Objective： The purpose of this study was to present the dosimetric study and evaluation the dose delivered to the skin tumor by using diode detector with total skin electron therapy （TSET）. Methods： The total skin...Objective： The purpose of this study was to present the dosimetric study and evaluation the dose delivered to the skin tumor by using diode detector with total skin electron therapy （TSET）. Methods： The total skin electron irradiation （TSEI） technique was used to treat ten patients with histological confirmed mycosis fungoides according to the Stanford staging system at the Radiotherapy Department, National Cancer Institute, Cairo University, Egypt. High dose rate electron beams with low electron energy 5 MeV from a Siemens linear accelerator were used for treatment. Diodes were calibrated at TSET distance 300 cm and field size （35 × 35） cm^2. Results： The result of diodes measurements showed the dose to flat surface of the body was within ：1：10 % from the prescribed dose. Special areas of the body such as the perineum ＆ eyelid showed large deviation up to 30% variation from the prescription dose. Conclusion： The diode results of this study will be used as a quality assurance check for all new patients treated with TSET and to compare it to the prescribed dose delivered to the patients. It is recommends to evaluate the diodes measurements for all patients throughout the full treatment cycle and to identify individually the boost dose areas.展开更多
Purpose: To present a protocol of a dual-field rotational (DFR) total skin electron therapy (TSET) and to provide an assessment of clinical implementation, dosimetry properties, and skin dose evaluation. Methods and M...Purpose: To present a protocol of a dual-field rotational (DFR) total skin electron therapy (TSET) and to provide an assessment of clinical implementation, dosimetry properties, and skin dose evaluation. Methods and Materials: The DFR-TSET combined the Stanford 6-field and McGill rotational methods. Dual 6 MeV electron beams in high dose total skin electron mode were used for DFR-TSET on a commercial linac. Beam profiles and dosimetric properties were measured using solid phantoms. The dose rate at expanded source-to-surface distance (SSD) was a combination of static rate and rotational rate. In vivo dosimetry of patient skin was performed on patients’ skin using film, metal oxide semiconductor field-effect transistors (MOSFET), and optically stimulated luminescent dosimeters (OSLD). Results: Dual field rotational total skin electron therapy exhibited good (≤±10%) uniformity in the beam profiles in the vertical direction at an extended SSD of 332 cm with a gantry angulation of ±20˚ deviated from the horizontal direction. In-vivo measurements confirmed acceptable uniformity of the patients’ total body surfaces and revealed anatomically self-blocked or shielded areas where underdosing occurred. Conclusions: The clinical implementation of DFR-TSET effectively utilizes the special mode on a linac. This technique provides short beam-on times, uniform dose distribution, large treatment field, and reduced dose of x-ray contamination to the patients. In-vivo measurements indicate satisfactory delivery and dose uniformity of the prescribed dose. Electron boost fields are recommended at normal SSDs to address underdosed areas.展开更多
The treatment of advanced stage MF is especially challenging as single agent overall response rates are in the 35% range and chronic recurrence is the rule. The treatment of CTCL across all stages of disease is aimed ...The treatment of advanced stage MF is especially challenging as single agent overall response rates are in the 35% range and chronic recurrence is the rule. The treatment of CTCL across all stages of disease is aimed at the goal of achieving and sustaining remission. Increasingly, low dose total skin electron beam therapy (TSEBT) is being utilized as a skin directed component in combination therapy for advanced stage CTCL. Researchers are seeking to better define the utility of low dose TSEBT as a method of debulking skin disease while simultaneously treating other disease compartments and in combination with sustained maintenance therapies of both the skin directed and systemic varieties. Data exists showing the efficacy of low dose TSEBT in early and advanced disease. There is also data documenting prolonged treatment responses with TSEBT plus adjuvant skin directed therapies such as PUVA and topical nitrogen mustard. Emerging data examining the role of low dose TSEBT in the prestem cell transplant preparation is also promising. This brief review summarizes the utility of low dose TSEBT in multiagent treatment regimens in CTCL.展开更多
