International Journal of Radiation Research
Volume:21 Issue: 2, Apr 2022

Ethyl cinnamate (Ethyl (2E)-3-phenylprop-2-enoate) is an aromatic compound of cinnamon. According to the Indian Ayurvedic medical system, cinnamon has been used to treat various diseases.The current study examines the potential of ethyl cinnamate (EC) in modulating radiation responses in cancerous (HepG2) and normal (BRL-3A) cells.

HepG2 and BRL3A cells were pre-treated with EC (75 µg/ml) for 24 hours before being subjected to a single 7.5 Gy dose of γ-ray. By using flow cytometry and western blotting, the primarysurvival pathways (PI3-AKT, JAK-STAT, MAPK & JNK), cell cycle inhibitors (p53 & p21), DNA damage indicators (ATM, ATR, γ-H2AX, cleaved PARP), anti-angiogenic TIMP2 and angiogenic factor MMP9 were analysed. The activity of the catalase enzyme was assessed by UV-Visible spectrophotometry.

The complex effects of EC on the suppression of pro-survival and anti-apoptotic proteins such as p-JNK, p-JAK2, p-STAT3, and p-p38MAPK results in enhanced radio-sensitization and radiation-induced cancer cell killing. The radio-response is potentiated by EC’s ability to suppress downstream effector proteins such as p21, p-p53, and MMPs and block radiation-triggered p-NF-κB signalling pathways. Additionally, EC effectively enhanced the radio-induced DNA damage in HepG2 cells by stimulating p-ATM, p-ATR, γ-H2AX and PARP cleavage. However, in BRL-3A cells, EC significantly reduced radiation-induced DNA damage.

The potential of EC as a radio-sensitizer in HepG2 cells and a radio-protector in BRL3A cells was observed in this investigation. Based on the elucidated molecular mechanisms, safety profile, and low cost, EC might be considered a promising adjuvant to enhance radio-therapeutic efficacy in cancer treatment.

To perform a comparison of the plan quality between volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) for multiple liver metastases using single-isocenter stereotactic body radiotherapy (SBRT).

Twenty-one patients who developed two or three adjacent liver metastases were included. For every patient, both VMAT and IMRT plans were replanned respectively for SBRT treatment. Dosimetric parameters, including the mean dose for the planning target volume, conformity index (CI), homogeneity index (HI) and gradient index (GI), were evaluated. Normal tissue sparing was also investigated. Finally, the total delivered monitor units (MUs) for both groups of treatment plans during irradiation were measured and compared.

Both groups of treatment plans satisfied normal tissue tolerance and produced clinically accepted dose distributions. The VMAT plans provided higher values of HI and GI as well as similar CI values in comparison with the IMRT plans. In addition, the VMAT plans obtained ultimately a improved mean dose to the target and a reduced dose to the organs at risk. However, there were no statistically significant differences in the V7Gy and D700cc of healthy liver, the mean dose and V15Gy of the ipsilateral kidney, the mean dose to the stomach, and the maximum dose to the heart between the two groups. Finally, the VMAT plans showed fewer MUs than the IMRT plans.

The plan quality of single-isocenter VMAT plans is superior to that of IMRT plans for the SBRT treatment of multiple metastatic liver tumors from the perspective of pure physical parameters.

The geometric and dosimetric accuracy of auto-segmentation OAR are of key importance for radiation oncologists who use auto-segmentation instead of manual segmentation. This study investigates the geometric and dosimetric accuracy of auto-segmentation OAR for early peripheral NSCLC using an artificial intelligence cloud online platform (AI Contour).

AI Contour was used to perform the contour segmentation of OAR on twenty patients with early peripheral NSCLC, to evaluate geometric and dosimetric accuracies. Manual segmentation and auto-segmentation were performed to depict the outlines of the heart, lung, trachea, esophagus, and spinal cord. For geometric accuracy, the authors acquired and compared the Dice similarity coefficient, Jaccard coefficient, Hausdorf distance, Center of mass deviation, Inclusive index, and Sensitivity index. For dosimetric accuracy, the dose statistical differences between manual- and auto-segmentation were analyzed. The absolute irradiation volume deviation (AVD) and volume percentage deviation (VPD) for the V5, V10, V15, and V20 of the lungs were assessed. The absolute irradiation dose deviation (ADD) and dose percentage deviation (DPD) for OAR were evaluated.

