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Flexible electronic device requires a novel micro-supercapacitors (MSCs) energy conversion-storage system based on two-dimensional (2D) materials to solve the problems of stiffness and complexity. Herein, we report a novel catalytic introduction method of graphene with adjustable porosity by high-energy photon beam. The graphene/Ti3C2Txheterostructure was constructed by electrostatic self-assembly, has a high cycle life (98% after 8000 cycles), energy density (11.02 mWh cm-3), and demonstrate excellent flexible alternating current line-filtering performance. The phase angle of -79.8° at 120 Hz and a resistance-capacitance constant of 0.068 ms. Furthermore, the porous graphene/Ti3C2Txstructures produced by multiple catalytic inductions allowed ions to deeply penetrate the electrode, thereby increasing the stacking density. The special 'pore-layer nesting' graphene structure with adjustable pores effectively increased the specific surface area, and its superior matching with electrolyte solutions greatly improved surface-active site utilization. This work offers an alternative strategy for fabricating a 2D heterostructure for an MSC.

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A 3D-printed bolus is being developed to deliver accurate doses to superficial cancers. In this study, flexible thermoplastic filaments, specifically PLA, TPU, PETG, and HIPS, were fabricated into boluses and then compared to commercial bolus for the variation of the dose elevation region of photon beams. The experimental results indicate that the maximum dose depth is similar, and the consistent trend of the percentage depth dose confirms the potential usage as a build-up bolus.

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BACKGROUND: The immuno-modulatory effects of ionizing radiation are well-known and preclinical studies suggest a synergistic effect of combining radiotherapy (RT) and IO. However, data regarding the clinical activity and safety of this approach are limited. METHODS: We present the cases of two patients with SCCHN primary progressing to PDL1-based IO within a clinical trial (NCT03383094), that received subsequent but not concurrent palliative RT using two different modalities (electron beam and photon beam therapies). RESULTS: Both patients achieved major and durable responses at 4 irradiated sites, with excellent tolerance and no grade ≥ 3 toxicities. Complete response occurred in 3 of the disease areas (all locoregional) and partial response in 1 metastatic lesion. CONCLUSION: Palliative radiotherapy after progression to IO was safe and demonstrated profound and durable responses in the cases presented.

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BACKGROUND: Central nervous system (CNS) tumours account for around 25% of childhood neoplasms. With multi-modal therapy, 5-year survival is at around 75% in the UK. Conventional photon radiotherapy has made significant contributions to survival, but can be associated with long-term side effects. Proton beam radiotherapy (PBT) reduces the volume of irradiated tissue outside the tumour target volume which may potentially reduce toxicity. Our aim was to assess the effectiveness and safety of PBT and make recommendations for future research for this evolving treatment. METHODS: A systematic review assessing the effects of PBT for treating CNS tumours in children/young adults was undertaken using methods recommended by Cochrane and reported using PRISMA guidelines. Any study design was included where clinical and toxicity outcomes were reported. Searches were to May 2021, with a narrative synthesis employed. RESULTS: Thirty-one case series studies involving 1731 patients from 10 PBT centres were included. Eleven studies involved children with medulloblastoma / primitive neuroectodermal tumours (n = 712), five ependymoma (n = 398), four atypical teratoid/rhabdoid tumour (n = 72), six craniopharyngioma (n = 272), three low-grade gliomas (n = 233), one germ cell tumours (n = 22) and one pineoblastoma (n = 22). Clinical outcomes were the most frequently reported with overall survival values ranging from 100 to 28% depending on the tumour type. Endocrine outcomes were the most frequently reported toxicity outcomes with quality of life the least reported. CONCLUSIONS: This review highlights areas of uncertainty in this research area. A well-defined, well-funded research agenda is needed to best maximise the potential of PBT. SYSTEMATIC REVIEW REGISTRATION: PROSPERO-CRD42016036802.

