15 years of 106 Ru eye plaque dosimetry at Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical Center using radiochromic film in a Solid Water phantom

2018 ◽  
Vol 4 (4) ◽  
pp. 045017 ◽  
Author(s):  
Samuel Trichter ◽  
Christopher G Soares ◽  
Marco Zaider ◽  
J Keith DeWyngaert ◽  
Larry A DeWerd ◽  
...  
2020 ◽  
Vol 8 (3) ◽  
Author(s):  
Caio Fernando Teixeira Portela ◽  
Thêssa Cristina Alonso ◽  
Arnado Prata Mourão

The precision in the dose values delivered in irradiation processes is essential for the efficiency and quality control of these processes. Radiochromic films can be used to record doses and the calibration of these films must be performed so that they can be used as dosimeters. The planning and control of the radiation released in a process allows to adjust the desired dose in the irradiated object. The photons in the primary beam interact with the matter of the object and the beam energy is attenuated due to these interactions. The attenuation depends on the characteristics of the beam and the composition of the irradiated matter. When a beam of photons propagates on an object, it tends to deposit more energy close to the surface and after reaching the maximum dose value, it decreases the dose values with depth. The films used in this work are of the Gafchromic External Beam Therapy (EBT) type, insensitive to visible light and can be prepared in places where sunlight and artificial light exists. Like many other dosimeters, which follow certain protocols, radiochromic films can provide an absolute dose measurement. Radiochromic films are characterized by their linearity, reproducibility, uniformity, sensitivity, and stability after irradiation. For the realization of the experiments, a part of the film to be irradiated was removed designated as background (BG). BG represents a piece of radiochromic film that will not change and reflects changes in film absorption in relation to environmental conditions such as temperature, visible light and scanning light, for example and that must be handled from it way that the film radiated. In this work, irradiations of a solid water phantom were performed using a source of cesium-137 with the deposition of a maximum absorbed dose value of 2.0 Gy. The phantom was placed 1,0 m far from the source collimator. Radiochromic films were placed inside the phantom to obtain the depth variation dose profile and axial dose profiles measured at 1.0 cm depth in the phantom. The dose variation profile in depth allowed to verify that the maximum dose value happened at a depth between 10 and 13 mm, very close to the surface due to the beam energy range (keV). The axial profiles presented a flatness of about 9.4 cm with a total field of 12 cm in diameter. 


2019 ◽  
Vol 7 (2A) ◽  
Author(s):  
Sabrina Donato Silva ◽  
André L.S Castro ◽  
Thais Melo Mendes ◽  
Luciana B. Nogueira ◽  
Tarcisio Passos Ribeiro Campos

Actually, cancer has gained a larger dimension and become a global public health problem. Radiotherapy (RT) is a neoplasia treatment and RT linear accelerators must undergo a strict dose quality control. Water or solid water phantoms can be used with this intuit. In recent years, radiochromic films with equivalent tissue composition have been widely used as dosimeters in the medical field. In this work the proposal was to analyze two distinct radiochromic film responses in water and solid water phantoms, a LINAC spectrum of 4MV beam. Solid water phantom, water phantom and EBT2 Radiochromic films were set in two distinct process of calibration. Films were exposed to a set of absorbed doses established by distinct monitor units (MU) specified in RT-center. Mathematical relations between the degree of red-intensity from digitized films and the absorbed dose for both methods were established. The coefficients of the polynomial function of the calibration curve were determined from the Origin software. The uncertainty of both processes was analyzed. The efficiency of the two calibration processes was set up. The adjustment of the calibration curve provided the coefficients of the second-order equation that relates the dose absorbed with the optical density of the film. The uncertainty regarding the calibration performed in water and solid water and the dose-error accuracy are in agreement with the literature. Both water and solid water were effective in calibration and can be used in routines of quality-control measurements. The results show that EBT2-radiochromic films are suitable to for dose-calibration in RT.


2020 ◽  
Vol 19 ◽  
pp. 153473542098391
Author(s):  
Chieh-Ying Chin ◽  
Yung-Hsiang Chen ◽  
Shin-Chung Wu ◽  
Chien-Ting Liu ◽  
Yun-Fang Lee ◽  
...  

