A National Cyberattack Affecting Radiation Therapy: The Irish Experience

Total quality culture in radiotherapy departments across Ontario

Radiation therapy for head and neck cancer frequently caused severe salivary gland dysfunction. The salivary gland dysfunction possibly decreased the protective function of saliva and caused dental caries. The purpose of this study was to obtain an illustration about DMF-T index in patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Department of Radiotherapy, Dr. Hasan Sadikin Hospital in January-February 2007. The study was a simple descriptive. The study was conducted on 7 males and 9 females undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer. The ages of patient are between 37 years and 77 years. The severity of caries was measured by DMF-T index. DMF-T index in 16 patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Dr. Hasan Sadikin Hospital is 10.6 as the result of this study. The conclusion of this study showed that the DMF-T index in 16 patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Dr. Hasan Sadikin Hospital had very high grade based on WHO classification, which the value was over 6.6.

Radiation Therapy for Symptomatic Bone Metastases: The Effect of Calculated Dose and Dose Distribution on Intensity of Pain Relief and Time of Pain Relief

New devices in radiation oncology

Background: The effects of radiation therapy can impact patients’ quality of life, leading to treatment interruptions and therefore sub-optimal outcomes. The main aim was to evaluate the preliminary effects of Ocoxin cream® in the prevention of radiation therapy. Methods: Fifty patients were enrolled in an observational, longitudinal, prospective, single-centre clinical trial in the Department of Radiation Therapy at the National Institute of Oncology and Radiobiology in Havana, Cuba. The Radiation Therapy Oncology Group (RTOG) toxicity criteria were used to classify the radiation therapy, and the Dermatology Life Quality Index (DLQI) instrument was used to assess quality of life. Results: Patients who met the inclusion criteria were enrolled consecutively and were treated with teletherapy using a 60Co source with 1.25 MeV energy. 70.0% of the patients were head and neck cancer patients. No grade 3 - 4 radiation therapy was reported, nor were there any interruptions in radiation treatment due to skin toxicity. Radiation therapy was observed in only 14.0% of patients, and of these, only two patients developed grade 2 toxicity. The perception of quality of life before vs. after radiation therapy remained within an average range of “no effect” (at the start of radiation therapy) to “small effect” (at the end of radiation therapy). Conclusions: This clinical study is the first report of the use of Ocoxin cream® in cancer patients and demonstrates that it is able to prevent radiation therapy and reduce the severity of toxicity of treatment with ionising radiation.

Monitoring the Situation: Implementation of a Patient Information Monitor in a Radiation Therapy Department Waiting Room

Measuring safety culture: Application of the Hospital Survey on Patient Safety Culture to radiation therapy departments worldwide

The SARS-CoV-2 pandemic and covid-19 diffusion are an international public health emergency.1 Cancer patients are particularly exposed to infections and their potential complications.2 In this context, the usual clinical decision-making process in radiation therapy is being consistently revised.3 There is an urgent need to share expertise and offer emergency guidance. It is crucial to minimise contacts and to reduce the complexity of radiation treatments where possible to optimise the workforce, keeping intact the effectiveness of the interventions.4 Radiation and systemic therapy modifications should be implemented depending on local circumstances.5 A general guiding principle should include approaches where clinical equivalence supported by trials testing de-escalation strategies is present even without level 1–2 evidence (box 1, bullet points 1).3 Patients with cancer have an intrinsic degree of frailty and therefore are prone to covid-19 complications. Age and comorbidities have been reported as independent risk factors for poor outcome during covid-19 infection and, of note, more than half of cancer patients are elderly and have significant comorbidities (box 1, bullet points 2).6 Hence, an appropriate evaluation of the risk-benefit of radiation therapy treatments is cogent. Urgent cases and non-deferrable treatments (ie, active tumours, spinal cord compression, life threatening bleeding) should be initiated or continued, provided there is full compliance with the safety regulations of local authorities for both patients and staff members. In non-urgent cases, irradiation can be postponed to an extent, depending on the clinical setting and the possibility to offer patients bridging systemic therapies. Whenever radiation therapy is indicated, dose prescription, fractionation and delivery techniques should be adapted, reduced in duration, and optimised (box 1, bullet points 3 and 4). A timely example of precision medicine application is non-metastatic breast cancer radiation …

