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2.
Int J Radiat Oncol Biol Phys ; 106(2): 440-448, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31928642

RESUMO

PURPOSE: Recent studies suggest that ultrahigh-dose-rate, "FLASH," electron radiation therapy (RT) decreases normal tissue damage while maintaining tumor response compared with conventional dose rate RT. Here, we describe a novel RT apparatus that delivers FLASH proton RT (PRT) using double scattered protons with computed tomography guidance and provide the first report of proton FLASH RT-mediated normal tissue radioprotection. METHODS AND MATERIALS: Absolute dose was measured at multiple depths in solid water and validated against an absolute integral charge measurement using a Faraday cup. Real-time dose rate was obtained using a NaI detector to measure prompt gamma rays. The effect of FLASH versus standard dose rate PRT on tumors and normal tissues was measured using pancreatic flank tumors (MH641905) derived from the KPC autochthonous PanCa model in syngeneic C57BL/6J mice with analysis of fibrosis and stem cell repopulation in small intestine after abdominal irradiation. RESULTS: The double scattering and collimation apparatus was dosimetrically validated with dose rates of 78 ± 9 Gy per second and 0.9 ± 0.08 Gy per second for the FLASH and standard PRT. Whole abdominal FLASH PRT at 15 Gy significantly reduced the loss of proliferating cells in intestinal crypts compared with standard PRT. Studies with local intestinal irradiation at 18 Gy revealed a reduction to near baseline levels of intestinal fibrosis for FLASH-PRT compared with standard PRT. Despite this difference, FLASH-PRT did not demonstrate tumor radioprotection in MH641905 pancreatic cancer flank tumors after 12 or 18 Gy irradiation. CONCLUSIONS: We have designed and dosimetrically validated a FLASH-PRT system with accurate control of beam flux on a millisecond time scale and online monitoring of the integral and dose delivery time structure. Using this system, we found that FLASH-PRT decreases acute cell loss and late fibrosis after whole-abdomen and focal intestinal RT, whereas tumor growth inhibition is preserved between the 2 modalities.


Assuntos
Órgãos em Risco/efeitos da radiação , Terapia com Prótons/instrumentação , Lesões Experimentais por Radiação/prevenção & controle , Proteção Radiológica/instrumentação , Radioterapia Guiada por Imagem/instrumentação , Abdome/efeitos da radiação , Animais , Proliferação de Células/efeitos da radiação , Desenho de Equipamento/métodos , Estudos de Viabilidade , Feminino , Fibrose , Raios gama , Intestino Delgado/patologia , Intestino Delgado/efeitos da radiação , Camundongos , Camundongos Endogâmicos C57BL , Tratamentos com Preservação do Órgão/instrumentação , Tratamentos com Preservação do Órgão/métodos , Órgãos em Risco/patologia , Neoplasias Pancreáticas/radioterapia , Terapia com Prótons/métodos , Proteção Radiológica/métodos , Radiometria/métodos , Radioterapia Guiada por Imagem/métodos , Espalhamento de Radiação , Células-Tronco/efeitos da radiação , Tomografia Computadorizada por Raios X
4.
Int J Radiat Biol ; 96(1): 100-111, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-29447591

RESUMO

Purpose: Characterization of a novel partial-body irradiation (PBI) shielding strategy in nonhuman primates (NHP; rhesus macaques), aimed at protecting the oral cavity, with respect to various gastrointestinal acute radiation syndrome (GI-ARS) syndrome parameters as well as buccal ulceration development.Materials and methods: NHPs were irradiated using a Cobalt-60 gamma source, in a single uniform dose, ranging from 9-13 Gy and delivered at 0.60-0.80 Gy min-1. Animals were either partially shielded via oral cavity shielding (PBIOS) or underwent total-body irradiation (TBI).Results: Clinical manifestations of GI-ARS, and also radiation-induced hematology and clinical chemistry changes, following PBIOS were comparable to the PBI NHP GI-ARS model utilizing shielding of the distal pelvic limbs and were significantly milder than TBI at similar radiation doses. Nadir citrulline levels were comparable between PBIOS and TBI but signs of recovery appeared earlier in PBIOS-treated animals. The PBIOS model prevented oral mucositis, whereas the TBI model presented buccal ulcerations at all tested radiation dose levels.Conclusions: Taken together, these results suggest that the PBIOS model is a suitable alternative to traditional PBI. For GI-ARS investigations requiring orally administered medical countermeasures, PBIOS confers added value due to the prevention of oral mucositis over traditional PBI.


