ABSTRACT
PURPOSE: To compare bone marrow-sparing intensity-modulated pelvic radiotherapy (BMS-IMRT) with conventional (four-field box and anteroposterior-posteroanterior [AP-PA]) techniques in the treatment of cervical cancer. METHODS AND MATERIALS: The data from 7 cervical cancer patients treated with concurrent chemotherapy and IMRT without BMS were analyzed and compared with data using four-field box and AP-PA techniques. All plans were normalized to cover the planning target volume with the 99% isodose line. The clinical target volume consisted of the pelvic and presacral lymph nodes, uterus and cervix, upper vagina, and parametrial tissue. Normal tissues included bowel, bladder, and pelvic bone marrow (PBM), which comprised the lumbosacral spine and ilium and the ischium, pubis, and proximal femora (lower pelvis bone marrow). Dose-volume histograms for the planning target volume and normal tissues were compared for BMS-IMRT vs. four-field box and AP-PA plans. RESULTS: BMS-IMRT was superior to the four-field box technique in reducing the dose to the PBM, small bowel, rectum, and bladder. Compared with AP-PA plans, BMS-IMRT reduced the PBM volume receiving a dose >16.4 Gy. BMS-IMRT reduced the volume of ilium, lower pelvis bone marrow, and bowel receiving a dose >27.7, >18.7, and >21.1 Gy, respectively, but increased dose below these thresholds compared with the AP-PA plans. BMS-IMRT reduced the volume of lumbosacral spine bone marrow, rectum, small bowel, and bladder at all dose levels in all 7 patients. CONCLUSION: BMS-IMRT reduced irradiation of PBM compared with the four-field box technique. Compared with the AP-PA technique, BMS-IMRT reduced lumbosacral spine bone marrow irradiation and reduced the volume of PBM irradiated to high doses. Therefore BMS-IMRT might reduce acute hematologic toxicity compared with conventional techniques.
Subject(s)
Bone Marrow/radiation effects , Pelvic Bones/radiation effects , Radiation Protection , Radiotherapy, Intensity-Modulated/methods , Uterine Cervical Neoplasms/radiotherapy , Adult , Aged , Combined Modality Therapy/methods , Female , Humans , Intestine, Small , Middle Aged , Radiotherapy Dosage , Rectum , Urinary Bladder , Uterine Cervical Neoplasms/drug therapyABSTRACT
Total body irradiation (TBI) is used as a preconditioning regimen prior to bone marrow transplant for treatment of hematologic malignancies. During TBI, large volumes of normal tissue are irradiated, and this can lead to toxicities, most significantly in the lungs. Intensity modulated total marrow irradiation (IMTMI) may be able to reduce these toxicities by directly targeting the bone marrow while minimizing the dose to critical structures. The goal of this study was to assess the feasibility of IMTMI by following the planning and delivery process for a Rando phantom. A three isocenter technique was used to provide a full body plan for treatment on a linear accelerator. Thermoluminescent detectors (TLDs) were placed at 22 positions throughout the phantom to compare the delivered doses to the planned doses. Individual intensity modulated radiation therapy verification plans were delivered to a solid water phantom for the three isocenters, and doses measured from an ion chamber and film were compared to the planned doses. The treatment plan indicated that target coverage was achieved with this IMTMI technique, and that the doses to critical structures were reduced by 29%-65% compared to conventional TBI. TLD readings demonstrated accurate dose delivery, with an average difference of 3.5% from the calculated dose. Ion chamber readings for the verification plans were all within 3% of the expected dose, and film measurements showed accurate dose distributions. Results from this study suggest that IMTMI using the three isocenter technique can be accurately delivered and may result in substantial dose reductions to critical structures.
Subject(s)
Bone Marrow/radiation effects , Lung/radiation effects , Particle Accelerators , Thermoluminescent Dosimetry/methods , Anthropometry , Calibration , Feasibility Studies , Humans , Phantoms, Imaging , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Reproducibility of Results , Tissue Distribution , Tomography, X-Ray Computed , Water/chemistryABSTRACT
We report on linear transmittance and reflectance as well as on third-harmonic generation in photonic crystal alloys formed by various compositions of polystyrene and poly (methyl methacrylate) colloidal spheres of the same size. These photonic crystal alloys are structurally ordered but contain refractive-index disorder and thus provide a random variation of scattering potential. The stopgap shows a monotonic shift in wavelength as a function of composition that can be fitted by assuming an effective dielectric constant for the colloidal spheres. In each alloy a dramatic enhancement of third-harmonic generation is observed, always on the short-wavelength side of the stopgap.
ABSTRACT
We have observed a dramatic enhancement of third-harmonic generation in 3D polystyrene-air photonic crystals pumped by a near infrared laser beam. As the pump wavelength is tuned, the peak of the enhancement occurs when the third-harmonic wavelength approaches the short-wavelength edge of the band gap. We show that the origin of the enhancement is phase matching provided by the periodic structure of the photonic crystals.
