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1.
Aim
To verify the reproducibility of patients irradiated after mastectomy on the immobilization system designed and manufactured for our hospital and to compare the Internal Protocol (IP) with the modified-No Action Level Protocol.Background
Application of forward IMRT techniques requires a good reproducibility of patient positioning. To minimize the set-up error, an effective immobilization system is important.Materials and methods
The study was performed for two groups of 65 each. In the first group, portal images for anterior field were taken in 1–3 fractions and, subsequently, three times a week. In this group, the mNAL protocol was used. In the second group, the IP was used. The portal images from the anterior field and from the gantry 0 were taken during the 1–3 and 10 fractions. In both groups, image registration was performed off-line. For each group the systematic and random errors and PTV margin were calculated.Results
In the first group the value of the population systematic errors and random errors were 1.6 ± 1.6 mm for the left–right, and 1.5 ± 1.7 mm for the cranial–caudal directions, respectively, 1.7 ± 1.3 mm, and 1.9 ± 1.3 mm for the second group. The PTV margins for the left–right and cranial–caudal directions were 5.1 and 4.9 mm for the first group and 5.4 and 6.4 mm for the second group.Conclusions
For patients immobilized with our support device treated according to the mNAL protocol or IP, a good set-up reproducibility was obtained. Implementation of IP limits the number of required images. 相似文献2.
The Effects of the Shape and Size of the Clinical Target Volume on the Planning Target Volume Margin
Purpose
To investigate the impact of clinical target volume (CTV) shape and size on CTV to planning target volume (PTV) margin expansion.Methods and Materials
Using numerical integration methods, margins accounting for random errors and systematic errors were calculated for CTVs of different shapes and sizes. We use and to represent the coefficients, for random errors and systematic errors, respectively, that ensure that every point of the CTV receives ≥95% of the prescribed dose.Results
The part of the margin accounting for random errors depends on CTV shape and size; generally, a convex part of a CTV would have a larger margin than a concave part. However, the part of the margin accounting for systematic errors is independent of CTV shape and size.Conclusions
CTV shape and size should be considered when generating a PTV. For a complex CTV, the margins of the various parts of the CTV are different and related to local forms. 相似文献3.
Liliana Martins Jose Guilherme Couto Barbara Barbosa 《Reports of Practical Oncology and Radiotherapy》2016,21(1):57-62
Aim
The aim of this study is to evaluate differences in terms of the setup errors observed using kV planar image compared to CBCT for oesophageal cancer patients.Background
Planar kV images are quick to acquire but only allow the observation of bony structures. CBCT allows the evaluation of soft tissues, which includes the oesophagus (and tumour) and OAR, giving a more accurate verification of the positioning.Materials and Methods
All patients were imaged with both techniques between January 2012 and March 2014 were included in the study (16 patients, 212 kV images and 116 CBCT images). Differences between the setup errors observed on the two images modalities were studied. A correlation study between TNM staging, tumour location and immobilization systems with setup errors was also done. Finally, the calculation of systematic and random errors allowed to determine the CTV–PTV margin.Results
A significant discrepancy (p < 0.05) between the setup errors observed with kV and CBCT was observed in the lateral direction. No statistical correlation was found between setup errors and tumour location, immobilization system or TNM staging. The CTV–PTV margin was smaller with CBCT in the vertical (0.6 cm vs. 0.9 cm) and longitudinal (0.7 cm vs. 1 cm) directions and smaller with kV for the lateral directions (0.8 cm vs. 0.9 cm).Conclusions
The chosen modality influences the setup error observed which will influence the correction applied. Allowing a better observation of the volumes of interest, CBCT should be the modality of choice in this pathology. The CTV–PTV margins could be shrunk if CBCT is used. 相似文献4.
