2019 17 4 67 694

Dosimetric comparison of hypofractionated stereotactic radiotherapy by three different modalities for benign skull base tumors adjacent to functioning optic pathways 2 2 Background: As the optic pathways are thought to be the structures most vulnerable to irradiation, skull base tumors involving them are especially challenging to treat. Stereotactic radiosurgery (SRS) / stereotactic radiotherapy (SRT) is an effective and safe option for the treatment of them. Characteristics of dosimetry of SRT for skull base tumors by Gamma Knife were evaluated in comparison with those by other modalities. Materials and Methods: Original Novalis (NV) multi-beam-intensity-modulated-SRT(MB-IM-SRT) plan and additional simulation plans of Gamma Knife (GK) and TomoTherapy (TT) were compared in 20 cases. For target covering, 95% dose was assigned for 95% of the planning target volume (PTV) (D[95%]=28.5 Gy / 5 fractions).  Conformity index (CI), homogeneity index (HI=D95% / maximum dose of PTV)), gradient index (GI=V[47.5% dose] / V[95% dose] of body), and the doses to organs at risk (OARs) were evaluated. Results: CI and GI were significantly better with GK than NV or TT. HI was significantly smaller (less homogeneous) with GK. D[1 ml] and V[20 Gy] of brainstem were significantly smaller with GK than NV or TT. V[20Gy] of whole brain was also significantly smaller with GK. D[0.1 ml] and V[20 Gy] of optic pathways were smaller with GK than NV or TT, though the differences did not reach statistical significance.  Conclusion: If a higher internal dose gradient is interpreted as an advantage for tumor ablation, GK SRT might be expected to be a more effective and safer treatment for skull base benign tumors adjacent to the optic pathways and brainstem when they are not large. 519 530 2019/08/28 1398/6/6 2019/08/28 1398/6/6 Y. Mori Y. Mori Department of Radiology and Radiation Oncology, Aichi Medical University, Nagakute, Aichi, Japan yoshim@aichi-med-u.ac.jp H. Nakazawa H. Nakazawa Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan C. Hashizume C. Hashizume Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan T. Tsugawa T. Tsugawa Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan T. Murai T. Murai Department of Radiology and Radiation Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan Skull base benign tumor radiosurgery IMRT optic nerve. Hasegawa T, Kida Y, Yoshimoto M, Koike J, Iizuka H, Ishii D (2003) Long-term outcomes of Gamma Knife surgery for cavernous sinus meningioma. J Neurosurg, 107: 745-751.##2. Kobayashi T (2009) Long-term results of gamma knife radiosurgery for 100 consecutive cases of craniopharyngioma and a treatment strategy. Prog Neurol Surg, 22: 63–76. ##3. Kobayashi T (2009) Long-term results of stereotactic gamma knife radiosurgery for pituitary adenomas. Specific strategies for different types of adenoma. Prog Neurol Surg, 22: 77-95.##4. Hashizume C, Mori Y, Kobayashi T, Shibamoto Y, Nagai A, Hayashi N (2019) Stereotactic radiotherapy using Novalis for craniopharyngioma adjacent to optic pathways. J Neurooncol, 98: 239–247. ##5. Mori Y, Hashizume C, Kobayashi T, Shibamoto Y, Kosaki K, Nagai A (2010) Stereotactic radiotherapy using Novalis for skull base metastases developing with cranial nerve symptoms. J Neurooncol, 98: 213–219. ##6. Wurm RE, Erbel S, Schwenkert I, Gum F, Agaoglu D, Schild R, Schlenger L, Scheffler D, Brock M, Budach V (2008) Novalis frameless image-guided noninvasive radiosurgery: initial experience. Neurosurgery, 62 (5 Suppl): A11–A17. ##7. Lindquist C and Paddick I (2007) The Leksell Gamma Knife Perfexion and comparisons with its predecessors. Neurosurgery 62 (Suppl 2): 721–732. ##8. Ruschin M, Nayebi N, Carlsson P, Brown K, Tamerou M, Li W, Laperriere N, Sahgal A, Cho YB, Ménard C, Jaffray D (2010) Performance of a novel repositioning head frame for gamma knife perfexion and image-guided linac-based intracranial stereotactic radiotherapy. Int J Radiat Oncol Biol Phys, 78: 306–313. ##9. Sayer FT, Sherman JH, Yen CP, Schiesinger GJ, Kersh R, Sheehan JP (2011) Initial experience with the eXtend System: a relocatable frame system for multiple- session gamma knife radiosurgery. World Neurosurg, 75: 665–672. ##10. Devriendt D, Smeldt FD, Glineur R, Massager N (2015) Five-fraction Gamma Knife radiosurgery using the Extend relocate system for benign neoplasms close to optic pathways. Pract Radiat Oncol, 5: e119-25.##11. Ruschin M, Komljenovic PT, Ansell S, Menard C, Boostsma G, Cho YB, Chung C, Jaffray D (2013) Cone beam computed tomography image guidance system for a dedicated intracranial radiosurgery treatment unit. Int J Radiat Oncol Biol Phys, 85: 243–250. ##12. Nakazawa H, Mori Y, Komori M, Tsugawa T, Kobayashi T, Hashizume C, Uchiyama Y, Hagiwara M (2014) Simulational study of a dosimetric comparison between a Gamma Knife treatment plan and an intensity-modulated radiotherapy plan for skull base tumors. J Radiat Res, 55: 518-526.##13. Perks JR, St George EJ, Hamri KE, Blackburn P, Plowman PN (2003) Stereotactic radiosurgery XVI: Isodosimetric comparison of photon stereotactic radiosurgery techniques (Gamma Knife vs. micromultileaf collimator linear accelerator) for acoustic neuroma – and potential clinical importance. Int J Radiat Oncol Biol Phys, 57:1450-1459.##14. Shaw E, Kline R, Gillin M, Souhami L, Hirschfeld A, Dinapoli R, Martin L (1993) Radiation Therapy Oncology Group: radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys 27:1231–1239. ##15. Paddick I (2000) A simple scoring ratio to index the conformity of radiosurgical treatment plans. Technical note. J Neurosurg, 93 (Suppl 3): 219-222. ##16. Paddick I, Lippitz B (2006) A simple dose gradient measurement tool to complement the conformity index. J Neurosurg, 105 (Suppl): 194–201. ##17. Oliver M, Chen J, Wong E, Van Dyk J, Perera F (2007) A treatment planning study comparing whole breast radiation therapy against conformal, IMRT and tomotherapy for accelerated partial breast irradiation. Radiother Oncol, 82: 317–323. ##18. Ma L, Xia P, Verhey LJ, Boyer AL (1999) A dosimetric comparison of fan-beam intensity modulated radiotherapy with Gamma knife stereotactic radiosurgery for treating intermediate intracranial lesions. Int J Radiat Oncol Biol Phys, 45: 1325–1330. ##19. Kumar T, Rakowski J, Zhao B, Rakowski J, Zhao B, Alkhafaji M, Burmeister J, Austin T, Vlachaki M (2010) Helical TomoTherapy versus stereotactic Gamma Knife radiosurgery in the treatment of single and multiple brain tumors: a dosimetric comparison. J Appl Clin Med Phys, 11: 27–41. 
##20. Kaul D, Badakhshi H, Gevaert T, Pasemann D, Budach V, Tulaesca C, Gruen A, Prasad V, Levivier M, Kufeld M (2015) Dosimetric comparison of different treatment modalities for stereotactic radiosurgery of meningioma. Acta Neurochir (Wien), 157: 559-564.##21. Nakamura JL, Pizkall A, Carol MP, Xia P, Smith V, Wara WM, Petti PL, Verhey LJ, Sneed PK (2003) Comparison of intensity-modulated radiosurgery with gamma knife radiosurgery for challenging skull base lesions. Int J Radiat Oncol Biol Phys, 55: 99–109. ##22. Soisson ET, Tome W, Richards GM, Mehta MP (2006) Comparison of linac based fractionated stereotactic radiotherapy and tomotherapy treatment plans for skull-base tumors. Radiother Oncol, 78: 313-321.##23. Hayashi N, Obata Y, Uchiyama Y, Mori Y, Hashizume C, Kobayashi T (2009) Assessment of spatial uncertainties in the radiotherapy process with the Novalis system. Int J Radiat Oncol Biol Phys, 75: 549–557. ##24. Mori Y, Hayashi N, Iwase M, Yamada M, Takikawa Y, Uchiyama Y, Oda k, Kaii O (2006) Stereotactic imaging for radiosurgery: localization accuracy of magnetic resonance imaging and positron emission tomography compared with computed tomography. Stereotact Funct Neurosurg, 84: 142–146.##25. Schlesinger D, Xu Z, Taylor F, Yen C-P, Sheehan J (2012) Interfraction and intrafraction performance of the Gamma Knife Extend system for patient positioning and immobilization. J Neurosurg, 117(Suppl): 217–224.## ##

A fast and accurate analytical method for 2D dose distribution calculation around brachytherapy sources in various tissue equivalent phantoms 2 2 Background: In this study, a fast dose kernel method (DKM) taking into account an appropriate buildup factor to calculate dose rate distributions around brachytherapy sources was presented. In addition, the dose distribution in various tissue-equivalent materials was investigated using this method. Materials and Methods: To validate the accuracy of the proposed method, the dose rates in water was calculated by dose kernel method and those obtained by Monte Carlo simulation, thermoluminescent dosimetry (TLD) measurements and AAPM Task Group 43 (TG-43) formalism were compared. The validated dose kernel method (DKM) and the MCNP5 code were then applied to evaluate the effect of tissue composition on dose distribution around a Low Dose Rate (LDR) Ir-192 source located in phantoms simulating water, bone and lung tissue. Results: The calculated dose rates were in good agreement with published data for water phantom. Statistical analysis showed that there is no significant difference in terms of dose distribution between the method used in this study and other established methods. Also, the results indicated that the tissue composition affects the dose distribution significantly. Based on the results of this study, the assumption of a homogeneous water phantom in dosimetry of radioactive sources used in brachytherapy may lead to either overestimation of up to 45% or underestimation of up to 19% in bone and lung tissues, respectively. Photon isodose distributions in water, bone and lung were also presented.  Conclusion: Results provides an alternative calculating method for quality assurance purposes using a fast and accurate dose kernel method. 531 540 2019/08/282019/09/23 1398/7/1 2019/08/282019/09/23 1398/7/1 R. Bechchar R. Bechchar EPRA, Department of Physics, Faculty of Sciences Semlalia, Marrakech, Morocco N. Senhou N. Senhou Medical Imaging Department, MC 1701, National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia J. ghassoun J. ghassoun EPRA, Department of Physics, Faculty of Sciences Semlalia, Marrakech, Morocco ghassoun@uca.ac.ma Brachytherapy Buildup factor Point kernel Phantom Dose TLD MCNP. Juste B, Miró R, Campayo JM, Díez S, Verdú G (2010) Radiotherapy treatment planning based on Monte Carlo techniques. Nucl Instr Meth Phys Res A, 619 (1): 252-257.##Bozkurt A, Acun H, Kemikler G (2013) Dosimetric investigation of LDR brachytherapy 192 Ir wires by Monte Carlo and TPS calculations. Japanese Journal of Radiology, 31(1): 24-30.##Rivard MJ, Coursey BM, DeWerd LA, Hanson WF, Kimmel SH, Ibbott GS, Mitch MG, Nath R, Williamson JF (2004) Update of AAPM Task Group No. 43 Report: A revised AAPM protocol for brachytherapy dose calculations. Med Phys, 31(3): 633-674. ##Zaker N, Zehtabian M, Sina S, Koontz C, Meigooni1 AS (2016) Comparison of TG‐43 dosimetric parameters of brachytherapy sources obtained by three different versions of MCNP codes. J Appl Clin Med Phys, 17(2): 379-390. ##Wu CH, Liao YJ, Liu YW, Hung SK, Lee MS, Hsu SM (2014) Dose distributions of an Ir-192 brachytherapy source in different media. BioMed Res Int, 2014: 946213.##Ghassoun J (2013) Effect of tissue Inhomogeneities on dose distributions from Cf-252 brachytherapy source. Appl Radiat Isot, 71(1): 1-6.##Gillin MT, Lopez F, Kline RW, Grimm DF, Niroomand-Rad A (1988) Comparison of measured and calculated dose distributions around an iridium 192 wire. J Med Phys, 15 (6): 915-918.##Van der Laarse R, Granero D, Pérez-Calatayud J, Meigooni A, Ballester F (2008) Dosimetric characterization of Ir-192 LDR elongated sources. Med Phys, 35(3): 1154-1161.##DeWerd LA, Liang Q, Reed JL, Culberson WS (2014) The use of TLDs for brachytherapy dosimetry. Radiation Measurements, 71: 276-281.##Karaiskos P, Papagiannis P, Angelopoulos A, Sakelliou L (2000) Dosimetry of Ir-192 wires for LDR interstitial brachytherapy following the AAPM TG-43 dosimetric formalism. Med Phys, 28(2): 156-166. ##International Commission on Radiation Units and Measurements (1989) Tissue substitutes in radiation dosimetry and measurement. ICRU Report no. 44, Bethesda. ##Hubbell JH and Seltzer SM (1995) Tables of X-ray mass attenuation coefficients and mass energy-absorption coefficients 1 keV to 20 MeV for elements Z= 1 to 92 and 48 additional substances of dosimetric interest, NISTIR 5632, National Institute of Standards and Technology.