The DSC for each OAR was higher than 0.77. The dosimetric difference between manual and auto-segmentation was small and not significant (p>0.05). For the lung, the AVD was less than 7 mL, the VPD was less than 3%, the ADD of OAR was at most 0.4 Gy, and the DPD was less than 4%.

The accuracy of the auto-segmented OAR for early peripheral NSCLC was acceptable based on AI Contour.

In this study, intensity-modulated radiation therapy plans were made with and without couch rotation in patients with right unilateral breast cancer, and a dosimetry analysis was carried out to compare the radiation doses received by target and normal tissues.

The radiotherapy planning tomography sets of 10 patients who underwent right unilateral mastectomies were retrospectively selected. Target volumes and normal at-risk organs were recontoured, two radiotherapy plans were created for each patient, and these plans were compared by dosimetry analyses.

Doses in the target volume (D2%, D98, D50, HI, VRI, and T-PTV-V95) were similar between the plans. In terms of organs at-risk doses, the maximum doses in the contralateral breast were similar between the plans, while the differences in all other organs at-risk dose parameters between the plans were statistically significant. All dosimetry parameters of the heart were significantly lower in the plans with couch rotation. Ipsilateral lung doses were higher in the plans with couch rotation. Contralateral lung and mean breast doses were significantly lower in the plans with couch rotation.

In this study, organs at-risk doses were reduced, especially for the heart and the contralateral breast, in patients who were subjected to postmastectomy radiotherapy with right thoracic wall and regional nodal irradiation without compromising radiotherapy dose coverage for the target volumes by rotating the treatment couch by 270°.

The purpose of this study is to evaluate the accuracy of 18F-fluorodeoxyglucose (FDG) positron emission tomography/Computed Tomography (PET/CT) in predicting tumor prognosis in patients with Small Cell Lung Cancer (SCLC).

From July 2015 to March 2019, all 30 SCLC patients who had analyzable PET/CTs and adequate clinical data were evaluated. Medical records were retrospectively reviewed, including age, gender, stage, performance status according to the Eastern Cooperative Oncology Group (ECOG), metabolic parameters on PET and treatment programs. Factors potentially affecting tumor prognosis were examined by models of univariate and multivariate Cox proportional hazards regression.

The median age of the cohort was 58 years (range: 39-93). A median follow-up period of 12 months was observed. Multivariate Cox proportional hazards regression demonstrated that the overall survival (OS) (p = 0.03) and progression-free survival (PFS) (p = 0.014) were related only to the metabolic tumor volume (MTV). The optimal cutoff threshold was 98 mm3, and the receiver operating characteristic (ROC) curve had an area under it of 0.75. In comparison to the high-MTV group, the low-MTV group had statistically substantially prolonged OS (p = 0.004) and PFS (p < 0.001).

The MTV of 18F-FDG PET/CT is a major independent prognostic factor in SCLC patients and has significant implications for OS and PSF.

Producing the ideal therapeutic electron beams from a clinical linear accelerator (Linac), is crucial to optimize dose delivery in radiotherapy. The aim of this study was to investigate the properties of electron beams with and without the scattering foil.

Varian Linac 2100CD head was simulated by means of MCNPX-2.7 program. After validation with measured data, scattering foils were removed and then different dosimetric properties of 6 and 9 MeV electron beams such as depth dose percentage, dose profile, range, surface dose, dose rate and photon contamination were calculated and compared for field sizes ranging from 0.25×0.25 to 10×10 cm2 in three states with primary and secondary scattering foil (SF), without primary scattering foil (PSFF) and without primary and secondary scattering foil (SFF).

By removing the scattering foils, dose rates and surface doses were increased more than 25 times in 0.25×0.25 cm2 field, and in the bigger fields, it was less in 10×10 cm2 field, almost 4 times and the photon contamination is reduced by 20% times in 0.25×0.25 cm2 field. Also, Adjacent organs receive a lower dose, Because the dose profile curve was shrieked, it was almost 1cm in field 2×2 cm2 and less than 1cm in other fields. The dose profile flatness was diminished in scattering foil-free (SFF) mode which is not crucial for the small fields.

Removing scattering foil improves dosimetric properties of electron beams specially to treat the superficial tumors and for the small field radiotherapy.

Vocal problems caused by Chemo-radiation therapy (CRT) can affect a patient’s quality of life (QOL) for a long time. This study aims to follow up and evaluate the voice of Persian-speaking patients with non-laryngeal head and neck cancer up to eighteen months after treatment.