Alejandro Floriano Icíar Santa-Olalla Alberto Sanchez-Reyes 《Reports of Practical Oncology and Radiotherapy》2013,18(3):173-178
Aim
To analyze intrafraction movement in patients undergoing frameless robotic radiosurgery and evaluate the influence of image acquisition frequency on global accuracy.Background
Stereotactic radiosurgery requires high spatial accuracy in dose delivery. In conventional radiosurgery, a rigid frame is used to guarantee a correct target alignment and no subsequent movement. Frameless radiosurgery with thermoplastic mask for immobilization cannot completely eliminate intrafraction patient movement. In such cases, it is necessary to evaluate its influence on global treatment accuracy.Materials and methods
We analyzed the intrafraction motion of the first 15 patients undergoing intracranial radiosurgery (39 fractions) with the CyberKnife VSI system at our institution. Patient position was measured at a 15–90-s interval and was used to estimate intrafraction patient movement.Results
With our acquisition image protocol and immobilization device, the 99% displacement error was lower than 0.85 mm. The systematic movement components were lower than 0.05 mm and the random component was lower than 0.3 mm in the 3 translational axes. Clear linear time dependence was found in the random component.Conclusions
Selection of the X-ray image acquisition time is necessary to meet the accuracy required for radiosurgery procedures with the CyberKnife VSI system. We verified that our image acquisition protocol met the 1-mm criterion. 相似文献5.
Letizia Deantonio Laura Masini Gianfranco Loi Giuseppina Gambaro Cesare Bolchini Marco Krengli 《Reports of Practical Oncology and Radiotherapy》2011,16(3):77-81
Aim
To investigate the clinical application of a technique for patient set-up verification in breast cancer radiotherapy based on a 3D surface image registration system.Background
Accurate and reproducible patient set-up is a prerequisite to correctly deliver fractionated radiotherapy. Various approaches are available to verify and correct patient setup for 3D image acquisition in a radiation treatment room.Materials and methods
The study analyzed the setup reproducibility of 15 patients affected by breast cancer and candidates for conformal radiotherapy by using the AlignRT system (VisionRT, London, UK). At the initial setup, electronic portal imaging device (EPID) images were compared with Digitally Reconstructed Radiographs (DRRs) and a reference three-dimensional (3D) surface image was obtained by AlignRT. Surface images were acquired prior to every subsequent setup procedure. The systematic and random errors along longitudinal and vertical directions were measured and compared for the two systems.Results
The procedure for surface registration, image acquisition and comparison with the reference image took less than 1 min on average. The T test for systematic error showed no significant difference between the 2 verification systems along the longitudinal (p = 0.69) and vertical (p = 0.67) axes. The T-test for random error showed a significant difference between the 2 systems along the vertical axis (p = 0.05).Conclusion
AlignRT is fast, simple, non-invasive and seems to be reliable in detecting patient setup errors. Our results suggest that it could be used to assess the setup reproducibility for breast cancer patients. 相似文献6.
Pawel Kuko?owicz Helena Kuko?owicz Izabela Tyburska 《Reports of Practical Oncology and Radiotherapy》2015,20(3):198-203
Background
Late rectal injury is a common side effect of external beam radiotherapy for prostate cancer.Aim
The aim of this study was to evaluate what total dose may be safely delivered for prostate patients for 3DCRT and IMRT techniques and the CTV–PTV margin.Materials and methods
3DCRT and IMRT plans were prepared for 12 patients. For each patient PTV was defined with CTV–PTV margins of 0.4, 0.6, …, 1.0 cm, and total doses of 70, 72, …, 80 Gy, with 2 Gy dose fraction. NTCP values for the rectum were calculated using the Lyman model. Both techniques were compared in terms of population mean DVH.Results
Significantly smaller NTCPs for IMRT were obtained. For both techniques diminishing the margin CTV–PTV of 2 mm leads to decreasing the NTCP of about 0.03. For total dose of 80 Gy the NTCP was smaller than 10% for the 4 mm margin only. The QUANTEC dose volume constraints were more frequently fulfilled for the IMRT technique than for the 3DCRT technique.Conclusions
The IMRT technique is safer for prostate patients than the 3DCRT. If very high total doses are applied the CTV–PTV margin of 0.4 cm and the IMRT technique should be used. If the CTV–PTV margin of 0.6 cm is applied, the NTCP is smaller than 10% for the 3DCRT and IMRT techniques for the total doses smaller than 74 Gy and 78 Gy, respectively. 相似文献7.
