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The influence of dose uncertainty on the assessment of radiation risks of non-cancer mortality among Russian participants in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant 剂量不确定性对评估清理切尔诺贝利核电站事故后果的俄罗斯参与者非癌症死亡率的辐射风险的影响
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-2-21-35
S. Chekin, M. Maksioutov, V. Kashcheev, S. Karpenko, K. Tumanov, A. M. Korelo, E. Kochergina, N. S. Zelenskaya, O. E. Lashkova, N. V. Shchukina, V. Ivanov
Currently, the system of standards and rules of radiation protection considers the need to con-straint the absorbed radiation doses in order to prevent the development of deterministic effects of ionizing radiation on humans. Deterministic effects in terms of mortality include bone marrow syndrome with a dose threshold of 1 Gy, gastrointestinal syndrome and pneumonitis with dose thresholds of 6 Gy. For inclusion in international radiation safety standards, a threshold of 0.5 Gy for cardiovascular and cerebrovascular diseases is being discussed. The wide experience of ra-diation-epidemiological studies shows that the deterministic effects of mortality are not limited to those effects that are currently considered in the system of standards and rules of radiation pro-tection. This paper presents estimates of radiation risks of mortality from diseases of the circula-tory system (CSD) and the digestive system, as well as dose thresholds corresponding to these effects, in the Russian cohort of liquidators of the Chernobyl accident registered in the National Radiation and Epidemiological Register (NRER), who have registered doses from external whole-body exposure to gamma radiation within 1 Gy. The risks were estimated over the follow-up peri-od 1986-2020. The stability of estimated radiation risks of mortality from CSD and from the di-gestive system diseases in relation to the uncertainty of personal doses received by liquidators has been studied. The absorbed doses received by 11% of the liquidators were estimated from the data of personal dosimeters, the maximum error was about 50%. For the remaining 89% of liquidators, group and route doses were registered, and the maximum uncertainty of individual doses was about 500%. For CSD mortality, the excess relative rates per 1 Gy (ERR/Gy) were 0.361 and 0.349, excluding and considering dose uncertainties, respectively. For mortality from diseases of the digestive system, ERR/Gy=0,791 excluding dose uncertainty and ERR/Gy=0,726 with considering dose uncertainty. Uncertainties in individual dose estimates result in 5% and 8% reductions in ERR/Gy estimates (for CSD mortality and digestive disease, respectively). This re-duction in risk estimates is not related to a bias in the dose estimates. It is caused by the statistical properties of radiation risk models in conventional radiation epidemiology. If the excessive mor-tality from the studied causes is attributed to deterministic effects, then the estimates of the corre-sponding dose thresholds, considering the uncertainty of individual doses, also increase quite slightly: for CSD – from 0,028 Gy to 0,029 Gy, and for diseases of the digestive system – from 0,013 Gy to 0,014 Gy. The obtained results confirm the high stability and validity of radiation risk assessments of non-oncological diseases obtained earlier from the doses of Russian partici-pants in the liquidation of the consequences of the Chernobyl accident registered in the unified federal database o
