Open Science Research Excellence

Open Science Index

Commenced in January 2007 Frequency: Monthly Edition: International Paper Count: 12

12
10004747
Pre-Malignant Breast Lesions, Methods of Treatment and Outcome
Abstract:

This retrospective study includes 60 patients with pre-invasive breast cancer. Aim of the study: Evaluation of premalignant lesions of the breast (DCIS), different treatment methods and outcome. Patients and methods: 60 patients with DCIS were studied from the period between 2005 to 2012, for 38 patients the primary surgical method was wide local resection (WLE) (63.3%) and the other cases (22 patients, 36.7%) had mastectomy, fourteen cases from those who underwent local excision received radiotherapy, while no adjuvant radiotherapy was given for those who underwent mastectomy. In case of hormonal receptor positive DCIS lesions hormonal treatment (Tamoxifen) was given after local control. Results: No difference in overall survival between mastectomy & breast conserving therapy (wide local excision and adjuvant radiotherapy), however local recurrence rate is higher in case of breast conserving therapy, also no role of Axillary evacuation in case of DCIS. The use of hormonal therapy decreases the incidence of local recurrence by about 98%. Conclusion: The main management of DCIS is local treatment (wide local excision and radiotherapy) with hormonal treatment in case of hormone receptor positive lesions.

11
10004358
Use of Curcumin in Radiochemotherapy Induced Oral Mucositis Patients: A Control Trial Study
Abstract:
Radiotherapy and chemotherapy are effective for treating malignancies but are associated with side effects like oral mucositis. Chlorhexidine gluconate is one of the most commonly used mouthwash in prevention of signs and symptoms of mucositis. Evidence shows that chlorhexidine gluconate has side effects in terms of colonization of bacteria, bad breadth and less healing properties. Thus, it is essential to find a suitable alternative therapy which is more effective with minimal side effects. Curcumin, an extract of turmeric is gradually being studied for its wide-ranging therapeutic properties such as antioxidant, analgesic, anti-inflammatory, antitumor, antimicrobial, antiseptic, chemo sensitizing and radio sensitizing properties. The present study was conducted to evaluate the efficacy and safety of topical curcumin gel on radio-chemotherapy induced oral mucositis in cancer patients. The aim of the study is to evaluate the efficacy and safety of curcumin gel in the management of oral mucositis in cancer patients undergoing radio chemotherapy and compare with chlorhexidine. The study was conducted in K.L.E. Society’s Belgaum cancer hospital. 40 oral cancer patients undergoing the radiochemotheraphy with oral mucositis was selected and randomly divided into two groups of 20 each. The study group A [20 patients] was advised Cure next gel for 2 weeks. The control group B [20 patients] was advised chlorhexidine gel for 2 weeks. The NRS, Oral Mucositis Assessment scale and WHO mucositis scale were used to determine the grading. The results obtained were calculated by using SPSS 20 software. The comparison of grading was done by applying Mann-Whitney U test and intergroup comparison was calculated by Wilcoxon matched pairs test. The NRS scores observed from baseline to 1st and 2nd week follow up in both the group showed significant difference. The percentage of change in erythema in respect to group A was 63.3% for first week and for second week, changes were 100.0% with p = 0.0003. The changes in Group A in respect to erythema was 34.6% for 1st week and 57.7% in second week. The intergroup comparison was significant with p value of 0.0048 and 0.0006 in relation to group A and group B respectively. The size of the ulcer score was measured which showed 35.5% [P=0.0010] of change in Group A for 1st and 2nd week showed totally reduction i.e. 103.4% [P=0.0001]. Group B showed 24.7% change from baseline to 1st week and 53.6% for 2nd week follow up. The intergroup comparison with Wilcoxon matched pair test was significant with p=0.0001 in group A. The result obtained by WHO mucositis score in respect to group A shows 29.6% [p=0.0004] change in first week and 75.0% [p=0.0180] change in second week which is highly significant in comparison to group B. Group B showed minimum changes i.e. 20.1% in 1st week and 33.3% in 2nd week. The p value with Wilcoxon was significant with 0.0025 in Group A for 1st week follow up and 0.000 for 2nd week follow up. Curcumin gel appears to an effective and safer alternative to chlorhexidine gel in treatment of oral mucositis.
10
10000244
Oncological Management of Medulloblastoma and New Viral Therapeutic Targets
Authors:
Abstract:

Medulloblastoma (MB) is one of the most prevalent brain tumours among paediatrics. Although its management has evolved over time still there is need to find new therapeutic targets for MB that can result in less normal tissue toxicity while improving survival and reducing recurrence. This literature review is aimed at finding new potential therapeutic targets for MB focusing on viruses that can be used as potential targets for MB. The review also gives an over-view of management of paediatric Medulloblastoma focusing on Radiotherapy management.

