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Biomedical subjects

A Wambersie

Publications and source records attributed to A Wambersie.

At least 37 records · Page 2Linked to original sources
PubMed1999

The benefit of Beam's eye view based 3D treatment planning for cervical cancer.

PURPOSE: The aim of this study was to evaluate the possibility of Beam's eye view (BEV) based three dimensional (3D) treatment planning, to reduce portions of organs at risk included in the treated volume without increasing the risk of geographical miss in external beam therapy of cervical cancer. MATERIALS AND METHODS: Three dimensional dose distribution of BEV based 3D treatment plans was compared to the 3D dose distribution derived from a four-field-box-technique using standard portals. A total of 20 patients with cervical cancer stage FIGO IIB and FIGO IIIB was included. Dose distribution in the target volumes and in the organs at risk of BEV based treatment planning, was compared to the dose distribution of the standard field technique using dose-volume-histograms. RESULTS: In 4/20 patients (20%) a geographical miss at the cervix uteri was observed for the standard field technique. The BEV based treatment planning resulted in an adequate coverage of target volume and additionally in a reduction of portions of bladder and bowel volume included in the treated volume (-13.5, -10%). In contrast the BEV based technique resulted in an increase of portions of the rectum volume included in the treated volume compared to standard portals due to a shift of the rectum by the enlarged cervix uteri from its posterior to a lateral position. An overall 7% reduction of treated volume was observed, although the maximum width of lateral fields increased for the BEV technique. Moreover, we have found a remarkable impact of bladder fillings on the amount of bowel and bladder volume included in the treated volume. CONCLUSION: BEV based 3D treatment planning for external beam therapy of cervical cancer offers a possibility to avoid geographical miss of part of the CTV with reduced portions of bladder and bowel volume included in the treated volume.

Female↗
PubMed1999

Recommended restrictions after 131I therapy: measured doses in family members.

Absorbed doses to family members of patients treated with (131)I were measured using thermoluminescent dosimeters worn on the chest. Twenty-two patients with thyroid cancer were hospitalized for 2 d for treatment with 3,700-7,400 MBq, and 18 hyperthyroid patients were treated on an outpatient basis with 200-600 MBq. Doses were measured over periods of 15-21 d following the administration of radioiodine in 35 partners and 38 children, aged 4 mo to 25 y. These results were correlated with dose rate measurements performed with an ionization chamber, and residual thyroid uptake was assessed by scintigraphy over the same period. In the cancer group, the residual activity in thyroid remnants was less than 50 MBq in all cases at day 4 following treatment and decayed with a mean half-life of 2.2 (SD: 0.8) d. The dose measured with thermoluminescent dosimeters was lower than 0.5 mSv in all partners and children. In the hyperthyroid group, the effective half-life averaged 6.2 (SD: 1.2) d. The median of the doses measured in partners and children were 1.04 mSv (range: 0.05-5.2) and 0.13 mSv (range: 0.04-3.1), respectively. Fifteen children (88%) received less than the dose constraint of 0.5 mSv. The ICRP recommend an annual limit of 1 mSv for the members of the public. In addition, dose constraints (for example: 0.5 mSv) should be complied with whenever possible. The recommended dose limits are generally well met among family members of patients treated with 1311 for cancer. The higher doses measured in hyperthyroid patients, compared to thyroid cancer patients, relate to a higher (131)I retention by the gland and justify more extended and stringent restriction periods, based on residual thyroid activity.

Adolescent↗
PubMed1999

A consistent set of neutron kerma coefficients from thermal to 150 MeV for biologically important materials.

Neutron cross sections for nonelastic and elastic reactions on a range of elements have been evaluated for incident energies up to 150 MeV. These cross sections agree well with experimental cross section data for charged-particle production as well as neutron and photon production. Therefore they can be used to determine kerma coefficients for calculations of energy deposition by neutrons in matter. Methods used to evaluate the neutron cross sections above 20 MeV, using nuclear model calculations and experimental data, are described. Below 20 MeV, the evaluated cross sections from the ENDF/B-VI library are adopted. Comparisons are shown between the evaluated charged-particle production cross sections and measured data. Kerma coefficients are derived from the neutron cross sections, for major isotopes of H, C, N, O, Al, Si, P, Ca, Fe, Cu, W, Pb, and for ICRU-muscle, A-150 tissue-equivalent plastic, and other compounds important for treatment planning and dosimetry. Numerous comparisons are made between our kerma coefficients and experimental kerma coefficient data, to validate our results, and agreement is found to be good. An important quantity in neutron dosimetry is the kerma coefficient ratio of ICRU-muscle to A-150 plastic. When this ratio is calculated from our kerma coefficient data, and averaged over the neutron energy spectra for higher-energy clinical therapy beams [three p (68) + Be beams, and a d (48.5) + Be beam], a value of 0.94 +/- 0.03 is obtained. Kerma ratios for water to A-150 plastic, and carbon to oxygen, are also compared with measurements where available.

