Preliminary pre-clinical studies on the side effects of breast cancer treatment.

Purpose: Technological advancement in the treatment of cancer together with early detection and diagnosis have considerably improved the survival of breast cancer patients. On the other hand, the potential of patients developing side effects from cancer treatment are not negligible. Despite the progress that has been made in terms of early diagnosis, therapy, and survival, including improvements in the chemotherapeutic agents, radiation and molecular targeted therapies, cardiotoxicity of cancer therapy is still cause for concern. Radiation therapy for breast cancer is associated with increased risk of heart disease and myocardial infarction. Furthermore, the association of radiation therapy to chemotherapy is an important aspect to be considered in the development of cardiac disease, as this could play an additional role as a risk factor. Besides the heart effect, other side effects can be observed in the bone, ovary, uteri, and other organs. This paper aims to review the recent literature to present the current understanding of side effects associated with breast cancer treatment. The focus is on recent preclinical studies that have assessed potential changes in different organs that may be injured after breast cancer treatment, both due to both radiation and chemotherapy agents.Conclusion: Radiation-induced heart disease is one important side effect that must be considered during the treatment planning and patient follow-up. The cardiac damage can be potentialized when chemotherapy is associated to radiotherapy, and the literature findings indicate that heart fibrosis plays an important role at the radio-chemotherapy induced cardiac damage. Literature findings also showed important side effects at the bone, that can lead to ospeoporosis, due to the decrease of calcium, after radio or chemotherapy treatments. This decrease could be explained by the ovarian failure observed at rats after chemotherapy treatment. It is of great importance to acknowledge the complications originating from the treatment, so that new strategies can be developed. In this way, it will be possible to minimize side effects and improve the patients' quality of life.

A pilot study of a postal dosimetry system using the Fricke dosimeter for research irradiators.

Cobalt-60 irradiators and soft X-ray machines are frequently used for research purposes, but the dosimetry is not always performed using the recommended protocols. This may lead to confusing and untrustworthy results within the conducted research. Postal dosimetry systems have already been approved by the IAEA, with thermoluminescence dosimeters (TLD) and optically stimulated luminescence (OSL) as the most commonly used dosimeter systems in these cases. The present study tests the Fricke dosimeter properties as a potential system to be used in postal dosimetry for a project using research irradiators. The Fricke solution was prepared according to the literature, and the linearity and fading tests were performed accordingly. All calculated doses were measured using a NE2571 Farmer ionization chamber as a reference. Doses ranging from 25 to 300 Gy were delivered by a research irradiator, with 150 kV and 22 mA to the Fricke solutions inside polyethylene (PE) bags (4 × 4 × 0.2 cm3). The results compared with the ionization chamber showed a linear response to the range of doses used. Fading tests showed no significant difference for the absorbed doses over 9 days, with a maximum difference of 1.5% found between days 0 and 3. The Fricke dosimeter presented good linearity, for low and high doses, and low uncertainties for the fading even for 9 days after irradiation. These preliminary results are motivating, and as the next step, we intend to design a postal dosimetry system using the PE bags of Fricke solution.

Technical Note: Fricke dosimetry for blood irradiators.

PURPOSE: The Fricke dosimeter has been shown to be a viable option as an absorbed dose standard. This work aims to provide the dose distribution in an irradiator container during blood irradiation using Fricke dosimetry. METHODS: Measurements were performed using a Gammacell Elan 3000 blood irradiator at Hemocenter in Rio de Janeiro, Brazil. A specific phantom was constructed and patented by the authors to perform these measurements. Fricke solution was prepared according to international protocols, and polyethylene bags filled with Fricke solution (n = 19) were spatially distributed within the phantom. Control bags were also submitted to the same process, except the irradiation. The irradiation time was calculated to give 25.7 Gy to the central portion of the phantom, the same dose used for blood bags. RESULTS: Encouraging results were obtained with an overall uncertainty of 2.1% (k = 1). The obtained results were compared with the doses calculated by the physicist from Hemocenter based on parameters provided by the manufacturer. The mean dose delivered to the Fricke bag in the center of the phantom (cavity 2) was 28.7 ± 0.5 Gy, which is 12% higher than the planned dose of 25.7 Gy. CONCLUSIONS: The obtained results showed that the setup (Fricke and phantom) is able to perform dosimetry for blood irradiators. The delivered dose was higher than expected. This highlights the importance in controlling all the parameters during irradiation to ensure the correct dose for all irradiated bags.

