[Analysis of Preventive Cases Using Resilience Engineering in Radiotherapy Department].

PURPOSE: Resilience engineering is the ability of a system to adjust its own functions and maintain the required behavior in the face of changes and disturbances, and resilience potential is a necessary requirement. We aimed to clarify the relationship between resilience potential and error prevention cases. METHOD: Based on the error cases reported in our department, we aggregated the relationship with resilience potential for each radiation treatment process. RESULT: As a result of tabulating the relationship, we were able to recognize and prevent errors by taking preventive measures from past cases. On the other hand, in cases that slipped through the check mechanism, errors were discovered because of a sense of discomfort in unusual situations, and some error cases could be prevented by increasing the resilience potential. CONCLUSION: This study found that preparation, observation, coping, and utilization of past experiences are related to resilience potential in preventive cases.

Universal Cost Bound of Quantum Error Mitigation Based on Quantum Estimation Theory.

We present a unified approach to analyzing the cost of various quantum error mitigation methods on the basis of quantum estimation theory. By analyzing the quantum Fisher information matrix of a virtual quantum circuit that effectively represents the operations of quantum error mitigation methods, we derive for a generic layered quantum circuit under a wide class of Markovian noise that, unbiased estimation of an observable encounters an exponential growth with the circuit depth in the lower bound on the measurement cost. Under the global depolarizing noise, we in particular find that the bound can be asymptotically saturated by merely rescaling the measurement results. Moreover, we prove for random circuits with local noise that the cost grows exponentially also with the qubit count. Our numerical simulations support the observation that, even if the circuit has only linear connectivity, such as the brick-wall structure, each noise channel converges to the global depolarizing channel with its strength growing exponentially with the qubit count. This not only implies the exponential growth of cost both with the depth and qubit count, but also validates the rescaling technique for sufficiently deep quantum circuits. Our results contribute to the understanding of the physical limitations of quantum error mitigation and offer a new criterion for evaluating the performance of quantum error mitigation techniques.

Assessment of biological dosimetric margin for stereotactic body radiation therapy.

PURPOSE: To develop a novel biological dosimetric margin (BDM) and to create a biological conversion factor (BCF) that compensates for the difference between physical dosimetric margin (PDM) and BDM, which provides a novel scheme of a direct estimation of the BDM from the physical dose (PD) distribution. METHODS: The offset to isocenter was applied in 1-mm steps along left-right (LR), anterior-posterior (AP), and cranio-caudal (CC) directions for 10 treatment plans of lung stereotactic body radiation therapy (SBRT) with a prescribed dose of 48 Gy. These plans were recalculated to biological equivalent dose (BED) by the linear-quadratic model for the dose per fraction (DPF) of d = 3-20 Gy/fr and α / ß = 3 - 10 . BDM and PDM were defined so that the region that satisfied that the dose covering 95% (or 98%) of the clinical target volume was greater than or equal to the 90% of the prescribed PD and BED, respectively. An empirical formula of the BCF was created as a function of the DPF. RESULTS: There was no significant difference between LR and AP directions for neither the PDM nor BDM. On the other hand, BDM and PDM in the CC direction were significantly larger than in the other directions. BCFs of D95% and D98% were derived for the transverse (LR and AP) and longitudinal (CC) directions. CONCLUSIONS: A novel scheme to directly estimate the BDM using the BCF was developed. This technique is expected to enable the BED-based SBRT treatment planning using PD-based treatment planning systems.

The CD44 standard isoform contributes to radioresistance of pancreatic cancer cells.

Resistance to chemoradiotherapy is one reason for the increased recurrence rate of pancreatic cancer after these therapies. These cells change the expression levels of several proteins, such as epithelial-mesenchymal transition (EMT), while acquiring the chemo- or radio-resistance. In this study, we focused on CD44, a pancreatic cancer stem cell marker. CD44 has isoforms with different functions: standard isoform (CD44s) and several variant isoforms (CD44v). However, little is known about the roles of these isoforms after ionizing irradiation. The purpose of this study was to investigate the role of CD44 isoforms in radioresistance of pancreatic cancer cells. AsPC-1 (a human pancreatic cancer cell line) was irradiated with 4 MV X-rays. The mRNA and protein levels of CD44s were strongly upregulated, dose dependently, compared with CD44v after irradiation. Thus, we further investigated CD44s at the point of cell proliferation. We evaluated cell proliferation and survival, using CD44s knockdown cells. CD44s knockdown did not change the proliferation rate for up to 72 h after the irradiation, but decreased cell viability in the colony formation assay. As one of the reasons for these effects, we found downregulation of phosphorylated extracellular signal-regulated kinase (Erk; which is involved with cell proliferation) by CD44s knockdown, time dependently. Moreover, radiation-induced EMT-like expression changes were detected and suppressed by CD44s knockdown. In conclusion, our work demonstrated that CD44 standard isoform was especially upregulated after high-dose X-ray irradiation in several isoforms of CD44 and contributed to longer-term cell survival after the irradiation through the maintenance of Erk phosphorylation and radiation-induced EMT.