Bladder dose–surface maps and urinary toxicity: Robustness with respect to motion in assessing local dose effects

The purpose of this study was to quantify the impact of inter-fraction modifications of bladder during RT of prostate cancer on bladder dose surface maps (DSM).Eighteen patients treated with daily image-guided Tomotherapy and moderate hypofractionation (70–72.8 Gy at 2.5–2.6 Gy/fr in 28 fractions and full bladder) were considered. Bladder contours were delineated on co-registered daily Megavoltage CT (MVCT) by a single observer and copied on the planning CT to generate dose–volume/surface histograms (DVH/DSH) and bladder DSMs. Discrepancies between planned and daily absorbed doses were analyzed through the average of individual systematic errors, the population systematic errors and the population random errors for the DVH/DSHs and DSMs.In total, 477 DVH/DSH and 472 DSM were available. DSH and DVH showed small population systematic errors of absolute surfaces (<3.4 cm²) and volumes (<8.4 cm³) at the highest doses.The dose to the posterior bladder base assessed on DSMs showed a mean systematic error below 1 Gy, with population systematic and random errors within 4 and 3 Gy, respectively. The region surrounding this area shows higher mean systematic errors (1–3 Gy), population systematic (8–11 Gy) and random (5–7 Gy) errors.In conclusion, DVH/DSH and DSMs are quite stable with respect to inter-fraction variations in the high-dose region, within about 2 cm from bladder base. Larger systematic variations occur in the anterior portion and cranially 2.5–3.5 cm from the base.Results suggest that dose predictors related to the high dose area (including the trigone dose) are likely to be sufficiently reliable with respect to the expected variations due to variable bladder filling.     

Novel tracking function of moving target using chaotic dynamics in a recurrent neural network model

Chaotic dynamics introduced in a recurrent neural network model is applied to controlling an object to track a moving target in two-dimensional space, which is set as an ill-posed problem. The motion increments of the object are determined by a group of motion functions calculated in real time with firing states of the neurons in the network. Several cyclic memory attractors that correspond to several simple motions of the object in two-dimensional space are embedded. Chaotic dynamics introduced in the network causes corresponding complex motions of the object in two-dimensional space. Adaptively real-time switching of control parameter results in constrained chaos (chaotic itinerancy) in the state space of the network and enables the object to track a moving target along a certain trajectory successfully. The performance of tracking is evaluated by calculating the success rate over 100 trials with respect to nine kinds of trajectories along which the target moves respectively. Computer experiments show that chaotic dynamics is useful to track a moving target. To understand the relations between these cases and chaotic dynamics, dynamical structure of chaotic dynamics is investigated from dynamical viewpoint.     

SBRT for prostate cancer: Challenges and features from a physicist prospective

Emerging data are showing the safety and the efficacy of Stereotactic Body Radiation Therapy (SBRT) in prostate cancer management. In this context, the medical physicists are regularly involved to review the appropriateness of the adopted technology and to proactively study new solutions. From the physics point of view there are two major challenges in prostate SBRT: (1) mitigation of geometrical uncertainty and (2) generation of highly conformal dose distributions that maximally spare the OARs. Geometrical uncertainties have to be limited as much as possible in order to avoid the use of large PTV margins. Furthermore, advanced planning and delivery techniques are needed to generate maximally conformal dose distributions. In this non-systematic review the technology and the physics aspects of SBRT for prostate cancer were analyzed. In details, the aims were: (i) to describe the rationale of reducing the number of fractions (i.e. increasing the dose per fraction), (ii) to analyze the features to be accounted for performing an extreme hypo-fractionation scheme (>6–7 Gy), and (iii) to describe technological solutions for treating in a safe way. The analysis of outcomes, toxicities, and other clinical aspects are not object of the present evaluation.     

SBRT for lung oligometastases: Who is the perfect candidate?

AimTo analyze the literature data about lung oligometastatic patients who underwent SBRT with regard to doses, fractionation, outcomes, response assessment and prognostic factors, trying to define “the right patient” for the local treatment.Background“Oligometastatic disease” is defined as a state in which metastases are limited in number and site and characterized by unusual cancer biology and behavior. In this setting local therapy could have a potential curative role. Recently, technological advances in Radiation Oncology permitted the introduction of Stereotactic Body Radiation Therapy (SBRT), a novel treatment modality that delivers ablative dose of radiation to the extra-cranial sites with high precision using single or a small number of fractions.Materials and methodsWe performed a literature search using Medical Subject Heading terms “stereotactic body radiation therapy” and “lung metastases”, considering a period of 10 years.ResultsMany non-randomized studies have shown that SBRT for lung oligometastases is safe and effective, with local control rates of about 80%. To date SBRT represents an alternative and competitive option in patients with lung oligometastatic disease who refuse surgical treatment or unsuitable for surgery. Based on published studies, SBRT might have major benefit for a patient with breast histology, disease-free interval ≥12 months, control of the primary tumor, small lesions, limited number of lesions and higher radiation dose delivered.ConclusionsWell-designed collaborative trials are necessary to draw final conclusions. To date, the discussion within a multidisciplinary team becomes crucial to perform a careful patients’ selection in the setting of oligometastatic disease.     

Can Black‐and‐White Ruffed Lemurs (Varecia variegata) Solve Object Permanence Tasks?

We examined object permanence in black‐and‐white‐ruffed lemurs (Varecia variegata) at Zoo Atlanta. A series of visible and invisible displacement tasks with suitable controls were presented to five adult subjects. Subjects performed significantly above chance on all regular tasks, except for the double invisible displacements. Subjects failed visible and invisible controls. Failure on the control trials did not appear to be because subjects used the “last box touched” strategy (subjects did not choose the last box touched significantly more than expected by chance). However, a substantial percentage of choices was made to the last box touched by the experimenter. There was no significant difference between this percentage, and the percentage of choices made to the baited box (on both visible and invisible controls), which indicates that subjects were drawn to both boxes which the experimenter visited/touched, and thus failed the controls. Based on the results from the present study, we believe that there is no evidence that black‐and‐white ruffed lemurs understand visible and invisible tasks in the traditional object permanence battery. Am. J. Primatol. 75:376‐386, 2013. © 2013 Wiley Periodicals, Inc.     

Mechanistic possibilities in prebiotic thiophosphate chemistry

Summary Two types of reactivities of thiophosphates have been demonstrated: one being nucleophilic displacement by the P-S moiety of nucleoside phosphorothioates and the other, phosphorylation via P-S cleavage as the driving force. We have designed a system where both displacement on carbon and P-S cleavage are possible. Adenosine derivatives have been synthesized with 5-deoxy-5-chloro and 5-O-tosyl substitutions as leaving groups utilizing the 3-O-phosphorothioate as the biphilic center. The main products of cyclization were 5-O-tosyl and 5-chloroadenosine 2:3-cyclic phosphate. Formation of 3:5-S-phosphorothioate was slow even using an excellent leaving group. This is possibly due to hydrogen bonding between the 2-OH and the neighboring P-O.^– KOH hydrolysis of the cyclic phosphorothioate yielded 2(3) phosphorothioates in a 1:1 ratio. The 2 and 3 isomers were separated and used to study the relative rates of cyclization. The cyclization via P-S cleavage of 2(3)-O-phosphorothioates showed that the 2 isomer was more reactive. This is the first report of superior reactivity of the 3-OH of a ribonucleoside.