Medical Radiology and Radiation Safety. 2012. Vol. 57. No. 5. P. 37-41

RADIATION THERAPY

N.V. Ilyin, Yu.N. Vinogradova, A.I. Karyagina, A.I. Urbansky, E.V. Trishkina

Electron-Photon Therapy in Malignant Solid Tumors Treatment with Lesions of the Eye

Russian Research Centre for Radiology and Surgical Technologies, Saint-Petersburg, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: To increase the radiation therapy efficacy in ophthalmooncological patients.

Material and methods: Investigation includes 36 patients with verified malignant solid tumors with lesions of the organ of sight - 32 patients with recurrence after operative treatment and 4 patients with metastases in the orbit. In 16 patients, besides the lesion of eyelids and orbit, an involvement of the maxillary sinus, ethmoidal labyrinth, frontal sinus, skin and soft tissues of face was revealed. All patients received electron-photon therapy (EFT) within period of 1994-2011, including irradiation of the structures of the organ of sight, and in 16 patients, in addition, neighboring injured areas. EFT was carried out at electron linear accelerators SL 75-5 (Philips) of 6 MeV and Elekta Precise by bremsstrahlung radiation of 6 and 18 MV or electrons of 4-18 MeV in 3 regimen of fractionation – conventional (CF, 18 patients), average (AF, 9 patients) and multi-fractionation (MF, 9 patients) to total focal equivalent doses of 55-70 Gy.

Results: After EFT, an objective response was recorded in 29 patients out of 36 (80.6 %), in 12 (33.3 %) out of them - complete response; stabilization was observed in 11 (19.5 %) patients without any

progression at the background of the treatment. In case of the irradiation of eyelids or eyelids and neighbouring structures, the complete or partial remission was noted in all patients; in EFT of the orbit or orbit and neighbouring structures, the response was recorded in 73.9 % of patients (p < 0.01). Irradiation of patients in regimen AF and MF was more effective in comparison with CF - 94.4 % and 66.7 % remissions, correspondingly, p < 0.01; and only in locally spread tumors, the response to the treatment was observed in all patients received EFT in regimen AF and MF. EFT enables to reveal early radiation reactions of stages I-II in 83.7 % of patients; there were not severe complications; reactions rate was higher in CF (94.4 % of patients) and in total in CF and AF (92.6 % of patients) than that in patients irradiated twice a day - 66.7 % of patients, p < 0.05. Onset time of radiation reactions appearance did not depend on fractionation regimen. After EFT, overall 3-5-year survival was 85.9 % and 70.4 %, respectively.

Conclusion: EFT is the important and effective method of treatment in patients with malignant solid tumors with lesions of the organ of sight.

Key words: radiotherapy, organ of sight, solid tumors

Medical Radiology and Radiation Safety. 2012. Vol. 57. No. 5. P. 20-30

RADIATION SAFETY

V.F. Demin¹, V.V. Romanov², V.Yu. Soloviev³

Harmonized Approach to the Health Safety Regulation in Different Areas of Human Activity

1. National Research Center “Kurchatov Institute”, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. Federal Medical Biological Agency, Moscow, Russia; 3. Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia

Abstract

Purpose: To create harmonization approach to the development of health safety standards (HSS) in nanotechnology and other areas of human activity.

Material and methods: Main principles of health risk assessment are: principles of justification and optimization of protection; risk level limit application.

Results: Two types of harmonization are suggested: at the first stage it is necessary to overcome existing divergences and prepare scientific basis of harmonization of hygienic regulations in different areas of human activity. It makes possible to prepare basis for international harmonization of health safety standards (HSS) and other hygienic regulations.

General approach to establishing HSSs and other levels of health risk assessment using risk analysis in different areas of human activity is suggested. On the basis of this approach, universal HSSs for workers and public are suggested. Based on these universal HSSs, general HSSs and other levels of health risk assessment for different modern harm sources are proposed.

Conclusion: The approach can be the basis for harmonization of international regulations and methodological documents in the area of innovative projects’ protection in different areas of industrial and economic human activities.

