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.

The aim of this study was to investigate the effects of oral branched-chain amino acids (BCAAs) intake on muscular (creatine kinase and myoglobin) and central (serotonin) fatigue during an incremental exercise protocol and to determine the time to exhaustion. Sixteen male long-distance runners (25.7 ± 2.0 yrs) performed two trials, 14 days apart. Using a double-blind, placebo-controlled, randomised crossover design, participants ingested either 20 g of BCAAs (BCAA trial) or a placebo 1 hour prior to performing an incremental exercise session on a treadmill. The starting speed was 8 km/h and this was increased by 1 km/h every 5 minutes until volitional exhaustion. Blood analysis indicated that plasma levels of serotonin were lower in the BCAA trial (259.3 ± 13.5 ng/ml) than the placebo trial (289.1 ± 14.5 ng/ml) (p < 0.05). There was a similar pattern of results for free fatty acid (p < 0.05). The creatine kinase level was higher in the BCAA trial (346.1 ± 33.7 U/L) than the placebo trial (307.3 ± 30.2 U/L). No significant difference between trials was observed regarding the level of myoglobin (p = 0.139). Time to exhaustion was longer in the BCAA trial (50.4 ± 2.3 min) than the placebo trial (46.6 ± 3.2 min). In conclusion, oral intake of 20 g of BCAAs 1 hour prior to an incremental treadmill exercise session increased time to exhaustion, probably due to the reduction in serotonin concentration. As myoglobin levels were within the normal range in both trials, we conclude that the participants did not reach muscular fatigue.

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.