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Fulltext Assessment of surface dose on the art phantom using threedimensional conformal breast radiotherapy

Norhayati Abdullah, Wong, Jeannie Hsiu Ding, Ng, Kwan Hoong, Ung, Ngie Min

Jurnal Sains Nuklear Malaysia, 2015;27(1):21-28.
MyJurnal

The assessment of surface dose is essential in radiotherapy to avoid deterministic effect or to
reduce the severity of side effects from radiation treatment. In this study, the surface dose for breast
cancer radiotherapy was measured using two types of dosimeter; Thermoluminescent Dosimeter
(TLD) and Optically Stimulated Luminescent Dosimeter (OSLD). The study was performed on the
left breast of female Alderson Radiation Therapy (ART) phantom. The treatment planning was
carried out on the ART phantom to determine the homogeneity of dose distribution within the target
organ is complied with the tolerance limits of 95% to 107% as recommended by the International
Commission on Radiation Units and Measurements (ICRU)’s Report No. 50. From the treatment
planning result, the phantom then was irradiated with 267 cGy dose per fraction for two beam
fields; medial tangential and lateral tangential fields using a 6 MV photon beam produced from
three-dimensional (3D) conformal radiotherapy. Result shows that the OSLD provides 25.7% and
23.5% higher surface dose compared to TLD for medial tangential and lateral tangential fields,
respectively. This condition may be due to higher effective point of measurement and angular
dependence of the OSLD compared to TLD. As a conclusion, suitable dosimeter should be selected
to ensure accurate estimation of surface dose could be made thus reduction of skin reaction to
patient could be achieved.

Matched MeSH terms: Radiotherapy, Conformal
Fulltext Preliminary study on peroxide vulcanization with gamma irradiation

Sofian Ibrahim, Chantara Thevy Ratnam, Chai, Chee Keong, Noor Hasni M. Ali, Mohd Noorwadi Mat Lazim, Khairiah Badri

Jurnal Sains Nuklear Malaysia, 2018;30(2):39-46.
MyJurnal

Peroxide pre-vulcanized natural rubber latex prepared by using gamma irradiation technique is an alternative over the conventionally prepared peroxide pre-vulcanized that used activator to promote the peroxide decomposition in natural rubber latex. Through this technique the problems aroused by some activators such as tends to darken the natural rubber latex film during the drying process can also be overcome. For this preliminary study, data obtained from crosslink density and mechanical measurements were used to evaluate the effectiveness of gamma irradiation in the vulcanization process. Increasing the quantity of tert-butyl hydroperoxide (t-BHPO) from 0.1 pphr to 0.3 pphr while the irradiation dose maintain at 12 kGy has successfully delivered peroxide vulcanized natural rubber latex films with average tensile strength, modulus @ 500% and modulus @ 700% around 15.33, 1.01 and 3.42 MPa, respectively. The effective pre-vulcanization irradiation dose with respect to maximum crosslinking density (85.8 %) was observed on film prepared at 0.1 pphr t-BHPO.

Matched MeSH terms: Radiotherapy Dosage
Fulltext The Effects of Probiotic Supplementation on the Incidence of Diarrhea in Cancer Patients Receiving Radiation Therapy: A Systematic Review with Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials

Devaraj NK, Suppiah S, Veettil SK, Ching SM, Lee KW, Menon RK, et al.

Nutrients, 2019 Nov 27;11(12).
PMID: 31783578 DOI: 10.3390/nu11122886

The protective effects of probiotic supplementation against radiation-induced diarrhea (RID) have been reported in previous systematic reviews; however so far, only non-conclusive results have been obtained. The objective of this study was to systematically update and evaluate the available evidence for probiotic supplementation. The protocol of this systematic review has been registered (CRD42018106059) with the International Prospective Register of Systematic Reviews (PROSPERO). The primary efficacy outcome was the incidence of RID. Secondary outcomes were the incidence of watery stool, soft stool, and antidiarrheal medication use. There were eight trials, and a total of 1116 participants were included in the primary analysis. Compared with placebo, probiotics were associated with a lower risk of RID [risk ratio (RR) = 0.62, 95% CI = 0.46, 0.83]. A requisite heterogeneity-adjusted trial sequential analysis indicated conclusive evidence for this beneficial effect. No statistically significant reduction in RID (RR = 0.52, 95% CI = 0.14, 1.91) was observed on subgroup analysis in patients receiving both radiation therapy and chemotherapy. However, those patients receiving only radiation therapy (RT) demonstrated significant benefit (RR = 0.61, 95% CI = 0.48, 0.78). There was a significant difference in the antidiarrheal medication use (RR = 0.54, 95% CI = 0.35, 0.84) observed with the use of probiotics. However, no significant difference was observed for the incidence of soft and watery stool. The use of probiotics is beneficial in preventing RID in patients receiving RT.