目前,辐射防护标准和规则体系考虑到有必要限制吸收的辐射剂量,以防止电离辐射对人类产生决定性影响。死亡率方面的决定性影响包括剂量阈值为1戈瑞的骨髓综合征、剂量阈值为6戈瑞的胃肠综合征和肺炎。目前正在讨论将0.5 Gy的心脑血管疾病阈值纳入国际辐射安全标准。辐射流行病学研究的广泛经验表明,死亡率的决定性影响并不局限于辐射防护标准和规则系统目前所考虑的那些影响。本文介绍了在国家辐射和流行病学登记册(NRER)中登记的俄罗斯切尔诺贝利事故清理者队列中因循环系统(CSD)和消化系统疾病而死亡的辐射风险的估计,以及与这些影响相对应的剂量阈值,这些人已登记了1 Gy以内的外部γ辐射照射剂量。这些风险是在1986-2020年随访期间估计的。已经研究了CSD和消化系统疾病死亡的估计辐射风险的稳定性与清算者个人接受剂量的不确定性之间的关系。11%的清理者接受的吸收剂量是根据个人剂量计数据估算的,最大误差约为50%。对于其余89%的清除者,登记了组剂量和路线剂量,个体剂量的最大不确定性约为500%。对于CSD死亡率,排除并考虑剂量不确定性后,每1 Gy的过量相对死亡率(ERR/Gy)分别为0.361和0.349。对于消化系统疾病的死亡率,不考虑剂量不确定性的ERR/Gy= 0.791,考虑剂量不确定性的ERR/Gy= 0.726。个体剂量估计值的不确定性导致ERR/Gy估计值降低5%和8%(分别针对CSD死亡率和消化系统疾病)。这种风险估计值的降低与剂量估计值的偏差无关。这是由于传统辐射流行病学中辐射风险模型的统计特性造成的。如果所研究原因造成的过高死亡率归因于确定性效应,那么考虑到个体剂量的不确定性,相应剂量阈值的估计值也会略有增加:对于CSD,从0.028戈瑞增至0.029戈瑞,对于消化系统疾病,从0.013戈瑞增至0.014戈瑞。所取得的结果证实,先前从登记在国家核研究委员会统一联邦数据库中的清理切尔诺贝利事故后果的俄罗斯参与者的剂量中获得的非肿瘤疾病辐射风险评估具有高度的稳定性和有效性。
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引用次数: 0
Fast neutrons irradiation as a way to overcome feline squamous cell carcinoma radioresistance: a pilot study 快中子辐照作为克服猫鳞状细胞癌放射抗性的一种方法:一项初步研究
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-1-115-126
M. Rodionov, S. Koryakin, V. Saburov, A. Moiseev, Y. Petrova, P. Shegay, S. A. Ivanov, A. Kaprin
For the study 4 cats with unresectable oral squamous cell carcinoma were treated with combina-tion of neutron and electron radiations. 3 cats had T2b and one had T3b stage. The first phase of treatment was performed with 14 MeV fast neutron beam, fraction dose varied from 1.0 to 1.3 Gy, 3 fractions a week, 3-5 fractions in total; in the second phase the animals were irradiated with 10 MeV electron beam, using same fractionation, fraction dose varied from 4 Gy, up to total dose of 8-36 Gy. In the course of treatment, most cats had partial or complete anorexia, the duration of which did not exceed two days, it was well controlled by antidepressants (mirtazapinum). Visual assessment and computed tomography performed from 13 to 30 days after treatment comple-tion demonstrated showed the significant regression of tumor volume (30-67%) in all cases. 3 out of 4 animals were alive at the time of the study, average follow-up period was 84 days, maximum follow-up period was 160 days. Radiation damage was limited to local alopecia followed by leu-kotrichia.
本研究对4只不可切除的口腔鳞状细胞癌猫进行了中子和电子联合放射治疗。3只猫患有T2b, 1只猫患有T3b期。第一期治疗采用14mev快中子束,分次剂量1.0 ~ 1.3 Gy,每周3次,共3 ~ 5次;第二阶段用10兆电子伏特的电子束照射动物,采用相同的分级,分级剂量从4 Gy到8-36 Gy不等。在治疗过程中,大多数猫出现部分或完全厌食症,持续时间不超过2天,抗抑郁药(米氮平)控制良好。治疗结束后13至30天进行的视觉评估和计算机断层扫描显示,所有病例的肿瘤体积均显著缩小(30-67%)。研究时4只动物中有3只存活,平均随访84天,最长随访160天。辐射损伤仅限于局部秃发,其次为浅色斑秃。
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引用次数: 0
Antitumor effect of photodynamic therapy with photosensitizer Photoran E6 on melanoma B-16 and response of mouse peripheral blood to PDT 光敏剂Photoran E6光动力疗法对黑色素瘤B-16的抗肿瘤作用及小鼠外周血对PDT的反应
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-3-77-86
O. Abramova, V. V. Drozhzhina, E. A. Kozlovtseva, T. P. Sivovolova, A. Kaprin
Photodynamic therapy (PDT) is the effective method for the total eradication of some types of solid malignant neoplasms. The paper presents results of research on the effectiveness of PDT of the melanoma B-16 with the intraperitoneally injected novel Russian photosensitizer (PS) "Photoran E6". To assess the response of melanoma to PDT, the following indicators were used: tumor growth inhibition index (TGI,%), tumor regression rate (%), absolute tumor growth rate (K) in mice with continued neoplasia growth. To assess the proportion of peripheral blood cells and their morphological characteristics the therapy efficiency integrated health indicators were used: increase in life expectancy (ILE,%) of mice under study in comparison with the control and the proportion of cured animals on the 90th day after PDT. The results of the study demonstrate high antitumor efficacy of Photoran E6 for PDT of mouse melanoma. The observed changes in hemogram parameters and in leukocyte indices also indicate the effectiveness of the therapy, changes in the control samples indicate the spread of the malignant process, proliferative processes, impaired normal regeneration of blood elements, severe intoxication that cause destruction and degeneration of blood cells and drastic changes in the course of immune response.
