_____________________________________________________________________________________________________Gy in 28 fractions.Plans were evaluated based on the ability to meet the dose volume histogram.The homogeneity index (HI), conformity index (CI) of target volume, the dose of organs at risk, radiation delivery time and monitor units were also compared.Paired T-test model analysis was used to analyse the two sets of data. Results:The results showing that postoperative endometrial carcinoma can be implemented CDR-CAS-IMAT plans on conventional Varian 23EX Linac for smoothly and quickly at busy cancer center.Comparing with the IMRT techonology CDR-CAS-IMAT plans can meet the clinical demand(see Figure1), gives comparable OAR and improved CI of PTV (see.Table 1), can reduction treatment time ((84.6±7.8)sVs. (422.7±46.7)s),MU((787.5±78.5)MUVs.(927.4±79.1)MU)and high dose irradiated volume; while increase the low dose irradiated volume of healthy tissues and the volume of the bladder and bowel irradiated 40 Gy and 30Gy, respectively.This point needs to pay attention to implementation in clinical.There were no significant differences in other statistical index.Conclusion: Endometrial carcinoma patients with CDR-CAS-IMAT on Varian Clinical 23IX can get equivalent or superior dose distribution compared with the IMRT technology.CDR-CAS-IMAT have much less treatment time and MU can reduce the uncertainty factor and patient discomfort in treatment.

Purpose: To validate the Acuros XB algorithm implemented in Eclipse Treatment planning system version 11 (Varian Medical System, Inc., Palo Alto, CA, USA) for photon dose calculation. Methods: Acuros XB is a Linear Boltzmann transport equation (LBTE) solver that solves LBTE equation explicitly and gives result equivalent to Monte Carlo. 6MV photon beam from Varian Clinac‐iX (2300CD) was used for dosimetric validation of Acuros XB. Percentage depth dose (PDD) and profiles (at dmax, 5, 10, 20 and 30 cm) measurements were performed in water for field size ranging from 2×2,4×4, 6×6, 10×10, 20×20, 30×30 and 40×40 cm 2 . Acuros XB results were compared against measurements and anisotropic analytical algorithm (AAA) algorithm. Results: Acuros XB result shows good agreement with measurements, and were comparable to AAA algorithm. Result for PDD and profiles shows less than one percent difference from measurements, and from calculated PDD and profiles by AAA algorithm for all field size. TPS calculated Gamma error histogram values, average gamma errors in PDD curves before dmax and after dmax were 0.28, 0.15 for Acuros XB and 0.24, 0.17 for AAA respectively, average gamma error in profile curves in central region, penumbra region and outside field region were 0.17, 0.21, 0.42 for Acuros XB and 0.10, 0.22, 0.35 for AAA respectively. Conclusion: The dosimetric validation of Acuros XB algorithms in water medium was satisfactory. Acuros XB algorithm has potential to perform photon dose calculation with high accuracy, which is more desirable for modern radiotherapy environment.

Purpose: To quantify the dosimetric accuracy of junction dose in double isocenter flattened and flatten filter free(FFF) intensity modulated radiation therapy(IMRT) and volumetric modulated arc therapy(VMAT) plan delivery using pelvis phantom. Methods: Five large field pelvis patients were selected for this study. Double isocenter IMRT and VMAT treatment plans were generated in Eclipse Treatment planning System (V.11.0) using 6MV FB and FFF beams. For all the plans same distance 17.0cm was kept between one isocenter to another isocenter. IMRT Plans were made with 7 coplanar fields and VMAT plans were made with full double arcs. Dose calculation was performed using AAA algorithms with dose grid size of 0.25 cm. Verification plans were calculated on Scanditronix Wellhofer pelvis slab phantom. Measurement point was selected and calculated, where two isocenter plan fields are overlapping, this measurement point was kept at distance 8.5cm from both isocenter. The plans were delivered using Varian TrueBeamTM machine on pelvis slab phantom. Point dose measurements was carried out using CC13 ion chamber volume of 0.13cm3. Results: The measured junction point dose are compared with TPS calculated dose. The mean difference observed was 4.5%, 6.0%, 4.0% and 7.0% for IMRT‐FB,IMRT‐FFF, VMAT‐FB and VMAT‐FFF respectively. The measured dose results shows closer agreement with calculated dose in Flatten beam planning in both IMRT and VMAT, whereas in FFF beam plan dose difference are more compared with flatten beam plan. Conclusion: Dosimetry accuracy of Large Field junction dose difference was found less in Flatten beam compared with FFF beam plan delivery. Even though more dosimetric studies are required to analyse junction dose for FFF beam planning using multiple point dose measurements and fluence map verification in field junction area.