Assuntos
Boca/efeitos da radiação , Proteção Radiológica/métodos , Síndrome Aguda da Radiação/sangue , Síndrome Aguda da Radiação/etiologia , Síndrome Aguda da Radiação/patologia , Animais , Citrulina/sangue , Radioisótopos de Cobalto/efeitos adversos , Raios gama/efeitos adversos , Macaca mulatta , Masculino , Análise de Sobrevida , Úlcera/sangue , Úlcera/etiologia , Úlcera/patologia
5.
An Bras Dermatol ; 94(5): 532-541, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31777353

RESUMO

BACKGROUND: The knowledge of general practitioners about photoprotection is unknown. OBJECTIVES: To develop and validate an instrument to evaluate the knowledge of general practitioners and pediatricians about photoprotection, gauging the knowledge of these professionals. METHODS: The study followed the steps: (1) Literature identification and item elaboration related to the theme; (2) Content validation; (3) Apparent validation; (4) Construct validation: internal consistency analysis and discriminatory analysis; (5) Reliability analysis. In Step 4, the instrument was applied to 217 general practitioners and pediatricians who worked in the host city of the study; the scores were compared with dermatologists scores. RESULTS: The final instrument had 41 items and showed satisfactory internal consistency (Cronbach's alpha=0.780), satisfactory reproducibility and good test-retest reliability (good-to-excellent kappa statistic in more than 60% of items). The discriminatory analysis registered a mean score of 54.1 points for dermatologists and 31.1 points for generalists and pediatricians, from a total of 82 possible points, representing a statistically significant difference (p<0.001). Generalists and pediatricians demonstrated an understanding of the relationship between excessive sun exposure and skin cancer, but they revealed lack of technical information necessary for their professional practice. STUDY LIMITATIONS: The instrument evaluates only knowledge, without evaluating the conduct of the participants. CONCLUSION: The results show that the instrument has good internal consistency and good reproducibility. It could be useful in the identification of general practitioners and pediatricians knowledge gaps on the subject, for the subsequent development of training and educational strategies.


Assuntos
Clínicos Gerais/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Pediatras/estatística & dados numéricos , Proteção Radiológica/métodos , Energia Solar , Inquéritos e Questionários/normas , Raios Ultravioleta/efeitos adversos , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exposição à Radiação/prevenção & controle , Reprodutibilidade dos Testes , Neoplasias Cutâneas/prevenção & controle , Estatísticas não Paramétricas , Protetores Solares/uso terapêutico
6.
Health Phys ; 117(6): 680-687, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31652209

RESUMO

Lutetium-177 dotatate, marketed under the name Lutathera®, is proving to be a valuable tool for physicians treating patients with neuroendocrine somatostatin-receptive tumors. Treatment consists of four cycles of 7.4 GBq of Lu dotatate infused intravenously over 30 to 40 minutes. This paper focuses on the radiation safety implications of patients undergoing Lu dotatate treatments at two large medical centers in the United States under the manufacturer's Expanded Access Protocol. Radiation safety precautions are described for the treatment of patients to control for radiation exposure and potential contamination. Ideally, the room used for administration should have a toilet, or one that is in close proximity, and covering should be provided to minimize contamination and clean up. The patient will meet the requirements in 10 CFR Part 35.75 for immediate release based on administered activity or measured exposure rate, but will need to be provided with written instruction on how to keep doses to other individuals ALARA. Disposal of the radioactive waste from Lu dotatate therapy can present some hazard control issues due to the long-lived Lu contaminant.Based on our experience, Lu dotatate therapy is an effective outpatient procedure that can safely occur in any hospital procedural room without the need for additional local shielding. Administration can be accomplished safely with attention paid to the administration set-up and proper administration procedures. Exposure to staff or to adjacent areas is minimal.