Total skin electron therapy (TSET) is used for the treatment of Mycosis Fungoides. Several tech-niques have been developed, in order to achieve homogeneous dose distribution over the complete body surface. To implemen...Total skin electron therapy (TSET) is used for the treatment of Mycosis Fungoides. Several tech-niques have been developed, in order to achieve homogeneous dose distribution over the complete body surface. To implement a TSET technique, one has to optimize a variety of parameters. Monte Carlo simulation of TSET can facilitate this optimization. The aim of this study was to commission and optimize a TSET technique using the 4 and 6 MeV electron and the high dose rate facility on the Elekta Precise accelerator. The EGS4nrc/BEAMnrc Monte Carlo code was used. The beam data were calculated and measured at two different scoring planes for a single beam. The Model was validated by comparing the simulation with measurements. Two different vertical angles were used to obtain a uniform dose. The angle was optimized for best dose uniformity. The Rando phantom is placed on a rotating platform and rotates 60 degrees apart to facilitate the six patient position orientations. The doses delivered in a phantom by complete treatment were measured with Kodak EDR2 films and TLDs. The dose distribution varied among various scanning directions by 2 - 3 mm and 3 - 4 mm for 4 and 6 MeV respectively. The composite percentage depth dose of all six dual fields for the 4 and 6 MeV yielded an R80 of ~4 mm and ~6 mm, respectively. Dose uniformity was ±6% for 4 MeV and ±5% for 6 MeV. The bremsstrahlung contamination was 0.9% - 1.3%. Good agreements were found with published literature and inline with international protocols.展开更多
Dear Editor,The Veterans Health Administration(VHA)plays a crucial role in the U.S.healthcare system,particularly for a population with a high prevalence of skin cancer[1].Timely total body skin examination(TBSE)is vi...Dear Editor,The Veterans Health Administration(VHA)plays a crucial role in the U.S.healthcare system,particularly for a population with a high prevalence of skin cancer[1].Timely total body skin examination(TBSE)is vital for managing cutaneous malignancies[2].Despite National Comprehensive Cancer Network(NCCN)guidelines advocating regular TBSE post-diagnosis[3].展开更多
Peach skin is a byproduct from the further processing of fresh peaches with the potential to be recovered and utilized as a natural antioxidant. Color analysis, phenolic content and antioxidant activity of peach skin ...Peach skin is a byproduct from the further processing of fresh peaches with the potential to be recovered and utilized as a natural antioxidant. Color analysis, phenolic content and antioxidant activity of peach skin from 13 varieties of peaches grown in South Carolina were determined. Color analysis indicated that Norman, Cary Mac, Ruby Prince and Flame Prince differed from other varieties of peaches. Antioxidant activity of peach skin extracts were evaluated by the total phenolics (TP), DPPH free radical scavenging (DPPH), ferric reducing antioxidant power (FRAP) and ferrous ion chelating (FIC) assays. The range of total phenolics content was 8.38 - 18.81 (gallic acid equivalent mg/g dry weight). The total phenolic content was highly correlated to DPPH and FRAP activity in peaches ranging from 8 - 23 AE/mg and 5 - 12 AE/mg, respectively. Three peach varieties with skins having the greatest antioxidant capacity were Red Globe, Scarlet Prince, and O’Henry.展开更多
Acid-soluble collagen was extracted from the skins of surf smelt and characterized. The yield of collagen was high about 24.0% on a dry weight basis. By SDS-polyacrylamide gel electrophoresis and CM-Toyopearl 650 M co...Acid-soluble collagen was extracted from the skins of surf smelt and characterized. The yield of collagen was high about 24.0% on a dry weight basis. By SDS-polyacrylamide gel electrophoresis and CM-Toyopearl 650 M column chromatography, this collagen is a heterotrimer with a chain composition of α1α2α3. The denaturation temperature was 32.5℃, about 4.5℃ lower than that from porcine skin. Attenuated total reflectance-fourier transform infrared analysis showed that the percentage of secondary structural components in this collagen were 11% α-helix, 34% β-sheet, 19% β-turn, and 21% others. It suggests that the triple helical structure is present in the acid-soluble collagen from the skins of the surf smelt in comparison to that from the skin of porcine.展开更多
文摘Objective： The purpose of this study was to present the dosimetric study and evaluation the dose delivered to the skin tumor by using diode detector with total skin electron therapy （TSET）. Methods： The total skin electron irradiation （TSEI） technique was used to treat ten patients with histological confirmed mycosis fungoides according to the Stanford staging system at the Radiotherapy Department, National Cancer Institute, Cairo University, Egypt. High dose rate electron beams with low electron energy 5 MeV from a Siemens linear accelerator were used for treatment. Diodes were calibrated at TSET distance 300 cm and field size （35 × 35） cm^2. Results： The result of diodes measurements showed the dose to flat surface of the body was within ：1：10 % from the prescribed dose. Special areas of the body such as the perineum ＆ eyelid showed large deviation up to 30% variation from the prescription dose. Conclusion： The diode results of this study will be used as a quality assurance check for all new patients treated with TSET and to compare it to the prescribed dose delivered to the patients. It is recommends to evaluate the diodes measurements for all patients throughout the full treatment cycle and to identify individually the boost dose areas.
