To evaluate the setup accuracy of surface-guided radiation therapy (SGRT) compared with traditional skin marks in patients undergoing hypofractionated whole breast irradiation, with a specific focus on our institution's practice of full eliminating skin marks from the computed tomography (CT) simulation. We retrospectively reviewed 184 breast cancer patients treated with hypofractionated whole breast irradiation between January 2022 and May 2023. Initial patient positioning was performed using either traditional skin marks (n = 93, 1488 sessions) or surface-guidance technology via AlignRT (n = 91, 1456 sessions). The setup accuracy was evaluated by analyzing translational couch shifts in vertical, longitudinal, and lateral directions through daily verification using orthogonal kV images in anterior-posterior and lateral directions obtained after initial positioning. The time from initial patient positioning to treatment was also compared. The average translational couch shifts after initial positioning with skin marks were 3.2 ± 1.8 mm, 3.3 ± 1.5 mm, and 2.8 ± 1.4 mm in the vertical, longitudinal, and lateral directions, respectively. For SGRT, the average translational couch shifts were 3.5 ± 1.5 mm, 3.3 ± 1.4 mm, and 2.8 ± 1.2 mm, respectively. There were no significant differences between SGRT and skin marks in any direction. The average time from initial patient positioning to treatment was shorter in patients with SGRT compared to those with skin marks, 261 s vs. 281 s. The elimination of skin marks from the CT simulation stage, facilitated by SGRT, resulted in comparable setup accuracy with traditional skin marks. In addition, SGRT significantly reduced the time from initial patient positioning to treatment, suggesting that SGRT can be effectively used in hypofractionated whole breast irradiation without the need for skin marks, potentially enhancing patient comfort and convenience.

This study aimed to investigate unwanted radiation exposure of radiosensitive organs during computed tomography (CT) scans of the hand. Furthermore, we investigated the effectiveness of a shield in reducing unwanted radiation exposure. In a prospective observational study, the patients were randomized to receive a shield during the hand CT scan. Two group of patients were further randomized to undergo multi-detector CT (MDCT) or cone-beam CT (CBCT). The radiation dose was measured in the target point and the nearest skin surface of radiosensitive organs by attached the thermoluminescent dosemeter chips. When shielding was performed, the radiation doses had decreased significantly with a mean of 79% (65-91%) in the MDCT group and 88.6% (85-93%) in the CBCT group. In the non-shielded group, the radiation doses to the radiosensitive organs decreased inversely with increasing distance, which means that the closer the target point is, the more unwanted radiation exposure increases. It is important to keep radiosensitive organs as far as possible from the target point during CT scan. In particular, it is necessary to shield the radiosensitive organs closer to the target point. Level of Evidence: Level II, Prospective observational study.

To evaluate the setup accuracy of surface-guided radiation therapy (SGRT) compared with traditional skin marks in patients undergoing hypofractionated whole breast irradiation, with a specific focus on our institution's practice of full eliminating skin marks from the computed tomography (CT) simulation. We retrospectively reviewed 184 breast cancer patients treated with hypofractionated whole breast irradiation between January 2022 and May 2023. Initial patient positioning was performed using either traditional skin marks (n = 93, 1488 sessions) or surface-guidance technology via AlignRT (n = 91, 1456 sessions). The setup accuracy was evaluated by analyzing translational couch shifts in vertical, longitudinal, and lateral directions through daily verification using orthogonal kV images in anterior-posterior and lateral directions obtained after initial positioning. The time from initial patient positioning to treatment was also compared. The average translational couch shifts after initial positioning with skin marks were 3.2 ± 1.8 mm, 3.3 ± 1.5 mm, and 2.8 ± 1.4 mm in the vertical, longitudinal, and lateral directions, respectively. For SGRT, the average translational couch shifts were 3.5 ± 1.5 mm, 3.3 ± 1.4 mm, and 2.8 ± 1.2 mm, respectively. There were no significant differences between SGRT and skin marks in any direction. The average time from initial patient positioning to treatment was shorter in patients with SGRT compared to those with skin marks, 261 s vs. 281 s. The elimination of skin marks from the CT simulation stage, facilitated by SGRT, resulted in comparable setup accuracy with traditional skin marks. In addition, SGRT significantly reduced the time from initial patient positioning to treatment, suggesting that SGRT can be effectively used in hypofractionated whole breast irradiation without the need for skin marks, potentially enhancing patient comfort and convenience.

This study aimed to investigate unwanted radiation exposure of radiosensitive organs during computed tomography (CT) scans of the hand. Furthermore, we investigated the effectiveness of a shield in reducing unwanted radiation exposure. In a prospective observational study, the patients were randomized to receive a shield during the hand CT scan. Two group of patients were further randomized to undergo multi-detector CT (MDCT) or cone-beam CT (CBCT). The radiation dose was measured in the target point and the nearest skin surface of radiosensitive organs by attached the thermoluminescent dosemeter chips. When shielding was performed, the radiation doses had decreased significantly with a mean of 79% (65-91%) in the MDCT group and 88.6% (85-93%) in the CBCT group. In the non-shielded group, the radiation doses to the radiosensitive organs decreased inversely with increasing distance, which means that the closer the target point is, the more unwanted radiation exposure increases. It is important to keep radiosensitive organs as far as possible from the target point during CT scan. In particular, it is necessary to shield the radiosensitive organs closer to the target point. Level of Evidence: Level II, Prospective observational study.