Assuntos
Complexos de Coordenação/uso terapêutico , Tumores Neuroendócrinos/radioterapia , Octreotida/análogos & derivados , Exposição à Radiação/prevenção & controle , Proteção Radiológica/normas , Gestão da Segurança/normas , Feminino , Humanos , Masculino , Octreotida/uso terapêutico , Monitoramento de Radiação/métodos , Proteção Radiológica/métodos , Dosagem Radioterapêutica , Medição de Risco/métodos
7.
Pneumologie ; 73(10): 573-577, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31537020

RESUMO

Substantial new data on early detection of lung cancer with low-dose CT has become available since the last joint statement of the German Roentgenological Society and the German Respiratory Society was published in 2011. The German S3 guideline on lung cancer was revised in 2018 and now contains a weak recommendation towards early detection of lung cancer with low-dose CT in a quality-assured early detection program. These new developments required a repositioning of the involved professional societies. This present joint statement describes main features of a quality-assured program for early detection of lung cancer with low-dose CT in Germany.


Assuntos
Detecção Precoce de Câncer , Neoplasias Pulmonares/diagnóstico por imagem , Proteção Radiológica/métodos , Proteção Radiológica/normas , Tomografia Computadorizada por Raios X/normas , Alemanha , Humanos , Guias de Prática Clínica como Assunto , Radiografia , Sociedades Médicas
8.
Free Radic Res ; 53(9-10): 1005-1013, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31514547

RESUMO

Pulse radiolysis was conducted to investigate: several fundamental reactions of a natural flavonoid, rutin, and its glycosylated form (αG-rutin) as a basis for their radiation protection properties; the reactions with •OH (radical scavenging) and dGMP radical, dGMP• (chemical repair), which was used as a model of initial and not yet stabilised damage on DNA. Three absorption peaks were commonly seen in the reactions of the flavonoids with •OH, showing that their reactive site is the common structure, i.e. aglycone. One among the three peaks was attributed to the flavonoid radical produced as a result of the removal of a hydrogen atom. The same peak was found in their reactions with dGMP•, showing that dGMP• is chemically repaired by obtaining a hydrogen atom supplied from the flavonoids. Such a spectral change due to the chemical repair was as clear as never reported. The rate constants of the chemical repair reaction were estimated as (9 ± 2)×108 M-1 s-1 and (6 ± 1)×108 M-1 s-1 for rutin and αG-rutin, respectively. The rate constants of the radical scavenging reactions towards •OH were estimated as (1.3 ± 0.3)×1010 M-1 s-1 and (1.0 ± 0.1)×1010 M-1 s-1 for rutin and αG-rutin, respectively. In addition, there was no obvious difference between rutin and αG-rutin, indicating that the glycosylation does not change early chemical reactions of rutin.


Assuntos
Radiólise de Impulso/métodos , Proteção Radiológica/métodos , Rutina/química , Flavonoides
10.
Environ Monit Assess ; 191(9): 560, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31407116

RESUMO

The possibility of disposing of fly ash (FA) and blast furnace slag (BFS), which are environmental wastes, by using them as substitutes in portland cement was examined in this study. Portland cement (CEM I), FA, BFS, CEN standard sand, and water were used in the production of mortars. Blended cements were obtained by substituting FA, BFS, and a mixture of FA and BFS (FABFS) at 5.0%, 10.0%, 15.0%, and 20.0% ratios in portland cement. Physical (Blaine area, density, initial and final setting time, and fineness), mechanical (flexural strength and compressive strength), radiation permeability (determination of linear absorption coefficient) and high-temperature experiments were performed on the FA, BFS, and FABFS samples. Mortar prism samples with a size of 40 × 40 × 160 mm were obtained using these cements. The samples were exposed to five temperatures: 20, 150, 300, 700, and 900 °C. Mortar samples kept at 20 °C were used as references. A total of 390 samples were studied under air cooling (spontaneous cooling at 20 ± 2 °C in laboratory environment). After the mortar samples reached at room temperature, flexural strength and compressive strength tests were carried out on the 28th and 90th days. The test results showed that FA, BFS, and FABFS can be used as pozzolanic additives in cement mortars both alone and together and can be applied in buildings with a high risk of fire up to certain temperature values. The sample with the highest linear absorption coefficient was the FABFS sample, and as the sample with the lowest radiation permeability, it was determined to be appropriate for use in buildings that are exposed to radiation effects.


