We seek to identify dosimetric and anatomic indicators of late rectal toxicity in prostate cancer patients treated with intensity modulated radiation therapy (IMRT). Data from 49 patients sampled from 698 patients treated for clinically localized prostate cancer at the Memorial Sloan-Kettering Cancer Center with IMRT to a dose of 81 Gy were analyzed. The end point of the study was late Grade 2 or worse rectal toxicity within 30 months of treatment. Dosimetric analysis was performed on the rectum surface in three dimensions and on two-dimensional dose maps obtained by flattening the rectum surface using a conformal mapping procedure. Several parameters including the percentage and absolute surface area of the rectum irradiated, mean dose as a function of location on the rectum, planning target volume (PTV) size and rectum size were analyzed for correlation to toxicity. Significance was set at p < 0.05 for a two-sided t-test. Correlation between absolute areas irradiated and toxicity was observed on both the rectum surface and flattened rectum. Patients with toxicity also received a significantly higher mean dose to the superior 25% of the rectum surface and 15% of the flattened rectum. PTV volume, PTV height, rectum surface area and average cross-sectional area were significantly larger in patients with toxicity. The conformal mapping procedure has potential utility for evaluating dose to the rectum and risk of toxicity. Late rectal toxicity was related to the irradiation of the upper part of the rectum and also to the absolute area irradiated, PTV size, and rectum size on the planning computed tomography (CT) scan.
Diffusive supersonic radiation transport, where the ratio of the diffusive radiation front velocity to the material sound speed >2 has been studied in experiments on low density (40 mg/cc to 50 mg/cc) foams. Laser-heated Au hohlraums provided a radiation drive that heated SiO2 and Ta2O5 aerogel foams of varying lengths. Face-on emission measurements at 550 eV provided clean signatures of the radiation breakout. The high quality data provides new detailed information on the importance of both the fill and wall material opacities and heat capacities in determining the radiation front speed and curvature. The Marshak radiation wave transport is studied in a geometry that allows direct comparisons with analytic models and two-dimensional code simulations. Experiments show important effects that will affect even nondiffusive and transonic radiation transport experiments studied by others in the field. This work is of basic science interest with applications to inertial confinement fusion and astrophysics.
We have made the first detailed measurements of a diffusive supersonic radiation wave in the laboratory. A 10 mg/cm(3) SiO2 foam is radiatively heated by the x-ray flux from a laser-irradiated hohlraum. The resulting radiation wave propagates axially through the optically thick foam and is measured via time-resolved x-ray imaging as it breaks out the far end. The data show that the radiation wave breaks out at the center prior to breaking out at the edges, indicating a significant curvature in the radiation front. This curvature is primarily due to energy loss into the walls surrounding the foam.
DISCLAIMER
AbstractThis paper presents the results of experiments in which a high-power laser was used to irradiate low density (4 -9 mg/cm3) silica aerogel and agar foam targets. The iaser-solid interaction and energy transport through the material were monitored with time-resolved imaging diagnostics, and the data show the production and propagation of an x-ray emission front in the plasma.The emission-front trajectory data are found to be in significant disagreement with detailed simulations, which predict a much more rapid heating of the cold material, and the data suggest that this discrepancy is not explainable by target inhomogeneities. Evidence suggests that energy transport into the cold material may be dominated by thermal conduction; however, no completely satisfactory explanation for the discrepancies is identified, and further experimental and theoretical research is necessary in order to resolve this important problem in laser-plasma interaction physics.
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