Tongue surface model can predict radiation tongue mucositis due to intensity-modulated radiation therapy for head and neck cancer

Acute radiation tongue mucositis has a profound effect on talking and eating. We examined whether the dose-volume histogram obtained from the tongue surface model correlates with mucositis severity, and whether it is useful for predicting acute radiation tongue mucositis in patients with head and neck cancer treated with intensity-modulated radiation therapy. Thirty-six patients who received intensity-modulated radiation therapy for head and neck cancer were analysed for acute radiation tongue mucositis according to the Common Terminology Criteria for Adverse Events, version 4.0, as well as the Radiation Therapy Oncology Group scoring systems. The corresponding high-dose locations in anatomical sub-regions in the tongue surface model and the development of high-grade acute radiation tongue mucositis were compared. The mucositis sites coincided with the high-dose anatomical sub-regions in the tongue surface model. There was a clear dose-response relationship between the mean dose to the tongue and the acute radiation tongue mucositis Radiation Therapy Oncology Group grade. According to the dose-volume histogram, patients receiving 16.0-73.0 Gy to the tongue were susceptible to grade 2-3 toxicity. The tongue surface model can predict the site and severity of acute radiation tongue mucositis. In future, radiation treatment plans ccould be optimized using this model.

A step towards international prospective trials in carbon ion radiotherapy: investigation of factors influencing dose distribution in the facilities in operation based on a case of skull base chordoma

Background

Carbon ion radiotherapy (CIRT) has been delivered to more than 20,000 patients worldwide. International trials have been recommended in order to emphasize the actual benefits. The ULICE program (Union of Light Ion Centers in Europe) addressed the need for harmonization of CIRT practices. A comparative knowledge of the sources and magnitudes of uncertainties altering dose distribution and clinical effects during the whole CIRT procedure is required in that aim.

Methods

As part of ULICE WP2 task group, we sent a centrally reviewed questionnaire exploring candidate sources of uncertainties in dose deposition to the ten CIRT facilities in operation by February 2017. We aimed to explore native beam characterization, immobilization, anatomic data acquisition, target volumes and organs at risks delineation, treatment planning, dose delivery, quality assurance prior and during treatment. The responders had to consider the clinical case of a clival chordoma eligible for postoperative CIRT according to their clinical practice. With the results, our task group discussed ways to harmonize CIRT practices.

Results

We received 5 surveys from facilities that have treated 77% of the patients worldwide per November 2017. We pointed out the singularity of the facilities and beam delivery systems, a divergent definition of target volumes, the multiplicity of TPS and equieffective dose calculation approximations.

Conclusion

Multiple uncertainties affect equieffective dose definition, deposition and calculation in CIRT. Although it is not possible to harmonize all the steps of the CIRT planning between the centers, our working group proposed counter-measures addressing the improvable limitations.

Oxygen induced enhancement of NIR emission in brookite TiO2 powders: comparison with rutile and anatase TiO2 powders

Brookite TiO₂ attracts considerable attention in photocatalysis owing to its superior performance in several photocatalytic reactions. In this work, we investigated the behavior of charge carriers in brookite, rutile, and anatase TiO₂ by using photoluminescence (PL) and transient absorption (TA) spectroscopies. PL measurements revealed that brookite TiO₂ exhibits a visible and a NIR emission at ∼520 nm and ∼860 nm, respectively. Addition of methanol vapor quenched both the visible and NIR emissions by the hole-consuming reaction of methanol. However, exposure to O₂ shows curious behaviors: the visible emission was quenched but the NIR emission was enhanced. These results can be accounted for by the enhancement of upward band bending resulting in the effective separation of electrons and holes into the bulk and the surface, respectively. Furthermore, the shallowly trapped electrons, which are responsible for visible PL, are consumed by O₂; hence, the visible emission is quenched. However, in the case of NIR emission, the deeply trapped electrons are responsible and they are mainly located at the surface defects. The O₂ adsorption promotes the hole accumulation at the surface and then assists the recombination of these deeply trapped electrons, resulting in the enhancement of the NIR emission. We also found that the lifetime of NIR emission (τ₁ = 43 ± 0 ns and τ₂ = 589 ± 1 ns) was much longer than that of visible emission (τ₁ = 15 ± 0 ns and τ₂ = 23 ± 0 ns), since the mobility of these deeply trapped electrons to encounter with holes is lower than that of the shallowly trapped electrons. However, even for this slow NIR emission, the actual lifetime of the deeply trapped electrons estimated by TA (1.5 ± 0.0 μs and 17 ± 0 μs) was one or two orders of magnitude longer, confirming that non-radiative recombination is dominant and it is much slower than radiative recombination: TAS and PL provide detailed information on the radiative and non-radiative recombination processes. The PL of anatase and rutile TiO₂ powders was also measured and the difference from brookite TiO₂ was discussed.