##Chen Z and Nath R (2001) Dose rate constant and energy spectrum of interstitial brachytherapy sources. Med Phys, 28(1): 86-96.##Sakhri-Brahimi Z, Guedioura D, Khelassi-Toutaoui N, Afiane M, Frahi-Amroun A (2018) Reference kerma rate evaluation using Sievert integral for extended sources. In AIP Conference Proceedings. AIP Publishing, 1994(1): 060005.##Harima Y, Sakamoto Y, Tanaka S, Kawai M (1986) Validity of the geometric-progression formula in approximating gamma-ray buildup factors. Nucl Sci Eng, 94(1): 24-35.##ANSI/ANS-6.4.3 (1991) Gamma Ray Attenuation Coefficient and Buildup Factors for Engineering Materials. American Nuclear Society, La Grange Park, Illinois.##Manohara SR, Hanagodimath SM, Gerward L (2011) Energy absorption buildup factors of human organs and tissues at energies and penetration depths relevant for radiotherapy and diagnostics. J Appl Clin Med Phys, 12(4): 296-312.##Tuli JK (1987) Evaluated Nuclear Structure Data File. Brookhaven National Laboratory Nuclear Data Center.##Angelopoulos A, Perris A, Sakellariou K, Sakelliou L, Sarigiannis K, Zarris G (1991) Accurate Monte Carlo calculations of the combined attenuation and build-up factors for energies (20-1500 keV) and distances (0-10 cm) relevant in brachytherapy. 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Indoor radon levels in the dwellings of the Gaza governorate neighborhoods’, Palestine 2 2 Background: Worldwide, indoor radon exposure is considered to be the second leading cause of lung cancer, particularly among people who stay indoors for a long time as the children and the elderly. The goal of this study is to get a better understanding of indoor radon levels in the houses of the Gaza governorate. Materials and Methods: One hundred eighty passive diffusion radon dosimeters containing CR-39 solid state nuclear track detectors (SSNTD) were distributed in the rooms of the Gaza governorates houses following a cluster random sampling. Only 154 dosimeters were found in the places and collected, while the remaining 26 dosimeters were lost. The detectors were left for two months during the period from March to June of 2006. Variability between dwellings neighborhoods, floors, rooms at the same floor, ventilation status, smoking, dwelling age were assessed. Results: The indoor radon concentrations in the houses of Gaza governorate were lower than the EPA and ICRP recommended limits (150 Bq/m3), with a mean indoor radon concentration (mean±SD) of 40±14 Bq/m3 and a range from 3 to 105 Bq/m3. The house ventilation status was the key variable which affects the indoor radon level, since badly ventilated houses had higher indoor radon concentrations, particularly in the basement floors rather than the higher floors. Conclusion: Despite fulfilling the international limits, we strongly recommend conducting a wider national survey for natural radiation measurements and mapping radon-borne areas throughout the country. Moreover, well ventilation of the house indoor environment is highly recommended. 541 548 2019/08/282019/09/232019/09/23 1398/7/1 2019/08/282019/09/232019/09/23 1398/7/1 S. Yassin S. Yassin Department of Physics, Faculty of Sciences, Islamic University of Gaza, Gaza, Palestine M. Al Sersawi M. Al Sersawi Department of Research, Directorate General of Human Resources Development, Ministry of Health, Gaza Strip, Palestine S. Abuzerr S. Abuzerr Department of Environmental Health Engineering, Faculty of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran samer_516@hotmail.com M. Darwish M. Darwish Department of Pharmacy, Al-Safwa University College, Karbala, Iraq CR-39 dosimeters detectors Gaza governorate buildings indoor radon. ## ##

A new normal portion of the esophagus (NPE) sparing technique for upper and middle esophagus cancer by SIB-IMRT automatic planning 2 2 Background: During upper and middle esophageal cancer patients' radiation therapy, dose hot spots located in the normal portion of the esophagus (NPE) may increase radiation esophagitis, so NPE may also needs sparing. Automatic planning may have an advantage on sparing NPE over conventional trial-and-error type planning. We compared radiation esophagitis predicted by two esophageal NTCP models between different optimization strategies. Materials and Methods: 20 upper and middle esophagus cancer patients were reviewed and re-optimized by three strategies: autoplan in which NPE was not spared called A1 plan; trial-and-error type plan in which NPE was spared called T plan; autoplan in which NPE was spared called A2 plan.Dose volume parameters of four different esophagus structures were compared between three types of plans. Predicted radiation esophagitis between different optimization strategies were compared. Results: Target dose coverage of three types of plans all met clinical desires. Dose hot spots of ESOwhole-PGTV and ESOinfield-PGTV from A2 plans are lowest in 3 types of plans. While Dose hot spots of ESOwhole and ESOin field from T plans are highest.V60 and Dmax of four types of esophagus structures in A2 plans are lower than T plans. AET =2 probabilities predicted by Kwint modle for A2 plans are slightly lower than T plans, respectively 70.1±2.5%,76.9±3.2%,54.8±1.7% and 72.7±2.8%.AET=3 probabilities were also lowest for A2 plans. Standard deviation of dose volume parameters and AETs of four types of esophagus structures in automatic plans are significant less than T plans. Conclusion: Upper and middle esophagus cancer patients who received SIB-IMRT could benefited by a new NPE sparing technique by automatic planning. It may decrease patients’ radiation esophagitis. 549 557 2019/08/282019/09/232019/09/232019/09/24 1398/7/2 2019/08/282019/09/232019/09/232019/09/24 1398/7/2 H. Wang H. Wang Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China H. Chen H. Chen Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China Y. Shao Y. Shao Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China H. Gu H. Gu Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China Y. Duan Y. Duan Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China A. Feng A. Feng Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China Z. Xu Z. Xu Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China xzyong12vip@sina.com NPE sparing technique NTCP model SIB-IMRT automatic planning. Adebahr S，Schimek-Jasch T, Nestle U, Brunner TB (2016) Oesophagus side effects related to the treatment of oesophageal cancer or radiotherapy of other thoracic malignancies. Best Practice & Research Clinical Gastroenterology, 30: 565.##Murro D and Jakata S (2015) Radiation esophagitis [J]. Arch Pathol Lab Med, 139(21): 826-830.##Simone CB (2017) Thoracic Radiation Normal Tissue Injury. Semin Radiat Oncol, 27(4): 370-377.##Cox JD, Pajak TF, Asbell S, Russell AH, Pederson J, Byhardt RW, Emami B (1993) Interruptions of high-dose radiation therapy decrease long-term survival of favorable patients with unresectable nonsmall cell carcinoma of the lung: analysis of 1244 cases from 3 radiation therapy oncology group (rtog) trials [J]. 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Correlation of ultrasound perfusion imaging and angiogenesis of ovarian tumors 2 2 Background: The aim of this present study was to evaluate the relationship between perfusion characteristics of ovarian tumors and tumor angiogenesis using contrast-enhanced ultrasound imaging. Materials and Methods: Dose 116 patients with ovarian tumors were preoperatively subjected to                contrast-enhanced perfusion imaging. Immunohistochemistry was performed to detect the expression of vascular endothelial growth factor (VEGF) and CD34 in ovarian tumors. The correlation between the VEGF positive index, microvessel density (MVD) of ovarian tumors and ultrasound perfusion parameters was investigated. We also established a nude mouse ovarian cancer SKOV3 xenograft model; the expression of VEGF and MVD in the transplanted tumor was observed, and their correlation with the ultrasound perfusion parameters was studied. Results: The MVD and VEGF positive indexes of ovarian tumors were positively correlated with the peak intensity (PI), area under the curve (AUC) and time from peak to one half (TTH) of the ultrasound perfusion parameters. The correlation coefficients between MVD and the PI, AUC and TTH were 0.69, 0.71 and 0.59, respectively, while the correlation coefficients between the VEGF positive index and the PI, AUC and TTH were 0.71, 0.65 and 0.68, respectively. Moreover, there were significant differences in the PI, AUC and TTH between the high-MVD and low-MVD groups (P<0.05). Furthermore, the same trend was found in the xenograft model. Conclusion: the ultrasound perfusion parameters PI, AUC and TTH of ovarian tumors were positively correlated with the tumor MVD and VEGF positive index, which reflects the angiogenesis status of ovarian tumors and provides important information for the diagnosis and treatment of ovarian tumors. 559 567 2019/08/282019/09/232019/09/232019/09/242019/09/25 1398/7/3 2019/08/282019/09/232019/09/232019/09/242019/09/25 1398/7/3 X. Liu X. Liu Department of Ultrasound, Huangshi Maternity & Children’s Health Hospital, Edong Healthcare. Huangshi, Hubei, 435000 C. Shen C. Shen Department of Ultrasound, Huangshi Maternity & Children’s Health Hospital, Edong Healthcare. Huangshi, Hubei, 435000 shencui198403@163.com Ovarian tumors Ultrasound perfusion imaging Angiogenesis Perfusion parameters. Mentzer SJ and Konerding MA (2014) Intussusceptive angiogenesis: expansion and remodeling of microvascular networks. Angiogenesis, 17: 499-509.##2. 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The effect of gold nanoparticles and irradiation on healthy and tumor human lung cells 2 2 Background: Cancer cells may develop resistance to radiation which results in decreasing effects of radiation therapy. The effectiveness of high dose radiation can be increased with previously delivered low dose. Also, the approach that has been used to enhance the efficacy of radiation is to increase the radiosensitization. The focus of interest is on usage of gold-based nanoparticles as radiosensitizers. Modification of gold nanoparticle surface may increase its effectiveness in cells. The aim of the study was to prepare and characterize nanogold/β-cyclodextrin formulation (nAu/β-CD) and to investigate cytotoxicity and differences in radio-adaptive response of irradiated normal and malignant cell lines. Materials and Methods: Nanoparticles distribution and zeta-potential of nAu/β-CD were obtained by dynamic light scattering (DLS). Cell lines MRC-5 and A549 were pretreated with 0.05 µM nAu/β-CD formulation and irradiated in single and double regimes. The MTT test was performed after 24 h and 72 h of recovery.  Results: Nanogold particles didn’t express cytotoxic effect on MRC-5 and A549 cells. Tested nanoformulations with nAu/β-CD ratio 1:1 achieved the best cytotoxic effect against A549 cell line. Pre-treatment with low dose (0.05 Gy) prior to therapeutic dose (2 Gy) and application of nAu/β-CD nanoformulation decreased the cell survival in all investigated samples, showing diverse effects on normal and tumor cells. Conclusion: Results indicate potential selectivity and increased efficiency of both applied radiation and pre-treatment with nAu/β-CD regarding the malignant cells, while sparing the normal tissue from radiation damage, which could be beneficial for the radiotherapy. 569 578 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/25 1398/7/3 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/25 1398/7/3 V.V. Kojić V.V. Kojić Oncology Institute of Vojvodina, Faculty of Medicine, University of Novi Sad, Put Dr Goldmana 4, 21204 Sremska Kamenica, Serbia I. Djan I. Djan Oncology Institute of Vojvodina, Faculty of Medicine, University of Novi Sad, Put Dr Goldmana 4, 21204 Sremska Kamenica, Serbia V.V. Bogdanović V.V. Bogdanović Oncology Institute of Vojvodina, Faculty of Medicine, University of Novi Sad, Put Dr Goldmana 4, 21204 Sremska Kamenica, Serbia I. Borišev I. Borišev Department of Chemistry, Biochemistry and Environmental Protection, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovića 3, 21000 Novi Sad, Serbia A.N. Djordjević A.N. Djordjević Department of Chemistry, Biochemistry and Environmental Protection, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovića 3, 21000 Novi Sad, Serbia T.V. Ivković-Kapicl T.V. Ivković-Kapicl Oncology Institute of Vojvodina, Faculty of Medicine, University of Novi Sad, Put Dr Goldmana 4, 21204 Sremska Kamenica, Serbia D.S. Jakimov D.S. Jakimov Oncology Institute of Vojvodina, Faculty of Medicine, University of Novi Sad, Put Dr Goldmana 4, 21204 Sremska Kamenica, Serbia jakimov.dimitar@onk.ns.ac.rs gold nanoparticles β–cyclodextrin cytotoxicity human cell lines radioadaptive irradiation. 