Technique considerations for implementing volumetric-modulated arc therapy for total body irradiation within an Australian tertiary institution.

Over the past decade, our institution delivered conventional total body irradiation (TBI) using Elekta's Monaco treatment planning system (TPS) with an extended SSD field arrangement and 18 megavoltage (MV) energy lateral fields. In 2020, there was a transition to the Eclipse™ treatment planning system and Truebeam® linear accelerators with 6 MV and 10 MV energies. These changes meant that essential components of the existing technique were unavailable for clinical use and a new approach to the institution technique was required to ensure continuation of service.

Development of a 3D-printed phantom for total skin electron therapy dose assessment.

Purpose: Total skin electron therapy (TSET) is a complex radiotherapy technique, posing challenges in commissioning and quality assurance (QA), especially due to significant variability in patient body shapes. Previous studies have correlated dose with factors such as obesity index, height, and gender. However, current treatment planning systems cannot simulate TSET plans, necessitating heavy reliance on QA methods using standardized anthropomorphic phantoms and in-vivo dosimetry.

Assessing focal spot alignment in clinical linear accelerators: a comprehensive evaluation with triplet phantoms.

A fundamental parameter to evaluate the beam delivery precision and stability on a clinical linear accelerator (linac) is the focal spot position (FSP) measured relative to the collimator axis of the radiation head. The aims of this work were to evaluate comprehensive data on FSP acquired on linacs in clinical use and to establish the ability of alternative phantoms to detect effects on patient plan delivery related to FSP. FSP measurements were conducted using a rigid phantom holding two ball-bearings at two different distances from the radiation source.

Peripheral Doses Beyond Electron Applicators in Conventional C-Arm Linear Accelerators: A Systematic Literature Review.

This review investigates peripheral dose levels in electron beam treatments, comparing different manufacturers including Varian, Elekta, and Siemens. Accurate measurement of peripheral dose is vital for patient safety and precise radiation delivery in radiation therapy. This review followed PRISMA standards, conducting a comprehensive literature search from 1978 to July 2023.

The Various Roles of PEDF in Cancer.

Pigment epithelium-derived factor (PEDF) is a natural immunomodulator, anti-inflammatory, anti-angiogenic, anti-tumour growth and anti-metastasis factor, which can enhance tumour response to PEDF but can also conversely have pro-cancerous effects. Inflammation is a major cause of cancer, and it has been proven that PEDF has anti-inflammatory properties. PEDF's functional activity can be investigated through measuring metastatic and metabolic biomarkers that will be discussed in this review.

Transformer CycleGAN with uncertainty estimation for CBCT based synthetic CT in adaptive radiotherapy.

. Clinical implementation of synthetic CT (sCT) from cone-beam CT (CBCT) for adaptive radiotherapy necessitates a high degree of anatomical integrity, Hounsfield unit (HU) accuracy, and image quality. To achieve these goals, a vision-transformer and anatomically sensitive loss functions are described.

Stereotactic body radiotherapy for early-stage lung cancer: a systematic review on the choice of photon energy and linac flattened/unflattened beams.

SBRT is an effective local treatment for patients with early-stage non-small cell lung cancer (NSCLC). This treatment is currently used in patients who have poor lung function or who decline surgery. As SBRT usually has small PTV margins, reducing the beam-on-time (BOT) is beneficial for accurate dose delivery by minimising intrafraction motion as well as improved patient comfort.

Risk of cardiac implantable device malfunction in cancer patients receiving proton therapy: an overview.

Age is a risk factor for both cardiovascular disease and cancer, and as such radiation oncologists frequently see a number of patients with cardiac implantable electronic devices (CIEDs) receiving proton therapy (PT). CIED malfunctions induced by PT are nonnegligible and can occur in both passive scattering and pencil beam scanning modes. In the absence of an evidence-based protocol, the authors emphasise that this patient cohort should be managed differently to electron- and photon- external beam radiation therapy (EBRT) patients due to distinct properties of proton beams.

Radiotherapy planning of spine and pelvis using single-energy metal artifact reduction corrected computed tomography sets.

Metal artifacts produce incorrect Hounsfield units and impact treatment planning accuracy. This work evaluates the use of single-energy metal artifact reduction (SEMAR) algorithm for treatment planning by comparison to manual artifact overriding. CT datasets of in-house 3D-printed spine and pelvic phantoms with and without metal insert(s) and two treated patients with metal implants were analysed.

An in-depth review of retrospective studies to assess the role of vascular brachytherapy for the treatment of complex patients with multiple risk factors for DES-ISR.

Background: Vascular brachytherapy (VBT) used to be an effective treatment modality for management of in-stent stenosis but was superceded by drug eluting stents (DES) which had shown a greater efficacy. However, there is no clear evidence to support superior management for in-stent restenosis (ISR) which continues to be a challenge.

Methods: We conducted a systematic review of the literature and appraised PubMed, Medline, Web of science, ProQuest and Cochrane databases from 2000 to 2020.

Circulating Tumour Cells (CTC), Head and Neck Cancer and Radiotherapy; Future Perspectives.

Head and neck cancer is the seventh most common cancer in Australia and globally. Despite the current improved treatment modalities, there is still up to 50⁻60% local regional recurrence and or distant metastasis. High-resolution medical imaging technologies such as PET/CT and MRI do not currently detect the early spread of tumour cells, thus limiting the potential for effective minimal residual detection and early diagnosis.

Hyperbaric oxygen therapy for chronic radiation-induced tissue injuries: Australasia's largest study.

Aim: Chronic radiation injuries, although uncommon, are associated with poor quality of life in oncology patients. The present study assesses the efficacy and safety of hyperbaric oxygen therapy in the management of chronic radiation-induced tissue injuries.

Methods: A retrospective analysis was performed in 276 consecutive patients treated with hyperbaric oxygen therapy for chronic radiation-induced tissue injuries at the Hyperbaric Medicine Unit, Townsville, Queensland, between March 1995 and March 2008.

Efficacy and tolerability of weekly low-dose cisplatin concurrent with radiotherapy in head and neck cancer patients.

Aims: In this retrospective analysis, we describe the efficacy and tolerability of weekly cisplatin 40 mg/m(2) used in concurrent chemoradiation of head and neck cancer at the Townsville Cancer Centre.

Methods: Review of medical records of patients who received radical chemoradiotherapy for head and neck cancer at Townsville Cancer Centre from 2003 to 2009.

Results: In all 102 patients were analysed, 62 of whom had definitive chemoradiation and the remainder adjuvant chemoradiotherapy.