光动力疗法(PDT)是彻底根除某些类型实体恶性肿瘤的有效方法。本文介绍了新型俄罗斯光敏剂(PS)腹腔注射治疗黑色素瘤B-16的疗效研究结果。“Photoran E6”。为了评估黑色素瘤对PDT的反应,采用以下指标:肿瘤生长抑制指数(TGI,%)、肿瘤消退率(%)、肿瘤持续生长小鼠的绝对肿瘤生长速率(K)。为了评估外周血细胞的比例及其形态特征,采用治疗效率综合健康指标:PDT后第90天,与对照组相比,研究小鼠的预期寿命增加(ILE,%)和治愈动物的比例。本研究结果表明,Photoran E6对小鼠黑色素瘤PDT具有较高的抗肿瘤作用。观察到的血象参数和白细胞指数的变化也表明治疗的有效性,对照样本的变化表明恶性过程的扩散、增殖过程、血液元素的正常再生受损、导致血细胞破坏和变性的严重中毒以及免疫反应过程的剧烈变化。
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引用次数: 0
Photodynamic therapy in dystrophic diseases of the vulva 外阴营养不良疾病的光动力治疗
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-3-121-130
N. A. Arutyunyan, S. N. Katsalap, V.F. Khmelevskaya, A. I. Alekhin
Dystrophic diseases of the vulva (DDV) are a group of diseases that have not been fully studied and are characterized by pain, itching, dyspareunia, dysuria, which significantly reduce the quality of life of patients, leading to vegetative-vascular and neurological disorders. Despite many different approaches, the problem of treating vulvar DDV remains unresolved, and among clinicians there is no single approach to treatment, which was the basis for studying the effectiveness of photodynamic therapy (PDT) with local application of a photosensitizer in patients with DDV. As part of the study, 35 patients with DDV were examined and treated. REVIXAN-DERMA gel was used as a photosensitizer, irradiation of the vulva was carried out using a medical laser device "LAMI" with a wavelength of 660 nm. One month after PDT of the vulva, we noted a clinical recovery in 70% of patients (no complaints), a normal vulvoscopic picture was observed in 60% of patients – epithelialization of cracks and erosions, restoration of the thickness of the epithelium, restoration of normal skin pattern, in the remaining 40% patients – epithelization of cracks and erosions, a decrease in the area of damage, restoration of the thickness of the epithelium was noted, in 70% of patients the cytogram was within the normal range, cells with signs of intraepithelial changes and malignancy were not found, in 30% of patients – a small number of horny scales, cells with signs of intraepithelial changes and malignancy were not found. During the PDT procedure of the vulva, no complications or side effects were registered. Thus, the results of the study after the use of PDT of the vulva with local application of the photosensitizer REVIXAN-DERMA gel indicate the effectiveness, safety and prospects of the method in the treatment of degenerative diseases of the vulva.
