OpenLLM-France/wikimedia huggingface dataset:
# Radiation Oncology/Anal canal/Staging

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
Anal Cancer Staging

## Staging
### Current staging

AJCC 8th edition (2017)-
NOTE: All newly diagnosed cases through December 31st 2017 should be staged with the 7th edition.
'"In order to ensure that the cancer care community has the necessary infrastructure in place for documenting 8th Edition stage, the AJCC Executive Committee, in dialogue with the National Cancer Institute (NCI-SEER), Centers for Disease Control and Prevention (CDC), the College of American Pathologists (CAP), the National Comprehensive Cancer Network (NCCN, the National Cancer Data Base (NCDB), and the Commission on Cancer (CoC), made the decision to delay the implementation of the 8th Edition Cancer Staging System to January 1, 2018.'
Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December 31st 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018."
(Source: https://cancerstaging.org/About/news/Pages/Implementation-of-AJCC-8th-Edition-Cancer-Staging-System.aspx)
Primary Tumor:
* Tis - high-grade squamous intraepithelial lesion
* T1 - 2 cm or less
* T2 - >2 - 5 cm
* T3 - >5 cm
* T4 - invades adjacent organ, e.g. vagina, urethra, bladder. (invasion of the rectal wall, perirectal skin, subcutaneous tissue, or sphincter muscle is not included as T4.)
Regional Nodes:
    Regional lymph nodes include: mesorectal, inguinal (superficial, deep), superior rectal (hemorrhoidal), external iliac, internal iliac (hypogastric)
* N0 - no regional lymph node metastases
* N1a - inguinal, mesorectal, or internal iliac lymph nodes
* N1b - external iliac nodes
* N1c - external iliac nodes + N1a
Distant Metastases:
* M0 - no
* M1 - yes
Stage grouping:
* 0 - Tis
* I - T1 N0
* IIA - T2 N0
* IIB - T3 N0
* IIIA - T1-2 N1
* IIIB - T4 N0
* IIIC - T3-4 N1
* IV - M1

### Older staging systems

AJCC 7th edition (2009)
Primary Tumor:
* Tis - carcinoma in situ
* T1 - 2 cm or less
* T2 - 2 - 5 cm
* T3 - >5 cm
* T4 - invades adjacent organ, e.g. vagina, urethra, bladder. (invasion of the rectal wall, perirectal skin, subcutaneous tissue, or sphincter muscle is not included as T4.)
Regional Nodes:
    Regional lymph nodes include: perirectal, lateral sacral, internal iliac (hypogastric), inguinal
* N0 - no lymph nodes
* N1 - perirectal lymph nodes
* N2 - unilateral internal iliac or (unilateral) inguinal lymph nodes or both
* N3 - perirectal AND inguinal lymph nodes; and/or bilateral internal iliac; and/or (bilateral) inguinal lymph nodes
Distant Metastases:
* M0 - no
* M1 - yes
Stage grouping:
* 0 - Tis
* I - T1 N0
* II - T2-3 N0
* IIIA - T1-3 N1, T4 N0
* IIIB - T4 N1, Any N2, Any N3
* IV - M1
AJCC 6th Edition (2002)
No changes compared to 7th edition
# Radiation Oncology/Anatomy/Clinical syndromes with cn palsy
## Cerebellopontine Angle Syndrome

* Acoustic Tumours
* CN IX and CN VIII and CN V can be affected
* Symptoms:
** IX:
*** Tinnitus
*** Gag reflex decreased
** VIII:
*** Vertigo
*** Deafness
** V
*** Facial Sensory defecit

## Jugular Foramen Syndrome (Vernet Syndrome)

* Glomus Jugular Tumours
* Base of skull fx
* Meningioma
* CN IX, X, XI
* Symptoms:
** Dull unilat aching pain behind ear
** XI
*** Ipsilateral Trapezius and SCM palsy
** IX
*** Depressed gag reflex
*** Loss of taste at post 1/3 tongue
*** Loss pf sensation of uvula
** X
*** Dysphonia
*** Dysphagia
*** Palatal drop
*** Loss of sensation of pharynx and larynx

## Retropharyngeal & Retroparotid Space Syndrome
### Collet-Sicard Syndrome

* CN IX, X, XI, XII
* Symptoms:
** Paralysis of the vocal cords, palate, trapezius muscle and sternocleidomastoid muscle.
** Anaesthesia of the larynx, pharynx and soft palate.

