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External human exposure and management immune system in pathogenesis of irritable bowel syndrome 2 2 External exposed radiation may play an important role in pathogens of irritable bowel syndrome (IBS), although is thought to arise due to a combination of genetic and environmental factors. The result is dysregulated immune responses due to alteration in the gut microbiota population and the subsequent development of gut inflammation. It has recently been shown that the effect of ionizing radiation on T-cell lymphocytes might be a risk factor of IBS. This article tries to discuss the effects of low dose radiation on alternation in the population of beneficial members of the gastrointestinal tract flora. The result may be activated inflammatory response of mucosal immune status induced Toll like receptors. Lipopolysaccharides produced by most gram-negative bacteria of gastrointestinal tract play a role in the initiation and progress of the Toll like receptors in the intestines. Circulating cytokines and soluble receptors released by activated Th2 can regulate neuronal function via endocrine mechanisms. Disturbance of the cytokine-mediated interaction between cells may lead to neuronal dysfunction or sensory dysfunction, motor dysfunction, or both sensory and motor dysfunction in patient with IBS. 165 171 2016/10/4 1395/7/13 2016/10/4 1395/7/13 M.R. Sheikh Sajjadieh M.R. Sheikh Sajjadieh National Medical Academy for Post Graduate Education Ukraine mohammad_esfahan@yahoo.com Irritable bowel syndrome radiation intestinal microbiota immune system 1. Sheikh Sajjadieh MR, Kuznetsova LV, and Bojenko VB (2010) Affects of ionizing radiation on T-cell population lymphocyte: A risk factor of irritable bowel syndrome. Toxicology and Industrial Health, 26: 323–330.##2. Sheikh Sajjadieh MR, Kuznetsova LV, Bojenk VB (2012) Dysbiosis in Ukrainian children with irritable bowel syndrome affected by natural radiation .Iran J Pediat, 22: 364-368.##3. Ohman L, Isaksson S, Lindmark AC, Posserud I, Stotzer PO, Strid H (2009) T-cell activation in patients with irritable bowel syndrome. American Journal of Gastroenterology, 104: 1205–1212.##4. Sanchez AL, Walters CB, Singleton DL, Wood NH, Mondon K (1999) Food ingestion doses from artificial radionuclides in Cumbrian diets, ten years post Chernobyl. Journal of Environmental Radioactivity, 46: 301–317.##5. Golikov V, Balonov M, Jacob P (2002) External exposure of the population living in areas of Russia contaminated due to the Chernobyl accident. Radiation and Environment Biophysics, 41: 185–193.##6. Akleyev A, Veremeyeva GA, Silkina LA, Vozilova AV (1999) Long term hemopoiesis and immunity status after chronic radiation exposure of red bone marrow in humans. Central European Journal of Occupational and Environmental Medicine, 5: 113–129.##7. Chadwick VS, Chen W, Shu D (2002) Activation of the mucosal immune system in irritable bowel syndrome. Gastroenterology, 122: 1778-1783.##8. Dunlop SP, Jenkins D, Neal KR, Naesdal J, Borgaonker M, Collins SM, Spiller RC (2003) Randomized, double-blind, placebo-controlled trial of prednisolone in post infectious irritable bowel syndrome. Aliment Pharmacol Ther, 18: 77-8.##9. Van Der Veek PP, Van Den Ber M, De Kroon YE (2005) Tumor necrosis factor-alpha and interleukin 10 gene polymorphisms in irritable bowel syndrome. American Journal of Gastroenterology, 100: 2510–2516.##10. Collins SM (1996) The immunomodulation of enteric neuromuscular function: implications for motility and inflammatory disorders. Gastroenterology, 111: 1683–1699.##11. Sheikh Sajjadieh MR, Kuznetsova LV, Bojenko VB (2010) Low internal radiation alerts innate immune status in Ukrainian children with clinically of irritable bowel syndrome. Toxicol Ind Health, 26: 525-31.##12. Sheikh Sajjadieh MR, Kuznetsova LV, Bojenko VB (2011) Effect of cesium radioisotope on humoral immune status in Ukrainian children with clinical symptoms of irritable bowel syndrome related to Chernobyl disaster. Toxicol Ind Health, 27: 51-6.##13. Lotze MT and Finn OJ (1991) Recent advance in cellular immunology: implications for immunity to cancer. Immunology Today, 11: 190 -194.##14. Sheikh Sajjadieh MR, Kuznetsova L, Bojenko V (2012) Cytokine status in Ukrainian children with irritable bowel syndrome residing in a contaminated area. Iran J Immunol, 9: 248-53.##15. Han SK, Song JY, Yun YS, Yi SY (2002) Gamma irradiation-reduced IFN-γ expression, STAT1 signals, and cell-mediated immunity. J Biochem Mol Biol, 35: 583-9.##16. De Kruyff RH, Fang Y, Umetsu DT (1995) IL-4-based helper activity of CD4+ T cells is radiation sensitive. Cell Immunol, 2: 248-56.##17. Sun Y and Liu S (1998) Change in mRNA level of TNF-alpha and IL-1beta in mouse peritoneal macrophage after whole body Xirradiation. Radiation Protection, 18: 119-25.##18. Pons I, Gras G, Courberand S, Benveniste O, Dormont D (1997) Consequences of gamma-irradiation on inflammatory cytokine regulation in human monocytes/macrophages. Int J Radiat Biol, 71: 157-66.##19. Field EH, Rouse TM, Gao Q, Chang B (1997) Association between enhanced Th2/Th1 cytokine profile and donor T-cell chimerism following total lymphoid irradiation. Hum Immunol, 52: 144-54.##20. Kremer IB, Hilkens CM, Sylva-Steenland RM, Koomen CW, Kapsenberg ML, Bos JD, Teunissen MB (1996) Reduced IL-12 production by monocytes upon ultraviolet-B irradiation selectively limits activation of T helper-1 cells. J Immunol, 157: 1913-8.##21. Berg RD (1996) The indigenous gastrointestinal microflora. Trends Microbiol, 4: 430-5.##22. van der Waaij D (1982) Colonization resistance of the digestive tract: Clinical consequences and implications. J Antimicrob Chemother, 10:263-70.##23. Gibson GR and Roberfroid MB (1995) Dietary modulation of the human colonic microflora: introducing the concept of prebiotics. J Nutr, 125:1401- 12.##24. Salminen S, Bouley C, Boutron-Ruault M-C (1998) Functional food science and gastrointestinal physiology and function. Nutr Soc, 80: 48-71.##25. Lidbeck A and Nord CE (1993) Lactobacilli and the normal human anaerobic microflora. Clin Infec Diseases, 16: 181-7.##26. Hessle C, Hanson LA, Wold AE (1999) Lactobacilli from human gastrointestinal mucosa are strong stimulators of IL-12 production. Clin Exp Immunol, 116: 276-82.##27. Reuter G (2001) The Lactobacillus and Bifidobacterium microflora of the human intestine: composition and succession. Curr Issues Intest Microbiol, 2: 43-53.##28. Cremon C, Carini G, De Giorgio R, Stanghellini V, Corinaldesi R, Barbara G ( 2010) Intestinal dysbiosis in irritable bowel syndrome: etiological factor or epiphenomenon? Expert Rev Mol Diagn, 10:389-93.##29. Hill DA and Artis D (2010) Intestinal bacteria and the regulation of immune cell homeostasis. Annu Rev Immunol, 28: 623-67.##30. Santhosh S, Dutta AK, Samuel P, Joseph AJ, Ashok Kumar J, Kurian G (2010) Cytokine gene polymorphisms in Irritable bowel syndrome in Indian population—a pilot case control study. Trop Gastroenterol, 31:30-3.##31. Bashir ME, Louie S, Shi HN, Nagler-Anderson C (2004) Toll-like receptor 4 signaling by I ntestinal microbes influences susceptibility to food allergy. J Immuno, 172: 6978–6987.##32. Dillon SA, Agrawal T, Van Dyke G, Landreth L, McCauley A, Koh C, Maliszewski S (2004) A Toll-like receptor 2 ligand stimulates Th2 responses in vivo, via induction of extracellular signal-regulated kinase mitogen-activated protein kinase and c-Fos in dendritic cell. J Immunol, 172: 4733–4743.##33. Re F and Strominger JL (2004) IL-10 released by concomitant TLR2 stimulation blocks the induction of a subset of Th1 cytokines that are specifically induced by TLR4 or TLR3 in human dendritic cells. J Immunol, 173: 7548–7555.##34. Redecke V, .Ha¨cker H, Datta SK, Fermin A, Pitha PM, Broide DH, Raz E (2004) Cutting edge: activation of Toll-like receptor 2 induces a Th2 immune response and promotes experimental asthma. J Immunol, 172: 2739–2743.##35. Wenink MH, Santegoets KC, Broen JC, van Bon L, S. Abdollahi R, Popa C, R Huijbens R, Remijn T, Lubberts E, van Riel PL,  van den Berg WB, Radstake (2009) TLR2 promotes Th2/Th17 responses via TLR4 and TLR7/8 by abrogating the type I IFN amplification loop. J Immunol, 183: 6960–6970.##36. Sheikh Sajjadieh MR , Kuznetsova LV, Bojenko VB (2009) Effect of ionizing radiation on development process of T-cell population lymphocytes in Chernobyl children. Int J Radiat Res, 7: 127-133.## ##