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Smad 2/3 and CD8+ distribution pattern in liver of mice vaccinated with gamma radiation-attenuated Schistosoma mansoni larvae 2 2 Background: Gamma radiation-attenuated vaccine has a very promising value in controlling schistosomiasis. The objective of this study is to investigate the effects of vaccination with gamma radiation-attenuated schistosomules regarding histopathological and immunohistochemical changes in mice model of human Schistosoma mansoni infection. Materials and Methods: The study is conducted upon 40 mice, divided into four groups of 10 each: uninfected control group A (normal control), Schistosoma mansoni infected group B (infected control), Group C subcutaneously injected with 200 Gy gamma radiation–attenuated schistosomules (vaccine control) and group D injected with the same dose of gamma radiation-attenuated schistosomules then challenged after 4 weeks by S. mansoni cercariae (vaccinated-challenged). Parts of liver tissues stained with Masson's trichrome (MT) stain for classifying the granulomas into cellular, fibrocellular or fibrous according to the amount of collagens; stained bluish green. Immunohistochemistry assay was then done on the other portion through expression of Smad2/3 protein and CD8+ in the extracellular matrix (ECM). Results: Compared to control infected group, mild histopathological changes with decrease of egg granulomas mainly cellular is detected in vaccinated-challenged group. This is accompanied with moderate immunohistochemical expression of Smad2/3 and CD8+ proteins in vaccine-control group and mild expression in vaccinated-challenged group. Conclusion: The The results indicate that vaccination with 200 Gy gamma-irradiated schistosomules could reduce histopathological and immunohistochemical changes induced due to infection which represents an effective strategy in disease control. 579 586 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/25 1398/7/3 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/25 1398/7/3 E.N. Hafez E.N. Hafez Department of Health Radiation Research, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Cairo, Egypt eman_naser612@hotmail.Com M.M. Amin M.M. Amin Department of Health Radiation Research, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Cairo, Egypt Schistosoma mansoni vaccination immunohistochemistry histochemistry. ##Bergquist RM, Donald M (2017) Schistosomiasis vaccine development: The missing link. 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Radiation dose assessment for radiation workers during 18F-FDG synthesis and dispensing activities in hot cells: a proposal to improve the safety of radiation protection measures for workers 2 2 Background: Hot cells are used in the production of radiopharmaceuticals to provide radiation workers with a safe environment in which to work. This study was conducted to measure the radiation dose that leaks through the walls of a hot cell.  Materials and Methods: For this study, hot cells of five big hospitals (≥ 1000 beds) in South Korea were selected. To calculate the radiation exposure outside the walls of the hot cell (i.e., the external dose) during fluorine-18 fluorodeoxyglucose (18F-FDG) synthesis and dispensing activities, exposure rates were measured with a Geiger Muller counter (GM counter) at five locations around the hot cells (10 measurements per each measurement point). Based on the measurements, operating conditions of the hot cells of the five hospitals were conservatively considered to calculate the effective dose. The radiation exposure inside the hot cell (i.e., the internal dose) was estimated considering the operating conditions of the hot cells of five large hospitals as well as international guidelines. Results: The Based on the experimental results, the impact of the internal dose was found to be negligibly low during 18F-FDG synthesis and dispensing activities (less than 0.21 mSv/y); however, the radiation leakage exhibited levels requiring caution in all directions, with a radiation leakage of up to 19.5 µSv/h measured on the lead glass windows of the hot cells in some hospitals. Conclusion: The conclusion is that radioisotope manufacturers operating radiopharmaceutical synthesis and dispensing hot cells should implement various improvements. Strengthening the shielding of the lead glass windows on the front and sides of cells, implementing real-time dosimetric monitoring, setting dose limits for radiopharmaceutical production processes, and regular worker rotations are needed. 587 593 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/6 1398/7/14 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/6 1398/7/14 S.T. Kim S.T. Kim Nuclear Emergency Division, Radiation Protection and Emergency Preparedness Bureau, Nuclear Safety and Security Commission, Seoul, Republic of Korea J. Kim J. Kim Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea J.M. Park J.M. Park Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea leodavinci@naver.com 18F-FDG hot cell radiation worker external dose internal dose. ##1. Juweid ME and Cheson BD (2006) Positron-emission tomography and assessment of cancer therapy. N Engl J Med, 354(5): 496–507.##2. Chew J and Silverman DH (2013) FDG-PET in early AD diagnosis. Med Clin North Am, 97(3): 485–494.##3. Takada S, Muto T, Ito N, Kitahara A, Chisaka H, Kuze I, et al. (1983) An estimation for the dispersal rates of radioactive materials under various handling. Radioisotopes, 32(5): 260–269.##4. ICRP (2007) The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP, 37(2-4).##5. ICRP (1994) Dose Coefficients for Intakes of Radionuclides by Workers. ICRP Publication 68. Ann. ICRP 24(4).##6. Jingu K, Kaneta T, Nemoto K, Ichinose A, Oikawa M, Takai Y, et al. (2006) The utility of 18F-fluorodeoxyglucose positron emission tomography for early diagnosis of radiation-induced myocardial damage. Int J Radiat Oncol Biol Phys, 66(3): 845–51.##7. ICRP (1973) Implications of Commission Recommendations that Doses be Kept as Low as Readily Achievable. ICRP Publication 22. Pergamon Press, Oxford. ##8. ICRP (1977) Recommendations of the ICRP. ICRP Publication 26. Ann ICRP, 1(3).##9. ICRP (1991) The 1991 Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann ICRP, 21: (1-3). ## ##

Surgery or radiotherapy, which is more effective for upper esophageal carcinoma? A retrospective cohort study based on 191 cases 2 2 Background: To compare radical surgery with definitive radiotherapy for upper third esophageal squamous cell carcinoma. Materials and Methods: A total of 191 patients were included in the study. Patients’ clinicopathologic features, and survival time were recorded. Kaplan-Meier (K-M) analysis was adopted to analyze Overall survival (OS), Disease-free survival(DFS), Progression-free survival(PFS), and a Cox multivariate model was used to adjust potential confound factors. Results: The K-M survival analysis showed that treatments, location of lesion, and length of lesion were all associated with the OS (P<0.005). In the surgery group, K-M survival  showed that T stage (T1 vs T2, P=0.012, T1 vs T3, P=0.002), location (upper vs upper merged middle, P<0.001), and length lesion (<5 cm vs >5 cm, P=0.015), affected the OS，T stage (T1 vs T2, P=0.018, T1 vs T3, P=0.020) and location of lesion (upper vs upper merged middle, P=0.007) was associated with DFS. The Cox model showed that none of these parameters independently influenced the OS and DFS. In the radiotherapy group, K-M survival showed that supraclavicular lymph node metastasis (P=0.007), concurrent chemo-radiotherapy (P=0.012), and sex (P=0.047) influenced the OS，adjuvant chemotherapy (P=0.013) and age (P=0.013) influenced PFS, The Cox model showed that supraclavicular lymph node metastasis (P=0.018) independently influenced OS and adjuvant chemotherapy (P=0.046) independently influenced PFS. Conclusion: Surgery has better therapeutic effect than radiotherapy. Patients with an upper merged middle lesion and advanced T stage for surgery, male, local advanced and without concurrent chemo-radiotherapy for radiotherapy have a poor prognosis. 595 603 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/7 1398/7/15 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/7 1398/7/15 X.S. Hu X.S. Hu Department of of Oncology, The Second Xiangya Hospital of Central South University, 410011Changsha, Hunan, China＆Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China S.M. Wen S.M. Wen Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China J. Bie J. Bie Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China F. Xian F. Xian Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China W.W. He W.W. He Department of Thoracic Surgery, Sichuan Cancer Hospital and Research Institute, 610000Chengdu, Sichuan, China D. Li D. Li Department of Oncology, Nanchong Central Hospital, 637000Nanchong, Sichuan, China 137666745@qq.com Esophageal upper squamous cell carcinoma surgery radiotherapy. 1. Torre LA, Bray F, Siegel RL  Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics 2012. CA Cancer J Clin, 65: 87-108.##2. Keighley MRB (2003) Gastrointestinal cancers in Europe. Aliment Pharmacol Ther, 18(3): 7–30.##3. Arnold M, Soerjomataram I, Ferlay J, Forman D (2015)Global incidence of oesophageal cancer by histological subtype in 2012. Gut, 64: 381-387.##4. Klevebro F, Lindblad M, Johansson J,  Lundell L, Nilsson M (2016) Outcome of neoadjuvant therapies for cancer of the oesophageal or gastro-oesophageal junction based on a national data registry. Br J Surg, 103: 1864-1873.##5. Siewert JR, Stein HJ, Feith M, Bruecher BL, Bartels H, Fink U (2001) Histologic tumor type is an independent prognostic parameter in esophageal cancer: lessons from more than 1,000 consecutive resections at a single center in the Western world. Ann Surg, 234(3): 360–369.##6. Best LM,  Mughal M,  Gurusamy KS (2016) Non-surgical versus surgical treatment or oeso- phageal cancer. Cochrane Database Syst Rev, 3: 1-58.##7. Bedenne L, Michel P, Bouché O, Milan C, Mariette C, Conroy T, Pezet D, Roullet B, Seitz JF, Herr JP, Paillot B, Arveux P, Bonnetain F, Binquet C. J Clin Oncol (2007) Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol, 25: 1160-1168.##8. Blazeby JM, Strong S, Donovan JL,Wilson C, Hollingworth W, Crosby T, Nicklin J, Falk SJ, Barham CP, Hollowood AD, Streets CG, Titcomb D, Krysztopik R, Griffin SM, Brookes ST (2014) Feasibility RCT of definitive chemoradiotherapy or chemotherapy and sur- gery for oesophageal squamous cell cancer. British Journal of Cancer, 111: 234 –240.##9. Bonnetain F, Bouché O, Michel P, Mariette C, Conroy T, Pezet D, Roullet B, Seitz F, P-aillot B, Arveux P, Milan, Bedenne (2006) A comparative longitudinal quality of life study using the Spitzer  quality of life index in randomized multicenter phase III trial (FFC-9102): chemoradiation followed by surgerycompared with chemoradiation alone in locally advanced squamous resectable thoracic esophageal cancer. Ann Oncol, 17: 827-834. ##10. Rice TW, Ishwaran H, Ferguson MK, Blackstone EH, Goldstraw P (2017) Cancer of the esophageal and esophagog- astric junction: an eighth edition staging primer. J Thorac Oncol, 12: 36-42.##11. Martínek J, Akiyama JI, Vacková Z, Blackstone EH, Goldstraw P (2016) Current treatment options for esophageal diseases. Ann N Y Acad Sci, 1381: 139- 151. ##12. Ruurda JP, Draaisma WA van Hillegersberg R,  Borel Rinkes IH, Gooszen HG, Ja- nssen LW, Simmermacher RK and Broeders IA (2005) Robot-assisted endoscopic surgery: a four-year single-center experience. Dig Surg, 22: 313–320.