CONTROL FACTORS FOR SITE ERRORS MANAGEMENT OF RADIOTHERAPY DELIVERY.

OBJECTIVE: The aim: This study aimed to define the factors related to irradiation field equality and target accuracy which will further influence the irradiation result. PATIENTS AND METHODS: Materials and methods: This is a prospective-qualitative study, conducted by observation of image data verification from cervical cancer patients in the Department of Radiotherapy, dr. Moewardi Hospital, Surakarta who had undergone several times a week irradiation utilizing Telecobalt60 device and by conducting an in-depth interview to ten Indonesian radiotherapy experts, in October 2018. The data was further analyzed using correlation - regression test. RESULTS: Results: From 30 verification image data of the irradiated patients, we conclude that the scheme, body size, and patient positioning factors have all revealed statistically significant correlations to the irradiation field equality. On the other hand, factors such as patient and tele-therapy device set-ups, tele-therapy device calibration, human resources quality, and tele-therapy device malfunctions have all revealed statistically significant correlations to the irradiation target accuracy. These facts were further strengthen by the supporting statements from 10 Indonesian radiotherapy experts. CONCLUSION: Conclusions: The impact factors of field equality and accuracy of the irradiation target could serve as an important control factors which is substantially required to manage and minimize site errors of the radiotherapy delivery.

COMPUTED RADIOGRAPHY UTILIZATION FOR TELECOBALT60 TO ACHIEVE THE RADIATION CERTAINTY.

OBJECTIVE: The aim: This research aimed to show the achievement of Telecobalt60 radiation certainty using computed radiography, in comparation with non-verified computed radiography. PATIENTS AND METHODS: Materials and methods: This research is a quantitative study, randomized double-blind, and consecutive sampling design. The study was conducted by observing and com¬paring the data of verified computed radiography (VerC) computed radiograph for Telecobalt60 compared to the non-verified computed radiography (nVerC) Telecobalt60 data. RESULTS: Results: The results showed that there are significant statistical differences in several measurement characteristics between the verified computed radiography arm and the non-verified computed radiography arm. All of the value divergences of the verified computed radiography arm are less than 7 mm while the non-verified computed radiography arm are 7 mm or more (P<0.050). Furthermore, all of the edge aspect of measurement in the verified computed radiography arms are less than the non-verified computed radiography, all without manual block utilization (P<0.050). CONCLUSION: Conclusions: We conclude that Telecobalt60 radiation certainty is significantly better achieved by using computed radiography, when compared to non-verified computed radiography Telecobalt60 use. This research contributes to provide evidence based for better Telecobalt60 radiation accuracy and quality of radiotherapy outcome by using computed radiography.

Ensuring safety and sustainability of radiotherapy services during the COVID-19 pandemic in resources constrain country: An Indonesian experience.

The global COVID-19 pandemic has placed a significant burden on the healthcare sector, overwhelming health services in affected countries worldwide. As healthcare facilities reorganize their services to adapt to this challenging problem, it is important that the sustainability of essential oncology services, including radiotherapy, is maintained. This article describes the Indonesian experience in ensuring sustainability of radiotherapy services during the pandemic, highlighting various important adjustments which were made to allow radiotherapy centers nationwide to continue operating while protecting staff and patients from the risk of disease transmission. As the backlog of patients waiting to start treatment will inevitably grow, some insight on how to proactively manage this issue will also be described.

Six fractions weekly as accelerated fraction radiotherapy: Is it applicable for nasopharyngeal cancer? A review.

Standard therapy for nasopharyngeal cancer (NPC) is concurrent chemoradiation. Nevertheless, therapeutic outcomes are often unsatisfactory particularly for locally advanced stage. To enhance the therapeutic outcome, we may consider using altered fraction radiotherapy. Altered fraction radiotherapy is divided into two large groups for the therapy of NPC: hyperfraction radiotherapy and accelerated fraction radiotherapy. One of the accelerated fraction regimens suitable for NPC therapy is an accelerated regimen of six radiotherapy fractions weekly. This regimen is considered safe whether using conventional 2D planning technique or advance technique. Response to radiotherapy is better owing to the decrease in overall treatment time (OTT). Furthermore, acute or late side effects for this therapy are not very different to those of standard therapy. The conclusion is that we recommend the use of an accelerated regimen of six radiotherapy fractions weekly for locally advanced stage NPC with contraindication to concurrent chemoradiation, due to the high degree of clinical outcome as well as better tolerated side effect for NPC patients, particularly for those with locally advanced stage NPC.

Adult Alveolar Rhabdomyosarcoma on Extremity, Successful Treatment with Radiotherapy following Chemotherapy: Serial Case Report.

Alveolar rhabdomyosarcoma (RMS) is one of the four subtypes of RMS. Alveolar RMS is the rare type found in adults, with the worse prognosis. We report 2 serial cases of alveolar RMS on extremity which was only treated with subtotal excision or incision biopsy. We further gave a total dose of 70 Gy radiotherapy on the local tumor and 50 Gy prophylaxis dose on regional lymph node after 6 cycles of anthracyclines-based chemotherapy. Postradiotherapy, contrast computed tomography scan revealed no tumor mass left (complete response).