal means of treatment delivery, associated patient outcomes, and implications arising from an increased use of hypofractionated regimens. © 2018 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

  11. Radiation therapy for the solitary plasmacytoma

    Directory of Open Access Journals (Sweden)

    Esengül Koçak

    2010-06-01

    Full Text Available Plasma-cell neoplasms are classically categorized into four groups as: multiple myeloma (MM, plasma-cell leukemias, solitary plasmacytomas (SP of the bone (SPB, and extramedullary plasmacytomas (EMP. These tumors may be described as localized or diffuse in presentation. Localized plasma-cell neoplasms are rare, and include SP of the skeletal system, accounting for 2-5% of all plasma-cell neoplasms, and EMP of soft tissue, accounting for approximately 3% of all such neoplasms. SP is defined as a solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. There appears to be a continuum in which SP often progresses to MM. The main treatment modality for SP is radiation therapy (RT. However, there are no conclusive data in the literature on the optimal RT dose for SP. This review describes the interrelationship of plasma-cell neoplasms, and attempts to determine the minimal RT dose required to obtain local control.

  12. Radianttrademark Liquid Radioisotope Intravascular Radiation Therapy System

    International Nuclear Information System (INIS)

    Eigler, N.; Whiting, J.; Chernomorsky, A.; Jackson, J.; Knapp, F.F. Jr.; Litvack, F.

    1998-01-01

    RADIANTtrademark is manufactured by United States Surgical Corporation, Vascular Therapies Division, (formerly Progressive Angioplasty Systems). The system comprises a liquid β-radiation source, a shielded isolation/transfer device (ISAT), modified over-the-wire or rapid exchange delivery balloons, and accessory kits. The liquid β-source is Rhenium-188 in the form of sodium perrhenate (NaReO 4 ), Rhenium-188 is primarily a β-emitter with a physical half-life of 17.0 hours. The maximum energy of the β-particles is 2.1 MeV. The source is produced daily in the nuclear pharmacy hot lab by eluting a Tungsten-188/Rhenium-188 generator manufactured by Oak Ridge National Laboratory (ORNL). Using anion exchange columns and Millipore filters the effluent is concentrated to approximately 100 mCi/ml, calibrated, and loaded into the (ISAT) which is subsequently transported to the cardiac catheterization laboratory. The delivery catheters are modified Championtrademark over-the-wire, and TNTtrademark rapid exchange stent delivery balloons. These balloons have thickened polyethylene walls to augment puncture resistance; dual radio-opaque markers and specially configured connectors

  13. Stereotactic radiation therapy for large vestibular schwannomas

    International Nuclear Information System (INIS)

    Mandl, Ellen S.; Meijer, Otto W.M.; Slotman, Ben J.; Vandertop, W. Peter; Peerdeman, Saskia M.

    2010-01-01

    Background and purpose: To evaluate the morbidity and tumor-control rate in the treatment of large vestibular schwannomas (VS) after stereotactic radiation therapy in our institution. Material and methods: Twenty-five consecutive patients (17 men, 8 women) with large VS (diameter 3.0 cm or larger), treated with stereotactic radiotherapy (SRT) or stereotactic radiosurgery (SRS) between 1992 and 2007, were retrospectively studied after a mean follow-up period of three years with respect to tumor-control rate and complications. Results: Actuarial 5-year maintenance of pre-treatment hearing level probability of 30% was achieved. Five of 17 patients suffered permanent new facial nerve dysfunction. The actuarial 5-year facial nerve preservation probability was 80%. Permanent new trigeminal nerve neuropathy occurred in two of 15 patients, resulting in an actuarial 5-year trigeminal nerve preservation probability of 85%. Tumor progression occurred in four of 25 (16%) patients. The overall 5-year tumor control probability was 82%. Conclusion: Increased morbidity rates were found in patients with large VS treated with SRT or SRS compared to the published series on regular sized VS and other smaller retrospective studies on large VS.

  14. Radiation therapy for long-bone metastases

    International Nuclear Information System (INIS)

    Wadasaki, Kouichi; Tomiyoshi, Hideki; Ooshima, Yoshie; Urashima, Masaki; Mori, Masaki

    1992-01-01

    Efficacy of palliative and prophylactic radiotherapies for metastatic bone pain and pathological fracture was investigated in 14 patients with long bone metastases. Irradiation sites were the femur in 10 patients, the humerus in 2, the radius in one, and the tibia in one. Radiographs showed osteolytic lesion in 13 patients and osteoblastic lesion in one. A total dose of 48.6 Gy to 87.3 Gy was delivered in daily fractional doses of 2 Gy (one patient), 2.5 Gy (3), 3 Gy (6), 4 Gy (2) and 5 Gy (2), 5 days a week. For 13 patients, except for one death within one month after the completion of irradiation, pain relief was attained. Of these patients, 7 (54%) had complete pain relief. In one patient, pathological fracture occurred as early as 10 days after the beginning of irradiation when irradiation efficacy was not attained. In none of the 13 others, was pathological fracture encountered. No side effects were seen at all during or after irradiation. Radiation therapy was an extremely effective means for managing patients with long bone metastases in terms of its palliative and prophylactic role. (N.K.)

  15. The Indiana University proton radiation therapy project

    International Nuclear Information System (INIS)

    Bloch, C.; Derenchuk, V.; Cameron, J.; Fasano, M.; Gilmore, J.; Hashemian, R.; Hornback, N.; Low, D.A.; Morphis, J.; Peterson, C.; Rosselot, D.; Sandison, G.; Shen, R.N.; Shidnia, H.

    1993-01-01

    A fixed horizontal beam line at the Indiana University cyclotron facility (IUCF) has been equipped for proton radiation therapy treatment of head, neck, and brain tumors. The complete system will be commissioned and ready to treat patients early in 1993. IUCF can produce external proton beams from 45 to 200 MeV in energy, which corresponds to a maximum range in water of 26 cm. Beam currents over 100 nA are easily attained, allowing dose rates in excess of 200 cGy/min, even for large fields. Beam spreading systems have been tested which provide uniform fields up to 20 cm in diameter. Range modulation is accomplished with a rotating acrylic device, which provides uniform depth dose distributions from 3 to 18 cm in extent. Tests have been conducted on detectors which monitor the beam position and current, and the dose symmetry. This report discusses those devices, as well as the cyclotron characteristics, measured beam properties, safety interlocks, computerized dose delivery/monitoring system, and future plans. (orig.)

  16. International meeting on radiation chemistry and processing

    International Nuclear Information System (INIS)

    1986-04-01

    The conference heard 76 papers; the abstracts of 74 of them were inputted in INIS. They deal with the basic principles and mechanisms of radiation chemistry, with radiolysis, radiation cross-linking of polymers, with methods and instruments for irradiation beam dosimetry, and with radiation application in the irradiation of foods and wastes. (M.D.)

  17. Chondronecrosis of the cricoid cartilage following radiation therapy

    International Nuclear Information System (INIS)

    Tanabe, Masahiro; Isshiki, Nobuhiko; Kojima, Hisayoshi

    1979-01-01

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

  18. Radiation therapy quality control in MRCCC radiotherapy units

    International Nuclear Information System (INIS)

    Fielda Djuita; Rina Taurisia; Andreas Nainggolan

    2011-01-01

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

  19. Direct determination of internal radiation dose in human blood

    OpenAIRE

    Tanır, Ayse Güneş; Güleç, Özge

    2014-01-01

    The purpose of this study is to measure the internal radiation dose using a human blood sample. In the literature, there is no process that allows the direct measurement of the internal radiation dose received by a person. The luminescence counts from a blood sample having a laboratory-injected radiation dose and the waste blood of the patient injected with a radiopharmaceutical for diagnostic purposes were both measured. The decay and dose-response curves were plotted for the different doses...