### Villaret's Syndrome (Retroparotid)

* CN IX, X, XI, XII, Sympathetic chain and sometime CN VII
* Symptoms:
** IX
*** Loss of posterior taste of tongue
*** Depressed gag reflex
** X
*** Loss of sensation of soft palate, pharynx and larynx
** XII
*** Ipsilateral deviation of tongue
** Sympathetic involvement
*** Horner's syndrome
# Radiation Oncology/Anal canal/RTOG Anal

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
* RTOG Website
* Wikibooks list of RTOG trials
Anal Cancer: RTOG OPEN TRIALS :
| Number | Title |
Anal Cancer: RTOG CLOSED TRIALS :
| Number | Title | Publication |
| 05-29 | A Phase II Evaluation of Dose-Painted IMRT in Combination with 5-Fluorouracil and Mitomycin-C for Reduction of Acute Morbidity in Carcinoma of the Anal Canal | PMID 23154075 |
| 98-11 | A Phase III Randomized Study of 5-Fluorouracil, Mitomycin, and Radiotherapy Versus 5-Fluorouracil, Cisplatin and Radiotherapy in Carcinoma of The Anal Canal | PMID 18430910 |
| 92-08 | Phase II Dose Escalation in Chemoradiation for Anal Cancer | PMID 18472363 |
| 87-04 | Role of Mitomycin in Combination with Fluorouracil and Radiotherapy, and of Salvage Chemoradiation in the Definitive Nonsurgical Treatment of Epidermoid Carcinoma of the Anal Canal | PMID 8823332 |
| 83-14 | Definitive Irradiation and Chemotherapy for Radiosensitization in Management of Anal Carcinoma | PMID 2724350 |
# Radiation Oncology/Anal canal/Review

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
Anal Cancer Review

## Epidemiology

* U.S. incidence: ~5,200; U.S. death rate ~700 (~13%)
* Risk factors: HPV 16-18 in ~75% cases, immunodeficiency, tobacco
* Clinical presentation: rectal bleeding, 20% asymptomatic
* Work-Up: DRE, inguinal evaluation, pelvic MRI/CT, chest/abdomen CT, PET not validated, GYN exam in women, consider HIV testing
* Anatomy: anal margin to anal verge to dentate line to anorectal sling
* Lymph node drainage: perirectal (N1), inguinal (N2), internal illiac (N2)
** LN positive ~30% (ACT II)
* 5-year survival
** Stage I: 69%
** Stage II: 59%
** Stage III: 41%
** Stage IV: 19%

## Surgery

* Local excision alone
** Not considered appropriate for any lesions in anal canal (NCCN v1.2010, ACR 2007)
** For T1N0 worse outcome (ACR 2007): 5-year local control ~70% (vs 80-90% with RT), 5-year OS ~50% (vs 90-100% with RT)
** For T1N0 well-differentiated, anal margin (NCCN v1.2010): May be considered
* APR
** 5-year OS ~50%
** Toxicity: permanent colostomy
* Surgery vs chemo-RT
** No randomized trials
** Swedish cohort data support better outcomes with chemo-RT