Predictive values of TNF-α, IL-6, IL-10 for radiation pneumonitis 2 2 Background: To investigate the expression of TNF-α, IL-6, IL-10 in the plasma of patients with lung cancer who received radiation therapy (RT), and to analyze the correlation between these cytokines and radiation pneumonitis (RP). Materials and Methods: Patients with lung cancer who received 3D-CRT in our hospital were prospectively evaluated. Circulating cytokine levels were measured with ELISA before RT and at the end of RT. Regular follow-up was undertaken 3 months after RT. Statistical analysis was applied to determine the relevance of cytokines to radiation-induced lung injury. Results: Of 104 patients, 29 (27.9%) developed RP. The levels of TNF-α and IL-6 levels in the plasma after RT were significantly higher than before RT (p<0.05), whereas IL -10 levels were significantly lower after RT than before RT (p<0.05). Before RT, TNF-α levels were higher in RP group (p<0.05),but there were no differences in TNF-α levels after RT. No association was observed between IL-6 and IL-10 levels and the risk of RP. Univariate analysis showed that baseline pulmonary function, smoking history, histopathology, lung volume receiving ≥20 Gy (V20), Mean lung dose (MLD) and total radiation dose were related to RP, but only MLD was an independent risk factor for RP in lung cancer patients (OR>1). Conclusion: TNF-α levels in plasma were closely related to RP but still cannot be used as predictors for RP. 173 179 2016/10/42016/10/4 1395/7/13 2016/10/42016/10/4 1395/7/13 B. Li B. Li Jiaozhou Central Hospital China S.H. Chen S.H. Chen Qingdao Economic Technological Development China H.J. Lu H.J. Lu the Affiliated Hospital of Qingdao University China Y. Tan Y. Tan the Affiliated Hospital of Qingdao University China Radiation pneumonitis tumor necrosis factor–α interleukin-6 interleukin-10 lung cancer 1. Bodnar M, Szylberg L, Kazmierczak W, et al. (2012) Differentiated expression of membrane type metalloproteinases (MMP-14, MMP-15) and pro-MMP2 in laryngeal squamous cell carcinoma. A novel mechanism. J Oral Pathol Med, 23(8): 231-234．##2. Ghafoori P, Marks LB, Vujaskovic Z et a1. (2008) Radiation-induced lung injury, Assessment, management, and prevention. Oncology, 22(1): 37-47.##3. Luzina IG, Todd NW, Sundararajan S, Atamas SP (2015) The cytokines of pulmonary fibrosis: Much learned, much more to learn. Cytokine, 74(1): 88-100.##4. Ding NH, Li JJ, Sun LQ (2013) Molecular mechanisms and treatment of radiation-induced lung fibrosis. Curr Drug Targets, 14(11): 1347-56.##5. Rube CE, Rodemann HP, Rube C (2004) The relevance of cytokines in the radiation-induced lung reaction. Experimental basis and clinical significance. Strahlenther Onkol, 180(9): 541-9.##6. Redlich CA, Gao X, Rockwell S, Kelley M, Elias JA (1996) IL-11 enhances survival and decreases TNF production after radiation induced thoracic injury. J Immunol, 157: 1705-10.##7. Luo Y, Wang M, Pang Z, Jiang F, Chen J, Zhang J (2013) Locally instilled tumor necrosis factor alpha antisense oligonucleotide contributes to inhibition of TH 2-driven pulmonary fibrosis via induced CD4+ CD25+ Foxp3+ regulatory T cells. J Gene Med, 15(11-12): 441-52. ##8. Chiang CS, Liu WC, Jung SM, Chen FH, Wu CR, McBride WH et al. (2005) Compartmental responses after thoracic irradiation of mice: strain differences. Int J Radiat Oncol Biol Phys, 62: 862-71.##9. Wolf J, Rose-John S, Garbers C (2014) Interleukin-6 and its receptors: a highly regulated and dynamic system. Cytokine, 70: 11-20.##10. Scheller J, Chalaris A, Schmidt-Arras D, Rose-John S (2011) The pro- and anti-inflammatory properties of the cytokine interleukin-6. Biochim Biophys Acta, 1813(5): 878-88.##11. Nicole BB, Lionel BE, Didier C, et al. (2004) Increased IL-6 and TGF-β concentrations in bronchoalveolar lavage fluid associated with thoracic radiotherapy. Radiation Oncology Biol Phys, 58: 758-767.##12. Minako S, Mayumi I, Yoichiro I, Toshie O, Hirohiko T, Takashi I (2008) CD44 and bak expression in IL-6 or TNF-alpha gene knockout mice after whole Lung irradiation. J Radiat Res, 48: 409-416.##13. Bao P, Zhao W, Li Y et al. (2015) Protective effect of ulinastatin in patients with non-small cell lung cancer after radiation therapy: a randomized, placebo-controlled study. Med Oncol, 32: 405.##14. Chen Y, Hyrien O, Williams J, Okunieff P, Smudzin T, Rubin P (2005) Interleukin (IL)-1A and IL-6:applications to the predictive diagnostic testing of radiation pneumonitis. Int J Radiat Oncol Biol Phys, 62: 260-6.##15. Arpin D, Perol D, Blay JY, Falchero L, Claude L, Vuillermoz-Blas S et al. (2005) Early variations of circulating interleukin-6 and interleukin-10 levels during thoracic radiotherapy are predictive for radiation pneumonitis. J Clin Oncol, 23: 8748-56.##16. Bradley JD, Hope A, El Naqa I, Apte A, Lindsay PE, Bosch WA et al. (2007) Nomogram to predict radiation pneumonitis, derived from a combined analysis of RTOG 9311 and institutional data. Int J Radiat Oncol Biol Phys, 69(4): 985-92.##17. Gravs PR, Siddiqui F, Anscher MS, Movsas B (2010) Radiation pulmonary toxicity: from mechanisms to management. Semin Radiat Oncol, 20: 201–7.##18. Schallenkamp JM, Miller RC, Brinkmann DH, Foote T, Garces YI (2007) Incidence of radiation pneumonitis after thoracic irradiation: Dose-volume correlates. Int J Radiat Oncol Biol Phys, 67: 410–416.##19. Wang YS, Chang HJ, Chang YC, Huang SC, Ko HL, Chang CC (2013) Serum amyloid a as a predictive marker for radiation pneumonitis in lung cancer patients. Int J Radiat Oncol Biol Phys, 85: 791-7.##20. Yilmaz S, Adas YG, Hicsonmez A, Andrieu MN, Akyurek S, Gokce SC et al. (2014) Evaluation of the radiation pneumonia development risk in lung cancer cases. Asian Pac J Cancer Prev, 15: 7371-7375.##21. Zhuang H, Hou H, Yuan Z, Wang J, Pang Q, Zhao L et al. (2014) Preliminary analysis of the risk factors for radiation pneumonitis in patients with non-small-cell lung cancer treated with concurrent erlotinib and thoracic radiotherapy. Onco Targets Ther, 7: 807-13. ##22. Zhang M, Qian J, Xing X, Kong F-M, Zhao L, Chen M et al. (2008) Inhibition of the tumor necrosis factor-A pathway is radioprotective for the lung. Clin Cancer Res, 14(6): 1868-76. ##23. Hill RP, Zaidi A, Mahmood J, Jelveh S (2011) Investigations into the role of inflammation in normal tissue response to irradiation. Radiother Oncol, 101: 73–79.##24. Rube CE, Uthe D, Wilfert F, Ludwig D, Yang K, Konig J et al. (2005) The bronchiolar epithelium as a prominent source of pro-inflammatory cytokines after lung irradiation. Int J Radiat Oncol Biol Phys, 61: 1482-92.##25. Hartsell WF, Scott CB, Dundas GS, Mohiuddim M, Meredith RF, Rubin P (2007) Can serum markers be used to predict acute and late toxicity in patients with lung cancer? Analysis of RTOG 91-03. Am J Clin Oncol, 30: 368-76.##26. Chen Y, Rubin P, Wiliams J, Hernady E, Smudzin T, Okuniefe P (2001) Circulating IL-6 as a predictor of radiation pneumonitis. Int J Radiation Oncology Biol.Phys, 49: 641- 648.##27. Fu ZZ, Peng Y, Cao LY, Chen Y-S, Li Kun, Fu B-H (2016) Correlations between serum IL-6 levels and radiation pneumonitis in lung cancer patients: A Meta-Analysis. J Clin Lab Anal, 30(2): 145-154.##28. Rube CE, Palm J, Erren M, Fleckenstein J. Konig J, Remberger K et al. (2008) Cytokine plasma levels: reliable predictors for radiation pneumonitis? PLoS One 3(8):e2898.##29. Stenmark MH, Cai XW, Shedden K, Hayman JA, Yuan S, Ritter T (2012) Combining physical and biological parameters to predict radiation-induced lung toxicity in patients with non-small-cell lung cancer treated with definitive radiation therapy. Int J Radiat Oncol Biol Phys, 84(2): e217-22.##30. Kim JY, Kim YS, Kim YK, Park HJ, Kim SJ, Kang JH et al. (2009) The TGF-beta1 dynamics during radiation therapy and its correlation to symptomatic radiation pneumonitis in lung cancer patients. Radiat Oncol, 4: 59.##31. Ogata T, Yamazaki H, Teshima T, Tsuchiya T, Nishimoto N, Matsuura, N (2012) Anti-IL-6 receptor antibody does not ameliorate radiation pneumonia in mice. Exp Ther Med; 4: 273-276.## ##

Radiation-induced expression of platelet endothelial cell adhesion molecule-1 in cerebral endothelial cells 2 2 Background: Radiation-induced molecular changes on the endothelial surface of brain arteriovenous malformations (AVM) may be used as markers for specific vascular targeting agents. In this study, we examined the level of expression of platelet endothelial cell adhesion molecule-1 (PECAM-1) on brain endothelial cell surface after radiation treatment, with the aim of targeting the radiation-induced PECAM-1 on the AVM endothelium with pro-thrombotic agents to selectively occlude AVM vessels. Materials and Methods: Mouse cerebral endothelial cells (bEnd.3) were irradiated with 5, 15, or 25 Gy. Real-time quantitative polymerase chain reaction (PCR) and in-cell enzyme-linked immunosorbent assay (ELISA) were performed to quantify the temporal gene and surface PECAM-1 protein expression up to 168 hours post-irradiation. Two-tailed unpaired t-tests were used to determine statistical significance. Results: PECAM-1 gene expression was found to be significantly elevated post-irradiation in real-time quantitative PCR, with the maximum level of gene expression being evident at 120 hours post-irradiation representing an 11-fold increase in comparison to non-irradiated controls (p<0.001). In-cell ELISA detected a similar up-regulation for protein expression on the cell surface with delayed peak time. Conclusion: Ionising radiation can induce the up-regulation of PECAM-1 on brain endothelial cell surface. This protein may be a potential candidate for facilitating selective AVM vessel occlusion through the application of radiosurgery followed by vascular targeting. 181 188 2016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/4 1395/7/13 B. Chen B. Chen Macquarie University Australia Z. Zhao Z. Zhao Macquarie University Australia zhenjun.zhao@mq.edu.au V. Lee V. Lee Macquarie University Australia R. 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Hashimoto T, Lawton MT, Wen G, Yang GY, Chaly T, Jr., Stewart CL, Dressman HK, Barbaro NM, Marchuk DA, and Young WL (2004) Gene microarray analysis of human brain arteriovenous malformations. Neurosurgery, 54: 410-23.##37. Matsubara S, Bourdeau A, terBrugge KG, Wallace C, and Letarte M Analysis of endoglin expression in normal brain tissue and in cerebral arteriovenous malformations. Stroke, 31: 2653-60.##38. Quarmby S, Kumar P, Wang J, Macro JA, Hutchinson JJ, Hunter RD, and Kumar S (1999) Irradiation induces upregulation of CD31 in human endothelial cells. Arterioscler Thromb Vasc Biol, 19: 588-97.##39. Gaugler MH, Squiban C, Mouthon MA, Gourmelon P, and van der Meeren A (2001) Irradiation enhances the support of haemopoietic cell transmigration, proliferation and differentiation by endothelial cells. Br J Haematol, 113: 940-50.##40. 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Dosimetric comparison between intensity modulated radiotherapy and three dimensional conformal radiotherapy planning in patients with locally advanced cervical carcinoma 2 2 Background: External beam radiotherapy (EBRT) is mainstay of treatment in patients with locally advanced cervical carcinoma (LACC). Three dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are mainly used in EBRT. However which one is superior is still controversial. Materials and Methods: Forty patients of LACC treated with IMRT were selected for this study. 