Development of a SIMMERRELAP5 coupling tool

The In-Box Loss Of Coolant (LOCA) postulated accident is considered a major concern for the safety connected with the development of EU-DEMO fusion reactor. Relating to the renewed interest in the Water-Cooled Lithium Led blanket concept, an innovative experimental campaign is under development at ENEA Brasimone laboratories aiming at investigating the consequences related to the In-Box LOCA applied to the WCLL breeding blanket. In this frame, a new coupling tool between the SIMMER-III (modified version to implement the PbLi/water chemical interaction) and the RELAP5/Mod3.3 codes (modified version to implement PbLi thermo-physical properties) has been developed together with its preliminary application to simple test cases with water as working fluid. The coupling procedure can be defined as a “two-way”, “non-overlapping”, “online” technique aiming at investigating multi-physics and multi-scales phenomena in support of the development of fusion reactor technologies

Analysis of Test D1.1 of the LIFUS5/Mod3 facility for In-box LOCA in WCLL-BB

The in-box Loss of Coolant Accident (LOCA) scenario is considered as one of the most affecting safety concerns for the Water-Cooled Lead Lithium Breeding Blanket (WCLL-BB) modules of the DEMOnstration (DEMO) reactor, which is sequentially followed by a multi-phase multi-component physical and chemical interaction. Therefore, the transient behavior of such accidents has to be carefully investigated during the design phase of the plant, to evaluate the consequences and to adopt the necessary mitigating countermeasures. This also requires a numerical predictive tool, which is capable to model such transients and predict the relevant phenomena under an operational condition and the connected safety parameters i.e. system pressure, temperature, chemical products mass, and volume fractions of all the existing components. Consequently, the SIMMER-III code was firstly improved at the University of Pisa by implementing the chemical reaction between PbLi eutectic alloy and water. In addition to this, an experimental campaign and a test-matrix have been recently designed according to the LIFUS5/Mod3 facility to perform a series of experiments and code post-test analyses. In the present work, the experimental data of the first LIFUS5/Mod3 test is used for the validation of the chemical model implemented in SIMMER-III through a comprehensive sensitivity study. The applied methodology for the code validation is based on a three-step procedure including qualitative analysis, quantitative analysis and the results from sensitivity analyses. The qualitative accuracy evaluation is performed through a systematic comparison between experimental and calculated time trends based on the engineering analysis, the resulting sequence of main events and the identification of phenomenological windows and of relevant thermo-hydraulic aspects. Afterwards, the accuracy of the code prediction is evaluated from a quantitative point of view by means of selected, widely used, figures of merit. Finally, the results from the sensitivity cases are analysed and quantified, to determine the effects of the most influencing code input options and transient parameters. Furthermore, the analysis is followed by applying the Fast Fourier Transform Method (FFTM) to the experimental signals and all the sensitivity calculations. The comparison shows a very good agreement for pressure transient between the experimental and numerical data, while for the temperature and the hydrogen production the results fall into acceptable criteria, which means that the code is reliable in capturing and predicting the transient values but not perfectly match with the experimental signals

Experimental activities for in-box LOCA of WCLL BB in LIFUS5/Mod3 facility

The new experimental facility LIFUS5/Mod3 has been designed, manufactured and installed to investigate the phenomena connected with the thermodynamic and chemical interaction between lithium-lead and water in case of in-box LOCA (Loss of Coolant Accident) of the WCLL breeding blanket concept and to validate the chemical model implemented in SIMMER code for fusion application. In order to fulfill these objectives, the necessary step is to obtain data, suitable to code validation, by means of an experimental campaign in LIFUS5/Mod3 facility, executed with controlled initial and boundary conditions. Thus, specific instrumentation and dedicated data acquisition system are installed on the facility to provide meaningful and reliable data. The final aim of the LIFUS5/Mod3 campaign is the SIMMER code validation, applying the standard methodology to post-test analyses. Besides, the expected outcomes of the tests are the improvement of the knowledge of physical behavior and of understanding of the phenomena, the investigation of the dynamic effects of energy release towards the structures and of the chemical reaction with the consequent hydrogen production, and the enlargement of the database for code validation

Focusing on the Person in Personalized Medicine: The Future of Patient-Centered Care in Radiation Oncology