Assuntos
Cinza de Carvão/análise , Materiais de Construção/análise , Poluentes Ambientais/análise , Eliminação de Resíduos/métodos , Resíduos Sólidos/análise , Carbono , Força Compressiva , Monitoramento Ambiental , Proteção Radiológica/métodos , Dióxido de Silício , Água
12.
Cancer Radiother ; 23(5): 449-465, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400956

RESUMO

Nowadays, ionizing radiations have numerous applications, especially in medicine for diagnosis and therapy. Pharmacological radioprotection aims at increasing detoxification of free radicals. Radiomitigation aims at improving survival and proliferation of damaged cells. Both strategies are essential research area, as non-contained radiation can lead to harmful effects. Some advances allowing the comprehension of normal tissue injury mechanisms, and the discovery of related predictive biomarkers, have led to developing several highly promising radioprotector or radiomitigator drugs. Next to these drugs, a growing interest does exist for biotherapy in this field, including gene therapy and cell therapy through mesenchymal stem cells. In this review article, we provide an overview of the management of radiation damages to healthy tissues via gene or cell therapy in the context of radiotherapy. The early management aims at preventing the occurrence of these damages before exposure or just after exposure. The late management offers promises in the reversion of constituted late damages following irradiation.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos/métodos , Terapia Genética/métodos , Lesões por Radiação/prevenção & controle , Proteção Radiológica/métodos , Amifostina/uso terapêutico , Animais , Antioxidantes/uso terapêutico , Ensaios Clínicos como Assunto , Fracionamento da Dose de Radiação , Edição de Genes , Vetores Genéticos/uso terapêutico , Proteínas de Choque Térmico/genética , Proteínas de Choque Térmico/uso terapêutico , Transplante de Células-Tronco Hematopoéticas , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Transplante de Células-Tronco Mesenquimais , Camundongos , Oxirredutases/genética , Oxirredutases/uso terapêutico , Lesões por Radiação/etiologia , Lesões por Radiação/terapia , Lesões Experimentais por Radiação/prevenção & controle , Lesões Experimentais por Radiação/terapia , Protetores contra Radiação/farmacologia , Protetores contra Radiação/uso terapêutico , Proteínas Recombinantes/genética , Proteínas Recombinantes/uso terapêutico , Fatores de Tempo
15.
Appl Radiat Isot ; 152: 115-126, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31295682

RESUMO

Compact Proton Therapy Centers, CPTC, have a single treatment room, and are technologically more affordable, smaller, advanced and easier to use. From a radiological protection point of view, the leading concern in CPTC are interactions of protons with components of the facility and patients that yield a broad emission of secondary particles, mainly high-energy neutrons, up to 230 MeV, and photons. Optimal design of shielding involves theoretical assumptions in the design phase and, consequently, experimental measurements with extended range neutron detectors must be carried out in the facility during the commissioning period to verify the design, assumptions and building of the enclosures. There are almost 50 CPTC under construction and planning around the world, hence the improvement of methodologies to verify the shielding and to evaluate the dose to workers and general public in CPTC is a trending issue. The aim of this work was to evaluate and compare the response of two commercial extended range REM meters, WENDI-II and LUPIN-II, for their application in shielding verification and radiation area monitoring in CPTC facilities, by estimating the ambient dose equivalent, H*(10), through the Monte Carlo code MCNP6. The results have been compared with previous works. Likewise, the performance evaluation of these devices in continuous energy neutron field have been carried out, using the AmBe/241 neutron source of the Neutronics Hall (NH) of the Neutron Measurements Laboratory of the Energy Engineering Department of Universidad Politecnica de Madrid (LMN-UPM), through Monte Carlo simulation with the MCNP6 code and experimental measurements. The work is framed into the project Contributions to Shielding and Dosimetry of Neutrons in CPTC.


Assuntos
Benchmarking , Dosímetros de Radiação/normas , Monitoramento de Radiação/métodos , Proteção Radiológica/métodos , Simulação por Computador , Humanos , Método de Monte Carlo , Nêutrons
16.
Br J Radiol ; 92(1102): 20190382, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31287739