##13. Shen Y, Feng M, Tan L, Wang H, Li J, Xi Y Wang Q (2014) Thoracoscopic esopha- g ectomy  in prone versus decubitus position: ergonomic evaluation from a randomized and contr- olled study. Ann Thorac Surg, 98: 1072-1078.##14. Igaki H, Kato H,Tachimori Y, Nakanishi Y, Shimoda T (2005) Surgery for clinical T 3 carcinomas of the upper thoracic oesophageal and the need for new trategies. British Journal of Surgery, 92: 1235-1240.##15. Nakagawa S, Nishimaki T, Kosugi M,  Ohashi M, Kanda T, Hatakeyama K (2003) Cervical lymphadenectomy is beneficial for patients with carcinoma of the upper and mid-thoracic esophageal. Dis esophageal, 16: 4–8. ##16. Saito R, Suzuki H, Motoyama S, Sasaki S, Okuyama M, Ogawa J, Kitamura M (2000) A clinical study of surgical treatment of patients with carcinoma of the cervical esophagus extending to the thoracic esophagus. Jpn J Thorac Cardiovasc Surg, 48: 417–423.##17. Peracchia A, Bonavina L, Botturi M, Pagani M, Via A, Saino G (2001) Current status of surgery for carcinoma of the hypopharynx and cervical esophagus. Dis Esoph, 14: 95 –97.##18. Versteijne E, van Laarhoven HW, van Hooft JE,  van Os RM, Geijsen ED, van Berge Henegouwen MI, Hulshof MC (2015) Definitive chemoradiation for patients with inoper- able a- nd /or unresectable esophageal cancer: locoregional recurrence pattern. Disesoph- agus, 28: 453-459.##19. Piessen G, Mariette C, Triboulet JP (2005) Cervical and upperthird thoracic esophageal carcinoma: a single pathological entity? Ann Chir, 130: 86–91.##20. Papp A, Cseke L, Farkas R,  Pavlovics G, Horvath G, Varga G, Szigeti A, Bellyei S, Marton S, Poto L, Kalmar K, Vereczkei A, Pozsgai E, Horvath OP (2010) Chemora- diotherapy in locally advanced squamous cell esophageal cancer-are upper third tumours more responsive? Pathol Oncol Res, 16: 193-200.##21. Igaki H, Kato H, Tachimori Y, Nakanishi Y (2003)Prognostic evaluation of patients with clinical T1 and T2 squamous cell carcinomas of the thoracic esophagus after 3-field lymph node dissection. Surgery, 133: 368–374.##22. Zhu LL, Yuan L, Wang H, Ye L, Yao GY, Liu C, Sun NN, Li XJ, Zhai SC, Niu LJ, Zhang JB, Ji HL, Li XM (2015) A Meta-Analysis of Concurrent Chemoradioth- erapy for Advanced Esophageal Cancer. PLoS One, 10: e0128616. ## ##

Estimation of absorbed fraction and specific energy of radon progeny for a Syrian adult tracheobronchial tree 2 2 Background: Ondo Estimating the health effect of 222Rn progeny deposited on inner surfaces of airways regions is of great interest because 222Rn progeny are considered the major contributors in imparted energy to lung structures. Materials and Methods: In this study, (CT) scan of a healthy, non-smoking Syrian volunteer male, 3D-Slicer 4.7.0 medical image processing software, Solidworks mechanical design software and MCNPX 2.5.B code were used to create the geometry and to evaluate the absorbed fraction and specific energy due to alpha particles emitted by inhaled radon progeny in nuclei and layers of sensitive cells in the epithelium of human trachea-bronchial tree. Absorbed fraction (AF) and specific energy were determined using Micro-dosimetry approach and airway tube wall as proposed by ICRP (1994), and NRC (1991). Results: Absorbed fractions (AFs) and specific energy of alpha particles were calculated for each generation from 1st to 15th. Comparison of average AFs values in sensitive layers was carried out with ICRP66 airway model where some significant differences were found due to dimensions differences between both models. Furthermore, AFs of cell nuclei had the same trend of those for layers, where the highest values were for 7.69 MeV alpha particles in BB region and the opposite in bb region.  Conclusion: Interactions of alpha particles with secretory and basal cells show significant differences which can influence dose weightings. Comparisons with ICRP66 data reveal the influence of geometry and target cells distribution on absorbed fraction and specific energy values. 605 615 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/9 1398/7/17 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/9 1398/7/17 B. Rawaa B. Rawaa Physics Department, Faculty of Science, Damascus University, Syria bardan.raw@gmail.com S. Al Tarabichi S. Al Tarabichi Physics Department, Faculty of Science, Damascus University, Syria Absorbed fraction specific energy Radon progeny micro-dosimetry Monte Carlo method. Krstic D, Nikezic D, Markovic VM, Vucic D ( 2013) Absorbed fractions in sensitive regions of human respiratory tract calculated by MCNP5/X software for electron and beta particles due to radon progeny. Rom J Phys, 58: 164-171. ##Angeles A and Espinosa G (2011) Study of deposited energy in lung tissue from radon’s progeny calculated by Monte Carlo. Rev Mex F´ıs, S 57(1): 97-101.##Leonard BE, Thompson RE, Beecher GC (2011) Human lung cancer risks from radon - part I - influence from bystander effects - a microdose analysis. Dose Response, 9(2): 243-92. ##Balázs G Madas (2016) Radon induced hyperplasia: effective adaptation reducing the##local doses in the bronchial epithelium. J Radiol Prot, 36(3): 653-666.##Farkas A, Hofmann W, Balásházy I, Szoke I, Madas BG, Moustafa M (2011) Effect of site-specific bronchial radon progeny deposition on the spatial and temporal distributions of cellular responses. Radiat Environ Biophys, 50(2): 281-97. ##Yu KN, Lau BMF, Nikezic D (2006) Assessment of environmental radon hazard using human respiratory tract models. J Hazard Mater, 132(1): 98-110.##International Commission on Radiological Protection ICRP (1994) Human respiratory tract model for radiological protection. ICRP Publication 66, Pergamon Press, Oxford. ##Nikezic D, Lau BM, Stevanovic N, Yu KN (2006) Absorbed dose in target cell nuclei and dose conversion coefficient of radon progeny in the human lung. J Environ Radioact, 89(1):18-29. ##Nikezic D and Yu KN (2001) Microdosimetric calculation of absorption fraction and the resulting dose conversion factor for radon progeny. Radiat Environ Biophys, 40(3): 207-211.##Hofmann W, Fakir H, Aubineau-Laniece I, Pihet P (2004) Interaction of alpha particles at the cellular level implications for the radiation weighting factor. Radiat Prot Dosimetry, 112(4): 493-500.##Lia WB, Hofmann W, Friedland W (2018) Microdosimetry and nanodosimetry for internal emitters. Radiat Meas, 115: 29-42. ##Hui TE, Poston JW, Fisher DR (1990) The Microdosimetry of radon decay products in the respiratory tract. 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Topically applied melatonin ameliorates radiation-induced skin fibrosis in mice 2 2 Background: We investigated whether topical administration of melatonin ameliorates radiation-induced skin fibrosis (RISF) and inhibits the expression of profibrogenic genes in mice. Materials and Methods: Forty-eight female BALB/c mice were randomly divided into three groups: topically applied 5% ethanol (Control), topically applied 5% ethanol plus irradiation (IR), and topically applied melatonin plus irradiation (Mel+IR). The right hind legs of the IR and Mel+IR group mice were exposed to two fractions of electron beam radiation (20 Gy × 2). For 4 weeks, melatonin solution (10 mg/day) was topically applied to Mel+IR group mice. Fourteen days after IR, the relative levels of transforming growth factor (TGF)-β1 mRNA expression and TGF-β1 protein in skin specimens were analyzed by real-time quantitative PCR and immunohistochemical staining. Dermal thickness and tissue collagen accumulation were measured at 100 days post irradiation. Results: The Radiation caused a 2.2-fold increase in TGF-β1 mRNA expression relative to that in control group, which was decreased by 37% following melatonin treatment (P = 0.024). We also observed substantial reduction of TGF-β1 expression in immunohistochemical studies. The mean values of dermal thickness were 105 ± 11 μm (Control), 195 ± 21 μm (IR), and 148 ± 19 μm (Mel+IR). Dermal thickness and collagen accumulation, which increased in the IR group, was significantly reduced by topically applied melatonin.  Conclusion: Topical administration of melatonin successfully attenuated RISF. 617 624 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/12 1398/7/20 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/12 1398/7/20 D.H. Kim D.H. Kim Department of Radiation Oncology, Otorhinolaryngology, and Hemato-oncology, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Pusan National University, Busan, Korea Y.M. Choi Y.M. Choi Department of Radiation Oncology, DongA University Hospital, Busan, Korea Y.K. Ki Y.K. Ki Department of Radiation Oncology, Pusan National University Yangsan Hospital and Pusan National University School of Medicine, Yangsan, Korea K.S. Cho K.S. Cho Department of Radiation Oncology, Otorhinolaryngology, and Hemato-oncology, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Pusan National University, Busan, Korea Y.J. Choi Y.J. Choi Department of Radiation Oncology, Otorhinolaryngology, and Hemato-oncology, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Pusan National University, Busan, Korea W.T. Kim W.T. Kim Department of Radiation Oncology, Otorhinolaryngology, and Hemato-oncology, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Pusan National University, Busan, Korea rokwt@hanmail.net Melatonin Radiation Fibrosis Transforming growth factor-β Topical application. . Stone HB, Coleman CN, Anscher MS, McBride WH (2003) Effects of radiation on normal tissue: consequences and mechanisms. Lancet Oncol, 4(9): 529-536.##2. Yarnold J and Brotons MV (2010) Pathogenetic mechanisms in radiation fibrosis. Radiother Oncol, 97(1): 149-161.##3. Brush J, Lipnick SL, Phillips T, Sitko J, McDonald JT, McBride WH (2007) Molecular mechanisms of late normal tissue injury. Semin Radiat Oncol, 17: 121–130.##4. Rudra DS, Pal U, Maiti NC, Reiter RJ, Swarnakar S (2013) Melatonin inhibits matrix metalloproteinase‐9 activity by binding to its active site. J Pineal Res, 54(4): 398-405.##5. Karbownik M and Reiter RJ (2000) Antioxidative effects of melatonin in protection against cellular damage caused by ionizing radiation. P Soc Exp Biol Med, 225(1): 9-22.##6. Reiter RJ, Tan D, Herman TS, Thomas CR (2004) Melatonin as a radioprotective agent: a review. Int J Radiat Oncol Biol Phys, 59(3): 639-653.##7. Wang H, Wei W, Wang N, Gui S, Wu L, Sun W, Xu SY (2005) Melatonin ameliorates carbon tetrachloride-induced hepatic fibrogenesis in rats via inhibition of oxidative stress. Life Sci, 77(15): 1902-1915.##8. Yildirim Z, Kotuk M, Erdogan H, Iraz M, Yagmurca M, Kuku I, Fadillioglu E (2006) Preventive effect of melatonin on bleomycin‐induced lung fibrosis in rats. J Pineal Res, 40(1): 27-33.##9. Fischer TW, Greif C, Fluhr JW, Wigger-Alberti W, Elsner P (2004) Percutaneous penetration of topically applied melatonin in a cream and an alcoholic solution. Skin Pharmacol Physiol, 17(4): 190-194.##10. Bangha E, Elsner P, Kistler G (1997) Suppression of UV-lnduced Erythema by Topical Treatment with Melatonin (N-Acetyl-5-Methoxytryptamine). Dermatology, 195(3): 248-252.##11. Ben-David MA, Elkayam R, Gelernter I, Pfeffer RM (2016) Melatonin for Prevention of Breast Radiation Dermatitis: A Phase II, Prospective, Double-Blind Randomized Trial. Isr Med Assoc J, 18(3-4): 188-192.##12. Martin M, Lefaix J, Delanian S (2000) TGF-β1 and radiation fibrosis: a master switch and a specific therapeutic target? Int J Radiat Oncol Biol Phys, 47(2): 277-290.##13. Ryu SH, Lee SW, Moon SY, Oh JY, Yang YJ, Park JH (2010) Establishment of a radiation-induced fibrosis model in BALB/c Mice. J Korean Soc Ther Radiol Oncol, 28(1):32-38.##14. Rodemann HP and Blaese MA (2007) Responses of normal cells to ionizing radiation. Semin Radiat Oncol, 17: 81–88.##15. Anscher MS (2010) Targeting the TGF-beta1 pathway to prevent normal tissue injury after cancer therapy. Oncologist, 15(4): 350-359.##16. Rübe CE, Uthe D, Schmid KW, Richter KD, Wessel J, Schuck A, Willich N, Rübe C (2000) Dose-dependent induction of transforming growth factor β (TGF-β) in the lung tissue of fibrosis-prone mice after thoracic irradiation. Int J Radiat Oncol Biol Phys, 47(4): 1033-1042.##17. Ghosh AK and Vaughan DE (2012) PAI‐1 in tissue fibrosis. J Cell Physiol, 227(2): 493-507.##18. Tan D, Reiter RJ, Manchester LC, Yan M, El-Sawi M, Sainz RM, Mayo JC, Kohen R, Allegra MC, Hardeland R (2002) Chemical and physical properties and potential mechanisms: melatonin as a broad spectrum antioxidant and free radical scavenger. Curr Top Med Chem, 2(2): 181-197.