3DCRT plans were also created for all the patients. 3DCRT and IMRT plans were compared on the basis of planning target volume (PTV) coverage, dose to normal organs, homogeneity index (HI) and conformity index (CI95%). Results:  In both the techniques 99% of PTV was covered with more than 96% of prescribed dose (PD). D15, D35 and D50 (Dose to 15%, 35% and 50% volume respectively) for bladder was reduced by 2.09%, 14.623% and 32.57% and for the rectum it was reduced by 7.46% ,23.82% and 43.68%  in IMRT compared to 3DCRT. V45 (volume receiving 45 Gy) in case of bowel were found to be much less in IMRT in comparison to 3DCRT. Insignificant difference found between doses to femoral heads in IMRT and 3DCRT. The CI95% in IMRT plans was found much better than that in 3DCRT whereas HI in both the techniques were found almost same. Conclusion:  IMRT significantly reduced the irradiated volume of OAR and improved dose conformity in the PTV compared to that by 3DCRT. So, it can be concluded that IMRT should be chosen as preferred technique for the EBRT of LACC with proper immobilizing devices and imaging. 189 196 2016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/4 1395/7/13 A. Naik A. Naik Sri Aurobindo Institute of Medical Sciences India O.P. Gurjar O.P. Gurjar Sri Aurobindo Institute of Medical Sciences India ominbarc@gmail.com P. Bagdare P. Bagdare Sri Aurobindo Institute of Medical Sciences India K.L. Gupta K.L. Gupta Sri Aurobindo Institute of Medical Sciences India V. Bhandari V. Bhandari Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, India India M. Kausar M. Kausar Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, India India D.D. Ladia D.D. Ladia Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, India India H.K. Mittal H.K. Mittal Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, India India External radiotherapy IMRT locally advanced cervical carcinoma 3DCRT. Barakat R, Markman M, Randall M (2009) Principles and practice of gynecologic oncology, 5th ed. Philadelphia: Lippincott Williams & Wilkins.##Nandakumar A, Ramnath T, Chaturvedi M (2009) The magnitude of cancer cervix in India. Indian J Med Res, 130: 219-21.##Schiffman M, Castle PE, Jeronim J, Rodrigue AC, Wacholde S (2007) Human papillomavirus and cervical cancer. Lancet, 370: 890–907.##Chemoradiotherapy for Cervical Cancer Meta-Analysis Collaboration (2008) Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomized trials. J Clin Oncol, 26: 5802-12.##Kirwan JM, Symonds P, Green JA, Tierney J, Collingwood M, Williams CJ (2003) A systemic review of acute and late toxicity of concomitant chemoradiation for cervical cancer. Radiother Oncol, 68: 217-26.##Eifel PJ, Levenback C, Wharton T, Oswald MJ (1995) Time course and incidence of late complications in patients treated with radiation therapy for FIGO stage IB carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys, 32: 1289-1300.##Forrest JL, Ackerman I, Barbera L, Barnes EA, Davidson M, Kiss A, et al. (2010) Patient outcome study of concurrent chemoradiation, external beam radiotherapy, and high-dose rate brachytherapy in locally advanced carcinoma of the cervix. Int J Gynecol Cancer, 20: 1074-8.##Hunt MA, Schultheiss TE, Desobry GE, Hakki M, Hanks GE (1995) An evaluation of setup uncertainties for patients treated to pelvic sites. Int J Radiat Oncol Biol Phys, 32: 227-33.##Gurjar OP, Mishra SP, Bhandari V, Pathak P, Pant S, Patel P (2014) A study on the necessity of kV-CBCT imaging compared to kV-Orthogonal portal imaging based on setup errors: Considering other socioeconomical factors. J Can Res Ther, 10: 583-6.##Pecorelli S, Zigliani L, Odicino F (2009) Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet, 105: 107-8.##Lim K, Small W Jr, Portelance L, Creutzberg C, Jürgenliemk-Schulz IM, Mundt A, et al. (2011) Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy for the definitive treatment of cervix cancer. Int J Radiat Oncol Biol Phys, 79: 348-55.##Gurjar OP and Mishra SP (2013) Dosimetric analysis of intensity modulated radiotherapy plans having one or more pairs of parallel opposed beams among the set of beams in some special cases. Radiat Prot Environ, 36: 138-42.##Portelance L, Chao KS, Grigsby PW, Bennet H, Low D (2001) Intensity-modulated radiation therapy (IMRT) reduces small bowel, rectum, and bladder doses in patients with cervical cancer receiving pelvic and para-aortic irradiation. Int J Radiat Oncol Biol Phys, 51: 261-6.##Heron DE, Gerszten K, Selvaraj RN, King GC, Sonnik D, Gallion H, et al. (2003) Conventional 3D conformal versus intensity-modulated radiotherapy for the adjuvant treatment of gynecologic malignancies: a comparative dosimetric study of dose-volume histograms small star, filled. Gynecol Oncol, 91: 39-45.##Roeske JC, Lujan A, Rotmensch J, Waggoner SE, Yamada D, Mundt AJ (2000) Intensity-modulated whole pelvic radiation therapy in patients with gynecologic malignancies. Int J Radiat Oncol Biol Phys, 48: 1613-21.##Van de Bunt L, van der Heide UA, Ketelaars M, de Kort GA, Jurgenliemk-Schulz IM (2006) Conventional, conformal, andintensity-modulated radiation therapy treatment planning ofexternal beam radiotherapy for cervical cancer: the impact of tumor regression. Int J Radiat Oncol Biol Phys, 64: 189-96.##Forrest J, Presutti J, Davidson M, Hamilton P, Kiss A, Thomas G (2012) A Dosimetric Planning study comparing intensity-modulated radiotherapy with four-field conformal pelvic radiotherapy for the definitive treatment of cervical carcinoma. Clin Oncol (R Coll Radiol) 24: 63-70. ##Mell LK, Tiryaki H, Ahn KH, Mundt AJ, Roeske JC, Aydogan B (2008) Dosimetric comparison of bone marrow-sparing intensity-modulated radiotherapy versus conventional techniques for treatment of cervical cancer. Int J Radiat Oncol Biol Phys, 71: 1504-10.##Yang B, Zhu L, Cheng H, Li Q, Zhang Y, Zhao Y (2012) Dosimetric comparison of intensity modulated radiotherapy and three-dimensional conformal radiotherapy in patients with gynecologic malignancies: a systematic review and meta-analysis. Radiat Oncol, 7: 197.##Mundt AJ, Mell LK, Roeske JC (2003) Preliminary analysis of chronic gastrointestinal toxicity in gynecology patients treated with intensity modulated whole pelvic radiation therapy. Int J Radiat Oncol Biol Phys, 56: 1354–60.##Mundt AJ, Roeske JC, Lujan AE, Yamada SD, Waggoner SE, Fleming G, Rotmensch J (2001) Initial clinical experience with intensity-modulated whole-pelvis radiation therapy in women with gynecologic malignancies. Gynecol Oncol, 82: 456-63.##Salama JK, Mundt AJ, Roeske J, Mehta N (2006) Preliminary outcome and toxicity report of extended-field, intensity-modulated radiation therapy for gynecologic malignancies. Int J Radiat Oncol Biol Phys, 65: 1170-76.##Brixey CJ, Roeske JC, Lujan AE, Yamada SD, Rotmensch J, Mundt AJ (2002) Impact of intensity-modulated radiotherapy on acute hematologictoxicity in women with gynecologic malignancies. Int J Radiat Oncol Biol Phys, 54: 1388-96.##Gandhi AK, Sharma DN, Rath GK, Julka PK, Subramani V, SharmaS, et al. (2013) Early clinical outcomes and toxicity of intensity modulated versus conventional pelvic radiation therapy for locally advanced cervix carcinoma: a prospective randomized study. Int J Radiat Oncol Biol Phys, 87: 542-8.##Buchali A, Koswig S, Dinges S, Rosenthal P, Salk J, Lackner G, et al. (1999) Impact of the filling status of the bladder and rectum on their integral dose distribution and the movement of the uterus in the treatment planning of gynaecological cancer. Radiother Oncol, 52: 29-34.##Chan P, Dinniwell R, Haider MA, Cho YB, Jaffray D, Lockwood G, et al. (2008) Inter- and intrafractional tumour and organ movement in patients with cervical cancer undergoing radiotherapy: a cinematic- MRI point-of-interest study. Int J Radiat Oncol Biol Phys, 70: 1507-15.##Huh SJ, Park W, Han Y (2004) Interfractional variation in position of the uterus during radical radiotherapy for cervical cancer. Radiother Oncol, 71: 73-9.##Ahmad R, Hoogeman MS, Bondar M, Dhawtal V, Quint S, De Pree I, et al. (2011) Increasing treatment accuracy for cervical cancer patients using correlations between bladder-filling change and cervix-uterus displacements: proof of principle. Radiother Oncol 98: 340-6.##Bondar L, Hoogeman M, Mens JW, Dhawtal G, de Pree I, Ahmad R, et al. (2011)Toward an individualized target motion management for IMRT of cervical cancer based on model-predicted cervix-uterus shape and position. Radiother Oncol, 99: 240–5.##Jhingran A, Winter K, Portelance L, Miller B, Salehpour M, Gaur R, et al. (2012) A phase II study of intensity modulated radiation therapy to the pelvis for postoperative patients with endometrial carcinoma: radiation therapy oncology group trial 0418. Int J Radiat Oncol Biol Phys, 84: 23-8.##Nuyttens JJ, Robertson JM, Yan D, Martinez A (2004) The influence of small bowel motion on both a conventional three-field and intensity modulated radiation therapy (IMRT) for rectal cancer. Cancer Radiother,  8: 297-304.## ##