Biophysical Phenomena↗
PubMed1998

Boron neutron capture therapy: principles and potential.

This book on the therapeutic applications of neutrons and high-LET radiations in cancer therapy would not have been complete without a review of the present situation of boron neutron capture therapy (BNCT) and a discussion of its future perspectives. BNCT is a special type of high-LET radiation therapy that attempts to achieve a selectivity at the cellular level. The rationale is to incorporate boron atoms selectively in the cancer cells and then bombard those atoms with thermal neutrons to produce a neutron capture reaction and subsequent decay that emits alpha and lithium particles. The efficiency of the technique depends upon achieving selective incorporation of the boron atoms in the cancer cells and not (or to a lesser extent) in the normal cells. The present status and future directions are described, with emphasis on boron carriers (drugs) and their delivery, as well as physical and treatment planning aspects.

Boron Neutron Capture Therapy↗
PubMed1998

Specification of radiation quality in fast neutron therapy: microdosimetric and radiobiological approach.

Specification of radiation quality is an important issue in fast neutron therapy since the biological effectiveness of the beams varies to a large extent with neutron energy. It must meet specific criteria, mainly derived from the accuracy requirement for absorbed dose delivery. A first approach to this problem consists in identifying physical parameters that can be related to Relative Biological Effectiveness (RBE) and which describe the beam production technique (e.g. neutron-producing reaction, p + Be or d + Be, energy of the incident particle). A second is based on microdosimetry, which provides a description of the secondary radiation components to which the biological consequences of irradiations are more directly correlated. A third approach consists in experimental RBE determinations in reference conditions: intestinal crypt regeneration in mice after irradiation to the whole body with single doses is proposed as a standard biological system for radiobiological calibrations of clinical fast neutron beams. Dosimetric, microdosimetric and radiobiological intercomparisons are encouraged since they provide a homogeneous set of data which facilitate the exchange of clinical information. They also constitute a basis for the clinical RBE approach and an overall check of the irradiation procedure. Therefore they should be recommended in every non-conventional radiation therapy facility.

Animals↗
PubMed1998

Relative biological effectiveness of neutrons for cancer induction and other late effects: a review of radiobiological data.

The risk of secondary cancer induction after a therapeutic irradiation with conventional photon beams is well recognised and documented. However, in general, it is totally overwhelmed by the benefit of the treatment. The same is true to a large extent for the combinations of radiation and drug therapy. After fast neutron therapy, the risk of secondary cancer induction is greater than after photon therapy. This can be expected from the whole set of radiobiological data, accumulated so far, which shows systematically a greater relative biological effectiveness (RBE) for neutrons for all the biological systems which have been investigated. Furthermore, the neutron RBE increases with decreasing dose and there is extensive evidence that neutron RBE is greater for cancer induction and for other late effects relevant in radiation protection than for cell killing at high doses as used in therapy. Almost no reliable human epidemiological data are available so far, and the aim of this work is to derive the best risks estimate for cancer induction after neutron irradiation and in particular fast neutron therapy. Animal data on RBE for tumour induction are analysed. In addition, other biological effects are reviewed, such as life shortening, malignant cell transformation in vitro, chromosome aberrations, genetic effects. These effects can be related, directly or indirectly, to cancer induction to the extent that they express a "genomic" lesion. Since neutron RBE depends on the energy spectrum, the radiation quality has to be carefully specified. Therefore, the microdosimetric spectra are reported each time they are available. Lastly, since heavy-ion beam therapy is being developed at several centres worldwide, the available data on RBE at low doses are reviewed. It can be concluded from this review that the risk of induction of a secondary cancer after fast neutron therapy should not be greater than 10-20 times the risk after photon beam therapy. For heavy ions, and in particular for carbon ions, the risk estimate should be divided by a factor of about 3 due to the reduced integral dose. The risk has to be balanced against the expected improvement in cure rate when the indication for high-LET therapy has been correctly evaluated in well-selected patient groups.