Yasushi Toge Yukihide Nishimura Jeffrey R. Basford Takako Nogawa Midori Yamanaka Takeshi Nakamura Munehito Yoshida Akira Nagano Fumihiro Tajima 《PloS one》2013,8(12)
Objective
To assess the separate effects of thumb and finger extension/flexion on median nerve position and cross-sectional area.Methods
Ultrasonography was used to assess median nerve transverse position and cross-sectional area within the carpal tunnel at rest and its movement during volitional flexion of the individual digits of the hand. Both wrists of 165 normal subjects (11 men, 4 women, mean age, 28.6, range, 22 to 38) were studied.Results
Thumb flexion resulted in transverse movement of the median nerve in radial direction (1.2±0.6 mm), whereas flexion of the fingers produced transverse movement in ulnar direction, which was most pronounced during flexion of the index and middle fingers (3.2±0.9 and 3.1±1.0 mm, respectively). Lesser but still statistically significant movements were noted with flexion of the ring finger (2.0±0.8 mm) and little finger (1.2±0.5 mm). Flexion of the thumb or individual fingers did not change median nerve cross-sectional area (8.5±1.1 mm2).Conclusions
Volitional flexion of the thumb and individual fingers, particularly the index and middle fingers, produced significant transverse movement of the median nerve within the carpal tunnel but did not alter the cross-sectional area of the nerve. The importance of these findings on the understanding of the pathogenesis of the carpal tunnel syndrome and its treatment remains to be investigated. 相似文献8.
Heling Zhou Kate Luby-Phelps Bruce E. Mickey Amyn A. Habib Ralph P. Mason Dawen Zhao 《PloS one》2009,4(11)
Background
It is recognized that cancer cells exhibit highly elevated glucose metabolism compared to non-tumor cells. We have applied in vivo optical imaging to study dynamic uptake of a near-infrared dye-labeled glucose analogue, 2-deoxyglucose (2-DG) by orthotopic glioma in a mouse model.Methodology and Principal Findings
The orthotopic glioma model was established by surgically implanting U87-luc glioma cells into the right caudal nuclear area of nude mice. Intracranial tumor growth was monitored longitudinally by bioluminescence imaging and MRI. When tumor size reached >4 mm diameter, dynamic fluorescence imaging was performed after an injection of the NIR labeled 2-DG, IRDye800CW 2-DG. Real-time whole body images acquired immediately after i.v. infusion clearly visualized the near-infrared dye circulating into various internal organs sequentially. Dynamic fluorescence imaging revealed significantly higher signal intensity in the tumor side of the brain than the contralateral normal brain 24 h after injection (tumor/normal ratio, TNR = 2.8±0.7). Even stronger contrast was achieved by removing the scalp (TNR = 3.7±1.1) and skull (TNR = 4.2±1.1) of the mice. In contrast, a control dye, IRDye800CW carboxylate, showed little difference (1.1±0.2). Ex vivo fluorescence imaging performed on ultrathin cryosections (20 µm) of tumor bearing whole brain revealed distinct tumor margins. Microscopic imaging identified cytoplasmic locations of the 2-DG dye in tumor cells.Conclusion and Significance
Our results suggest that the near-infrared dye labeled 2-DG may serve as a useful fluorescence imaging probe to noninvasively assess intracranial tumor burden in preclinical animal models. 相似文献9.
Marta Adamczyk Tomasz Piotrowski Ewa Adamiak 《Reports of Practical Oncology and Radiotherapy》2012,17(2):104-109
Background
Radiotherapy treatment requires delivering high homogenous dose to target volume while sparing organs at risk. That is why accurate patient positioning is one of the most important steps during the treatment process. It reduces set-up errors which have a strong influence on the doses given to the target and surrounding tissues.Aim
The aim of this study was to investigate the efficiency of combining bony anatomy and soft tissue imaging position correction strategies for patients with prostate cancer.Materials and methods
The study based on pre-treatment position verification results determined for 10 patients using kV images and CBCT match. At the same patients’ position, two orthogonal kV images and set of CT scans were acquired. Both verification methods gave the information about patients’ position changes in vertical, longitudinal and lateral directions.Results
For 93 verifications, the mean values of kV shifts in vertical, longitudinal and lateral directions equaled: −0.11 ± 0.54 cm, 0.26 ± 0.38 cm and −0.06 ± 0.47 cm, respectively. The same values achieved for CBCT matching equaled: 0.07 ± 0.62 cm, 0.22 ± 0.36 cm and −0.02 ± 0.45 cm. Statistically significant changes between the values of shifts received during the first week of treatment and the rest time of the irradiation process were found for 2 patients in the lateral direction and 2 patients in vertical direction among kV results and for 3 patients in the longitudinal direction among CBCT results. A significant difference between kV and CBCT match results was found in the vertical direction.Conclusions
In clinical practice, CBCT combined with kV or even portal imaging improves precision and effectiveness of prostate cancer treatment accuracy. 相似文献10.