The comparison of dose distribution of different 3D conformal and conventional radiotherapy plans for gastric cancer 2 2 Aims: It was aimed to investigate postoperative conformal radiotherapy planning that provides the best target volume and the least dose for critical organs in cancers of stomach. Methods: This study was conducted on the CT simulation images of thirty patients diagnosed with gastric cancer. Target volumes and the organs at risk were contoured. AP-PA reciprocal parallel field conventional plan and three- and four-field 3D conformal plans were created using linear accelerator. Target volumes and doses consumed by organs at risk were compared by dose-volume histograms. Results: While a sufficient dose could be applied to target volumes in all plans with conformal planning, average figures showed that 95% of porta hepatis area failed to take the prescribed dose (D95) in some plans by using AP-PA reciprocal parallel zone conventional plans. The most convenient protection for spinal cord, heart and kidneys was obtained by conformal four-field technique and the liver doses were increased in conformal four-field plans but did not exceed the tolerance dose. And also, in the conventional AP-PA reciprocal parallel field plans, tolerance dose of spinal cord (4500 cGy) was exceeded. Conclusion: In this study, conformal four-field technique was superior considering target volume dose distributions, and especially spinal cord doses in all localizations and heart doses in cardia tumors. Kidney doses were also reduced in conformal four-field planning, but failed to reach statistical significance. There was a not exceeding tolerance limits dose increase in liver 197 203 2016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 M. Izmirli M. Izmirli Department of Radiation Oncology Turkey izmirlimustafa@hotmail.com G. Yilmazer G. Yilmazer Department of Radiation Oncology Turkey T. Cakir T. Cakir Department of Radiation Oncology Turkey Z.A. Palabiyik Z.A. Palabiyik Department of Radiation Oncology Turkey M. Nart M. Nart Department of Radiation Oncology Turkey Gastric cancer 3-dimensional conformal radiotherapy dose-volume histogram. 1. Yao JC, Mansfield PF, Pisters PWT, Feig BW, Janjan NA, Crane C, Ajani JA (2003) Combined-modality therapy for gastric cancer. Semin Surg Oncol, 21(4):223-7. ##2. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics 2002. CA Cancer J Clin, 55(2):74–108. ##3. Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. (2001) Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med, 345(10):725-30. ##4. Macdonald JS, Smalley SR, Benedetti J, Estes N, Haller DG, Ajani JA, Gunderson LL, Jessup M, Martenson JA (2004) Preoperative combined radiation and chemotherapy improves disease-free survival (DFS) and overall survival (OS) in resected adenocarcinoma of the stomach and gastroesophageal junction: Undate of the results of Intergroup Study INT-0116 (SWOG 9008). Gastrointestinal Cancers Symposium Program / Proceedings, Abstract; 106 p. ##5. Halperin E, Perez C, Brady L (2008) The discipline of radiation oncology. In: Perez and Brady’s principles and practice of radiation oncology, 5th ed. (Halperin EC, Perez CA, Brady LW, eds) Lippincot Williams and Wilkins, Philadelphia, USA; 2-75 p. ##6. Purdy JA (2008) Three-dimensionel conformal radiotherapy; physics, treatment planning, and clinical aspects. In: Perez and Brady’s principles and practice of radiation oncology. 5th ed. (Halperin EC, Perez CA, Brady LW, eds) Lippincot Williams and Wilkins, Philadelphia, USA; 218-38 p. ##7. 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Effects of Probiotics with or without Honey on Radiation-induced Diarrhea 2 2 Background: Diarrhea is a well-recognized side effect associated with pelvic radiation; however, there is not any effective common treatment for radiation-induced diarrhea. A popular alternative is probiotics, which have been used in several gastrointestinal disorders. Probiotics are live microbial food supplements. Furthermore, honey is a putative nutritional with a variety of health effects, including antibacterial, antioxidant, anti-inflammatory and prebiotic. The present study evaluated the effects of probiotic with or without honey on radiation-induced diarrhea. Materials and Methods: Sixty-seven adult patients with pelvic cancer underwent radiotherapy for four weeks. They randomized to receive probiotic (n = 22), probiotic plus honey (n = 21) or placebo (n = 24) from one week before radiotherapy for five weeks. Diarrhea grade and stool consistency score were recorded weekly according to the Common Toxicity Criteria system and the Bristol scales, respectively. Results: The results showed a decrease in the daily number of bowel movements (p = 0.003 and 0.006), diarrhea grade (p = 0.001 and 0.001) and the need for antidiarrheal medication (p = 0.021 and 0.041) also an increase in the stool consistency (p = 0.004 and 0.005) in patients who either used probiotic or probiotic plus honey (respectively), these were significant in weeks 4 and 5 of treatment. Conclusion: Probiotics with or without honey can reduce the incidence of radiation-induced diarrhea and the need for antidiarrheal medication 205 213 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 H.s. Mansouri-Tehrani H.s. Mansouri-Tehrani Department of Biotechnology Iran M. Rabbani Khorasgani M. Rabbani Khorasgani Department of Biology Iran M. Roayaei M. 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Safe distal margin resection in patients with low rectal cancer undergoing neoadjuvant chemoradiation 2 2 Background: Colorectal carcinoma is the third most common cause of death in Iran. This study was performed in order to determine the appropriate distal clearance margin (DCM) for resection of rectal cancer in patients who undergo neoadjuvant chemoradiotherapy for sphincter preserving procedure. Materials and Methods: This was a cross-sectional study conducted in Shahid Faghihi Hospital of Shiraz University of Medical Sciences from 2006 to 2011. We included all patients with low rectal cancer who underwent neoadjuvant chemoradiotherapy. The medical charts of patientsand disease characteristics were recorded. The local recurrence, recurrence-free survival and mortality rates were compared between those with DCM ≥2cm and DCM <2cm. Results: Overall, 82 patients with a mean age of 56.7 ± 16.4 years were included. The DCM was found to be ≥2cm in 45 (54.9%) patients and <2cm in 37 (45.1%). The two study groups were comparable in terms of age (p=0.573), sex (p=0.505), histopathological tumor grade (p=0.165), and distance of tumor to anal verge (p=0.125). Patients with DCM ≥2cm had a lower local recurrence rate (35.6% vs. 97.3%; p<0.001), a higher recurrence-free survival rate (88.9% vs. 67.6%; p=0.032) and a lower mortality rate (11.1% vs. 32.4%; p=0.027). Conclusion: Although some studies have showed that DCM<2cm leads to similar results compared to DCM≥ 2cm, our findings revealed that obtaining a distal clearance margin of 2cm for resection of rectal cancer in patients who have undergone neo-adjuvant chemoradiotherapy is associated with a lower local recurrence rate, higher recurrence-free survival rate and lower mortality rate. 215 220 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 L. Ghahramani L. Ghahramani Colorectal Research Center Iran M. Forooghi M. Forooghi Department of General Surgery Iran M. Mohammadianpanah M. Mohammadianpanah Colorectal Research Center Iran S.V Hosseini S.V Hosseini Colorectal Research Center Iran A. Izadpanah A. Izadpanah Colorectal Research Center Iran S. RahimiKazerooni S. RahimiKazerooni Colorectal Research Center Iran F. Ghafarpasand F. Ghafarpasand Shiraz University of Medical Sciences Iran H. Khazraei H. Khazraei Colorectal Research Center Iran Khazraee@sums.ac.ir Rectal cancer low anterior resection (LAR) chemoradiotherapy (CRM) distal clearance margin (DCM) local recurrence. 1. Rezaianzadeh A, Safarpour AR, Marzban M, Mohaghegh A (2015) A systematic review over the incidence of colorectal cancer in Iran. Ann Colorectal Res, 3(1):e25724.##2. Hoseini S, Moaddabshoar L, Hemati S, Mohammadianpanah M (2014) An overview of clinical and pathological characteristics and survival rate of colorectal cancer in Iran. Ann Colorectal Res, 2(1):e17264.##3. Siegel R, Naishadham D, Jemal A (2013) Cancer statistics, 2013. CA Cancer J Clin, 63(1):11-30.##4. Luna-Perez P, Rodriguez-Ramirez S, Vega J, Sandoval E, Labastida S (2001) Morbidity and mortality following abdominoperineal resection for low rectal adenocarcinoma. Rev Invest Clin, 53(5):388-95.##5. Monson JR, Weiser MR, Buie WD, Chang GJ, Rafferty JF, Rafferty J (2013) Practice parameters for the management of rectal cancer (revised). Dis Colon Rectum, 56(5):535-50.##6. Balch GC, De Meo A, Guillem JG (2006) Modern management of rectal cancer: a 2006 update. World J Gastroenterol, 12(20): 3186-95.##7. Omidvari S, Hamedi SH, Mohammadianpanah M, Razzaghi S, Mosalaei A, Ahmadloo N, et al. (2013) Comparison of abdominoperineal resection and low anterior resection in lower and middle rectal cancer. Journal of the Egyptian National Cancer Institute, 25(3):151-60.##8. Guillem JG, Chessin DB, Shia J, Suriawinata A, Riedel E, Moore HG, et al. (2007) A prospective pathologic analysis using whole-mount sections of rectal cancer following preoperative combined modality therapy: implications for sphincter preservation. Ann Surg, 245(1):88-93.##9. Kuvshinoff B, Maghfoor I, Miedema B, Bryer M, Westgate S, Wilkes J, et al. (2001) Distal margin requirements after preoperative chemoradiotherapy for distal rectal carcinomas: are < or = 1 cm distal margins sufficient? Ann Surg Oncol, 8(2):163-9.##10. Leo E, Belli F, Miceli R, Mariani L, Gallino G, Battaglia L, et al. (2009) Distal clearance margin of 1 cm or less: a safe distance in lower rectum cancer surgery. Int J Colorectal Dis, 24(3):317-22.##11. Moore HG, Riedel E, Minsky BD, Saltz L, Paty P, Wong D, et al. (2003) Adequacy of 1-cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy. Ann Surg Oncol, 10(1):80-5.##12. Shimada Y, Takii Y, Maruyama S, Ohta T (2011) Intramural and mesorectal distal spread detected by whole-mount sections in the determination of optimal distal resection margin in patients undergoing surgery for rectosigmoid or rectal cancer without preoperative therapy. Dis Colon Rectum, 54(12):1510-20.##13. Shirouzu K, Isomoto H, Kakegawa T (1995) Distal spread of rectal cancer and optimal distal margin of resection for sphincter-preserving surgery. Cancer, 76(3): 388-92.##14. Silberfein EJ, Kattepogu KM, Hu CY, Skibber JM, Rodriguez-Bigas MA, Feig B, et al. (2010) Long-term survival and recurrence outcomes following surgery for distal rectal cancer. Ann Surg Oncol, 17(11): 2863-9.