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

    Directory of Open Access Journals (Sweden)

    Abhilash

    2016-03-01

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

  1. Radiation Therapy Infrastructure and Human Resources in Low- and Middle-Income Countries: Present Status and Projections for 2020

    International Nuclear Information System (INIS)

    Datta, Niloy R.; Samiei, Massoud; Bodis, Stephan

    2014-01-01

    Purpose: Radiation therapy, a key component of cancer management, is required in more than half of new cancer patients, particularly in low- and middle-income countries (LMICs). The projected rise in cancer incidence over the next decades in LMICs will result in an increasing demand for radiation therapy services. Considering the present cancer incidence and that projected for 2020 (as listed in GLOBOCAN), we evaluated the current and anticipated needs for radiation therapy infrastructure and staffing by 2020 for each of the LMICs. Methods and Materials: Based on World Bank classification, 139 countries fall in the category of LMICs. Details of teletherapy, radiation oncologists, medical physicists, and radiation therapy technologists were available for 84 LMICs from the International Atomic Energy Agency–Directory of Radiotherapy Centres (IAEA-DIRAC) database. Present requirements and those for 2020 were estimated according to recommendations from the IAEA and European Society for Radiotherapy and Oncology (ESTRO-QUARTS). Results: Only 4 of the 139 LMICs have the requisite number of teletherapy units, and 55 (39.5%) have no radiation therapy facilities at present. Patient access to radiation therapy in the remaining 80 LMICs ranges from 2.3% to 98.8% (median: 36.7%). By 2020, these 84 LMICs would additionally need 9169 teletherapy units, 12,149 radiation oncologists, 9915 medical physicists, and 29,140 radiation therapy technologists. Moreover, de novo radiation therapy facilities would have to be considered for those with no services. Conclusions: Twelve pragmatic steps are proposed for consideration at national and international levels to narrow the gap in radiation therapy access. Multipronged and coordinated action from all national and international stakeholders is required to develop realistic strategies to curb this impending global crisis

  2. Optimizing patient positioning for intensity modulated radiation therapy in hippocampal-sparing whole brain radiation therapy.

    Science.gov (United States)

    Siglin, Joshua; Champ, Colin E; Vakhnenko, Yelena; Witek, Matthew E; Peng, Cheng; Zaorsky, Nicholas G; Harrison, Amy S; Shi, Wenyin

    2014-01-01

    Sparing the hippocampus during whole brain radiation therapy (WBRT) offers potential neurocognitive benefits. However, previously reported intensity modulated radiation therapy (IMRT) plans use multiple noncoplanar beams for treatment delivery. An optimized coplanar IMRT template for hippocampal-sparing WBRT would assist in clinical workflow and minimize resource utilization. In this study, we sought to determine the optimal patient position to facilitate coplanar treatment planning and delivery of hippocampal-sparing WBRT using IMRT. A variable angle, inclined board was utilized for patient positioning. An anthropomorphic phantom underwent computed tomography simulation at various head angles. The IMRT goals were designed to achieve target coverage of the brain while maintaining hippocampal dose-volume constraints designed to conform to the Radiation Therapy Oncology Group 0933 protocol. Optimal head angle was then verified using data from 8 patients comparing coplanar and noncoplanar WBRT IMRT plans. Hippocampal, hippocampal avoidance region, and whole brain mean volumes were 1.1 cm(3), 12.5 cm(3), and 1185.1 cm(3), respectively. The hippocampal avoidance region occupied 1.1% of the whole brain planning volume. For the 30-degree head angle, a 7-field coplanar IMRT plan was generated, sparing the hippocampus to a maximum dose of 14.7 Gy; D100% of the hippocampus was 7.4 Gy and mean hippocampal dose was 9.3 Gy. In comparison, for flat head positioning the hippocampal Dmax was 22.9 Gy with a D100% of 9.2 Gy and mean dose of 11.7 Gy. Target coverage and dose homogeneity was comparable with previously published noncoplanar IMRT plans. Compared with conventional supine positioning, an inclined head board at 30 degrees optimizes coplanar whole brain IMRT treatment planning. Clinically acceptable hippocampal-sparing WBRT dosimetry can be obtained using a simplified coplanar plan at a 30-degree head angle, thus obviating the need for complex and time consuming noncoplanar

  3. Applicator-guided intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Low, Daniel A.; Grigsby, Perry W.; Dempsey, James F.; Mutic, Sasa; Williamson, Jeffrey F.; Markman, Jerry; Chao, K.S. Clifford; Klein, Eric E.; Purdy, James A.

    2002-01-01

    Purpose: We are introducing a novel method for delivering highly conformal dose distributions to cervical cancer tumors using external beam intensity-modulated radiation therapy. The method, termed applicator-guided intensity-modulated radiation therapy (AGIMRT), will use an applicator substitute placed in the vagina and uterus to provide spatial registration and immobilization of the gynecologic organs. The main reason for the applicator substitute will be to localize the fornices, cervix, and uterus with the expectation that the other nearby organs will also be reproducibly positioned with respect to the applicator substitute. Intensity-modulated radiation therapy (IMRT) dose distributions will be used as a substitute for high-dose-rate intracavitary brachytherapy procedures. The flexibility of IMRT will enable customized dose distributions that have the potential to reduce complications and improve local control, especially for locally advanced disease. Methods and Materials: To test the advantages of IMRT over intracavitary brachytherapy, volumetric scans of three cervical cancer patients were obtained with implanted CT-compatible applicators. IMRT dose distribution simulations using tomotherapy, were compared against intracavitary brachytherapy using cesium tubes to investigate the dosimetric differences of the two modalities. Because these tumor volumes do not image well on CT, the target volumes were defined as the isodose surface containing the traditional point A, defined as 2 cm superior to the vaginal fornices and 2 cm lateral to the intrauterine canal. One patient had a uterus that wrapped superior and anterior to the bladder. For this case, the cervix and uterus were selected as the target volume. To determine the potential for using an applicator substitute to localize internal organs, the posterior bladder and anterior rectal surfaces were localized relative to the colpostats. Comparisons of the colpostat-localized surfaces were conducted for two

  4. Interaction of radiation with solids. Proceedings of 9. International conference

    International Nuclear Information System (INIS)

    Anishchik, V.M.; Uglov, V.V.; Baran, L.V.; Azarko, I.I.

    2011-09-01

    In the collection are the papers presented at the 9 International Conference 'Interaction of radiation with solids' (20-22 September 2011) and covering the following topics: processes of interaction of radiation with solids, radiation effects in solids, interaction of plasma with the surface, modification of material properties, formation, structure and properties of coatings, equipment for radiation technologies. Addressed to researchers and students of natural science faculties.

  5. Interaction of radiation with solids. Proceedings of 11. International conference

    International Nuclear Information System (INIS)

    Anishchik, V.M.

    2015-09-01

    In the collection are the papers presented at the 11 International Conference 'Interaction of radiation with solids' (23-25 September 2015) and covering the following topics: processes of interaction of radiation and plasma with solids, radiation effects in solids, ray methods of formation of nanomaterials and nanostructures, modification of material properties, structure and properties of coatings, equipment for radiation technologies. Addressed to researchers and students of natural science faculties. (authors)

  6. New technologies in radiation therapy: ensuring patient safety, radiation safety and regulatory issues in radiation oncology.

    Science.gov (United States)

    Amols, Howard I

    2008-11-01

    New technologies such as intensity modulated and image guided radiation therapy, computer controlled linear accelerators, record and verify systems, electronic charts, and digital imaging have revolutionized radiation therapy over the past 10-15 y. Quality assurance (QA) as historically practiced and as recommended in reports such as American Association of Physicists in Medicine Task Groups 40 and 53 needs to be updated to address the increasing complexity and computerization of radiotherapy equipment, and the increased quantity of data defining a treatment plan and treatment delivery. While new technology has reduced the probability of many types of medical events, seeing new types of errors caused by improper use of new technology, communication failures between computers, corrupted or erroneous computer data files, and "software bugs" are now being seen. The increased use of computed tomography, magnetic resonance, and positron emission tomography imaging has become routine for many types of radiotherapy treatment planning, and QA for imaging modalities is beyond the expertise of most radiotherapy physicists. Errors in radiotherapy rarely result solely from hardware failures. More commonly they are a combination of computer and human errors. The increased use of radiosurgery, hypofractionation, more complex intensity modulated treatment plans, image guided radiation therapy, and increasing financial pressures to treat more patients in less time will continue to fuel this reliance on high technology and complex computer software. Clinical practitioners and regulatory agencies are beginning to realize that QA for new technologies is a major challenge and poses dangers different in nature than what are historically familiar.

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

    International Nuclear Information System (INIS)

    Tuddenham, W.J.