This prospective study was conducted to assess the voice of disease-free patients with various head and neck malignancies treated with CRT. The voice assessment was conducted at four points: before, at the end of treatment, and six and eighteen months after treatment. At the time of the last assessment, there were only 30 patients with an average age of 48.86±14.89 and in the range of (18-75) years. For a comprehensive assessment, acoustic, expert-rater, and subjective evaluation of voice was conducted. The Pearson correlation coefficient for all acoustic parameters, subgroups of the Persian VHI-30 questionnaire, and perceptual measurements were computed. The effect of essential factors on patient QOL associated with the voice in different groups was examined.

All acoustic parameters, other than fundamental and habitual frequencies, subjective and perceptual data values increased significantly (P < 0.001) during the treatment and decreased at the last assessment. None of the values have returned to pre-treatment levels. There was a significant relationship between some acoustic parameters, Persian VHI-30 questionnaire values, and G on the GRBAS scale. Chemotherapy and smoking were influential factors in patients' QOL.

Vocal problems and reduced voice related QOL in patients treated with CRT may persist for years after treatment.

This study aimed to determine the diagnostic value of ground-glass opacities on computed tomography combined with computed tomography re-examination in patients with suspected novel coronavirus pneumonia.

Suspected cases of novel coronavirus pneumonia were identified retrospectively between January 23 and February 18, 2020. Computed tomography examination was conducted for all patients. For all suspected cases, real-time reverse transcription-polymerase chain reaction detection of novel coronavirus nucleic acid was conducted. Computed tomography re-examination in the short term was also performed.

Among 92 patients suspected with novel coronavirus pneumonia, 15 were diagnosed with coronavirus disease 2019. There were ground-glass opacities on chest computed tomography in 34 patients, and 8 of these patients were confirmed to have novel coronavirus pneumonia. In total, 30 patients showed no absorption on computed tomography re-examination, of which 10 (10/30) were diagnosed with novel coronavirus pneumonia. Additionally, 20 patients had non-absorption of lesions when ground-glass opacities on initial and follow-up computed tomography were combined, and 13 of these patients were confirmed to have novel coronavirus pneumonia. For ground-glass opacities on computed tomography combined with non-absorption of lesions on computed tomography re-examination, the sensitivity and specificity for the diagnosis of the novel coronavirus were 86.7% and 90.1%, respectively.

Among suspected patients with novel coronavirus pneumonia, combining ground-glass opacities on computed tomography with a computed tomography re-examination might improve the accuracy of diagnosis.

While there have been marked improvements in radiotherapeutic techniques in recent years, the emergence of radioresistance remains a pressing challenge to the clinical treatment of esophageal squamous cell carcinoma (ESCC). Altered DNA methylation is believed to play a role in the etiology of such resistance. This study was designed to explore patterns of altered genome-wide gene expression and DNA methylation patterns in radioresistant ESCC cells (TE1-res) in an effort to provide a foundation for the future study of the molecular drivers that underlie this form of therapeutic resistance.

A microarray-based approach was used to conduct genome-wide DNA methylation and gene expression analyses using matched radioresistant and radioresistant ESCC cells. The mechanistic basis for ESCC cell radioresistance was then further examined through functional enrichment and protein-protein interaction analyses.

Relative to parental TE1 cells, TE1-res cells exhibited marked changes in their DNA methylation profiles, with the disproportional distribution of differentially methylated CpG sites (dmCpGs) in CpG islands and shore regions. Ontological analyses revealed that genes that were differentially expressed and methylated were enriched in the Ras protein signal transduction, regulation of DNA damage response, and angiogenesis pathways. Protein-protein interaction analyses further suggested that ACTL8, M-RAS, TRIB2, GATA5, ERBB4, FN1, DIRAS1, BTK, ROR1, and NPR3 may serve as hub proteins within TE1-res cells.

These analyses revealed a significant association between DNA methylation and TE1-res cell radioresistance, highlighting several candidate genes and pathways that may be amenable to clinical targeting in an effort to increase the radiosensitivity of these ESCC cells.

Cytokines have a recognized role in the physiopathology of cancer disease and could be involved also in the “abscopal effect”. Aim of this work is the preliminary analysis of inflammatory mediators in patients with oligometastatic non-small-cell lung cancer (NSCLC) undergoing stereotactic radiotherapy (SRT).

