International Journal of Cancer Therapy and Oncology
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Impact of head immobilization position on dose distribution in patients of brainstem glioma
Get PDFPurpose: The purpose of this study is to investigate the impact of patient position (supine and prone) on conventional bilateral field, three dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) treatment plans in patients of brainstem glioma with a view to exploring the possibility of avoiding beam entry through immobilization accessories. Methods: Five patients of brainstem glioma were immobilized and scanned in supine and prone positions with a combination of head rest and thermoplastic cast. Each patient was planned with three techniques: (i) 2-fields bilateral (ii) 3-fields 3DCRT, and (iii) 5-fields IMRT. Plan quality was analyzed in terms of planning target volume (PTV) coverage and dose to various critical organs at risk (OAR) for both the supine and prone treatment positions. Results: In case of bilateral fields (parallel opposed) planning, the PTV coverage and dose to the OAR were almost similar for both the supine and prone positions. In 3DCRT plan, although the PTV coverage and dose to critical structures were comparable for both the supine and prone position, dose to cochlea was lower for the prone position plan. A modest decrease in maximum dose to optic nerves and mean dose to temporal lobes were also observed for the prone position plan. In IMRT plans, the PTV coverage and homogeneity were comparable in both the supine and prone positions. Reduction in average maximum and mean doses to all OARs with functional subunit (FSU) in series and parallel respectively was observed in the IMRT plan for prone position when compared to the supine position.Conclusion: Supine and prone positions resulted in almost similar dose distribution in all the three techniques applied. At some instances, the prone position showed better normal tissues sparing when compared to supine. Moreover, prone position is more likely to avoid attenuation due to immobilization devices and uncertainty in dose calculation under large inhomogeneities
Xanthogranulomatous Colitis masquerading as carcinoma of colon
Get PDFXanthogranulomatous inflammation (XGI) is an uncommon pathological diagnosis involving various organ systems, the most common being the gall bladder and kidney. It can masquerade as a malignant mass thus, requiring a clinical suspicion for accurate and timely diagnosis. A 65-year-old woman presented with acute onset of obstipation and vomiting suggesting acute obstruction. Contrast enhanced computed tomography of abdomen revealed a solid irregular mass in the ascending colon with large necrotic areas and surrounding enlarged nodes suggestive of malignancy arising from right colon. Right hemi-colectomy was performed. Histopathology of the surgical specimen showed florid inflammatory infiltrate with collection of histiocytes, lymphocytes and polymorphs. Further immunohistochemistry was conducted, and CD68 and CD45 were found to be positive and pan-cytokeratin was negative. A clinico-pathological diagnosis was thus established to be xanthogranulomatous colitis
Malignant minor salivary gland tumors: A retrospective study of 28 cases: Clinical experience of a single institution
Get PDFPurpose: This retrospective study was done to report our experience with the management of patients with primary malignant tumors of minor salivary glands that were treated with various combinations of surgery, radiation, and chemotherapy and to review treatment outcome. Methods: The records of all patients with malignant minor salivary gland tumors presenting for treatment at our department between 2000 and 2010 were retrospectively reviewed. Variables were collected and outcome measures were defined in terms of overall survival, disease-free survival. Descriptive statistics were compiled and statistically evaluated. Survival was described using the Kaplan-Meier method. Results: Twenty eight patients (10 males and 18 females) ranging in age from 18 to 80 years (median, 64 years) met the criteria for inclusion in the study. The majority of tumors were located in the oral cavity (n = 20), followed by nasal cavity and paranasal sinuses (n = 8). Adenoid cystic carcinoma was the most common neoplasm (n = 18). All patients were treated with surgery as the primary modality. Neck dissection was performed in 18% of patients, and all patients (n = 28) were treated with adjuvant external beam radiation therapy to a dose of 50 to 60 Gy. The disease-free survival rate and overall survival at 5 years were 80% and 85%, respectively. Conclusion: Postoperative radiation therapy is effective in preventing local recurrence in most patients with minor salivary gland tumors after gross total excision
Radiation doses and risks to neonates undergoing radiographic examinations in intensive care units in Tunisia
Get PDFPurpose: To assess the radiation doses to neonates from diagnostic radiography in order to derive the local diagnostic reference levels (LDRLs) for optimisation purposes.Methods: This study was carried out in the neonatal intensive care units (NICU) of two hospitals in Tunis. 134 babies, with weights ranging from 635 g to 6680 g, performed chest-abdomen X-ray examinations. Neonates were categorized into groups of birth weight. For each X-ray examination, patient data and exposure parameters were recorded. Dose area product (DAP) was measured and entrance surface dose (ESD) was estimated. Effective dose was calculated from the Monte Carlo simulation software PCXMC.Results: DAP values increased with neonatal weight and demonstrated a wide variation (5.0 - 43.0 mGy.cm2, mean 23.4 mGy.cm2) for patient weight from 600 g to 4000 g. A wide variation was also observed for ESD (14 - 93 μGy, mean 55.2 μGy). The LDRLs expressed in term of DAP were estimated to be 17.6 mGy.cm2 and 29.1 mGy.cm2 for the first and the second NICU, respectively. In terms of effective dose, the average value was about 31.6 μSv per single radiological examination. The results show the necessity to use a standardized protocol with high voltage technique combined to lower current time product (mAs) values and an adapted collimation which could lead to further reductions in the neonatal doses. Conclusion: This study presents the LDRLs and the effective doses for neonates in two NICUs and demonstrates the necessity to optimize patient protection for this category of patient
ESMO Symposium on Signalling Pathways in Cancer
