Intensity modulated radiation therapy with simultaneous integrated boost based dose escalation on neoadjuvant chemoradiation therapy for locally advanced distal esophageal adenocarcinoma

AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR) rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%) and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n = 16),the p CR rate was 47%(n = 8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n = 7) and 53%(n = 9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.

Estimation of enhanced low dose rate sensitivity mechanisms using temperature switching irradiation on gate-controlled lateral PNP transistor

The mechanisms occurring when the switched temperature technique is applied,as an accelerated enhanced low dose rate sensitivity(ELDRS)test technique,are investigated in terms of a specially designed gate-controlled lateral PNP transistor(GLPNP)that used to extract the interface traps(Nit)and oxide trapped charges(Not).Electrical characteristics in GLPNP transistors induced by ^(60)Co gamma irradiation are measured in situ as a function of total dose,showing that generation of Nit in the oxide is the primary cause of base current variations for the GLPNP.Based on the analysis of the variations of Nit and Not,with switching the temperature,the properties of accelerated protons release and suppressed protons loss play critical roles in determining the increased Nit formation leading to the base current degradation with dose accumulation.Simultaneously the hydrogen cracking mechanisms responsible for additional protons release are related to the neutralization of Not extending enhanced Nit buildup.In this study the switched temperature irradiation has been employed to conservatively estimate the ELDRS of GLPNP,which provides us with a new insight into the test technique for ELDRS.

Natural background radiation dose rate levels and incidences of reproductive abnormalities in high radiation area in Abeokuta, Southwestern Nigeria

A 10 y (1999-2008) birth records from two public and most accessible maternity hospitals locally in the city of Abeokuta, Nigeria were used to investigate the possible association of high outdoor gamma radiation exposure on reproductive abnormalities in the city. From the delivery record of 11,923 births in the period under study, a total number of 485 incidences of reproductive abnormalities were recoded. These incidences comprise 228 multiple births, 190 still births and, 67 premature births. Using the available terrestrial gamma radiation exposure data for the city and different reproductive abnormalities, regression assessment was carried out using the Pearson Product Moment (PPM) correlation statistics. The correlation showed that the incidences of reproductive abnormalities and the radiation dose levels were negatively correlated and correlation coefficient values were very low for each of the reproductive abnormalities considered. Factors such as socio-economic potentials of patients, dietary and other environmental factors may have substantial influence on the reproductive defects in the area other than radiation. However, the present study has added to the radiometric information needed in understanding the relationship between natural outdoor radiation exposure and occurrences of reproductive abnormalities in areas of high radiation in the country.

Natural Radiation Dose and Geomagnetic Effect

Earth keeps getting bombarded by high-energy particles that originate in the outer space and in Sun. Cosmic radiation in Earth’s atmosphere consists of a photon and directly ionizing component and a neutron component. Charged particles of cosmic radiation are deflected by the geomagnetic field that is more expressed at the equator than near the poles. Photon radiation was measured by Radiameter ESM FH 40G-L10 at 26 main meteorological stations in all parts of Croatia. The correlation between the photon dose rate and latitude was examined, as well as multiple correlations for the photon dose, latitude and altitude. The obtained positive correlation coefficients were statistically significant. The neutron component of the cosmic radiation was measured by series of nuclear track-etched detectors, at the same meteorological stations during one year period. The dependence of the neutron dose rate on the altitude was found and the associated equation of the linear regression was derived. Relation between the values of neutron dose N and altitude h, showed significant dependence of the neutron dose on altitude. However, the correlation of neutron dose and geographic (geomagnetic) latitude was not statistically significant, probably due to a small range of geographic latitudes for the measuring stations in Croatia.