##19. Drobnik J and Dabrowski R (1999) Pinealectomy-induced elevation of collagen content in the intact skin is suppressed by melatonin application. Cytobios, 100(393): 49-55.##20. Shirazi A, Ghobadi G, Ghazi-Khansari M (2007) A radiobiological review on melatonin: a novel radioprotector. J Radiat Res, 48(4): 263-272.##21. Izykowska I, Cegielski M, Gebarowska E, Podhorska-Okolow M, Piotrowska A, Zabel M, Dziegiel P (2009) Effect of melatonin on human keratinocytes and fibroblasts subjected to UVA and UVB radiation in-vitro. In-vivo, 23(5): 739-745.##22. Fischer TW, Slominski A, Zmijewski MA, Reiter RJ, Paus R (2008) Melatonin as a major skin protectant: from free radical scavenging to DNA damage repair. Exp Dermatol, 17(9): 713-730.##23. Xavier S, Piek E, Fujii M, Javelaud D, Mauviel A, Flanders KC, Samuni AM, Felici A, Reiss M, Yarkoni S, Sowers A, Mitchell JB, Roberts AB, Russo A (2004) Amelioration of radiation-induced fibrosis: inhibition of transforming growth factor-beta signaling by halofuginone. J Biol Chem, 279(15): 15167-15176.##24. Martín Renedo J, Mauriz JL, Jorquera F, Ruiz Andrés O, González P, González Gallego J (2008) Melatonin induces cell cycle arrest and apoptosis in hepatocarcinoma HepG2 cell line. J Pineal Res, 45(4): 532-540.##25. 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Evaluation of swallowing function with clinical and dosimetric parameters in head and neck cancer patients receiving radio (chemo)therapy 2 2 Background: This study aimed to evaluate the relationship between late dysphagia and dosimetric–clinical parameters in patients receiving radiotherapy for head and neck cancer (HNC). Materials and Methods: Twenty-six HNC patients treated with three-dimensional conformal radiotherapy were evaluated. A total dose of 66–70 Gy in 33–35 fractions was administered for curative purposes. Six swallowing organs at risk were contoured for each patient: the superior, middle and inferior pharyngeal constrictor muscles (SPCM, MPCM and IPCM); the cervical oesophagus (CE); the base of tongue (BOT); and the larynx. The mean dose in Gray [Dmean(Gy)], maximum dose in Gray [Dmax(Gy)] and percentages of organ volumes receiving ≥ 50 Gy, ≥ 60 Gy and ≥ 70 Gy [V50 (%), V60 (%) and V70 (%), respectively] were calculated from the dose–volume histograms for each structure. Dysphagia was evaluated using video laryngoscopy, the European Organization for Research and Treatment of Cancer quality of life module for HNC and the Leipzig scale. Results: Dmean, V60 and V70 for the BOT; Dmean and V60 for the SPCM; Dmean, Dmax, V60 and V70 for the IPCM; Dmean, Dmax, V60 and V70 for the larynx; and Dmean, Dmax, V50 and V70 for the CE were correlated with the presence of pharyngeal secretion. Only V50 for the CE was correlated with abnormal glottic closure. Dmean, Dmax, V60 and V70 for the BOT and the SPCM were correlated with liquid swallowing problems. Dmax for the MPCM; Dmean, Dmax, V60 and V70 for the IPCM; and Dmax, V60 and V70 for the CE were correlated with the Leipzig score. Conclusion: The dose–volume parameters of swallowing organs were found to be associated with different rates of late dysphagia in HNC patients receiving radiotherapy. The identification of dosimetric parameters that predict late dysphagia is not adequate yet. Well-designed multi-institutional studies are necessary to clarify the dose–volume constraints. 625 632 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/12 1398/7/20 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/12 1398/7/20 G. Turkkan G. Turkkan Department of Radiation Oncology, Trakya University Faculty of Medicine, Edirne, Turkey gorkemturkkan@gmail.com M. Caloglu M. Caloglu Department of Radiation Oncology, Trakya University Faculty of Medicine, Edirne, Turkey V. Yurut-Caloglu V. Yurut-Caloglu Department of Radiation Oncology, Trakya University Faculty of Medicine, Edirne, Turkey A.R. Karasalihoglu A.R. Karasalihoglu Department of Otolaryngology, Trakya University Faculty of Medicine, Edirne, Turkey M. Dogan M. Dogan Department of Radiation Oncology, Trakya University Faculty of Medicine, Edirne, Turkey C. Uzal C. Uzal Department of Radiation Oncology, Trakya University Faculty of Medicine, Edirne, Turkey dysphagia head and neck cancer radiotherapy. Adelstein DJ, Li Y, Adams GL, Wagner H, Jr., Kish JA, Ensley JF, Schuller DE, Forastiere AA (2003) An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol, 21(1): 92-8.##2. Denis F, Garaud P, Bardet E, Alfonsi M, Sire C, Germain T, Bergerot P, Rhein B, Tortochaux J, Calais G (2004) Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol, 22(1): 69-76.##3. Dirix P, Abbeel S, Vanstraelen B, Hermans R, Nuyts S (2009) Dysphagia after chemoradiotherapy for head-and-neck squamous cell carcinoma: dose-effect relationships for the swallowing structures. Int J Radiat Oncol Biol Phys, 75(2): 385-92.##4. Caudell JJ, Schaner PE, Desmond RA, Meredith RF, Spencer SA, Bonner JA (2010) Dosimetric factors associated with long-term dysphagia after definitive radiotherapy for squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys, 76(2): 403-9.##5. Feng FY, Kim HM, Lyden TH, Haxer MJ, Feng M, Worden FP, Chepeha DB, Eisbruch A (2007) Intensity-modulated radiotherapy of head and neck cancer aiming to reduce dysphagia: early dose-effect relationships for the swallowing structures. Int J Radiat Oncol Biol Phys, 68(5): 1289-98.##6. Gregoire V, Eisbruch A, Hamoir M, Levendag P (2006) Proposal for the delineation of the nodal CTV in the node-positive and the post-operative neck. Radiother Oncol, 79(1): 15-20.##7. Gregoire V, Levendag P, Ang KK, Bernier J, Braaksma M, Budach V, Chao C, Coche E, Cooper JS, Cosnard G, Eisbruch A, El-Sayed S, Emami B, Grau C, Hamoir M, Lee N, Maingon P, Muller K, Reychler H (2003) CT-based delineation of lymph node levels and related CTVs in the node-negative neck: DAHANCA, EORTC, GORTEC, NCIC,RTOG consensus guidelines. Radiother Oncol, 69(3): 227-36.##8. Christianen ME, Langendijk JA, Westerlaan HE, van de Water TA, Bijl HP (2011)Delineation of organs at risk involved in swallowing for radiotherapy treatment planning. Radiother Oncol, 101(3): 394-402.##9. Bjordal K, Hammerlid E, Ahlner-Elmqvist M, de Graeff A, Boysen M, Evensen JF, Biorklund A, de Leeuw JR, Fayers PM, Jannert M, Westin T, Kaasa S (1999) Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J Clin Oncol, 17(3): 1008-19.##10. Mittal BB, Pauloski BR, Haraf DJ, Pelzer HJ, Argiris A, Vokes EE, Rademaker A, Logemann JA (2003) Swallowing dysfunction--preventative and rehabilitation strategies in patients with head-and-neck cancers treated with surgery, radiotherapy, and chemotherapy: a critical review. Int J Radiat Oncol Biol Phys, 57(5): 1219-30.##11. Deantonio L, Masini L, Brambilla M, Pia F, Krengli M (2013) Dysphagia after definitive radiotherapy for head and neck cancer. Correlation of dose-volume parameters of the pharyngeal constrictor muscles. Strahlenther Onkol, 189(3): 230-6.##12. Truong MT, Lee R, Saito N, Qureshi MM, Ozonoff A, Romesser PB, Wang J, Sakai O (2012) Correlating computed tomography perfusion changes in the pharyngeal constrictor muscles during head-and-neck radiotherapy to dysphagia outcome. Int J Radiat Oncol Biol Phys, 82(2): e119-27.##13. Marks LB, Yorke ED, Jackson A, Ten Haken RK, Constine LS, Eisbruch A, Bentzen SM, Nam J, Deasy JO (2010) Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys, 76(3 Suppl): S10-9.##14. Rancati T, Schwarz M, Allen AM, Feng F, Popovtzer A, Mittal B, Eisbruch A (2010) Radiation dose-volume effects in the larynx and pharynx. Int J Radiat Oncol Biol Phys, 76(3 Suppl): S64-9.##15. Christianen ME, Schilstra C, Beetz I, Muijs CT, Chouvalova O, Burlage FR, Doornaert P, Koken PW, Leemans CR, Rinkel RN, de Bruijn MJ, de Bock GH, Roodenburg JL, van der Laan BF, Slotman BJ, Verdonck-de Leeuw IM, Bijl HP, Langendijk JA (2012) Predictive modelling for swallowing dysfunction after primary (chemo)radiation: results of a prospective observational study. Radiother Oncol, 105(1): 107-14.##16. Jensen K, Lambertsen K, Grau C (2007) Late swallowing dysfunction and dysphagia after radiotherapy for pharynx cancer: frequency, intensity and correlation with dose and volume parameters. Radiother Oncol, 85(1): 74-82.##17. Erkal EY, Canoglu D, Kaya A, Aksu G, Sarper B, Akansel G, Meydanci T, Erkal HS (2014) Assessment of early and late dysphagia using videofluoroscopy and quality of life questionnaires in patients with head and neck cancer treated with radiation therapy. Radiat Oncol, 9: 137.##18. Caudell JJ, Schaner PE, Meredith RF, Locher JL, Nabell LM, Carroll WR, Magnuson JS, Spencer SA, Bonner JA (2009) Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys, 73(2): 410-5. ## ##

Audiometric findings in patients with head and neck chemoradiotherapy and radiotherapy: short-term outcomes 2 2 Background: Hearing loss is a major concern in the patient with head and neck cancer (HNC) undergoing radiotherapy (RT) and/or chemotherapy (CHT). The present study aimed to assess the incidence of sensorineural hearing loss (SNHL) at 6 months follow-up after RT and/or concurrent Cisplatin-based CHT.  Materials and Methods: In this prospective study, 60 patients with histopathologically proven HNC underwent three-dimensional conformal radiotherapy (3DCRT) (35 patients) and concurrent Cisplatin-based CHT and RT (25 patients). The status of the hearing was assessed pre-treatment (baseline), one day, 1, 3 and 6 months after treatment by pure tone audiometry (PTA) and other audiometric tests such as tympanometry (TM), acoustic reflex (AR), and speech audiometry (SA). Results: In the RT group, SNHL was observed in 18 patients and hearing loss occurred in 47 % (33 of 70 ears) of ears. In the chemo-radiotherapy (CRT) group, SNHL was discerned in 20 patients and hearing loss appeared in 88 % (44 of 50 ears) of ears. Perforation of the tympanic membrane occurred in 2/35 patients in the RT group and 1/25 patients in the CRT group. The AR threshold (ART) of patients with CRT significantly increased compared to the RT group at the end of 6 months after treatment (P <0.05). Meanwhile, there was a significant difference in the speech discrimination score (SDS) and speech recognition threshold (SRT) between the CRT group and RT group at the 6 months after treatment (P <0.05). Conclusion: The incidence of hearing loss in patients that underwent CRT was higher. The auditory system should be considered as a critical organ at risk (OAR) in treatment planning. 633 641 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/13 1398/7/21 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/13 1398/7/21 A.H. Rezaeyan A.H. Rezaeyan Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran H. Ghaffari H. Ghaffari Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran S.R. Mahdavi S.R. Mahdavi Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran A.R. Nikoofar A.R. Nikoofar Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran M. Najafi M. Najafi Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Science, Kermanshah, Iran F. Koosha F. Koosha Radiology Technology Department, Allied Medicine Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran S. Cheraghi Cheraghi S. Cheraghi Cheraghi Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran cheraghi.s@iums.ac.ir Sensorineural hearing loss head and neck cancer radiotherapy cisplatin-based chemotherapy. Hunter KD, Parkinson EK, Harrison PR (2005) Profiling early head and neck cancer. Nat Rev Cancer, 5: 127-35.##2. Chen H, Huang H, Li G, et al. (2017) Application of computed tomography and magnetic resonance imaging fusion images for delineating gross tumor volume in three-dimensional conformal radiotherapy of nasopharyngeal carcinoma. Int J Radiat Res, 15: 251-257.##3. Kaizu H, Hata M, Takano S, et al. (2018) Treatment outcomes of (chemo) radiotherapy for oropharyngeal cancers: influence of the use of 15 MV X-rays in radiation boost. Int J Radiat Res, 16: 257-267.##4. Cognetti DM, Weber RS, Lai SY (2008) Head and neck cancer: an evolving treatment paradigm. Cancer, 113: 1911-1932.