This was a feasibility multi-institutional study that prospectively included oligometastatic NSCLC patients undergoing SRT from June 2018 until August 2018 and healthy controls. Blood samples were collected at three different time points (1-5 days before SRT, 1-5 days after SRT and 28-35 days after SRT). A commercially available kit was used for quantitative analysis of 44 inflammation molecules. Nine patients and four healthy controls were enrolled.

  Several cytokines (54.5%) resulted undetectable in a significant percentage of the samples and were not further analyzed. Levels of seven inflammatory molecules (bDNF, MIP-1b, PDGF-bb, PIGF-1, RANTES, SDF1-a, and bNGF) showed significant variations after SRT in the NSCLC patients cohort.

Significant plasmatic concentration changes after SRT were reported for a relevant proportion of the evaluated molecules. The results of this study will contribute to define a selection of cytokines and chemokines that will be analyzed in a prospective trial with a larger sample of patients.

The transfer of dissolved radionuclide in water into the indoor air is one of the major pathways for radon-222 (222Rn). In water treatment and production plants (WTPPs), there is a risk that radon degasses from the water and enters into the indoor air. Hence, this study assessed different WTPPs to determine the amount of 222Rn workers are exposed to as a result of their occupation.

An Electret Passive Environmental Radon Monitor (E-PERM®) device was used to investigate the indoor radon levels in the processing, packaging, and storage rooms of five (5) well-known and active WTPPs in Ogbomoso, Nigeria, and descriptive statistics was used for the analysis of data obtained.

The radon concentration obtained varies between 44 - 149 Bq/m3 with an average of 69.28 ± 20.06 Bq/m3 in the processing rooms, 27 – 44 Bq/m3 with an average of 36.02 ± 4.05 Bq/m3  in the packaging rooms and 34 – 144 Bq/m3 with an average of 71.15 ± 42.81 Bq/m3 in the storage rooms. The average annual effective dose obtained for each of the WTPPs varies between 1.00 mSvy-1 and 2.00 mSvy-1.

The results showed that all the investigated WTPPs had high radon concentration and annual effective dose when compared with the action level proposed by local and international organizations. Hence, the workers are at risk to 222Rn during water treatment and production processes.

Amifostine (AMI) protects against radiotherapy (RT)-induced toxicities and melatonin (MEL) is a potent free radical scavenger. This study was performed to investigate the protective effects of AMI and MEL on radiation-induced oral mucositis (ROM).

Thirty female Sprague-Dawley rats were randomly divided into five groups as follows: the control (Cont), RT alone (RT), RT+AMI, RT+MEL, and RT+AMI+MEL. RT groups were irradiated with a single dose of 15 Gy to the head. AMI (200 mg/kg) and MEL (100 mg/kg) were administered intraperitoneally 1 hour before radiation exposure. Changes in body weights and histology in irradiated tongue tissues were analyzed 10 days after exposure.

AMI and/or MEL treatment significantly prevented irradiation-induced body weight loss and promoted epithelial cell proliferation. Mean epithelial thickness was markedly higher in the AMI+MEL group (73.9 ± 9.7 um) than in the RT group (28.8 ± 13.9 um) (P<0.001), and Ki67 expression was significantly higher in AMI, MEL, and AMI+MEL groups than in the RT group (p < 0.001). Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) revealed that AMI+MEL treatment significantly inhibited radiation-induced apoptosis in irradiated epithelium (p=0.006).

AMI and MEL administrations similarly protected animals from ROM and, when co-administered, had additive effects.

Preoperative assessment of lymph node metastasis (LNM) status is the basis of individual treatment for rectal cancer (RC). However, conventional imaging methods are not accurate enough.

We collected 282 RC patients who were divided into the training dataset (n=225) and the test dataset (n=57) with an 8:2 scale. A large number of deep learning (DL) features and hand-crafted radiomics (HCR) features of primary tumors were extracted from the arterial and venous phases of the computed tomography (CT) images. Three machine learning models, including support vector machine (SVM), k-nearest neighbor (KNN),and multi-layer perceptron (MLP) were utilized to predict LNM status in RC patients. A stacking nomogram was constructed by selecting optimal machine learning models for arterial and venous phases, respectively, combined with predictive clinical features.