## Non-surgical approaches

* RT alone
** Control rate depends on size of primary
** Tumors <4 cm and cN0 have excellent 10-year local control (85-90%) and overall survival (~80%)
** Larger tumors have only ~60% local control rate and ~50% overall survival
* Chemo-RT vs RT alone
** 2 trials (UKCCCR, EORTC), mostly in T3-T4 or N+ patients
** No difference in overall survival; UKCCCR improved cancer-specific survival. 5-year OS ~55%
** Local control benefit: 40-50% to 65%
** Colostomy-free benefit: 40% to 70%
* Chemo-RT: chemo options
** RTOG 8704 (Flam) +/- Mitomycin
*** Worse colostomy without MMC: 4-year MMC- 22% vs MMC+ 9% (SS)
*** Worse DFS without MMC: 4-year 51% vs 73% (SS); no difference in OS
** RTOG 9811 (Ajani, update Gunderson) Induction/concurrent 5-FU + cisplatin vs concurrent 5-FU + Mitomycin
*** Worse local control: cisplatin 67% vs Mitomycin 75%; colostomy rate 19% vs 10% (SS)
*** No impact on survial on initial analysis: 5-year OS 70-75%
*** However on update (Gunderson): DFS and OS were statistically better for RT + FU/MMC versus RT + FU/CDDP (5-year DFS, 67.8% v 57.8%; P = .006; 5-year OS, 78.3% v 70.7%; P = .026). There was a trend toward statistical significance for CFS (P = .05), LRF (P = .087), and CF (P = .074).
*** Uncreal whether worse outcomes due to induction or due to cisplatin
* Chemo-RT: RT options
** RTOG 92-08 (Konski) split course to 59.6 Gy
*** Worse colostomy-free survival and DFS
** RTOG 0529 (Kachnic) IMRT with concurrent 5-FU/mitomycin-C:
*** 77% experienced grade 2+ gastrointestinal/genitourinary acute AEs (9811 77%). There was, however, a significant reduction in acute grade 2+ hematologic, 73% (9811 85%, P=.032), grade 3+ gastrointestinal, 21% (9811 36%, P=.0082), and grade 3+ dermatologic AEs 23% (9811 49%, P<.0001) with DP-IMRT. On initial pretreatment review, 81% required DP-IMRT replanning, and final review revealed only 3 cases with normal tissue major deviations.
# Muggles' Guide to Harry Potter/Major Events
## Battles

* Voldemort's First Downfall
* Duel in the Chamber of Secrets
* Duel in the Cemetery
* Battle at the Department of Mysteries
* Battle of the Astronomy Tower
* Escape from Privet Drive
* Infiltration of the Ministry of Magic
* Malfoy Manor
* Break-in at Gringotts
* Battle of Hogwarts

## Exams

* Year-end exams
* OWL exams
* NEWT exams

## Student Offices

* Prefects
* Head Boy or Head Girl
* Quidditch captain

## Competitions

* Quidditch
** Quidditch World Cup
* Triwizard Tournament
** First Task
** Yule Ball
** Second Task
** Third Task
* House Cup

## Relationships

* Cho Chang
* Hermione Granger
* Harry Potter
* Ginny Weasley
* Ron Weasley
* Viktor Krum

## Deaths

* Cedric's Death
* Dumbledore's Death
* Sirius' Death
* Mad-Eye Moody's Death
* Dobby's Death
* Fred Weasley's Death
* Pettigrew's Death
* Remus' Death
* Nymphadora's Death
* Snape's Death
* Voldemort's Death

## Organizations

* Death Eaters
* Dumbledore's Army
* Inquisitorial Squad
* Order of the Phoenix
* S.P.E.W.

## Other

* Events in the Shrieking Shack
* Visiting Godric's Hollow
* The Life and Lies of Albus Dumbledore
* Visiting Xenophilius Lovegood
* Harry - Voldemort Shared Thoughts
* Events in the Forbidden Forest
# Radiation Oncology/Cervix/Guidelines

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
Cervical Cancer Guidelines
Screening
Target Volume Delineation
* Gyn IMRT Consortium / RTOG:
** 2011 PMID 20472347 -- "Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy for the definitive treatment of cervix cancer." (Lim K, Int J Radiat Oncol Biol Phys. 2011 Feb 1;79(2):348-55. Epub 2010 May 14.)
* Gyn IMRT Consortium: Postoperative Treatment; 2008 PMID 18037584 -- "Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy in postoperative treatment of endometrial and cervical cancer." (Small W, Int J Radiat Oncol Biol Phys. 2008 Jun 1;71(2):428-34. Epub 2007 Nov 26.)
** RTOG Atlas
* Image-guided brachytherapy working group
** 2004 PMID 15519788 — "Proposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma: Report from Image-Guided Brachytherapy Working Group." Nag et al. Int J Radiat Oncol Biol Phys. 2004 Nov 15;60(4):1160-72.
* Japan Clinical Oncology Group, JCOG
** 2016 PMID 26767622 -- "Proposed definition of the vaginal cuff and paracolpium clinical target volume in postoperative uterine cervical cancer." (Murakami N, Pract Radiat Oncol. 2016 Jan-Feb;6(1):5-11.)
Brachytherapy
# Radiation Oncology/Carcinoid/Lung