##15. Bernstein TE, Endreseth BH, Romundstad P, Wibe A (2012) What is a safe distal resection margin in rectal cancer patients treated by low anterior resection without preoperative radiotherapy? Colorectal Dis, 14(2): e48-55.##16. Park IJ and Kim JC (2010) Adequate length of the distal resection margin in rectal cancer: from the oncological point of view. J Gastrointest Surg, 14(8):1331-7.##17. Lavery IC, Lopez-Kostner F, Fazio VW, Fernandez-Martin M, Milsom JW, Church JM (1997) Chances of cure are not compromised with sphincter-saving procedures for cancer of the lower third of the rectum. Discussion 84-5; Surgery, 122(4):779-84.##18. Grinnell RS (1954) Distal intramural spread of carcinoma of the rectum and rectosigmoid. Surg Gynecol Obstet, 99(4):421-30.##19. Williams NS, Dixon MF, Johnston D (1983) Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: a study of distal intramural spread and of patients' survival. Br J Surg, 70(3):150-4.##20. Lee SH, Lee KC, Choi JH, Oh JH, Baek JH, Park SH, et al. (2008)Chemoradiotherapy followed by surgery in rectal cancer: improved local control using a moderately high pelvic radiation dose. Jpn J Clin Oncol, 38(2):112-21.##21. Wibe A, Syse A, Andersen E, Tretli S, Myrvold HE, Soreide O (2004) Oncological outcomes after total mesorectal excision for cure for cancer of the lower rectum: anterior vs. abdominoperineal resection. Dis Colon Rectum, 47(1):48-58.##22. Baik SH, Kim NK, Lee YC, Kim H, Lee KY, Sohn SK, et al. (2007) Prognostic significance of circumferential resection margin following total mesorectal excision and adjuvant chemoradiotherapy in patients with rectal cancer. Ann Surg Oncol, 14(2): 462-9.##23. Adam IJ, Mohamdee MO, Martin IG, Scott N, Finan PJ, Johnston D, et al. (1994)Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet, 344(8924):707-11.##24. Ridgway PF and Darzi AW (2003)The role of total mesorectal excision in the management of rectal cancer. Cancer Control, 10(3):205-11.##25. Grann A, Minsky BD, Cohen AM, Saltz L, Guillem JG, Paty PB, et al. (1997) Preliminary results of preoperative 5-fluorouracil, low-dose leucovorin, and concurrent radiation therapy for clinically resectable T3 rectal cancer. Dis Colon Rectum, 40(5):515-22.##26. Scott N, Jamali A, Verbeke C, Ambrose NS, Botterill ID, Jayne DG (2008) Retroperitoneal margin involvement by adenocarcinoma of the caecum and ascending colon: what does it mean? Colorectal Dis, 10(3):289-93.##27. Andreola S, Leo E, Belli F, Bonfanti G, Sirizzotti G, Greco P, et al. (2001) Adenocarcinoma of the lower third of the rectum surgically treated with a <10-MM distal clearance: preliminary results in 35 N0 patients. Ann Surg Oncol, 8(7): 611-5.##28. Miha Lučovnik MO (2008) Resection margins in rectal cancerFolia Gastroenterol Hepatol. Folia Gastroenterol Hepato, 6(1): 31-35.## ##

Potent radioprotective effect of herbal immunomodulator drug (IMOD) on mouse bone marrow erythrocytes as assayed with the micronucleus test 2 2 Background: Although numerous natural or synthetic drugs have been tested for their radioprotective capacity, yet no suitable drug has been introduced for routine clinical use. In this study the radioprotective effect of "a new herbal immunomodulator" commercially known as IMOD, specifically made to decrease the side effects of HIV virus, was investigated on mouse bone marrow cells. Materials and Methods: Female NMRI mice (in a group of five) were exposed to 2 Gy gamma radiation following three days of intravenously injection (IV) of IMOD at various doses. Mice were sacrificed 48 and 72 h after irradiation. Bone marrow was flushed and slides for bone marrow smears were prepared according to standard method. After staining slides in May Grunwald and Giemsa, polychromatic erythrocytes (PCE) and normochromatic erythrocytes (NCE) were scored for presence of micronucleus (MN). Results: The results showed that gamma irradiation increased the frequency of micronuclei dramatically and excreted cytotoxic effect of cell proliferation. Injection of various doses of IMOD before irradiation however, led to a considerable reduction in the frequency of micronuclei in bone marrow erythrocytes as well as cellular toxicity. Conclusion: Results indicated radioprotective capability of IMOD with a dose reduction factor (DRF) of about 2.3 at a dose of 20 mg/kg body weight. The considerably high DRF might be indicative that IMOD besides being an immunomodulator might also posses’ antioxidant property.   221 228 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 A. Shakeri-Boroujeni A. Shakeri-Boroujeni Department of Radiology Technology Iran H. Mozdarani H. Mozdarani Department of Medical Genetics Iran mozdarah@modares.ac.ir M. Mahmmoudzadeh M. Mahmmoudzadeh Novin Medical Radiation Institute Iran F. Faeghi F. Faeghi Department of Radiology Technology Iran Radioprotection immunomodulator IMOD mouse bone marrow micronucleus assay. Ohnishi T (2012) The disaster at Japan’s Fukushima-Daiichi nuclear power plant after the March 11, 2011 earthquake and tsunami, and the resulting spread of radioisotope contamination. Radiat Res, 177: 1-14.##Fushiki S (2013) Radiation hazards in children-lessons from Chernobyl, Three Mile Island and Fukushima. Brain Dev, 35: 220–227.##Mozdarani H (2012) Biological Complexities in Radiation Carcinogenesis and Cancer Radiotherapy: Impact of New Biological Paradigms. Genes, 3: 90-114.##Patt HM, Tyree EB, Straube RL, Smith DE (1949) Cysteine protection against X irradiation. Science, 110(2852): 213–214.##Weiss JF and Landauer MR (2009) History and development of radiation-protective agents. Int J Radiat Biol, 85: 539–573.##Kouvaris JR, Kouloulias VE, Vlahos LJ (2007) Amifostine: the first selective-target and broad-spectrum radioprotector. Oncologist, 12: 738–747.##Hall EJ and Giaccia AJ (2012) Radiobiology for the Radiobiologist. Philadelphia, PA: Lippincott Williams and Wilkins.##El-Nahas SM, Mattar FE, Mohamed AA (1993) Radioprotective effect of vitamins C and E. Mutat Res, 301: 143-7.##Zangeneh M, Mozdarani H, Mahmoudzadeh A (2015) Potent radioprotective effects of combined regimens of famotidine and vitamin C against radiation-induced micronuclei in mouse bone marrow erythrocytes. Radiat Environ Biophys, 54: 175-181.##Akramiene D, Kondrotas A, Didziapetriene J, Kevelaitis E (2007) Effects of beta-glucan on the immune system. Medicina (Kaunas), 43(8): 597-606.##Kim HJ, Kim MH, Byon YY (2007) Radioprotective effects of an acidic polysaccharide of panax ginseng on bone marrow cells. J Vet Sci, 8: 39-44.##Lee Tk, Johnke RM, Allison RR, Kevin F, Brien O, Dobbs LJ (2005) Radioprotective potential of ginseng. Mutagenesis, 20(4): 237-243.##Stickney DR, Dowding C, Authier S (2007) 5-androstenediol improves survival in clinically unsupported rhesus monkeys with radiation-induced myelosuppression. Int J Immunopharmacol, 7: 500-505.##Mozdarani H, Salimi M, Froughizadeh M (2008) Effect of cimetidine and famotidine on survival of lethally gamma irradiated mice Iran. J Radiat Res, 5(4): 187-19.##Shahidi M and Mozdarani H (2003) Potent radioprotective effect of therapeutic dosesofranitidine and famotidine against gamma-rays induced micronuclei in vivo. Iran J Radiat Res, 1(1): 29 - 35.##Mozdarani H and Gharbali A (1993) Radioprotective effects of Cimetidine in mousebone marrow cells exposed to gamma rays as assayed by the micronucleus test. Int J Radiat Biol, 64: 189-194.##Adhvaryu MR, Srivastav SP, Vaniawala S, Reddy MN (2008) A comparative study of radioprotection by four Indian medicinal herbs against genotoxicity induced by sub-lethal gamma irradiation in Swiss albino mice. Iran J Radiat Res, 6(1): 19-30.##Paul P, Unnikrishnan MK, Nagappa AN (2011) Phytochemicals as radioprotectors. Indian Journal of Natural Products and Resources, 2(2): 137-150.##Shastry CS, Aswathanarayana BJ, Ganesh S, Kalluraya B, Santanu S, Atanu B (2012) Herbal radioprotector: re-emerging trend in the field of radio therapy. Journal of Pharmacy Research, 5(4): 2355-2365##Nair CKK and Menon A (2013) Consumption of antioxidant dietary agents, curcumin and vitamin C, protects cellular DNA from gamma-radiation. Int J Radiat Res, 11(1): 11-16.##Bala K, Saini P, Katare DP (2014) Current status and future potential of herbal radioprotectants. World Journal of Pharmacy and Pharmaceutical Sciences, 3(8): 1341-1366.##Li Y-N, Zhang W-B, Zhang J-H, Xu P, Hao M-H (2016) Radioprotective effect and other biological benefits associated with flavonoids. Tropical Journal of Pharmaceutical Research, 15(5): 1099-1108.##Painuli S and Kumar N (2016) Prospects in the development of natural radioprotective therapeutics with anti-cancer properties from the plants of Uttarakhand region of India. Journal of Ayurveda and Integrative Medicine, 7: 62-68.##Khorramkhorshid HR, Novitsky A, Abdollahi Y, Shahhosseiny M, Sadeghi B, Madani H, Rahimi R, Farzamfar B (2008) Studies on potential mutagenic and genotoxic activity of Setarud. DARU, 16(4): 223-228.##Khoramkhorshid HR, Moshfegh A, Mahdavi B, VeladimirBakayev V, Shahhoseini MH, Gharibdust F (2007) Evaluation of IMOD influence on cytokine profile in skin blister exudates healthy subject. Iran J Allergy, Asthma Immunol, 6: s11- s22.##Schmid W (1975) The Micronucleus Test. Mutat Res, 31: 9-15.##Mozdarani H (2003) Radioprotective properties of histamine H2 receptor antagonists: Present and future prospects. J Radiat Res, 44: 145-149.##Mozdarani H, Ghoraeian P (2008) Modulation of gamma-ray-induced apoptosis in human peripheral blood leukocytes by famotidine and vitamin C. Mutat Res, Genet Toxicol Environ Mutage, 649: 71-78.##Mozdarani H and Nazari E (2009) Cytogenetic damages in preimplantation mouse embryos generated after paternal and parental gamma-irradiation and the influence of vitamin C. Reproduction, 137(1): 35-43.##Mahdavi M and Mozdarani H (2011) Protective effects of famotidine and vitamin C against radiation induced cellular damage in mouse spermatogenesis process. Int J Radiat Res, 8(4): 223-230.