外阴营养不良疾病(dystrotrophic diseases of the vulva, DDV)是一类尚未得到充分研究的疾病,以疼痛、瘙痒、性交困难、排尿困难为特征,显著降低患者的生活质量,导致植物血管和神经系统疾病。尽管有许多不同的方法,治疗外阴DDV的问题仍然没有解决,临床医生没有单一的治疗方法,这是研究光动力疗法(PDT)局部应用光敏剂治疗DDV患者有效性的基础。作为研究的一部分,35名DDV患者接受了检查和治疗。采用revxan - derma凝胶作为光敏剂,使用波长为660 nm的医用激光装置“LAMI”照射外阴。外阴PDT一个月后,我们发现70%的患者临床恢复(无主诉),60%的患者观察到正常的外阴镜图像-裂缝和糜烂上皮化,上皮厚度恢复,正常皮肤模式恢复,其余40%的患者-裂缝和糜烂上皮化,损伤面积减少,上皮厚度恢复。70%的患者细胞图在正常范围内,未发现有上皮内改变和恶性肿瘤征象的细胞,30%的患者有少量角质鳞片,未发现有上皮内改变和恶性肿瘤征象的细胞。在外阴PDT手术过程中,无并发症和副作用记录。因此,外阴PDT局部应用光敏剂revxan - derma凝胶后的研究结果表明了该方法治疗外阴退行性疾病的有效性、安全性和前景。
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引用次数: 2
Intracavitary «in vivo» dosimetry at the high dose rate brachytherapy in oncogynecology 高剂量率近距离放疗在妇科肿瘤中的腔内“体内”剂量测定
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-4-119-131
V. Bogacheva, V. Stepanenko, L. Krikunova, A. Petukhov, G. Kulieva, T.V. Kolyshenkov, E. Zharova, V. A. Korotkov, S. A. Ivanov, P. Shegay, A. Kaprin
The technology for construction and application of flexible dosimetric assemblies with LiF:Mg,Ti microcrystals (sizes of about 0.1 mm) for off-line measurements of the spatial distribution of the absorbed dose inside organs at risk (rectum, urethra, vagina) at high dose rate brachytherapy in oncoginecology has been developed. The transfer from the usage of luminescent dosimeters LiF:Mg,Ti with macro sizes (more than 1 mm) to microdosimetrs with sizes of about 0.1 mm, in combination with the developed protocols of dose estimations using mini-aliquots (10 mg) of lu-minescent microdosimeters, provided possibility to increase the accuracy of dose measurements in the therapeutic dose range at high dose rate brachytherapy of gynecological malignancies. The developed technology of intracavitary dosimetry at a high dose rate brachytherapy (Ir-129 source) in oncogynecology was tested in the clinic (25 patients). It was found that, as a rule, the measured doses were in a good agreement with the calculated doses in the areas of interest. However, in four cases (16% of all patients) there was an excess of the measured local absorbed doses over the calculated ones (from 0.6 to 1 Gy) in the urethra and rectum (in the organs of maximum calculated doses). These cases may be considered as a basis for monitoring of the patients’ condition in the post-therapeutic period. However, the values of maximal dose were within acceptable dose range, as recommended by GEC-ESTRO. The developed technology of «in vivo» dosimetry allows to adjust the dosimetrical plans at multifractional high dose rate brachytherapy. The results of clinical approbation of the developed technology of «in vivo» dosimetry show the importance of this technology as an essential element of dosimetric assurance of the quality of high dose rate brachytherapy in oncogynecology.
利用LiF:Mg,Ti微晶体(尺寸约为0.1 mm)构建和应用柔性剂量计组件的技术,用于离线测量肿瘤生态学中高剂量率近距离放射治疗中危险器官(直肠、尿道、阴道)内吸收剂量的空间分布。从使用宏观尺寸(大于1mm)的发光剂量计LiF:Mg,Ti转变为使用约0.1 mm尺寸的微剂量计,结合使用小当量(10mg)发光微剂量计的剂量估计方案,为提高高剂量率近距离妇科恶性肿瘤治疗剂量范围内剂量测量的准确性提供了可能。在妇科肿瘤的高剂量率近距离放射治疗(Ir-129源)中发展的腔内剂量测定技术在临床(25例患者)中进行了测试。结果发现,在有关地区,通常测量的剂量与计算的剂量是完全一致的。然而,在4例(占所有患者的16%)中,尿道和直肠(最大计算剂量的器官)的测量局部吸收剂量超过计算剂量(从0.6 Gy到1 Gy)。这些病例可作为治疗后患者病情监测的基础。然而,最大剂量值在可接受的剂量范围内,根据GEC-ESTRO推荐。发达的“体内”剂量测定技术允许在多段式高剂量率近距离治疗中调整剂量测量计划。“体内”剂量测定技术的临床批准结果表明,该技术作为保证妇科肿瘤近距离高剂量率放射治疗质量的剂量测定基本要素的重要性。
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引用次数: 0
Using the unified model for calculating energy absorbed fractions from incorporated emitters of monoenergetic electrons and photons in bio-objects composed from various materials 用统一的模型计算由不同材料组成的生物物体中单能电子和光子结合发射体的能量吸收分数
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-4-148-160
T. Sazykina
A technique was developed to extending the methodology of analytical estimations of absorbed fractions to the case of spherical bio-objects composed from various materials. The internal source of exposure was emitter of monoenergetic photons or electrons uniformly distributed throughout the object’s volume. Analytical results were tested, using published sets of Monte Carlo data on spheres composed from bone tissues, lung tissues, soft muscle tissues and water. Existence of ‘universal curves’ for rescaled absorbed fractions, which combine Monte Carlo data on various materials was confirmed for monoenergetic electrons and photons. Analytical results are in adequate agreement with Monte Carlo data on each biomaterial. Advantage of the unified method is the express calculating of radiation absorbed fractions without employing complicated Monte Carlo codes, and numerous interpolating procedures. The extension of the methodology to various materials provides new opportunities for internal dosimetry of living organisms, including assessment of doses to different organs and tissues.