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
Pulmonary carcinoid tumors

## Reviews

* 2003 - PMID 12839856 — "Update in pulmonary carcinoid tumors: a review article." Hage R et al. Ann Surg Oncol. 2003 Jul;10(6):697-704.
# Radiation Oncology/Cervix

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
* Cervix: Main Page |
* Overview |
* Micro-invasive |
* Early Stage Non-Bulky |
* Early Stage Bulky |
* Locally Advanced |
* Brachytherapy |
* Cervix Randomized |
* GOG Trials |
* RTOG Cervix
* Staging
* Official Guidelines
* Overview (for now contains most of the info; in process of splitting it up)
* Preinvasive (HG-SIL / CIN)
* Microinvasive (Stage IA)
* Early Stage Non-bulky (Stage IB1 and IIA <4cm)
* Early Stage Bulky (Stage IB2 and IIA >4cm)
* Locally Advanced (Stage IIB-IVA)
* Para-Aortic Recurrence
* Palliation
* Radiation Technique
* Brachytherapy
* Proton Therapy
* Randomized Evidence
* Cervical Cancer in Pregnancy
* GOG trials
* RTOG cervix trials
# Radiation Oncology/Cardiac metastasis

From solid tumors
* Lung cancer
* Upper gastrointestinal malignancies
* Breast cancer
* Melanoma
From lymphoma or leukemia
# Punjabi/Muharni/Velars
## Second Row

Look at the following pictures. The caption below each picture describes in Punjabi the object in the picture. Once you have recognized the objects, use your knowledge of Gurmukhi to read the captions. The captions contain the initial letter of the object name besides the object name in Punjabi and in English. Follow this by loudly reading each caption without the English word. Take the help of the sound file if necessary. Practise it repeatedly till you master it i.e. till you are able to fluently speak it.
* Punjabi Muharni - Second row
* ਕ - ਕਬੂਤਰ Pigeon
* ਖ - ਖੰਭ Feather
* ਗ - ਗੇਂਦ Ball
* ਘ - ਘੋੜਾ Horse
* ਙ - ਖਾਲੀ
Play for following Muharni - second row.

### Exercises

* Practise speaking the words of the Muharni given above in the text. Play the sound file for help in speaking.
* Write the following words in alphabetical order.
   * ਗੇਂਦ, 2. ਕਬੂਤਰ, 3. ਘੋੜਾ, 4. ਖੰਭ
* ਕਬੂਤਰ
* ਖੰਭ
* ਗੇਂਦ
* ਘੋੜਾ
# Punjabi/Muharni/FullMuharni
## Full Muharni

You have already learnt the Punjabi Muharni row by row. This lesson contains all these lessons in one single page. There is an audio file at the end of the page to help you correctly pronounce the object names shown in the Muharni.
* Punjabi Muharni - First row
* ੳ - ਊਠ Camel
* ਅ - ਅਨਾਰ Pomegranate
* ੲ - ਇੱਟ Brick
* ਸ - ਸੱਪ Snake
* ਹ - ਹਾਥੀ Elephant
* Punjabi Muharni - Second row
* ਕ - ਕਬੂਤਰ Pigeon
* ਖ - ਖੰਭ Feather
* ਗ - ਗੇਂਦ Ball
* ਘ - ਘੋੜਾ Horse
* ਙ - ਖਾਲੀ
* Punjabi Muharni - Third row
* ਚ - ਚਾਕੂ Knife
* ਛ - ਛੱਤਰੀ Umbrella
* ਜ - ਜਹਾਜ਼ Aeroplane
* ਝ - ਝੰਡਾ Flag
* ਞ - ਖਾਲੀ
* Punjabi Muharni - Fourth row
* ਟ - ਟਮਾਟਰ Tomato
* ਠ - ਠੋਡੀ Chin
* ਡ - ਡਾਕੀਆ Postman
* ਢ - ਢੋਲ Drum
* ਣ - ਖਾਲੀ
* Punjabi Muharni - Fifth row
* ਤ - ਤੋਤਾ Parrot
* ਥ - ਥੈਲਾ Bag
* ਦ - ਦੰਦ Teeth
* ਧ - ਧੌਣ Neck
* ਨ - ਨੱਕ Nose
* Punjabi Muharni - Sixth row
* ਪ - ਪਪੀਤਾ Papaya
* ਫ - ਫੁੱਲ Flower
* ਬ - ਬੰਦੂਕ Gun
* ਭ - ਭਾਲੂ Bear
* ਮ - ਮੱਛੀ Fish
* Punjabi Muharni - Seventh row
* ਯ - ਯੱਕਾ Ace
* ਰ - ਰੇਸ਼ਮ Silk
* ਲ - ਲੂੰਬੜੀ Fox
* ਵ - ਵੱਛਾ Calf
* ੜ - ਖਾਲੀ
# Punjabi/Muharni/Labials
## Sixth row - the Labials