##Naeeji A, Mozdarani H, Shabestani Monfared A, Faeghi F, Ahmadi AA, Gholami M, Behzadi R, Momtaz MR (2016) Oral Administration of Vitamin C, Cimetidine and Famotidine on Micronuclei Induced by Low Dose Radiation in Mouse Bone Marrow Cells. J Biomed Phys Eng, accepted in press.##Citrin D,  Cotrim AP,  Hyodo F,  Baum BJ, Krishna MC,  Mitchell JB (2010) Radioprotectors and Mitigators of Radiation-Induced Normal Tissue Injury. The Oncologist,   15 (4): 360-371.##Mortazavi S, Foadi M, Mozdarani H, Haghani M, Mosleh-Shirazi M, Abolghasemi P, et al. (2015) Future role of vitamin C in radiation mitigation and its possible applications in manned deep space missions: survival study and the measurement of cell viability . Int J Radiat Res, 13 (1): 55-60.##Kuntic VS, Stankovic MB, Vujic ZB, Brboric JS, Uskokovic-Markovic SM. (2013) Radioprotectors; the evergreen topic. Chem Biodivers, 10: 1791e803.##Li Y-N, Zhang W-B, Zhang J-H, Xu P, Hao M-H (2016) Radioprotective effect and other biological benefits associated with flavonoids. Trop J Pharm Res, 15(5): 1099-1108.##Kumar S and  Tiku AB (2016) Biochemical and Molecular Mechanisms of Radioprotective Effects of Naringenin, a Phytochemical from Citrus Fruits. J Agric Food Chem, 64(8): 1676–1685.##Xu P, Zhang WB, Cai XH, Lu DD, He XY, Qiu PY, Wu J (2014) Flavonoids of Rosa roxburghii Tratt act as radioprotectors. Asian Pacific J Cancer Preven, 15(19): 8171-8175.##Reshma K, Ashalatha VR, Dinesh M, Vasudevan D (2005) Effect of ocimum flavonoids as a radioprotector on the erythrocyte antioxidants in oral cancer. Indian J Clin Biochem, 20(1): 160-4.##Reshma K,  Rao AV,  Dinesh M,  Vasudevan DM (2008) Radioprotective effects of ocimum flavonoids on leukocyte oxidants and antioxidants in oral cancer. Indian J Clin Biochem, 23(2): 171-175.##Londhe JS, Devasagayam TP, Foo LY, Ghaskadbi SS (2009) Radioprotective properties of polyphenols from Phyllanthus amarus Linn. J Radiat Res, 50: 303-9.##Veerapur VP, Prabhakar KR, Parihar VK, Kandadi MR, Ramakrishana S, Mishra B, et al. (2009) Ficus racemosa Stem Bark Extract: A Potent Antioxidant and a Probable Natural Radioprotector. Evid Based Complement Alternat Med, 6: 317-24.##Benkovic V, Knezevic AH, Dikic D, Lisicic D, Orsolic N, Basic I, et al. (2009) Radioprotective effects of quercetin and ethanolic extract of propolis in gamma-irradiated mice. Arh Hig Rada Toksikol, 60: 129-38.## ##

Variation of annual effective dose from external ionizing radiation among radiation workers of Bahawalpur Institute of Nuclear Medicine and Oncology (BINO), Pakistan 2 2 Background: The aim of the study was to analyze the effective dose record of occupationally exposed radiation workers at Bahawalpur Institute of Nuclear Medicine and Oncology department. Materials and Methods: Annual effective doses of occupationally exposed workers were measured by film badge dosimetry by sending the dosimeters to Radiation Dosimetry Laboratory (RDL), Pakistan Institute of Nuclear Science and Technology (PINSTECH), Islamabad, Pakistan. 46 Radiation workers dose records were studied for a period of 14-years (2000-13). Professionally exposed radiation workers were divided into groups depending upon their professions.    Results: Average effective doses of oncologists, nuclear physicians, medical physicists, radiation technologists, nurses and other supporting staff were in the range of 0.64-1.86, 0.61-2.27, 0.63-1.74, 0.67-2.53, 0.65-2.31 and 0.68-1.79 mSv respectively. The highest annual dose received by radiation technologist was 4.95 mSv. Nobody received the radiation dose greater than 5 mSv in any year and no overexposure case has been noticed throughout the study period. Conclusion: The results revealed that occupationally exposed individuals received doses lower than the recommended annual limits of 20 mSv y-1. This study provides basis to set up action level that is obligatory by Pakistan Nuclear Regulatory Authority, Pakistan 229 235 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 M.A. Gadhi M.A. Gadhi Pakistan Atomic Energy Commission Bahawalpur Pakistan asghargadhi@gmail.com Sh. Fatmi Sh. Fatmi Pakistan Atomic Energy Commission Bahawalpur Pakistan M.Sh. Gadhi M.Sh. Gadhi University of the Punjab Pakistan U. Mahmood U. Mahmood Pakistan Atomic Energy Commission Bahawalpur Pakistan M. Shakil M. Shakil Department of Physics Pakistan S.A. Buzdar S.A. Buzdar Department of Physics Pakistan Effective dose occupational exposure dose limits ionizing radiation. International Atomic Energy Agency (1996) Safety Standards. International basic safety standards for protection against ionizing radiation and for Safety of Radiation sources. 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Determination of radioactivity levels of soil samples and the excess of lifetime cancer risk in Rize province, Turkey 2 2 Background: Turkey, especially the northern part of it, was one of the countries which were contaminated by the Chernobyl accident.  Rize is a city located in the Northeastern district of Turkey which was heavily influenced by the Chernobyl nuclear accident. Materials and Methods: In this study, the activity concentrations of natural (226Ra, 232Th, 40K) and artificial (137Cs) were measurements in soil samples  collected from 132 different points in Rize province of Turkey using gamma spectrometry with a high-purity germanium detector. Results: The average activity concentrations of 226Ra, 232Th and 40K were found to be 85.75±11.77, 51.08±9.42, and 771.57±37.65 Bq/kg in soil samples, respectively. In order to evaluate the radiological hazard of the natural radioactivity, radium equivalent activity (Raeq), representative level index (Iγr), the external hazard index (Hex), the total absorbed dose rate (D), the annual effective dose equivalent (AEDE) and excess life time cancer risk (ELCR) have been calculated and compared with the internationally approved values. Conclusion: The outdoor air absorbed dose rates (D) due to terrestrial gamma rays for soil have been calculated because of agricultural area and living in the surrounding. It is important to determine background radiation level in order to evaluate the health hazards. Annual effective gamma doses and the lifetime risks of cancer were higher than the world’s average. Moreover compared to the World’s average, the lifetime risk of cancer doubled for most of the localities. 237 244 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 S. Dizman S. Dizman Department of Physics Turkey F.K. Görür F.K. Görür Department of Physics Turkey filizkorkmaz@yahoo.com R. Keser R. Keser Department of Physics Turkey Radioactivity soil lifetime cancer risk gamma dose. IAEA (International Atomic Energy Agency) (1996) Technical Report Series 96-00725, Vienna, Austria.##NCRP (National Council on Radiation Protection and Measurement) (1975) Natural background radiation in the U.S., Soil Radioactivity, No. 45.##Teodere DF and Edwards JN (1993) Housing, stres and well-being, evidence from Thailand. 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Radiat Prot Dosim, 162: 630-637.##Yıldız N, Oto B, Turhan Ş, Uğur FA, Gören E (2014) Radionuclide determination and radioactivity evaluation of surface soil samples collected along the Erçek Lake basin in eastern Anatolia, Turkey. J Geochem Explo, 146: 34-39.##Damla N and Aldemir K (2014) Radon survey and soil gamma doses in primary schools of Batman, Turkey. Isotopes Environ Health, 50: 226-234.##Tabar E, Kumru MN, Ichedef M, Sac MM (2013) Radioactivity level and the measurement of soil gas radon concentration in Dikili geothermal area, Turkey. Int J Radiat Res, 11(4): 253-261.##Keser R, Gorur FK, Akcay N, Okumusoglu NT (2011) Radionuclide concentration in tea, cabbage, orange, kiwi and soil and lifetime cancer risk due to gamma radioactivity in Rize, Turkey. J Sci Food Agr, 91: 987-991.##Taskin H, Karavus M, Ay P, Topuzoglu A, Hidiroglu S, Karahan G (2009) Radionuclide concentrations in soil and lifetime cancer risk due to gamma radioactivity in Kirklareli,Turkey. J Environ Radioactiv, 100: 49–53.##Erees FS, Akozcan S, Parlak Y, Çam S (2006) Assessment of dose rates around Manisa (Turkey). Radiat Meas, 41: 598–601.##Karahan G and Bayulken A (2000) Assessment of gamma dose rates around Istanbul(Turkey). J Environ Radioact, 47: 213–221.##Kiliç O, Belivermis M, Topçuoglu S, Cotuk Y, Coskun M, Cayir A, Kuçer R (2008) Radioactivity concentrations and dose assessment in surface soil samples from east and south of Marmara Region, Turkey. Radiat Prot Dosim, 128(3): 324-330.##Merdanoglu B and Altınsoy N (2006) Radioactivity concentrations and dose assessment for soil samples from Kestanbol granite area, Turkey. Radiat Prot Dosim, 121: 399–405.##Kam E and Bozkurt A (2007) Environmental radioactivity measurements in Kastamonu region of northern Turkey. Appl Radiat Isot, 65: 440–444.##Orgun Y, Altınsoy N, Sahin SY, Gungor Y, Gultekin AH, Karahan G, Karacık Z (2007) Natural and anthropogenic radionuclides in rocks and beach sands from Ezine region (Canakkale),Western Anatolia, Turkey. Appl Radiat Isot, 65: 739–747.##Degerlier M, Karahan G, Ozger G (2008) Radioactivity concentrations and dose assessment for soil samples around Adana, Turkey. J Environ Radioact, 99: 1018–1025.##Bozkurt A, Yorulmaz N, Kam E, Karahan G, Osmanlioglu AE (2007) Assessment of environmental radioactivity for Sanliurfa region of southeastern Turkey. Radiat Meas, 42: 1387–1391.##Kurnaz A, Kuçukomeroglu B, Keser R, Okumusoglu NT, Korkmaz F, Karahan G, Cevik U (2007) Determination of radioactivity levels and hazards of soil and sediment samples in Firtina Valley (Rize, Turkey). Appl Radiat Isot, 65: 1281–1289.##Celik N, Cevik U, Celik A, Koz B (2009) Natural and artificial radioactivity measurements in Eastern Black Sea region of Turkey. 