Animals↗
PubMed1998

[Nuclear accidents and iodine prophylaxis. Part 1: Risks due to irradiation of the thyroid gland].

In the frame of the emergency procedures in the case of an accident in a nuclear plant, this paper presents a survey of the information available on the risks related to the irradiation of the thyroid gland. Attention is focused on thyroid cancer resulting from an exposure to radioactive isotopes of iodine and especially and iodine-131. The consequences of the medical exposures as well as of the Hiroshima and Nagasaki irradiations are recalled first. Then the recently available informations on the effects on the populations exposed after the Tchernobyl accident are analysed more in details. Ten years after the accident, the most striking and the least questionable effects is a significant increase of the incidence of differentiated thyroid cancer in children, in the areas most exposed to the initial radioactive clouds. Young children are particularly vulnerable to this type of cancer which is of aggressive nature and shows a short latency period. These observations justify an iodine prophylaxis for the populations living in the vicinity of nuclear plants. Special attention should be paid to the protection of young children.

Adolescent↗
PubMed1997

RBE variation as a function of depth in the 200-MeV proton beam produced at the National Accelerator Centre in Faure (South Africa).

BACKGROUND AND PURPOSE: Thorough knowledge of the RBE of clinical proton beams is indispensable for exploiting their full ballistic advantage. Therefore, the RBE of the 200-MeV clinical proton beam produced at the National Accelerator Centre of Faure (South Africa) was measured at different critical points of the depth-dose distribution. MATERIAL AND METHODS: RBEs were determined at the initial plateau of the unmodulated and modulated beam (depth in Perspex = 43.5 mm), and at the beginning, middle and end of a 7-cm spread-out Bragg peak (SOBP) (depths in Perspex = 144.5, 165.5 and 191.5 mm, respectively). The biological system was the regeneration of intestinal crypts in mice after irradiation with a single fraction. RESULTS: Using 60Co gamma-rays as the reference, the RBE values (for a gamma-dose of 14.38 Gy corresponding to 10 regenerated crypts) were found equal to 1.16 +/- 0.04, 1.10 +/- 0.03, 1.18 +/- 0.04, 1.12 +/- 0.03 and 1.23 +/- 0.03, respectively. At all depths, RBEs were found to increase slightly (about 4%) with decreasing dose, in the investigated dose range (12-17 Gy). No significant RBE variation with depth was observed, although RBEs in the SOBP were found to average a higher value (1.18 +/- 0.06) than in the entrance plateau (1.13 +/- 0.04). CONCLUSION: An RBE value slightly larger than the current value of 1.10 should be adopted for clinical application with a 200-MeV proton beam.

Animals↗
PubMed1996

RBE variation between fast neutron beams as a function of energy. Intercomparison involving 7 neutrontherapy facilities.

In fast neutron therapy, the relative biological effectiveness (RBE) of a given beam varies to a large extent with the neutron energy spectrum. This spectrum depends primarily on the energy of the incident particles and on the nuclear reaction used for neutron production. However, it also depends on other factors which are specific to the local facility, eg, target, collimation system, etc. Therefore direct radiobiological intercomparisons are justified. The present paper reports the results of an intercomparison performed at seven neutrontherapy centres: Orléans, France (p(34)+Be), Riyadh, Saudi Arabia (p(26)+Be), Ghent, Belgium (d(14.5)+Be), Faure, South Africa (p(66)+Be), Detroit, USA (d(48)+Be), Nice, France (p(65)+Be) and Louvain-la-Neuve, Belgium (p(65)+Be). The selected radiobiological system was intestinal crypt regeneration in mice after single fraction irradiation. The observed RBE values (ref cobalt-60 gamma-rays) were 1.79 +/- 0.10, 1.84 +/- 0.07, 2.24 +/- 0.11, 1.55 +/- 0.04, 1.51 +/- 0.03, 1.50 +/- 0.04 and 1.52 +/- 0.04, respectively. When machine availability permitted, additional factors were studied: two vs one fraction (Ghent, Louvain-la-Neuve), dose rate (Detroit), influence of depth in phantom (Faure, Detroit, Nice, Louvain-la-Neuve). In addition, at Orléans and Ghent, RBEs were also determined for LD50 at 6 days after selective abdominal irradiation and were found to be equal to the RBEs for crypt regeneration. The radiobiological intercomparisons were always combined with direct dosimetric intercomparisons and, when possible in some centres, with microdosimetric investigations.