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24029-e24029
Author(s):  
Laura Vater ◽  
Anup Trikannad Ashwini Kumar ◽  
Neha Sehgal ◽  
Maria Khan ◽  
Kelsey Bullens ◽  
...  

e24029 Background: Continued cigarette smoking among patients with cancer leads to numerous adverse health outcomes, even among patients with non-tobacco-related cancers such as breast, colon, and prostate cancer. Continued smoking is associated with poorer response to cancer treatment, increased risk for treatment-related toxicities, and shorter overall survival. While some patients with a smoking-related cancer make efforts to quit smoking at the time of diagnosis, patients with other forms of cancer might not understand the negative effects of continued smoking. In this study, we assessed patient knowledge of the harms of continued smoking, previous cessation attempts, and cessation support. Methods: We surveyed 102 adults with breast, colon, and prostate cancer at three locations: an NCI-designated cancer center, an urban safety-net medical center, and a rural cancer center. Patients were asked about current smoking behaviors, beliefs about the harms of continued smoking, quit attempts and resources used, and cessation support. We also surveyed seven oncologists to assess beliefs about harms of continued smoking, cessation support provided to patients, training and confidence in cessation counseling, and barriers to providing cessation support. Results: Most patients (82%) agreed or strongly agreed that continued smoking may shorten life expectancy, and 70% agreed or strongly agreed that continued smoking increased the risk of getting a different type of cancer. Only 41% of patients agreed or strongly agreed that continued smoking may cause more side effects from cancer treatment, and only 40% agreed or strongly agreed that ongoing smoking may affect treatment response. The majority of patients (86%) had tried to quit smoking for good, with an average 4.1 quit attempts per patient. Patients reported that physicians advised them to quit the majority of the time (92%), prescribed medication 33% of the time, and followed up on cessation attempts 43% of the time. Overall, oncologists had higher knowledge of the harms of continued smoking on treatment outcomes and survival. Those in practice for 20 years or more had higher confidence in cessation counseling than those in practice less than 4 years. Oncologists described lack of time and lack of confidence in cessation counseling as barriers to providing more cessation support. Conclusions: Among 102 patients with breast, colon, and prostate cancer who currently smoke, there was incomplete knowledge of the harms of continued smoking. Oncologists believe that tobacco cessation is important and frequently advise patients to quit, however they less frequently prescribe medication or follow up on cessation efforts. Interventions are needed to educate patients with cancer about the harms of continued smoking and to provide further cessation support.