##5. Hitchcock YJ, Tward JD, Szabo A, et al. (2009) Relative contributions of radiation and cisplatin-based chemotherapy to sensorineural hearing loss in head-and-neck cancer patients. Int J Radiat Oncol Biol Phys, 73: 779-88.##6. Schultz C, Goffi-Gomez MVS, Liberman PHP, et al. (2010) Hearing Loss and Complaint in Patients With Head and Neck Cancer Treated With Radiotherapy. JAMA Otolaryngol Head Neck Surg, 136: 1065-1069.##7. Grau C and Overgaard J (1996) Postirradiation sensorineural hearing loss: a common but ignored late radiation complication. Int J Radiat Oncol Biol Phys, 36: 515-7.##8. 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(2014) Cochlea sparing effects of intensity modulated radiation therapy in head and neck cancers patients: a long-term follow-up study. J Otolaryngol Head Neck Surg, 43:30-30.##14. Low WK, Toh ST, Wee J, et al. (2006) Sensorineural hearing loss after radiotherapy and chemoradiotherapy: a single, blinded, randomized study. J Clin Oncol, 24:1904-9.##15. Eleonoor ART, Wouter AD, Merel NL, et al. (2014) A New Grading System for Ototoxicity in Adults. Ann Otol Rhinol Laryngol, 123: 711-718.##16. Wei Y, Zhou T, Zhu J, et al. (2014) Long-term outcome of sensorineural hearing loss in nasopharyngeal carcinoma patients: comparison between treatment with radiotherapy alone and chemoradiotherapy. Cell Biochem Biophys, 69: 433-7.##17. Yasui N, Adachi N, Kato M, et al. (2014) Cisplatin-induced Hearing Loss: The Need for a Long-term Evaluating System. J Pediatr Hematol Oncol, 36: e241-e245.##18. Tsan D-L, Lin C-Y, Kang C-J, et al. 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Protective role of Terminalia against γ-rays induced cardiotoxicity in rats 2 2 Background: Gamma-rays-induced cellular damages in the vital organs of rats. The study investigates the protective impacts of Terminalia (T. arjuna) against γ-rays induced cardiac injuries in rats. Materials and Methods: Dose A dose of 400 mg/kg body weight of T. arjuna was administered to male rats via gastric intubation for 30 days before whole body γ-irradiation (8 Gy). Results: The animals exposed to γ-rays showed a significant rise in levels of lipid-peroxidation (MDA), cardiac injury markers; Aspartate transaminase (AST) and lactate dehydrogenase (LDH), inflammatory markers; tumor necrosis factor-alfa (TNF-α) and interleukin-6 (IL-6), and finally, reduced oxidative enzyme markers; superoxide dismutase (SOD) and glutathione peroxidase (GPx) as compared to control group. The histopathological sections from irradiated rat group showed myocardium necrosis, loss of striations in myofibrils and leuckocytic infiltration. Pre-treatment with T. arjuna reduced the altered levels of these markers, which was further confirmed by histopathological observations. A tendency towards normal architectures of the myocardium was distinguished and a decrease in the degree of damages and inflammations in the myocytes was demonstrated. Conclusion: T. arjuna modifies antioxidants and inflammatory markers in rat heart and also prevents the myocardium from γ-rays-induced myocardial damages and should have prophylactic value in the prevention of heart toxicity. 643 649 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/13 1398/7/21 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/13 1398/7/21 A.A. Elkady A.A. Elkady Health Radiation Research Department, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Nasr City, Cairo, Egypt elkadyah13@gmail.com R.M. Ebrahim R.M. Ebrahim Health Radiation Research Department, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Nasr City, Cairo, Egypt S.S. Tawfik S.S. Tawfik Health Radiation Research Department, National Centre for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, Nasr City, Cairo, Egypt Terminalia radioprotector γ-rays heart rats. . Islam MZ, Islam MN, Bhowmik TK, Saha B, Hossain MS, Ahmed H, Ali MS, Shakil SS (2018) Paul PK. Relationship between triglyceride and HDL-C ratio with acute coronary syndrome. Mymensingh Med J, 27(2): 289-93.##2. 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Front Biosci (Elite Ed), 10: 469-80. ## 7. Mishra K, Ojha H, Kallepalli S, Alok A, Kumar Chaudhury N (2014) Protective effect of ferulic acid on ionizing radiation induced damage in bovine serum albumin. Int J Radiat Res, 12(2): 113-21.##8. Castillo H, Li X, Schilkey F, Smith GB (2018) Transcriptome analysis reveals a stress response of Shewanella oneidensis deprived of background levels of ionizing radiation. PLoS One, 13(5): e0196472.##9. Althaf Hussain S, Kareem MA, Rasool SN, Al Omar SY, Saleh A, Al-Fwuaires MA, Daddam JR, Devi KL (2018) Trace Element determination and cardioprotection of Terminalia pallida fruit ethanolic extract in isoproterenol induced myocardial infarcted rats by ICP-MS. Biol Trace Elem Res, 181(1): 112-21.##10. Yahyapour R, Motevaseli E, Rezaeyan A, Abdollahi H, Farhood B, Cheki M, Rezapoor S, Shabeeb D, Musa AE, Najafi M, Villa V (2018) Reduction-oxidation (redox) system in radiation-induced normal tissue injury: molecular mechanisms and implications in radiation therapeutics. Clin Transl Oncol, 20(8): 975-88. ##11. Rather RA, Malik VS, Trikha D, Bhat O,  Dhawan V (2016) Aqueous Terminalia arjuna extract modulates expression of key atherosclerosis-related proteins in a hypercholesterolemic rabbit: A proteomic-based study. Proteomics Clin Appl, 10: 750–59.##12. Bishop S and Liu SJ (2017) Cardioprotective action of the aqueous extract of Terminalia arjuna bark against toxicity induced by doxorubicin. Phytomedicine, 36: 210–16.##13. Amalraj A and Gopi S (2016) Medicinal properties of Terminalia arjuna (Roxb.) Wight & Arn.: A review. J Tradit Complement Med, 7(1): 65–78.##14. Afshari AR, Sadeghnia HR, Mollazadeh H (2016) A review on potential mechanisms of terminalia chebula in Alzheimer’s disease. Adv Pharmacol Sci, 2016: 8964849.##15. Shukla SK, Sharma SB, Singh UR, Ahmad S, Dwivedi S (2015a) Terminalia arjuna (Roxb.) Wight & Arn. augments cardioprotection via antioxidant and antiapoptotic cascade in isoproterenol induced cardiotoxicity in rats. Indian J Exp Biol, 53(12): 810-8.##16. Bancroft D, Stevens A, Turmer R (1996) Theory and practice of histological technique, 4th ed. Edinburgh; Churchill Livingstone, pp: 47–67.##17. Snedecor GW and Cochran WG (1989) Statistical Methods, 8th ed. Wiley-Blackwell, p: 503.##18. Takauji Y, Miki K, Mita J, Hossain MN, Yamauchi M, Kioi M, Ayusawa D, Fujii M (2016) Triphala, a formulation of traditional Ayurvedic medicine, shows protective effect against X-radiation in HeLa cells. J Biosci, 41(4): 569-75.##19. 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Assessment of fetal and maternal radiation absorbed dose in 18F-FDG PET imaging 2 2 Background: Clinical application of PET imaging for diagnosis, staging,                    re-staging treatment planning and treatment response assessment have become a major focus of studies in the past decades. Fetus is more sensitive to ionizing radiation, consequently, radiation absorption risks need to be assessed carefully. The objective of this article is to accurately estimate the absorbed dose during pregnancy in PET examinations. The method adopted in this article is simulative-analytic. Materials and Methods: The absorbed dose from administrating 18F-FDG during pregnancy is estimated through the BodyBuilder anthropomorphic mathematical phantom (inexpensive) together with Monte Carlo simulations in order to obtain a reliable and feasible methodology. In this simulation, the Specific Absorbed Fractions (SAF) is estimated for organs of 3, 6 and 9-months fetal. Results: The obtained results indicate that the absorbed dose of 18F-FDG PET imaging the fetal is 2.50×10-2 mGy/MBq early; 2.04×10-2 mGy/MBq first three months of pregnancy, 1.80 ×10-2 mGy/MBq second three months, and 1.50 ×10-2 mGy/MBq in the third three months of pregnancy. Maternal absorbed dose estimation here is (R2=0.965) which perfectly corresponds to ICRP publication. Conclusion: The results from Monte Carlo code with BodyBuilder anthropomorphic phantoms and ICRP recommendation are of acceptable correlation. Applying the pure BodyBuilder anthropomorphic phantoms in this simulation, which yields agreeable results in addition to its low time consumption, corresponds to the available finding by other researchers while reducing calculation times. Moreover, the fetal & maternal absorbed doses remain however well below the threshold for any deterministic effects. 651 657 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/13 1398/7/21 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/13 1398/7/21 N. Ahmadi N. Ahmadi Department of Nuclear Engineering, Faculty of Advanced Sciences & Technologies, University of Isfahan, Isfahan, Iran A. Karimian A. Karimian Department of Biomedical Engineering, University of Isfahan, Isfahan, Iran M.N. Nasrabadi M.N. Nasrabadi Department of Nuclear Engineering, Faculty of Advanced Sciences & Technologies, University of Isfahan, Isfahan, Iran mnnasrabadi@ast.ui.ac.ir A. Rahmim A. Rahmim Department of Radiology, Johns Hopkins University, Baltimore MD, USA Fetal dose maternal dose GATE/GEANT4 PET/CT 18F-FDG. ##1. Zanotti-Fregonara P, Champion C, Trébossen R, Maroy R, Devaux J-Y, Hindié E (2008) Estimation of the β+ dose to the embryo resulting from 18F-FDG administration during early pregnancy. J Nucl Med, 49:679–682.##2. Zanotti-Fregonara P, Jan S, Taieb D, Cammilleri S, Trébossen R, Hindié E, Mundler O (2010) Absorbed 18F-FDG dose to the fetus during early pregnancy. J Nucl Med,51:803–805.##3. Takalkar AM, Khandelwal A, Lokitz S, Lilien DL, Stabin MG (2011) 18F-FDG PET in pregnancy and fetal radiation dose estimates. J Nucl Med, 52:1035–1040.##4. Zanotti-Fregonara P, Koroscil TM, Mantil J, Satter M (2012) Radiation dose to the fetus from [(18)F]-FDG administration during the second trimester of pregnancy. Health Phys, 102:217–9.##5. Zanotti-Fregonara P, Laforest R, Wallis JW (2015) Fetal Radiation Dose from 18F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR. J Nucl Med, 56:1218–22.##6. Benveniste H, Fowler JS RW (2003) Maternal-fetal in vivo imaging: a combined PET and MRI study. J Nucl Med, 44:1522–1530.##7. Stabin MG (2004) Proposed addendum to previously published fetal dose estimate tables for 18F-FDG. J Nucl Med, 45:634–5.##8. Cristy M and Eckerman KF (1987) Specific absorbed fractions of energy at various ages from internal photon sources: 6, Newborn. ORNL/TM-8381. doi: 10.2172/6202949.##9. Stabin MG (1996) MIRDOSE: personal computer software for internal dose assessment in nuclear medicine. J Nucl Med, 37:538–46.##10. Stabin MG, Sparks RB, Crowe E (2005) OLINDA/EXM: the second-generation personal computer software for internal dose assessment in nuclear medicine. J Nucl Med, 46:1023–1027.##11. Valentin J (2002) Basic anatomical and physiological data for use in radiological protection: reference values. Ann ICRP, 32:1–277.##12. Zanotti-Fregonara P, Chastan M, Edet-Sanson A, Ekmekcioglu O, Erdogan EB, Hapdey S, Hindie E, Stabin MG (2016) New fetal doses from 18FDG administered during pregnancy: standardization of dose calculations and estimations with voxel-based anthropomorphic phantoms. J Nucl Med jnumed-116##13. Zanotti-Fregonara P, Stabin MG (2017) New Fetal Radiation Doses for18F-FDG Based on Human Data. J Nucl Med, 58:1865–1866.##14. Shi CY, Xu XG, Stabin MG (2008) SAF values for internal photon emitters calculated for the RPI-P pregnant-female models using Monte Carlo methods. Med Phys, 35:3215–3224.##15. Weissleder R (2010) Molecular imaging: principles and practice. ##16. Van Riper K (2005) BodyBuilder user’s guide. White Rock, NM White Rock Sci. ##17. Stabin MG, Watson EE, Cristy M, Ryman JC, Eckerman KF, Davis JL, Marshall D, Gehlen MK (1995) Mathematical models and specific absorbed fractions of photon energy in the nonpregnant adult female and at the end of each trimester of pregnancy. Oak Ridge National Lab., TN (United States).##18. Press WH (2007) Numerical recipes 3rd edition: The art of scientific computing. Cambridge university press.##19. Snyder WS, Ford MR, Warner GG, Watson SB (1975) S’absorbed dose per unit cumulated activity for selected radionuclides and organs.(MIRD pamphlet no. 11) Society of Nuclear Medicine, New York. Google Sch, 11:5–257.##20. Shinohara A, Hanaoka H, Sakashita T, Sato T, Yamaguchi A, Ishioka NS, Tsushima Y (2017) Rational evaluation of the therapeutic effect and dosimetry of auger electrons for radionuclide therapy in a cell culture model. Ann Nucl Med, 1–9.##21. Valentin J (1998) Radiation dose to patients from radiopharmaceuticals: (Addendum 2 to ICRP Publication 53) ICRP Publication 80 Approved by the Commission in September 1997. Ann ICRP, 28:1–1.##22. Andersson M, Johansson L, Minarik D, Leide-svegborn S, Mattsson S (2014) Effective dose to adult patients from 338 radiopharmaceuticals estimated using ICRP biokinetic data , ICRP / ICRU computational reference phantoms and ICRP 2007 tissue weighting factors. EJNMMI Phys, doi: 10.1186/2197-7364-1-9.##23. Thomas SR, Stabin MG, Chen C-T, Samaratunga RC (1999) MIRD Pamphlet No. 14 Revised: A Dynamic Urinary Bladder Model for Radiation Dose. J Nucl Med, 40:102S--123S.##24. Bland JM and Altman D (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 327:307–310.##25. Russell JR, Stabin MG, Sparks RB, Watson E (1997) Radiation absorbed dose to the embryo/fetus from radiopharmaceuticals. Health Phys, 73:756–769.##26. Zanotti-Fregonara P, Jan S, Champion C, Trébossen R, Maroy R, Devaux J-Y, Hindié E (2009) In-vivo quantification of 18F-FDG uptake in human placenta during early pregnancy. Health Phys, 97:82–85.##27. Xie T and Zaidi H (2014) Fetal and Maternal Absorbed Dose Estimates for Positron-Emitting Molecular Imaging Probes. J Nucl Med, 55:1459–1466.##28. Wayson MB (2012) Computational internal dosimetry methods as applied to the University of Florida series of hybrid phantoms. University of Florida.##29. Wahl RL and Wagner HN (2009) Principles and practice of PET and PET/CT. Lippincott Williams & Wilkins.##30. Shao F, Chen Y, Huang Z, Cai L, Zhang Y (2016) Unexpected Pregnancy Revealed on 18F-NaF PET/CT. Clin Nucl Med, 41:e202–e203.## ##