    1976-01-01

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

  8. Delivery of therapeutic radioisotopes using nanoparticle platforms: potential benefit in systemic radiation therapy.

    Science.gov (United States)

    Zhang, Longjiang; Chen, Hongwei; Wang, Liya; Liu, Tian; Yeh, Julie; Lu, Guangming; Yang, Lily; Mao, Hui

    2010-12-03

    Radiation therapy is an effective cancer treatment option in conjunction with chemotherapy and surgery. Emerging individualized internal and systemic radiation treatment promises significant improvement in efficacy and reduction of normal tissue damage; however, it requires cancer cell targeting platforms for efficient delivery of radiation sources. With recent advances in nanoscience and nanotechnology, there is great interest in developing nanomaterials as multifunctional carriers to deliver therapeutic radioisotopes for tumor targeted radiation therapy, to monitor their delivery and tumor response to the treatment. This paper provides an overview on developing nanoparticles for carrying and delivering therapeutic radioisotopes for systemic radiation treatment. Topics discussed in the review include: selecting nanoparticles and radiotherapy isotopes, strategies for targeting nanoparticles to cancers, together with challenges and potential solutions for the in vivo delivery of nanoparticles. Some examples of using nanoparticle platforms for the delivery of therapeutic radioisotopes in preclinical studies of cancer treatment are also presented.

  9. Delivery of therapeutic radioisotopes using nanoparticle platforms: potential benefit in systemic radiation therapy

    Science.gov (United States)

    Zhang, Longjiang; Chen, Hongwei; Wang, Liya; Liu, Tian; Yeh, Julie; Lu, Guangming; Yang, Lily; Mao, Hui

    2010-01-01

    Radiation therapy is an effective cancer treatment option in conjunction with chemotherapy and surgery. Emerging individualized internal and systemic radiation treatment promises significant improvement in efficacy and reduction of normal tissue damage; however, it requires cancer cell targeting platforms for efficient delivery of radiation sources. With recent advances in nanoscience and nanotechnology, there is great interest in developing nanomaterials as multifunctional carriers to deliver therapeutic radioisotopes for tumor targeted radiation therapy, to monitor their delivery and tumor response to the treatment. This paper provides an overview on developing nanoparticles for carrying and delivering therapeutic radioisotopes for systemic radiation treatment. Topics discussed in the review include: selecting nanoparticles and radiotherapy isotopes, strategies for targeting nanoparticles to cancers, together with challenges and potential solutions for the in vivo delivery of nanoparticles. Some examples of using nanoparticle platforms for the delivery of therapeutic radioisotopes in preclinical studies of cancer treatment are also presented. PMID:24198480

  10. Optimal Radiation Therapy for Small Cell Lung Cancer.

    Science.gov (United States)

    Gensheimer, Michael F; Loo, Billy W

    2017-04-01

    Radiation therapy plays an important role in the management of both limited stage and extensive stage small cell lung cancer. For limited stage disease, there has been a trend toward reduced size of thoracic radiation fields, which has the potential to reduce toxicity. FDG-PET staging helps make this possible by more accurately identifying areas of nodal and metastatic involvement. Trials have demonstrated similar outcomes using a range of radiation fractionation schedules, allowing flexibility in individualizing treatment. Using advanced radiation therapy techniques such as intensity-modulated radiation therapy, it may be possible to deliver fewer, higher dose fractions and achieve similar results to the hyperfractionated regimen. For extensive stage disease, consolidative thoracic radiation therapy after chemotherapy was recently shown to improve overall survival in certain patient subsets. Prophylactic cranial irradiation continues to play an important role in management of all stages of small cell lung cancer. Debate continues about the neurocognitive effects of this treatment, and whether MRI surveillance is an acceptable alternative. Strategies such as hippocampal avoidance may reduce the cognitive effects of prophylactic cranial irradiation in the future. Finally, in the last few years stereotactic ablative radiation therapy followed by chemotherapy has emerged as a promising treatment for stage I small cell lung cancer. This radiation treatment is usually given over 1-5 fractions and appears to provide a good rate of local control with a low rate of serious toxicity.

  11. Target volumes in gastric cancer radiation therapy

    International Nuclear Information System (INIS)

    Caudry, M.; Maire, J.P.; Ratoanina, J.L.; Escarmant, P.

    2001-01-01

    The spread of gastric adenocarcinoma may follow three main patterns: hemato-genic, lymphatic and intraperitoneal. A GTV should be considered in preoperative or exclusive radiation therapy. After non-radical surgery, a 'residual GTV' will be defined with the help of the surgeon. The CTV encompasses three intricated volumes. a) A 'tumor bed' volume. After radical surgery, local recurrences appear as frequent as distant metastases. The risk depends upon the depth of parietal invasion and the nodal status. Parietal infiltration may extend beyond macroscopic limits of the tumor, especially in dinitis plastica. Therefore this volume will include: the tumor and the remaining stomach or their 'bed of resection', a part of the transverse colon, the duodenum, the pancreas and the troncus of the portal vein. In postoperative RT, this CTV also includes the jejuno-gastric or jejuno-esophageal anastomosis. b) A peritoneal volume. For practical purposes, two degrees of spread must be considered: (1) contiguous microscopic extension from deeply invasive T3 and T4 tumors, that remain amenable to local sterilization with doses of 45-50 Gy, delivered in a CTV including the peritoneal cavity at the level of the gastric bed, and under the parietal incision; (2) true 'peritoneal carcinomatosis', with widespread seeds, where chemotherapy (systemic or intraperitoneal) is more appropriate. c) A lymphatic volume including the lymph node groups 1 to 16 of the Japanese classification. This volume must encompass the hepatic pedicle and the splenic hilum. In proximal tumors, it is possible to restrict the lover part of the CTV to the lymphatic volume, and therefore to avoid irradiation of large intestinal and renal volumes. In distal and proximal tumors, involvement of resection margins is of poor prognosis -a radiation boost must be delivered at this level. The CTV in tumors of the cardia should encompass the lover part of the thoracic esophagus and the corresponding posterior mediastinum. In

  12. Selective Internal Radiation Therapy (SIRT) with yttrium-90 resin microspheres plus standard systemic chemotherapy regimen of FOLFOX versus FOLFOX alone as first-line treatment of non-resectable liver metastases from colorectal cancer: the SIRFLOX study.

    Science.gov (United States)

    Gibbs, Peter; Gebski, Val; Van Buskirk, Mark; Thurston, Kenneth; Cade, David N; Van Hazel, Guy A

    2014-12-01

    In colorectal cancer (CRC), unresectable liver metastases are linked to poor prognosis. Systemic chemotherapy with regimens such as FOLFOX (combination of infusional 5-fluorouracil, leucovorin and oxaliplatin) is the standard first-line treatment. The SIRFLOX trial was designed to assess the efficacy and safety of combining FOLFOX-based chemotherapy with Selective Internal Radiation Therapy (SIRT or radioembolisation) using yttrium-90 resin microspheres (SIR-SpheresR; Sirtex Medical Limited, North Sydney, Australia). SIRFLOX is a randomised, multicentre trial of mFOLFOX6 chemotherapy+/-SIRT as first-line treatment of patients with liver-only or liver-predominant metastatic CRC (mCRC). The trial aims to recruit adult chemotherapy-naive patients with proven liver metastases with or without limited extra-hepatic disease, a life expectancy of >=3 months and a WHO performance status of 0-1. Patients will be randomised to receive either mFOLFOX6 or SIRT+mFOLFOX6 (with a reduced dose of oxaliplatin in cycles 1-3 following SIRT). Patients in both arms can receive bevacizumab at investigator discretion. Protocol chemotherapy will continue until there is unacceptable toxicity, evidence of tumour progression, complete surgical resection or ablation of cancerous lesions, or the patient requests an end to treatment. The primary endpoint of the SIRFLOX trial is progression-free survival (PFS). Secondary endpoints include: PFS in the liver; tumour response rate (liver and any site); site of tumour progression; health-related quality of life; toxicity and safety; liver resection rate; and overall survival. Assuming an increase in the median PFS from 9.4 months to 12.5 months with the addition of SIRT to mFOLFOX6, recruiting >=450 patients will be sufficient for 80% power and 95% confidence. The SIRFLOX trial will establish the potential role of SIRT+standard systemic chemotherapy in the first-line management of mCRC with non-resectable liver metastases. SIRFLOX Clinical

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

    Science.gov (United States)

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

    2016-09-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  15. NMR with Combined Antiangiogenic and Radiation Therapies - Breast Cancer

    National Research Council Canada - National Science Library

    Brown, Stephen

    2000-01-01

    The original goal of the present study was to determine optimal strategies for combining radiation and antiangiogenic therapies in spontaneous murine tumors and to evaluate the potential of Nuclear Magnetic Resonance (NMR...

