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Gaito S, France AK, Aznar M, Crellin A, Indelicato DJ, Kirkby K, Pan S, Whitfield G, Price G, Sitch P, Smith E. Equity of Access to Proton Beam Therapy in England: A National NHS analysis. Int J Radiat Oncol Biol Phys 2023; 117:e19. [PMID: 37784822 DOI: 10.1016/j.ijrobp.2023.06.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Policies to improve population health have often focused on equitable access to health services. While new technologies have an enormous potential in improving health outcomes, they may not always be equally accessible across diverse geographical areas and socio-economic backgrounds. Between 2008 and 2018, 1352 patients with eligible indications for Proton Beam Therapy (PBT) were treated overseas within the NHS Proton Overseas Programme (POP) and 947 patients have been treated at the Christie since the National NHS PBT service started in December 2018. The 8 most common PBT cancer indications cover more than 80% of the referrals and referral rates depend on several factors. Aim of this study is to evaluate equity of access to PBT throughout the country and how this has changed since the national PBT service inception. MATERIALS/METHODS Incidence data were available for 7/8 of the most common PBT cancer indications. These data were provided by the National Disease Registration Service (NDRS) by diagnosis, age group and by the 7 NHS regions in England. The incidence data referred to the time period 2013-2019. The first national NHS PBT center started accepting referrals in October 2018, therefore this time period was split in pre-NHS PBT (1/1/13-30/9/18) and post-NHS PBT (1/10/18-31/12/19). Demographics and clinical characteristics of patients referred for PBT were extracted from the national NHS PBT registry for matching clinical diagnoses and time period. The ratio between the referred (observed) and newly diagnosed (expected) patients is the Proton Utilization Proportion (PUP), which tracks the proportion of eligible patients using the technology. RESULTS For the 7 common PBT indications examined, the total number of newly diagnosed patients was 2134 in the pre-NHS PBT period and 461 in the post-NHS PBT period. The (accepted) referrals were 587 and 300 in the pre-and post-NHS PBT period, respectively. An increase in the PUP between the pre-NHS PBT and the post-NHS PBT is noted for any diagnostic category, age group and NHS region. The most noticeable increase is noticed for Medulloblastoma, which became a commissioned indication for PBT only in 2016.The PUP in England increased post-NHS PBT by 137% overall. Of note, post-NHS PBT, 99% of the patients aged 0-15 with these 7 common indications for PBT were referred and treated with PBT. CONCLUSION Promoting equality of access to cutting-edge radiotherapy technologies is at the heart of NHS England's values. Throughout the development of the policies and processes related to PBT access in the UK, the NHS has given regard to the need to reduce geographical variation which may contribute to health inequalities. The PUP has increased since the opening of a National PBT service in England, which uses a central web-based Proton Referral Pathway managed by a National Proton Office. Further analysis will follow to examine whether socio-economic or geographical barriers exist within each region.
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Affiliation(s)
- S Gaito
- The Christie NHS Foundation Trust, Manchester, United Kingdom; The University of Manchester, Manchester, United Kingdom
| | - A K France
- The Christie NHS Foundation Trust, Proton Clinical Outcomes Unit, Manchester, United Kingdom
| | - M Aznar
- The University of Manchester, Manchester, United Kingdom
| | - A Crellin
- The University of Manchester, Manchester, United Kingdom; NHS England, London, United Kingdom
| | - D J Indelicato
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL
| | - K Kirkby
- The Christie NHS Foundation Trust, Manchester, United Kingdom; The University of Manchester, Manchester, United Kingdom
| | - S Pan
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - G Whitfield
- The Christie NHS Foundation Trust, Manchester, United Kingdom; The University of Manchester, Manchester, United Kingdom
| | - G Price
- The University of Manchester, Manchester, United Kingdom
| | - P Sitch