The stacking nomogram performed well in predicting LNM status, with an area under the curve (AUC) of 0.914 [95% confidence interval (CI): 0.874-0.953] in the training dataset, and an AUC of 0.942 (95%CI: 0.886-0.997) in the test dataset. The AUC of the stacking nomogram were higher than those of CT_reported_N_status, ASVM, and VSVM model in the training dataset (P <0.05). However, in the test dataset, although the AUC of the stacking nomogram was higher than the VSVM, the difference was not obvious (P =0.1424).

The developed deep learning radiomics stacking nomogram showed to be effective in predicting the preoperative LNM status in RC patients.

Glioma is the most common type of tumor in the nervous system. Glioma grading remains challenging despite advancements in diagnostic and treatment systems. Preoperative classification is essential to determining optimal treatment and prognosis for gliomas. This study aimed to use magnetic resonance imaging (MRI) to develop accurate nomogram models for glioma grading.

Eighty-three patients who had undergone a glioma biopsy from June 2017 to November 2021 were retrospectively collected. Two multiparametric MRIs were acquired: T2-weighted and T1-weighted gadolinium contrast-enhanced of 83 glioma patients from one medical institution. Using the open-source python package PyRadiomics, 107 radiomics features were identified for each sequence MRI. We analyzed the probabilities of low-grade gliomas (LGG) and high-grade gliomas (HGG) using logistic regression and the least absolute shrinkage and selection operator regression (LASSO). We identified seven features affecting LGG and HGG differentiated using the lasso algorithm. Next, logistic regression analysis was performed to build a classification model, and five features were obtained. Nomograms were created to predict the incidence of HGG and LLG. To evaluate the prediction performance of the models, receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC), sensitivity, specificity, and accuracy were calculated.

For multivariate logistic regression models, according to the best-selected features based on MRI images and clinical data, five parameters were independent predictors of LGG from HGG (P<0.001). The highest prediction performance in terms of AUC, sensitivity, specificity, and accuracy was 0.97, 89.19%, 91.11%, and 90.24%, respectively.

The radiomics nomogram models created from quantitative images and clinical data performed well in differentiating LGG from HGG.

This study aimed to review computed tomography (CT) findings in COVID-19 patients, and establish correlations between CT findings in patients with a short vs. long disease course, and in those with mild vs. severe disease.

From February 2020 to March 2020, 58 patients with SARS-CoV-2 infections were retrospectively included. Clinical, laboratory, and CT findings were compared between patients with a short vs. long disease course, and in subgroups with mild vs. severe disease. Correlation analyses were performed to determine factors correlated to greater disease severity in patients with short/long disease courses, respectively.

Fifty-eight patients were included; 29 in the short disease course and 29 in the long disease course group. CT findings were similar between patients with a short and a long disease course (all, P > 0.05). Among the short disease course group, severe disease patients had significantly higher rates of right upper lobe involvement, 5 lobes affected, pericardial effusion, pleural involvement and bilateral pleural thickening, grid shadow, higher-density vascular shadows, crazy-paving appearance, lung consolidation, an air bronchogram sign, and fibrous foci than those with mild disease. Among the long disease course group, severe disease patients had significantly higher rates of right upper lobe and middle lobe involvement, 5 lobes affected, pleural effusion and thickening, grid shadow, higher-density vascular shadows, crazy-paving appearance, lung consolidation, an air bronchogram sign, and atelectasis.

CT imaging findings may help to predict disease severity in COVID-19.

Natural radioactivity concentrations of 238 U, 232 Th, and 40 K in surface soil specimens from various sectors in Sadr city were collected and measured by HPGe detector.

Twenty specimens were collected from selected sites in the study district. The total average activity concentrations of radionuclides 238 U, 232 Th and 40 K were 15.35±0.82 Bq/kg, 13.31±0.79 Bq/Kg, and 315.39±18.05 Bq/kg, respectively. Correlations between these radionuclides demonstrate a secular equilibrium in the examined soil.

It was found that the average rate of absorbed dose is 87.510±21.555 nGy/h which is below the maximum limit except for specimens S13 and S14, where their values are close to the permissible limit. The indoor gamma-ray absorbed dose rate exceeds the permissible limit in the soil specimens S13 and S14. Radium equivalent activities, external and internal hazard indices, representative, with respect to the examined soil, do not override the global limits.

Average concentrations of the radioactive elements were lower than the worldwide mean values. 40 K concentration and lifetime cancer risk  and  in soil specimens S13, S14, and S20 were above the recommended limit, while total annual effective dose equivalent   is very close to the permissible limits provided by UNSCEAR and ICRP.