Matched MeSH terms: Neoplasms/radiotherapy*; Radiotherapy/adverse effects*
Fulltext Using 157Gd doped carbon and 157GdF4 nanoparticles in proton-targeted therapy for effectiveness enhancement and thermal neutron reduction: a simulation study

Tabbakh F, Hosmane NS, Tajudin SM, Ghorashi AH, Morshedian N

Sci Rep, 2022 Oct 18;12(1):17404.
PMID: 36258012 DOI: 10.1038/s41598-022-22429-0

There are two major problems in proton therapy. (1) In comparison with the gamma-ray therapy, proton therapy has only ~ 10% greater biological effectiveness, and (2) the risk of the secondary neutrons in proton therapy is another unsolved problem. In this report, the increase of biological effectiveness in proton therapy has been evaluated with better performance than 11B in the presence of two proposed nanomaterials of 157GdF4 and 157Gd doped carbon with the thermal neutron reduction due to the presence of 157Gd isotope. The present study is based on the microanalysis calculations using GEANT4 Monte Carlo tool and GEANT4-DNA package for the strand breaks measurement. It was found that the proposed method will increase the effectiveness corresponding to the alpha particles by more than 100% and also, potentially will decrease the thermal neutrons fluence, significantly. Also, in this work, a discussion is presented on a significant contribution of the secondary alpha particles in total effectiveness in proton therapy.

Matched MeSH terms: Radiotherapy Dosage
Radiotherapy for recurrent juvenile nasopharyngeal angiofibroma

Ekaputra E, Dhamiyati W, Dwianingsih EK, Meidania L, Kurniawan T, Yanuarta SE, et al.

Med J Malaysia, 2024 Aug;79(Suppl 4):95-97.
PMID: 39215424

Juvenile nasopharyngeal angiofibroma (JNA) is a rare paediatric tumour known for its local destructiveness and high recurrence rate. Surgery is the primary treatment modality for JNA, though other options, such as hormonal therapy, embolisation and radiotherapy, exist for inoperable cases. The location of the tumour makes surgical intervention challenging. A 14-year-old male presented with epistaxis and headaches as the chief complaints and was diagnosed with nasopharynx angiofibroma by computed tomography (CT) scan in 2018. Pre-operative embolisation was performed and followed by surgical removal of a 4 cm tumour in January 2019. Pathological examination revealed CD34 positivity, S100 negativity and Ki-67 positivity (5 to 10%), confirming angiofibroma. In October 2019, a 3.6 cm recurrent tumour was treated with embolisation and a second surgery. Pathological findings again confirmed JNA. The patient underwent four surgeries in total, but epistaxis persisted. In 2021, local radiotherapy was administered using intensity-modulated radiation therapy (IMRT) at a dose of 60 Gy in 25 fractions. Serial magnetic resonance imaging (MRI) post-radiotherapy showed a decreasing tumour size, with no further epistaxis and no observed radiation side effects 2 years post-treatment. Radiation therapy remains a strong alternative for managing recurrent JNA.

Matched MeSH terms: Radiotherapy, Intensity-Modulated
Rare embryonal rhabdomyosarcoma of external acoustic canal: a case report and literature review

Eksan MS, Noorizan Y, Chew YK, Noorafidah MD, Asma A

Am J Otolaryngol, 2014 Nov-Dec;35(6):814-5.
PMID: 25128187 DOI: 10.1016/j.amjoto.2014.07.009

Embryonal rhabdomyosarcoma of external ear canal is very rare, even in the pediatric population. We report an embryonal rhabdomyosarcoma of external acoustic canal, occurring in a 12-year-old Chinese girl who presented with left ear canal mass. Wide local excision of the mass was done under local anesthesia. Histopathological examination revealed the diagnosis. She then underwent 20 cycles of radiotherapy. CECT scan post treatment showed clearance of tumor cell. Now, patient is disease free for 5 years. We believe that early diagnosis followed by complete resection of the tumor with clear margin and radiotherapy improves the prognosis of the disease.