“Radiation Hormesis”中的剂量率效应

为了揭示不同剂量率Ｘ射线低剂量全身照射对低剂量辐射兴奋效应（ＲａｄｉａｔｉｏｎＨｏｒｍｅｓｉｓ）的影响，采用不同剂量率（１２．７ｍＧｙ／ｍｉｎ和０．２Ｇｙ／ｍｉｎ）对Ｂａｌｂ／ｃ小鼠进行低剂量全身照射，研究了低剂量辐射兴奋效应中的剂量率效应。结果表明：采用不同剂量率Ｘ射线照射同一剂量时，所引起的生物效应不同。剂量率为１２．７ｍＧｙ／ｍｉｎ时，脾细胞３Ｈ－ＴｄＲ参入量对ＣｏｎＡ的反应性明显增强，尤其以７６．７ｍＧｙ和１０５．５ｍＧｙ照射组最为显著（Ｐ＜０．０１），表现出明显的辐射免疫兴奋效应。而剂量率为０．２Ｇｙ／ｍｉｎ时，在１０５．５ｍＧｙ以内，脾细胞３Ｈ－ＴｄＲ参入量对ＣｏｎＡ的反应性无明显变化。该结果提示：高剂量率低剂量全身照射不能引起低剂量辐射兴奋效应。

An Accelerated Simulation Method for ELDRS of Bipolar Operational Amplifiers Using a Dose-Rate Switching Experiment

Through different dose-rate switching evaluation methods,the radiation-response rules of operational amplifiers are studied when the irradiation dose rate is switched from high to low under different radiation temperatures and total doses. The experimental results indicate that the response characteristics could be affected by the switching total doses, irradiation temperatures,and dose rates individually or together. Accelerated evaluation on the ELDRS can be realized by adopting a proper dose-rate switching method. Meanwhile, the irradiation time can also be reduced. Finally, the mechanisms of the difference between various radiation responses are analyzed.

Secondary and activated X(γ)radiation of SPHIC particle therapy facility

We report the secondary X(γ)radiation from the accelerator in a normal operating state and activated X(γ)radiation from the accelerator devices when the accelerator stops operating in the cancer treatment facility of the Shanghai Proton and Heavy Ion Center(SPHIC).These radiation measurements show us the structural radiation distribution along the beam lines and devices inside the accelerator room when the beam is on and off and can support the radiation protection design of the accelerator facility used for cancer treatment and help evaluate the accumulated radiation dose in the case of an emergency,such as a personal safety system failure or a radiation accident.The radiation dose rate measured in this facility shows that the facility is safe from the radiation protection point.After shooting the quality assurance(QA)beam,the radiation dose rate in the treatment room was also measured to investigate the radiation dose space distribution and decay time dependence.In addition,the time period before safely entering the treatment room after determining the shooting of the QA beam is recommended to be approximately 5 min.

High Dose Rate (HDR) Brachytherapy for Mycosis Fungoides of the Wrist

Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma accounting for approximately half of all cutaneous T-cell lymphomas. Radiation therapy is an effective treatment for early stage MF and has been shown to result in long-term disease-free intervals, with even curative potential. Radiation is also effective as palliative treatment for the localized lesion resistant to the topic or other treatments. In the current study, we report using high dose rate (HDR) radiation treatment for a patient with resistant mycosis fungoides involving the wrist. We report a convenient treatment with an ideal radiation dose distribution, and a excellent clinical outcome.

Dose-rate effects of low-dropout voltage regulator at various biases

A low-dropout voltage regulator,LM2941,was irradiated by ^(60)Coγ-rays at various dose rates and biases for investigating the total dose and dose rate effects.The radiation responses show that the key electrical parameters, including its output and dropout voltage,and the maximum output current,are sensitive to total dose and dose rates, and are significantly degraded at low dose rate and zero bias.The integrated circuits damage change with the dose rates and biases,and the dose-rate effects are relative to its electric field.

Gamma radiation levels in the ambient environment of the QNPP Base

Monitoring results of gamma dose rate level in 1992～2004 in the ambient environment of the Qinshan Nuclear Power Plants(QNPP)Base,the northeast of Zhejiang Province,are reported in this paper.It is shown that the gamma dose rate of five monitoring sites of 2.5 km to QNPP Base is 84～113 nGy/h,with an average of 96 nGy/h in the 13 years.The average value is close to the background level of 93 nGy/h prior to operation of the QNPP Base,and is lower than the monitoring result of 101 nGy/h at the reference site in Hangzhou City.Within 50 km from the QNPP Base,the cumulative dose rate of the thermoluminescent dosimeter(TLD)is 90 nGy/h,which is lower than the back- ground level of 111 nGy/h.