  16. Automatic Organ Localization for Adaptive Radiation Therapy for Prostate Cancer

    National Research Council Canada - National Science Library

    Joshi, Sarang

    2004-01-01

    The focus of this study is adaptive radiation therapy (ART) for prostate cancer, in which the treatment is to be adjusted over time, based on CT images acquired on the treatment table before each daily treatment...

  17. Multiple Aperture Radiation Therapy (MART) for Breast Cancer

    National Research Council Canada - National Science Library

    Li, Tianfang

    2006-01-01

    .... In this USAMRMC-supported project, we have developed a multiple-aperture radiation therapy (MART) procedure dedicated to breast irradiation, which combines the planning simplicity of the conventional OFT with the superior dose distribution of IMRT methods...

  18. Review of the afterloading techniques in gynecologic radiation therapy

    International Nuclear Information System (INIS)

    Rotte, K.

    1975-01-01

    A review of clinically used afterloading techniques - remote controlled and manually operated ones - is given by tables. The advantages of afterloading techniques are discussed with regard to radiation protection as well as to the therapy of gynecologic carcinomas. (orig.) [de

  19. CART - a Scandinavian approach to computer aided radiation therapy

    International Nuclear Information System (INIS)

    Walstam, R.

    1987-01-01

    The CART project, a program of computer-aided radiation therapy developed as a joint venture by Scandinavian countries is described. The history is outlined and the individual areas of the CART program are listed. (L.O.). 3 refs

  20. 11th International Conference of Radiation Research

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-07-18

    Topics discussed in the conference included the following: Radiation Physics, Radiation Chemistry and modelling--Radiation physics and dosimetry; Electron transfer in biological media; Radiation chemistry; Biophysical and biochemical modelling; Mechanisms of DNA damage; Assays of DNA damage; Energy deposition in micro volumes; Photo-effects; Special techniques and technologies; Oxidative damage. Molecular and cellular effects-- Photobiology; Cell cycle effects; DNA damage: Strand breaks; DNA damage: Bases; DNA damage Non-targeted; DNA damage: other; Chromosome aberrations: clonal; Chromosomal aberrations: non-clonal; Interactions: Heat/Radiation/Drugs; Biochemical effects; Protein expression; Gene induction; Co-operative effects; ``Bystander'' effects; Oxidative stress effects; Recovery from radiation damage. DNA damage and repair -- DNA repair genes; DNA repair deficient diseases; DNA repair enzymology; Epigenetic effects on repair; and Ataxia and ATM.

  1. Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  2. Calcifications in mediastinal lymphoma after radiation therapy of Hodgkin's disease

    International Nuclear Information System (INIS)

    Frank, P.; Menges, V.

    1976-01-01

    One case of calcifications in mediastinal lymphoma after radiation therapy of Hodgkin's disease is reported. The incidence of these calcifications is remarkably low. They are mostly localized in the anterior mediastinum showing a characteristical pattern which is initially stippled, later confluent and coral-shaped. An open interval after radiation therapy is typical for this phenomenon. The cause of the calcifications is discussed. (orig.) [de

  3. The physical basis and future of radiation therapy

    OpenAIRE

    Bortfeld, T; Jeraj, R

    2011-01-01

    The remarkable progress in radiation therapy over the last century has been largely due to our ability to more effectively focus and deliver radiation to the tumour target volume. Physics discoveries and technology inventions have been an important driving force behind this progress. However, there is still plenty of room left for future improvements through physics, for example image guidance and four-dimensional motion management and particle therapy, as well as increased efficiency of more...

  4. Role of radiation therapy for 'juvenile' angiofibroma

    Energy Technology Data Exchange (ETDEWEB)

    Gudea, F.; Vega, M.; Canals, E.; Montserrat, J.M.; Valdano, J. (Univ. Autonoma de Barcelona (Spain). Hospital de la Santa Creu i Sant Pau (Spain))

    1990-09-01

    Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm which occurs primarily in male adolescents and is characterized by aggressive local growth. The controversy concerning appropriate treatment for patients with juvenile angiofibroma persists. Radiation therapy and survival resection have both been reported to be effective to control a high proportion of these tumours. The case reported here demonstrates a locally advanced JNA controlled by radiation therapy. (author).

  5. Intraarterial chemotherapy combined with radiation therapy for advanced cancer of uterine cervix

    International Nuclear Information System (INIS)

    Noguchi, Masato; Murata, Rumi; Sagoh, Tadashi

    1998-01-01

    The results of intraarterial chemotherapy (IA-CT) combined with definitive radiation therapy for 23 advanced and bulky carcinomas of uterine cervix are reported. IA-CT with cisplatin 50 mg and doxorubicin 30 mg was administered by one shot method in bilateral internal iliac arteries. The protocol consisted of one to three treatment sessions every 3 weeks. Nine of eleven patients with clinical stage III achieved a complete local response (82%), and the 3- and 5-year survival in these cases were 72% and 72%, respectively. These results were superior to the response (58%), 3- and 5-year survivals (68%, 58%) obtained in 19 patients treated mainly with radiation therapy alone. The side effect of grade 2 and 3 for the intestine, such as ileus and hemorrhagic colitis, was noted in 3 patients (15%). In addition, 3 of 8 patients with radical surgery and postoperative radiation therapy after IA-CT developed insufficient fracture of pelvic bone. These complications accompanied by IA-CT combined with radiation therapy and/or surgery increased slightly, compared with that by the previous therapy without IA-CT, but were not critical. The results suggest that IA-CT following radiation therapy is effective to improve the prognosis of patients with stage III cervical cancer. (author)

  6. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas

    Energy Technology Data Exchange (ETDEWEB)

    Gay, Hiram A., E-mail: hgay@radonc.wustl.edu [Washington University School of Medicine, St Louis, MO (United States); Barthold, H. Joseph [Commonwealth Hematology and Oncology, Weymouth, MA (United States); Beth Israel Deaconess Medical Center, Boston, MA (Israel); O' Meara, Elizabeth [Radiation Therapy Oncology Group, Philadelphia, PA (United States); Bosch, Walter R. [Washington University School of Medicine, St Louis, MO (United States); El Naqa, Issam [Department of Radiation Oncology, McGill University Health Center, Montreal, Quebec (Canada); Al-Lozi, Rawan [Washington University School of Medicine, St Louis, MO (United States); Rosenthal, Seth A. [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States); Lawton, Colleen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Lee, W. Robert [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Sandler, Howard [Cedars-Sinai Medical Center, Los Angeles, CA (United States); Zietman, Anthony [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Myerson, Robert [Washington University School of Medicine, St Louis, MO (United States); Dawson, Laura A. [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Willett, Christopher [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Kachnic, Lisa A. [Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA (United States); Jhingran, Anuja [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Portelance, Lorraine [University of Miami, Miami, FL (United States); Ryu, Janice [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States); and others

    2012-07-01

    Purpose: To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The following were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified. Results: The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, Adnexa{sub R}, Adnexa{sub L}, Prostate, SeminalVesc, PenileBulb, Femur{sub R}, and Femur{sub L}. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed. Conclusions: Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research.

  7. Comparison of split-course radiation therapy and continuous radiation therapy for unresectable bronchogenic carcinoma: 5 year results

    International Nuclear Information System (INIS)

    Lee, R.E.; Carr, D.T.; Childs, D.S. Jr.

    1976-01-01

    One hundred and eighty-eight patients with inoperable or unresectable bronchogenic carcinoma were stratified by cell type, TNM staging, and prior surgery and then randomized into two treatment groups: continuous radiation therapy and split-course radiation therapy. There was no difference in clinical or objective improvement in the two groups. Survival rates for cases of squamous cell carcinoma, small cell carcinoma, and adenocarcinoma were the same after both regimens of therapy. Split-course therapy resulted in a significantly better survival rate in cases of large cell carcinoma but the number of cases was small. We doubt that the difference is clinically significant. Objective roentgenographic response was accompanied by improved survival in squamous cell carcinoma, but not in the other three cell types. Split-course radiation therapy is superior to continuous radiation therapy because it is better tolerated by the patient and because re-examination of the patient prior to the second half of split-course therapy permits the detection of new metastatic disease that has become manifest during the rest period and spares the patient the futile second half of radiation therapy

  8. Cranial Radiation Therapy and Damage to Hippocampal Neurogenesis

    Science.gov (United States)

    Monje, Michelle

    2008-01-01

    Cranial radiation therapy is associated with a progressive decline in cognitive function, prominently memory function. Impairment of hippocampal neurogenesis is thought to be an important mechanism underlying this cognitive decline. Recent work has elucidated the mechanisms of radiation-induced failure of neurogenesis. Potential therapeutic…

  9. The Radiation Therapy Oncology in the context of oncological practice

    International Nuclear Information System (INIS)

    Kasdorf, P.

