| 1. |
- Lindholm, C-E, et al.
(author)
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Prognostic factors for tumour response and skin damage to combined radiotherapy and hyperthermia in superficial recurrent breast carcinomas
- 1995
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In: International Journal of Hyperthermia. - : Informa UK Limited. - 0265-6736 .- 1464-5157. ; 11:3, s. 337-355
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Journal article (peer-reviewed)abstract
- Prognostic factors for complete tumour response and acute skin damage to combined hyperthermia and radiotherapy were analysed in material of patients with breast cancer, recurrent in previously irradiated areas. Radiotherapy was given daily to a total absorbed dose of 30.0 Gy in 2 weeks or 34.5 Gy in 3 weeks. The first radiotherapy schedule was combined with heat twice weekly, a total of four heat treatments (schedule A). The second radiotherapy schedule was combined with heat either once or twice a week resulting in a total of three (schedule B) or six (schedule C) heat treatments. Heat was induced with microwaves (2450, 915 or 434 MHz) via external applicators and always given after the radiotherapy fraction. The complete response (CR) rate in evaluable patients was 71% (49/69). There was no significant difference in CR rate between the three different hyperthermia schedules. The CR rates were 74% (14/19), 65% (15/23) and 74% (20/27) for schedules A, B and C respectively. The only factor predicting CR, evaluated both uni- and multivariately, was the CRE-value for the present radiotherapy dose (p = 0.02). If only tumours treated with 915 MHz were taken into account, however, then the highest minimum temperature at a given heat session predicted complete response (p = 0.03). This was true also in a multivariate analysis of this subgroup of tumours. A Kaplan-Meier analysis (log rank test) showed no significant difference in duration of CR between the different treatment schedules. Cox's proportional hazards method revealed three significant factors: tumour size (negatively correlated, p = 0.007), the time interval between the diagnosis of the primary tumour and the present treatment (p = 0.02) and the average temperature (0.03). Maximum acute skin reactions in the treatment field were scored according to an ordinal scale of 0-8, modified after WHO 1979. Twenty-six treatment areas (32%) expressed more severe skin damage (score > or = 5) in terms of desquamation with blisters (14%) and necrosis or ulceration (19%). Factors correlated with skin damage were the size of the lesion area (p = 0.011), the highest average maximum temperature during a given heat session (p = 0.03) and the fractionation schedule of hyperthermia (p = 0.05). The extent of previous radiotherapy absorbed dose, previous surgery in the treated area or previous chemotherapy had no significant influence on the acute skin reactions.
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| 2. |
- Knöös, Tommy, et al.
(author)
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Limitations of a pencil beam approach to photon dose calculations in lung tissue
- 1995
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In: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 40:9, s. 1411-1420
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Journal article (peer-reviewed)abstract
- A common limitation in treatment planning systems for photon dose calculation is to ignore the impact on electron transport and photon scatter from patient heterogeneities. The heterogeneity correlation is often based on scaling operations along beam rays as for the method according to Batho or the more novel approach of 1D convolutions along beam paths applied in pencil-beam-based systems. The effects of the limitation have been studied in a mediastinum geometry for a wide range of beam qualities by comparing the results from a pencil-beam-based treatment planning system with the results from Monte Carlo calculations. As expected, the deviations within unit-density volumes are small while deviations in low-density volumes increase with increasing beam energy from approximately 3% for 4 MV to 14% for 18 MV x-rays as a result of increased electron disequilibrium.
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| 3. |
- Weber, Lars, et al.
(author)
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Build-up cap materials for measurement of photon head-scatter factors
- 1997
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In: Physics in Medicine and Biology. - 1361-6560. ; 42:10, s. 1875-1886
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Journal article (peer-reviewed)abstract
- The suitability of high-Z materials as build-up caps for head-scatter measurements has been investigated. Build-up caps are often used to enable characterization of fields too small for a mini-phantom. We have studied lead and brass build-up caps with sufficiently large wall thicknesses, as compared to the range of contaminating electrons originating in the accelerator head, and compared them with build-up caps made of ionization chamber equivalent materials, i.e. graphite. The results were also compared with measurements taken using square and cylindrical polystyrene mini-phantoms. Field sizes ranging from 3 cm x 3 cm up to 40 cm x 40 cm were studied for nominal photon energies of 4, 6, 10 and 18 MV. The results show that the use of lead and brass build-up caps produces normalized head-scatter data slightly different from graphite build-up caps for large fields at high photon energies. At lower energies, however, no significant differences were found. The intercomparison between the two different plastic mini-phantoms and graphite caps showed no differences.
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| 4. |
- Weber, Lars, et al.
(author)
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Verification of a dynamic wedge implementation in a pencil beam based dose planning system
- 1995
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In: Radiotherapy and Oncology. - : Elsevier BV. - 1879-0887 .- 0167-8140. ; 37:Suppl. 1, s. 26-26
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Journal article (peer-reviewed)abstract
- The use of dynamic movements on linear accelerators during irradiation have found a revised interest lately due to the integration of computers to control the linear accelerator. An example of this is the generation of fields that resemble ordinary wedge fields. These fields are produced by moving one of the collimator blocks during irradiation, i. e. dynamic wedges.A pencil beam based system with the possibility of modelling dynamically modulated dose distributions from collimator movement specifications has extensively been investigated. Special interest has been focused on depth doses, profiles and output factors which have been generated by dynamic wedge fields. The data from the treatment planning system has been verified with measurements in water on a Varian 4 MV linear accelerator.The results indicate that calculations accurately predicts the outcome from dynamic wedges without any additional measurements than those used for characterisation of static open beams.
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