文摘Purpose: To present a protocol of a dual-field rotational (DFR) total skin electron therapy (TSET) and to provide an assessment of clinical implementation, dosimetry properties, and skin dose evaluation. Methods and Materials: The DFR-TSET combined the Stanford 6-field and McGill rotational methods. Dual 6 MeV electron beams in high dose total skin electron mode were used for DFR-TSET on a commercial linac. Beam profiles and dosimetric properties were measured using solid phantoms. The dose rate at expanded source-to-surface distance (SSD) was a combination of static rate and rotational rate. In vivo dosimetry of patient skin was performed on patients’ skin using film, metal oxide semiconductor field-effect transistors (MOSFET), and optically stimulated luminescent dosimeters (OSLD). Results: Dual field rotational total skin electron therapy exhibited good (≤±10%) uniformity in the beam profiles in the vertical direction at an extended SSD of 332 cm with a gantry angulation of ±20˚ deviated from the horizontal direction. In-vivo measurements confirmed acceptable uniformity of the patients’ total body surfaces and revealed anatomically self-blocked or shielded areas where underdosing occurred. Conclusions: The clinical implementation of DFR-TSET effectively utilizes the special mode on a linac. This technique provides short beam-on times, uniform dose distribution, large treatment field, and reduced dose of x-ray contamination to the patients. In-vivo measurements indicate satisfactory delivery and dose uniformity of the prescribed dose. Electron boost fields are recommended at normal SSDs to address underdosed areas.
文摘The treatment of advanced stage MF is especially challenging as single agent overall response rates are in the 35% range and chronic recurrence is the rule. The treatment of CTCL across all stages of disease is aimed at the goal of achieving and sustaining remission. Increasingly, low dose total skin electron beam therapy (TSEBT) is being utilized as a skin directed component in combination therapy for advanced stage CTCL. Researchers are seeking to better define the utility of low dose TSEBT as a method of debulking skin disease while simultaneously treating other disease compartments and in combination with sustained maintenance therapies of both the skin directed and systemic varieties. Data exists showing the efficacy of low dose TSEBT in early and advanced disease. There is also data documenting prolonged treatment responses with TSEBT plus adjuvant skin directed therapies such as PUVA and topical nitrogen mustard. Emerging data examining the role of low dose TSEBT in the prestem cell transplant preparation is also promising. This brief review summarizes the utility of low dose TSEBT in multiagent treatment regimens in CTCL.
文摘Total skin electron therapy (TSET) is used for the treatment of Mycosis Fungoides. Several tech-niques have been developed, in order to achieve homogeneous dose distribution over the complete body surface. To implement a TSET technique, one has to optimize a variety of parameters. Monte Carlo simulation of TSET can facilitate this optimization. The aim of this study was to commission and optimize a TSET technique using the 4 and 6 MeV electron and the high dose rate facility on the Elekta Precise accelerator. The EGS4nrc/BEAMnrc Monte Carlo code was used. The beam data were calculated and measured at two different scoring planes for a single beam. The Model was validated by comparing the simulation with measurements. Two different vertical angles were used to obtain a uniform dose. The angle was optimized for best dose uniformity. The Rando phantom is placed on a rotating platform and rotates 60 degrees apart to facilitate the six patient position orientations. The doses delivered in a phantom by complete treatment were measured with Kodak EDR2 films and TLDs. The dose distribution varied among various scanning directions by 2 - 3 mm and 3 - 4 mm for 4 and 6 MeV respectively. The composite percentage depth dose of all six dual fields for the 4 and 6 MeV yielded an R80 of ~4 mm and ~6 mm, respectively. Dose uniformity was ±6% for 4 MeV and ±5% for 6 MeV. The bremsstrahlung contamination was 0.9% - 1.3%. Good agreements were found with published literature and inline with international protocols.
