Role of radiation therapy in gastric adenocarcinoma

Outcomes in patients with gastric cancer in the United States remain disappointing, with a five-year overall survival rate of approximately 23%. Given high rates of local-regional control following surgery, a strong rationale exists for the use of adjuvant radiation therapy. Randomized trials have shown superior local control with adjuvant radiotherapy and improved overall survival with adjuvant chemoradiation. The benefit of adjuvant chemoradiation in patients who have undergone D2 lymph node dissection by an experienced surgeon is not known, and the benefit of adjuvant radiation therapy in addition to adjuvant chemotherapy continues to be defined. In unresectable disease, chemoradiation allows long-term survival in a small number of patients and provides effective palliation. Most trials show a benefit to combined modality therapy compared to chemotherapy or radiation therapy alone. The use of pre-operative, intra-operative, 3D conformal, and intensity modulated radiation therapy in gastric cancer is promising but requires further study. The current article reviews the role of radiation therapy in the treatment of resectable and unresectable gastric carcinoma, focusing on current recommendations in the United States.

Complete response to radiation therapy of orbital metastasis from hepatocellular carcinoma

The incidence of hepatocellular carcinoma(HCC)is increasing in the United States,and 50%-75%o patients with HCC will develop metastatic disease Orbital metastases from HCC are extremely rare.We report the case of a 52-year-old male with known metastatic HCC,who presented with severe proptosis and diplopia.An orbital mass was identified on magnetic resonance imaging(MRI)and confirmed to have hypermetabolic activity on positron emission tomography/computed tomography.He received a palliative course of external beam radiation therapy to the right orbit.Intensity modulated radiation therapy (IMRT)was used to allow sparing of critical norma tissues in close proximity to the tumor.One month after completion of IMRT to 58 Gray in 30 fractions delivered over 6 wk,the patient had a complete clinical,radiologic(MRI)and symptomatic response The patient continues to have local control in the orbi 1.7 years after therapy completion.All critical norma structures were kept below the tolerance dose using IMRT,and no toxicities were observed.

Prostate specific antigen bounce after intensity-modulated radiation therapy in an Asian population

Objective:Serum prostate specific antigen(PSA)is commonly used to evaluate treatment response after definitive radiation therapy(RT).However,PSA levels can temporarily rise without a clear reason,termed“PSA bounce”,and often engender great anxiety for both patients and physicians.The present study aimed to determine the prevalence and factors that predict“PSA bounce”after intensity-modulated radiation therapy(IMRT),and the relevance to biochemical failure and cancer recurrence in an Asian population.Methods:We retrospectively reviewed 206 patients who received IMRT for prostate cancer from 2004 to 2012 in the National Cancer Centre Singapore.These patients were followed up with regular PSA monitoring.We defined“PSA bounce”as a rise of 0.1 ng/mL,followed by two consecutive falls.Patients with biochemical failure(PSA nadir t 2 ng/mL)were further evaluated for cancer recurrence.Results:Sixty-one patients(29.6%)experienced“PSA bounce”,at a median time of 16 months and lasted for 12 months.Age remained the most consistent predictor of the incidence,duration and extent of“PSA bounce”.Other contributory factors included baseline PSA,Gleason score and PSA nadir.Hormonal therapy and prostate volume did not affect this phenomenon.Sixteen patients(7.8%)developed biochemical recurrence,at median time of 32 months,of which 11 were confirmed to have metastatic disease.The median follow-up time was 71 months.

Clinical study on concurrent and sequential therapy of intensity modulated radiation therapy (IMRT) combined with NP regimen chemotherapy in the treatment of middle and advanced non-small cell lung cancer

Objective: To evaluate the clinical effects of concurrent and sequential therapy for middle and advanced stage non-small cell lung cancer (NSCLC) useing IMRT combined with NP regimen chemotherapy. Methods: Eighty patients with middle and advanced stage NSCLC were randomized into two groups. Forty patients were underwent sequential therapy and other 40 patients were underwent concurrent therapy. IMRT was used in radiotherapy and NP regimen of vinorelbine+cispatin (NP) was used in chemotherapy. Results: (1) The overall response (CR+PR) rate was 75% in concurrent group and 45% in sequential group (P<0.05); (2) The treatment courses were 84 days and 140 days for concurrent group and sequential group respectively (P<0.05); (3) One-year survival rate in concurrent group was 72.4% and 52.3% in sequential group respectively; (4) The toxic effects can be tolerable by all of patients. Conclusion: The concurrent chemo-radiotherapy has better overall re- sponse, one-year survival rate and shorter treatment course than the sequential chemo-radiotherapy, so it is a better method for the treatment of middle and advanced stage NSCLC, but the long term survival rate will be studied.