    2010-01-01

    This work is about the radiation therapy oncology in the context of oncological practice. The radiotherapy is a speciality within medicine that involves the generation, application and dissemination of knowledge about the biology, causes, prevention and treatment of the cancer and other pathologies by ionising radiation

  10. Coronary artery calcium in breast cancer survivors after radiation therapy

    NARCIS (Netherlands)

    Takx, Richard A P; Vliegenthart, Rozemarijn; Schoepf, U Joseph; Pilz, Lothar R; Schoenberg, Stefan O; Morris, Pamela B; Henzler, Thomas; Apfaltrer, Paul

    The purpose of the current study is to investigate whether breast cancer survivors after radiation therapy have a higher burden of coronary artery calcium as a potential surrogate of radiation-induced accelerated coronary artery disease. 333 patients were included. 54 patients underwent chest CT ae

  11. Development of a versatile algorithm for optimization of radiation therapy

    International Nuclear Information System (INIS)

    Gustafsson, Anders.

    1996-12-01

    A flexible iterative gradient algorithm for radiation therapy optimization has been developed. The algorithm is based on dose calculation using the pencil-beam description of external radiation beams in uniform and heterogeneous patients. The properties of the algorithm are described, including its ability to treat variable bounds and linear constraints, its efficiency in gradient calculation, its convergence properties and termination criteria. 116 refs

  12. Spinal metastases: multimodality imaging in diagnosis and stereotactic body radiation therapy planning.

    Science.gov (United States)

    Jabehdar Maralani, Pejman; Lo, Simon S; Redmond, Kristin; Soliman, Hany; Myrehaug, Sten; Husain, Zain A; Heyn, Chinthaka; Kapadia, Anish; Chan, Aimee; Sahgal, Arjun

    2017-01-01

    Due to increased effectiveness of cancer treatments and increasing survival rates, metastatic disease has become more frequent compared to the past, with the spine being the most common site of bony metastases. Diagnostic imaging is an integral part of screening, diagnosis and follow-up of spinal metastases. In this article, we review the principles of multimodality imaging for tumor detection with respect to their value for diagnosis and stereotactic body radiation therapy planning for spinal metastases. We will also review the current international consensus agreement for stereotactic body radiation therapy planning, and the role of imaging in achieving the best possible treatment plan.

  13. History of International Workshop on Mini-Micro- and Nano- Dosimetry (MMND) and Innovation Technologies in Radiation Oncology (ITRO)

    Science.gov (United States)

    Rosenfeld, Anatoly B.; Zaider, Marco; Yamada, Josh; Zelefsky, Michael J.

    2017-01-01

    The biannual MMND (former MMD) - IPCT workshops was founded in collaboration between the Centre for Medical Radiation Physics, University of Wollongong and the Memorial Sloan Kettering Cancer Center (MSKCC) in 2001 and has become an important international multidisciplinary forum for the discussion of advanced quality assurance (QA) dosimetry technology for radiation therapy and space science, as well as advanced technologies for clinical cancer treatment.

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

    Science.gov (United States)

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

    2010-01-01

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

  15. Predictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer

    OpenAIRE

    Zhao, Yaqin; Chen, Lu; Zhang, Shu; Wu, Qiang; Jiang, Xiaoqin; Zhu, Hong; Wang, Jin; Li, Zhiping; Xu, Yong; Zhang, Ying Jie; Bai, Sen; Xu, Feng

    2015-01-01

    Background Radiation pneumonitis (RP) is a common side reaction in radiotherapy for esophageal cancer. There are few reports about RP in esophageal cancer patients receiving postoperative intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). This study aims to analyze clinical or dosimetric factors associated with RP, and provides data for radiotherapy planning. Methods We reviewed 68 postoperative esophageal cancer patients who were treated with radiothera...

  16. Prototype demonstration of radiation therapy planning code system

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  17. Prototype demonstration of radiation therapy planning code system

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-09-01

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

  18. Anesthesia for pediatric external beam radiation therapy

    International Nuclear Information System (INIS)

    Fortney, Jennifer T.; Halperin, Edward C.; Hertz, Caryn M.; Schulman, Scott R.

    1999-01-01

    Background: For very young patients, anesthesia is often required for radiotherapy. This results in multiple exposures to anesthetic agents over a short period of time. We report a consecutive series of children anesthetized for external beam radiation therapy (EBRT). Methods: Five hundred twelve children ≤ 16 years old received EBRT from January 1983 to February 1996. Patient demographics, diagnosis, anesthesia techniques, monitoring, airway management, complications, and outcome were recorded for the patients requiring anesthesia. Results: One hundred twenty-three of the 512 children (24%) required 141 courses of EBRT with anesthesia. Anesthetized patients ranged in age from 20 days to 11 years (mean 2.6 ± 1.8 ). The frequency of a child receiving EBRT and requiring anesthesia by age cohort was: ≤ 1 year (96%), 1-2 years (93%), 2-3 years (80%), 3-4 years (51%), 4-5 years (36%), 5-6 years (13%), 6-7 years (11%), and 7-16 years (0.7%). Diagnoses included: primary CNS tumor (28%), retinoblastoma (27%), neuroblastoma (20%), acute leukemia (9%), rhabdomyosarcoma (6%), and Wilms' tumor (4%). Sixty-three percent of the patients had been exposed to chemotherapy prior to EBRT. The mean number of anesthesia sessions per patient was 22 ± 16. Seventy-eight percent of the treatment courses were once daily and 22% were twice daily. Anesthesia techniques included: short-acting barbiturate induction + inhalation maintenance (21%), inhalation only (20%), ketamine (19%), propofol only (12%), propofol induction + inhalation maintenance (7%), ketamine induction + inhalation maintenance (6%), ketamine or short-acting barbiturate induction + inhalation maintenance (6%). Monitoring techniques included: EKG (95%), O 2 saturation (93%), fraction of inspired O 2 (57%), and end-tidal CO 2 (55%). Sixty-four percent of patients had central venous access. Eleven of the 74 children with a central line developed sepsis (15%): 6 of the 11 were anesthetized with propofol (55%), 4 with a

  19. Quantitative assessment of global lung inflammation following radiation therapy using FDG PET/CT: a pilot study

    International Nuclear Information System (INIS)

    Abdulla, Sarah; Salavati, Ali; Saboury, Babak; Torigian, Drew A.; Basu, Sandip; Alavi, Abass

    2014-01-01

    Radiation pneumonitis is the most severe dose-limiting complication in patients receiving thoracic radiation therapy. The aim of this study was to quantify global lung inflammation following radiation therapy using FDG PET/CT. We studied 20 subjects with stage III non-small-cell lung carcinoma who had undergone FDG PET/CT imaging before and after radiation therapy. On all PET/CT studies, the sectional lung volume (sLV) of each lung was calculated from each slice by multiplying the lung area by slice thickness. The sectional lung glycolysis (sLG) was calculated by multiplying the sLV and the lung sectional mean standardized uptake value (sSUVmean) on each slice passing through the lung. The lung volume (LV) was calculated by adding all sLVs from the lung, and the global lung glycolysis (GLG) was calculated by adding all sLGs from the lung. Finally, the lung SUVmean was calculated by dividing the GLG by the LV. The amount of inflammation in the lung parenchyma directly receiving radiation therapy was calculated by subtracting tumor measurements from GLG. In the lung directly receiving radiation therapy, the lung parenchyma SUVmean and global lung parenchymal glycolysis were significantly increased following therapy. In the contralateral lung (internal control), no significant changes were observed in lung SUVmean or GLG following radiation therapy. Global lung parenchymal glycolysis and lung parenchymal SUVmean may serve as potentially useful biomarkers to quantify lung inflammation on FDG PET/CT following thoracic radiation therapy. (orig.)

