[Radiotherapy after tumour prostheses-status, indication, coordination]. / Strahlentherapie nach Tumorendoprothesen ­ Stellenwert, Indikation, Koordination.

BACKGROUND: Patients with complex tumour prostheses often require radiotherapy or radiochemotherapy. OBJECTIVES: Possible tumour diagnoses, indications, planning and therapy procedures, and prognosis of radiotherapy in the context of an interdisciplinary treatment for bone sarcomas are reviewed, including interactions of metal prostheses with radiation and possible subsequent complications. METHODS: Literature search, summary of personal experience. RESULTS: Complex prosthetic procedures are usually applied to patients suffering from Ewing sarcoma or osteosarcoma. In patients with Ewing sarcoma, radiotherapy is an integral part of multimodal treatment, while in patients with osteosarcoma radiotherapy is indicated in special situations. Planning and implementation of radiotherapy treatment can be impaired by metal implants within the target volume (artefacts in the planning computerized tomography, interaction of metal with the therapeutic beam). However, it is-to our knowledge-a point of debate whether radiotherapy after implantation of a prosthesis could impair healing or prosthesis fixation to bone. The data available in the literature suggest that prostheses implanted after radiotherapy entail a higher rate of complications. Multidisciplinary treatment improves the prognosis for these patients markedly. CONCLUSIONS: Patients with sarcomas of the bone undergoing interdisciplinary treatment consisting of surgery, radiotherapy and chemotherapy have a favourable prognosis and an acceptable functionality of the limb can be expected.

Dosimetric properties and commissioning of cone-beam CT image beam line with a carbon target.

BACKGROUND AND PURPOSE: Accurate patient positioning before radiotherapy is often verified using advanced imaging techniques such as cone-beam computed tomography (CBCT). Even for dedicated imaging beam lines, the applied dose is not necessarily negligible with respect to the treatment dose and should be considered in the treatment plan. MATERIALS AND METHODS: This study presents measurements of the beam properties of the Siemens kView (Siemens AG, Munich, Germany) image beam line (IBL) and the commissioning in the Philips Pinnacle(3) treatment planning system (TPS; Philips, Amsterdam, Netherlands). RESULTS: The percent depth dose curve reaches its maximum at a depth of 10 mm, with a surface dose of 44 %. The IBL operates in flattening filter-free mode, showing the characteristic dose falloff from the central axis. Stability over several days to months is within less than 2 % dose deviation or 1 mm distance-to-agreement. Modelling of the IBL beam line was performed using the Pinnacle(3) automatic modelling routine, with absolute dosimetric verification and film measurements of the fluence distribution. CONCLUSION: After commissioning of the IBL beam model, the dose from the imaging IBL CBCT can be calculated. Even if the absolute dose deposited is small, repeated imaging doses may sum up to significant amounts and can shift the position of the dose maximum by several centimetres.

The vertical profile of winds on Titan.

One of Titan's most intriguing attributes is its copious but featureless atmosphere. The Voyager 1 fly-by and occultation in 1980 provided the first radial survey of Titan's atmospheric pressure and temperature and evidence for the presence of strong zonal winds. It was realized that the motion of an atmospheric probe could be used to study the winds, which led to the inclusion of the Doppler Wind Experiment on the Huygens probe. Here we report a high resolution vertical profile of Titan's winds, with an estimated accuracy of better than 1 m s(-1). The zonal winds were prograde during most of the atmospheric descent, providing in situ confirmation of superrotation on Titan. A layer with surprisingly slow wind, where the velocity decreased to near zero, was detected at altitudes between 60 and 100 km. Generally weak winds (approximately 1 m s(-1)) were seen in the lowest 5 km of descent.