文摘Dear Editor,The Veterans Health Administration(VHA)plays a crucial role in the U.S.healthcare system,particularly for a population with a high prevalence of skin cancer[1].Timely total body skin examination(TBSE)is vital for managing cutaneous malignancies[2].Despite National Comprehensive Cancer Network(NCCN)guidelines advocating regular TBSE post-diagnosis[3].
文摘Peach skin is a byproduct from the further processing of fresh peaches with the potential to be recovered and utilized as a natural antioxidant. Color analysis, phenolic content and antioxidant activity of peach skin from 13 varieties of peaches grown in South Carolina were determined. Color analysis indicated that Norman, Cary Mac, Ruby Prince and Flame Prince differed from other varieties of peaches. Antioxidant activity of peach skin extracts were evaluated by the total phenolics (TP), DPPH free radical scavenging (DPPH), ferric reducing antioxidant power (FRAP) and ferrous ion chelating (FIC) assays. The range of total phenolics content was 8.38 - 18.81 (gallic acid equivalent mg/g dry weight). The total phenolic content was highly correlated to DPPH and FRAP activity in peaches ranging from 8 - 23 AE/mg and 5 - 12 AE/mg, respectively. Three peach varieties with skins having the greatest antioxidant capacity were Red Globe, Scarlet Prince, and O’Henry.
文摘Acid-soluble collagen was extracted from the skins of surf smelt and characterized. The yield of collagen was high about 24.0% on a dry weight basis. By SDS-polyacrylamide gel electrophoresis and CM-Toyopearl 650 M column chromatography, this collagen is a heterotrimer with a chain composition of α1α2α3. The denaturation temperature was 32.5℃, about 4.5℃ lower than that from porcine skin. Attenuated total reflectance-fourier transform infrared analysis showed that the percentage of secondary structural components in this collagen were 11% α-helix, 34% β-sheet, 19% β-turn, and 21% others. It suggests that the triple helical structure is present in the acid-soluble collagen from the skins of the surf smelt in comparison to that from the skin of porcine.
文摘目的探究肝细胞生长因子(hepatocyte growth factor,HGF)通过靶向转化生长因子-β1/Sma和Mad相关蛋白(transforming growth factor-β1/Sma-Mad-related protein,TGF-β1/Smad)信号通路促进全层皮肤缺损大鼠创面愈合的影响及机制。方法自2021年1—6月,六盘水市人民医院(德坞院区)烧伤整形美容外科通过建立全层皮肤缺损大鼠模型,将大鼠模型分为模型组(24只)、全层皮肤缺损+HGF组(23只);正常大鼠作为对照组(26只)。对比各组大鼠不同时间创面愈合情况,愈合率,组织形态学变化,HGF m RNA表达水平,不同时间血流强度,炎症因子[白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-4(interleukin-4,IL-4)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因-α(tumor necrosis factor-α,TNF-α)、白细胞介素-10(interleukin-10,IL-10)]表达水平,不同时间血管内皮细胞增殖能力及TGF-β1/Smad蛋白表达水平。并利用双荧光素酶报告基因实验验证HGF和TGF-β1/Smad的靶向关系。结果与对照组相比,模型组HGF m RNA、IL-10水平降低,IL-1β、TGF-β1 m RNA表达、血管内皮细胞增殖(12 h、24 h)、p-Smad、IL-4、Smad mRNA表达、IL-6、TGF-β1、TNF-α表达水平升高;全层皮肤缺损+HGF组血管内皮细胞增殖(12 h、24 h)、IL-10、HGF m RNA表达水平升高,IL-1β、Smad m RNA、IL-6、TGF-β1、p-Smad、IL-4、TGF-β1 m RNA、TNF-α表达水平降低,差异具有统计学意义(P<0.05)。与模型组相比,全层皮肤缺损+HGF组创面愈合率(7 d、14 d、21 d)、IL-10、血流强度(伤后7 d、10 d、14 d)、HGF m RNA表达、血管内皮细胞增殖(12 h、24 h)水平升高,IL-4、IL-6、Smad m RNA、TGF-β1 mRNA、TNF-α、IL-1β表达水平降低,差异具有统计学意义(P<0.05)。双荧光素酶报告基因结果显示,与HGF-mimic共转染后,TGF-β1-3'-UTR-WT组的相对荧光酶活性比TGF-β1-3'UTR-MUT组下降,差异有统计学意义(P<0.05)。结论HGF通过抑制TGF-β1/Smad信号通路,促进创面血管内皮细胞增殖,降低创面炎症反应水平,增加血流强度,从而促进创面愈合。