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - E Smith
- The Christie NHS Foundation Trust, Manchester, United Kingdom; The University of Manchester, Manchester, United Kingdom
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Warmenhoven JW, Henthorn N, Santina E, Chadwick A, Morris R, Sayed-Rahman S, Kitsell E, Boast D, Merchant M, Kirkby K. WORLDS FIRST AUTOMATED HYPOXIA END-STATION FOR IN VITRO PROTON IRRADIATION. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01573-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Tambas M, van der Laan H, Steenbakkers R, Doyen J, Timmermann B, Orlandi E, Hoyer M, Haustermans K, Georg P, Burnet N, Kirkby K, Gregoire V, Calugaru V, Troost E, Hoebers F, Calvo F, Widder J, Eberle F, van Vulpen M, Maingon P, Skóra T, Weber D, Bergfeldt K, Kubes J, Langendijk J. PH-0328 Current practice for selection of adult patients for proton therapy across Europe. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07301-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Defourny N, Spencer K, Tunstall D, Cosgrove V, Kirkby K, Henry A, Lievens Y, Hall P. OC-0058 Impact of increased hypofractionation on treatment cost. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06752-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Shortall J, Vasquez Osorio E, Cree A, Song Y, Dubec M, Chuter R, Price G, McWilliam A, Kirkby K, Mackay R, van Herk M. Inter- and intra-fractional stability of rectal gas in pelvic cancer patients during MRIgRT. Med Phys 2021; 48:414-426. [PMID: 33164217 DOI: 10.1002/mp.14586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 10/08/2020] [Accepted: 10/31/2020] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Due to the electron return effect (ERE) during magnetic resonance imaging guided radiotherapy (MRIgRT), rectal gas during pelvic treatments can result in hot spots of over-dosage in the rectal wall. Determining the clinical impact of this effect on rectal toxicity requires estimation of the amount and mobility (and stability) of rectal gas during treatment. We therefore investigated the amount of rectal gas and local inter- and intra-fractional changes of rectal gas in pelvic cancer patients. METHODS To estimate the volume of gas present at treatment planning, the rectal gas contents in the planning computed tomography (CT) scans of 124 bladder, 70 cervical and 2180 prostate cancer patients were calculated. To estimate inter- and intra-fractional variations in rectal gas, 174 and 131 T2-w MRIs for six cervical and eleven bladder cancer patients were used. These scans were acquired during four scan-sessions (~20-25 min each) at various time-points. Additionally, 258 T2-w MRIs of the first five prostate cancer patients treated using MRIgRT at our center, acquired during each fraction, were analyzed. Rectums were delineated on all scans. The area of gas within the rectum delineations was identified on each MRI slice using thresholding techniques. The area of gas on each slice of the rectum was used to calculate the inter- and intra-fractional group mean, systematic and random variations along the length of the rectum. The cumulative dose perturbation as a result of the gas was estimated. Two approaches were explored: accounting or not accounting for the gas at the start of the scan-session. RESULTS Intra-fractional variations in rectal gas are small compared to the absolute volume of rectal gas detected for all patient groups. That is, rectal gas is likely to remain stable for periods of 20-25 min. Larger volumes of gas and larger variations in gas volume were observed in bladder cancer patients compared with cervical and prostate cancer patients. For all patients, local cumulative dose perturbations per beam over an entire treatment in the order of 60 % were estimated when gas had not been accounted for in the daily adaption. The calculated dose perturbation over the whole treatment was dramatically reduced in all patients when accounting for the gas in the daily set-up image. CONCLUSION Rectal gas in pelvic cancer patients is likely to remain stable over the course of an MRIgRT fraction, and also likely to reappear in the same location in multiple fractions, and can therefore result in clinically relevant over-dosage in the rectal wall. The over-dosage is reduced when accounting for gas in the daily adaption.
