Prediction of AVM obliteration after stereotactic radiotherapy using radiobiological modelling

This study was carried out in order to derive the radiobiological parameters of the dose-response relation for the obliteration of arteriovenous malformation (AVM) following single fraction stereotactic radiotherapy. Furthermore, the accuracy by which the linear Poisson model predicts the probability of obliteration and how the haemorrhage history, location and volume of the AVM influence its radiosensitivity are investigated. The study patient material consists of 85 patients who received radiation for AVM therapy. Radiation-induced AVM obliterations were assessed on the basis of post-irradiation angiographies and other radiological findings. For each patient the dose delivered to the clinical target volume and the clinical treatment outcome were available. These data were used in a maximum likelihood analysis to calculate the best estimates of the parameters of the linear Poisson model. The uncertainties of these parameters were also calculated and their individual influence on the dose-response curve was studied. AVM radiosensitivity was assumed to be the same for all the patients. The radiobiological model used was proved suitable for predicting the treatment outcome pattern of the studied patient material. The radiobiological parameters of the model were calculated for different AVM locations, bleeding histories and AVM sizes. The range of parameter variability had considerable effect on the dose-response curve of AVM. The correlation between the dosimetric data and their corresponding clinical effect could be accurately modelled using the linear Poisson model. The derived response parameters can be introduced into the clinical routine with the calculated accuracy assuming the same methodology in target definition and delineation. The known volume dependence of AVM radiosensitivity was confirmed. Moreover, a trend relating AVM location with its radiosensitivity was observed.     

Ion beam transport in tissue-like media using the Monte Carlo code SHIELD-HIT

The development of the Monte Carlo code SHIELD-HIT (heavy ion transport) for the simulation of the transport of protons and heavier ions in tissue-like media is described. The code SHIELD-HIT, a spin-off of SHIELD (available as RSICC CCC-667), extends the transport of hadron cascades from standard targets to that of ions in arbitrary tissue-like materials, taking into account ionization energy-loss straggling and multiple Coulomb scattering effects. The consistency of the results obtained with SHIELD-HIT has been verified against experimental data and other existing Monte Carlo codes (PTRAN, PETRA), as well as with deterministic models for ion transport, comparing depth distributions of energy deposition by protons, 12C and 20Ne ions impinging on water. The SHIELD-HIT code yields distributions consistent with a proper treatment of nuclear inelastic collisions. Energy depositions up to and well beyond the Bragg peak due to nuclear fragmentations are well predicted. Satisfactory agreement is also found with experimental determinations of the number of fragments of a given type, as a function of depth in water, produced by 12C and 14N ions of 670 MeV u(-1), although less favourable agreement is observed for heavier projectiles such as 16O ions of the same energy. The calculated neutron spectra differential in energy and angle produced in a mimic of a Martian rock by irradiation with 12C ions of 290 MeV u(-1) also shows good agreement with experimental data. It is concluded that a careful analysis of stopping power data for different tissues is necessary for radiation therapy applications, since an incorrect estimation of the position of the Bragg peak might lead to a significant deviation from the prescribed dose in small target volumes. The results presented in this study indicate the usefulness of the SHIELD-HIT code for Monte Carlo simulations in the field of light ion radiation therapy.     

Mean energy in electron beams

The mean energy of the energy spectrum is an essential parameter for the dosimetry of therapeutic electron beams. Frequently it is assumed that the mean energy of such beams remains constant across the beam and only its degradation with depth is considered. The present work analyzes the variation of the mean energy of primary electrons with depth and lateral position in an electron beam using the Monte Carlo method. Results are compared with relations commonly employed for determination of mean energy at a depth. For the variation of the mean electron energy with depth in broad beams, good agreement was found between Monte Carlo results and an analytic continuous slowing down expression, which takes the variation of radiation stopping power with depth into account. Due to the calculated lateral variation of the mean energy, the relative absorbed dose profile determined with an air ionization chamber in a clinical beam should differ by less than 1% from the measured ionization profile.     

Biologically effective doses in radiotherapy of cervical carcinoma*

Presented study evaluates biologically effective dose (BED) in patients receiving low-medium dose-rate (LDR/MDR) brachytherapy (BRT) plus external beam radiotherapy (XRT) based on tumor cell proliferation values in cancer of the cervix patients. This study includes 229 patients treated entirely by radiotherapy at the Centre Oncology in Krakow. Doses to Point A were estimated for total treatment for each brachytherapy insertion. BED3 were calculated for reference points in the rectum. The linear quadratic equation was used to calculate BED, which is proportional to log cell kill, and the normalized total dose (NTD), that is, equivalent to a 2 Gy fraction schedule. In BEDs 10 calculation overall treatment time for each patient. Tumor proliferation rate was based on Bromodeoxyuridine labeling index (BrdUrdLI) assessed on biopsy material before beginning the radiotherapy. Total BED at those points was summed for each patient. The medium overall treatment time was 90 days (range 30--210). The mean calculated total BED for point A for tumour and "early reactions" was equal to 104.0 Gy10 and 229.0 Gy3 for the rectum, equivalent to NTD=86.6 Gy and 137.4 Gy in 2 Gy fractions, respectively. Kaplan-Meier analysis revealed that age >50 years, higher than mean BRBEDs and totBEDs doses, gaps in treatments shorter than 40 days and disease free survival (DFS) was significant prognostic factor for overall survival. In the multivariate Cox anaysis age >50 years, BRBED10 >77 Gy and gaps ?40 days appeared to be significant for overall survival. None of the examined parameters was significant for tumor control. However, patient? age and shorter gaps in the treatment were predictive for DFS.     

A Qualitative Exploration to Understand the Sexual Behavior and Needs of Young Adults: A Study Among College Students of Pune,India

Indian Journal of Pediatrics - Youth and adolescents are the priority population to target the interventions as risky behaviors persist and they contribute to almost half of the new Human...     

Relative biological effectiveness of boron ions on human melanoma cells

PURPOSE: To compare the difference in relative biological effectiveness (RBE) between (10)B ions and a (60)Co gamma-ray beam for human melanoma cells using in vitro cell survival based on a clonogenic assay. MATERIALS AND METHODS: Cells were irradiated in vitro under aerobic conditions with (60)Co and (10)B ions with different linear energy transfer (LET) (40, 80 and 160 eV nm(-1)). The dose to the cells was determined using ferrous sulphate dosimetry and an ionisation chamber. The standard linear-quadratic model and the newly proposed repairable conditionally repairable damage (RCR) model were used to calculate the RBE. RESULTS: The RBE at 10% cell survival for 40, 80 and 160 eV nm(-1) boron ions compared with (60)Co were 1.98 (1.83-2.22), 2.85 (2.64-3.11) and 3.37 (3.17-3.58), respectively, of almost independence of the model used in the calculation. CONCLUSIONS: Different cell survival models may generate different RBE, especially at low doses and high cell survival levels.     

Dynamic aspects of colonic Crohn's disease.

Changing patterns of the lesions in colonic Crohn's disease were studied in 86 patients who underwent multiple consequetive roentgen examinations. Local progression of lesions was seen in 56 out of 86 patients; rapid local advancement from mild to severe lesions was not uncommon. Temporary regression of lesions was only seen in 7%; definitive permanent healing on conservative treatment was not observed. Preoperative extension of lesions was seen in 29%, with ultimate involvement of the rectum in 7% and development of anal fistulae in 17%. Clinical implications of the findings are briefly discussed.