Bioflavonoids as Important Component of Biological Protection from Ionizing Radiation

New advances in the area of deciphering the mechanism for a possible modification of the biological effects of radiation exposure at the genetic level make it possible to distinguish the group of radiation protective agents having their own specific features in the implementation of their beneficial effects. The mechanism of the radioprotective action of bioflavonoids is worthy of a detailed analysis in view of their great biological importance. Radiobiological studies show that antioxidants can reduce the radiation damage to membranes and favor more adequate energy dependent adaptive and reparative processes after the exposure to radiation. Bioflavonoids are significant component of “biological protection” for a enhance of resistance of the body to environmental factors that are adverse for human health, including ionizing radiation, with reducing the risk of carcinogenic effects and decreasing the biological age. The best practical value of bioflavonoids, can be considered as the agents for prophylaxis against the development of oxidative stress. These are the reasons why the administration of natural antioxidants have a pathogenetic justification for exposures to chronic (months, years) low-rate-dose ionizing radiation. These agents were previously and are currently being developed for use during long-term, low-ratedose exposures to radiation, under conditions of long space missions. Acting as low-dose stressors through a hormetic mechanism and a “substrate” support of adaptive shifts radiomodulators results in an increase in the antioxidant defense of the body and the rearrangement of its functioning in the new environment with the modulation of gene expression of antioxidant response elements by activation of Nrd2/KeapI and Sirtuin/FoxO pathways and a decrease in the transcription factor NF-κB.

Research on radiation dose rate distribution in the backscattering neutron hall of CSNS

Purpose To evaluate the prompt and induced dose rate in backscattering neutron hall for radiation protection and safety management.Method The dose rates were calculated by Monte Carlo code FLUKA,with the"multi-step"simulation method based on traditional"two-step simulation"method.Conclusion Operation time of staff workers does not need to be restricted.But with the increase in beam power and irra-diation time,serious consideration might need to be taken as the dose rate of samples may be higher than the limit value.

Radiation dose rate estimates to marine biota resulting from the routine radioactive releases of the nuclear power plants in Daya Bay

Five marine organisms in Daya Bay are selected for estimating the dose rates. Internal exposure and its 5 pathways are also considered. The concentrations of 43 kinds of background and additional radionuclides in seawater are from the survey of background radioactivity and the prediction of routine radioactive releases of the 4 reactors. Point source dose distribution functions are used to estimate the dose rates to various organisms from a and β radiation.

肿瘤放射治疗的发展

恶性肿瘤是目前人类死亡的主要原因之一,以美国为代表的发达国家中,超过半数的肿瘤患者在治疗过程中需要单独或联合使用放射治疗。过去的半个世纪以来,放射治疗围绕着“增效减毒”的原则展开技术迭代,不断和手术、化疗以及新兴的免疫疗法等其他手段相结合,极大地提高了治疗疗效和可及性。21世纪以来,通过采用更先进的剂量递送方式、结合实时影像的自适应规划、引入人工智能和新的粒子辐射类型等先进技术,放射治疗的安全性和有效性都得到了提高。本文回顾了近几十年来放射治疗领域的技术进步,展示了在加速器平台上进行高剂量率放射治疗研究的典型案例,总结了放射治疗相关的新兴研究热点,并对该领域的发展方向做出了展望。

