| 1. |
- Akkurt, I, et al.
(författare)
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Photoneutron yields from tungsten in the energy range of the giant dipole resonance
- 2003
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Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 48:20, s. 3345-3352
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Tidskriftsartikel (refereegranskat)abstract
- Photoneutron production on the nuclei of high-Z components of medical accelerator heads can lead to a significant secondary dose during a course of bremsstrahlung radiotherapy, However, a quantitative evaluation of secondary neutron dose requires improved data on the photoreaction yields. These have been measured as a function of photon energy, neutron energy and neutron angle for W-nat, using tagged photons at the MAX-Lab photonuclear facility in Sweden. This work presents neutron yields for W-nat(gamma, n) and compares these with the predictions of the Monte Carlo code MCNP-GN, developed specifically to simulate photoneutron production at medical accelerators.
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| 2. |
- Li, Jun, et al.
(författare)
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ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study
- 2020
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Ingår i: Annals of Surgical Oncology. - : SPRINGER. - 1068-9265 .- 1534-4681. ; 27, s. 1372-1384
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Tidskriftsartikel (refereegranskat)abstract
- Background ALPPS is found to increase the resectability of primary and secondary liver malignancy at the advanced stage. The aim of the study was to verify the surgical and oncological outcome of ALPPS for intrahepatic cholangiocarcinoma (ICC). Methods The study cohort was based on the ALPPS registry with patients from 31 international centers between August 2009 and January 2018. Propensity score matched patients receiving chemotherapy only were selected from the SEER database as controls for the survival analysis. Results One hundred and two patients undergoing ALPPS were recruited, 99 completed the second stage with median inter-stage duration of 11 days. The median kinetic growth rate was 23 ml/day. R0 resection was achieved in 87 (85%). Initially high rates of morbidity and mortality decreased steadily to a 29% severe complication rate and 7% 90-day morbidity in the last 2 years. Post-hepatectomy liver failure remained the main cause of 90-day mortality. Multivariate analysis revealed insufficient future liver remnant at the stage-2 operation (FLR2) to be the only risk factor for severe complications (OR 2.91, p = 0.02). The propensity score matching analysis showed a superior overall survival in the ALPPS group compared to palliative chemotherapy (median overall survival: 26.4 months vs 14 months; 1-, 2-, and 3-year survival rates: 82.4%, 70.5% and 39.6% vs 51.2%, 21.4% and 11.3%, respectively, p amp;lt; 0.01). The survival benefit, however, was not confirmed in the subgroup analysis for patients with insufficient FLR2 or multifocal ICC. Conclusion ALPPS showed high efficacy in achieving R0 resections in locally advanced ICC. To get the most oncological benefit from this aggressive surgery, ALPPS would be restricted to patients with single lesions and sufficient FLR2.
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| 3. |
- Zanini, A, et al.
(författare)
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Monte Carlo simulation of the photoneutron field in linac radiotherapy treatments with different collimation systems
- 2004
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Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 49:4, s. 571-582
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Tidskriftsartikel (refereegranskat)abstract
- Bremsstrahlung photon beams produced by linac accelerators are currently the most commonly used method of radiotherapy for tumour treatments. When the photon energy exceeds 10 MeV the patient receives an undesired dose due to photoneutron production in the accelerator head. In the last few decades, new sophisticated techniques such as multileaf collimators have been used for a better definition of the target volume. In this case it is crucial to evaluate the photoneutron dose produced after giant dipole resonance (GDR) excitation of the high Z materials (mainly tungsten and lead) constituting the collimator leaves in view of the optimization of the radiotherapy treatment. A Monte Carlo approach has been used to calculate,the photoneutron dose arising from the GDR reaction during radiotherapy with energetic photon beams. The simulation has been performed using the code MCNP4B-GN which is based on MCNP4B, but includes a new routine GAMMAN to model photoneutron production. Results for the facility at IRCC (Istituto per la Ricerca e la Cura del Cancro) Candiolo (Turin), which is based on 18 MV x-rays from a Varian Clinac 2300 C/D, are presented for a variety of different collimator configurations.
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