To investigate the effects of different radiotherapy regimens on the prognosis of patients with brain metastases.

Patients with brain metastases undergoing radiotherapy from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into a whole-brain radiotherapy (WBRT) group, stereotactic ablative radiotherapy (SABR) group, and WBRT+SABR group, and overall survival (OS) and progression-free survival (PFS) were analyzed.

Forty patients were candidates for the analysis, with a median age of 57.5 years and a median follow-up time of 27.4 months. The median OS and PFS were 35.7 and 13.5 months, respectively, and the median radiotherapy dose was 41.7 Gy. The median OS times for patients who received WBRT (n = 12), SABR (n = 21), and WBRT+SABR (n = 7) were 41.8, 70.6, and 56.8 months, respectively (p = 0.7). The median PFS times were 10.2 months, 34.3 months, and 25.9 months, respectively (p = 0.322). Subgroup analysis indicated that the OS times were 25.4 months after WBRT (n = 7), 79.1 months after SABR (n = 11), and 65.9 months after WBRT+SABR (n = 5) among patients with brain metastases from lung cancer (p = 0.028). The patients had PFS times of 7.1, 33.4, and 29.1 months after irradiation with WBRT, SABR, and combination therapy, respectively (p = 0.009).

The three different radiotherapy regimens had no significant effects on the prognosis of patients with brain metastases. SBAR was superior to WBRT and WBRT+SABR with respect to the prognosis of patients with brain metastases from lung cancer. The sample size of this retrospective study was small; therefore, larger, prospective studies are needed.

We aimed to report demographic features, tumor characteristics, and survival outcomes of the patients with esophageal cancer (EC) in the Eastern Anatolian Region of Turkey, where upper gastrointestinal tumors are endemic.

Our retrospective investigation was performed on patients with EC treated in Erzurum Regional Training and Research Hospital Clinics of Medical and Radiation Oncology between 2005 and 2017. The patients with stage IIA-IV disease and completed at least one treatment modality (surgery/ definitive chemoradiotherapy(CRT)/palliative chemotherapy(CT) or radiotherapy(RT)) had enrolled in the study. The demographic and clinicopathological characteristics, TNM stage, oncological treatment modalities applied, and survival outcomes were statistically analyzed.

Our study consisted of 251(women, 57.4%) patients with EC with a female/male ratio of 1.34/1. The median age of the patients was determined as 62 years. The primary tumor was frequently localized in the middle(46.6%) and lower(46.2%) part of the esophagus, and the majority had squamous cell carcinoma histopathological subtype(86.1%). The median follow-up period and overall survival (OS) time were 21.2 and 19.0 months, respectively. A five-year OS rate was detected as 19.3%. As a result of multivariate analysis; grade, stage and concurrent CRT were determined as independent prognostic factors (p=0.004, p=0.019, and p=0.014, respectively). The median OS of stage II-III and IV patients were 25.79 versus 10.02 months (p<0.001). Among stage II-III patients, the best median OS was in the surgery+ adjuvan RT/CRT group(37.02 months). In stage IV patients, the median OS of female patients was found to be statistically significantly higher than that of males(15.77 versus 9.29 months p=0.007).

EC is a significant health problem in the Eastern Anatolian Region of Turkey. Differences were detected according to age and gender, tumor characteristics, histological subtype, and disease stage rates in patients with EC living in this region, but the survival rate was similar with the literture. Surgery+ adjuvant RT/CRT provided better OS in the non-metastatic patients than other treatment modalities.

Total Body Irradiation (TBI) is a specialized radiotherapy technique and it varies from routine radiotherapy techniques that involve a complex treatment procedure. It is therefore mandatory to perform an in-vivo dosimetry check to ensure dose accuracy and homogeneity during treatment. There is also a clear demand for in-vivo dose validation which must be reliable. The primary objective of this work is to review in-vivo dosimetry measured for our TBI patients using Film.

In this study, in-vivo dosimetric data of 185 patients who received TBI during 2015 to 2021 were evaluated. The measurements were performed at 14 anatomical sites using GafchromicTM EBT-3 film (The Ashland Inc., Bridgewater, USA). For mid-plane dosimetry, a special TBI phantom was designed and used for measurements.