Look at the following pictures. The caption below each picture describes in Punjabi the object in the picture. Once you have recognized the objects, use your knowledge of Gurmukhi to read the captions. The captions contain the initial letter of the object name besides the object name in Punjabi and in English. Follow this by loudly reading each caption without the English word. Take the help of the sound file if necessary. Practise it repeatedly till you master it i.e. till you are able to fluently speak it.
* Punjabi Muharni - Sixth row
* ਪ - ਪਪੀਤਾ Papaya
* ਫ - ਫੁੱਲ Flower
* ਬ - ਬੰਦੂਕ Gun
* ਭ - ਭਾਲੂ Bear
* ਮ - ਮੱਛੀ Fish
Play for following Muharni - sixth row.

### Exercises

1. Practise speaking the words of the Muharni given above in the text. Play the sound file for help in speaking.
2. Write the following words in alphabetical order.
    1. ਭਾਲੂ, 2. ਪਪੀਤਾ, 3. ਮੱਛੀ, 4. ਬੰਦੂਕ, 5. ਫੁੱਲ
* ਪਪੀਤਾ
* ਫੁਲ
* ਬੰਦੂਕ
* ਭਾਲੂ
* ਮੱਛੀ
# Punjabi/Muharni/Palatals
## Third Row

Look at the following pictures. The caption below each picture describes in Punjabi the object in the picture. Once you have recognized the objects, use your knowledge of Gurmukhi to read the captions. The captions contain the initial letter of the object name besides the object name in Punjabi and in English. Follow this by loudly reading each caption without the English word. Take the help of the sound file if necessary. Practise it repeatedly till you master it i.e. till you are able to fluently speak it.
* Punjabi Muharni - Third row
* ਚ - ਚਾਕੂ Knife
* ਛ - ਛੱਤਰੀ Umbrella
* ਜ - ਜਹਾਜ਼ Aeroplane
* ਝ - ਝੰਡਾ Flag
* ਞ - ਖਾਲੀ
Play for following Muharni - third row.

### Exercises

* Practise speaking the words of the Muharni given above in the text. Play the sound file for help in speaking.
* Write the following words in alphabetical order.
   * ਜਹਾਜ਼, 2. ਝੰਡਾ , 3. ਚਾਕੂ, 4. ਛੱਤਰੀ
* ਚਾਕੂ
* ਛੱਤਰੀ
* ਜਹਾਜ਼
* ਝੰਡਾ
# Punjabi/Muharni/Retroflexes
## Fourth row - the Retroflexes

Look at the following pictures. The caption below each picture describes in Punjabi the object in the picture. Once you have recognized the objects, use your knowledge of Gurmukhi to read the captions. The captions contain the initial letter of the object name besides the object name in Punjabi and in English. Follow this by loudly reading each caption without the English word. Take the help of the sound file if necessary. Practise it repeatedly till you master it i.e. till you are able to fluently speak it.
* Punjabi Muharni - Fourth row
* ਟ - ਟਮਾਟਰ Tomato
* ਠ - ਠੋਡੀ Chin
* ਡ - ਡਾਕੀਆ Postman
* ਢ - ਢੋਲ Drum
* ਣ - ਖਾਲੀ
Play for following Muharni - fourth row.