Intense low-noise terahertz generation by relativistic laser irradiating near-critical-density plasma

Low-noise terahertz(THz)radiation over 100 MV/cm generation by a linearly-polarized relativistic laser pulse interacting with a near-critical-density(NCD)plasma slab is studied by theory and particle-in-cell(PIC)simulations.A theoretical model is established to examine the dipole-like radiation emission.The THz radiation is attributed to the singlecycle low-frequency surface current,which is longitudinally constrained by the quasi-equilibrium established by the laser ponderomotive force and the ponderomotively induced electrostatic force.Through theoretical analysis,the spatiotemporal characteristics,polarization property of the THz radiation,and the relation between the radiation strength with the initial parameters of driving laser and plasma are obtained,which are in good consistence with the PIC simulation results.Furthermore,it is found by PIC simulations that the generation of thermal electrons can be suppressed within the appropriate parameter regime,resulting in a clear THz radiation waveform.The appropriate parameter region is given for generating a low-noise intense THz radiation with peak strength reaching 100 MV/cm,which could find potential applications in nonlinear THz physics.

Heat transfer model for microwave hot in-place recycling of asphalt pavements

In order to solve for temperature fields in microwave heating for recycling asphalt mixtures, a two-dimensional heat transfer model for the asphalt mixtures within the heating range is built based on the theory of unsteady heat conduction. Four onedimensional heat transfer models are established for the asphalt mixtures outside the heating range, which are simplified into four half-infinite solids. The intensity of the radiation electric field is calculated through experiment by using heating water loads. It is suggested that the mathematical model of boundary conditions can be established in two ways, which are theoretical deduction and experimental reverse. The actual temperature field is achieved by fitting temperatures of different positions collected in the heating experiment. The simulant temperature field, which is solved with the Matlab PDE toolbox, is in good agreement with the actual temperature field. The results indicate that the proposed models have high precision and can be directly used to calculate the temperature distribution of asphalt pavements.

Helical tomotherapy and volumetric modulated arc therapy:New therapeutic arms in the breast cancer radiotherapy

AIM To analyse clinical and dosimetric results of helical tomotherapy(HT) and volumetric modulated arc therapy(VMAT) in complex adjuvant breast and nodes irradiation.METHODS Seventy-three patients were included(31 HT and 42 VMAT). Dose were 63.8 Gy(HT) and 63.2 Gy(VMAT) in the tumour bed, 52.2 Gy in the breast, 50.4 Gy in supraclavicular nodes(SCN) and internal mammary chain(IMC) with HT and 52.2 Gy and 49.3 Gy in IMC and SCN with VMAT in 29 fractions. Margins to particle tracking velocimetry were greater in the VMAT cohort(7 mm vs 5 mm).RESULTS For the HT cohort, the coverage of clinical target volumes was as follows: Tumour bed: 99.4% ± 2.4%; breast: 98.4% ± 4.3%; SCN: 99.5% ± 1.2%; IMC:96.5% ± 13.9%. For the VMAT cohort, the coverage was as follows: Tumour bed: 99.7% ± 0.5%, breast: 99.3% ± 0.7%; SCN: 99.6% ± 1.4%; IMC: 99.3% ± 3%. For ipsilateral lung, Dmean and V20 were 13.6 ± 1.2 Gy, 21.1% ± 5%(HT) and 13.6 ± 1.4 Gy, 20.1% ± 3.2%(VMAT). Dmean and V30 of the heart were 7.4 ± 1.4 Gy, 1% ± 1%(HT) and 10.3 ± 4.2 Gy, 2.5% ± 3.9%(VMAT). For controlateral breast Dmean was 3.6 ± 0.2 Gy(HT) and 4.6 ± 0.9 Gy(VMAT). Acute skin toxicity grade 3 was 5% in the two cohorts.CONCLUSION HT and VMAT in complex adjuvant breast irradiation allow a good coverage of target volumes with an acceptable acute tolerance. A longer follow-up is needed to assess the impact of low doses to healthy tissues.