Matched MeSH terms: Ear Neoplasms/radiotherapy; Rhabdomyosarcoma, Embryonal/radiotherapy
Study of epithelial migration in the tympanic membrane and bony external auditory canal wall in patients with irradiated nasopharyngeal carcinoma

Santhi K, Prepageran N, Tang IP, Raman R

Otol Neurotol, 2015 Feb;36(2):318-22.
PMID: 24751743 DOI: 10.1097/MAO.0000000000000378

The objectives of this study were to determine the presence of epithelial migration in patients with postirradiated nasopharyngeal carcinoma (NPC) and to compare the rate of epithelial migration in the tympanic membrane (TM) and the bony external auditory canal (EAC) of postirradiated NPC ears with normal ears by means of the ink dot method.

Matched MeSH terms: Carcinoma/radiotherapy; Nasopharyngeal Neoplasms/radiotherapy
Fulltext LINAC based radiosurgery and radiotherapy for neurosurgical diseases: what have we learnt so far

Zamzuri I, Badrisyah I, Rahman GI, Pal HK, Muzaimi M, Jafri AM, et al.

Med J Malaysia, 2011 Oct;66(4):346-9.
PMID: 22299555 MyJurnal

Stereotactic radiosurgery uses a single fraction high dose radiation while stereotactic radiotherapy uses multifractionated lower dose focused radiation.

Matched MeSH terms: Brain Neoplasms/radiotherapy*; Intracranial Arteriovenous Malformations/radiotherapy*
Fulltext Recurrent multiple myeloma presenting as a breast plasmacytoma

Kalyani A, Rohaizak M, Cheong SK, Nor Aini U, Balasundaram V, Norlia A

Med J Malaysia, 2010 Sep;65(3):227-8.
PMID: 21939175

We describe a patient with multiple myeloma, who initially responded to chemotherapy and went into remission. She presented 10 months later with a right breast lump which was confirmed by core biopsy to be a plasmacytoma. Further treatment with radiotherapy, thalidomide and later second line chemotherapy appeared unsuccessful and she showed rapid disease progression with rising paraproteins and new extramedullary plasmacytoma lesions in the forehead, supraclavicular region, nasopharynx, liver, spleen, pancreas and paraaortic lymph nodes.

Matched MeSH terms: Breast Neoplasms/radiotherapy; Plasmacytoma/radiotherapy
Mediastinal irradiation and its effect on the cardiovascular system

Tang D, Peng EW, Giri D, Chowdhary M, Sarkar P

Br J Hosp Med (Lond), 2009 Apr;70(4):222-4.
PMID: 19357601 DOI: 10.12968/hmed.2009.70.4.41626

Mediastinal irradiation for various malignancies can cause radiation injury to mediastinal structures, most importantly the cardiovascular system. This article reviews the effect of radiation on cardiovascular structures and the manifestations of various radiation-induced heart diseases.

Matched MeSH terms: Mediastinal Neoplasms/radiotherapy*; Radiotherapy Dosage
Metastasis to the sinonasal tract from sigmoid colon adenocarcinoma

bin Sabir Husin Athar PP, bte Ahmad Norhan N, bin Saim L, bin Md Rose I, bte Ramli R

Ann Acad Med Singap, 2008 Sep;37(9):788-3.
PMID: 18989497

INTRODUCTION: Metastatic adenocarcinoma from the gastrointestinal tract to the sinonasal tract is rare. The histological morphology of this lesion is indistinguishable from the colonic variant of primary sinus adenocarcinoma or intestinal-type adenocarcinoma (ITAC).
CLINICAL PICTURE: This is a report of a case of metastatic adenocarcinoma of colorectal origin to the paranasal sinuses in a 52-year-old female who was previously treated for adenocarcinoma of the sigmoid colon. A histologic study of the surgical specimen from the sinonasal cavity demonstrated a tumour identical to the patient's prior primary tumour of the colon. The sinonasal neoplastic tissue showed marked positivity for carcinoembryonic antigen and expressed cytokeratin 20, which differentiates metastatic colonic adenocarcinoma from ITAC.
TREATMENT/OUTCOME: The patient received palliative radiation but died 3 months after the diagnosis.
CONCLUSION: Distinguishing metastatic adenocarcinoma from gastrointestinal tract from ITAC can be difficult. In view of the resemblance, immunohistochemical staining can help in differentiating them. It is important to recognise these as metastatic lesions as the treatment is mainly palliative.