For most of the patients, the in-vivo dosimetry result and the mean dose to the whole body were within ±10% (90.1% - 110%) of the prescription dose. The standard deviation was calculated for all the patients and the values were observed between 2.4cGy to 24cGy. Also, the analysis shows that both surface and mid-plane dosimetry were within the acceptable limits of ±10% of prescription dose. The mean mid-plane dose with film and ionization chamber shows 1.5% variation at the umbilicus.

This extensive patient data analysis, as well as the reproducibility of patient dosimetry values and dose homogeneity of ±10% from the prescription dose, proves that the TBI treatments at our center meet the acceptable limits and EBT3 films are reliable in TBI in-vivo dosimetry.

The Background To explore the influence of centrifugal massage on reducing the incidence of compartment syndrome after contrast extravasation (CM) and reducing the tension.

A total of 62 patients with iodine contrast agent extravasation who underwent CT angiography in our hospital from March 2020 to March 2022 were chosen and separated into observation group (OG, n=31) and control group (CG, n=31) following the nursing plan. Patients in the CG adopted external application of drugs, and patients in the OG received centrifugal massage. The occurrence and duration of swelling, the incidence of compartment syndrome after contrast extravasation, nursing satisfaction, patients’ symptoms, and psychological status were compared between both groups.

The swelling degree and duration and incidence of compartment syndrome after contrast extravasation in the OG were declined relative to the CG (P<0.05). After 24 and 48 hours of intervention, patients in the OG had elevated self-rating scales compared to the CG (P<0.05). The nursing satisfaction of patients in the OG was elevated compared to the CG (P<0.05). After intervention, the anxiety and depression scores of the OG was decreased compared to the CG (P<0.05). The effective rate of treatment in the OG was elevated compared to the CG (P>0.05).

Centrifugal massage for patients with CT enhanced scanning can prevent the incidence of CM after contrast extravasation, reduce the damage of contrast agent to tissues, and improve nursing satisfaction.

Radiation therapy inevitably causes certain radiation damage to normal cells such as human vascular endothelial cells (HVECs), in addition to eliminating tumor cells. This article discusses the influence of miR-711 on the survival and apoptosis of human umbilical vein endothelial cells (HUVECs) after X-ray radiation.

The expression of miR-711 and v-maf musculoaponeurotic fibrosarcoma oncogene family protein G (MAFG) was detected by real-time quantitative polymerase chain reaction (RT-qPCR), and the content of vascular cell adhesion molecule 1 (VCAM-1) in serum was detected by Enzyme-linked immunosorbent assay (ELISA). The survival and apoptosis of HUVECs after X-ray irradiation were analyzed by functional experiments, and validation of MAFG as a miR-711 target was done by dual-luciferase reporter assay.

In the serum of prostate cancer patients miR-711 was up-regulated, while MAFG was down-regulated compared to the control group. After X-ray radiation intervention, miR-711 levels were increased, in contrast, MAFG levels decreased with a concomitant increase in VCAM-1 expression.. The percentage of survival level of HUVECs decreased gradually and the apoptosis rate of HUVECs increased as the dosage of X-ray radiation increased. Notably, after 2Gy X-ray radiation, the miR-711 inhibitor increased the survival rate of HUVECs while reducing the apoptosis rate, in contrast to the miR-711 mimic decreased the survival rate of HUVECs and increased the apoptosis. Besides, luciferase activity assay demonstrated the targeting of miR-711 to MAFG.

The inhibition of miR-711 might abrogate the function of X-ray irradiation on the survival and apoptosis of HUVECs.

The purpose of this study is to contrast the output factors using non-identical detectors with different setups and their effect on the plan of therapy.

The measurements were obtained for 6MV beams with various volume chambers using Varian True beam™ STx linear accelerator (LINAC). With chambers set up at source to axis distance (SAD) and source to surface distance (SSD) at two different depths, the output factors were measured (both 5 and 10 cm). The smallest output factors were assessed with the SAD technique at 5 cm of depth and the largest output factor was observed with the SSD approach at 10 cm depth and had been moved to the system for treatment planning and variation in calculated and measured dose was noted.

 A variation in measured dose from Treatment Planning System (TPS) calculated ranges from 0 to -2.7 % for small field plans calculated with SAD technique and -0.22 to -2.31 % for plans calculated with SSD technique. For large fields, it ranges from -0.89 to 0.8 % for SAD and -0.6 to 0.64 % for the SSD technique. The Statistical significance was checked and was found to be greater than 0.05.