A Real-time Modeling of Photovoltaic Array

This paper mainly aims at the modeling problem of the photovoltaic (PV) array with a 30 kW PV grid-connected generation system. An iterative method for the time-varying parameters is proposed to model a plant of PV array. The relationship of PV cell and PV array is obtained and the solution for PV array model is unique. The PV grid-connected generation system is used to demonstrate the effectiveness of the proposed method by comparing the calculated values with the actual output of the system.

Theoretical and experimental study of the intensity distribution in biological tissues

Based on the diffusion approximate theory （DA）, a theoretical model about the distribution of the intensity of a narrow collimation beam illuminating on a semi-lnfinite biological tissue is developed. In order to verify the correctness of the model, a novel method of measuring the distributions of the intensity of light in Intralipid-10% suspension at 650 nm is presented and ts of the distributions of the distance-dependent intensity of scattering light in different directions are made. The investigations show that the results from our diffusion model are in good agreement with the experimental results beyond and in the areas around the light source, and the distance-dependent intensity in the incident direction attenuates approximately in the exponential form. Furthermore, our theoretic results indicate the anisotropic characteristics of the intensity in different directions of scattering light inside the biological tissue.

Hypersonic impact flash characteristics of a long-rod projectile collision with a thin plate target

Impact flash occurs when objects collide at supersonic speeds and can be used for real-time damage assessment when weapons rely on kinetic energy to destroy targets.However,the mechanism of impact flash remains unclear.A series of impact flash experiments of flat-head long-rod projectiles impacting thin target plates were performed with a two-stage light gas gun.The impact flash spectra for 6061 aluminum at 1.3e3.2 km/s collision speeds were recorded with a high-speed camera,a photoelectric sensor,and a time-resolved spectrometer.The intensity of the impact flash exhibited a pulse characteristic with time.The intensity(I)increased with impact velocity(V0)according to IfVn 0,where n?4.41 for V0>2 km/s.However,for V0<2 km/s,n?2.21,and the intense flash duration is an order of magnitude less than that of higher V0.When V0>2 km/s,a continuous spectrum(thermal radiation background)was observed and increased in intensity with V0.However,for V0<2 km/s,only atomic line spectra were detected.There was no aluminum spectral lines for V0<2 km/s,which indicated that it had not been vaporized.The initial intense flash was emission from excited and ionized ambient gases near the impact surface,and had little relationship with shock temperature rise,indicating a new mechanism of impact flash.

Dose Distribution Verifications of IMRT for NPC

In order to explore a dose distribution verification procedure of intensity modulated radiation therapy （IMRT） for nasopharyngeal carcinoma （NPC） and establish its evaluation criteria, we performed 35 two-dimensional （2D） patient-specific IMRT verifications over the year i006. The percent of pixels passing 7 and the normalized agreement test （NAT） index were mainly used to represent the agreement between the measured and computed dose distributions with three criteria （2%/2 mm, 3%/3 mm and 5%/3 mm） as recommended in the literature. The results were that all cases passed through verifications with three criteria except that the NAT index of one case was beyond the limitation, and the three tolerance levels of 2%/2mm, 3%/3 mm and 5%/3 mm produced similar clinical verification results but led to different percent of pixels passing Y and NAT index. Our data showed that the percent of pixels passing y and the NAT index were complementary to evaluate future IMRT verifications as two significant metrics. Due to the influence of the noise and the trait of the software, we considered an IMRT plan as acceptable in case of the percent ofpixels passing y 〉95% and the NAT index 〈5 with the 5%/3 mm criteria for IMRT patient-specific quality assurance （QA）.