Matched MeSH terms: Adenocarcinoma/radiotherapy; Paranasal Sinus Neoplasms/radiotherapy
Fulltext Oropharyngeal flora changes in patients with head and neck malignancy post radiotherapy

Muthu K, Raman R, Gopalakrishnan G

Med J Malaysia, 2004 Dec;59(5):585-90.
PMID: 15889559

Radiotherapy has been recognized as a valuable modality of treatment in the management of head and neck cancers. It can have a direct bactericidal effect on the normal flora of the oropharynx. The objective of this study is to determine the changes in the oropharyngeal flora after external beam radiation. This prospective non randomized control study was performed to aid in identification of organisms involved in sepsis, as well as aid in choosing appropriate antibiotics for surgical procedures in irradiated patient. Forty patients with various head and neck malignancy and thirty control patients were selected. Oropharyngeal swabs were taken prior to radiotherapy, at the end and one month after radiotherapy. A single swab was taken from the control group. A full bacteriological analysis was performed. There was a statistically significant decrease in Alpha Hemolytic Streptococci and Neisseria species post radiotherapy. B Proteus and Candida Albicans showed a statistical significant increase in patients with head and neck cancer post radiotherapy. These changes remained even one month after radiotherapy.

Matched MeSH terms: Carcinoma/radiotherapy*; Head and Neck Neoplasms/radiotherapy*
Anesthetic management of a parturient with superior vena cava obstruction for cesarean section

Chan YK, Ng KP, Chiu CL, Rajan G, Tan KC, Lim YC

Anesthesiology, 2001 Jan;94(1):167-9.
PMID: 11135739
Matched MeSH terms: Mediastinal Neoplasms/radiotherapy*; Pregnancy Complications, Neoplastic/radiotherapy*
Accurate measurement of exposure rate from a 60Co teletherapy source: deviations from the inverse-square law

Samat SB, Evans CJ, Kadni T, Dolah MT

Br J Radiol, 2000 Aug;73(872):867-77.
PMID: 11026863

A cylindrical gamma-ray 60Co source of activity alpha is predicted to produce an exposure rate X at a distance d in vacuum, given by X = gamma(T)(alpha/d2), where gamma(T) is the specific gamma-ray constant. It has been documented that this formula may be used to approximate X with an accuracy of 1% from a source of length l, provided that d/l > or = 5. It is shown that the formula is accurate to 0.1% under these conditions, provided that the distance is measured from the centre of the source. When absorption in the source and scattering in the collimator are considered, the position of the origin d = 0 can shift by a distance of the order of centimetres. Absorption in air between the source and the ionization chamber adds an exponential factor to the formula. It is shown that even when these modifications are included the discrepancy in the results, although generally less than 1%, is still large compared with the measurement errors. Some suggestions are made for the origin of this discrepancy.

Matched MeSH terms: Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted/methods*
Fulltext A successful pregnancy outcome in treated vulval rhabdomyosarcoma

Ariza M, Rafaee T, Adeeb N, Muhaizan WM, Isa MR

Med J Malaysia, 1999 Sep;54(3):371-3.
PMID: 11045067

A 14 year old girl presented in 1986 with a huge perineal swelling which was progressively increasing in size and associated with loss of weight and loss of appetite. Biopsy from the mass revealed rhabdomyosarcoma of the vulva. She was treated with chemotherapy and radium implant. She responded well to the regime. Fibrosis of the vulva and vagina caused difficulty in consummation. Once it was corrected, she conceived easily and proceeded to a normal pregnancy and delivery.

Matched MeSH terms: Rhabdomyosarcoma/radiotherapy*; Vulvar Neoplasms/radiotherapy*
Fulltext Papillary adenocarcinoma of the nasopharynx--case report and review of the literature

Nojeg MM, Jalaludin MA, Jayalakshmi P

Med J Malaysia, 1998 Mar;53(1):104-6.
PMID: 10968147

We report a rare tumour of the nasopharynx- papillary adenocarcinoma. This is usually of low grade and certainly in out patient it behaved so. It is even rarer to have this tumour in a patient with Turner's syndrome in whom there is a high incidence of gynaecological malignancy. It has not previously been documented and the occurrence in this patient is probably coincidental.