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Affiliation(s)
- J Shortall
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
| | - E Vasquez Osorio
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
| | - A Cree
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Y Song
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - M Dubec
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - R Chuter
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - G Price
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - A McWilliam
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - K Kirkby
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - R Mackay
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - M van Herk
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
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Rothwell B, Kirkby N, Merchant M, Chadwick A, Lowe M, Mackay R, Kirkby K. PO-1810: Determining the boundaries of the FLASH effect. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01828-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Shortall J, Vasquez Osorio E, Cree A, Dubec M, Chuter R, McWilliam A, Kirkby K, Mackay R, Van Herk M. PO-1651: Inter and intra-fractional stability of rectal gas in cervical cancer patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Shortall J, Vasquez Osorio E, Aitkenhead A, Berresford J, Agnew J, Budgell G, Chuter R, McWilliam A, Kirkby K, Mackay R, van Herk M. Experimental verification the electron return effect around spherical air cavities for the MR-Linac using Monte Carlo calculation. Med Phys 2020; 47:2506-2515. [PMID: 32145087 DOI: 10.1002/mp.14123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Dose deposition around unplanned air cavities during magnetic resonance-guided radiotherapy (MRgRT) is influenced by the electron return effect (ERE). This is clinically relevant for gas forming close to or inside organs at risk (OARs) that lie in the path of a single beam, for example, intestinal track during pelvic treatment. This work aims to verify Monte Carlo calculations that predict the dosimetric effects of ERE around air cavities. For this, we use GafChromic EBT3 film inside poly-methyl methacrylate (PMMA) -air phantoms. METHOD Four PMMA phantoms were produced. Three of the phantoms contained centrally located spherical air cavities (0.5, 3.5, 7.5 cm diameter), and one phantom contained no air. The phantoms were split to sandwich GafChromic EBT3 film in the center. The phantoms were irradiated on an Elekta Unity system using a single 10 × 10 cm2 7-MV photon beam under the influence of a 1.5-T transverse magnetic field. The measurements were replicated using the Elekta Monaco treatment planning system (TPS). Gamma analysis with pass criteria 3%/3 mm was used to compare the measured and calculated dose distributions. We also consider 3%/2 mm, 2%/3 mm, and 2%/2 mm pass criteria for interest. RESULTS The gamma analysis showed that >95% of the points agreed between the TPS-calculated and measured dose distributions, using 3%/3 mm criteria. The phantom containing the largest air cavity had the lowest agreement, with most of the disagreeing points lying inside the air cavity (dose to air region). CONCLUSIONS The dose effects due to ERE around spherical air cavities are being calculated in the TPS with sufficient accuracy for clinical use.
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Affiliation(s)
- J Shortall
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
| | - E Vasquez Osorio
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
| | - A Aitkenhead
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - J Berresford
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - J Agnew
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - G Budgell
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - R Chuter
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - A McWilliam
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - K Kirkby
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - R Mackay
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - M van Herk
- Department of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
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Brown S, Mee T, Kirkby N, Faivre-Finn C, Kirkby K. Does travel time for SABR treatment, impact upon the management of early-stage inoperable NSCLC? Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30107-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kirkby K, Pozzi A, Tomlinson J, Alvarez L, Foster S. Scientific Principles for Post-CCL Repair Rehabilitation: An Evidence-Based Approach. Vet Comp Orthop Traumatol 2019. [DOI: 10.1055/s-0039-1692240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- K. Kirkby
- Sound Veterinary Rehabilitation Center, Shoreline, Washington, United States
| | - A. Pozzi
- Clinic for Small Animal Surgery, University of Zurich, Zurich, Switzerland
| | - J. Tomlinson
- Twin Cities Animal Rehabilitation & Sports Medicine Clinic, Burnsville, Minnesota, United States
| | - L. Alvarez
- Integrative and Rehabilitative Medicine, The Animal Medical Center, New York, New York, United States
| | - S.A. Foster
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, United States