Determination of the absorbed dose to water for medium-energy x-ray beams using Fricke dosimetry.

PURPOSE: For x-ray beams in the low and medium energy range, reference dosimetry is established in terms of air kerma. Fricke dosimetry has shown great potential in the absolute measurements of the absorbed dose to water for high-energy ranges. Therefore, the main purpose of this work was to compare the absorbed dose to water for medium-energy x-ray beams obtained through Fricke dosimetry with that obtained from the air kerma rate. METHODS: To determine the absorbed dose to water using Fricke dosimetry, the polyethylene bags methodology was chosen. Fricke solution was irradiated at four different beam qualities. The absorbed dose to water values obtained using Fricke dosimetry were compared to those obtained using the standard protocol, using the Z-score. RESULTS: Values of the Z-score were <2 for all measurements of absorbed dose to water, which means that the values obtained using Fricke dosimetry are equivalent to those obtained using the reference protocol. The combined standard uncertainty for the absorbed dose to water obtained by Fricke dosimetry was lower than that obtained with the ionization chamber. CONCLUSIONS: Chemical dosimetry using a standard FeSO4 solution has been demonstrated to be a potential option as a standard for the quantity absorbed dose to water for medium kV x-ray qualities.

Feasibility study of the Fricke chemical dosimeter as an independent dosimetric system for the small animal radiation research platform (SARRP).

For the small animal radiation research platform (SARRP) with X-ray beams in the medium energy range (tube operating voltage at 220 kVp), reference dosimetry is based on the AAPM TG-61 recommendations following the in-phantom method. The objective of this study was to evaluate the feasibility of the Fricke solution as a dosimeter to determine the absorbed dose to water. Feasibility studies at this X-ray energy range are not widely available. We evaluated the accuracy, dose linearity and dose rate dependence in a comparison with an NE 2571 Farmer ionization chamber (IC) and measurements in water. The G(Fe3+) factor was calculated from the curve fitting of the chemical yields for two radioactive sources (192Ir and 60Co) and one X-ray system with a tube operating at 150 and 250 kVp. The same methodology was followed for the dependence of the G(Fe3+) value on the energy and the dose agreement assessment for 180 and 200 kVp in the SARRP. The Fricke system exhibits a good linear response over the range of 5-70 Gy and an accuracy better than 2% for a 2 Gy/min dose rate. The dose rate dependence is smaller than 1% for dose rates greater than 1 Gy/min. The dependence of the G(Fe3+) value on the energy is smaller than 0.41%, with dose agreements better than 2%. The feasibility of the dosimeter for measurements at high doses and high dose rates makes it a suitable tool for dosimetric verifications in several preclinical irradiation configurations.

Effects of soft X-ray radiation damage on paraffin-embedded rat tissues supported on ultralene: a chemical perspective.

Radiation damage is an important aspect to be considered when analysing biological samples with X-ray techniques as it can induce chemical and structural changes in the specimens. This work aims to provide new insights into the soft X-ray induced radiation damage of the complete sample, including not only the biological tissue itself but also the substrate and embedding medium, and the tissue fixation procedure. Sample preparation and handling involves an unavoidable interaction with the sample matrix and could play an important role in the radiation-damage mechanism. To understand the influence of sample preparation and handling on radiation damage, the effects of soft X-ray exposure at different doses on ultralene, paraffin and on paraffin-embedded rat tissues were studied using Fourier-transform infrared (FTIR) microspectroscopy and X-ray microscopy. Tissues were preserved with three different commonly used fixatives: formalin, glutaraldehyde and Karnovsky. FTIR results showed that ultralene and paraffin undergo a dose-dependent degradation of their vibrational profiles, consistent with radiation-induced oxidative damage. In addition, formalin fixative has been shown to improve the preservation of the secondary structure of proteins in tissues compared with both glutaraldehyde and Karnovsky fixation. However, conclusive considerations cannot be drawn on the optimal fixation protocol because of the interference introduced by both substrate and embedding medium in the spectral regions specific to tissue lipids, nucleic acids and carbohydrates. Notably, despite the detected alterations affecting the chemical architecture of the sample as a whole, composed of tissue, substrate and embedding medium, the structural morphology of the tissues at the micrometre scale is essentially preserved even at the highest exposure dose.