Matched MeSH terms: Adenocarcinoma, Papillary/radiotherapy*; Nasopharyngeal Neoplasms/radiotherapy*
Fulltext Breast cancer in pregnancy--our experience with six patients in the University Hospital, Kuala Lumpur

Yip CH, Taib NA, Abdullah MM, Wahid I

Med J Malaysia, 2000 Sep;55(3):308-10.
PMID: 11200709

Presentation of breast cancer during pregnancy is a rare situation and one that requires a multidisciplinary approach involving an obstetrician, surgeon and oncologist. Management should be along the same principles as in non-pregnant patients and delay is not justifiable. Mastectomy and axillary clearance is the best option, followed by chemotherapy, which is safe after the first trimester. Radiation if required should be delayed until after delivery of the baby. We present here our experience with 6 patients who presented with breast cancer during pregnancy. Five patients refused any treatment until after delivery, while one underwent only a mastectomy and axillary clearance. The outcome was poor; all of them died between 14 months and 52 months. The poor outcome probably reflects the late stage at presentation in four of the patients (State 3 and 4) rather than the delay in treatment, while delay in treatment in the two who presented with early cancer (Stage 1 and 2) led to a more advanced stage after delivery.

Matched MeSH terms: Breast Neoplasms/radiotherapy; Pregnancy Complications, Neoplastic/radiotherapy
Fulltext Results of long-term follow-up after compensated fixed-dose therapy for thyrotoxicosis

Zaini A, Khir A, Doi SA, Chan SP, Paramsothy M, Khoo BH

J Int Med Res, 1992 Jun;20(3):279-88.
PMID: 1397673

To evaluate the effects of simple compensated fixed-dose iodine-131 therapy for thyrotoxicosis, the long-term results for 74 patients treated with a fixed dose of iodine-131 ranging from 5 to 12 mCi (185 to 444 MBq) were evaluated in the first 2 years of a trial. The dose selected was loosely based on the gross size of the thyroid gland. Routine antithyroid drug therapy was given for a minimum of 3 months after iodine-131 therapy. The mean (+/- SD) duration of follow-up was 74.5 +/- 42 months. The results indicated that roughly 25% of patients treated in this way will become hypothyroid after 5 years and that 85% are cured (need no further therapy during the follow-up period) using a single dose of iodine-131. Of those cured using a single iodine-131 dose, 81% were no longer receiving drugs after 6 months and 85% after 1 year. Such a regimen seems currently to be among the best available where prolonged periods of medication-free euthyroidism after therapy are sought.

Matched MeSH terms: Radiotherapy Dosage; Thyrotoxicosis/radiotherapy*
Fulltext Preradiation peplomycin for advanced squamous cell carcinomas

Azhar T, Singh P

Med J Malaysia, 1988 Mar;43(1):40-3.
PMID: 2468988
Matched MeSH terms: Carcinoma, Squamous Cell/radiotherapy; Head and Neck Neoplasms/radiotherapy
Fulltext Effectiveness of the Laser Application in Temporomandibular Joint Disorder: A Systematic Review of 1172 Patients

Zwiri A, Alrawashdeh MA, Khan M, Ahmad WMAW, Kassim NK, Ahmed Asif J, et al.

Pain Res Manag, 2020;2020:5971032.
PMID: 33005278 DOI: 10.1155/2020/5971032

Objective: The aim of this systematic review was to evaluate the effectiveness of laser application in temporomandibular joint disorder.
Methods: PubMed, SCOPUS, Science Direct, Web of Science, and Google Scholar electronic databases were searched systematically with restricting the languages to only English and year (January 2001 to March 2020), and studies were selected based on the inclusion criteria. Study quality and publication bias were assessed by using the Robvis, a software package of R statistical software.
Results: This systematic review included 32 studies (1172 patients) based on the inclusion and exclusion criteria. Most of the studies reported significant reduction of pain by the use of the laser during TMD treatment. Two-thirds of the study (78.13%) found a better outcome comparing with conventional one. According to Robvis, 84.4% of the studies were high methodological studies with low risk of bias.
Conclusion: TMD patients suffer with continuous pain for long time even after conventional treatment. Laser therapy shows a promising outcome of pain reduction for TMD patients. Therefore, laser therapy can be recommended for the TMD patients' better outcome. This trial is registered with PROSPERO (CRD42020177562).

Matched MeSH terms: Pain/radiotherapy; Temporomandibular Joint Disorders/radiotherapy*

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