Abdomen↗
PubMed1996

Present status, trends and needs in fast neutron therapy.

Fast neutrons were introduced in cancer therapy, in the 1970s, on the basis of radiobiological arguments. After 30 years, these arguments are still valid and have not been refuted by more recent experimental data. Although neutron therapy has been applied routinely for about 25 years, there is still no general agreement concerning its value and its place among the other radiation therapy techniques. In order to be able to draw objective conclusions from the available clinical results and mainly to compare the results from the different centres in a relevant way, a consensus has to be reached on several issues: 1) a protocol for dose measurement in a homogeneous phantom in reference conditions; 2) dose computation at the level of the target volume(s) and the normal tissues at risk; 3) method of dose specification for reporting; and 4) specification of radiation quality in neutron therapy and the related RBE problems. The International Commission on Radiation Units and Measurements (ICRU) has published recommendations on Clinical Neutron Dosimetry (ICRU Report 45, 1989) which are now universally applied. As far as dose specification for reporting is concerned, ICRU recommendations for photons (ICRU Report 50, 1993) can be extended and adapted for fast neutrons. However, special care is required to take into account the tissue compositions. In fast neutron therapy, specification of radiation quality raises a particular problem because the neutron RBE, relative to gamma rays, is higher than unity (it ranges from about 2 to 5) and furthermore significantly varies with neutron beam energy. In addition, the RBE also varies with dose and biological system. In these conditions, besides the classical concept of RBE introduced jointly by the ICRP and the ICRU in 1963, the concepts of "reference RBE" and "clinical RBE" are proposed here for application in fast neutron therapy. Microdosimetry provides an adequate method to describe radiation quality, at the point of interest in the irradiated medium and in the actual irradiation conditions. From the analysis of microdosimetric spectra, a RBE value of a particular neutron beam, for a given biological system, can be predicted provided that the biological weighing function for that biological system has been obtained. In any case, correlation of the microdosimetric description of a given beam and the experimental RBE values for that beam improves the confidence in both sets of data.

Cancer Care Facilities↗
PubMed1996

The multileaf collimator for fast neutron therapy at Louvain-la-Neuve.

The multileaf collimator of the fast neutron therapy facility at Louvain-la-Neuve is described, as well as some of the physics experiments performed in order to evaluate the attenuation of neutron beams in different materials and thus optimize the composition of the collimator leaves. The multileaf collimator consists of two sets of 22 leaves each, which can be moved independently. They are made of iron and their thickness is 95 cm. Seven borated polyethylene disks are located in the distal part of the leaves in order to absorb more efficiently the low-energy component of the neutron spectrum. The width of the leaves is 1 cm at their distal part. The leaves can move 11 cm outwards and 6 cm inwards from their reference position, and field sizes up to 25.7 x 24.8 cm, as well as irregular field shapes, can be obtained. The inner part of the leaves and their two sides are always focused on the target. The complete multileaf collimator can rotate around the beam axis, from -90 degrees to +90 degrees from the reference position. The width of the penumbra (80-20% isodoses) is 0.64 cm and 1.17 cm at the depth of the maximum buildup and at 10 cm in depth respectively, for a 10 x 10 cm field size. The collimator is adequate for the energy of the p(65)+Be neutron beam of Louvain-la-Neuve and has been adapted to the fixed vertical beam. It has been designed following the original plans of Scanditronix, adjusted and fully assembled at the workshop of the Centre de Recherches du Cyclotron (CRC). Systematic measurements were performed in order to optimize the design and the composition of the leaves. In particular the attenuations of the actual beam and of monoenergetic neutron beams were measured in different materials such as iron and polyethylene. Above (upstream) the multileaf collimator, a fixed pre-collimator (iron thickness 50 cm; section 1 x 1 m) defines a conical aperture aligned on the largest opening of the leaves. It contains the two transmission chambers and a 2 cm thick polyethylene layer used for hardening the beam.

Belgium↗
PubMed1996

Response analysis of TLD-300 dosimeters in heavy-particle beams.