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OBJECTIVE: It seems that dose rate (DR) and photon beam energy (PBE) may influence the sensitivity and response of polymer gel dosimeters. In the current project, the sensitivity and response dependence of optimized PASSAG gel dosimeter (OPGD) on DR and PBE were assessed. MATERIALS AND METHODS: We fabricated the OPGD and the gel samples were irradiated with various DRs and PBEs. Then, the sensitivity and response (R2) of OPGD were obtained by MRI at various doses and post-irradiation times. RESULTS: Our analysis showed that the sensitivity and response of OPGD are not affected by the evaluated DRs and PBEs. It was also found that the dose resolution values of OPGD ranged from 9 to 33 cGy and 12 to 34 cGy for the evaluated DRs and PBEs, respectively. Additionally, the data demonstrated that the sensitivity and response dependence of OPGD on DR and PBE do not vary over various times after the irradiation. CONCLUSIONS: The findings of this research project revealed that the sensitivity and response dependence of OPGD are independent of DR and PBE.

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BACKGROUND: Plastic scintillating detectors (PSD) have gained popularity due to small size and are ideally suited in small-field dosimetry due to no correction needed and hence detector reading can be compared to dose. Likewise, these detectors are active and water equivalent. A new PSD from Blue Physics is characterized in photon beam. PURPOSE: Innovation in small-field dosimetry detector has led us to examine Blue Physics PSD (BP-PSD) for use in photon beams from linear accelerator. METHODS: BP-PSD was acquired and its characteristics were evaluated in photon beams from a Varian TrueBeam. Data were collected in a 3D water tank. Standard parameters; dose, dose rate, energy, angular dependence and temperature dependence were studied. Depth dose, profiles and output in a reference condition as well as small fields were measured. RESULTS: BP-PSD is versatile and provides data very similar to an ion chamber when Cerenkov radiation is properly accounted. This device measures data pulse by pulse which very few detectors can perform. The differences between ion chamber data and PSD are < 2% in most cases. The angular dependence is a bit pronounces to 1.5% which is due to PSD housing. Depth dose and profiles are comparable within < 1% to an ion chamber. For small fields this detector provides suitable field output factor compared to other detectors and Monte Carlo (MC) simulated data without any added correction factor. CONCLUSIONS: The characteristics of Blue Physics PSD is uniquely suitable in photon beam and more so in small fields. The data are reproducible compared to ion chamber for most parameters and ideally suitable for small-field dosimetry without any correction factor.

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Objective:To calibrate the absorbed doses of the configured ray water with different gears of energies in accelerator based on<The use of plane-parallel ionization chambers in high-energy electron and photon beams>of International Atomic Energy Agency(IAEA)277 and 381 reports,so as to ensure the accuracy of the output dose of the linear accelerator during clinical radiotherapy.Methods:Elekta Infinity linear accelerator was used in this study,and the photon beam energies were respectively 6MV flattening filter(FF)mode and 6MV flattening filter free(FFF)mode.The electron beam energies were respectively 4,6,8,10,12 and 15MeV.According to the IAEA TRS277 and TRS381 reports,the calibrations of output doses in photon and electron beam waters were performed respectively by using the PTW dosimeter,PTW30013 finger type of ionization chamber and PTW34001 parallel plate ionization chamber.The error of each step was analyzed,and the accuracies of the calibrations of using different standards for the output waters of linear accelerator were compared.Results:The output amounts of photon beams of FF mode and FFF mode of 6MV at the maximum dose point in water were respectively 1.003 and 1.008cGy/MU.The output amounts of the energy of each gear of electron beams of 4,6,8,10,12 and 15MeV at the maximum dose point in water were respectively 1.003,1.002,0.998,0.999,1.000 and 1.003 cGy/MU.The calibration of the output of each gear of energy rays at the maximum dose point in water was 1cCy corresponded to 1MU,which error was less than 1%.Conclusion:The calibration for the output dose amount of accelerator in water on the basis of IAEA TRS277 and trs381 can ensure the accuracy of the output dose of the accelerator.

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BACKGROUND: This study was to examine the depth dose enhancement in orthovoltage nanoparticle-enhanced radiotherapy for skin treatment by investigating the impact of various photon beam energies, nanoparticle materials, and nanoparticle concentrations. METHODS: A water phantom was utilized, and different nanoparticle materials (gold, platinum, iodine, silver, iron oxide) were added to determine the depth doses through Monte Carlo simulation. The clinical 105 kVp and 220 kVp photon beams were used to compute the depth doses of the phantom at different nanoparticle concentrations (ranging from 3 mg/mL to 40 mg/mL). The dose enhancement ratio (DER), which represents the ratio of the dose with nanoparticles to the dose without nanoparticles at the same depth in the phantom, was calculated to determine the dose enhancement. RESULTS: The study found that gold nanoparticles outperformed the other nanoparticle materials, with a maximum DER value of 3.77 at a concentration of 40 mg/mL. Iron oxide nanoparticles exhibited the lowest DER value, equal to 1, when compared to other nanoparticles. Additionally, the DER value increased with higher nanoparticle concentrations and lower photon beam energy. CONCLUSIONS: It is concluded in this study that gold nanoparticles are the most effective in enhancing the depth dose in orthovoltage nanoparticle-enhanced skin therapy. Furthermore, the results suggest that increasing nanoparticle concentration and decreasing photon beam energy lead to increased dose enhancement.