Ricardo Cendales Felipe Torres Juan Arbelaez Armando Gaitan Jaider Vasquez Ivan Bobadilla 《Reports of Practical Oncology and Radiotherapy》2015,20(1):38-42
Aim
To describe daily displacements when using fiducial markers as surrogates for the target volume in patients with prostate cancer treated with IGRT.Background
The higher grade of conformity achieved with the use of modern radiation technologies in prostate cancer can increase the risk of geographical miss; therefore, an associated protocol of IGRT is recommended.Materials and methods
A single-institution, retrospective, consecutive study was designed. 128 prostate cancer patients treated with daily on-line IGRT based on 2D kV orthogonal images were included. Daily displacement of the fiducial markers was considered as the difference between the position of the patient when using skin tattoos and the position after being relocated using fiducial markers. Measures of central tendency and dispersion were used to describe fiducial displacements.Results
The implant itself took a mean time of 15 min. We did not detect any complications derived from the implant. 4296 sets of orthogonal images were identified, 128 sets of images corresponding to treatment initiation were excluded; 91 (2.1%) sets of images were excluded from the analysis after having identified that these images contained extreme outlier values. If IGRT had not been performed 25%, 10% or 5% of the treatments would have had displacements superior to 4, 7 or 9 mm respectively in any axis.Conclusions
Image guidance is required when using highly conformal techniques; otherwise, at least 10% of daily treatments could have significant displacements. IGRT based on fiducial markers, with 2D kV orthogonal images is a convenient and fast method for performing image guidance. 相似文献11.
Nithya Kanakavelu E. James Jebaseelan Samuel 《Reports of Practical Oncology and Radiotherapy》2015,20(3):188-197
Background and aim
The clinical use of imaging system in image guided radiotherapy (IGRT) necessitates performing periodic quality assurance of the system to be confident in applying corrections for patient set-up errors. We aim to develop and implement a quality assurance (QA) programme for megavoltage (MV) based image guidance system and assess its long term performance for a period of 3 years.Materials and methods
Periodic QA tests were performed for the MV planar and cone beam computed tomography (CBCT) imaging system to assess the system safety, mechanical and geometrical accuracy, image quality and dose. The tests were performed using the equipment supplied by the manufacturer along with the image guidance system and using simple methods developed in-house. The test results were compared with expected or baseline values established during commissioning.Results
The safety system was found to be functional. The results of mechanical and geometrical tests were in good agreement with the expected results. The system mechanical positioning was stable and reproducible within ±2 mm accuracy. The image quality and the imaging dose of the planar and CBCT imaging were found to agree with the baseline values and the manufacturer specifications.Discussion
Throughout the three-year period, all the QA tests were within the specification. The mechanical and geometrical tests are most crucial as they directly affect the patient positioning accuracy.Conclusion
We conclude that the MV image guidance system is efficient to perform IGRT and insist to perform periodic QA tests and calibration for the system. 相似文献12.