发展了一种技术,将吸收分数的分析估计方法扩展到由各种材料组成的球形生物物体的情况。内部曝光源是单能量光子或电子的发射器,均匀分布在整个物体的体积上。分析结果进行测试,使用公布的蒙特卡罗数据集,由骨组织、肺组织、软肌肉组织和水组成的球体。在单能电子和光子中,重新标度吸收分数的“通用曲线”的存在,结合了各种材料的蒙特卡罗数据。每种生物材料的分析结果与蒙特卡罗数据完全一致。统一方法的优点是不需要使用复杂的蒙特卡罗代码和大量的插值程序,就可以快速计算辐射吸收分数。将该方法扩展到各种材料,为生物体的内部剂量学提供了新的机会,包括评估对不同器官和组织的剂量。
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引用次数: 0
Comparison assessment of the potential radiation hazard of tailing dumps in the Sughd region of Tajikistan 塔吉克斯坦苏格德地区尾矿库潜在辐射危害的比较评价
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-2-118-127
U. Mirsaidov, K. Nazarov, M. M. Makhmudova, S. Murodov, K. A. Ermatov, M. Akhmedov
The global environmental changes have been observed since the nineties of the twentieth centu-ry. The current environmental situation is caused mainly due to the intensive human activity. Dur-ing 46 years, from 1945 to 1991, radioactive waste from uranium processing was accumulated in the Sughd region in Tajikistan, the former USSR Republic. According to various estimates the to-tal amount of accumulated radioactivity varies from 240 to 285 TBq. The tailings are the major sources of environmental pollution, they contain emanating gas, aerosols, dust and filterable solutions. The purpose of the work is to conduct comparison assessment of the potential radiation hazard of “Digmai” and “Adrasman” tailing dumps and Istiklol-city in the Sughd region and to estimate radiological risks to the population living near the tailing dumps. For radon monitoring both integral and instantaneous measurements were used. For instant measurements of radon volu-metric activity the PPA-01M-03 LLC “HTM-Protection” (Russia) raidometer was used. The back-ground radiation in the area under study was measured with Dosimeters DKS-96 “Dose” (Rus-sia), DKS-AT1123 “Atomtech” (Belarus), MKS-AT6130 “Atomtech” (Belarus) and PackEye FHT complex-1377 “Thermo” (Germany). The paper presents data on comparison assessment of po-tential hazard of radioactive tailing dumps in the Sughd area. The impact of uranium tailing dumps on radioecological situation in the Sughd region, as well as in cities and districts of the Sughd region was assessed. The most unfavorable radioecological situation in the Sughd region is in areas with the ambient dose equivalent power (MAED)>0.35-0.40 μSv/h. The coordinates of the areas location coincide with coordinates of the radioactive tailing dumps Istiklol-city and Gaziyeon (“Digmai”) location, and their adjacent territories. According to comparison assessment, the tailing dumps “Digmai” and “Factory of Poor Ores” (Istiklol-city) are potentially the most haz-ardous facilities. It means that for radioecological safety of the environment and the population, it is recommended to carry out cleaning and remediation of the tailing dumps as a priority: «Dig-mai» and «Factory of poor ores».
