[Clinical Efficacy of Cepharanthin(R)for Radiotherapy-Induced Leukopenia - A Nationwide, Multicenter, and Observational Study].

The clinical efficacy and safety of cepharanthin for the treatment of radiotherapy-induced leukopenia were reevaluated at multiple institutions.Clinical data of cancer patients aged over 20 years old, who received a total radiotherapy dose above 40 Gy, and who were treated with cepharanthin for more than 2 weeks between April 2007 and November 2012, were evaluated. Data from 65 patients(males: 31, females: 34)from 7 facilities were analyzed to assess efficacy and adverse events.The mean leukocyte count was significantly higher at the end of the treatment compared with the initial data.However, no significant differences were observed in erythrocyte and platelet counts.No adverse events attributed to cepharanthin were reported.Although this was a retrospective study, cepharanthin was found to be safe and significantly effective for the management of leukopenia caused by radiotherapy.

Three-dimensional conformal arc radiotherapy using a C-arm linear accelerator with a computed tomography on-rail system for prostate cancer: clinical outcomes.

BACKGROUND: We report the feasibility and treatment outcomes of image-guided three-dimensional conformal arc radiotherapy (3D-CART) using a C-arm linear accelerator with a computed tomography (CT) on-rail system for localized prostate cancer. METHODS AND MATERIALS: Between 2006 and 2011, 282 consecutive patients with localized prostate cancer were treated with in-room CT-guided 3D-CART. Biochemical failure was defined as a rise of at least 2.0 ng/ml beyond the nadir prostate-specific antigen level. Toxicity was scored according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. RESULTS: A total of 261 patients were analyzed retrospectively (median follow-up: 61.6 months). The median prescribed 3D-CART dose was 82 Gy (2 Gy/fraction, dose range: 78-86 Gy), and 193 of the patients additionally received hormonal therapy. The 5-year overall survival rate was 93.9 %. Among low-, intermediate-, and high-risk patients, 5-year rates of freedom from biochemical failure were 100, 91.5 and 90.3 %, respectively. Rates of grade 2-3 late gastrointestinal and genitourinary toxicities were 2.3 and 11.4 %, respectively. No patient experienced late grade 4 or higher toxicity. CONCLUSIONS: In-room CT-guided 3D-CART was feasible and effective for localized prostate cancer. Treatment outcomes were comparable to those previously reported for intensity-modulated radiotherapy.

A packed building-block compensator (TETRIS-RT) and feasibility for IMRT delivery.

A packed building-block compensator (TETRIS-RT) for IMRT (Intensity Modulated Radiation Therapy) delivery has been proposed. The compensator contains two kinds of cubic blocks: x-ray absorbing blocks for intensity modulation and x-ray transparent blocks for packing. The packed blocks are placed inside a rectangular enclosure, and the resulting compensators can be attached to a linac gantry head through a rotatable mount for efficient multiportal IMRT. A fabrication device and a sorting device were also developed. The fabrication device can automatically stack two different types of blocks to produce a compensator while the sorting device can separate each type of the blocks for subsequent fabrication. Preliminary film experiments have shown that an additional leakage dose through the rounded edges of the ten-layered x-ray absorbing blocks was 0.9% of the delivered dose with a total shielded dose ratio of 10% including the peak leakage. It was observed that the proposed compensator may provide a highly modulated dose distribution. This suggests its feasibility for IMRT delivery with a limit of 1 cm x 1 cm spatial resolution at isocenter in the plane perpendicular to the beam, and larger discrete intensity steps of approximately 10% compared to conventional compensators. Advantages of the proposed compensator include that the compensator blocks are reusable and can be utilized to automatically and quickly fabricate a compensator, thereby minimizing human labor.

A packed building-block compensator (TETRIS-RT) and feasibility for IMRT delivery.

A packed building-block compensator (TETRIS-RT) for IMRT (Intensity Modulated Radiation Therapy) delivery has been proposed. The compensator contains two kinds of cubic blocks: x-ray absorbing blocks for intensity modulation and x-ray transparent blocks for packing. The packed blocks are placed inside a rectangular enclosure, and the resulting compensators can be attached to a linac gantry head through a rotatable mount for efficient multiportal IMRT. A fabrication device and a sorting device were also developed. The fabrication device can automatically stack two different types of blocks to produce a compensator while the sorting device can separate each type of the blocks for subsequent fabrication. Preliminary film experiments have shown that an additional leakage dose through the rounded edges of the ten-layered x-ray absorbing blocks was 0.9% of the delivered dose with a total shielded dose ratio of 10% including the peak leakage. It was observed that the proposed compensator may provide a highly modulated dose distribution. This suggests its feasibility for IMRT delivery with a limit of 1cm×1cm spatial resolution at isocenter in the plane perpendicular to the beam, and larger discrete intensity steps of approximately 10% compared to conventional compensators. Advantages of the proposed compensator include that the compensator blocks are reusable and can be utilized to automatically and quickly fabricate a compensator, thereby minimizing human labor.