9
10000455
Assessing Chemo-Radiotherapy Induced Toxicity and Quality of Life of Cancer Patients
Authors:
Abstract:

Chemotherapy and radiotherapy are one of the major treatment modalities that play important role in the management of a number of different cancers. This study for the first time evaluates the toxicity of these treatment modalities and its impact on quality of life of cancer patients in Pakistan. The study also for the first time determines what cancer patients of different ages and cancer stages believe would be an effective intervention to manage their psychosocial needs and treatment induced toxicity. The article also provides evidence based approach for the use of variety of interventions to mange cancer treatment induced morbidity and toxicity. In light of the present study and reviewed research data, evidence based recommendations are also made for selection of appropriate interventions to manage Pain, Nausea and Vomiting, Anxiety and Depression, Fatigue and Overall QOL of cancer survivors.

8
9999305
Investigation of VMAT Algorithms and Dosimetry
Authors:
Abstract:

Purpose: Planning and dosimetry of different VMAT algorithms (SmartArc, Ergo++, Autobeam) is compared with IMRT for Head and Neck Cancer patients. Modelling was performed to rule out the causes of discrepancies between planned and delivered dose. Methods: Five HNC patients previously treated with IMRT were re-planned with SmartArc (SA), Ergo++ and Autobeam. Plans were compared with each other and against IMRT and evaluated using DVHs for PTVs and OARs, delivery time, monitor units (MU) and dosimetric accuracy. Modelling of control point (CP) spacing, Leaf-end Separation and MLC/Aperture shape was performed to rule out causes of discrepancies between planned and delivered doses. Additionally estimated arc delivery times, overall plan generation times and effect of CP spacing and number of arcs on plan generation times were recorded. Results: Single arc SmartArc plans (SA4d) were generally better than IMRT and double arc plans (SA2Arcs) in terms of homogeneity and target coverage. Double arc plans seemed to have a positive role in achieving improved Conformity Index (CI) and better sparing of some Organs at Risk (OARs) compared to Step and Shoot IMRT (ss-IMRT) and SA4d. Overall Ergo++ plans achieved best CI for both PTVs. Dosimetric validation of all VMAT plans without modelling was found to be lower than ss-IMRT. Total MUs required for delivery were on average 19%, 30%, 10.6% and 6.5% lower than ss-IMRT for SA4d, SA2d (Single arc with 20 Gantry Spacing), SA2Arcs and Autobeam plans respectively. Autobeam was most efficient in terms of actual treatment delivery times whereas Ergo++ plans took longest to deliver. Conclusion: Overall SA single arc plans on average achieved best target coverage and homogeneity for both PTVs. SA2Arc plans showed improved CI and some OARs sparing. Very good dosimetric results were achieved with modelling. Ergo++ plans achieved best CI. Autobeam resulted in fastest treatment delivery times.

7
9998920
A Survey of IMRT and VMAT in UK
Authors:
Abstract:

Purpose: This E-survey was carried out to facilitate the implementation and Education of VMAT (Volumetric Modulated Arc Therapy) in Radiotherapy-RT departments and reasons for not using IMRT (Intensity Modulated Radiotherapy). VMAT Skills in demand were also identified. Method: E-Survey was distributed to NHS hospitals across UK by email. Thirty NHS and related centres in England, 21 in Scotland, 3 in Ireland and 1 in Wales were contacted. This Survey was intended for those working in RT and Medical Physics and who were responsible for Treatment Planning and training. Results: This E-survey have indicated pathways adopted by staff to acquire VMAT skills, strategies to efficiently implement VMAT in RT departments and for obtaining VMAT Education. Conclusion: Despite poor survey response this survey has managed to highlight requirements for education and implementation of VMAT that are also applicable to IMRT. Other RT centres in world can also find these results useful.

6
9996861
Evolution of Cord Absorbed Dose during of Larynx Cancer Radiotherapy, with 3D Treatment Planning and Tissue Equivalent Phantom
Abstract:

Radiation doses to tissues and organs were measured using the anthropomorphic phantom as an equivalent to the human body. When high-energy X-rays are externally applied to treat laryngeal cancer, the absorbed dose at the laryngeal lumen is lower than given dose because of air space, which it should pass through, before reaching the lesion. Specially, in case of high-energy X-rays, the loss of dose is considerable. Three-dimensional absorbed dose distributions have been computed for high-energy photon radiation therapy of laryngeal and hypopharyngeal cancers, using a coaxial pair of opposing lateral beams in fixed positions. Treatment plans obtained under various conditions of irradiation.