RESUMO

OBJECTIVES: To measure leakage ambient dose equivalent H*(10) from stray secondary neutron and photon radiation around proton therapy (PT) facility and evaluate adequacy of shielding design. METHODS AND MATERIALS: H*(10) measurement were carried out at 149 locations around cyclotron vault (CV), beam transport system (BTS) and first treatment room (GTR3) of a multiroom PT facility using WENDI-II and SmartIon survey meter. Measurement were performed under extreme case scenarios wherein maximum secondary neutrons and photons were produced around CV, BTS and GTR3 by stopping 230MeV proton of 300nA on beam degrader, end of BTS and isocenter of GTR3. Weekly time average dose rate (TADR) were calculated from H*(10) value measured at selective hot spots by irradiating actual treatment plans of mix clinical sites. RESULTS: The maximum total H*(10) were within 2 µSv/hr around CV, 5 µSv/hr around outer wall of BTS which increases up to 62 µSv/hr at the end of inside BTS corridor. Maximum H*(10) of 20.8 µSv/hr in treatment control console (P125), 23.4 µSv/hr behind the common wall between GTR3 and GTR2 (P132) and 25.7 µSv/hr above isocenter (P99) were observed around GTR3. Reduction of beam current from 6 to 3 nA and 1 nA at nozzle exit lead to decrease in total H*(10) at P125 from 20.8 to 11.35 and 4.62 µSv/hr. In comparison to extreme case scenario, H*(10) value at P125, P132 and P99 from clinically relevant irradiation parameters were reduce by a factor ranging from 8.6 for high range cube to 46.4 for brain clinical plan. The maximum weekly TADR per fraction was highest for large volume, sacral chordoma patient at 8.5 µSv/hr compare to 0.3 µSv/hr for brain patient. The calculated weekly TADR for 30 mix clinical cases and 15 fractions of 1 L cube resulted total weekly TADR of 83-84 µSv/hr at P125, P132 and P99. The maximum annual dose level at these hot spots were estimated at 4.37 mSv/Yr. CONCLUSION: We have carried out an extensive measurement of H*(10) under different conditions. The shielding thickness of our PT facility is adequate to limit the dose to occupational worker and general public within the permissible stipulated limit. The data reported here can bridge the knowledge gap in ambient dose around PT facility and can also be used as a reference for any new and existing proton facility for intercomparison and validation. ADVANCES IN KNOWLEDGE: First extensive investigation of neutron and photon H*(10) around PT facility and can bridge the knowledge gap on ambient dose.


Assuntos
Ciclotrons , Ambiente de Instituições de Saúde , Nêutrons , Fótons , Terapia com Prótons/instrumentação , Monitoramento de Radiação/métodos , Monitoramento de Radiação/instrumentação , Proteção Radiológica/métodos , Radiometria/instrumentação , Radiometria/métodos , Espalhamento de Radiação
17.
Int J Radiat Biol ; 95(11): 1472-1483, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31290706

RESUMO

Purpose: This work investigates the effect of resveratrol and melatonin on structural and functional changes of two enzymes, lactate dehydrogenase (LDH) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH), exposed to radiation-induced reactive oxygen species.Materials and methods: Solutions of dehydrogenases with or without antioxidants (resveratrol or melatonin) were irradiated with X-rays under the atmosphere of air and at room temperature (21 ± 2 °C). In order to determine the protective effect of melatonin and resveratrol in radiation-induced damage to GAPDH and LDH spectroscopy and HPLC methods were used. Furthermore, plausible binding sites of melatonin or resveratrol to the GAPDH or LDH molecule were analysed.Results and conclusions: Resveratrol shows better protective properties in the inactivation of GAPDH when compared to melatonin. LDH does not contain ‒SH groups in its active site, and is not inactivated by water radiolysis products other than hydroxyl radicals or the secondary radicals of the studied low-molecular-weight compounds. Resveratrol and melatonin protected the structure of LDH to a greater extent than GAPDH. This difference can be attributed to the fact that LDH potentially binds more resveratrol or melatonin molecules (27 binding sites for resveratrol and 40 for melatonin) than GAPDH (10 binding sites for resveratrol and 18 for melatonin).


Assuntos
Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , L-Lactato Desidrogenase/metabolismo , Melatonina/administração & dosagem , Proteção Radiológica/métodos , Resveratrol/administração & dosagem , Ar , Animais , Antioxidantes/química , Domínio Catalítico , Cisteína/química , Relação Dose-Resposta à Radiação , Concentração de Íons de Hidrogênio , Cinética , Modelos Moleculares , Coelhos , Espécies Reativas de Oxigênio , Temperatura Ambiente , Raios X
18.
Health Phys ; 117(6): 656-660, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31348020