No full textThe 2015 Symposium will concentrate on targeting the MAPK pathway: from RAS to MEK. The programme will cover preclinical data and genetics relevant for the understanding of the functional mechanisms in the RAS/ERK/MEK pathway, regulation of MAPK signalling, the rationale and strategies to inhibiting the pathway, biomarkers, mechanisms of resistance, as well as how to overcome it, and some important interactions with other pathways.Updates will also be provided on different aspects important for rational clinical development of novel RAS/ERK/MEK inhibitors, as well as an exploration – from a clinical perspective – of recent achievements and data from ongoing research and clinical trials, targeting the axes of the MAPK pathway across a wide range of solid tumours.CLICK HERE for more informatio
Long term palliation of a metastatic primary gliosarcoma with stereotactic body radiotherapy
Get PDFPrimary gliosarcoma (PGS) is rare and is known for extra cranial metastases. The overall outcome is dismal and hence the focus is on providing the best quality of life. This report describes a seventy-year-old lady who at presentation had metastatic primary gliosarcoma with intractable cough. Her lung lesion was treated with stereotactic body radiotherapy (SBRT) to a dose of 10 Gy per fraction for three consecutive days. She was free of cough till her death at eighteen months after treatment. This is probably the first reported case of excellent long-term quality of life in a patient of metastatic primary gliosarcoma
Journal of Proton Therapy
No full textJournal of Proton Therapy (JPT) is an international open access, peer-reviewed journal, which publishes original research, technical reports, reviews, case reports, editorials, and other materials on proton therapy with focus on radiation oncology, medical physics, medical dosimetry, and radiation therapy.No article processing/submission feeNo publication feePeer-review completion within 3-6 weeksImmediate publication after the completion of final author proofreadDOI assignment for each published articleFree access to published articles for all readers without any access barriers or subscriptionThe views and opinions expressed in articles are those of the author/s and do not necessarily reflect the policies of the Journal of Proton Therapy.Authors are encouraged to submit articles for publication in the inaugural issue of the Journal of Proton Therapy by online or email to [email protected] Website of Journal of Proton Therapy: http://www.protonjournal.org
Volumetric modulated arc therapy for spine SBRT patients to reduce treatment time and intrafractional motion
Get PDFVolumetric modulated arc therapy (VMAT) is an efficient technique to reduce the treatment time and intrafractional motion to treat spine patients presented with severe back pain. Five patients treated with spine stereotactic body radiation therapy (SBRT) using 9 beams intensity modulated radiation therapy (IMRT) were retrospectively selected for this study. The patients were replanned using two arcs VMAT technique. The average mean dose was 104% ± 1.2% and 104.1% ± 1.0% in IMRT and VMAT, respectively (p = 0.9). Accordingly, the average conformal index (CI) was 1.3 ± 0.1 and 1.5 ± 0.3, respectively (p = 0.5). The average dose gradient (DG) distance was 1.5 ± 0.1 cm and 1.4 ± 0.1 cm, respectively (p = 0.3). The average spinal cord maximum dose was 11.6 ± 1.0 Gy and 11.8 ± 1.1 Gy (p = 0.8) and V10Gy was 7.4 ± 1.4 cc and 8.6 ± 1.7 cc (p = 0.4) for IMRT and VMAT, respectively. Accordingly, the average number of monitor units (MUs) was 6771.7 ± 1323.3 MU and 3978 ± 576.7 MU respectively (p = 0.02). The use of VMAT for spine SBRT patients with severe back pain can reduce the treatment time and intrafractional motion
Correlation between gamma analysis for midline and lateralized tumors by using volumetric modulated arc therapy
Get PDFPurpose: The aim of this study was to evaluate the fluence for midline and lateralized tumors for volumetric modulated arc therapy (VMAT) by using a two-dimensional array.Methods: For this study, we selected 60 patients who were undergoing VMAT. The octavius phantom was computed tomography (CT) scanned and imported to the planning system. Verification plans were created for each plan and exported. The measurements were performed using 2D seven29 ion chamber array. Fluence measurement values for all the delivered plans were analyzed using VeriSoft software. The TPS calculated values were then compared with the measured gamma values. Results: The gamma pass percentage for midline tumors was found to be higher than that for lateralized tumors. The standard deviations between the gamma values for midline and lateralized tumors were 1.96 and 2.86, respectively. Moreover, the standard deviations between the point doses for midline and lateralized tumors were 0.360 and 0.283, respectively. The mean gamma passing rate was 96.96% for midline tumors and 96.57% for lateralized tumors for 3%DD/3-mm criteria. There is no significance found in the gamma values for midline and lateralized tumors with p-value 0.08. Conclusion: No particular correlation was found between the gamma pass percentage for midline tumors and that for lateralized tumors. Only a marginal difference was found in the gamma pass percentage
Quality assurance of simultaneous treatment of two targets in pelvic region planned with single isocenter using three dimensional conformal radiotherapy (3DCRT) technique
Get PDFPurpose: The purpose of this study was to conduct quality assurance of a three dimensional conformal radiotherapy (3DCRT) of two targets in pelvis region planned with single isocenter technique. Methods: A treatment plan was generated with two identical water phantoms with ionization chamber (IC) sleeves (IC-1 & IC-2), simulated as if targets are in pelvis region, simultaneously irradiated with single isocenter technique with a dose prescription of 300 cGy for point dose verification. A two dimensional ion chamber array detector was used for fluence verification.Results: Calculated minimum, mean and maximum dose (in cGy) for IC-1 & IC-2 were 295, 303 and 307 as per dose volume histogram. The global dose maximum was found to be 307.4 cGy. Measured point doses to both lesions were within ±2.5% of the computed dose. A pass percentage of 97% was obtained with the set of criteria 3 mm distance to agreement and 3% dose difference for fluence verification.Conclusion: Treatment execution of two targets simultaneously with single isocenter can reduce positional errors and delivery time