Research on the Properties of a Surface-Type Infrared Decoy and Effect of Multiple Launching

To study the properties of a new surface-type infrared decoy,the numerical dispersion model and the infrared radiance model of the plates are established. In addition,the temperature of a single plate was measured during combustion experiment,and the spatial position and infrared radiance of each plate are calculated in plate cloud by the two models respectively. Furthermore,the radar images of the plate cloud are simulated and analyzed in dependence of time and direction for single and multiple launching. The result shows that the surface-type infrared decoy can be a point source of interference when the missile is remote tracking. In the meanwhile,the plates cloud shelters the infrared characteristics of the plume and jets of aircraft when the missile is on IR imaging guidance mode. Moreover,With the analysis of the plate cloud dispersion at different intervals and the infrared radiation intensity in the case of different launching number,it can be concluded that a comfortable launching interval can maintain a continuous plate cloud,launching the decoys simultaneously increase the increment of the radiation intensity obviously,the multiple launching is an effective way to enhance the interference property of the decoy.

Treatment of Massive Low-Grade Chondrosarcoma of Nasal Septum with Helical Tomotherapy: A Case Report

Chondrosarcomas are malignant bone tumors which develop as a cartilaginous differentiation of primary mesenchymal cells and the second most frequently seen malignant tumor of the bone after osteosarcoma. These malignancies are slowly growing non-epithelial tumors with unknown etiology and most frequently seen during the 4 decades of life. They are frequently localized on pelvis, ribs and long bones. Nasal septum CSs are very rarely seen malignancies. They originate from septal mucosa or cartilage and it is difficult to make a diagnosis unless they reach a certain size. A few cases of CSs with nasal septum have been reported in the literature. In cases of CSs, surgery is the gold standard treatment modality;however in surgically unresectable cases or close to margins, radiotherapy plays a significant role in primary and adjuvant treatment. Based on the position of the tumor in head and neck and extremely closeness of the tumor to vital organs as optic nerve, chiasm and brain, image guided-intensity modulated radiation therapy (IG-IMRT) becomes very effective and reliable modalities and may be a favorable treatment alternative.

STUDY ON LOCATION OF HOT SPOT AT TUBE WALL FOR FIRED CYLINDRICAL FURNACE COMBUSTION

Based on the analysis of heat radiation intensity from flame, a new mathematical model ofthe tube-wall temperatmp of heated tubes is developed by taking down-fired, upright-tube cylindricalfurnace for example. The proposed mathematical model can be employed to indicate both the positionand size of the hot spot at fire-facing wall of heated tube of combustion chamber, and is characteristicof simplicity and efficiency If coupled with thermoelectric couple or infrared viewer, the presentedlocation method of combustion hot spot can offer engineers very valuable proposal to keep furnacerunning more safely The same is true for any other type of tubular furnaces.

Axial Magnetic Field Effects on Xenon Short-Arc Lamps

The effect of an axial magnetic field （AMF） on an old xenon short-arc lamp is experimentally investigated in this work. As the AMF increases up to 18 roT, the visible radiation power and electric power ascend more than 80% and 70% respectively, and the radiation efficiency is improved by 23% for the best increment at 12 mT AMF. The measurement of radiation intensity shows that the increment of radiation intensity comes mostly from the plasma area close to the cathode tip, and partially from the other area of the arc column. Successive images of the arc indicate that the arc column not only rotates about its axis, but revolves around the axis of electrodes with the AMF. The arc column structure is constricted, distorted and elongated as the AMF increases. It is suggested that the improvements of the radiation intensity and radiation efficiency are attributed to the constriction of the arc column, which is mainly induced by the enhanced cathode jet.

Neoadjuvant chemoradiotherapy for locally advanced gastric cancer with bulky lymph node metastasis:Five case reports

BACKGROUND Neoadjuvant chemoradiotherapy(NACRT)has not been accepted as a general therapy for gastric cancer because of its localized effect and toxicity for radiosensitive organs.However,if radiation therapy could compensate for the limited or inadequate treatment choices available for elderly patients and/or those at high risk,the available therapeutic options for advanced gastric cancer might increase.From this perspective,we present our experiences of five patients with advanced gastric cancer in whom we used NACRT therapy with interesting results.CASE SUMMARY We admitted five patients with clinical Stage III gastric cancer and bulky lymph node metastasis or adjacent organ invasion at the time of diagnosis.A total of 50 Gy of preoperative intensity modulated radiation therapy was delivered to the patients in doses of 2.0 Gy/d,together with a regimen of concomitant chemotherapy comprising two courses of oral tegafur/gimeracil/oteracil(S-1;65 mg/m2 per day)for three consecutive weeks followed by two weeks of rest,starting at the same time as radiotherapy.All patients underwent no residual tumor resection and a pathological complete response of the primary tumors was achieved in two patients.The incidence of hematological toxicity was low,although the digestive toxicities of anorexia and diarrhea developed in three of the five patients,necessitating termination of radiation therapy at 30 Gy and S-1 at three weeks.However,even 30 Gy of irradiation and half the dose of S-1 resulted in sufficient downstaging,indicating that even a reduced amount of NACRT could confer considerable effects.CONCLUSION Slightly reduced NACRT might be useful and safe for patients with locally advanced gastric cancer.