RESUMO

Occupational exposure to ionizing radiation from medical practices in China has been collected for a 7 y period between 2010 and 2016 from roughly 220 individual monitoring service providers through the Chinese Registry of Radiation Workers. Statistical dose distributions and characteristic tendencies are presented based on the evaluation in terms of six occupational categories. A reduction can be seen in average annual effective dose for interventional radiology, nuclear medicine, diagnostic radiology, radiotherapy, dental radiology, and others by 52%, 47%, 46%, 34%, 69%, and 31%, respectively, for the 7 y period. More than 94.5% of radiation workers received annual doses less than the public dose limit (1 mSv) in 2016. Workers engaged in nuclear medicine and interventional radiology activities were found to receive relatively more dose than the other fields of practice. Diagnostic radiology makes the dominant contribution of 68% to the collective effective dose of 73,641.3 person mSv received by 211,613 radiation workers in medical practices in 2016. The observation of workers in medical practices receiving well below the recommended occupational dose limit (20 mSv) could be a result of an improvement in radiation protection practices in the medical field in China. However, it is still necessary to control and manage the workplace and radiation workers to avoid unnecessary exposures, in particular for the workers engaged in nuclear medicine and interventional radiology activities.


Assuntos
Exposição Ocupacional/análise , Monitoramento de Radiação/métodos , Monitoramento de Radiação/estatística & dados numéricos , Proteção Radiológica/métodos , China , Humanos , Doses de Radiação
19.
Dentomaxillofac Radiol ; 48(7): 20190014, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31237774

RESUMO

The objective of this paper is to provide recommendations towards the appropriate use of thyroid shielding in dental cone beam CT (CBCT). Based on current evidence of thyroid radiosensitivity, dosimetric data in the presence and absence of shielding, and a depiction of potential adverse effects of thyroid shielding, a concise set of recommendations was prepared. According to current risk models, thyroid sensitivity is particularly high at a young age, and much higher for females. In the literature, involving adult male, female and paediatric reference phantoms, the use of a tightly fitted thyroid collar with a lead-equivalent thickness of at least 0.25 mm has consistently shown a significant reduction (average: 45.9%) of the equivalent dose to the thyroid. It can therefore be recommended that thyroid shielding should be routinely used for children undergoing CBCT scanning and is recommended for adults up to the age of 50. The increase of the X-ray tube current from automatic exposure control systems due to thyroid shielding can be avoided by placing the shielding collar after acquiring the scout images. Should real-time tube current modulation be implemented in dental CBCT imaging in the future, perspectives regarding the appropriate use of shielding may change according to current trends in CT. In view of the manifestation of metal artefacts, shielding is best avoided if radiological evaluation of tissues below the lower border of the mandible is needed.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Proteção Radiológica , Radiografia Dentária/métodos , Glândula Tireoide , Adolescente , Adulto , Criança , Pré-Escolar , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagens de Fantasmas , Doses de Radiação , Proteção Radiológica/métodos , Dosimetria Termoluminescente , Adulto Jovem
20.
Radiol Med ; 124(8): 777-782, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31104276

RESUMO

Radiotherapy is one of the primary treatment options in cancer management. Modern radiotherapy includes complex processes requiring many different kinds of expertise. Among them, knowledge and skills are needed in clinical oncology, radiobiology, radiotherapy planning and simulation, dose measurement and calculation, radiation safety and medical physics. Radiation oncologists should assume the full and final responsibility for treatment, follow-up and supportive care of the patient. For all these activities, radiation oncologist should coordinate and collaborate with a team including different professionals: nurses, radiographers (RTT), clinical engineers, information system experts, taking advantage in particular of the dosimetry expertise of the medical physicist. Radiation therapy is widely recognized to be one of the safest areas of modern medicine, and errors are very rare. However, radiation protection recommendations developed at national level should comply with the EURATOM Directive 2013/59. This paper describes several contemporary and emerging concerns related to radioprotection in radiation therapy including quality and safety in external beam radiotherapy and brachytherapy, foetal dose, secondary malignancies, and the safety issues related to the new techniques and treatment strategies.


Assuntos
Neoplasias/radioterapia , Exposição Ocupacional/prevenção & controle , Segurança do Paciente/normas , Exposição à Radiação/prevenção & controle , Proteção Radiológica/normas , Prevenção de Acidentes , Braquiterapia/efeitos adversos , Braquiterapia/métodos , Braquiterapia/normas , Criança , Competência Clínica , Feminino , Humanos , Oncologia/normas , Neoplasias Induzidas por Radiação/prevenção & controle , Gravidez , Proteção Radiológica/métodos , Radioterapia/efeitos adversos , Radioterapia/métodos , Radioterapia/normas , Risco , Gestão da Segurança
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