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PURPOSE: This study evaluated the properties of a scintillation sheet-based dosimetry system for beam monitoring with high spatial resolution, including the effects of this system on the treatment beam. The dosimetric characteristics and feasibility of this system for clinical use were also evaluated. METHODS: The effects of the dosimetry system on the beam were evaluated by measuring the percentage depth doses, dose profiles, and transmission factors. Fifteen treatment plans were created, and the influence of the dosimetry system on these clinical treatment plans was evaluated. The performance of the system was assessed by determining signal linearity, dose rate dependence, and reproducibility. The feasibility of the system for clinical use was evaluated by comparing intensity distributions with reference intensity distributions verified by quality assurance. RESULTS: The spatial resolution of the dosimetry system was found to be 0.43 mm/pixel when projected to the isocenter plane. The dosimetry system attenuated the intensity of 6 MV beams by about 1.1%, without affecting the percentage depth doses and dose profiles. The response of the dosimetry system was linear, independent of the dose rate used in the clinic, and reproducible. Comparison of intensity distributions of evaluation treatment fields with reference intensity distributions showed that the 1%/1 mm average gamma passing rate was 99.6%. CONCLUSIONS: The dosimetry system did not significantly alter the beam characteristics, indicating that the system could be implemented by using only a transmission factor. The dosimetry system is clinically suitable for monitoring treatment beam delivery with higher spatial resolution than other transmission detectors.

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In this study, ion recombination correction factor (kS) and beam quality conversion factor ( [Formula: see text] ) values were extracted following the recommendations of the TRS-398 and TG-51 dosimetry protocols for widely used cylindrical ionization chambers for high energy photon beam dosimetry to quantify the agreement between the instructions for these two protocols for absolute dosimetry inside water. Four different types of cylindrical ionization chambers comprising Farmer (TM30013), Semiflex 0.125 cm3 (TM31010), Semiflex 0.3 cm3 (TM31013), and PinPoint (TM31016) were considered, and kS and [Formula: see text] values were determined at photon energies of 6 MV and 15 MV. The maximum difference between the measured kS values according to the instructions in the TRS-398 and TG-51 protocols was 0.03%. The kS data measured with both protocols agreed well with those measured by using the Jaffe-plot approach, where the maximum difference was about 0.33%. The observed differences between the [Formula: see text] factors measured by using the TRS-398 and TG-51 dosimetry protocols at photon energies of 6 MV and 15 MV were 0.37% and 0.55%, respectively. The [Formula: see text] values measured using the TG-51 dosimetry protocols were slightly closer to those measured by a reference ionization chamber dosimeter. We conclude that the maximum differences were about 0.4% and 0.6% in the absorbed dose measurements according to the TRS-398 and TG-51 instructions at photon energies of 6 MV and 15 MV, respectively. The type of ionization chamber employed also affected the differences, where the maximum and minimum dose differences were found using the Farmer and PinPoint chambers, respectively.

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With the complexity and high demands on quality assurance (QA) of photon beam radiation therapy, end-to-end (E2E) QA is necessary to validate the entire treatment workflow from pre-treatment imaging to beam delivery. A polymer gel dosimeter is a promising tool for three-dimensional (3D) dose distribution measurement. The purpose of this study is to design a fast "one delivery" polymethyl methacrylate (PMMA) phantom with a polymer gel dosimeter for the E2E QA test of the photon beam. The one delivery phantom is composed of ten calibration cuvettes for the calibration curve measurement, two 10 cm gel dosimeter inserts for the dose distribution measurement, and three 5.5 cm gel dosimeters for the square field measurement. The one delivery phantom holder is comparable in size and shape to that of a human thorax and abdomen. In addition, an anthropomorphic head phantom was employed to measure the patient-specific dose distribution of a VMAT plan. The E2E dosimetry was verified by undertaking the whole RT procedure (immobilization, CT simulation, treatment planning, phantom set-up, imaged-guided registration, and beam delivery). The calibration curve, field size, and patient-specific dose were measured with a polymer gel dosimeter. The positioning error can be mitigated with the one-delivery PMMA phantom holder. The delivered dose measured with a polymer gel dosimeter was compared with the planned dose. The gamma passing rate is 86.64% with the MAGAT-f gel dosimeter. The results ascertain the feasibility of the one delivery phantom with a polymer gel dosimeter for a photon beam in E2E QA. The QA time can be reduced with the designed one delivery phantom.