踝关节骨折的低剂量螺旋CT影像检查效果

目的 探讨踝关节骨折的低剂量螺旋CT影像检查效果。方法 研究中60例踝关节骨折患者均在2020年1月—2023年7月随机抽选自我院;临床对所有踝关节骨折患者合理展开常规剂量螺旋CT扫描操作以及低剂量螺旋CT扫描操作,对两种方法的辐射剂量、诊断符合率、客观性图像质量指标以及图像清晰度分级展开比较。结果 与常规剂量CT诊断剂量长度乘积(DLP)以及CT容积剂量指数(CTDIvol)展开比较,低剂量CT测定结果均更低(均P <0.05);低剂量CT与常规剂量CT对于总诊断符合率、CT值、噪声值(SD)、图像信噪比(SNR)以及图像清晰度展开比较,结果均未呈现出统计学差异(P> 0.05)。结论 临床对踝关节骨折患者在实施CT诊断期间,发现低剂量CT以及常规剂量CT的诊断效果均较为明显,对于踝关节的损伤位置均可以明确诊断,但低剂量螺旋CT扫描运用,可将辐射剂量显著降低,所以安全性更高。

低剂量胸部CT检查对胸部肿瘤性病变的检出和诊断效果评价

目的探讨低剂量胸部CT检查对胸部肿瘤性病变的检出率和诊断价值。方法选取2000例胸部肿瘤患者随机均分为A、B两组,A组1000例使用常规剂量胸部CT扫描,B组1000例使用低剂量胸部CT扫描。结合患者的临床和影像学资料,对照评价低剂量胸部CT检查的图像质量、疾病检出率和良恶性肺结节诊断的准确率。结果与常规剂量相比,低剂量胸部CT检查总辐射剂量降低了60.23%。主观图像质量:纵隔窗质量略有下降,差异有统计学意义(P=0.001),肺窗和骨窗的图像质量差异无统计学意义(P=0.753和0.501);疾病检出率:对肺部小结节,胸腺结节、甲状腺结节、淋巴瘤、胸壁肿物、肾脏和肾上腺结节的检出率差异无统计学意义(P=0.294、0.743、0.530、0.616、0.459、0.339和0.125);对肺部小结节中癌前病变、早期肺癌的诊断准确率差异无统计学意义(P=0.345和0.648);对胸部良性病变和未定性病变诊断比较差异有统计学意义(P=0.001和*0.037)。结论低剂量胸部CT检查辐射剂量较常规CT检查大幅度降低,图像质量可以满足诊断要求,对多种胸部肿瘤性疾病的检出率及肺结节的良恶性诊断差异无统计学意义,但对部分良性和未定性病变的诊断准确率略有不足。

50~120kV脉冲X射线参考辐射场建立及剂量率测量

为满足国内医疗、安检等脉冲辐射场所对剂量监测仪表准确溯源的需求,基于栅控技术建立满足规范和标准要求的50~120 kV毫秒级脉冲X射线参考辐射场,其脉冲宽度在1~6 300 ms范围内可调。通过对该辐射场的管电压稳定性、剂量线性、重复性、脉冲波形等关键参数进行研究测试,建立脉冲X射线参考波形,并使用30 cm3的圆柱电离室开展脉冲剂量率测量研究。结果表明,管电压预设60 kV时,介入法、非介入法测量管电压的相对偏差均不超过±1.5%;可输出参考波形脉冲的最小脉冲宽度为20 ms,在1 m处95%均匀辐射野直径约为5.5 cm;且N系列、RQR系列辐射质条件下的剂量率范围可分别扩展至0.002~10 mGy/s和0.03~250 mGy/s,可用于防护仪表的量值溯源。

^(177)Lu-DOTATATE治疗GEP-NEN的体外辐射剂量学研究

目的:探讨^(177)Lu-DOTATATE治疗胃肠胰神经内分泌肿瘤(gastroenteropancreatic neuroendocrine neoplasm,GEP-NEN)后不同时间点患者体外辐射水平,为辐射安全及患者管理提供参考依据。方法:选择2023年5—11月在复旦大学附属肿瘤医院接受^(177)Lu-DOTATATE住院治疗的GEP-NEN患者作为研究对象,单次静脉给予(7618.5±241.9)MBq的^(177)Lu-DOTATATE治疗,在给药后不同时间点,测量其正前方1 m处的周围剂量当量率,分析周围剂量当量率随时间的变化规律。结果:纳入的30例GEP-NEN患者共行78次^(177)Lu-DOTATATE治疗,给药结束后即刻其正前1 m处的平均剂量当量率为20.0μSv/h。周围剂量当量率随时间呈指数衰减,其降至10μSv/h的平均时间为3.95 h,95%CI上限时间为4.6 h。24 h内周围剂量当量率的有效半衰期为1.42 h。结论:在每次^(177)Lu-DOTATATE治疗后,其周围剂量当量率随时间快速降低,平均3.95 h时其在1 m处的周围剂量当量率降至10μSv/h。在4.6 h时,95%的患者可降至10μSv/h以下。本研究为中国制定^(177)Lu-DOTATATE治疗时患者的出院标准或患者的管理提供试验数据和依据。