Investigation of indoor radon concentration in dwellings of Aleshtar (western part of Iran) and estimation of the annual effective dose from exposure to radon 2 2 Background: One of the most important natural sources of human exposure is inhalation of radon radioactive gas and its decay products in homes and at workplaces. According to the World Health Organization, radon is the second leading cause of lung cancer. This study is the first survey of indoor radon concentration in dwellings of the Aleshtar city (west of Iran). Materials and methods: In this work, radon concentrations were measured in 24 dwellings by using a passive method known as Alpha Track Detectors (ATDs) with CR-39 polycarbonate film for three months during the year 2016. In addition, the annual effective dose due to radon exposure was estimated for residents. Results: The indoor radon concentration ranged from 1.01 to 206.53 Bq/m3 with an average value of 55.19 Bq/m3 (CI (Confidence Interval) 95%: 31.46 - 78.92), and the average annual effective dose to the population in Aleshtar was estimated to be 1.39 mSv/y. According to the result of this study, there was a significant difference between apartment buildings and villas as well as between different floors in terms of the average radon concentration. Conclusion: It was found that radon concentration in 20.8% of dwellings was higher than the reference levels recommended by the World Health Organization (100 Bq/m3). 659 666 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/20 1398/7/28 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/20 1398/7/28 H. Hassanvand H. Hassanvand Master of Environmental Health Engineering, Lorestan University of medical sciences, Khorramabad, Iran M. Birjandi M. Birjandi Department of public Health, School of Health and nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran A. Amiri A. Amiri Department of Geography, Faculty of Literature and Humanities sciences, Lorestan University, Khorramabad, Iran M.S. Hassanvand M.S. Hassanvand Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran B. Kamarehie B. Kamarehie Nutrition Health Research Center and Department of Environmental Health Engineering, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran b.kamarehie@gmail.com, Radon Indoor Air CR-39 Iran-Lorestan. Ghorbanipour M, Hosseini Alhashemi A, Gharloghi S, Adeli M, Gholami M (2017) Health Risk Assessment of Natural Background Radiation in Residents of Khorramabad, Iran. Iranian Journal of Medical Physics, 14(1): 23-8.##2. Shahbazi-Gahrouei D, Setayandeh S, Gholami M (2013) A review on comparison of natural radiation in Iran with other countries. International Journal of Low Radiation, 9(1): 1-11.##3. Mehdipour LA, DoostMohammadi F, Saion E, Qasemi N, Hadavi M (2014) Influence of ventilation conditions on the radon annual effective dose of the lungsimulatedfor radon prone areas of Ramsar. IOSR Journal of Applied Physics, 6(3): 65-70.##4. Peckham EC, Scheurer ME, Danysh HE, Lubega J, Langlois PH, Lupo PJ (2015) Residential Radon Exposure and Incidence of Childhood Lymphoma in Texas, 1995–2011. Int J of environmental research and public health, 12(10): 12110-26.##5. Yeboah SM (2014) Indoor radon in selected homes in Aburi municipality: Measurement uncertainty, decision analysis and remediation strategy: University of Ghana.##6. Mowlavi AA, Fornasier MR, Binesh A, De Denaro M (2012) Indoor radon measurement and effective dose assessment of 150 apartments in Mashhad, Iran. Environmental monitoring and assessment, 184(2): 1085-8.##7. Pirsaheb M, Najafi F, Khosravi T, Hemati L (2013) A systematic review of radon investigations related to public exposure in Iran. Iranian Red Crescent Medical Journal, 15(11): e10204.##8. Appleton JD (2013) Radon in air and water. Essentials of medical geology: Springer, pp: 239-77.##9. Singh P, Singh P, Singh S, Sahoo B, Sapra B, Bajwa B (2015) A study of indoor radon, thoron and their progeny measurement in Tosham region Haryana, India. Journal of Radiation Research and Applied Sciences, 8(2): 226-33.##10. Madureira J, Paciência I, Rufo J, Moreira A, de Oliveira Fernandes E, Pereira A (2016) Radon in indoor air of primary schools: determinant factors, their variability and effective dose. Environmental Geochemistry and Health, 38(2): 523-33.##11. WHO (2009) WHO handbook on indoor radon: a public health perspective: World Health Organization.##12. Mehdipour LA, Saion EB, Sidek A, Halimah M, GoodarzNaseri M, AbdolHalimShaari MN (2013) Influence of chimney effect on the radon effective dose of the lung simulated for radon prone areas of Ramsar in winter season. IOSR-JAP, 4(4): 33-7.##13. World Bank (2016) The Cost of Air Pollution: Strengthening the Economic Case for Action. Washington, DC 204332016.##14. Charles M (2010) Effects of Ionizing Radiation: United Nations Scientific Committee on the Effects of Atomic Radiation: UNSCEAR 2006 Report, Volume 1—Report to the general assembly, with scientific annexes A and B. Radiation Protection Dosimetry, 138(2): 187-9.##15. Miles J and Appleton J (2005) Mapping variation in radon potential both between and within geological units. Journal of Radiological Protection, 25(3): 257-63.##16. Dubois G (2005) An overview of radon surveys in Europe 2005. EC, Office for Official Publications of the European Communities. 2005:168 Report.##17. Rahimi SA and Nikpour B (2013) Measurement of radon concentration of air samples and estimating radiation dose from radon in Sari province. Universal Journal of Public Health, 1(2): 26-31.##18. Bouzarjomehri F and Ehrampoush M (2008) Radon level in dwellings basement of Yazd-Iran. Iran J Radiat Res, 6(3): 141-4.##19. Hadad K, Doulatdar R, Mehdizadeh S (2007) Indoor radon monitoring in Northern Iran using passive and active measurements. Journal of Environmental Radioactivity, 95(1): 39-52.##20. Amirzadi M, Hosseini PMS, Taheri M, Babakhani A (2012) Complementary measurements of radon concentration in water sources and natural exposure in dwellings in the vicinity of the Ramsar HLNRA, Iran. Nuclear Technology and Radiation Protection, 27(4): 399-403.##21. Gillmore G and Jabarivasal N (2010) A reconnaissance study of radon concentrations in Hamadan city, Iran. Natural Hazards and Earth System Sciences, 10(4): 857-63.##22. Pirsaheb M, Najafi F, Haghparast A, Azizi E, Hemati L (2014) Effective dose and concentration of radon and thoron gases at hospitals of Kermanshah University of Medical Sciences. Journal of Kermanshah University of Medical Sciences, 18(6): 362-70.##23. Hadad K, Hakimdavoud M, Hashemi-Tilehnoee M (2011) Indoor radon survey in Shiraz-Iran using developed passive measurement method. Int J Radiat Res, 9(3): 175-82.##24. Hadad K and Mokhtari J (2015) Indoor radon variations in central Iran and its geostatistical map. Atmospheric Environment, 102: 220-7.##25. Hassanvand H, Hassanvand MS, Birjandi M (2018) Indoor Radon Measurement in Dwellings of Khorramabad City, Iran. Iranian Journal of Medical Physics, 15(1): 19-27.##26. Montazerabadi A, Ahmadian M, Vahed M, Yousefi N, Fatehizadeh A, Borhani P, et al. (2012) Evaluation Of 222 Rn Rate In Medical Dormitory Of Kerman City. Int J Radiat Res, 10(3-4): 171-5.##27. Fahiminia M, Fouladi Fard R, Ardani R, Naddafi K, Hassanvand M, Mohammadbeigi A (2016) Indoor radon measurements in residential dwellings in Qom, Iran. Int J of Radiat Res, 14(4): 331.##28. Radon I (1992) Radon Decay Product Measurement Device Protocols. Document EPA, 402.##29. Radiation UNSCotEoA (2000) Sources and effects of ionizing radiation. UNSCEAR 2000 report to the General Assembly, with scientific annexes. Volume I: Sources. 2000.##30. ICRP (1995) ICRP Publication 69: Age-dependent Doses to Members of the Public from Intake of Radionuclides: Part 3 Ingestion Dose Coefficients: Elsevier Health Sciences; 1995.##31. Kim Y, Chang BU, Park HM, Kim CK, Tokonami S (2011) National radon survey in Korea. Radiation protection dosimetry, 146(1-3): 6-10.##32. Kurnaz A, Küçükömeroğlu B, Çevik U, Çelebi N (2011) Radon level and indoor gamma doses in dwellings of Trabzon, Turkey. Applied Radiation and Isotopes, 69(10): 1554-9.##33. 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CT value organ and homogeneous assigned methods-based radiation treatment planning of pelvic cavity tumors 2 2 Objective: By dividing the CT value into different intervals, the authors aimed to investigate the effect of CT value variation on dosimetric results and propose a method to combine MRI with assigned CT values. Materials and Methods:  Imaging data were analyzed from thirty patients in three different regions by a treatment planning system. The average CT value of each tissue or organ, standard deviation and 95% confidence interval were obtained by the Eclipse treatment planning system. Fifteen patients were included in this study by IMRT. Eclipse was used for all delineations, registrations, and dose calculations. In the synthetic CT image, the CT values of the target and OAR were assigned according to the sampled CT value above. The homogeneous assigned method divides the human tissue CT image into another synthetic CT image that only assigns bones and water. Dosimetric differences and dose homogeneity were compared under the same dose and field conditions. Results: By dividing the CT value with the interval method and verifying it with dose calculation, different CT value intervals can reflect different human tissues or organs. The effect of CT value variation between -100 HU and 100 HU on dose calculation is within 2%. Compared with the same treatment plan on different CT images, there is little deviation between the synthetic CT image and the original CT image. The Dmax, Dmean, Dmean, D98%, D95%, D5%, and D2% of PTV are all below 1.61%, and the dose percentage and volume percentage of OAR are below 1.86%. Conclusion: The combination of MRI with assigned CT values is feasible for the performance of MR alone in pelvis tumor treatment plans. 667 674 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/202019/10/21 1398/7/29 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/202019/10/21 1398/7/29 D.Z. Jiang D.Z. Jiang Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Z.T. Dai Z.T. Dai Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China, 430071 School of Physics and Technology, Wuhan University, Wuhan , China, 430072 Z.R. Bao Z.R. Bao Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei H. Liu H. Liu Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei H.L. Zhao H.L. Zhao Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei C.H. Xie C.H. Xie Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei C. Chen C. Chen Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Y.F. Zhou Y.F. Zhou Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei J. Zhang J. Zhang Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei 47944157@qq.com CT value interval organ assigned homogeneous assigned cervical carcinoma dose calculation TPS. Buzug Thorsten M (2008) Applications in radiotherapy treatment planning. Radiotherapy and Oncology, 42(1): 1-15. 