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Radiation therapy is one of the most effective tools in cancer therapy. However, success varies individually, necessitating improved understanding of radiobiology. Three-dimensional (3D) tumor spheroids are increasingly gaining attention, being a superior in vitro cancer model compared to 2D cell cultures. This in vitro study aimed at comparing radiation responses in 2D and 3D cell culture models of different human cancer cell lines (PC-3, LNCaP and T-47D) irradiated with varying doses (1, 2, 4, 6, 8 or 20 Gy) of X-ray beams. Radiation response was analyzed by growth analysis, various cell viability assays (e.g., clonogenic assay, resazurin assay) and amount of DNA damage (γH2AX Western Blot). Results showed decreasing cell proliferation with the increase of radiation doses for all cell lines in monolayers and spheroids of LNCaP and T-47D. However, significantly lower radiosensitivity was detected in spheroids, most pronounced in PC-3, evincing radiation resistance of PC-3 spheroids up to 8 Gy and significant growth inhibition only by a dose escalation of 20 Gy. Cell line comparison showed highest radiosensitivity in LNCaP, followed by T-47D and PC-3 in 2D, whereas, in 3D, T-47D showed highest sensitivity. The results substantiate the significant differences in radiobiological response to X-rays between 2D and 3D cell culture models.

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The study aimed to evaluate the planning characteristics of spinal stereotactic body radiotherapy (SBRT) using mono- and dual-isocentric volumetrically modulated arc therapy (VMAT) techniques. The dosimetric indices were compared between different beam arrangement techniques for spinal SBRT planning, including spinal cord avoidance, planning target volume (PTV) dose coverage, conformity, homogeneity, and gradient index. A total of 8 PTVs were contoured on RANDO phantom computed tomography (CT) images, with 4 PTVs per section of the spine (thoracic and lumbar). VMAT plans for each PTV were generated using 4 different beam arrangement techniques with a 6-MV FFF photon beam, two of which were mono-isocentric (MI) and 2 of which were dual-isocentric (DI). Dose calculations for all plans were performed using the Acuros XB algorithm. The study found that when non-contiguous spinal lesions are widely spaced, it may be more effective to use 4-Arcs DI to generate a better homogeneity index and gradient index, whereas 2-Arcs MI was beneficial for closely spaced lesions. Furthermore, the use of more arcs with a dual isocenter reduced the volume of partial cord receiving 10 Gy (V10Gy), maximum dose to 0.03 cc of partial cord (D0.03cc), and monitor units (MUs). The results showed that DI has a higher plan quality than MI for treating non-contiguous spine SBRT, with better homogeneity and a lower dose to the spinal cord, as well as comparable tumor coverage, delivery accuracy, and adequate tumour coverage. 4-Arcs DI had the sharpest dose falloff and achieved the lowest overall spinal cord doses at the expense of twice the treatment time as 2Arcs-MI. These results could help figure out which VMAT beam arrangements are best for treating non-contiguous spinal tumors.