Author(s):  
Cesar Cuero

<p>La Academia Panameña de Medicina y Cirugía, se siente honrada, en resaltar la figura de uno de sus miembros distinguidos, el Académico Titular José Manuel Fábrega Sosa, MD, FACS, FSSO, APMC. Este distinguido cirujano, panameño, hizo sus estudios profesionales en la Universidad de Notre Dame, Notre Dame, Indiana donde se graduó con honores siendo miembro de la Sociedad de honor AlphaEpsilonDelta. Continuó sus estudios de medicina en la George Washington University School of Medicine, Washington, DC., donde obtuvo el grado de Medicina, graduándose también con honores siendo nombrado en la Sociedad de Honor de Medicina de los Estados Unidos, AlphaOmegaAlpha. Hizo su residencia en cirugía en el New York Hospital Cornell Medical Center y en Oncología Quirúrgica en el Memorial Sloan Kettering Cancer Center de Nueva York. Ha sido Certificado y Recertificado por el American Board of Surgery. Fellow y ExGobernador del American College of Surgeons y Ex Presidente del Capítulo de Panamá del American College of Surgeons. Además de Fellow de la Society of Surgical Oncology. A nivel local, entre otros es Ex Presidente de la Academia Panameña de Medicina y Cirugía. Y Profesor Extraordinario de Cirugía, de la Facultad de Medicina, de la Universidad de Panamá. Presidente y miembro fundador de la Asociación Panameña de Cirugía Oncológica (APCO). Aparte de tener licencia en la República de Panamá, tiene licencia del estado de California y de Washington DC en los Estados Unidos. Recientemente, ha sido merecedor a un reconocimiento, reservado para pocos cirujanos destacados, en el mundo, ser reconocido como Honorary Fellow del American College of Surgeons (Colegio Americano de Cirujanos), luego de 43 años de brindar sus conocimientos para el cuidado y bienestar de sus pacientes. Cabe destacar que al presente Solo hay 487 cirujanos en el mundo entero que han recibido tal distinción. El Colegio Americano de Cirujanos otorga este honor cada año, a cuatro o cinco candidatos que han prestado servicios humanitarios, especialmente en el campo de la ciencia médica. Es el tercer panameño en recibir este reconocimiento; el primero en ser distinguido fue el doctor Augusto S. Boyd, en 1923; luego el neurólogo Antonio González Revilla, en 1973. La universidad de Cornell, de donde egresó, lo declaró exalumno meritorio y es el único egresado en recibir esa distinción. En Panamá; la Asamblea Nacional lo reconoció como ciudadano ejemplar y meritorio y el presidente de la república lo condecoró con la Orden Manuel Amador Guerrero en el “Grado de Gran Cruz”. Honrar, honra, y la Academia Panameña de Medicina y Cirugía, y La Revista Médica de Panamá, se enorgullecen de presentar a este ilustre panameño y latinoamericano.</p><p>ABSTRACT</p><p>The Panamanian Academy of Medicine and Surgery is honored to highlight the figure of one of its distinguished members, the Tenured Academician José Manuel Fábrega Sosa, MD, FACS, FSSO, APMC. This distinguished Panamanian surgeon did his professional studies at the University of Notre Dame, Notre Dame, Indiana where he graduated with honors as a member of the AlphaEpsilonDelta Honor Society. He continued his medical studies at the George Washington University School of Medicine, Washington, DC., Where he obtained a degree in Medicine, also graduating with honors and being named in the American Honor Society of Medicine, AlphaOmegaAlpha. He did his residency in surgery at New York Hospital Cornell Medical Center and in Surgical Oncology at Memorial Sloan Kettering Cancer Center in New York. He has been Certified and Recertified by the American Board of Surgery. Fellow and Former Governor of the American College of Surgeons and Former President of the Panama Chapter of the American College of Surgeons. In addition to Fellow of the Society of Surgical Oncology. At the local level, among others, he is Former President of the Panamanian Academy of Medicine and Surgery. And Extraordinary Professor of Surgery, Faculty of Medicine, University of Panama.</p><p>President and founding member of the Panamanian Association of Oncological Surgery (APCO). Apart from being licensed in the Republic of Panama, it is licensed by the state of California and Washington DC in the United States. Recently, he has been worthy of a recognition, reserved for few outstanding surgeons, in the world, being recognized as Honorary Fellow of the American College of Surgeons (American College of Surgeons), after 43 years of providing his knowledge for the care and well-being of your patients. It should be noted that there are currently only 487 surgeons worldwide who have received such a distinction. The American College of Surgeons awards this honor each year to four or five candidates who have provided humanitarian services, especially in the field of medical science. He is the third Panamanian to receive this recognition; the first to be distinguished was Dr. Augusto S. Boyd, in 1923, then the neurologist Antonio González Revilla, in 1973. Cornell University, where he graduated, declared him a meritorious alumnus and is the only graduate to receive that distinction. In Panama, the National Assembly recognized him as an exemplary and meritorious citizen and the President of the Republic decorated him with the Manuel Amador Guerrero Order in the “Grand Cross Degree”. Honor, honor, and the Panamanian Academy of Medicine and Surgery, and La Revista Médica de Panama, are proud to present this illustrious Panamanian and Latin American.</p>


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Youn I Choi ◽  
Jun-won Chung ◽  
Kyoung Oh Kim ◽  
Kwang An Kwon ◽  
Yoon Jae Kim ◽  
...  

Backgrounds/Aims. Watson for Oncology (WFO) is a cognitive technology that processes medical information by analyzing the latest evidence and guidelines. However, studies of the concordance rate between WFO and clinicians for advanced gastric cancer (AGC) are lacking.Methods. We retrospectively reviewed 65 patients with AGC who consulted WFO and the Gachon Gil Medical Center multidisciplinary team (GMDT) in 2016 and 2017. The recommendations of WFO were compared with the opinions of the GMDT. WFO provided three treatment options: recommended (first treatment option), for consideration (second treatment option), and not recommended.Results. In total, 65 patients (mean age 61.0 years; 44 males and 21 females) were included in the study. The concordance rate between WFO and the GMDT was 41.5% (27/65) at the recommended level and 87.7% (57/65) at the for consideration level. The main causes of discordance between WFO and the GMDT were as follows. First, WFO did not consider the medical history. Second, WFO recommended the use of agents that are considered outdated in Korea. Third, some patients wanted to be involved in a clinical trial. Fourth, some patients refused to use the biologic agents recommended by WFO for financial reasons as they were not covered by medical insurance.Conclusions. The concordance rate at the recommended level was relatively low but was higher at the for consideration level. Discordances arose mainly from the different medical circumstances at the Gachon Gil Medical Center (GMC) and the Memorial Sloan Kettering Cancer Center (MSKCC), the main WFO consulting center. The utility of WFO as a tool for supporting clinical decision making could be further improved by incorporating regional guidelines.


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