Key words: risk assessment, risk index, methodology, health risk standard, harmonization, decision making principle

Medical Radiology and Radiation Safety. 2012. Vol. 57. No. 5. P. 31-36

RADIATION MEDICINE

I.A. Galstyan, N.M. Nadejina

Local Radiation Injuries as Complications of Medical Radiation Exposure

Burnazyan Federal Medical Biophysic Center of Federal Medical Biology Agency of Russia, Moscow, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: To familiarize medical doctors with situations of diagnostic and therapeutic medical radiation exposure where the development of acute radiation injuries in patients is possible. The clinical cases are addressed to medical doctors to whom patients with complaints in connection with developing local radiation injuries (LRI) can apply.

Material and methods: The analysis of archival materials of 214 patients with the LRI which were under dynamic supervision of clinic of Burnazyan FMBC has allowed to reveal 15 patients injured with medical radiation.

Results: Descriptions of case histories for 13 out of 15 patients exposed to medical radiation concerning various neoplasms and nononcological diseases and at which LRI of the II-IV degree were developed.

Conclusions: 1. Carrying out radiation diagnostic and therapeutic procedures occasionally can become complicated by LRI development.

2. The reasons of development of radiation injuries can be: technical malfunction of the equipment, safety measures violation by personnel carrying out procedures, the specific features of the patient changing routine characteristics of exposure; the severe somatic status of the patient is the reason of more severe trophopathy of irradiated tissues.
3. In cardiological practice of the diagnostic and medical procedures which are carried out under an X-ray control, approximately 3 % of cases led to development of acute LRI. Repeated interventions possibly develop of signs of chronic radiation dermatitis.

Key words: local radiation injuries, complications of medical radiation exposure, radiation therapy, X-rays -examination

REFERENCES

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Medical Radiology and Radiation Safety. 2012. Vol. 57. No. 5. P. 11-19

RADIATION SAFETY

M.Ph. Kiselev¹, T.V. Azizova², A.V. Akleyev³, R.M. Aleksakhin⁴, V.K. Ivanov⁵, A.N. Koterov⁶, I.I. Kryshev⁷, B.K. Lobach⁸, O.A. Pavlovsky⁹, S.A. Romanov², A.V. Sazhin⁶, S.M. Shinkarev⁶

On the 59th Session of the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) (Vienna, 21-25 May 2012)

1. Federal Medical-Biological Agency of Russia (FMBA of Russia), Moscow; 2. Southern Urals Biophysics Institute of FMBA of Russia, Ozyorsk, Chelyabinsk Region; 3. Urals Research Center of Radiation Medicine of FMBA of Russia, Chelyabinsk; 4. Russian Institute of Agricultural Radiology and Agroecology of Russian Agricultural Academy, Obninsk; 5. Medical Radiological Research Centre of MHR, Obninsk; 6. Burnasyan Federal Medical Biophysical Center of FMBA of Russia, Moscow. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 7. Research & Production Association “Typhoon” of Roshydromet, Obninsk; 8. Nuclear Energy State Corporation “Rosatom”, Moscow; 9. Nuclear Safety Institute of RAS, Moscow.

CONTENTS

Introduction

1. On the UN General Assembly resolution 66/70 (December 2011)
2. Discussion of scientific reports on nine projects:

• Report R.686 “The Ability to attribute risks and effects to radiation exposure” and report R.687 “Uncertainties in risk estimates for cancer due to exposure to ionizing radiation”
• Report R.688 “Radiation exposures from electricity generation” and report R.689 “Methodology for estimating human exposures due to radioactive discharges”
• Report R.690 “Biological effects of selected internal emitters (tritium, uranium)”
• Report R.691 “Levels and effects of radiation exposure due to the nuclear accident after the 2011 great east-Japan earthquake and tsunami”
• Report R.692 “Effects of radiation exposure on children”
• Report R.693 “Epidemiology of low-dose-rate exposures of the public to natural and artificial environmental sources of radiation” and report R.694 “Mechanisms of radiation actions at low doses”

3. Consideration of the Report of the UNSCEAR Secretariat
4. Recommendations for future work program
5. Preparation of a report of UNSCEAR to the next session of the UN General Assembly. General conclusions

Key words: risk assessment, risk index, methodology, health risk standard, harmonization, decision making principle

REFERENCES

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