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PURPOSE: Multi-axis ionization chamber arrays can be used for quality assurance (QA) and measurement of linear accelerator (linac) specific data. In this work, the ability of the IC Profiler (Sun Nuclear Corp., Melbourne, Florida) detector array to measure the photon beam quality specifier %dd(10) x $_\textrm {{\it x}}$ and TPR20, 10 was investigated. To investigate the method for beam energy QA using a two-dimensional detector array, a Monte Carlo-based model of the detector array was developed and validated. METHODS: A Monte Carlo-based model of the IC Profiler detector array with Quad Wedge accessories was developed in detail from drawings provided by the manufacturer using the egs++ class library from the EGSnrc code system. Monte Carlo simulations were used to calculate the absorbed dose in the 251 ionization chambers of the IC profiler in the 6 MV Elekta Precise radiation field. To validate the results from the Monte Caro simulations, measurements were performed on clinical 6 MV linacs. To vary the photon beam quality of the Elekta 6 MV linac, the current of the bending magnet was varied. Furthermore, the area ratio A R $AR$ was calculated from IC Profiler measurements with the Quad Wedge accessories. RESULTS: Measurements as well as Monte Carlo simulations confirmed the linear relationship between the area ratio A R $AR$ and the investigated photon beam quality specifier %dd(10) x $_\textrm {{\it x}}$ and TPR20, 10 for the investigated radiation source. Furthermore, the Monte Carlo-simulated data were within the 95% confidence interval of the linear fit to the measured data. This enabled the Monte Carlo-based IC Profiler model to be used for further investigations. The A R $AR$ values were calculated for various electron beam sizes and the angle of incidence on the target of the linac. CONCLUSIONS: A Monte-Carlo-based model of the detector array was developed, which could successfully reproduce measurements, demonstrating that even very complex geometries can be modeled in EGSnrc. Moreover, the study showed that the validated Monte Carlo model has the potential to investigate variations in beam parameters and their effects on AR ratios and %dd(10) x $_\textrm {{\it x}}$ that may not be investigated experimentally. While these findings may help users gain a deeper understanding of the QA method, the Monte Carlo model enables other complex investigations, such as the simulation of measurements in the presence of magnetic fields, or the simulation of measurements on novel treatment delivery techniques and devices.

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Purpose: Modern Linacs are equipped with multiple photon energies for radiation therapy, and proper energy is chosen for each case based on tumor characteristics and patient anatomy. The aim of this study is to investigate whether it is necessary to have more than two photons energies. Methods: The principle of photon energy synthesis is presented. It is shown that a photon beam of any intermediate energy (Esyn) can be synthesized from a linear combination of a low energy (Elow) and a high energy (Ehigh). The principle is validated on a wide range of scenarios: different intermediate photon energies on the same Linac; between Linacs from the same manufacturer or different manufacturers; open and wedge beams; and extensive photon energies available from published reference data. In addition, 3D dose distributions in water phantom are compared using Gamma analysis. The method is further demonstrated in clinical cases of various tumor sites and multiple treatment modalities. Experimental measurements are performed for IMRT plans and they are analyzed using the standard clinical protocol. Results: The synthesis coefficients vary with energy and field size. The root mean square error (RMSE) is within 1.1% for open and wedge fields. Excellent agreement was observed for British Journal of Radiology (BJR) data with an average RMSE of 0.11%. The 3D Gamma analysis shows a good match for all field sizes in the water phantom and all treatment modalities for the five clinical cases. The minimum gamma passing rate of 95.7% was achieved at 1%/1mm criteria for two measured dose distributions of IMRT plans. Conclusion: A Linac with two photon energies is capable of producing dosimetrically equivalent plans of any energy in-between through the photon energy synthesis, supporting the notion that there is no need to equip more than two photon energies on each Linac. This can significantly reduce the cost of equipment for radiation therapy.

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PURPOSE: This phantom study investigated through Monte Carlo simulation how the dose enhancement varied with depth, when gold nanoparticles (NPs) were added using the flattening filter-free (FFF) photon beams in gold NP-enhanced radiotherapy. METHOD: A phantom with materials varying from pure water to a mixture of water and gold NPs at different concentrations (3-40 mg/mL) were irradiated by the 6 and 10 MV flattening filter (FF) and FFF photon beams. Monte Carlo simulations were carried out to determine the depth doses along the central beam axis of the phantom up to a depth of 40 cm. The dose enhancement ratio (DER) and FFF enhancement ratio (FFFER) were calculated based on the Monte Carlo results. RESULTS: The DER values were found decreased with an increase of depth and increase of NP concentration in the phantom. For the maximum NP concentration of 40 mg/mL, the DER values decreased 6.9, 12, 4.6 and 7.2% at a phantom depth from 2 to 40 cm, using the 6 MV FF, 6 MV FFF, 10 MV FF and 10 MV FFF photon beams, respectively. The maximum DER values for the 6 MV beams were 1.08 (FF) and 1.14 (FFF), while those for the 10 MV beams were 1.04 (FF) and 1.07 (FFF). When the FF was removed from the linear accelerator head, the FFFER showed a more significant increase of dose enhancement for the 6 MV beams (1.057) than the 10 MV (1.031). CONCLUSION: From the DER and FFFER values based on the Monte Carlo results, it is concluded that the dose enhancement with depth was dependent on the NP and beam variables, namely, NP concentration, presence of FF in the beam and beam energy. Dose enhancement was more significant when using the lower photon beam energy (i.e., 6 MV), FFF photon beam and higher NP concentration in the study.