  20. Development of medical application methods using radiation. Radionuclide therapy

    International Nuclear Information System (INIS)

    Choi, Chang Woon; Lim, S. M.; Kim, E.H.; Woo, K. S.; Chung, W. S.; Lim, S. J.; Choi, T. H.; Hong, S. W.; Chung, H. Y.; No, W. C.; Oh, B. H.; Hong, H. J.

    1999-04-01

    In this project, we studied following subjects: 1. development of monoclonal antibodies and radiopharmaceuticals 2. clinical applications of radionuclide therapy 3. radioimmunoguided surgery 4. prevention of restenosis with intracoronary radiation. The results can be applied for the following objectives: 1) radionuclide therapy will be applied in clinical practice to treat the cancer patients or other diseases in multi-center trial. 2) The newly developed monoclonal antibodies and biomolecules can be used in biology, chemistry or other basic life science research. 3) The new methods for the analysis of therapeutic effects, such as dosimetry, and quantitative analysis methods of radioactivity, can be applied in basic research, such as radiation oncology and radiation biology

  1. Development of medical application methods using radiation. Radionuclide therapy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Chang Woon; Lim, S. M.; Kim, E.H.; Woo, K. S.; Chung, W. S.; Lim, S. J.; Choi, T. H.; Hong, S. W.; Chung, H. Y.; No, W. C. [Korea Atomic Energy Research Institute. Korea Cancer Center Hospital, Seoul, (Korea, Republic of); Oh, B. H. [Seoul National University. Hospital, Seoul (Korea, Republic of); Hong, H. J. [Antibody Engineering Research Unit, Taejon (Korea, Republic of)

    1999-04-01

    In this project, we studied following subjects: 1. development of monoclonal antibodies and radiopharmaceuticals 2. clinical applications of radionuclide therapy 3. radioimmunoguided surgery 4. prevention of restenosis with intracoronary radiation. The results can be applied for the following objectives: (1) radionuclide therapy will be applied in clinical practice to treat the cancer patients or other diseases in multi-center trial. (2) The newly developed monoclonal antibodies and biomolecules can be used in biology, chemistry or other basic life science research. (3) The new methods for the analysis of therapeutic effects, such as dosimetry, and quantitative analysis methods of radioactivity, can be applied in basic research, such as radiation oncology and radiation biology.

  2. Radiation therapy for primary spinal cord tumors in adults

    International Nuclear Information System (INIS)

    Jeremic, B.; Grujicic, D.; Jovanovic, D.; Djuric, L.; Mijatovic, L.

    1990-01-01

    This paper evaluates the role of radiation therapy in management of primary spinal cord tumors in adults. Records of 21 patients with primary spinal cord tumors treated with radiation therapy after surgery were retrospectively reviewed. Histologic examination showed two diffuse and 10 localized ependymomas, six low-grade gliomas, and three malignant gliomas. Surgery consisted of gross tumor resection in six patients, subtotal resection in three patients, and biopsy in 12 patients. Three patients also received chemotherapy. Radiation dose range from 45 to 55 Cy

  3. The pitfalls of dosimetric commissioning for intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    Tohyama, Naoki; Kodama, Takashi; Hatano, K.

    2013-01-01

    Intensity modulated radiation therapy (IMRT) allows higher radiation dose to be focused to the target volumes while minimizing the dose to OAR. To start of clinical treatment in IMRTvwe must perform commissioning strictly than 3D-conformal radiotherapy (CRT). In this report, pitfalls of dosimetric commissioning for intensity modulated radiation therapy were reviewed. Multileaf collimator (MLC) offsets and MLC transmissions are important parameters in commissioning of RTPS for IMRT. Correction of depth scaling and fluence scaling is necessary for dose measurement using solid phantom. (author)

  4. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical charged-particle radiation therapy system...-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system...) intended for use in radiation therapy. This generic type of device may include signal analysis and display...

  5. Intensity Modulated Radiation Therapy. Development of the technique

    International Nuclear Information System (INIS)

    Rafailovici, L.; Alva, R.; Chiozza, J.; Donato, H.; Falomo, S.; Cardiello, C.; Furia, O.; Martinez, A.; Filomia, M.L.; Sansogne, R.; Arbiser, S.; Dosoretz, B.

    2008-01-01

    Full text: Introduction: Intensity Modulated Radiation Therapy (IMRT) is a result of advances in computer sciences that allowed the development of new technology related to planning and radiation therapy. IMRT was developed to homogenize the dose in the target volumes and decrease the dose in the surrounding healthy tissue. Using a software with high calculation capacity a simultaneous irradiation with different doses in a given volume is achieved. IMRT is based on internal planning. Material and methods: 628 patients were treated with IMRT in prostate lesions, head and neck, breast, thorax, abdomen and brain since August 2008. The software for IMRT is the XIO CMS and the accelerator used is a Varian Clinac 6 / 100. IMRT requires a first simulation, where immobilization systems are selected (mats, thermoplastic masks, among others) and the demarcation of the target structures, healthy tissue and dose prescription by a tattoo. Images of CT / MRI are merged when necessary. Once the system made the treatment optimization, this one is regulated by modulators. These are produced by numerical control machines from digital files produced by software. In a second modulation the planned irradiation is checked and tattoo is carried out according with this. We have a strict process of quality assurance to assess the viability of the plan before its implementation. We use the Map Check it possible to compare the dose on the central axis and the distribution in the whole plane regarding to that generated by the planning system. From 03/2008 the virtual simulation process was implemented integrating the described stages. Results and Conclusions: IMRT is a complex technique. The meticulous planning, implementation of process and quality control allows the use of this technique in a reliable and secure way. With IMRT we achieved a high level of dose conformation, less irradiation of healthy tissue, lower rates of complications and the dose escalation for some tumors. (authors) [es

  6. Stage III thymoma: results of postoperative radiation therapy

    International Nuclear Information System (INIS)

    Krueger, J.B.; Sagerman, R.H.; King, G.A.

    1988-01-01

    The results of postoperative radiation therapy in 12 patients with stage III thymoma treated during 1966-1986 were reviewed. Surgical therapy consisted of total resection in one, subtotal resection in seven, and biopsy only in four. Megavoltage irradiation in the dose range of 3,000-5,600 cGy was employed, with nine patients receiving a dose of at least 5,000 cGy. The local control rate was 67%. The actuarial observed and adjusted 5-year survival rates were 57% and 75%, respectively. These results indicate that postoperative radiation therapy is an effective therapeutic modality in the control of stage III thymoma

  7. Radiation-Induced Second Cancer Risk Estimates From Radionuclide Therapy

    Science.gov (United States)

    Bednarz, Bryan; Besemer, Abigail

    2017-09-01

    The use of radionuclide therapy in the clinical setting is expected to increase significantly over the next decade. There is an important need to understand the radiation-induced second cancer risk associated with these procedures. In this study the radiation-induced cancer risk in five radionuclide therapy patients was investigated. These patients underwent serial SPECT imaging scans following injection as part of a clinical trial testing the efficacy of a 131Iodine-labeled radiopharmaceutical. Using these datasets the committed absorbed doses to multiple sensitive structures were calculated using RAPID, which is a novel Monte Carlo-based 3D dosimetry platform developed for personalized dosimetry. The excess relative risk (ERR) for radiation-induced cancer in these structures was then derived from these dose estimates following the recommendations set forth in the BEIR VII report. The radiation-induced leukemia ERR was highest among all sites considered reaching a maximum value of approximately 4.5. The radiation-induced cancer risk in the kidneys, liver and spleen ranged between 0.3 and 1.3. The lifetime attributable risks (LARs) were also calculated, which ranged from 30 to 1700 cancers per 100,000 persons and were highest for leukemia and the liver for both males and females followed by radiation-induced spleen and kidney cancer. The risks associated with radionuclide therapy are similar to the risk associated with external beam radiation therapy.

