Dose verification of volumetric modulated arc therapy (VMAT) by use of in-treatment linac parameters.

Linac parameters such as the multi-leaf collimator (MLC) position and jaw position, cumulative monitor units (MUs), and the corresponding gantry angle were recorded during the clinical delivery of volumetric modulated arc therapy for prostate, lung, and head/neck cancer patients. Then, linac parameters were converted into the beam-data format used in the treatment planning system, and the dose distribution was reconstructed. The dose-volume histogram and the dose difference (DD) were compared with the corresponding values in the treatment plan. A reproducible error of in-treatment linac parameters was observed when a sudden change of beam intensity or MLC/jaw speed occurred. The maximum cumulative MU error was more than 4 MU for lung cancer cases, and the maximum MLC position exceeded 5 mm for prostate and head/neck cancer patients. However, these errors were quickly compensated for at the next control point. All treatments analyzed in the present study were delivered within 0.4% accuracy at the planning target volume. The cumulative dose agreed with that of the plan within 3% of the prescribed dose. The 1% DD was 93.9, 99.9, and 93.4% of the prescription dose for prostate, lung, and head/neck cancer patients, respectively.

Serial measurement of free light chain detects poor response to therapy early in three patients with multiple myeloma who have measurable M-proteins.

Free light chain (FLC) assays are important in the diagnosis and monitoring of patients with multiple myeloma (MM). Serum FLC concentrations also correlate with disease course in the majority of MM patients and have been incorporated into the new response criteria. Although baseline values of FLC are prognostic in newly diagnosed MM, serial measurement of serum FLC does not appear to be of greater value in patients who have measurable M-proteins by electrophoresis. We examined the kinetics of serum FLC in six patients with newly diagnosed MM during treatment with high-dose dexamethasone (HD-DEX) and bortezomib and dexamethasone. In some cases, the involved serum FLC increased in the latter part of each chemotherapy cycle before the start of the next cycle, especially in HD-DEX, suggesting that the response to these agents may be insufficient for induction therapy for MM. Earlier disease assessment by serum FLC assays may be of value in detecting poorly responding patients who require alternative forms of therapy.

Quality assurance of volumetric modulated arc therapy using Elekta Synergy.

PURPOSE. Recently, Elekta has supplied volumetric modulated arc therapy (VMAT) in which multi-leaf collimator (MLC) shape, jaw position, collimator angle, and gantry speed vary continuously during gantry rotation. A quality assurance procedure for VMAT delivery is described. METHODS AND MATERIALS. A single-arc VMAT plan with 73 control points (CPs) and 5-degree gantry angle spacing for a prostate cancer patient has been created by ERGO + + treatment planning system (TPS), where MLC shapes are given by anatomic relationship between a target and organs at risk and the monitor unit for each CP is optimized based on given dose prescriptions. Actual leaf and jaw positions, gantry angles and dose rates during prostate VMAT delivery were recorded in every 0.25 seconds, and the errors between planned and actual values were evaluated. The dose re-calculation using these recorded data has been performed and compared with the original TPS plan using the gamma index. RESULTS. Typical peak errors of gantry angles, leaf positions, and jaw positions were 3 degrees, 0.6 mm, and 1 mm, respectively. The dose distribution obtained by the TPS plan and the recalculated one agreed well under 2%-2 mm gamma index criteria. CONCLUSIONS. Quality assurance for prostate VMAT delivery has been performed with a satisfied result.

Cysteine-derived s-protected oxazolidinones: potential chemical devices for the preparation of peptide thioesters.

[reaction: see text]. An N-S acyl-transfer-mediated preparation of peptide thioesters using the S-protected oxazolidinone derived from cysteine has been developed and applied to the synthesis of a 32-mer biologically active peptide by native chemical ligation protocols.

New rapid enzyme-linked immunosorbent assay to detect antibodies against bacterial surface antigens using filtration plates.

An easy and rapid ELISA system, Filtration ELISA, to detect antibodies against bacterial cell surface antigens was developed using a 96-well filtration plate fitted with a 0.22microm membrane (MultiScreen-GV, Millipore). Bacterial whole cells were used as antigens without fixing the cells with formalin etc. The whole cell antigens were washed by vacuum filtration through a filter and resuspended in washing buffer. Assay reactions could be done in the wells without losing the solution. The technique was established using antisera of mice immunized with Escherichia coli, and then evaluated by assaying antibodies to Shiga-toxin producing E. coli O157:H7 (STEC), Staphylococcus aureus and Lactobacillus acidophilus in fecal extracts of 157 children who had eaten school lunches contaminated with STEC in comparison with 25 age-matched control children. The lunch group showed significantly higher IgA antibody titers against STEC than the control group (p<0.0005), but not against L. acidphilus. The results indicate that Filtration ELISA is a quantitative and specific technique for measuring antibodies against antigens on the surface of bacteria without extracting antigens from the bacteria. This technique is widely applicable to the assay of antibodies in various samples including serum and fecal extract against various kinds of bacteria.