Seyed-Mostafa Ghavami Asghar Mesbahi Ismaeel Pesianian Abbas Shafaee Mohammad-Reza Aliparasti 《Reports of Practical Oncology and Radiotherapy》2010,15(6):172-175
Background
Polymer gel dosimetry has been used extensively in radiation therapy for its capability in depicting a three dimensional view of absorbed dose distribution. However, more studies are required to find less toxic and more efficient polymers for application in radiotherapy dosimetry.Aim
The purpose of this work was to evaluate the N-isopropyl acrylamide (NIPAM) gel dosimetric characteristics and optimize the protocol for X-ray computed tomography (CT) imaging of gel dosimeters for radiation therapy application.Material and methods
A polymer gel dosimeter based on NIPAM monomer was prepared and irradiated with 60Co photons. The CT number changes following irradiation were extracted from CT images obtained with different sets of imaging parameters.Results
The results showed the dose sensitivity of ΔNCT (H) = 0.282 ± 0.018 (H Gy−1) for NIPAM gel dosimeter. The optimized set of imaging exposure parameters was 120 kVp and 200 mA with the 10 mm slice thickness. Results of the depth dose measurement with gel dosimeter showed a great discrepancy with the actual depth dose data.Conclusion
According to the current study, NIPAM-based gel dosimetry with X-ray CT imaging needs more technical development and formulation refinement to be used for radiation therapy application. 相似文献13.
Giuseppina Apicella Debora Beldì Giansilvio Marchioro Sara Torrente Sara Tunesi Corrado Magnani Alessandro Volpe Carlo Terrone Marco Krengli 《Reports of Practical Oncology and Radiotherapy》2015,20(2):113-122
Aim
To assess the outcomes of patients treated with postoperative RT in relation to the possible prognostic factors.Background
Postoperative radiotherapy (RT) has been proved to reduce the risk of biochemical recurrence in high-risk prostate cancer patients. Baseline prostate specific antigen (PSA), pathological Gleason score (GS), positive surgical margins, nodal status and seminal vesicle invasion are independent predictors of biochemical relapse.Materials and methods
The clinical records of 282 patients who underwent postoperative RT were retrospectively reviewed. The prognostic value of postoperative PSA, preoperative risk class, nodal status, pathological GS, margins status, and administration of hormonal therapy (HT) was analyzed.Results
Postoperative RT was delivered with a median dose to the prostatic fossa of 66 Gy (range 50–72) in 1.8–2 Gy/fraction. Median follow-up was 23.1 months (range 6–119). Five-year actuarial biochemical disease-free survival (bDFS) and overall survival rates were 76% and 95%, respectively. Higher bDFS was found for patients with postoperative PSA <0.02 ng/ml (p = 0.03), low preoperative risk class (p = 0.01), pN0 (p = 0.003), GS 4–6 (p = 0.0006), no androgen deprivation therapy (p = 0.02), and irrespective of surgical margin status (p = 0.10). Multivariate analysis showed that postoperative PSA and Gleason score had a significant impact on bDFS (p = 0.039 and p = 0.05, respectively).Conclusions
Postoperative RT with a dose of 66 Gy offers an acceptable toxicity and an optimal disease control after radical prostatectomy in patients with different risk features. A postoperative PSA >0.02 ng/ml could be considered as a prognostic factor and a tool to select patients at risk for progression. 相似文献14.
Rafael E. Lengua Maria F. Gonzalez Kaory Barahona Milton E. Ixquiac Juan F. Lucero Erick Montenegro Jose L. Lopez Guerra Javier Jaén Luis A. Linares 《Reports of Practical Oncology and Radiotherapy》2014,19(4):234-238
Aim
This study evaluates the acute toxicity outcome in patients treated with RapidArc for localized prostate cancer.Background
Modern technologies allow the delivery of high doses to the prostate while lowering the dose to the neighbouring organs at risk. Whether this dosimetric advantage translates into clinical benefit is not well known.Materials and methods
Between December 2009 and May 2012, 45 patients with primary prostate adenocarcinoma were treated using RapidArc. All patients received 1.8 Gy per fraction, the median dose to the prostate gland, seminal vesicles, pelvic lymph nodes and surgical bed was 80 Gy (range, 77.4–81 Gy), 50.4 Gy, 50.4 Gy and 77.4 Gy (range, 75.6–79.2 Gy), respectively.Results
The time between the last session and the last treatment follow up was a median of 10 months (range, 3–24 months). The incidence of grade 3 acute gastrointestinal (GI) and genitourinary (GU) toxicity was 2.2% and 15.5%, respectively. Grade 2 acute GI and GU toxicity occurred in 30% and 27% of patients, respectively. No grade 4 acute GI and GU toxicity were observed. Older patients (>median) or patients with V60 higher than 35% had significantly higher rates of grade ≥2 acute GI toxicity compared with the younger ones.Conclusions
RapidArc in the treatment of localized prostate cancer is tolerated well with no Grade >3 GI and GU toxicities. Older patients or patients with higher V60 had significantly higher rates of grade ≥2 acute GI toxicity. Further research is necessary to assess definitive late toxicity and tumour control outcome. 相似文献15.
