The Estimation of the Number of Underground Coal Miners and Normalization Collective Dose at Present in China.

Due to the improvement of production technology and the adjustment of energy structure, as well as the town-ownership and private-ownership coal mines (TPCM) were closed or merged by national policy, the number of underground miner has changed comparing with 2004 in China, so collective dose and normalization collective dose in different type of coal mine should be changed at the same time. In this paper, according to radiation exposure by different ventilation condition and the annual output, the coal mines in China are divided into three types, which are named as national key coal mines (NKCM), station-owned local coal mines (SLCM) and TPCM. The number of underground coal miner, collective dose and normalization collective dose are estimated at present base on surveying annual output and production efficiency of raw coal in 2005-2014. The typical total value of the underground coal miners recommended in China is 5.1 million in 2005-2009, and in which there are respectively included 1 million, 0.9 million and 3.2 million for NKCM, SLCM and TPCM. There are total of 4.7 million underground coal miner in 2010-2014, and the respectively number for NKCM, SLCM and TPCM are 1.4 million, 1.2 million and 2.1 million. The collective dose in 2005-2009 is 11 335 man·Sv·y-1, and in which there are respectively included 280, 495 and 10 560 man·Sv·y-1 for NKCM, SLCM and TPCM. As far as 2010-2014, there are total of 7982 man·Sv·y-1, and 392, 660 and 6930 man·Sv·y-1 for each type of coal mines. Therefore, the main contributor of collective dose is from TPCM. The normalization collective dose in 2005-2009 is 0.0025, 0.015 and 0.117 man·Sv per 10 kt for NKCM, SLCM and TPCM, respectively. As far as 2010-2014, there are 0.0018, 0.010 and 0.107 man·Sv per 10 kt for each type of coal mines. The trend of normalization collective dose is decreased year by year.

A phase III study of late course accelerated hyperfractionated radiotherapy versus conventionally fractionated radiotherapy in patients with nasopharyngeal carcinoma.

OBJECTIVE: To compare the efficacy and toxicity of late course accelerated hyperfractionated radiotherapy (LCAF) with conventionally fractionated (CF) radiotherapy in the treatment of nasopharyngeal carcinoma (NPC). METHODS: Between March 1998 and November 2002, 200 eligible patients with NPC were randomized to receive either LCAF (48 Gy in 40 fractions, 2 fractions per day, 1.2 Gy/fraction, with an interval of ≥6 h, 5 d/wk, followed by 30 Gy in 20 fractions using 2 fractions per day, 1.5 Gy/fraction, 5 d/wk) or CF (35 fractions, 2.0 Gy/fraction/d, 5 d/wk, to a total dose of 70 Gy). RESULTS: All patients completed the treatment. Overall baseline characteristics of the study population of the 2 arms were well balanced. With a median follow-up of 6.9 years, the 5-year local control rate was higher in the LCAF arm (87.6% vs. 75.9%, P=0.044). The 5-year overall survival rates were 74.1% vs. 58.0% (P=0.024) for the LCAF arm and the CF arm, respectively. LCAF patients had a higher occurrence of acute mucositis and a more evident weight loss than CF patients, whereas incidence rates of radiation-induced damage to the central nervous system were similar in the 2 arms. CONCLUSIONS: LCAF achieved higher local control and overall survival rates than CF radiotherapy, without increasing radiation-related late complications such as cranial nerve palsy.

Impact of residual and intrafractional errors on strategy of correction for image-guided accelerated partial breast irradiation.

