Total body irradiation delivered using a dedicated Co-60 TBI unit: Evaluation of dosimetric uniformity and dose verification.

This work presents the dosimetric characteristics of Total Body Irradiation (TBI) delivered using a dedicated Co-60 TBI unit. We demonstrate the ability to deliver a uniform dose to the entire patient without the need for a beam spoiler or patient-specific compensation. Full dose distributions are calculated using an in-house Monte Carlo treatment planning system, and cumulative dose distributions are created by deforming the dose distributions within two different patient orientations.

A bi-institutional multi-disciplinary failure mode and effects analysis (FMEA) for a Co-60 based total body irradiation technique.

Background: We aim to assess the risks associated with total body irradiation (TBI) delivered using a commercial dedicated Co-60 irradiator, and to evaluate inter-institutional and inter-professional variations in the estimation of these risks.

Methods: A failure mode and effects analysis (FMEA) was generated using guidance from the AAPM TG-100 report for quantitative estimation of prospective risk metrics. Thirteen radiation oncology professionals from two institutions rated possible failure modes (FMs) for occurrence (O), severity (S), and detectability (D) indices to generate a risk priority number (RPN).

Monte Carlo commissioning of radiotherapy LINAC-Introducing an improved methodology.

Purpose: Monte Carlo (MC) commissioning of medical linear accelerator (LINAC) is a time-consuming process involving a comparison between measured and simulated cross beam/lateral profiles and percentage depth doses (PDDs) for various field sizes. An agreement between these two data sets is sought by trial and error method while varying the incident electron beam parameters, such as electron beam energy or width, etc. This study aims to improve the efficiency of MC commissioning of a LINAC by assessing the feasibility of using a limited number of simulated PDDs.

Dosimetric evaluation of incorporating the revised V4.0 calibration protocol for breast intraoperative radiotherapy with the INTRABEAM system.

In breast-targeted intraoperative radiotherapy (TARGIT) clinical trials (TARGIT-B, TARGIT-E, TARGIT-US), a single fraction of radiation is delivered to the tumor bed during surgery with 1.5- to 5.0-cm diameter spherical applicators and an INTRABEAM x-ray source (XRS).

Evaluation of the dosimetric impact of manufacturing variations for the INTRABEAM x-ray source.

Introduction: INTRABEAM x-ray sources (XRSs) have distinct output characteristics due to subtle variations between the ideal and manufactured products. The objective of this study is to intercompare 15 XRSs and to dosimetrically quantify the impact of manufacturing variations on the delivered dose.

Methods And Materials: The normality of the XRS datasets was evaluated with the Shapiro-Wilk test, the accuracy of the calibrated depth-dose curves (DDCs) was validated with ionization chamber measurements, and the shape of each DDC was evaluated using depth-dose ratios (DDRs).

Dosimetric evaluation of the INTRABEAM system for breast intraoperative radiotherapy: A single-institution experience.

Breast intraoperative radiotherapy (IORT) with the INTRABEAM system uses a 50 kV x-ray source to deliver a single fraction of radiation therapy to the lumpectomy cavity during breast-conserving surgery. We seek to perform a dosimetric analysis of the lumpectomy cavity for rigid spherical applicators. Water phantom measurements were acquired to validate the vendor-provided x-ray calibration.

Gleason pattern 5 is associated with an increased risk for metastasis following androgen deprivation therapy and radiation: An analysis of RTOG 9202 and 9902.

Background/purpose: Stratification of Gleason score (GS) into three categories (2-6, 7, and 8-10) may not fully utilize its prognostic discrimination, with Gleason pattern 5 (GP5) previously identified as an independent adverse factor.

Materials/methods: Patients treated on RTOG 9202 (n = 1292) or RTOG 9902 (n = 378) were pooled and assessed for association of GS and GP5 on biochemical failure (BF), local failure (LF), distant metastasis (DM), and overall survival (OS). Fine and Gray's regression and cumulative incidence methods were used for univariate and multivariate analyses.

Spontaneous Coronary Artery Dissection Associated with Anal Cancer Management with Fluorouracil and Radiotherapy.

Spontaneous coronary artery dissection (SCAD) is thought to be a rare condition that is hard to predict due to the lack of easily identifiable warning signs. We report the case of a 49-year-old woman with a locally advanced Stage IIIB anal squamous cell carcinoma who presented with chest pain and a positive stress test, ST elevations in her inferior echocardiogram leads, and induced chest pain with exercise without heart perfusion defects. Coronary catheterization revealed a right coronary artery dissection, which led to the diagnosis of SCAD.

Ethical violations and discriminatory behavior in the MedPhys Match.

Purpose: The purpose of this survey study is to investigate behaviors in conflict with the ethical standards of the Medical Physics Residency (MedPhys) Match (MPM) process as stated in the MPM rules (a) and with the nondiscrimination regulations of the Equal Employment Opportunity Commission (EEOC) (b), in addition to other behaviors that may in other ways erode the fairness of the system.

Methods: A survey was sent to all applicants and program directors registered for the 2015 and 2016 MPM. Survey questions asked about application, interview, and postinterview experiences, match results, and overall satisfaction with the process.

Inadvertent high-dose therapy with temozolomide in a child with recurrent pontine glioma followed by a rapid clinical response but deteriorated after substitution with low-dose therapy.

We present a case of inadvertent high-dose therapy with temozolomide in a child with recurrent diffuse intrinsic pontine glioma followed by a rapid clinical response. The patient was a 7-year-old boy who initially presented with a history of left facial palsy, double vision, headache, and ataxia. His symptoms were completely resolved following radiotherapy but recurred 3 months after.