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Exposure assessment of the radon in residential tap water in Kastamonu 2 2 Background: It is considered that if radon gas is inhaled and ingested, it is the primary health risks for lung and stomach cancers. This paper presents the measurement results of radon activity concentrations both residential tap water and dam water for Kastamonu city Centre-Turkey. Materials and Methods: The radon activity concentrations of water samples collected from 60 tap waters at four locations and 12 dam water of study area were determined. Radon concentrations were measured using the professional radon monitor AlphaGUARD PQ2000 PRO (Genitron Instruments). Results: The mean value for all residential tap water samples and dam water samples were ascertained as 0.050 Bq l-1 and 0.741 Bq l-1, respectively. The annual effective doses were calculated for the inhalation of radon released to air when water is used and the ingestion of drinking water. The mean values for inhalation and ingestion were found to be 0.1266 μSv y-1 and 0.0105 μSv y-1, respectively. For the radon exposure from ingestion, the annual effective doses were calculated for infants, children, and adults, separately. Conclusion: When the results compared with the internationally recommended safe limits, the tap waters of Kastamonu city Centre is safe for drinking purposes in terms of radon activity concentrations. 245 250 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 A. Kurnaz A. Kurnaz Department of Physics Turkey akurnaz@kastamonu.edu.tr M. Atıf Çetiner M. Atıf Çetiner Department of Physics Turkey Radon exposure tap water effective dose Kastamonu. Ojo TJ and Ajayi IR (2014) A Review on Environmental Radon and Its Potential Health Risk on Humans. IOSR J Environ Sci Tox Food Techno, 8: 1-8.##Lee J and Kim G (2006) A simple and rapid method for analyzing radon in coastal and ground waters using a radon-in-air monitor. J Environ Radioact, 89: 219-228.##United States Environmental Protection Agency (USEPA) (1994) Report to the United States Congress on Radon in Drinking Water, Multimedia Risk and Cost Assessment of Radon. United States Environmental Protection Agency, Office of Water, 4601, EPA 811-R-94-001.##Pirsaheb M, Najafi F, Khosravi T, Hemati L, (2013) A Systematic Review of Radon Investigations Related to Public Exposure in Iran. Iranian Red Cres Med J, 15(11): e10204. ##Binesh A, Mohammadi S, Mowlavi AA, Parvaresh P (2010) Evaluation of the radiation dose from radon ingestion and inhalation in drinking water. Int J Water Res Environ Eng, 2: 174-178.##United States Environmental Protection Agency (USEPA) (2010) Risk Assessment of Radon in Drinking Water, Initial EPA Perspectives on NAS Report: Risk Assessment of Radon in Drinking Water.##World Health Organization (WHO) (2009) WHO handbook on indoor radon a public health perspective, 1: 4.##MTA, General Directorate of Mineral Research and Exploration (2012) Seismic zonation map. http://www.mta.gov.tr/v2.0/deprem/index.php?id=dep_bol_harita.##Republic of Turkey Governorship of Kastamonu. http://www.kastamonu.gov.tr/cografi-yapi.asp, 2014.##Correa JN, Paschuk SA, Schelin HR, Barbosa L, Sadula T, Matsuzaki CA (2009) Measurements of radon concentration level in drinking water at urban area of Critiba (Brazil). International Nuclear Atlantic Conference-INAC 2009, September 27 to October 2, Rio de Janeiro, Brazil, ISBN:978-85-99141-03-8.##United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) (1993) 1993 Report to the General Assembly, with scientific annexes. United Nations sales publication E.94.IX.2. United Nations, New York.##European :::union::: (EU) (2001) Commission Recommendation of 20 December 2001 on the Protection of the Public Against Exposure to Radon in Drinking Water Supplies. Official Journal of the European Communities, L 344: 85-88.##Vitz E (1991) Towards a standard method for determining waterborne radon. 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Appl Radiat Isot, 60: 801–804.##Otwoma D, Mustapha AO (1998) Measurement of 222Rn Concentration in Kenyan Groundwater. Health Phys, 74: 91.##Amrani D and Cherouati DE (1999) Health effects from radon-222 in drinking water in Algiers. J Radiol Prot, 19: 275.##Sarrou I and Pashalidis I (2003) Radon Levels in Cyprus. J Environ Radioact, 68: 269.##Abbady A, Ahmed NK, Saied MH, El-Kamel AH, Ramadan S (1995) Variation of 222Rn concentration in drinking water in Qena. Bull Fac Sci, 24: 101–106.##Kant K, Upadhyay SB, Chakarvarti SK (2005) Alpha activity in Indian thermal springs. Iran J Radiat Res, 2 (4):197-204.##Karahan G, Öztürk N, Bayülken A (2000) Natural Radioactivity in Various Surface Waters in Istanbul, Turkey. Wat Res, 34 (18): 4367-4370.##Erees FS, Aytas S, Sac MM, Yener G, Salk M (2007) Radon concentrations in thermalwaters related to seismic events along faults in the Denizli Basin,Western Turkey. Radiat Meas, 42: 80- 86.##Yalım HA, Sandıkcıoğlu A, Unal R, Orhun O (2007) Measurements of radon concentrations in wellwaters near the Aksehir fault zone in Afyonkarahisar, Turkey. Radiat Meas, 42: 505- 508.##Yarar Y, Günaydi T, Çelebi N (2006) Determination of Radon Concentrations of The Dikili Geothermal Area in Western Turkey. Radiat Prot Dosim, 118 (1): 78-81.##Tarim UA, Gurler O, Akkaya G, Kilic N, Yalcin S, Kaynak G, Gundogdu O (2012) Evaluation of radon concentration in well and tap waters in Bursa, Turkey. Radiat Prot Dosim, 150 (2): 207-212.##Öner F, Yalim HA, Akkurt A, Orbay M (2009) The Measurements of radon concentrations in drinking water and The Yesilırmak river water in the area of Amasya in Turkey, Radiat Prot Dosim, 133(4): 223-226.##Yiğitoğlu I, Öner F, Yalim HA, Akkurt A, Okur A, Özkan A (2010) Radon concentrations in water in the region of Tokat city in Turkey. 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Pediatric dose assessment in common CT examination towards establishment of related regional DRL in Mazandaran, Iran 2 2 Background: Computed Tomography (CT) is main contributor of population dose from diagnostic X-ray examinations. Children are more radiosensitive than adults, thus optimization of CT examination in these patients is essential. The purpose of this study was to evaluate dose delivered to pediatric patients’ undergoing CT examination of the common examinations and also establishing local Diagnostic Reference Levels (DRLs). Materials and Methods: Questionnaires were designed for data collection at seven public hospitals and information about patient, protocol and CT system were recorded during 2013 and 2014. Dose measurement was performed in four age groups: 0-1, 1-5, 5-10 and 10-15 years old and two CT dose quantity including CTDIw   and DLP were calculated. Results: Values  of 40, 48, 59.5, 59.5 mGy; 16.9, 16.9, 17.14, 17.14 mGy; 17, 17, 17, 17 mGy; 17, 17, 19.2, 19.2 mGy in terms of CTDIw and 448, 538, 758, 758 mGy cm; 129, 129, 154, 167 mGy cm; 184, 225, 306, 315 mGy cm; 289, 408, 595, 670 mGy cm in terms of DLP as regional DRL for brain, sinus, chest, abdomen and pelvic examinations were obtained respectively. Conclusion: The variations in dose of some examination were considerable. As the role and usage of CT technology continues to expand, it is important that all practitioners adapt optimized protocols, especially for pediatrics scanning, following proposed reference levels 251 256 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 A. Janbabanezhad-Toori A. Janbabanezhad-Toori Radiobiology and Radiation Protection Iran M.R. Deevband M.R. Deevband Department of Medical Physics and Biomedical Engineering Iran mdeevband@sbmu.ac.ir A. Shabestani-Monfared A. Shabestani-Monfared Department of Medical Physics Iran R. Abdi R. Abdi Department of Radiology Iran M. Nabahati M. Nabahati Department of Radiology Iran Computed tomography pediatric diagnostic reference level radiation dosimetry. 1. Aroua A, Trueb P, Vader JP, Valley JF, Verdun FR (2007) Expousure of the swiss population by radiodiagnostics. 2003 review. Health phys, 92: 442-8.##2. Coren ME, Ng V, Rubens M, Bush A (1998) The value of ultrafast computed tomography in the investigation of pediatric chest disease. Pediatr Pulmonol, 26: 389-95.##3. Brenner DJ, Elliston CD, Hall EJ, Berdon WE (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR, 176: 289-96.##4. Brenner DJ and Hall EJ (2007) Computed tomography: an increasing source of radiation exposure. N Engl J Med, 357: 2277–84.##5. Donnelly LF, Emery KH, Brody AS, et al. (2001) Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large children’s hospital. AJR, 176:303–06.##6. Hall EJ. Lessons we have learned from our children (2002) cancer risks from diagnostic radiology. Pediatr Radiol, 32: 700–706.##7. International Commission on Radiation Protection (2000) Managing patient dose in computed tomography. ICRP Publication 87, Annals of ICRP 30 (4).##8. Rehani MM and Tsapaki V (2011) Impact of the International Atomic Energy Agency (IAEA) actions on radiation protection of patients in many countries. Radiat Prot Dosimetry, 147:34-37.##9. [No authors listed] (2002) The ALARA (as low as reasonably achievable) concept in pediatric CT intelligent dose reduction. Pediatr Radiol, 32: 217–313.##10. United Nations Scientific Committee on the Effects of Atomic Radiation. UNSCEAR 2008 report, vol. I: sources of ionizing radiation. Annex A: medical radiation exposures. New York, NY: United Nations, 2010##11. Rogers LF (2001) Taking care of children: check out the parameters used for helical CT. (editorial) AJR, 176: 287.##12. Paterson A, Frush DP, Donnelly LF (2001) Helical CT of the body: are settings adjusted for pediatric patients? AJR, 176: 297–301.##13. American College of Radiology Website. ACR appropriateness criteria. www.acr.org/Secondary- MainMenuCategories/quality_safety/app_criteria. aspx. Accessed May 1, 2011.##14. International Commission on Radiological Protection (1991) 1990 Recomendations of the International Commission on Radiological Protection. ICRP Publication 60, Annals of ICRP 21 (1-3). ##15. International Commission on Radiological Protection (1996) Radiological Protection and Safety in Medicine. ICRP Publication 73. Annals of ICRP 26 (2).##16. Shrimpon PC, Hiller MC, Lewis MA, Dunn M (2006) National survey of doses from CT in the UK. Br J Radiol, 79: 968-80.##17. Vedun FR, Gutierrez D, Vader JP, Aroua A, Alamo-Maestre LT, Bochud F, Gudinchet F (2008) CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Swidzerland. Eur Radiol, 18: 1980-86.##18. Shrimpton PC and Wall BF (2000) Reference doses for peadiatric computed tomography. Radiot Prot Dosimetry, 90: 249-52.##19. Glanski M, Nagel HD, Stamm G (2006) Paediatric CT exposure practice in the Federal Republic of Germany: Result of nationwide survey in 2005-2006. Medizinische, Hochschule, Hannover.##20. Tack D, Gevenois PA (2004) Radiation dose in computed tomography of the chest. JBR-BTR, 87: 281-88.## ##

