It is necessary to take into account bone structures among organ at risk (OAR) involved in irradiation fields. The detailed analysis of the dose distribution and the use of collimators allow to decrease the total dose to OAR. An adequate management, early diagnosis and prompt, proper treatment may protect patients from long-term morbidities.
Prophylactic cranial irradiation (PCI) is performed on patients with limited or extensive small-cell lung cancer to reduce incidence of brain metastases and prolong survival. PCI may induce neurocognitive impairment. Decreasing irradiation of neural stem cells (NSC) might reduce PCI-induced toxicity. We tested the feasibility of reducing irradiation doses to neural stem cell (NSC) regions while maintaining prescribed doses to the planned target volume (PTV).Irradiation plans utilizing intensity-modulated radiotherapy (IMRT), helical TomoTherapy, and RapidArc for 10 consecutive lung cancer patients were evaluated. The dose distribution, dose-volume histograms, and dose homogeneity indexes were analyzed. Planned and actual dose distributions were compared by dosimetric analysis. Both helical tomotherapy and LINAC-based IMRT reduced the radiation dose to the NSC regions by approximately 45% while maintaining the full dose to the rest of brain. Measured dose distributions matched the planned dose distributions.Protecting the regions of active neurogenesis is technically feasible. Whether reducing the dose by 35% to 45% is sufficient to reduce treatment toxicity, however, can only be addressed in a randomized study. Further reducing the dose within the NSC region might also significantly decrease the dosage to the PTV.
The aim of the study was to use thermal imaging to evaluate long-term chest temperature changes in patients who had previously been treated with radiotherapy. The examination with a thermal imaging camera involved 144 women—48 of them were patients after RT, 48 were females before breast cancer radiotherapy and the last group of participants were 48 healthy women. All patients (before and after radiotherapy) were divided into women after mastectomy and those after conservative surgery. In addition, the first group of women, those who had received radiotherapy, were divided into three other groups: up to 1 year after RT, over 1 year and up to 5 years after RT and over 5 years after RT. Due to this, it was possible to compare the results and analyse the differences between the temperature in the healthy and treated breasts. The comparison of obtained temperature results showed that the area treated by ionizing radiation is characterized by a higher temperature even a few years after the finished treatment. It is worth mentioning that despite the fact that the difference was visible on the thermograms, the patients had no observable skin lesion or change in color at the treatment site. For the results of the study provided for the group of healthy patients, there were no significant differences observed between the average temperatures in the breasts. The use of thermal imaging in the evaluation of skin temperature changes after radiotherapy showed that the average temperature in the treated breast area can change even a long time after treatment.
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