Rationalisation of Fractionation in RadiotherapyL. G. Lajtha, R. Oliver and F. EllisL. G. LajthaRadiobiology Laboratory, Department of Radiotherapy, Churchill Hospital, OxfordSearch for more papers by this author, R. OliverRadiobiology Laboratory, Department of Radiotherapy, Churchill Hospital, OxfordSearch for more papers by this author and F. EllisRadiobiology Laboratory, Department of Radiotherapy, Churchill Hospital, OxfordSearch for more papers by this authorPublished Online:28 Jan 2014https://doi.org/10.1259/0007-1285-33-394-634SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail AboutAbstractA rationale of fractionation of X-ray doses, based on the multi-hit nature of X-ray dose response curves for reproductive integrity in mammalian cells is presented. Previous article Next article FiguresReferencesRelatedDetailsCited byAdaptive fractionation at the MR-linac3 January 2023 | Physics in Medicine & BiologyCancer Stem Cell Radioresistance and Enrichment: Where Frontline Radiation Therapy May Fail in Lung and Esophageal Cancers10 March 2011 | Cancers, Vol. 3, No. 1Adaptive fractionation therapy: I. Basic concept and strategy9 September 2008 | Physics in Medicine and Biology, Vol. 53, No. 19Different fractionation schemes tested by histological examination of autopsy specimens from lung cancer patients*H. J. Eichhorn28 January 2014 | The British Journal of Radiology, Vol. 54, No. 638Book review Radiation Therapy Technology (Examination Review). 814 Multiple Choice Questions and Referenced Explanatory Answers. Ed. StrykerJ., ClementJ. A., VelkeyD. E. and GruverC. A., pp. 265, 1980 (Medical Examination Publishing Co., New York), £14·00. ISBN 0–87488–459–1Brendan Hale28 January 2014 | The British Journal of Radiology, Vol. 54, No. 638Grundlagen der strahlentherapeutischen MethodenSome Parameters of Cell Proliferation in a Solid Tumor119 May 2005 | Veterinary Radiology, Vol. 9, No. 1The Application of Cell Survival Theory to High Dose-rate Intracavitary TherapyW. E. Liversage29 May 2014 | The British Journal of Radiology, Vol. 39, No. 461Dose-Effect Relationships for Radiation Damage to Organized TissuesNature, Vol. 199, No. 4890II. Dose-time Relationships in Radiotherapy and the Validity of Cell Survival Curve ModelsJ. F. Fowler and Babette E. Stern29 May 2014 | The British Journal of Radiology, Vol. 36, No. 423Theoretical aspects of dose-time factors in radiotherapy techniqueClinical Radiology, Vol. 14, No. 4Cell Population Kinetics following Different Regimes of IrradiationL. G. Lajtha and R. Oliver29 May 2014 | The British Journal of Radiology, Vol. 35, No. 410Review Problems of Infection, Immunity and Allergy in Acute Radiation Diseases (from the Russian). By KlemparskayaN. N., AlekseyevaO. G., PetrovR. V. and SosovaV. F., translated by VentersLydia, pp. viii + 154, 34 illus., 1961 (Oxford, Pergamon Press), 50s.R. H. Mole29 May 2014 | The British Journal of Radiology, Vol. 35, No. 410Problems of Radiosensitivity in Mixed Cell Populations with Particular Reference to RadiotherapyR. Oliver and L. G. Lajtha28 January 2014 | The British Journal of Radiology, Vol. 34, No. 406Some Radiobiological Considerations in RadiotherapyL. G. Lajtha and R. Oliver28 January 2014 | The British Journal of Radiology, Vol. 34, No. 400CorrespondenceJ. E. Burns28 January 2014 | The British Journal of Radiology, Vol. 34, No. 400CorrespondenceW. J. Weston28 January 2014 | The British Journal of Radiology, Vol. 34, No. 400CorrespondenceC. W. Wilson28 January 2014 | The British Journal of Radiology, Vol. 34, No. 400 Volume 33, Issue 394October 1960Pages: 595-658 © The British Institute of Radiology History ReceivedMarch 01,1960Published onlineJanuary 28,2014 Metrics Download PDF

Xanthomatous hypophysitis

Background: Side effects of radiotherapy (RT) could be temporary or permanent, can be severe, and affect quality of life. An investigation into the side effects of RT on breast cancer patients would help evaluate the incidences and associated risk factors in the low-income countries for patients undergoing RT in order to ensure maximum treatment with very minimal side effects. Objective: To assess the side effects of RT in patients with breast cancer undergoing RT in Lagos University Teaching Hospital. Materials and Methods: This was a descriptive, cross-sectional study. Self-administered questionnaires were distributed to breast cancer patients on RT that have received treatment for at least 2 weeks at the RT Department between March and August 2016. A total of 146 questionnaires were distributed, whereas 139 were completely filled and returned for the evaluation and analysis, given a response rate of 95.2%. Results: The common side effects noticed from the analysis of this research work included skin erythema (87.1%), fatigue (74.1%), telangiectasia (69.1%), pain (89.9%), breast swelling (45.3%), and loss of hair in the armpit and chest area (87.1%), and the less common ones were breast shrinkage (20.1%), lymphedema (41.0%), cardiac complications (30.9%), lung problems (12.9%), sore throat (7.9%), brachial plexopathy (24.5%), and damage to the bones (ribs; 3.6%). Management of the side effects by patients revealed that 30 (21.6%) used analgesics, 28 (20.1%) used steroidal cream, 27 (19.4%) avoided deodorants and antiperspirant, 22 (15.8%) exercised, 15 (10.8%) took antibiotics, 10 (7.2%) took herbs, and 7 (5%) had to stop treatment temporarily for minimum of a week due to severe morbidity. Conclusion: A large percentage of breast cancer patients undergoing RT experience painful side effects (89.9%), of these 87% experience skin erythema, 74% experience fatigue, and 69% experience telangiectasia.