BACKGROUND: The cone beam CT (CBCT) guided radiation can reduce the systematic and random setup errors as compared to the skin-mark setup. However, the residual and intrafractional (RAIF) errors are still unknown. The purpose of this paper is to investigate the magnitude of RAIF errors and correction action levels needed in cone beam computed tomography (CBCT) guided accelerated partial breast irradiation (APBI). METHODS: Ten patients were enrolled in the prospective study of CBCT guided APBI. The postoperative tumor bed was irradiated with 38.5 Gy in 10 fractions over 5 days. Two cone-beam CT data sets were obtained with one before and one after the treatment delivery. The CBCT images were registered online to the planning CT images using the automatic algorithm followed by a fine manual adjustment. An action level of 3 mm, meaning that corrections were performed for translations exceeding 3 mm, was implemented in clinical treatments. Based on the acquired data, different correction action levels were simulated, and random RAIF errors, systematic RAIF errors and related margins before and after the treatments were determined for varying correction action levels. RESULTS: A total of 75 pairs of CBCT data sets were analyzed. The systematic and random setup errors based on skin-mark setup prior to treatment delivery were 2.1 mm and 1.8 mm in the lateral (LR), 3.1 mm and 2.3 mm in the superior-inferior (SI), and 2.3 mm and 2.0 mm in the anterior-posterior (AP) directions. With the 3 mm correction action level, the systematic and random RAIF errors were 2.5 mm and 2.3 mm in the LR direction, 2.3 mm and 2.3 mm in the SI direction, and 2.3 mm and 2.2 mm in the AP direction after treatments delivery. Accordingly, the margins for correction action levels of 3 mm, 4 mm, 5 mm, 6 mm and no correction were 7.9 mm, 8.0 mm, 8.0 mm, 7.9 mm and 8.0 mm in the LR direction; 6.4 mm, 7.1 mm, 7.9 mm, 9.2 mm and 10.5 mm in the SI direction; 7.6 mm, 7.9 mm, 9.4 mm, 10.1 mm and 12.7 mm in the AP direction, respectively. CONCLUSIONS: Residual and intrafractional errors can significantly affect the accuracy of image-guided APBI with nonplanar 3DCRT techniques. If a 10-mm CTV-PTV margin is applied, a correction action level of 5 mm or less is necessary so as to maintain the RAIF errors within 10 mm for more than 95% of fractions. Pre-treatment CBCT guidance is not a guarantee for safe delivery of the treatment despite its known benefits of reducing the initial setup errors. A patient position verification and correction during the treatment may be a method for the safe delivery.

Late course accelerated hyperfractionated radiotherapy of nasopharyngeal carcinoma (LCAF).

BACKGROUND AND PURPOSE: To study the efficacy of late course accelerated fractionated (LCAF) radiotherapy in the treatment of nasopharyngeal carcinoma (NPC). The end-points were local control, radiation-induced complications, and factors influencing survival. PATIENTS AND METHODS: Between December 1995 and April 1998, 178 consecutive NPC patients were admitted for radiation treatment. The radiation beam used was (60)Co gamma or 6 MV X rays. For the first two-thirds of the treatment, two daily fractions of 1.2 Gy were given to the primary lesion, with an interval of > or =6h, 5 days per week to a total dose of 48 Gy/40 fractions, over a period of 4 weeks. For the last third of the treatment, i.e., beginning the 5th week of treatment, an accelerated hyperfractionated schedule was carried out. The dose per fraction was increased to 1.5 Gy, 2 fractions per day with an interval of > or =6h, the total dose for this part of the protocol was 30 Gy/20 fractions over 2 weeks. Thus the total dose was 78 Gy in 60 fractions in 6 weeks. RESULTS: All patients completed the treatment. Acute mucositis: none in 2 cases, Grade 1 in 43 cases, Grade 2 in 78 cases, Grade 3 in 52 cases, and Grade 4 in 3 cases. Local control rate: the 5 year nasopharyngeal local control rate was 87.7%, and the cervical lymph nodes local control rate was 85.7%. The 5-year distant metastasis rate was 26.1%, and 5 year survivals were 67.9%, 16 (9%) patients had radiation-induced cranial nerve palsy, 7(4%) patients had temporal lobe or brainstem damage. CONCLUSIONS: With this treatment schedule, patients' tolerance was good, local control and 5 year survivals were better than conventional fractionation schedules, and radiation-related late complications did not increase, as 5-year survival rates of conventional fractionation radiotherapy were only 58%. Randomized clinical trials are being carried out to further confirm the efficacy of LCAF for nasopharyngeal carcinoma.

The estimation of the number of underground coal miners and the annual dose to coal miners in China.

This paper introduces an estimation method for the number of underground coal miners and the annual dose to coal miners in China. It shows that there are about 6 million underground miners at present and the proportion is about 1, 1 and 4 million for national key coal mines, state-owned local coal mines, and township and private-ownership coal mines, respectively. The collective dose is about 1.65 x 10(4) person-Sv y(-1), of which township and private-ownership coal mines contribute about 91%. This paper also points out that the 2000 UNSCEAR report gives the number of miners of coal production and their collective dose, which are underestimated greatly because the report only includes the number of underground miners in national key coal mines, which only accounts for 1/6 of the workers all working under the best ventilation conditions in China.