### Exercises

1. Practise speaking the words of the Muharni given above in the text. Play the sound file for help in speaking.
2. Write the following words in alphabetical order.
    1. ਠੋਡੀ, 2. ਢੋਲ, 3. ਡਾਕੀਆ, 4. ਟਮਾਟਰ
* ਟਮਾਟਰ
* ਠੋਡੀ
* ਡਾਕੀਆ
* ਢੋਲ
# Punjabi/Shahmukhi

* Lesson 1 •
* Lesson 2 •
* Lesson 3 •
* Lesson 4 •
* Lesson 5 •
* Lesson 6 •
* Lesson 7 •
* Lesson 8 •
* Lesson 9 •
* Lesson 10 •
* Lesson 11
Writing systems of Punjabi
We have noted that Punjabi is spoken in Punjab, India as well as Punjab, Pakistan. There are different writing systems on either side of the international border. It is written in Gurmukhi script in India. Gurmukhi is also the official script of Punjabi there. However Shahmukhi script is used to write Punjabi in Pakistan. In this Part we are concerned with Punjabi as written in Shahmukhi script.

## Shahmukhi script

Here you will learn the Shahmukhi script for writing Punjabi.

### Contents

* Lesson 1: Letters bē to sē
* Lesson 2: Letters jīm to zāl
* Lesson 3: Letters rē to zuāt
* Lesson 4: Letters tōē to gāf
* Lesson 5: Letters lām to baṛī yē
* Lesson 6: Vowels a, i, and u
* Lesson 7: Vowels ā, ī, ē, and ai
* Lesson 8: Vowels ū, ō, and ū
* Lesson 9: Extra symbols, punctuation, numerals, explanation for multiple letters for t, s, h, and z
* Lesson 10: Reading Exercises I
* Lesson 11: Reading Exercises II
See also: Shahmukhi script on Wikipedia
# Punjabi/Muharni/Semi-vowels
## Seventh row - the Semi-vowels

Look at the following pictures. The caption below each picture describes in Punjabi the object in the picture. Once you have recognized the objects, use your knowledge of Gurmukhi to read the captions. The captions contain the initial letter of the object name besides the object name in Punjabi and in English. Follow this by loudly reading each caption without the English word. Take the help of the sound file if necessary. Practise it repeatedly till you master it i.e. till you are able to fluently speak it.
* Punjabi Muharni - Seventh row
* ਯ - ਯੱਕਾ Ace
* ਰ - ਰੇਸ਼ਮ Silk
* ਲ - ਲੂੰਬੜੀ Fox
* ਵ - ਵੱਛਾ Calf
* ੜ - ਖਾਲੀ
Play for following Muharni - seventh row.

### Exercises

1. Practise speaking the words of the Muharni given above in the text. Play the sound file for help in speaking.
2. Write the following words in alphabetical order.
    1. ਵੱਛਾ, 2. ਰੇਸ਼ਮ, 3. ਲੂੰਬੜੀ, 4. ਯੱਕਾ
* ਯੱਕਾ
* ਰੇਸ਼ਮ
* ਲੂੰਬੜੀ
* ਵੱਛਾ
# Radiation Oncology/Physics/Atomic

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials

## Related Wikibooks

* Wikibook: Basic Physics of Nuclear Medicine
# Radiation Oncology/Physics/Dosimetry

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
Dosimetry
* Biologic damage to DNA and other structures depends on the amount of ionizing (directly or indirectly) energy absorbed from the radiation beam and deposited into the tissue
* Absorbed dose is defined as energy absorbed per unit mass of tissue. It is essentially the measure of liberated electrons
* It is difficult to measure absorbed dose directly in tissues; instead, ionization is measured in air (exposure) and then converted to absorbed dose tissue equivalent
* Bragg–Gray cavity theory

## Radiation Exposure

* Dose of radiation absorbed correlates directly with the energy of the beam
* Gray = basic unit of absorbed dose, in energy (J) per unit mass (kg). Replaces rad (100 rad = 1 Gy)
* to be continued ...