Background
Cone-beam Computed Tomography (CBCT) and stereophotography are two of the latest imaging modalities available for three-dimensional (3-D) visualization of craniofacial structures. However, CBCT provides only limited information on surface texture. This can be overcome by combining the bone images derived from CBCT with 3-D photographs. The objectives of this study were 1) to evaluate the feasibility of integrating 3-D Photos and CBCT images 2) to assess degree of error that may occur during the above processes and 3) to identify facial regions that would be most appropriate for 3-D image registration.Methodology
CBCT scans and stereophotographic images from 29 patients were used for this study. Two 3-D images corresponding to the skin and bone were extracted from the CBCT data. The 3-D photo was superimposed on the CBCT skin image using relatively immobile areas of the face as a reference. 3-D colour maps were used to assess the accuracy of superimposition were distance differences between the CBCT and 3-D photo were recorded as the signed average and the Root Mean Square (RMS) error.Principal Findings:
The signed average and RMS of the distance differences between the registered surfaces were −0.018 (±0.129) mm and 0.739 (±0.239) mm respectively. The most errors were found in areas surrounding the lips and the eyes, while minimal errors were noted in the forehead, root of the nose and zygoma.Conclusions
CBCT and 3-D photographic data can be successfully fused with minimal errors. When compared to RMS, the signed average was found to under-represent the registration error. The virtual 3-D composite craniofacial models permit concurrent assessment of bone and soft tissues during diagnosis and treatment planning. 相似文献16.
Erik HFM van der Heijden Wouter Hoefsloot Hieronymus WH van Hees Olga CJ Schuurbiers 《Respiratory research》2015,16(1)
Background
Videobronchoscopy is an essential diagnostic procedure for evaluation of the central airways and pivotal for the diagnosis and staging of lung cancer. Technological improvements have resulted in high definition (HD) images with advanced real time image enhancement techniques (i-scan).Objectives
In this study we aimed to explore the sensitivity of HD+ i-scan bronchoscopy for detection of epithelial changes like vascular abnormalities and suspicious preinvasive lesions, and tumors.Methods
In patients scheduled for a therapeutic or diagnostic procedure under general anesthesia videos of the bronchial tree were made using 5 videobronchoscopy modes in random order: normal white light videobronchoscopy (WLB), HD-bronchoscopy (HD), HD bronchoscopy with surface enhancement technique (i-scan1), HD with surface- and tone enhancement technique (i-scan2) and dual mode autofluorescence videobronchoscopy (AFB). The videos were scored in random order by two independent and blinded expert bronchoscopists.Results
In 29 patients all videos were available for analysis. Vascular abnormalities were scored most frequently in HD + i-scan2 bronchoscopy (1.33 ± 0.29 abnormal or suspicious sites per patient) as compared to 0.12 ± 0.05 site for AFB (P = 0.003). Sites suspicious for preinvasive lesions were most frequently reported using AFB (0.74 ± 0.12 sites per patient) as compared to 0.17 ± 0.06 for both WLB and HD bronchoscopy (P = 0.003). Tumors were detected equally by all modalities. The preferred modality was HD bronchoscopy with i-scan (tone- plus surface and surface enhancement in respectively 38% and 35% of cases P = 0.006).Conclusions
This study shows that high definition bronchoscopy with image enhancement technique may result in better detection of subtle vascular abnormalities in the airways. Since these abnormalities may be related to preneoplastic lesions and tumors this is of clinical relevance. Further investigations using this technique relating imaging to histology are warranted. 相似文献17.