  8. Radiation and society: Comprehending radiation risk. V. 3. Proceedings of an international conference

    International Nuclear Information System (INIS)

    1997-01-01

    This IAEA international conference on Radiation and Society was the first major international meeting devoted to the comprehension of radiation risk, public attitude towards radiation risk and hazards encountered by the general public in contaminated areas. Volume three of the proceedings contains the speeches, ten introductory papers, summaries of the technical discussion sessions, the key note paper on uncertainties in the health impact of environmental pollutants. Refs, figs, tabs

  9. Radiation Therapy for Neovascular Age-related Macular Degeneration

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-03-01

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

  10. International cooperation in the field of radiation application

    International Nuclear Information System (INIS)

    Sato, Shoichi

    1993-01-01

    Bilateral and multilateral research cooperations have been implemented at TRCRE, JAERI, producing favourable results in the field of radiation application. Frameworks and some achievements are described and the significance of the international cooperation is discussed. (Author)

  11. Radiation dosimetry onboard the International Space Station ISS

    International Nuclear Information System (INIS)

    Berger, Thomas

    2008-01-01

    Besides the effects of the microgravity environment, and the psychological and psychosocial problems encountered in confined spaces, radiation is the main health detriment for long duration human space missions. The radiation environment encountered in space differs in nature front that on earth, consisting mostly of high energetic ions from protons up to iron, resulting in radiation levels far exceeding the ones encountered on earth for occupational radiation workers. Therefore the determination and the control of the radiation load on astronauts is a moral obligation of the space faring nations. The requirements for radiation detectors in space are very different to that on earth. Limitations in mass, power consumption and the complex nature of the space radiation environment define and limit the overall construction of radiation detectors. Radiation dosimetry onboard the International Space Station (ISS) is accomplished to one part as ''operational'' dosimetry aiming for area monitoring of the radiation environment as well as astronaut surveillance. Another part focuses on ''scientific'' dosimetry aiming for a better understanding of the radiation environment and its constitutes. Various research activities for a more detailed quantification of the radiation environment as well as its distribution in and outside the space station have been accomplished in the last years onboard the ISS. The paper will focus on the current radiation detectors onboard the ISS, their results, as well as on future planned activities. (orig.)

  12. A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT)

    International Nuclear Information System (INIS)

    Ding, Xuanfeng; Dionisi, Francesco; Tang, Shikui; Ingram, Mark; Hung, Chun-Yu; Prionas, Evangelos; Lichtenwalner, Phil; Butterwick, Ian; Zhai, Huifang; Yin, Lingshu; Lin, Haibo; Kassaee, Alireza; Avery, Stephen

    2014-01-01

    With traditional photon therapy to treat large postoperative pancreatic target volume, it often leads to poor tolerance of the therapy delivered and may contribute to interrupted treatment course. This study was performed to evaluate the potential advantage of using passive-scattering (PS) and modulated-scanning (MS) proton therapy (PT) to reduce normal tissue exposure in postoperative pancreatic cancer treatment. A total of 11 patients with postoperative pancreatic cancer who had been previously treated with PS PT in University of Pennsylvania Roberts Proton Therapy Center from 2010 to 2013 were identified. The clinical target volume (CTV) includes the pancreatic tumor bed as well as the adjacent high-risk nodal areas. Internal (iCTV) was generated from 4-dimensional (4D) computed tomography (CT), taking into account target motion from breathing cycle. Three-field and 4-field 3D conformal radiation therapy (3DCRT), 5-field intensity-modulated radiation therapy, 2-arc volumetric-modulated radiation therapy, and 2-field PS and MS PT were created on the patients’ average CT. All the plans delivered 50.4 Gy to the planning target volume (PTV). Overall, 98% of PTV was covered by 95% of the prescription dose and 99% of iCTV received 98% prescription dose. The results show that all the proton plans offer significant lower doses to the left kidney (mean and V 18 Gy ), stomach (mean and V 20 Gy ), and cord (maximum dose) compared with all the photon plans, except 3-field 3DCRT in cord maximum dose. In addition, MS PT also provides lower doses to the right kidney (mean and V 18 Gy ), liver (mean dose), total bowel (V 20 Gy and mean dose), and small bowel (V 15 Gy absolute volume ratio) compared with all the photon plans and PS PT. The dosimetric advantage of PT points to the possibility of treating tumor bed and comprehensive nodal areas while providing a more tolerable treatment course that could be used for dose escalation and combining with radiosensitizing

  13. A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT)

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Xuanfeng; Dionisi, Francesco; Tang, Shikui; Ingram, Mark; Hung, Chun-Yu; Prionas, Evangelos; Lichtenwalner, Phil; Butterwick, Ian; Zhai, Huifang; Yin, Lingshu; Lin, Haibo; Kassaee, Alireza; Avery, Stephen, E-mail: stephen.avery@uphs.upenn.edu

    2014-07-01

    With traditional photon therapy to treat large postoperative pancreatic target volume, it often leads to poor tolerance of the therapy delivered and may contribute to interrupted treatment course. This study was performed to evaluate the potential advantage of using passive-scattering (PS) and modulated-scanning (MS) proton therapy (PT) to reduce normal tissue exposure in postoperative pancreatic cancer treatment. A total of 11 patients with postoperative pancreatic cancer who had been previously treated with PS PT in University of Pennsylvania Roberts Proton Therapy Center from 2010 to 2013 were identified. The clinical target volume (CTV) includes the pancreatic tumor bed as well as the adjacent high-risk nodal areas. Internal (iCTV) was generated from 4-dimensional (4D) computed tomography (CT), taking into account target motion from breathing cycle. Three-field and 4-field 3D conformal radiation therapy (3DCRT), 5-field intensity-modulated radiation therapy, 2-arc volumetric-modulated radiation therapy, and 2-field PS and MS PT were created on the patients’ average CT. All the plans delivered 50.4 Gy to the planning target volume (PTV). Overall, 98% of PTV was covered by 95% of the prescription dose and 99% of iCTV received 98% prescription dose. The results show that all the proton plans offer significant lower doses to the left kidney (mean and V{sub 18} {sub Gy}), stomach (mean and V{sub 20} {sub Gy}), and cord (maximum dose) compared with all the photon plans, except 3-field 3DCRT in cord maximum dose. In addition, MS PT also provides lower doses to the right kidney (mean and V{sub 18} {sub Gy}), liver (mean dose), total bowel (V{sub 20} {sub Gy} and mean dose), and small bowel (V{sub 15} {sub Gy} absolute volume ratio) compared with all the photon plans and PS PT. The dosimetric advantage of PT points to the possibility of treating tumor bed and comprehensive nodal areas while providing a more tolerable treatment course that could be used for dose

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  15. A phase II trial for the optimisation of treatment position in the radiation therapy of prostate cancer

    DEFF Research Database (Denmark)

    O'Neill, L.; Armstrong, J.; Buckney, S.

    2008-01-01

    Background: Patient immobilisation and position are important contributors to the reproducibility and accuracy of radiation therapy. In addition the choice of position can alter the external contour of the treated area and has the potential to alter the spatial relationship between internal organs....... The published literature demonstrates variation in the use of the prone and supine position for prostate cancer radiation therapy. Previous investigators using different protocols for patient preparation, imaging and target volume definition have demonstrated changes in the calculated therapeutic ratio...

  16. Protocol for Combined Analysis of FOXFIRE, SIRFLOX, and FOXFIRE-Global Randomized Phase III Trials of Chemotherapy +/- Selective Internal Radiation Therapy as First-Line Treatment for Patients With Metastatic Colorectal Cancer.

    Science.gov (United States)

    Virdee, Pradeep S; Moschandreas, Joanna; Gebski, Val; Love, Sharon B; Francis, E Anne; Wasan, Harpreet S; van Hazel, Guy; Gibbs, Peter; Sharma, Ricky A

    2017-03-28

    In colorectal cancer (CRC), unresectable liver metastases are associated with a poor prognosis. The FOXFIRE (an open-label randomized phase III trial of 5-fluorouracil, oxaliplatin, and folinic acid +/- interventional radioembolization as first-line treatment for patients with unresectable liver-only or liver-predominant metastatic colorectal cancer), SIRFLOX (randomized comparative study of FOLFOX6m plus SIR-Spheres microspheres versus FOLFOX6m alone as first-line treatment in patients with nonresectable liver metastases from primary colorectal carcinoma), and FOXFIRE-Global (assessment of overall survival of FOLFOX6m plus SIR-Spheres microspheres versus FOLFOX6m alone as first-line treatment in patients with nonresectable liver metastases from primary colorectal carcinoma in a randomized clinical study) clinical trials were designed to evaluate the efficacy and safety of combining first-line chemotherapy with selective internal radiation therapy (SIRT) using yttrium-90 resin microspheres, also called transarterial radioembolization. The aim of this analysis is to prospectively combine clinical data from 3 trials to allow adequate power to evaluate the impact of chemotherapy with SIRT on overall survival. Eligible patients are adults with histologically confirmed CRC and unequivocal evidence of liver metastases which are not treatable by surgical resection or local ablation with curative intent at the time of study entry. Patients may also have limited extrahepatic metastases. Final analysis will take place when all participants have been followed up for a minimum of 2 years. Efficacy and safety estimates derived using individual participant data (IPD) from SIRFLOX, FOXFIRE, and FOXFIRE-Global will be pooled using 2-stage prospective meta-analysis. Secondary outcome measures include progression-free survival (PFS), liver-specific PFS, health-related quality of life, response rate, resection rate, and adverse event profile. The large study population will

  17. Technical aspects of image-guided respiration-gated radiation therapy

    International Nuclear Information System (INIS)

    Jiang, Steve B.

