Unlabelled: Interventional radiotherapy (brachytherapy) has become the new therapeutic standard in the management of early stages nasal vestibule tumors; in fact it allows for high local control rates and low toxicity profiles. However, since more and more patients will receive interventional radiotherapy (brachytherapy) as primary treatment, it is desirable to implement novel strategies to reduce the dose to organs at risk with the future aim to result in further lowering long-term side effects.

Materials And Methods: We were able to identify two different strategies to reduce dose to the treatment volume, including the implantation technique (the implant can be interstitial, endocavitary or mixed and the catheters may be placed either using the Paris system rules or the anatomical approach) and the dose distribution within the implant (the most commonly used parameter to consider is the dose non-uniformity ratio). We subsequently propose two novel strategies to reduce dose to organs at risk, including the use of metal shields for fixed organs as in the case of the eyes and the use of a mouth swab to push away mobile organs, such in the case of the mandible. We used two different algorithms to verify the values namely the TG-43 and the TG-186.

Results: We provided an accurate literature review regarding strategies to reduce toxicity to the treatment volume, underlining the pros and cons of all implantation techniques and about the use dose non-uniformity ratio. Regarding the innovative strategies to reduce the dose to organs at risk, we investigated the use of eye shielding and the use of swabs to push away the mandible by performing an innovative calculation using two different algorithms in a series of three consecutive patients. Our results show that the dose reduction, both in the case of the mandible and in the case of eye shielding, was statistically significant.

Conclusion: Proper knowledge of the best implantation technique and dose non-uniformity ratio as highlighted by existing literature is mandatory in order to reduce toxicity within the treatment volume. With regard to the dose reduction to the organs at risk we have demonstrated that the use of eye shielding and mouth swab could play a pivotal role in clinical practice; in fact, they are effective at lowering the doses to the surrounding organs and do not require any change to the current clinical workflow.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573955PMC
http://dx.doi.org/10.3390/jcm12196154DOI Listing

Publication Analysis

Top Keywords

strategies reduce
20
reduce dose
16
organs risk
16
interventional radiotherapy
12
radiotherapy brachytherapy
12
novel strategies
12
dose organs
12
treatment volume
12
dose non-uniformity
12
non-uniformity ratio
12

Similar Publications

A new human autologous hepatocyte/macrophage co-culture system that mimics drug-induced liver injury-like inflammation.

Arch Toxicol

December 2024

Department of Hepatobiliary Surgery and Visceral Transplantation, Clinic and Polyclinic for Visceral, Transplant, Thoracic and Vascular Surgery, Leipzig University Medical Center, Leipzig, Germany.

The development of in vitro hepatocyte cell culture systems is crucial for investigating drug-induced liver injury (DILI). One prerequisite for monitoring DILI related immunologic reactions is the extension of primary human hepatocyte (PHH) cultures towards the inclusion of macrophages. Therefore, we developed and characterized an autologous co-culture system of PHH and primary human hepatic macrophages (hepM) (CoC1).

View Article and Find Full Text PDF

From spectroscopic data variability to optimal preprocessing: leveraging multivariate error in almond powder adulteration of different grain size.

Anal Bioanal Chem

December 2024

Department of Analytical Chemistry and Organic Chemistry, Universitat Rovira i Virgili, Carrer Marcel·lí Domingo 1, 43007, Tarragona, Spain.

Analysing samples in their original form is increasingly crucial in analytical chemistry due to the need for efficient and sustainable practices. Analytical chemists face the dual challenge of achieving accuracy while detecting minute analyte quantities in complex matrices, often requiring sample pretreatment. This necessitates the use of advanced techniques with low detection limits, but the emphasis on sensitivity can conflict with efforts to simplify procedures and reduce solvent use.

View Article and Find Full Text PDF

Background: In Ghana, the government has integrated herbal medicine into the formal healthcare system in response to widespread use of traditional remedies. However, empirical evidence supporting the contribution of integrated healthcare to malaria control remains limited. This study employed a phenomenological qualitative research design to explore the experiences of medical doctors and pharmacists from the coastal, forest and savannah regions of Ghana regarding the integration of modern and herbal medicine in the treatment and control of malaria.

View Article and Find Full Text PDF

Introduction: Chronic alcohol consumption and tobacco usage are major risk factors for esophageal squamous cell carcinoma (ESCC). Excessive tobacco and alcohol consumption lead to oxidative stress and the generation of reactive carbonyl species (RCS) which induce DNA damage and cell apoptosis. This phenomenon contributes to cell damage and carcinogenesis in various organs including ESCC.

View Article and Find Full Text PDF

Adolescents are susceptible to developing depression and anxiety, and educational interventions could improve their mental well-being. This systematic review aimed to evaluate the effectiveness of universal educational prevention interventions in improving mental health literacy, depression, and anxiety among adolescents. Eight electronic databases were searched until June 2024: Cochrane Library, PubMed, EMBASE, CINAHL, PsycINFO, Scopus, Web of Science, ProQuest Dissertations, and Theses Global.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!