Numerous efforts in radiation oncology aim to improve the value of clinical care. To evaluate the success of these efforts, outcome measures must be well defined and incorporate the beliefs of the patients they affect. These outcomes have historically centered on rates of tumor control, overall survival, and adverse events as perceived and reported by providers. However, the future of patient-centered care in radiation oncology is increasingly focusing on the person in the population and the individual in the studies to more closely reflect the ideals of personalized medicine. Formally known as patient-centered outcomes, this metric encompasses parameters of patient satisfaction, engagement, and treatment compliance. Evaluations that investigate the safety and efficacy of treatments are increasingly soliciting participation from patients within a model of shared decision making that improves patients\u27 knowledge, satisfaction, physical and emotional well-being, and trust in providers. Modern clinical trials that embrace this approach may even focus on patient-reported outcomes as the primary end point, as opposed to time-honored physician-reported events. The authors explore the growing role of patient-centered care, the incorporation of shared decision making, and the relevant body of existing and developing literature on this topic in radiation oncology. The authors report recent discoveries from this area of study and describe how they can not only support high-quality, high-value patient care but also enhance recruitment to clinical oncology trials, both of which are challenging to achieve in today\u27s relatively resource-strapped environment

Real World Outcomes versus Clinical Trial Results of Durvalumab Maintenance in Veterans with Stage III Non-Small Cell Lung Cancer

One year of durvalumab following concurrent chemoradiotherapy improves progression-free (PFS) and overall survival (OS) for patients with stage III non-small cell lung cancer (NSCLC). However, the real-world efficacy of durvalumab has not been determined. We conducted a multi-center observational cohort study across the Veterans Health Administration, including patients with stage III NSCLC who received concurrent chemoradiotherapy and durvalumab, compared to patients who received concurrent chemoradiotherapy alone. Kaplan–Meier and Cox regression approaches were used to identify factors associated with PFS and OS. We calculated a hazard ratio and efficacy-effectiveness factor to compare OS of veterans to the referenced clinical trial population. A total of 1006 patients with stage III NSCLC who received concurrent chemoradiotherapy and at least one dose of durvalumab from November 2017 to April 2021 were compared to 989 patients who received concurrent chemoradiotherapy alone from January 2015 to December 2016. Adjuvant durvalumab was associated with higher PFS (HR 0.62, 95% CI 0.55–0.70, p p p = 0.02: EE gap 0.73). OS of veterans with stage III NSCLC treated with adjuvant durvalumab is improved compared to a modern comparator but is reduced compared to the PACIFIC population

An International Expert Survey on the Indications and Practice of Radical Thoracic Reirradiation for Non-Small Cell Lung Cancer

Purpose: Thoracic reirradiation for non-small cell lung cancer with curative intent is potentially associated with severe toxicity. There are limited prospective data on the best method to deliver this treatment. We sought to develop expert consensus guidance on the safe practice of treating non-small cell lung cancer with radiation therapy in the setting of prior thoracic irradiation. Methods and Materials: Twenty-one thoracic radiation oncologists were invited to participate in an international Delphi consensus process. Guideline statements were developed and refined during 4 rounds on the definition of reirradiation, selection of appropriate patients, pretreatment assessments, planning of radiation therapy, and cumulative dose constraints. Consensus was achieved once ≥75% of respondents agreed with a statement. Statements that did not reach consensus in the initial survey rounds were revised based on respondents' comments and re-presented in subsequent rounds. Results: Fifteen radiation oncologists participated in the 4 surveys between September 2019 and March 2020. The first 3 rounds had a 100% response rate, and the final round was completed by 93% of participants. Thirty-three out of 77 statements across all rounds achieved consensus. Key recommendations are as follows: (1) appropriate patients should have a good performance status and can have locally relapsed disease or second primary cancers, and there are no absolute lung function values that preclude reirradiation; (2) a full diagnostic workup should be performed in patients with suspected local recurrence and; (3) any reirradiation should be delivered using optimal image guidance and highly conformal techniques. In addition, consensus cumulative dose for the organs at risk in the thorax are described. Conclusions: These consensus statements provide practical guidance on appropriate patient selection for reirradiation, appropriate radiation therapy techniques, and cumulative dose constraints