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Kirkby K, Mackay R, Kirkby N, Warmenhoven J, Henthorn N, Chadwick A, Ingram S, Rothwell W, Smith E, Burnet N, Aitkenhead A, Merchant M. SP-0034 Mathematical Modelling of radiation response in Proton Therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30454-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lewis T, Kennedy J, Price G, Mee T, Kirkby K, Kirkby N, Woolf D, Bayman N, Chan C, Coote J, Faivre-Finn C, Harris M, Hudson A, Pemberton L, Salem A, Sheikh H, Mistry H, Cobben D. PO-0775 Palliative lung radiotherapy: audit of prescribing practice and survival analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31195-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shortall J, Vasquez Osorio E, Green A, Chuter R, McWilliam A, Kirkby K, Mackay R, Van Herk M. OC-0522 Characterising dose changes due to unplanned gas cavities in Magnetic Resonance guided Radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30942-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brown S, Van Herk M, Chuter R, Falk S, Kirkby K, Mackay R, Harrington K, Cosgrove V, Gray A, Hall E, Hawkins M, Hawkes D, Henry A, Maughan T, Nutting C, Oelfke U, Royle G, Sebag-Montefiore D, Sharma R, Van Den Heuvel F, Faivre-Finn C. Advanced Radiotherapy Technologies Network in the UK (ART-NET) – focus on lung cancer. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30166-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fathi K, Galer S, Palmans H, Kirkby K, Nisbet A. Geant4 coupled with Comsol heat transfer simulations to determine correction factors of a novel micro-calorimeter. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30083-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mack SJ, Kirkby K, Malalana F, McGowan CM. Elevations in serum muscle enzyme activities in racehorses due to unaccustomed exercise and training. Vet Rec 2014; 174:145. [DOI: 10.1136/vr.101669] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S. J. Mack
- The Philip Leverhulme Equine Hospital; The University of Liverpool; Leahurst Campus Neston Wirral CH64 7TE UK
| | - K. Kirkby
- The Setters Physiotherapy Practice; 13 Church Road, Long Hanborough Witney Oxfordshire OX29 8JE UK
| | - F. Malalana
- The Philip Leverhulme Equine Hospital; The University of Liverpool; Leahurst Campus Neston Wirral CH64 7TE UK
| | - C. M. McGowan
- Department of Musculoskeletal Biology; Institute of Ageing and Chronic disease; The University of Liverpool; Leahurst Campus Neston Wirral CH64 7TE UK
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Fathi K, Galer S, Palmans H, Hao L, Gallop J, Nisbet A, Kirkby K. EP-1461: Monte Carlo simulations of direct energy deposition in a novel microcalorimeter. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Galer S, Shipley D, Hao L, Palmans H, Kirkby K, Nisbet A. PO-0800: Geant4 Monte Carlo simulations of a microdosimetric Tissue Equivalent Proportional Counter for carbon ion therapy. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30918-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Galer S, Palmans H, Hao L, Kirkby K, Nisbet A. PD-0033 MICRODOSIMETRIC SPECTRA MEASURED WITH A TISSUE-EQUIVALENT MICROCALORIMETER IN A LOW-ENERGY PROTON BEAM. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Borghesi M, Kar S, Prasad R, Kakolee FK, Quinn K, Ahmed H, Sarri G, Ramakrishna B, Qiao B, Geissler M, Ter-Avetisyan S, Zepf M, Schettino G, Stevens B, Tolley M, Ward A, Green J, Foster PS, Spindloe C, Gallegos P, Robinson AL, Neely D, Carroll DC, Tresca O, Yuan X, Quinn M, McKenna P, Dover N, Palmer C, Schreiber J, Najmudin Z, Sari I, Kraft M, Merchant M, Jeynes JC, Kirkby K, Fiorini F, Kirby D, Green S. Ion source development and radiobiology applications within the LIBRA project. ACTA ACUST UNITED AC 2011. [DOI: 10.1117/12.888262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Galer S, Palmans H, Shipley D, Hao L, Nisbet A, Kirkby K. 1112 poster A NOVEL DETECTOR FOR THE MEASUREMENT OF MICRODOSI-METRIC SPECTRA FOR PROTONS AND LIGHT IONS. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71234-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bangiri A, Jeynes J, Kirkby K. 1588 poster THE EFFECT OF CISPLATIN, CARBOPLATIN AND RADIATION ON PEO AND SKOV-3 OVARIAN CANCER CELLS. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Green S, Borghesi M, Neely D, McKenna P, Najmudin Z, Palmer C, Sari I, Tolley M, Ward A, Carroll D, Kar S, Doria D, Green J, Brenner C, Kirby D, Fiorini F, Kirkby K, Merchant M, Jeynes C, Palmans H, Shipley D, Nutbrown R, Thomas R, Kraft M, Kakolee K, Prasad R. 1425 poster LASER-PLASMA ACCELERATION OF PARTICLES FOR PROTON AND ION-BEAM RADIOTHERAPY: AN UPDATE FROM THE LIBRA CONSORTIUM. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71547-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The interest in proton and ion-beam therapy has increased substantially in recent years, leading the Bureau International des Poids et Mesures to recommend that a new quantity be defined to account for the biological effect of treatment modalities used in the radiotherapy. In response, we have begun work on the design of a new microbolometer based on the inductive superconducting transition-edge detector (ISTED) designed at the National Physical Laboratory. Our work aims to expand the use of the ISTED from its current use as an infra-red detector to the measurement of energy deposition of photons, hadrons and ions by incorporating a tissue-equivalent absorber. We present here the work carried out till date, including the detection of single visible photons, with an energy resolution of 0.2 eV and a time response of a few microseconds, using a 15-µm Superconducting QUantum Interference Device operating at 9 K. We also describe thermal computational modelling carried out for a simple ISTED absorber. Finally, we discuss the work currently in progress and that to be carried out before the detector is realised.
