Modern Radiotherapy Era in Breast Cancer

Radiation therapy (RT) is one of the major treatment modalities that are used in breast cancer treatment, and depending on the chest-wall anatomy, RT fields have to be customized. Techniques used in planning have been evolving since last two decades from two dimensional (2D) to three-dimensional (3D), while intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and even proton therapy have been an option in daily approach. In addition, technological hardware and software advances in delivery and planning systems, total treatment duration of breast RT have been shortened in last decades along with recent hypofractionated radiotherapy schemes or emerging partial-breast irradiation protocols. The other attractive approach—accelerated partial breast irradiation (APBI) could be a reasonable option for highly selected subpopulation of early-stage breast cancer patients out of a clinical trial. Long-term follow-up results have emerged heart and coronary sparing with maximum safety and efficacy. The most important advance could be named as cardiac sparing—deep breath-hold approach—in all the modern technique improvement. Although most advanced techniques in management of breast cancer have not been verified to increase survival, we suggest recommending resource stratified advanced in order to provide best technical and clinical care in this long-term survivor candidates

Intensity-Modulated Radiotherapy versus 3-Dimensional Conformal Radiotherapy Strategies for Locally Advanced Non-Small-Cell Lung Cancer

Chemoradiotherapy is the current standard of care in patients with advanced inoperable stage IIIA or IIIB non-small cell lung cancer (NSCLC). Three-dimensional radiotherapy (3DCRT) has been a trusted method for a long time and has well-known drawbacks, most of which could be improved by Intensity Modulated Radiotherapy (IMRT). IMRT is not currently the standard treatment of locally advanced NSCLC, but almost all patients could benefit to a degree in organ at risk sparing, dose coverage conformality, or dose escalation. The most critical step for a radiation oncology department is to strictly evaluate its own technical and physical capabilities to determine the ability of IMRT to deliver an optimal treatment plan. This includes calculating the internal tumor motion (ideally 4DCT or equivalent techniques), treatment planning software with an up-to-date heterogeneity correction algorithm, and daily image guidance. It is crucial to optimise and individualise the therapeutic ratio for each patient during the decision of 3DCRT versus IMRT. The current literature rationalises the increasing use of IMRT, including 4D imaging plus PET/CT, and encourages the applicable knowledge-based and individualised dose escalation using advanced daily image-guided radiotherapy

Vaginal cuff brachytherapy practice in endometrial cancer patients: a report from the Turkish Oncology Group

Purpose: The American Brachytherapy Association is attempting to develop standards for delivering brachytherapy, although differences in practice have been reported in the literature. This study evaluated vaginal cuff brachytherapy (VBT) practice and quality of life-related recommendations among Turkish radiation oncologists. Material and methods: A nationwide web-based 17-item survey was distributed to the members of the Turkish Society for Radiation Oncology. These members received e-mail notifications, and a link was posted on the Turkish Society for Radiation Oncology internet site to solicit voluntary responses The survey addressed the simulation processes, target volume, prescribed dose, delivery schedules, and recommendations related to vaginal side effects. Results: Fifty-seven radiation oncologists responded to the survey. The most used dose fraction schemes for adjuvant VBT were 7 Gy x 3 fractions (30%), 5.5 Gy x 5 fractions (26%), and 6 Gy x 5 fractions (28%). The preferred VBT scheme was 5 Gy x 3 fractions (50%) when the external beam radiotherapy (EBRT) dose was 45 Gy external radiotherapy, while the preferred schemes were 6 Gy x 3 fractions (30%) or 5 Gy x 3 fractions (32%) when the external radiotherapy dose was increased to 50.4 Gy. One-half of the respondents delivered VBT twice a week, and the dose was prescribed to 0.5 cm from vaginal mucosa by 86% of the respondents. There was no common definition for the dose prescription length, which was defined as 3 cm from the vaginal cuff in 33% of responses and as 4 cm in 35% of responses. For serous and clear cell histological types, 38% of the respondents targeted full cylinder length. To prevent vaginal side effects, 78% of the respondents recommended using a vaginal dilator and/or sexual intercourse after VBT. Conclusions: This survey revealed variations in the clinical practice of VBT among Turkish radiation oncologists, which suggests that standardization is necessary

A square-pyramidal iron(III) complex obtained from 2-hydroxy-benzophenone-S-allyl-thiosemicarbazone: synthesis, characterization, electrochemistry, quantum chemical studies and antioxidant capability

2-Hydroxybenzophenone-S-allyl-thiosemicarbazone and 3-allyl-salicylaldehyde were condensed by template effect of iron(III) ion to yield the N2O2 type-chelate complex. The S-allyl-thiosemicarbazone (1) and the iron(III) complex (2) were characterized by elemental analysis, magnetic measurements, electronic, infrared, Raman and H-1-NMR spectra, and also single-crystal X-ray diffraction technique. Electrochemical characterization of the iron(III) complex was carried out by using cyclic voltammetry. The complex gives a metal based one electron reversible Fe-III/Fe-II reduction and, S-allyl-thiosemicarbazone-based oxidation and reduction reactions. The reduction potentials of the S-allyl-thiosemicarbazone and the complex are calculated in terms of Gibbs free energy change of the redox reaction at the theory level of UwB97XD/LANL2DZ/PCM. The optimized geometries and vibrational frequencies of the compounds were calculated using the DFT/UwB97XD method with the 6-31 G(d,p) basis set and compared to experimental data. TD-DFT was employed to examine the electronic transitions of the complex and to conduct the NBO charges at the same level. For the compounds, in vitro total antioxidant capacity (as TEAC coefficient) and scavenging activity of reactive oxygen species (ROS) which are hydroxyl radical (center dot OH), superoxide anion radical (center dot O-2-), and hydrogen peroxide (H2O2) have been determined by using spectroscopic methods