5
16877
Absorbed Dose Measurement in Gonads Menduring Abdominal and Pelvicradiotherapy
Abstract:

Two different testicular tissues have to be distinguished in regard to radiation damage: first the seminiferous tubules, corresponding to the sites of spermatogenesis, which are extremely radiosensitive. Second the testosterone secreting Leydig cells, which are considered to be less radiosensitive. This study aims to estimate testicular dose and the associated risks for infertility and hereditary effects from Abdominal and pelvic irradiation. Radiotherapy was simulated on a humanoid phantom using a 15 MV photon beam. Testicular dose was measured for various field sizes and tissue thicknesses along beam axis using an ionization chamber and TLD. For transmission Factor Also common method of measuring the absorbed dose distribution and electron contamination in the build-up region of high-energy beams for radiation therapy is by means of parallel-plate Ionisation chambers. Gonadal dose was reduced by placing lead cups around the testes supplemented by a field edge block. For a tumor dose of 100 cGy, testicular dose was 2.96-8.12 cGy depending upon the field size and the distance from the inferior field edge. The treatment at parameters, the presence of gonad shield and the somatometric characteristics determine whether testicular dose can exceed 1 Gy which allows a complete recovery of spermatogenesis.

4
4877
Uniformity of Dose Distribution in Radiation Fields Surrounding the Spine using Film Dosimetry and Comparison with 3D Treatment Planning Software
Abstract:
The overall penumbra is usually defined as the distance, p20–80, separating the 20% and 80% of the dose on the beam axis at the depth of interest. This overall penumbra accounts also for the fact that some photons emitted by the distal parts of the source are only partially attenuated by the collimator. Medulloblastoma is the most common type of childhood brain tumor and often spreads to the spine. Current guidelines call for surgery to remove as much of the tumor as possible, followed by radiation of the brain and spinal cord, and finally treatment with chemotherapy. The purpose of this paper was to present results on an Uniformity of dose distribution in radiation fields surrounding the spine using film dosimetry and comparison with 3D treatment planning software.
3
3928
Estimating the Absorbed Dose to THYROID during Chest wall Radiotherapy
Abstract:
Thyroid cancer-s overall contribution to the worldwide cancer burden is relatively small, but incidence rates have increased over the last three decades throughout the world. This trend has been hypothesised to reflect a combination of technological advances enabling increased detection, but also changes in environmental factors, including population exposure to ionising radiation from fallout, diagnostic tests and treatment for benign and malignant conditions. The Thyroid dose received apparently shielded by cerrobend blocks was about 8cGy in 100cGy Expose
2
9216
A Model for the Characterization and Selection of Beeswaxes for use as base Substitute Tissue in Photon Teletherapy
Abstract:
This paper presents a model for the characterization and selection of beeswaxes for use as base substitute tissue for the manufacture of objects suitable for external radiotherapy using megavoltage photon beams. The model of characterization was divided into three distinct stages: 1) verification of aspects related to the origin of the beeswax, the bee species, the flora in the vicinity of the beehives and procedures to detect adulterations; 2) evaluation of physical and chemical properties; and 3) evaluation of beam attenuation capacity. The chemical composition of the beeswax evaluated in this study was similar to other simulators commonly used in radiotherapy. The behavior of the mass attenuation coefficient in the radiotherapy energy range was comparable to other simulators. The proposed model is efficient and enables convenient assessment of the use of any particular beeswax as a base substitute tissue for radiotherapy.
1
11053
Experimental Validation of Treatment Planning for Multiple Radiotherapy Fields by EDR2 Film Dosimeter
Abstract:
To investigate the applicability of the EDR-2 film for clinical radiation dosimetry, percentage depth-doses, profiles and distributions in open and dynamically wedged fields were measured using film and compared with data from a Treatment Planning system.The validity of the EDR2 film to measure dose in a plane parallel to the beam was tested by irradiating 10 cm×10 cm and 4 cm×4 cm fields from a Siemens, primus linac with a 6MV beam and a source-to-surface distance of 100 cm. The film was placed Horizontally between solid water phantom blocks and marked with pin holes at a depth of 10 cm from the incident beam surface. The film measurement results, in absolute dose, were compared with ion chamber measurements using a Welhoffer scanning water tank system and Treatment Planning system. Our results indicate a maximum underestimate of calculated dose of 8 % with Treatment Planning system.
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