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Affiliation(s)
- S Galer
- National Physical Laboratory, Hampton Road, Teddington, Middlesex TW11 0LW, UK.
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Jena R, Jeynes C, Peacock J, Thomas C, Duane S, Burnet N, Kirkby K, Stancanello J. SU-GG-T-487: Lack of Dose Rate Effect with Ultra-High Dose Rate Irradiation of Normal Tissue Fibroblasts and RT112 Tumour Cells. Med Phys 2010. [DOI: 10.1118/1.3468885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jones B, Green S, Dale RG, Peach K, Kirkby K. Particle Radiotherapy in the UK. Clin Oncol (R Coll Radiol) 2008; 20:67-8. [PMID: 17689937 DOI: 10.1016/j.clon.2007.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 06/26/2007] [Indexed: 10/23/2022]
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Margadant DL, Kirkby K, Andrew SE, Gelatt KN. Effect of topical tropicamide on tear production as measured by Schirmer's tear test in normal dogs and cats. Vet Ophthalmol 2003; 6:315-20. [PMID: 14641829 DOI: 10.1111/j.1463-5224.2003.00313.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the effect of a single dose of topical 1% tropicamide on tear production as measured by the Schirmer tear test (STT) in the normal dog and cat. MATERIAL AND METHODS Twenty-eight dogs and 32 cats received 50 micro l : l of 1% tropicamide in one eye and the opposite eye served as the control. STTs were performed immediately before instillation of tropicamide and then at 1, 4, 8 and 24 h post drug instillation. STT results were compared between the control and treated eyes at the different times. RESULTS Aqueous tear production in dogs, measured by STT, was not significantly reduced. The mean +/- SEM STTs for the baseline time for control and tropicamide-treated eyes were 19.9 +/- 0.8 and 20.3 +/- 0.8 mm wetting/min, respectively. For the control eyes, the subsequent mean +/- SEM STT levels were 20.3 +/- 0.9 (1 h), 21.1 +/- 0.8 (4 h), 20.1 +/- 0.9 (8 h), and 18.7 +/- 0.7 (24 h). For the tropicamide-treated eyes, the subsequent mean +/- SEM STT levels were 19.4 +/- 0.9 (1 h), 19.3 +/- 0.9 (4 h), 20.0 +/- 0.9 (8 h), and 18.4 +/- 0.8 (24 h). Aqueous tear production of both eyes was significantly reduced in cats at 1 h but returned to baseline by 4 h post tropicamide instillation. The mean +/- SEM STT levels for the baseline time in cats for control and tropicamide-treated eyes were 14.9 +/- 0.8 and 14.7 +/- 0.8 mm wetting/min, respectively. Subsequent mean +/- SEM STT levels for the control eyes were 6.4 +/- 1.1 (1 h), 11.9 +/- 1.0 (4 h), 13.9 +/- 0.8 (8 h), and 16.4 +/- 1.0 (24 h). For the tropicamide-treated eyes, the subsequent mean +/- SEM STT levels were 5.3 +/- 0.8 (1 h), 10.2 +/- 0.8 (4 h), 14.7 +/- 1.0 (8 h), and 16.6 +/- 1.0 (24 h). CONCLUSION Single dose 1% tropicamide does not significantly lower tear production rates, as measured by the STT, in normal dogs. However, in normal cats single doses of 1% tropicamide in one eye cause significant reductions in tear production of both eyes at 1 h that recovered to baseline levels by 4 h.