In vivo dosimetry is recommended as part of the quality control procedure for treatment verification in radiation therapy. Using thermoluminescence, such controls are planned in the p(65) + Be neutron and 85 MeV proton beams produced at the cyclotron at Louvain-La-Neuve and dedicated to therapy applications. A preliminary study of the peak 3 (150 degrees C) and peak 5 (250 degrees C) response of CaF2:Tm (TLD-300) to neutron and proton beams aimed to analyse the effect of different radiation qualities on the dosimetric behaviour of the detector irradiated in phantom. To broaden the range of investigation, the study was extended to an experimental 12C heavy ion beam (95 MeV/nucleon). The peak 3 and 5 sensitivities in the neutron beam, compared to 60Co, varied little with depth. A major change of peak 5 sensitivity was observed for samples positioned under five leaves of the multi-leaf collimator. While peak 3 sensitivity was constant with depth in the unmodulated proton beam, peak 5 sensitivity increased by 15%. Near the Bragg peak, peak 3 showed the highest decrease of sensitivity. In the modulated proton beam, the sensitivity values were not significantly smaller than those measured in the unmodulated beam far from the Bragg peak region. The ratio of the heights of peak 3 and peak 5 decreased by 70% from the 60Co reference radiation to the 12C heavy-ion beam. This parameter was strongly correlated with the change of radiation quality.

Carbon↗
PubMed1996

Radioiodine treatment of thyroid carcinoma in patients on maintenance hemodialysis.

To deliver optimal radioiodine activity in hemodialyzed patients with thyroid carcinoma, the behavior of radioiodine was followed during six treatments. During hemodialysis, blood activity decreases with a half-life of 3.4 +/- 0.5, (1SD) h. The whole body dose was calculated from the total activity determined during 10 days after 131I administration. A reasonable strategy may consist in delivering 25% of the currently prescribed activity (925 MBq-25 mCi) and to perform the first dialysis session after 24 h to reduce total body irradiation.

Adult↗
PubMed1996

Measurements of radiobiological effectiveness in the 85 MeV proton beam produced at the cyclotron CYCLONE of Louvain-la-Neuve, Belgium.

The RBE of the 85 MeV proton beam produced at the cyclotron of Louvain-la-Neuve using 60Co gamma rays as the reference radiation was determined for survival of Chinese hamster ovary cells in vitro and for intestinal crypt regeneration in mice in vivo. Cell survival curves determined at different depths yielded, for a surviving fraction (SF) of 0.01, RBE values of 1.11 +/- 0.05 at the initial plateau of the unmodulated beam, 1.10 +/- 0.03 at the middle of a 0.5-cm spread-out Bragg peak (SOBP), 1.03 +/- 0.03 at the beginning of a 3-cm SOBP and 1.07 +/- 0.03 at the end of a 3-cm SOBP. The highest RBE values were obtained at the middle of the 0.5-cm SOBP and at the end of the 3-cm SOBP (RBE = 1.22 and 1.16, respectively, at SF = 0.5), although the variations are not statistically significant. Irradiations with 3-Gy fractions separated by an interval of 3.5 h yielded RBEs of 1.11 +/- 0.30 and 0.90 +/- 0.32 at the initial plateau and at the middle of the 0.5-cm SOBP, respectively. Irradiations of mice at the middle of the 3-cm SOBP yielded an RBE of 1.08 +/- 0.03 for 20 regenerated crypts at a proton dose of 12.3 Gy.

Animals↗
PubMed1996

[Exposure to ionizing radiation: radiobiological and pathogenic effects (2)].

The present paper describes the radiobiological effects induced by an exposure to ionizing radiation and their pathogenesis. The different skin reactions are described in detail because of their importance and frequency. Thus the acute skin lesions after high doses and the late effects resulting, either from high doses, or from accumulation of chronic irradiation, are studied. The main early syndromes are then characterized: neurological, gastro-intestinal, bone-marrow and prodromic. As far as the complex problem of radiocarcinogenesis is concerned, the main results derived from studies by international organizations such as the ICRP and the UNSCEAR are reported: risk coefficient of 5% per gray, for lethal radioinduced cancer, after total body irradiation, at low dose of low-LET radiation. The effects of irradiation in utero are then considered: risk of malformation after irradiation during the two first months of pregnancy and risk of mental retardation after irradiation during the third and the fourth months. Finally, the genetic risk is presented as being equal to one fourth of the risk of carcinogenesis at low doses. The effects of irradiation on the gonads are also described.

Embryonic and Fetal Development↗