RESUMO
Recent decades have witnessed transformative advances in radiation physics and computer technology, revolutionizing the precision of radiation therapy. The adoption of intricate treatment techniques such as three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, volumetric-modulated arc therapy, and image-guided radiotherapy necessitates robust quality assurance (QA) programs. This study introduces the SunCHECK™ Machine (SCM), a web-based QA platform, presenting early results from its integration into a comprehensive QA program. linear accelerators (LINAC) demand QA programs to uphold machine characteristics within accepted tolerances. The increasing treatment complexity underscores the need for streamlined procedures. The selection of QA tools is vital, requiring efficiency, accuracy, and alignment with clinic needs, as per recommendations such as the AAPM task group 142 report. The materials and methods section details SCM implementation in various QA aspects, encompassing daily QA (DQA), imaging QA with Catphan, conventional output assessment with a water phantom, and LINAC isocenter verification through the Winston-Lutz test. Challenges in QA processes, such as manual data transcription and limited device integration, are highlighted. Early results demonstrate SCM's significant reduction in QA time, ensuring accuracy and efficiency. Its automation eliminates interobserver variation and human errors, contributing to time savings and near-immediate result publication. SCM's role in consolidating and storing DQA data within a single platform is emphasized, offering potential in resource optimization, especially in resource-limited settings. In conclusion, SCM shows promise for efficient and accurate mechanical and dosimetric QA in radiation therapy. The study underscores SCM's potential to address contemporary QA challenges, contributing to improved resource utilization without compromising quality and safety standards.
RESUMO
Colorectal cancer is a leading cause of cancer-related mortality, with nearly half of the affected patients developing liver metastases. For three decades, liver resection (LR) has been the primary curative strategy, yet its applicability is limited to about 20% of cases. Liver transplantation (LT) for unresectable metastases was attempted unsuccessfully in the 1990s, with high rates of perioperative death and recurrence. There is now more interest in this strategy due to improvements in systemic therapies and surgical techniques. A significant study conducted by the Oslo group showed that patients receiving liver transplants had a 60% chance of survival after five years. Significantly better results have been achieved by using advanced imaging for risk stratification and further refining selection criteria, especially in the Norvegian SECA trials. This review carefully charts the development and history of LT as a treatment option for colorectal cancer liver metastases. The revolutionary path from the early days of exploratory surgery to the current situation of cautious optimism is traced, highlighting the critical clinical developments and improved patient selection standards that have made LT a potentially curative treatment for such challenging very well selected cases.
Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Transplante de Fígado , Humanos , Transplante de Fígado/efeitos adversos , Transplante de Fígado/métodos , Neoplasias Colorretais/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Hepáticas/secundárioRESUMO
OBJECTIVES: Machine perfusion of liver grafts has gained popularity for its abilities to preserve liver grafts,reduce cold storage damage, and evaluate graft viability before transplant. However, debate persists regarding the optimal solutions, logistics, and biomarkers for assessing graft quality. To shed light on the lengthy debates surrounding the use of machine perfusion in liver graft preservation,this study utilized bibliometric analysis to evaluate the status and development trends of main research areas. MATERIALS AND METHODS: On December 10th, 2022, we conducted a literature search using the Web of Science database to identify articles related to liver machine perfusion. The search included only original studies and reviews and excluded meeting abstracts, letters, notes, editorials, short surveys, book chapters, and errata. We identified the number of citations and encompassed various aspects, such as annual trends, countries, institutions, authors, journals, and key words. We used VOSviewer version 1.6.18 to generate tables and figures. RESULTS: After manually removing irrelevant papers, we included 264 articles (89 reviews; remaining were original studies). The articles were cited 5743 times, averaging 21.92 per article. We found that the United Kingdom (n = 76) was the country that produced the most articles,followed by theUnited States (66 articles). Most papers in our search were published in Liver Transplantation (n = 31) and Transplantation (n = 16). CONCLUSIONS: Bibliometric analysis provided insights into debates and advancements in liver graft preservation using machine perfusion. The analysis showed leading countries and key research areas in the field. This overview serves as a valuable resource for researchers, offering a foundation for further exploration and guiding future investigations in the field of machine perfusion for liver graft preservation.
Assuntos
Transplante de Fígado , Perfusão , Humanos , Criopreservação , Bases de Dados Factuais , Reino UnidoRESUMO
BACKGROUND: The United States has witnessed significant advancements in the field of organ transplantation over the course of the last five decades, as demonstrated by a notable increase in the quantity of academic research. The presence of a highly dynamic research environment necessitates continuous evaluations to maintain the integrity and progress of the field. AIM: To evaluate the total output and thematic emphasis of transplant research conducted in the United States. METHODS: On January 10, 2023, we conducted a bibliometric search of United States research output in transplantation journals from the Web of Science database's Science Citation Index Expanded. We excluded editorials, meeting abstracts, and other non-article types. We analyzed annual trends, authors, institutions, articles, keywords, and countries collaborating with the United States, using VOSviewer 1.6.18 to create figures and tables. RESULTS: The United States published 25956 papers (3078 reviews and 22878 articles) representing 37.7% of the world's scientific output. Canada emerged as the top collaborator with the United States, co-authoring 1263 articles. Leading institutions in United States transplantation research were the University of Pittsburgh (1749 articles), Mayo Clinic (1605 articles), Harvard Medical School (1549 articles), and Johns Hopkins University (1280 articles). The top three keywords with over 2000 occurrences were "recipients," "survival," and "outcomes," indicating a focus on graft and recipient outcome markers by United States researchers. CONCLUSION: Our findings demonstrate the United States leadership in organ transplantation research, contributing significantly to the global scientific output in this field. However, opportunities exist for fostering expansive partnerships, particularly with developing countries. This study provides valuable insights into the transplantation research landscape in the United States, emphasizing the importance of ongoing evaluations to maintain and propel advancements in this critical medical discipline. The results may facilitate future collaborations, knowledge exchange, and the pursuit of innovative solutions in the realm of organ transplantation.