The percentage difference in output factors at two depths was more prominent for low energy beams (6 MV) than for beams of greater energy. This might be a result of the loss of lateral equilibrium as the depth is changed. The output factor measurement at 10 cm of depth and 100 cm SSD is suitable for small fields (3 x 3 cm2) as it increases the lateral equilibrium and hence reduces the error.

The primary goal of this research is to identify the best energy or energy combination for an Intensity Modulated Radiotherapy (IMRT) treatment plan of esophageal cancer.

Ten retrospective oesophagus case patients were selected, treated with 6MV IMRT plans and later replanned with different energies and energy combinations. The same prescription, planning parameters and optimization constraints were applied to all plans which were analysed and compared based on certain plan parameters and dosimetric parameters. Comparisons were also made using technical specifications, such as Monitor Units (MUs) and Treatment Time (TT).

The study shows most significant results with (6X+10X) plan. The Planning Target Volume (PTV) mean dose, D2%, D98%, D50% and Conformity Index (CI95%) improved as 29.68±0.38, 30.86±0.38, 27.42±0.67, 29.84±0.39 and 1.103±0.08 from their respective base plan values with the p-values 0.068, 0.176, 0.006, 0.159 and 0.085 respectively. Among Organs at risks (OARs), the right lung V20, left lung V20, spine mean dose and spine D1% values reduced to 7.99±6.0, 10.59±7.7, 19.99±9.7 and 18.63±9.4 from 8.70±6.50, 11.98±7.9, 22.76±7.6 and 20.04+8.0 respectively with the p-values 0.172, 0.259, 0.090 and 0.092. Total MU and TT in the original plan were 5054.28±2286.1, and 25.12±11.2, however they were lowered to 3036.54±1556.2, and 16.52±11.2, with p-values of 0.043 and 0.137, respectively.

This study concludes that the mixed energy plan (6X+10X) is optimal for high-quality IMRT therapy because of its superior dosimetric indices (i.e., PTV coverage, OAR doses, and technical factors like MUs, TT, and low photoneutron generation).

Malignant pleural mesothelioma (MPM) diagnoses are primarily based on pleural biopsy. Invasive procedures may result in iatrogenic dissemination of tumor cells along the subcutaneous channels. The purpose of our study was to clarify the effect of prophylactic radiotherapy on the incidence of metastasis in patients afflicted with MPM.

Relevant studies were searched in PubMed, Cochrane Library, and Embase databases from the establishment of the library to February 2022. The quality of the included studies was evaluated, and the data were statistically analyzed.

Seven articles were obtained, and 1030 patients were included in the study, which allowed comparison of the procedure to track metastases (PTMs) incidences between radiotherapy and control groups. The results revealed statistically significant differences in the incidence of PTMs between the two groups (OR=0.48, 95% confidence interval [CI]:0.33, 0.69, p<0.0001). Subgroup analysis further showed that preventive radiotherapy could effectively reduce the incidence of PTMs in MPM patients who underwent large-caliber invasive procedures but could not reduce the incidence of PTMs after small-caliber invasive procedures. Prophylactic radiotherapy in patients with epithelial PTM types could reduce the incidence (OR=0.27, 95% CI:0.11, 0.69, P=0.006).

Prophylactic radiotherapy is safe and can effectively prevent the occurrence of iatrogenic PTMs in patients with epithelial MPM who have undergone thoracotomy, thoracoscopy, indwelling chest wall drainage tubes, and other large-caliber operations.

To explore the diagnostic value of digital 320-slice volume computed tomography (CT) scanning in gastrointestinal lipoma.

The clinical data and CT features of 21 gastrointestinal lipoma cases confirmed by pathology were analyzed retrospectively. The tumor location, size, density, and clinical manifestations were summarized.

Among 21 patients, nine, four, three, and three cases occurred in the duodenum, descending colon, stomach, and ascending colon, respectively; one case each occurred in the jejunum and sigmoid colon. Tumors located in the duodenum were asymptomatic, while those located in the colon presented with abdominal pain and diarrhea. CT images demonstrated round, oval, and short intestinal fat-like density masses in the gastrointestinal tract with varying sizes. The CT value was in the range of -80 to -120 HU. Routine enhanced scans revealed no enhancements. Three cases were accompanied by intussusception. Pathological examination showed prominent fibrovascular septa.

Digital 320-slice volume CT scans have advantages over other modalities in the diagnosis of gastrointestinal lipoma and may help evaluate the tumor and surrounding tissues, supporting clinical practice.