Aim The aim of this study was to compare the healthrelated quality of life (HRQoL) of breast cancer survivors (BCSs) with that of the general female population in a northern state of Malaysia. Subjects and methods A comparative cross-sectional study using EuroQoL-5 Dimensions (EQ-5D), a standardized generic instrument, was conducted at Penang General Hospital in Malaysia. Because of its applicability across a wide range of populations as well as for patients and its economic use, the EQ-5D questionnaire was used. A convenience sample of 150 female BCSs (20 years or older) and an equal number from the general population (matched with age bracket and ethnicity) were examined. Chi-square (χ 2 ) test and independent t-test were applied to detect differences in reported problems and overall HRQoL scores between the two groups.

PurposesExposure of skin to high doses of radiation may lead to the development of erythematous skin changes. The aims of this study were to measure skin doses and to identify potential factors that may contribute to skin reactions in nasopharyngeal cancer patients undergoing intensity-modulated radiation therapy (IMRT).Material and methodsThis study was a prospective study with 21 nasopharyngeal cancer patients treated by IMRT. Personal data were collected and in vivo skin dose measurements were performed using Thermoluminescent dosimeters. All patients were monitored clinically and skin reactions were classified according to the Radiation Therapy Oncology Group criteria. Univariate and multivariate logistic regression was conducted using Statistical Package for Social Sciences Software to identify skin toxicity risk factors.ResultsGrade 1 toxicity was observed in eight patients, Grade 2 in 11 patients and Grade 3 in two patients towards the end of treatment. It was found that accumulative skin doses >7 Gy (p<0·05) was a risk factor for skin toxicity. However, previous or concomitant chemotherapy with radiotherapy and stage of cancer were not significant factors for the severity of skin reactions.ConclusionThe neck skin should be identified as a sensitive structure for dose optimisation. Skin dose measurement and skin-sparing techniques are highly recommended for head and neck patients treated with IMRT.

PurposesTo design, construct and evaluate an anthropomorphic head and neck phantom for the dosimetric evaluation of 3D-conformal radiotherapy (3D-CRT) dose planning and delivery, for protocols developed by the Radiation Therapy Oncology Group (RTOG).Materials and methodsAn anthropomorphic head and neck phantom was designed and fabricated using Perspex material with delineated planning target volumes (PTVs) and organs at risk (OARs) regions. The phantom was imaged, planned and irradiated conformally by a 3D-CRT plan. Dosimetry within the phantom was assessed using thermoluminescent dosimeters (TLDs). The reproducibility of phantoms and TLD readings were checked by three repeated identical irradiations. Subsequent three clinical 3D-CRT plans for nasopharyngeal patients have been verified using the phantom. Measured doses from each dosimeter were compared with those acquired from the treatment planning system (TPS).ResultsPhantom's measured doses were reproducible with <3·5% standard deviation between the three TLDs’ repeated measurements. Verification of three head and neck 3D-CRT patients’ plans was implemented, and good agreement between measured values and those predicted by TPS was found. The percentage dose difference for TLD readings matched those corresponding to the calculated dose to within 4%.ConclusionThe good agreement between predicted and measured dose shows that the phantom is a useful and efficient tool for 3D-CRT technique dosimetric verification.

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To cite this article: Khaldoon M. Radaideh (2020) Dosimetric impact of weight loss and anatomical changes at organs at risk during intensity-modulated radiotherapy for head-andneck cancer,

Background: Dose reference levels (DRLs) are used as indicators as well as guidance for dose optimization and to ensure justification of appropriate dose for a given clinical indication. The main aims of this study were to establish local DRLs for each CT imaging protocol as a reference point to evaluate the radiation dose indices and to compare our DRLs with those established in other countries and against the internationally reported guidelines. Materials and methods: 2000 CT dose reports of different adult imaging protocols from January 2021 until April 2022 were collected retrospectively at different hospitals in Jordan. Data were collected from CT scans that were performed using different types and models of CT scanners and included four adult non-enhanced, helical CT imaging protocols; Head, Chest, Abdomen-Pelvis, and Chest-Abdomen-Pelvis. Results: The average doses of CTDIvol, DLP, and effective dose were (65.11 mGy, 1232.71 mGy·cm, 2.83 mSv) for the head scan, (16.6 mGy, 586.6 mGy·cm, 8.21 mSv) for the chest scan, (17.91 mGy, 929.9 mGy·cm, 13.9 mSv) for the abdomen-pelvis scan, and (19.3 mGy, 1152 mGy·cm, 17.25 mSv) for the chest-abdomen-pelvis scan. In comparison with results from different international studies, DLP values measured in the present study were lower for the chest-abdomen-pelvis and abdomen-pelvis CT scans, and higher for the head CT and chest CT scans. Conclusions: It is very important that each country establishes its own DRLs and compares them with those reported by other countries, especially the developed ones. It is also important that these levels are regularly updated.

AimTo evaluate the Klarity® Mask with respect to skin doses and toxicity secondary to head and neck cancer radiation treatment.Materials and methodsThis prospective study included five nasopharyngeal cancer patients who underwent intensity-modulated radiation therapy and monitored for skin toxicity. An anatomical Perspex head and neck phantom was designed and used. All patients’ treatment plans were separately transferred to the phantom. Dosimetric measurements were performed using chip-shaped thermoluminescent dosimeters (LiF:Mg,Ti TLDs) which were distributed at certain target points on the phantom. Phantom was irradiated twicely with and without a Klarity® Mask. Three fractions for each patient plan were obtained and compared with treatment planning system (TPS) doses as guided by computed tomography.ResultsThe Klarity mask used for patient immobilisation increased the surface dose by 10·83% more than that without the mask. The average variations between skin dose measurements with and without the Klarity mask for all patients’ plans ranged from 10·26 to 11·83%. TPS overestimated the surface dose by 19·13% when compared with thermoluminescent dosimeters that measured the direct skin dose.ConclusionsKlarity immobilisation mask increases skin doses, as a consequence, surface dose measurements should be monitored and must be taken into account.

Objective: Irrational and overzealous use of antibiotics in addition to multidrug resistance has increased at an alarming limits around the world.  This study aimed to evaluate the knowledge and practices toward antibiotic use among students at Yarmouk University Material and Method: A cross-sectional descriptive survey using a structured electronic version of valid questionnaire was distributed among participants. Google form was prepared based on available questionnaire in literature, revised by a group of academic pharmacist to validate the questionnaire. Test-retest was performed for a small group and cronbach alpha was calculated. The form was distributed randomly among under- and postgraduate students at Yarmouk University via their mails. Results: A total of 1154 individuals who completed questionnaires were analyzed. The knowledge of antibiotic use and resistance was quite good; 72.7% reported correct responses with a mean score of 16 out of 22. High rates of antibiotic use were found with 92% of respondents used antibiotics in the past three months. Inappropriate practice toward antibiotic was common; 48% used it for incorrect indication (e.g., common cold, fever, and pain), 60% used for improper duration and 20% don’t take the correct doses. Conclusions: Interventions on enhancing awareness and understanding of rational antimicrobial use are highly recommended by promoting expert-driven behavioural change, effective communication, education and training. Furthermore, law restriction on antibiotic dispensing should be introduced.