Evaluation of regional nodes irradiation during breast cancer radiotherapy 2 2 Background: The purpose of this study was to evaluate nodal irradiation with conventional three-field's technique. Materials and Methods: Fifty patients with breast cancer were enrolled in this study. Computed tomography scans in the supine treatment position were imported into a treatment planning system. Levels I-III axillary and supraclavicular nodes were identified and their depths to the anterior skin surface were measured. Two tangential fields and one anterior- posterior supraclavicular field were developed to treat all of the patients. Dose –volum histogram was evaluated for quality measurement. Results: The mean depths of the level I, II and III axillary and supraclavicular nodes varied widely (4.6, 5.7, 6.1 and 5.9 cm, respectively). Complete coverage of level II was not achieved by tangential fields. In some patients the optimal dose was not prescribed. The median dose administered to level I, II and III was 42.6 Gy (10 to 53 Gy), 41.9 Gy (8.3 to 54 Gy) and 41.3 Gy (5 to 52 Gy), respectively. The median dose to supraclavicular nodes was 46.9 Gy (from 38 to 51 Gy).The mean regional nodal volumes included in the 95% isodose were 47, 48, 45.7, and 65.1 percent for level I-III and supraclavicular, respectively. Conclusion: As the depth of regional nodes varies widely, thus using a fixed calculation depth for dose prescription is not optimal. Careful depth measurement for each patient is necessary. Moreover, the use of conventional three- field technique is not optimal for all patients. At least in some patients, adding posterior axillary boost field is necessary, to optimize axillary coverage. 257 261 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 M.H. Larizadeh M.H. Larizadeh Radiation Oncology Department Iran larizad_mh@yahoo.com A. Neamati A. Neamati Bahonar Hospital Iran V. Moazed V. Moazed Bahonar Hospital Iran F. Bahremand F. Bahremand Department of Medical Physics Iran Axillary nodes breast cancer radiotherapy supraclavicular nodes tangential fields. Overgaard M, Hansen PS, Overgaard J, Rose C, Andersson M, Bach F, Kjaer M, Gadeberg C, Mouridsen H, Jensen M, Zedeler K (1997) Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N Engl J Med, 337:949–55. ## VAN Beek S, De Jaeger K, Mijnheer B, Van Vliet-Vroeginde C (2008) Evaluation of a single isocenter technique for axillary radiotherapy in breast cancer. Medical Dosimetry, 33: 191-198.## Hoebers FJ, Borger JH, Hart AA, Peters JL, Th EJ, Lebeque JV (2000) Primary axillary radiotherapy as axillary treatment in breast-conserving therapy for patients with breast carcinoma and clinically negative axillary lymph nodes. Cancer, 88(7): 1633–42.## Haffty BG, McKhann C, Beinfield M,Fischer D and Fischer J (1993) Breast conservation therapy without axillary dissection: A rational treatment strategy in selected patients. Arch Surg, 128: 315–1319.## Dengel LT, Van Zee KJ, King TA, Stempel M, Cody HS,EL-Tamer M, Gemigang ML, Sclafani LM, Sacchini VS, Heerdt AS,Plitas G, Junqueira M, Capko D, Patil S, Morrow M (2014) Axillary dissection can be avoided in the majority of clinically node negative patients undergoing breast-conserving therapy. Ann Surg Oncol, 21(1): 22–27.## Louis-Sylvestre C, Clough K, Asselain B, Vilcoq JR, Salmon RJ, Campana F, Fourquet A (2004) Axillary treatment in conservative management of operable breast vancer: Dissection or Radiotherapy? Results of a randomized study with 15 years of follow-Up. J Clin Oncol, 22(1): 97-101. ## Hurkmansa CW, Borger JH, Rutgers EJ, van Tienhoven G (2003) Quality assurance of axillary radiotherapy in the EORTC AMAROS trial 10981/22023: the dummy run. Radiotherapy and Oncology, 68: 233–240.##Sabel MS (2013) The Need for axillary lymph node dissection in T1/T2 breast cancer surgery - counterpoint. Cancer Res, 73: 7156-7160.##Reimer T, Hartmann S, Stachs A , Gerber B(2014) Local treatment of the axilla in early breast Cancer: Concepts from the National Surgical Adjuvant Breast and Bowel Project B-04 to the Planned Intergroup Sentinel Mamma Trial. Breast Care, 9: 87–95. ##Reed DR, Lindsley SK, Mann GN, Austin-Seymour M, Korssjoen T, Anderson T, Moe R (2005) Axillary lymph node dose with tangential breast irradiation. Int J Radiat Oncol Biol Phys, 61: 358-364.##Bentel GC, Marks LB, Hardenbergh PH (2000) Variability of the depth of supraclavicular and axillary lymph nodes in patients with breast cancer: is it posterior axillary boost field necessary? Int J Radiat Oncol Biol Phys, 47: 755–8.##Takeda A, Shigematsu N, Kondo M, Amemiya A, Kawaquchi O, Sato M, Kutsuki S, Toya K, Ishibashi R,Kawase T, Tsukamoto N, Kuba A (2000) The modified tangential irradiation technique for breast cancer: How to cover the entire axillary region. Int J Radiat Oncol Biol Phys, 46(4): 815–822.##Kirova YM, Castropena P, Dendale R, Servois V,Bollet MA, Fournier- Bidoz N, Campana F, Fourquet A (2010) Simplified rules for everyday delineation of lymph node areas for breast cancer radiotherapy. 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The use of polyvinyl chloride films dyed with methyl red in radiation dosimetry 2 2 Background: The purpose of this work was to investigate the use of polyvinyl chloride (PVC) dyed with methyl red as a high dose radiation dosimetry. Materials and Methods: Commercial PVC films from Sabic made from resins PVC57S with thickness of 60 µm and methyl red with a molecular weight of 269.31 were used. Irradiation was carried out using a 60Co γ-ray generator with sources arranged in rectangular holder with a total activity of 73.6926 kCi. Absorbance measurements were made by Jasco V- 630 UV-VIS spectrophotometer. Dose rate and irradiation temperature effects as well as post-irradiation storage in dark and indirect daylight conditions on dosimetry performance were also investigated. Results: The results showed a linear relationship between the relative absorbance (response) and the absorbed dose at the wavelength 548 nm in the range of 0-150 kGy. The response was found to be independent of both dose rate and irradiation temperature. Conclusion: The experimental results indicate that PVC films dyed with methyl red may be used for a high dose radiation dosimetry. 263 267 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 2016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/42016/10/4 1395/7/13 M. Kattan M. Kattan Department of Radiation Technology Syria ascientific@aec.org.sy Y. Daher Y. Daher Department of Radiation Technology Syria Polyvinyl chloride gamma radiation methyl red dosimetry. McLaughlin WL, Boyd AW, Chadwick KH, McDonald JC, Miller A (1989) Dosimetry for radiation processing. Taylor & Francis. ##McLaughlin WL (1970) Radio chromic dye-cyanide dosimeter films. In: Holm, N.W., Berry, R.J. (Eds.), Manual on Radiation Dosimetry Marcel Dekker, New York, p. 377.##McLaughlin WL (1974) Sterilization by ionizing radiation. In: Gaughran RL, Guide AJ (Eds), vol. I. Multiscience, Montrial, p. 219.##Kantz AD, Hmphers KC (1979) Quality assurance for radiation processing. Radiat Phys Chem, 14: 575.##Tamura N, Tanaka R, Mitomo S, Alsuda K, Nagai S (1981) Properties of cellulose triacetate dosimeter. Radiat Phys Chem, 31: 529. ##Tanaka R, Mitomo S, Tamura N (1984) Effect of temperature, relative humidity and dose rate on the sensitivity of cellulose triacetate dosimeter to electron and gamma rays. Int J Appl Radiat Isot, 35: 875. ##7 Abdel-Rehim, F, Miller A, McLaughlin WL (1985) Response of radiation monitoring labels to gamma rays. Radiat Phys Chem, 25: 767.##Ebrahimi Tazehmahalleh F, Gholamhosseinian H, Layegh M, Ebrahimi Tazehmahalleh N, Esmaily H (2008) Determining rectal dose through cervical cancer radiotherapy by 9 MV photon beam using TLD and XR type T GAFCHROMIC® Film 5. Iran J Radiat Res, 6 (3): 129-134.##Technical report series (2002) Dosimetry for food irradiation. IAEA, Vienna, no. 409, p. 94.##Khan HM and Ahmad G (1988) Radiation dosimetry using clear PMMA and PVC in the range of 5-45 kGy. J Radioanal Nucl Chem Art, 125(1): 127.##Kattan M, Daher Y, Alkassiri H (2007) A high dose dosimeter based polyvinyl chloride dyed with malachite green. Radiat Phys Chem, 76: 1195.##Kattan M, Al Kassiri H, Daher Y (2011) Using polyvinyl chloride dyed with bromocresol purple in radiation dosimetry. Appl Radiat Isot, 69: 377.##Ajji Z (2006) Usability of aqueous solution of methyl red as high-dose dosimetry for gamma radiation. Radiat Meas, 41: 438.##Al Zahrany A, Rabaeh K, Basfar A (2011) Radiation-induced color bleaching of methyl red in polyvinyl butyral film dosimeter. Radiat Phys Chem, 80: 1263.##ASTM E1026-95 (2002) Standard practice for using the Fricke Reference Standard Dosimetry System. American Society for Testing and Materials, West Conshohocken, PA, USA.##Ebraheem S, Abdel-Fattah AA, Said FI, Ali ZI (2000) Polymer-1.00 based triphenyl tetrazolium chloride films for ultraviolet radiation Storage in dark monitoring. Radiat Phys Chem, 57: 195.## ##