The 3%/3 mm criteria were not strict enough to identify any discrepancies between planned and measured doses, and DVH deviations were less than 2% in most parameters. Therefore, gamma criteria of 2%/2 mm and DVH related parameters could be a useful tool for pretreatment verification for VMAT in prostate cancer.

The present study aimed to identify the mechanisms underlying the increase in vascular permeability in mouse skin following irradiation. The left ears of C3H mice were subjected to 2 and 15 Gy of radiation in a single exposure. At 24 h after irradiation, the ears were excised and tissue sections were stained with toluidine blue to assess mast cell degranulation. Vascular endothelial growth factor (VEGF) expression was assessed via immunohistochemistry and western blotting. Approximately 5% (3%-14%) (mean [95% CI]) of mast cells in the skin of control mice were degranulated; moreover, at 24 h after 2 Gy irradiation, this value increased to approximately 20% (17%-28%). Mast cell degranulation by 15 Gy irradiation (32% [24%-40%]) was greater than that by 2 Gy irradiation. Significant differences were observed in mast cell degranulation among the control, 2 Gy and 15 Gy groups (p = 0.012). Furthermore, VEGF-positive reactions were observed in the cytoplasm of scattered fibroblasts in the dermis. In immunohistochemistry tests, VEGF expression at 24 h after irradiation increased slightly in the 2 Gy group compared to that in the control group, whereas no difference in VEGF expression was observed in the 15 Gy group compared to that in the control group. Expression of VEGF in western blots was consistent with that in immunohistochemistry. In conclusion, mast cell degranulation was increased in mouse skin at 24 h after irradiation in a dose-dependent manner. In contrast, VEGF expression was slightly increased following only low-dose (2 Gy) irradiation.

The T3N0 NSCLC subtype that showed the most favorable prognosis is the one with endobronchial tumors within 2 cm of the carina. Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.

Purpose We evaluated the prognostic significance of T3 subtypes and the role of adjuvant radiotherapy in patients with resected the American Joint Committee on Cancer stage IIB T3N0M0 non-small cell lung cancer (NSCLC).

Cisplatin has been mainly used for lung-cancer,. However, cisplatin has many side effects, so the usage of cisplatin has a limitation. Recently, autophagy has become an important mechanism of cell death. The purpose of this study was to determine whether low dose cisplatin treated lung cancer cell induce autophagy and the autophagy inhibition resulted in apoptosis or necrosis. H460 cells were treated with 5 μM or 20 μM cisplatin for 12, 24, or 48 h. To detect the cisplatin-induced autophagy, we examined the autophagic vacuoles, and LC3 localization. To confirm the low-dose of cisplatin could induce autophagy, we detectd acidic vesicle using autophagy specific inhibitors(3-MA). To confirm the result of autophagy inhibition, we had done Annexin-V/PI and cell cycle assay. To find out the cisplatin mediated autophagic mechanisms, we examined the apoptotic regulator, p53. We used p53-/- null cancer cell line, H1299, to prove the role of p53 during autophagy. Low dose of cisplatin(5 μM) induced the autophagy after 24 h treatment in H460. Also low dose of cisplatin showed autophagic vacuoles and cytoplasmic LC3 formation in H460. The induction of autophagy by low dose cisplatin was inhibited by 3-MA, which was proven by reduced acidic vesicles. When the autohpagy inhibited, Annexin-V+/PI- and subG1 was an increased. The inhibition of autophagy resulted in decrease of LC3B-II band. Also cleaved caspase-3 and PARP were increased. Taken together, low dose cisplatin induced autophagy and the inhibition of autophagy resulted in the apoptosis.

Abstract Cisplatin has been mainly used for lung-cancer. However, cisplatin has many side effects, so the usage of cisplatin has a limitation. Recently, autophagy has become an important mechanism of cell death. The purpose of this study was to determine whether low dose cisplatin treated lung cancer cell induce autophagy and the autophagy inhibition resulted in apoptosis or necrosis. H460 cells were treated with 5 μM or 20 μM cisplatin for 12, 24, or 48 h. To detect the cisplatin-induced autophagy, we examined the autophagic vacuoles, and LC3 localization. To confirm the low-dose of cisplatin could induce autophagy, we detectd acidic vesicle using autophagy specific inhibitors(3-MA). To confirm the result of autophagy inhibition, we had done Annexin-V/PI and cell cycle assay. To find out the cisplatin mediated autophagic mechanisms, we examined the apoptotic regulator, p53. We used p53-/- null cancer cell line, H1299, to prove the role of p53 during autophagy. Low dose of cisplatin(5 μM) induced the autophagy after 24 h treatment in H460. Also low dose of cisplatin showed autophagic vacuoles and cytoplasmic LC3 formation in H460. The induction of autophagy by low dose cisplatin was inhibited by 3-MA, which was proven by reduced acidic vesicles. When the autohpagy inhibited, Annexin-V+/PI- and subG1 was an increased. The inhibition of autophagy resulted in decrease of LC3B-II band. Also cleaved caspase-3 and PARP were increased. Taken together, low dose cisplatin induced autophagy and the inhibition of autophagy resulted in the apoptosis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2271. doi:1538-7445.AM2012-2271