## CBCT Exposure

* Vanderbilt; 2009 PMID 19147025 -- "Radiation dose from kilovoltage cone beam computed tomography in an image-guided radiotherapy procedure." (Ding GX, Int J Radiat Oncol Biol Phys. 2009 Feb 1;73(2):610-7.)
** Monte Carlo simulation, adult and pediatric
** H&N scan, half-fan mode: adult vs. peds eye 7 vs 8 cGy, cord 5 vs 6 cGy, brain 5 vs 6 cGy, vertebra 18 vs 23 cGy. Full-fan mode 10-20% lower dose
** Abdomen, half-fan mode: prostate 3 and 7 cGy, femoral heads 7 and 17 cGy
** Conclusion: Doses can total 3 Gy over entire treatment course

## Review

radiationtherapy.tk
# Radiation Oncology/Physics/Photophysics

* Basic photophysics in the framework of photobiology is concerned with processes that occur when sunlight, filtered through the Earth's atmosphere, interacts with matter (atoms and molecules) present on Earth
* The spectrum of solar radiation striking the Earth spans 100 nm to 10$^6$ nanometers (1 nm = 10$^{-9}$ m) and can be divided into the ultraviolet (UV) range (100 nm to 400 nm), visible range (400 nm to 700 nm) and infrared (IR) range (700 nm to 10$^6$ nm)
* UV radiation has both damaging and beneficial effects on living matter
** UV radiation is also responsible for the photochemical reaction leading to production of the protective ozone layer in the atmosphere
* As the name suggests the visible part of the spectrum is the light that human eyes can detect
** Visible light is only one small part of the electromagnetic spectrum, which is classified by wavelength into radio wave, microwave, infrared, visible, ultraviolet, X-rays and gamma rays
# Radiation Oncology/Physics/Dosimetry/Bragg–Gray cavity theory

* Bragg-Gray cavity theory relates the radiation dose in a cavity volume of material g to the dose that would exist in a surrounding medium m in the absence of the cavity volume
* It was developed in 1936 by British scientists Louis Harold Gray, William Henry Bragg, and William Lawrence Bragg
# Radiation Oncology/Physics/ASTRO Curriculum

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
| Subject | Hours | References |
| Atomic and nuclear structure | 2 | Khan Ch 1, Cherry Ch 2 |
| Production of X-rays, photons, electrons | 2 | Khan Ch 3, Hendee Ch 2 |
| Treatment machines and generators, simulators | 3 | Chan Ch 4&7, Metcalfe Ch 1, Van Dyk Ch 4-7 |
| Radiation interactions | 3 | Khan Ch 5, Metcalfe Ch 2, Cherry Ch 6, Hendee Ch 3 |
| Radiation beam quality and dose | 3 | Khan Ch 7, Hendee Ch 4 |
| Radiation measurement and calibration | 3 | Khan Ch 8, Hendee Ch 5&6 |
| Photons and X-rays | 7 | Khan Ch 11-13, Metcalfe Ch 6 |
| Electrons | 2 | Khan Ch 14, AAPM TG-25/70 |
| External beam QA | 2 | Khan Ch 17, AAPM TG-40 |
| Informatics | 1 | |
| Radiation protection, shielding | 2 | Khan Ch 16, NCRP 151, Thomadsen Ch 10, McGinley |
| Imaging | 4 | Van Dyk Ch 2, Curry Ch 10-16, 19, 20, 22-24, Sprawls |
| 3D-CRT, ICRU, beam-related biology | 3 | Khan&Potish Ch 4, 10, 18-28, ICRU-62 |
| Patient setup and treatment | 2 | Van Dyk Ch 7, Bentel |
| IMRT | 3 | Khan Ch 20, Palta&Mackie, Roeske&Mundt |
| Special procedures (SRS, TBI, etc) | 3 | Khan Ch 21, 18, Metcalfe Ch 5 |
| Brachytherapy | 6 | Khan Ch 22-24, Thomadsen Ch 28-33, 41-49 |
| Radiopharmaceuticals | 2 | Khan Ch 15, Cherry Ch 5, Thomadsen Ch 11 |
| Hyperthermia | 1 | Hall Ch 28 |
| Particle therapy | 1 | Van Dyk Ch 20-21 |
| Total | 55 |
# Radiation Oncology/Physics/Dose evaluation

* Front Page: Radiation Oncology | RTOG Trials | Randomized Trials
Dose Evaluation
* Bragg-Gray cavity theory
** Radiation dose in a cavity volume of material to the dose that would exist in a surrounding medium in the absence of the cavity volume
* Spencer-Attix Cavity Theory
** Hugo Bouchard. Phys Med Biol. 2012. A theoretical re-examination of Spencer-Attix cavity theory (PMID: 22572534)