Ramachandran Prabhakar Milind Kumar Suja Cheruliyil Silpa Jayakumar Satheesan Balasubramanian Jim Cramb 《Reports of Practical Oncology and Radiotherapy》2013,18(4):209-213
Aim
To study the use of RapidArc techniques in the treatment of prostate cancer patients with hip prosthesis.Background
An important aspect of treatment planning is to achieve dose homogeneity inside the planning target volume (PTV). Especially for those patients presenting with hip prosthesis, it becomes a challenging task to achieve dose uniformity inside the PTV.Materials and methods
Five prostate patients presenting with hip prosthesis who had undergone radical radiotherapy were selected for this study. Depending on the composition of prosthesis, a predefined set of Hounsfield values were assigned to each study set. RapidArc plans were generated on an Eclipse treatment planning system. Two arcs that include clockwise and counter-clockwise arcs were used in all these cases. To avoid beams passing through the prosthesis, a simple structure was defined around it with 1 cm margin and a strict dose constraint applied to the block during VMAT optimization.Results
The mean D2/D98 ratio of PTV for all the patients was 1.06 ± 0.01. The mean percentage rectum volume receiving 50 Gy, 60 Gy, 70 Gy and 75 Gy for all the patients were 33.1 ± 5.9, 21.7 ± 5.5, 13.8 ± 4.4 and 9.5 ± 3.0, respectively.Conclusions
This study shows that using a double arc RapidArc technique is a simple and effective treatment method of treating prostate cancer in patients presenting with a hip prosthesis. The definition of a beam avoidance structure encompassing the prosthesis and applying strict dose constraints to it reduces the beam contribution to the prosthesis 相似文献18.
Joann J. Kang Norma Allemann Thasarat Vajaranant Jose de la Cruz Maria Soledad Cortina 《PloS one》2013,8(8)
Objective
To quantitatively evaluate the anterior segment using anterior segment optical coherence tomography (AS-OCT) following Boston keratoprosthesis type 1.Methods
A retrospective study consisted of AS-OCT imaging at a single time point postoperatively in 52 eyes. Main outcomes measures include anatomical and functional anterior chamber depth (ACD), angle (ACA) and peripheral and proximal synechiae.Results
The mean time point of imaging was 19.3 months postoperatively. Average anatomical and functional ACD was 2.0 and 0.21 mm respectively, and mean ACA ranged from 2.5° to 6.14° in representative meridians. An average of 8.7 clock hours of angle closure was observed in the 25 eyes in which all meridians were imaged. The majority of eyes showed peripheral (86.5%) and proximal (67.3%) synechiae.Conclusions
AS-OCT is a useful tool for quantitative evaluation of anterior segment and angle after keratoprosthesis, which is otherwise poorly visible. The majority of eyes showed shallow ACD, extensive angle closure and synechiae formation. 相似文献19.
Adela Poitevin-Chacón José Hinojosa-Gómez 《Reports of Practical Oncology and Radiotherapy》2013,18(2):57-60
Aim
This survey is performed to learn about the structure of radiotherapy in México.Background
Radiation oncology practice is increasing because of the higher incidence of cancer. There is no published data about radiotherapy in México.Materials and methods
A questionnaire was sent to the 83 registered centers in the database of the Mexican regulatory agency. One out of the 32 states has no radiotherapy. 27 centers from 14 states provided their answers.Results
829 patients are treated annually with any radiotherapy modality in each center. Two centers have one cobalt machine, 7 have a cobalt and a linac and 10 have more than one linac. Five centers use 2D planning systems, 22 use 3D; 9, conventional simulators; 22, CT based simulation, and 1 center has no simulation. Most of the centers verify beams with films, electronic portal image devices and cone beam CTs are also used. Intensity modulated and image guided radiotherapy are performed in 5 states. Breast, prostate, cervix, lung, rectum and head and neck cancer are the six most common locations. There are 45 public and 38 private centers, 2 dedicated to children. Two gamma knife units, 5 Novalis systems, 1 tomotherapy and 2 cyberknife machines are working. All centers have at least one radiation oncologist, one physicist and one radiotherapist.Conclusions
Definitive conclusions cannot be drawn from this limited feedback due to a low participation of centers. This survey about radiotherapy in Mexico shows the heterogeneity of equipment as well as medical and technical staff in the whole country. 相似文献20.