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Affiliation(s)
- D L Margadant
- Department of Small Animal Clinical Sciences, PO Box 100126, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126, USA
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Abstract
OBJECTIVE To examine the experience, knowledge and attitudes of recipients of transcranial magnetic stimulation (TMS) regarding the treatment. There have been no studies of patient views about TMS. METHOD A 60-item survey was administered by telephone to persons with depressive illness who received TMS at Royal Hobart Hospital, Tasmania. RESULTS Forty-eight patients were interviewed. About two-thirds also had a history of treatment with electroconvulsive therapy (ECT). Experience and opinions about TMS were generally very positive. Almost three-quarters of interviewees believed TMS had been helpful. The vast majority rated TMS as more acceptable than having, or the prospect of having, ECT. The majority would have TMS again and would recommend it to others. CONCLUSIONS The mostly favourable experiences and attitudes reported by interviewees will be reassuring to patients, their families and treating health professionals when TMS is being considered.
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Affiliation(s)
- G Walter
- Child and Adolescent Mental Health Services, Central Sydney Area Health Service, Australia.
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30
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Abstract
The Phobic Origins Questionnaire (POQ) [Ost, L.-G. & Hugdahl, K. (1981). Acquisition of phobias and anxiety response patterns in clinical patients. Behaviour Research and Therapy, 19, 439-447.] is the most commonly cited instrument for determining the origins of phobic anxiety and data obtained using this instrument strongly support the role of conditioning in the acquisition of fear reactions. The construct validity of the POQ in assessing episodes of conditioning has been questioned [e.g. Menzies, R. G. & Clarke, J. C. (1994). Retrospective studies of the origins of phobias: a review. Anxiety, Stress and Coping, 7, 305-318.] This paper examined the convergent validity of the POQ by comparing origins' classifications based on the POQ to classifications based on alternative instruments. The convergent validity of the POQ was found to be extremely poor. The POQ was consistently associated with a much greater likelihood of classifying the origin of fear reactions as due to direct conditioning episodes than was found using alternative instruments. The findings question the usefulness of the POQ in examining the origins of phobic anxiety.
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Affiliation(s)
- R G Menzies
- Department of Behavioural Sciences, Faculty of Health Services, University of Sydney, Lidcombe, NSW, Australia
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31
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Abstract
The differential effects of the revised NEO Personality Inventory (NEO PI-R) personality factors and intelligence on response to a computerized vicarious exposure treatment for agoraphobia were investigated. The Fear Questionnaire (FQ), the Agoraphobia Cognitions Questionnaire (ACQ), and the Body Sensations Questionnaire (BSQ) were used to assess agoraphobic symptomatology. Fourteen females and four males with agoraphobia diagnoses completed three 45-minute weekly treatment sessions. There was a significant decrease in scores on all three measures following treatment. Compared with published population norms, the agoraphobic subjects showed very high neuroticism, low extroversion, and high openness. Lower agreeableness factor scores predicted good treatment outcome. The NEO PI-R openness factor was negatively correlated with proficiency on the computer program; however, proficiency on the computer program did not correlate with symptom improvement. Overall, these results suggest that personality interacts with treatment at different stages of the therapeutic process.
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Affiliation(s)
- L Harcourt
- Department of Psychology, Clinical School, University of Tasmania, Australia
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32
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Abstract
OBJECTIVE To survey the social outcome of patients with schizophrenia attending State mental health facilities in southern Tasmania. METHOD Using the Statewide Mental Health Register, patients using inpatient and outpatient facilities who received a diagnosis of schizophrenia between 1981 and 1988 were identified (n = 771), and demographic and illness measures, and admissions and length of inpatient stay were compiled. The Life Skills Profile (LSP) was completed by mental health personnel for the 247 who were regular attenders or inpatients in 1991. RESULTS Social morbidity as indexed by the LSP was highest in psychiatric hospital inpatients and patients in long-term rehabilitation programs, and lower in patients attending community centres. The majority of patients in suburban settings and attending community centres lived with their families, whereas patients in the inner city or in the rehabilitation service were mainly in hostel accommodation or living alone. Patients with schizophrenia attending State services were of a similar age range but had a longer duration of illness and more admissions, and had spent more days in hospital than patients who were not in regular contact with the service. CONCLUSIONS The distribution of social morbidity in schizophrenia confirms that the public health system is supporting a group with high social morbidity. Patients with the highest morbidity are receiving the highest levels of care and intervention.
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Affiliation(s)
- K Kirkby
- Division of Clinical Sciences, University of Tasmania, Hobart, Australia
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