自二十世纪九十年代以来,全球环境的变化已经被观察到。目前的环境状况主要是由于人类活动的密集造成的。在1945年至1991年的46年期间,铀加工产生的放射性废料积聚在前苏联共和国塔吉克斯坦的苏格德地区。根据各种估计,累积的放射性总量在240至285 TBq之间。尾矿是环境污染的主要来源,它们含有排放气体、气溶胶、粉尘和可过滤溶液。本研究的目的是对苏格德地区“迪格迈”和“阿德拉斯曼”尾矿库与伊斯蒂克廖尔市的潜在辐射危害进行比较评估,并估计尾矿库附近居民的辐射风险。氡监测采用积分测量和瞬时测量两种方法。对于氡体积活度的即时测量,使用PPA-01M-03 LLC“HTM-Protection”(俄罗斯)辐射计。使用剂量计DKS-96“Dose”(俄罗斯)、DKS-AT1123“Atomtech”(白俄罗斯)、MKS-AT6130“Atomtech”(白俄罗斯)和PackEye FHT复合物-1377“Thermo”(德国)测量了研究区域的本背景辐射。本文介绍了苏格德地区放射性尾矿库潜在危害的比较评价资料。评价了铀尾矿堆积场对苏格地区以及苏格地区各城市和地区放射性生态状况的影响。环境剂量当量功率(MAED)为0.35 ~ 0.40 μSv/h的区域是苏德地区最不利的辐射生态状况。该地区位置的坐标与放射性尾矿堆放场的坐标相一致,istiklol市和Gaziyeon(“Digmai”)的位置及其邻近领土。根据比较评价,“迪格迈”尾矿库和“贫矿厂”(Istiklol-city)是潜在危害最大的设施。这意味着,为了环境和人口的放射性生态安全,建议优先进行尾矿堆积场的清理和修复:“迪麦”和“贫矿厂”。
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引用次数: 0
Optimization of radiotherapy combined course for rectal cancer 直肠癌放疗联合疗程的优化
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-2-128-136
A. Grigorieva, A. Bulavskaya, T. A. Nguyen, S. Stuchebrov, Z. Startseva, V. Velikaya, N. Turgunova, I. Miloichikova
Due to the new rapidly developed technological equipment for radiotherapy available in cancer clinics, the study of the optimal combination of topometric preparation of a patient with planning and the delivery of treatment in order to achieve the main goal of radiation therapy – maximum exposure of the foci with minimal damage to healthy tissue. The reduction of dose to critical or-gans and healthy tissues in general is an important and urgent task. The purpose of the paper is to explore the possibility of optimization of the combined radiation therapy in patients with rectal cancer, with account of advanced approaches to topometric preparation of a patient and dosime-try planning. Six patients 47-59 years of age, with the stage III of the lower ampullary rectal can-cer, received two-phase pre-operative combined radiotherapy at the Tomsk Cancer Research In-stitute NMRC. The Phase 1 – distant radiation therapy delivery in standard mode with a single fo-cal dose (ROD) of 2 Gy, 5 times a week, totally 20 fractions, to focal dose (SOD) of 40 Gy. The Phase 2 – intracavitary radiation therapy, ROD – 3 Gy, SOD – 15 Gy, locally in the tumor area, 2 times a week, total number – 5 fractions. The conventional radiation therapy planning was carried out with the use of the XiO 3-D dosimetry planning system for the "Theratron Equinox 80" (radia-tion of the isotope Co-60, Egamma=1.25 MeV), gamma-therapeutic apparatus, and for the SL75-5-MT (Electron braking radiation, E=6 MeV) linear accelerator. For conformal radial therapy the plan-ning system for linear accelerator «Elekta Synergy» (electron brake radiation, E=6 MeV) is used. For intracavitary radiotherapy the dosimetry planning system HDRPlus for the apparatus "Multi-Source" (radiation of isotope Co-60, Egamma=1.25 MeV) is used. Radiation doses to critical organs of pa-tients with lower ampullary rectal cancer exposed to combined course of radiotherapy was calculated. It has been shown that the use of advanced techniques for pretreatment topometric preparation of a patient and dosimetry planning makes possible optimization of combined radiotherapy with account of radiation doses to critical organs.