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We aimed to report the clinical outcomes following stereotactic body radiation therapy (SBRT) using photon or proton equipment in early-stage lung cancer. We retrospectively reviewed 202 cT1-2N0M0 lung cancer patients who underwent SBRT with 60 Gy in four consecutive fractions between 2010 and 2019 at our institution: 168 photon SBRT and 34 proton SBRT. Patients who underwent proton SBRT had relatively poor baseline lung condition compared to those who underwent photon SBRT. Clinical outcomes were comparable between treatment modalities: 5-year local control (90.8% vs. 83.6%, p = 0.602); progression-free survival (61.6% vs. 57.8%, p = 0.370); overall survival (51.7% vs. 51.9%, p = 0.475); and cause-specific survival (70.3% vs. 62.6%, p = 0.618). There was no statistically significant difference in grade ≥ 2 toxicities: radiation pneumonitis (19.6% vs. 26.4%, p = 0.371); musculoskeletal (13.7% vs. 5.9%, p = 0.264); and skin (3.6% vs. 0.0%, p = 0.604). In the binary logistic regression analysis of grade ≥3 radiation pneumonitis, poor performance status and poor baseline diffusion capacity of lung for carbon monoxide were significant. To summarize, though patients with high risk of developing lung toxicity underwent proton SBRT more frequently, the SBRT techniques resulted in comparable oncologic outcomes with similar toxicity profiles. Proton SBRT could be considered for patients at high risk of radiation pneumonitis.

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BACKGROUND AND OBJECTIVE: Phosphenes are visual light phenomena that are experienced when there is no apparent light that stimulates the eye. In oncology, phosphenes are also present during radiation therapy for patients with tumors of the central nervous system, eyes, head and neck. Due to the discomfort of patients treated with irradiation to the head regions, research is conducted to determine whether the dose to the ocular structures is predictive for the occurrence of phosphenes. The objective was to demonstrate the relationship between the doses of the retina and vitreous humour with the appearance of phosphenes. MATERIAL AND METHOD: A descriptive study was carried out in a prospective cohort in 25 patients older than 18 years, with malignant tumours located at the level of the brain, both of primary and secondary origin, subjected to irradiation in 6 MV linear accelerators, during February 2020 to January 2021. As independent variables: Retinal dose and vitreous humour dose, and as dependent variables: Light flashes and stable light. Logistic regression analysis was used for prediction, using the SPSS statistical program (version 26.0). RESULT: A final date of 380 external radiotherapy treatments. The presence of any of the events in a prevalence of 58.7% of the total of fractions. The distribution for the presence of both events, flash of light and stable light, was 69.1%, 20.6% and 10.3% respectively. In the logistic regression analysis, for the light flare, only the dose factor in vitreous was significant (OR: 1.74, IC [1.059-2.419] p: 0.001). For stable light, the dose in the retina (OR: 1.73, IC [1.121-2.341] p: 0.005), and dose in the vitreous humor (OR: 1.82, IC [1.335-2.315] p: 0.003). CONCLUSIONS: There is a predictive relationship between the doses of irradiation of the retina and vitreous humour, for the generation of phosphenes. These results help radiotherapy centres take these anatomical structures into account to reduce the presence of phosphenes in patients. Likewise, it would help to reduce phosphenes, keeping the bunker area illuminated during the treatment.

