Résumé
Oxygen is vital for aerobic processes of metabolism and respiration- It has been also implicated in many diseases and degenerative conditions. Free radicals formed from reactive oxygen and nitrogen species act as key players in the initiation and progression of tumor cells and enhance their metastatic potential. The imbalance in the formation and use of free radicals in the tissue creates oxidative stress. Inadequacy in normal cells antioxidant defense system or excessive free radical formation or even both can cause the cell to experience the oxidative stress. This review outlines the involvement of free radicals in different aspects of cancer, from prevention to initiation, progression, treatment and to reduce morbidity and mortality.
Résumé
Aim: The aim of this study is to identify an ideal location of isocenter in intensity-modulated radiotherapy (IMRT) treatment plans. Materials and Methods: A total of 28 clinical target volumes and 4 English capital letters (C, L, T, and H) target volumes were considered in this study. Two IMRT treatment plans were generated for each target volume in the ECLIPSETM treatment planning system (TPS), first one with isocenter automatically placed (ISOAUTO) by TPS and the second one with geometric center-based isocenter (ISOGEOM). The geometric center of a cuboid volume, which was formed encompassing around the target volume in sagittal, transverse, and frontal planes, is considered as the geometric center of the target volume as well as the isocenter (ISOGEOM) of the IMRT plans. While performing the IMRT treatment plans using the beam angle optimization and dose volume optimization, the normal tissue objectives and target volume objectives were kept similar in both the plans. The dosimetrical parameters between the two groups of plans were compared. Results: The distance between ISOGEOM and ISOAUTO ranged from 0.16 cm to 3.04 cm with a mean and median of 0.85 cm and 0.69 cm, respectively. The ISOGEOM-based IMRT plans exhibited statistically significant advantages in total monitor units reduction (100% of cases, P ≤ 0.001), total number of field reduction (66% of cases, P ≤ 0.001), and reduction of patient mean dose (69% of cases, P ≤ 0.001) over ISOAUTO-based IMRT plans. The conformity index, homogeneity index and target mean dose were comparable between both group of plans. Conclusion: Significant dosimetrical advantages may be observed, when the geometric centroid of target volume is considered as isocenter of IMRT treatment plan.