由于癌症诊所放射治疗的新技术设备的快速发展,为了实现放射治疗的主要目标-最大限度地暴露病灶,对健康组织的损害最小,研究患者的地形测量准备与计划和治疗交付的最佳组合。总的来说,减少对关键器官和健康组织的剂量是一项重要而紧迫的任务。本文的目的是探讨优化直肠癌患者联合放射治疗的可能性,考虑到患者的地形测量准备和剂量计划的先进方法。6例47-59岁的下壶腹直肠癌III期患者在托木斯克癌症研究所NMRC接受了两期术前联合放疗。第一阶段-远距离放射治疗以标准模式递送,单局剂量(ROD)为2gy,每周5次,共20次,至局剂量(SOD)为40gy。2期腔内放疗,ROD - 3gy, SOD - 15gy,局部肿瘤区放疗,每周2次,总次数- 5次。使用XiO三维剂量计系统对“Theratron Equinox 80”(同位素Co-60辐射,Egamma=1.25 MeV)、伽玛治疗仪和SL75-5-MT(电子制动辐射,E=6 MeV)直线加速器进行常规放射治疗计划。对于适形放射治疗,使用线性加速器«Elekta Synergy»(电子制动辐射,E=6 MeV)的规划系统。腔内放疗使用“多源”(同位素Co-60辐射,Egamma=1.25 MeV)仪器的剂量计规划系统HDRPlus。计算下壶腹直肠癌患者在联合放疗过程中对关键器官的辐射剂量。研究表明,使用先进的技术对患者进行预处理,地形测量准备和剂量计计划,可以优化联合放疗,并考虑对关键器官的辐射剂量。
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引用次数: 1
Hyperfractionated irradiation for early laryngeal cancer 高分割放射治疗早期喉癌
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-1-127-135
A. V. Semenov, K. Gordon, Rozhnov
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引用次数: 0
Endovascular implantation of a stent graft into the aorta in a hybrid operating room using a modern mobile X-ray C-arm: a clinical case 在混合手术室使用现代移动x线c臂血管内支架植入主动脉:一例临床病例
Pub Date : 2022-01-01 DOI: 10.21870/0131-3878-2022-31-2-111-117
E. Charchyan, S. Abugov, R. S. Polyakov, V. G. Sorokin, V. Garbuzov, K. Kotenko
Thanks to the development of modern mobile imaging devices, the treatment of such a serious pa-thology as aortic aneurysm has become more accessible. Thoracic aortic aneurysms are the most common pathology of the thoracic aorta. It occurs with increasing frequency (10 cases per 100,000 people per year). The most common cause of the disease is atherosclerosis. To date, the treat-ment of this serious pathology has become more accessible due to the development of modern mobile imaging devices. As compared to stationary devices, the portable devices for angiography of the latest generation are movable and can be moved from site to site quickly and easily they produce high quality angiograms, the system can be accessible to any health-care institutions. The paper presents the first in Russia successful case of endoprosthetics of the thoracic aorta using mobile C-arm RFD Ziehm Vision. A 75-year-old man was found to have a symptomatic thoracic aortic aneurysm up to 67 mm in diameter, complicated by intramural (1.2 cm thick) and periaortic hematomas and compression atelectasis of the lower lobe of the left lung. The patient underwent prosthetics of the root, ascending part and arch of the aorta with a 30x8 (mm) synthetic prosthesis and intraoperative stenting of the descending thoracic aorta on a mobile C-arm. Our clinical expe-rience shows that difficult hybrid interventions can be successful if they are carried out in a surgical operating room with the use of a high-power C-arm with angiography function. This approach al-lows specialists to obtain image of required quality, with low exposure of a patient to ionizing radia-tion. The method can be used in the absence of stationary angiographs.
由于现代移动成像设备的发展,治疗像主动脉瘤这样严重的病理变得更加容易。胸主动脉瘤是最常见的胸主动脉病变。它的发生频率越来越高(每年每10万人中有10例)。最常见的病因是动脉粥样硬化。迄今为止,由于现代移动成像设备的发展,这种严重病理的治疗变得更容易获得。与固定设备相比,最新一代的便携式血管造影设备是可移动的,可以快速轻松地从一个站点移动到另一个站点,它们可以产生高质量的血管造影,任何医疗机构都可以使用该系统。本文介绍了俄罗斯第一个使用移动c臂RFD Ziehm Vision的胸主动脉内假体的成功案例。一位75岁男性被发现有症状性胸主动脉瘤,直径达67毫米,并发左肺下叶壁内(1.2厘米厚)和主动脉周围血肿和压迫性肺不张。患者采用30x8 (mm)人工假体对主动脉根、升段和弓进行假体修复,术中在移动c型臂上置入胸降主动脉支架。我们的临床经验表明,如果在外科手术室使用具有血管造影功能的高倍率c型臂进行困难的混合干预,可以取得成功。这种方法使专家能够获得所需质量的图像,患者暴露于电离辐射的程度很低。该方法可以在没有固定血管造影的情况下使用。
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"Radiation and Risk" Bulletin of the National Radiation and Epidemiological Registry
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