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Antecedentes y objetivo Los fosfenos son fenómenos de luz visual que se experimentan cuando no hay luz aparente que estimule el ojo. En oncología, los fosfenos también están presentes durante la radioterapia para pacientes con tumores del sistema nervioso central, ojos, cabeza y cuello. Debido a la incomodidad de los pacientes tratados con irradiación en las regiones de la cabeza, se realiza investigación para determinar si la dosis en las estructuras oculares son predicción para la ocurrencia de fosfenos. El objetivo fue demostrar la relación entre las dosis de retina y humor vítreo con la aparición de fosfenos. Material y método Se realizó un estudio descriptivo, en una cohorte prospectiva en 25 pacientes mayores de 18 años, con tumores malignos localizados a nivel de encéfalo, tanto de origen primario como secundario, sometidos a irradiación en aceleradores lineales de 6MV, durante febrero 2020 a enero del 2021. Como variables independientes: dosis a retina y dosis a humor vítreo, y como variables dependientes: destellos de luz y luz estable. Para la predicción se utilizó el análisis de regresión logística, mediante el programa estadístico SPSS® versión 26.0. Resultado Una data final de 380 tratamientos de radioterapia externa. La presencia de cualquiera de los eventos en un predominio del 58,7% del total de fracciones. La distribución por la presencia de ambos eventos, destello de luz y luz estable, fue del 69,1, 20,6 y 10,3%, respectivamente. En el análisis de regresión logística, para el destello de luz, solo fue significativo el factor de dosis en vítreo (OR: 1,74; IC 95%: 1,059-2,419; p: 0,001). Para la luz estable, fueron significativos la dosis en retina (OR: 1,73; IC 95%: 1,121-2,341; p: 0,005) y dosis en humor vítreo (OR: 1,82; IC 95%: 1,335-2,315; p: 0,003). Conclusiones Existe una relación predictiva entre las dosis de irradiación de la retina y del humor vítreo, para la generación de fosfenos (AU)

Background and objective Phosphenes are visual light phenomena that are experienced when there is no apparent light that stimulates the eye. In oncology, phosphenes are also present during radiation therapy for patients with tumors of the central nervous system, eyes, head and neck. Due to the discomfort of patients treated with irradiation to the head regions, research is conducted to determine whether the dose to the ocular structures is predictive for the occurrence of phosphenes. The objective was to demonstrate the relationship between the doses of the retina and vitreous humor with the appearance of phosphenes. Material and method A descriptive study was carried out in a prospective cohort in 25 patients older than 18 years, with malignant tumors located at the level of the brain, both of primary and secondary origin, subjected to irradiation in 6MV linear accelerators, during February 2020 to January 2021. As independent variables: Retinal dose and vitreous humor dose, and as dependent variables: Light flashes and stable light. Logistic regression analysis was used for prediction, using the SPSS statistical program (version 26.0). Result A final date of 380 external radiotherapy treatments. The presence of any of the events in a prevalence of 58.7% of the total of fractions. The distribution for the presence of both events, flash of light and stable light, was 69.1%, 20.6% and 10.3% respectively. In the logistic regression analysis, for the light flare, only the dose factor in vitreous was significant (OR: 1.74; 95% CI: 1.059-2.419; p: 0.001). For stable light, the dose in the retina (OR: 1.73; 95% CI: 1.121-2.341; p: 0.005), and dose in the vitreous humor (OR: 1.82; 95% CI: 1.335-2.315; p: 0.003). Conclusions There is a predictive relationship between the doses of irradiation of the retina and vitreous humor, for the generation of phosphenes (AU)

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Cancer is one of the major diseases that seriously threaten the human health. Radiotherapy is a common treatment for cancer. It is noninvasive and retains the functions of the organ where the tumor is located. Radiotherapy includes photon beam radiotherapy, which uses X-rays or gamma rays, and particle beam radiotherapy, using beams of protons and heavy ions. Compared with photon beam radiotherapy, particle beam radiotherapy has excellent dose distribution, which enables it to kill the primary tumor cells more effectively and simultaneously minimize the radiation-induced damage to normal tissues and organs surrounding the tumor. Despite the excellent therapeutic effect of particle beam radiotherapy on the irradiated tumors, it is not an effective treatment for metastatic cancers. Therefore, developing novel and effective treatment strategies for cancer is urgently needed to save patients with distant cancer metastasis. Immunotherapy enhances the body's own immune system to fight cancer by activating the immune cells, and consequently, to achieve the systemic anticancer effects, and it is considered to be an adjuvant therapy that can enhance the efficacy of particle beam radiotherapy. This review highlights the research progress of the antimetastasis effect and the mechanism of the photon beam or particle beam radiotherapy combined with immunotherapy and predicts the development prospects of this research area.

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