Radiation therapy plays a crucial role in the management of pediatric cancer. With recent advancements in treatment techniques and radiation delivery, stricter immobilization is required. However, achieving this in pediatric patients is challenging and often necessitates daily anesthesia. In this study, we present an audit of pediatric patients who underwent radiation therapy under anesthesia, highlighting associated complications and providing a roadmap for resource allocation. We collected data on pediatric patients who required radiotherapy under anesthesia, including demographic details, tumor characteristics, anesthesia specifics, observed complications, and any treatment gaps. Descriptive statistics were used to analyze demographic, tumor, and treatment characteristics. Univariate and multivariate analyses were performed to identify correlations with various variables. From January 2021 to December 2023, 67 patients were scheduled for radiotherapy with daily anesthesia. The median age of the patients was 4 years (interquartile range: 2-5 years). Of these, 34 patients required anesthesia for the entire course of treatment, 22 patients needed anesthesia for part of the treatment, and seven patients did not require anesthesia after the simulation. Overall, anesthesia was needed for 59.12% of sessions. Complications occurred in 66 sessions (8.2%) involving 26 patients. Treatment had to be paused in eight cases, with a median delay of 8 days. The treatment compliance rate was 96.9%. An age of <3 years was significantly associated with the need for anesthesia during radiation. The complication rate was notably higher in patients who required anesthesia for the entire course of radiotherapy. While the use of anesthesia ensures proper immobilization during radiation treatment for pediatric patients, it carries the risk of complications. Therefore, it is essential to continuously explore and support efforts to allow patients to undergo radiation without the need for anesthesia.

Patients with spinal metastasis from cancer of unknown primary origin have limited life expectancy and poor quality of life. Surgery and radiation therapy remain the main treatment options, but, to our knowledge, there are limited data concerning quality-of-life improvement after surgery and radiation therapy and even fewer data on whether surgical intervention would affect quality of life. Patients were enrolled between January 2009 and January 2014 at the Changzheng Hospital, Shanghai, People's Republic of China. The quality of life of 2 patient groups (one group that underwent surgery followed by postoperative radiation therapy and one group that underwent radiation therapy only) was assessed by the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire during a 6-month period. A subgroup analysis of quality of life was performed to compare different surgical strategies in the surgical group. A total of 287 patients, including 191 patients in the group that underwent surgery and 96 patients in the group that underwent radiation therapy only, were enrolled in the prospective study; 177 patients completed all 5 checkpoints and 110 patients had died by the final checkpoint. The surgery group had significantly higher adjusted quality-of-life scores than the radiation therapy group in each domain of the FACT-G questionnaire (all p < 0.05). Subgroup analysis showed that adjusted functional and physical well-being scores were higher in the circumferential surgical decompression group. Surgery followed by postoperative radiation therapy improved and maintained quality of life in patients with spinal metastasis from cancer of unknown primary origin in the 6-month assessment. In terms of surgical strategies, circumferential decompression seems better than laminectomy alone in quality-of-life improvement. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Multiple reports of adverse events related to an error of dose fractionation or session frequency in radiation therapy – Technical analysis

Introduction: One of the useful standard quality assurance techniques in radiation therapy is monitoring entrance doses in in-vivo dosimetry. An overall tolerance limit of 5% of the absorbed radiation dose has been recommended by the International Commission of Radiological Units. The implementation of an in vivo dosimetry still remains as a challenge to clinical medical physicists. As a result, the practice of constant monitoring of patients undergoing radiation therapy in most of the radiotherapy departments in Africa has not been given much attention. The study aimed at the evaluation of in-vivo entrance dosimetry using diodes to verify the accuracy of the radiation delivered to patients, compared to prescribed doses. Material and Methods: In this paper, a protocol for in vivo dosimetry using a two flat surface Sun Nuclear Corporation diode in a radiotherapy department has been implemented in equinox Cobalt 60 beams. A water phantom calibrated was performed using the International Atomic Energy Agency standards (TRS 398). Calibration coefficients were determined with diodes using a Perspex phantom to derive correction factors. A total number of 137 patients’ doses were measured with the diodes during the treatment of 4 different sites. Results: The average deviation between the measured and expected entrance dose performed by the phantom studies was 5% (0.34±1.8%) in almost all cases. Conclusion: The developed protocol in this study indicates that in vivo dosimetry using silicon diodes is reliable, which can be adopted as a universal quality assurance tool in the radiotherapy departments. Moreover, measurements with diodes can be acquired online which produces an instant readout and is relatively cheaper as compared to the ion chamber.