Analysis of Solar House Efficiency in Cold Climatic Conditions like Armenia

During last decades the solar passive heating of buildings found rather wide application. It has been used effectively in an estimated 17,000 commercial buildings in the United States-ranging from offices to schools, and airport terminals. At present there exist two main types of solar houses, ＂house collector＂ and ＂wall collector＂. A part of researchers find that the use of＂house collector＂ is more simple and efficient. The other part is sure that ＂wall collector＂ is more convenient to use and it has higher efficiency. But our analysis show that in existing literature there is not any method for evaluating efficiency of solar houses. Moreover, there is not in. use a concept on solar houses efficiency. To us each type of solar houses has its own advantages and disadvantages. In this paper solar passive ＂House-Collector＂ heating modes of houses and their efficiency are discussed. For calculation of designing parameters of solar houses a simplified method is presented, taking into consideration both the heat gains and heat losses.

Research Progress of Two-d imensional Matrix Detectors in IMRT Dose Verification

With the continuous development of science and technolog ies in China,radiotherapy technology in medical field has been very significant ly developing,and intensity modulated radiation therapy(IMRT)technology has been the most widely used.This paper first introduces the components and types of two-dimensional matrix detector,two-dimensional ionization chamber matrix detector and two-dimensional semiconductor matrix detector,then analyzes the dosimetric characteristics of the two-dimensional matrix detector.In the end,the various applications of the two-dimensional matrix detector are analyzed and discussed in detail.The paper aims to promote the two-dimensional matrix detector’s development in the field of radiotherapy in China.

Influence of cryogenic permanent magnet undulator motion error on magnetic field error and radiation intensity loss

A cryogenic permanent magnet undulator prototype designed for Chinese High Energy Photon Source Test Facility(HEPSTF)at Institute of High Energy Physics is constructed and now commissioning.Motion precision of girders is a significant parameter to guarantee gap error so as to avoid phase error and radiation intensity loss.In order to study and minimize girder parallelism errors,RADIA and SPECTRA are used to calculate qualified motion precision.Spring Modules and single motor closed-loop feedback are designed to compensate the errors.Magnetic field is finally tuned to reach specifications.Details of the study and analysis will be presented in this paper.

A Systematic Approach to Patient-Specific Quality Assurance for Volumetric Modulated Arc Therapy

We developed the first non-commercial treatment planning system for volumetric modulated arc therapy(VMAT) in the United States. Because VMAT involves multi-parameter modulations, it is imperative to develop a comprehensive, rigorous and yet, practical procedure for routine patient-specific quality assurance(QA). In this paper, we presented our own approach as being currently implemented in our institution.Our patient-specific QA procedure involves multi-levels: pre-treatment QA,on-treatment QA, and posttreatment QA. The pre-treatment QA focuses on dosimetry verification, which is done with the commercial Map CHECK in Map PHAN mounted on an isocentric mounting fixture(IMF). This method is also referred to the fixed-gantry technique,i.e., the beams always remain perpendicular to the detector plane. The on-treatment QA involves in vivo optically stimulated luminescent dosimetry(OSLD).Prior to the treatment, two nano Dot TM OSLD dosimeters are placed on the patient abdomen under 1 cm bolus at the isocenter location. The irradiated dosimeters are then read by a nano Dot TM reader and the average reading of the two is calculated. The post-treatment QA involves the analysis of the Dyna Log and DLog files. The Dyna Log is a treatment log file that contains the planned and actual leaf positions at a given gantry angle. The DLog is a treatment log file that contains the planned segmented treatment table(STT) and the corresponding segment boundary samples, i.e., the actual delivered MU and gantry angle increment at each control point.