PTW Detector7293种剂量验证方法在调强放射治疗中的对比研究

目的 :对比PTW Detector729 3种验证方法在调强放射治疗(intensity modulated radiation therapy,IMRT)剂量验证中的差异。方法:回顾性选取2022年1—12月于某院完成放射治疗的鼻咽癌、肺癌、乳腺癌、宫颈癌和全脑放射治疗患者共50例,使用PTW Detector729二维电离室矩阵配合PTW RW3固体水与PTW Ocavius 4D旋转模体对50例患者的IMRT计划分别进行归零机架角2D剂量验证、实际机架角2D剂量验证和实际机架角3D剂量验证。将剂量评估阈值设为10%,统计3种验证方法在3%/1 mm、2%/2 mm、3%/2 mm和3%/3 mm 4种评估标准下的γ通过率。采用SPSS 22.0统计学软件进行数据分析。结果:在10%剂量评估阈值标准下,归零机架角2D剂量验证的γ通过率最高,差异有统计学意义(P<0.05);实际机架角2D剂量验证的γ通过率高于实际机架角3D剂量验证,差异有统计学意义(P<0.05)。3种验证方法的γ通过率在3%/1 mm、2%/2 mm、3%/2 mm和3%/3 mm 4种标准下逐渐升高,且在3%/2 mm标准下均超过90%,结果满足临床放射治疗要求。结论:3种验证方法的验证结果均能达到IMRT剂量验证实践指南要求,根据IMRT开展情况选择合适的验证方法,对确保治疗方案安全、有效实施具有重要意义。

利用地面γ总量转换为空气吸收剂量率进行环境辐射水平评价——以桂阳县潘家村和永兴县土桥村实测数据为例

在长期的铀矿普查中,我国积累了海量的γ总量数据资料,但应用这些数据进行放射性环境评价的研究极少。本文从γ总量和空气吸收剂量率的测量原理出发,通过梳理γ总量、放射性核素含量与空气吸收剂量率之间的关系,建立起地面γ总量与空气吸收剂量率之间的联系,分析了仪器参数对测量误差的影响,认为γ总量仪器bK/bU=2.287、bTh/bU=0.430时,测量的γ总量与空气吸收剂量率满足严格线性关系,因此γ总量仪器的bK/bU、bTh/bU值越接近这两个数值,测得的γ总量转换为空气吸收剂量率越准确;利用湖南省电离辐射计量站模型进行了γ总量转换为空气吸收剂量率的系数求解,并分析了误差,推测了仪器参数中钾的铀当量值、钍的铀当量值的大致范围;在郴州市桂阳县潘家村岩体和郴州市永兴县土桥村灰岩地区进行了γ总量、γ能谱、空气吸收剂量率的同点位实测,结果显示,当核素含量比CK/CU均值小于1、CTh/CU均值小于3时,利用γ总量(FD3013仪器测得)估算的空气吸收剂量率与利用Beck公式根据能谱估算的空气吸收剂量率的误差基本处于同等水平,均方根误差均小于15%。根据国内核素的CK/CU、CTh/CU均值,认为国内大部分地区可以利用由FD3013仪器(或类似性能仪器)测得的γ总量数据估算空气吸收剂量率。利用已有铀矿普查资料中的γ总量数据转换计算有效空气吸收剂量率,为快速大面积评估环境天然放射性外照射水平提供了方法参考。