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Radiosensitizing effect of combined triptolide and irradiation treatment in lung cancer cell lines 2 2 Background: No study has reported radiosensitizing effect of triptolide in lung cancer cell lines. We explored the effect and underlying molecular mechanisms of combined triptolide and irradiation treatment in lung cancer cell lines. Materials and Methods: Colony formation assays were conducted to test the radiosensitizing effect of triptolide in A549 and H460 lung cancer cell lines. Survival fractions and sensitizing enhancement ratios were calculated. To determine the underlying mechanism of triptolide and irradiation combination, immunofluorescence cytometric analysis of apoptosis was conducted after treatment with triptolide and/or 4 Gy irradiation. To explore the molecular mechanisms of apoptosis induced by triptolide and irradiation combined treatment, western blot analysis was conducted after treatment with triptolide and/or irradiation (1, 2, 3, or 4 Gy). The antibodies used for Western blotting were PARP, JNK, p53, HSP70, and Akt. Results: Combined triptolide and irradiation treatment significantly decreased the surviving fractions than irradiation alone in both cell lines. Triptolide and irradiation combination treatment also resulted in significant increase in apoptosis rates than irradiation alone in both cell lines. The expression of PARP cleavage, JNK, and p53 were prominent in the groups treated with triptolide and irradiation combination. The expression of HSP70 and Akt were suppressed in groups treated with the triptolide and irradiation combination. Conclusion: This study showed that triptolide in combination with irradiation enhanced antitumor effects in lung cancer cell lines. 675 682 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/202019/10/212019/10/22 1398/7/30 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/202019/10/212019/10/22 1398/7/30 M. Kong M. Kong Division of Lung/Head and Neck Oncology, Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea J.W. Lee J.W. Lee Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Republic of Korea M. Yun M. Yun Department of Bioindustry & Bioresource Engineering, College of Life Sciences, Sejong University, Seoul, Republic of Korea S.H. Lee S.H. Lee Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea humanmd04@daum.net Radiotherapy lung cancer triptolide radiation sensitizing agent. ##1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin, 61(2): 69-90.##2. Shin A, Oh CM, Kim BW, Woo H, Won YJ, Lee JS (2017) Lung Cancer Epidemiology in Korea. Cancer Res Treat, 49(3): 616-626.##3. Kim YJ, Song SY, Jeong SY, Kim SW, Lee JS, Kim SS, et al. (2015) Definitive radiotherapy with or without chemotherapy for clinical stage T4N0-1 non-small cell lung cancer. Radiat Oncol J, 33(4): 284-293.##4. Harris JP, Murphy JD, Hanlon AL, Le QT, Loo BW, Jr., Diehn M (2014) A population-based comparative effectiveness study of radiation therapy techniques in stage III non-small cell lung cancer. Int J Radiat Oncol Biol Phys, 88(4): 872-884.##5. 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(2007) Enhanced antitumor effect of combined triptolide and ionizing radiation. Clin Cancer Res, 13(16): 4891-4899.##20. Zhang W, Kang M, Zhang T, Li B, Liao X, Wang R (2016) Triptolide Combined with Radiotherapy for the Treatment of Nasopharyngeal Carcinoma via NF-kappaB-Related Mechanism. Int J Mol Sci, 17(12): 2139.##21. Chen YW, Lin GJ, Hueng DY, Huang SH, Chia WT, Shieh YS, et al. (2014) Enhanced anti-tumor activity of triptolide in combination with irradiation for the treatment of oral cancer. Planta Med, 80(4): 255-261.##22. Zhang S, Wang L, Liu H, Zhao G, Ming L (2014) Enhancement of recombinant myricetin on the radiosensitivity of lung cancer A549 and H1299 cells. Diagn Pathol, 9:68.##23. Yuan S, Qiao T, Chen W (2011) CpG oligodeoxynucleotide 1826 enhances the Lewis lung cancer response to radiotherapy in murine tumor. Cancer Biother Radiopharm, 26(2): 203-208.##24. Illum H (2012) Current status of radiosensitizing agents for the management of rectal cancer. 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Studies on carcinogenic effect on the veterans of taking atmospheric nuclear weapons testing troops in Gansu, China 2 2 Background: To explore the carcinogenic effect about the veterans of taking atmospheric nuclear weapons testing troops in Gansu, China. Materials and Methods: During 2005-2014, all the veterans of taking atmospheric nuclear weapons testing troops were required to have a medical examination in Gansu, 3721 veterans were requested to make an occupational health examination. They were exposed the radioactive fallout particles from atmospheric nuclear burst (the total β radioactive substances and the        radio-nuclides: 3H, 90Sr, 137Cs, 239Pu, 99Mo 95Zr,97Zr,131I,133I,and 132Te etc.), they were away from testing sites 10-30 Km. Cancer patients were required to provide the in-patient case history and check pathologically report. For part of the veterans, the level of radiation dose was 100-150mSv.  Results: There were 40 primary tumor and 25 malignant tumors, incidence rate was 1075 /105 and 672/105; The cancer incidence of the transportation corps was 1253 /105, average age was 48.08 years, average service life was 6.08 years; The cancer incidence of the engineering corps is 762 /105,average age is 55.56 years, average service life was 5.48 years; The comparison of the cancer incidence was shown that the trend of escalation about the cancer incidence along with the servicing year increase; In order of the cancer incidence: gastric cancer, lung cancer, carcinoma of colon, esophagus cancer, rectum cancer and skin cancer, the incidence rate was remarkably increasing (p<0.01). Conclusion: It was shown that the trend of escalation about the cancer incidence along with the servicing year increase, the first was neoplasms of digestive system; it may be due to the contaminated radioactive materials transferred through the digestive tract, hence leading to in vivo irradiation. 683 688 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/202019/10/212019/10/222019/10/22 1398/7/30 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/202019/10/212019/10/222019/10/22 1398/7/30 G. Liu G. Liu Gansu province center for disease control and prevention, Lanzhou, Gansu, China lgscfll@163.com R. Zhang R. Zhang Gansu province center for disease control and prevention, Lanzhou, Gansu, China l. Niu l. 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Sobin LH, Gospodarowicz MK, WiPekind Ch (2009) Interna-onal Union against Cancer (UICC) TNM Classifica_on of Malignant Tumour.7th ed. Wiley-Blackwell, the United State of America.##10. NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE). National Cancer Institute, USA. Accessed Jul 17, 2015.##11. Chen WQ, Zheng RS, Zhang SW, Zen HM, Zuo TT, Jia MM, Xia CF, Zou XL, Hao J (2016) Report of Cancer Incidence and Mortality in China 2012. China Cancer, 25(1): 1-8.##12. Wang XH, Zhang XD, Li HL, Liu YQ (2012) Cancer epidemiology research center, Gansu medical science institute, Lanzhou 730050, China explores the incidence, trend and the spectrum of tumors in Lanzhou City, 2005-2007. Chinese Journal of Disease Control & Prevention, 02: 50-56.##13. Dutta D, Balaji Subramanian S, Murli V, Sudahar H, Gopalakrishna Kurup PG, Potharaju M (2012) Dosimetric comparison of Linac-based (BrainLAB(R)) and robotic radiosurgery (Cyber Knife (R)) stereotactic system plans for acoustic schwannoma. 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Successful diagnosis of synchronous primary cancer of the lung and esophagus by endobronchial ultrasound-guided transbronchial 2 2 Multiple primary cancers of the esophagus and lung were mostly reported in individual cases. Most patients visited a doctor because of dysphagia or respiratory symptoms. Chest CT can determine the location of lesions but cannot clearly determine the nature of lesions. Definite diagnosis needs bronchoscopy combined with gastroscopy, lung biopsy combined with gastroscopy or surgical operation to obtain pathological tissue. Recently, we confirmed a case of multiple primary cancer of the esophagus and lung by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and shared the diagnosis and treatment process. The advantages of this technique are that endobronchial ultrasound can determine the nature of mediastinal and hilar lesions, and needle aspiration biopsy is characterized by minimal invasion and repeatable biopsy, thus providing pathological diagnosis, especially for multiple primary cancers, that avoids misdiagnosis or missed diagnosis. 689 694 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/202019/10/212019/10/222019/10/222019/10/22 1398/7/30 2019/08/282019/09/232019/09/232019/09/242019/09/252019/09/252019/09/252019/10/62019/10/72019/10/92019/10/122019/10/122019/10/132019/10/132019/10/132019/10/202019/10/212019/10/222019/10/222019/10/22 1398/7/30 M. Li M. Li Department of Respiratory Medicine Affiliated Hospital of Jining Medical University, Shandong F.L. Shan F.L. Shan Department of Respiratory Medicine Affiliated Hospital of Jining Medical University, Shandong L. Li L. Li Department of Pathology Affiliated Hospital of Jining Medical University, Shandong Y.F. HU Y.F. HU Bronchoscopy Room Affiliated Hospital of Jining Medical University, Shandong L.N. Jiang L.N. Jiang Department of Respiratory Medicine Affiliated Hospital of Jining Medical University, Shandong S.H. Jiang S.H. Jiang Department of Respiratory Medicine Affiliated Hospital of Jining Medical University, Shandong shenghuajiang@126.com Synchronous primary cancer endobronchial ultrasound-guided transbronchial needle aspiration. Demandante CG, Troyer DA, Miles TP (2003 ) Multiple primary malignant neoplasms: case report and a comprehensive review of the literature. Am J Clin Oncol, 26(1):79-83.##Yasufuku K, Chiyo M, Koh E, Moriya Y, Iyoda A, Sekine Y, Shibuya K, Iizasa T, Fujisawa T (2005) Endobronchial ultrasound guided transbronchial needle aspiration for staging of lung cancer. Lung Cancer, 50(3): 347-54.##Yasufuku K, Chiyo M, Sekine Y, Chhajed PN, Shibuya K, Iizasa T, Fujisawa T (2004) Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest, 126(1): 122-8.##Warren S and Gates O (1932) Multiple primary malignant tumors: a survey of the literature and statistical study. Am J Cancer, 16: 1358–414.##Liu Z, Liu C, Guo W, Li S, Bai O (2015) Clinical analysis of 152 cases of multiple primary malignant tumors in 15,398 patients with malignant tumors. PLoS One, 10(5): e0125754.##Mukerji AN (2018) Wolf A. Synchronous Esophageal and Lung Cancer. Thorac Surg Clin, 28(1): 97-104.##Ishii H, Sato H, Tsubosa Y, Kondo H (2008) Treatment of double carcinoma of the esophagus and lung. Gen Thorac Cardiovasc Surg, 56(3): 126-30.##Tokumitsu Y, Yamamoto T, Kitamura Y, Ando S, Tsushimi K, Tangoku AA (2009) case of mediastinoscope-assisted transhiatal esophagectomy for thoracic esophageal cancer after radical operation for lung cancer. Gan To Kagaku Ryoho, 36(12): 2445-7.##Hujala KT, Sipilä JI, Grénman R (2001) Mediastinoscopy-its role and value today in the differential diagnosis of mediastinal pathology. Acta Oncol, 40(1): 79-82.##Varela-Lema L, Fernández-Villar A, Ruano-Ravina A (2009) Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: a systematic review. Eur Respir J, 33(5): 1156-64.##Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH (2009) Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer, 45(8): 1389-96.##Hsu PK, Huang CS, Hsieh CC, Wu YC, Hsu WH (2014) Role of right upper mediastinal lymph node metastasis in patients with esophageal squamous cell carcinoma after tri-incisional esophagectomies. Surgery, 156(5): 1269-77.## ##