    2006-01-01

    In this review article, we discuss various technical aspects of image-guided respiration-gated radiation therapy. We first review some basic concepts related to respiratory gating, including gating window, duty cycle, residual motion, internal/external gating, amplitude/phase gating, etc. We then discuss 2 implementations of image-guided respiration-gated treatment, i.e., the Mitsubishi/Hokkaido technique for internal gating and the MGH technique for external gating. Several existing problems related to respiratory gating, namely external gating mode (phase vs. amplitude), imaging dose for internal gating, gated treatment for lung cancer without implanted fiducial makers, as well as gated intensity-modulated radiation therapy issues, are also discussed along with potential solutions

  18. Oxygenation of spontaneous canine tumors during fractionated radiation therapy

    International Nuclear Information System (INIS)

    Achermann, R.E.; Ohlerth, S.M.; Bley, C.R.; Inteeworn, N.; Schaerz, M.; Wergin, M.C.; Kaser-Hotz, B.; Gassmann, M.; Roos, M.

    2004-01-01

    Background and purpose: tumor oxygenation predicts treatment outcome, and reoxygenation is considered important in the efficacy of fractionated radiation therapy. Therefore, the purpose of this study was to document the changes of the oxygenation status in spontaneous canine tumors during fractionated radiation therapy using polarographic needle electrodes. Material and methods: tumor oxygen partial pressure (pO 2 ) measurements were performed with the eppendorf-pO 2 -Histograph. The measurements were done under general anesthesia, and probe tracks were guided with ultrasound. pO 2 was measured before radiation therapy in all dogs. In patients treated with curative intent, measurements were done sequentially up to eight times (total dose: 45-59.5 Gy). Oxygenation status of the palliative patient group was examined before each fraction of radiation therapy up to five times (total dose: 24-30 Gy). Results: 15/26 tumors had a pretreatment median pO 2 ≤ 10 mmHg. The pO 2 values appeared to be quite variable in individual tumors during fractionated radiation therapy. The pO 2 of initially hypoxic tumors (pretreatment median pO 2 ≤ 10 mmHg) remained unchanged during fractionated radiotherapy, whereas in initially normoxic tumors the pO 2 decreased. Conclusion: hypoxia is common in spontaneous canine tumors, as 57.7% of the recorded values were ≥ 10 mmHg. The data of this study showed that initially hypoxic tumors remained hypoxic, whereas normoxic tumors became more hypoxic. (orig.)

  19. Technological progress in radiation therapy for brain tumors

    LENUS (Irish Health Repository)

    Vernimmen, Frederik Jozef

    2014-01-01

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

  20. Gluteus Maximus Turnover Flap for Sacral Osteomyelitis After Radiation Therapy.

    Science.gov (United States)

    Ishiwata, Sho; Yanagawa, Takashi; Saito, Kenichi; Takagishi, Kenji

    2015-07-01

    Developments in radiation therapy modalities offer alternative treatments for unresectable malignant tumors in the pelvis and trunk. However, poor vascularity as a result of radiation therapy makes the treated lesion susceptible to infection, and there are no established treatments for pelvic osteomyelitis with a large dead space after radiation therapy. The authors report 2 cases of sacral osteomyelitis after radiation therapy that were treated successfully with a gluteus maximus turnover flap. To create the flap, the distal portion of the lower third of the muscle was detached from the trochanter. The distal edge of the flap was turned toward the sacral defect and sewn to the remnant of the sacrum, which filled the dead space with the muscle bulk. A 68-year-old man with a recurrent sacral chordoma was treated with carbon ion radiation therapy; however, a sacral infection developed 5 months later. Debridement and a course of antibiotics could not control the infection and did not induce sufficient formation of granulation tissue in the large and deep dead space. The turnover flap with both gluteus maximus muscles cured the deep-seated infection and closed the wound. A 58-year-old woman had sacral osteoradionecrosis with infection. A turnover flap created with the left gluteus maximus muscle controlled the infection and closed the wound after the first operation, a V-Y flap, failed. This study showed that a gluteus maximus muscle turnover flap effectively controlled infectious lesions with large and deep dead space around the sacrum. Copyright 2015, SLACK Incorporated.

  1. Alterations of nutritional status: impact of chemotherapy and radiation therapy

    International Nuclear Information System (INIS)

    Donaldson, S.S.; Lenon, R.A.

    1979-01-01

    The nutritional status of a cancer patient may be affected by the tumor, the chemotherapy and/or radiation therapy directed against the tumor, and by complications associated with that therapy. Chemotherpay-radiotherapy is not confined exclusively to malignant cell populations; thus, normal tissues may also be affected by the therapy and may contribute to specific nutritional problems. Impaired nutrition due to anorexia, mucositis, nausea, vomiting, and diarrhea may be dependent upon the specific chemotherapeutic agent, dose, or schedule utilized. Similar side effects from radiation therapy depend upon the dose, fractionation, and volume irradiated. When combined modality treatment is given the nutritional consequences may be magnified. Prospective, randomized clinical trials are underway to investigate the efficacy of nutritional support during chemotherapy-radiotherapy on tolerance to treatment, complications from treatment, and response rates to treatment. Preliminary results demonstrate that the administration of total parenteral nutrition is successful in maintaining weight during radiation therapy and chemotherapy, but that weight loss occurs after discontinuation of nutritional support. Thus, longterm evaluation is mandatory to learn the impact of nutritional support on survival, diease-free survival, and complication rates, as well as on the possible prevention of morbidity associated with aggressive chemotherapy-radiation therapy

  2. Exposure of the Heart in Breast Cancer Radiation Therapy: A Systematic Review of Heart Doses Published During 2003 to 2013.

    Science.gov (United States)

    Taylor, Carolyn W; Wang, Zhe; Macaulay, Elizabeth; Jagsi, Reshma; Duane, Frances; Darby, Sarah C

    2015-11-15

    Breast cancer radiation therapy cures many women, but where the heart is exposed, it can cause heart disease. We report a systematic review of heart doses from breast cancer radiation therapy that were published during 2003 to 2013. Eligible studies were those reporting whole-heart dose (ie, dose averaged over the whole heart). Analyses considered the arithmetic mean of the whole-heart doses for the CT plans for each regimen in each study. We termed this "mean heart dose." In left-sided breast cancer, mean heart dose averaged over all 398 regimens reported in 149 studies from 28 countries was 5.4 Gy (range, internal mammary chain (IMC), average mean heart dose was 4.2 Gy and varied with the target tissues irradiated. The lowest average mean heart doses were from tangential radiation therapy with either breathing control (1.3 Gy; range, 0.4-2.5 Gy) or treatment in the lateral decubitus position (1.2 Gy; range, 0.8-1.7 Gy), or from proton radiation therapy (0.5 Gy; range, 0.1-0.8 Gy). For intensity modulated radiation therapy mean heart dose was 5.6 Gy (range, radiation therapy delivered the lowest average mean heart dose (2.6 Gy, range, 1.0-6.0 Gy), and tangential radiation therapy with a separate IMC field the highest (9.2 Gy, range, 1.9-21.0 Gy). In right-sided breast cancer, the average mean heart dose was 3.3 Gy based on 45 regimens in 23 studies. Recent estimates of typical heart doses from left breast cancer radiation therapy vary widely between studies, even for apparently similar regimens. Maneuvers to reduce heart dose in left tangential radiation therapy were successful. Proton radiation therapy delivered the lo