ABSTRACT Lung cancer cells show both inherent and acquired resistance to chemotherapy. Epigenetics and miRNA are new mediators of response to anticancer agents. In the present study, we used an isogenic pair of lung adenocarcinoma cell lines; A549 (wild-type) and A549DOX11 (doxorubicin resistant) and two epigenetic modifiers (trichostatin A, TSA and 5-aza-2′-deoxycytidine, 5AZA) to study the role of epigenetics and miRNA in resistance of non-small cell lung cancer (NSCLC) cells to doxorubicin. Our results demonstrate differential expression of epigenetic markers whereby the level of HDACs 1, 2, 3 &4, DNA methyltransferase (DNMT1), acetylated H2B and acetylated H3 were lower in A549DOX11 compared to A549 cells. Fourteen miRNAs were dys-regulated in A549DOX11 cells compared to A549 cells. This was associated with reduced apoptosis and higher resistance of A549DOX11cells to doxorubicin and etoposide than A549 cells. Sequential treatment with TSA/5AZA followed by doxorubicin resulted in : (i) enhanced sensitivity of A549DOX11 cells to doxorubicin more than A549 especially at low concentrations, (ii) enhanced doxorubicin-induced DNA damage in both cell lines, (iii) dysregulation of some miRNAs in A549 cells. In conclusion, A549DOX11 cells resistant to DNA damaging drugs have epigenetic profile and miRNA expression different from the sensitive cells. Moreover, epigenetic modifiers may reverse the resistance of certain NSCLC cells to DNA damaging agents by enhancing their ability to induce DNA damage. This may open the door for using epigenetic profile/miRNA expression of some cancer cells as markers for response to doxorubicin and the use of combination doxorubicin/epigenetic modifiers to reduce doxorubicin toxicity.

Lung cancer cells show both inherent and acquired resistance to chemotherapy. Epigenetics and miRNA are new mediators of response to anticancer agents. In the present study, we used an isogenic pair of lung adenocarcinoma cell lines; A549 (wild-type) and A549DOX11 (doxorubicin resistant) and two epigenetic modifiers (trichostatin A, TSA and 5-aza-2′-deoxycytidine, 5AZA) to study the role of epigenetics and miRNA in resistance of non-small cell lung cancer (NSCLC) cells to doxorubicin. Our results demonstrate differential expression of epigenetic markers whereby the level of HDACs 1, 2, 3 &4, DNA methyltransferase (DNMT1), acetylated H2B and acetylated H3 were lower in A549DOX11 compared to A549 cells. Fourteen miRNAs were dys-regulated in A549DOX11 cells compared to A549 cells. This was associated with reduced apoptosis and higher resistance of A549DOX11cells to doxorubicin and etoposide than A549 cells. Sequential treatment with TSA/5AZA followed by doxorubicin resulted in : (i) enhanced sensitivity of A549DOX11 cells to doxorubicin more than A549 especially at low concentrations, (ii) enhanced doxorubicin-induced DNA damage in both cell lines, (iii) dysregulation of some miRNAs in A549 cells. In conclusion, A549DOX11 cells resistant to DNA damaging drugs have epigenetic profile and miRNA expression different from the sensitive cells. Moreover, epigenetic modifiers may reverse the resistance of certain NSCLC cells to DNA damaging agents by enhancing their ability to induce DNA damage.

9140 Background: Symptoms secondary to hormone changes significantly impact QoL in cancer patients. This cross-sectional study examines prevalence of hypogonadism and its correlation with symptoms. Methods: Serum, demographic variables, and medical histories were collected from 428 male HIC subjects at 3 diverse cancer centers. Morning blood samples were analyzed for Total Testosterone (TT), Free T (FT), Bio-available T (BAT), and Sex Hormone Binding Globulin. Functional Assessment of Cancer Therapy-Prostate (FACT-P) QoL questionnaire was used to measure physical, social, emotional and functional domains plus sexual function. Exclusion criteria: men <18 yrs, prostate cancer (ca), testicular ca, male breast ca, known hypogonadism, and HIV. Results: Mean and median TT was 337.46 and 310 ng/dl (interquartile range: 190-443). Mean age of subjects was 62.05±13.17 years. The Table summarizes the study results. The crude prevalence of hypogonadism (defined as TT<300ng/dl) was 48% (95%CI, 43-53%). The prevalence (95% CI) based on FT (hypogonadal <52pg/dl) and BAT (hypogonadal <95ng/dl for men <70 years of age and <60 ng/dl for men 70 and older) were 78% (73-82%) and 66% (61-70%), respectively. Hypogonadal subjects had decreased Total QoL score on FACT-P (p=0.01) and decreased 3 item sexual function subset (p=0.003) (Satisfaction with sex life, erectile function, “I feel like a man”). Conclusions: The prevalence of hypogonadism is unexpectedly high. Confirming previous studies, measurement of FT or BAT detected a higher prevalence of hypogonadism than TT alone. Comparison with the FACT-P shows significant reduction of both overall QoL and sexual function for hypogonadal men. A placebo-controlled T replacement trial could explore improvement of overall QoL and sexual function in hypogonadal male cancer patients. Mean ± SEM TT ng/dl FT pg/ml BAT ng/dl FACT-Ptotal score FACT-P sexual function score Eugonadal (n = 211) 487.1 ± 11.62 50.3 ± 1.48 93.6 ± 2.8 79.8 ± 1.13 9.6 ± 0.31 Hypogonadal (n = 196) 176.3 ± 6.00 24.7 ± 1.09 45.1 ± 2.2 75.6 ± 1.23 8.3 ± 0.30 P value <0.001 <0.001 <0.001 0.01 0.003 No significant financial relationships to disclose.

An acoustic pulse echo scheme for non-intrusive detection of flaws in metal pipelines has been investigated in the laboratory. The primary pulse is generated by a pulsed magnetic field enclosing a short section of a free pipe. The detection is by an electrostatic detector surrounding a short section of the pipe. Reflected pulses from thin areas, with a longitudinal extension of about one pipe radius and a reduction of the wall thickness of 40%, can be detected clearly.