The aim of this study was to compare open asymmetric field-in-field (FIF) to physical wedge for compensation of dose inhomogeneity in tangential whole breast irradiation. Patients and Methods: Ten consecutive patients had undergone breast conserving surgery followed by whole breast irradiation were considered. Two 3D treatment plans were generated for each patient using: physical wedge and FIF techniques. For both plans, the doses to 2% (D2) and 98% (D98) of the planning target volume (PTV), as well as PTV95%, PTV97-103%, and PTV>107% of the prescribed dose were used to evaluate the effect on dose homogeneity. The evaluation of organ at risk (OAR) carried out by comparing volumes received over 40% of dose (17Gy) in the ipsilateral lung, 80% of dose (34Gy) in the heart, and mean dose of contralateral lung. Also, the average total monitor units (MU) for both were compared. Results: The FIF technique was better than physical wedged technique in terms of D2, D98, PTV>107%. FIF technique achieved 8.1% dose improvement index compared to physical wedges technique and 34% reduction in the mean monitor units as it reported 470 MU and 310 MU for physical wedges and FIF technique respectively. The differences between the two techniques were insignificant regarding the OAR. FIF can save up to 219 seconds compared to tangential wedged field. Conclusion: Asymmetric FIF technique improves PTV conformity without compromising OAR. It also reduces treatment time and hence can replace physical wedge, especially in busy departments.

The aim of this study was to compare open asymmetric field-in-field (FIF) to physical wedge for compensation of dose inhomogeneity in tangential whole breast irradiation. Patients and Methods: Ten consecutive patients had undergone breast conserving surgery followed by whole breast irradiation were considered. Two 3D treatment plans were generated for each patient using: physical wedge and FIF techniques. For both plans, the doses to 2% (D2) and 98% (D98) of the planning target volume (PTV), as well as PTV95%, PTV97-103%, and PTV>107% of the prescribed dose were used to evaluate the effect on dose homogeneity. The evaluation of organ at risk (OAR) carried out by comparing volumes received over 40% of dose (17Gy) in the ipsilateral lung, 80% of dose (34Gy) in the heart, and mean dose of contralateral lung. Also, the average total monitor units (MU) for both were compared. Results: The FIF technique was better than physical wedged technique in terms of D2, D98, PTV>107%. FIF technique achieved 8.1% dose improvement index compared to physical wedges technique and 34% reduction in the mean monitor units as it reported 470 MU and 310 MU for physical wedges and FIF technique respectively. The differences between the two techniques were insignificant regarding the OAR. FIF can save up to 219 seconds compared to tangential wedged field. Conclusion: Asymmetric FIF technique improves PTV conformity without compromising OAR. It also reduces treatment time and hence can replace physical wedge, especially in busy departments.

Linear accelerators with x-ray collimators that move independently are becoming increasingly common for treatment with asymmetric fields. In this paper we present a simplified approach to the calculation of dose for asymmetric fields. A method is described for calculating the beam profiles, depth doses and output factors for asymmetric fields of radiation produced by linear accelerators (siemens mevatron M2) with independent jaws. Values are calculated from data measured for symmetric fields. Symmetric field data are modified using opened off-axis factors (OAFs) and primary off-centre ratios (POCRs) which are obtained from in air measurements of the largest possible opened field. Beam hardening occurring within the flattening filter is taken into account using of attenuation coefficients for opened field and used to generate the opened POCR at different depths. A full investigation to compare measured and calculated profiles demonstrates favorable agreement

Linear accelerators with x-ray collimators that move independently are becoming increasingly common for treatment with asymmetric fields. In this paper we present a simplified approach to the calculation of dose for asymmetric fields. A method is described for calculating the beam profiles, depth doses and output factors for asymmetric fields of radiation produced by linear accelerators (siemens mevatron M2) with independent jaws. Values are calculated from data measured for symmetric fields. Symmetric field data are modified using opened off-axis factors (OAFs) and primary off-centre ratios (POCRs) which are obtained from in air measurements of the largest possible opened field. Beam hardening occurring within the flattening filter is taken into account using of attenuation coefficients for opened field and used to generate the opened POCR at different depths. A full investigation to compare measured and calculated profiles demonstrates favorable agreement

Linear accelerators with x-ray collimators that move independently are becoming increasingly common for treatment with asymmetric fields. In this paper we present a simplified approach to the calculation of dose for asymmetric fields. A method is described for calculating the beam profiles, depth doses and output factors for asymmetric fields of radiation produced by linear accelerators (siemens mevatron M2) with independent jaws. Values are calculated from data measured for symmetric fields. Symmetric field data are modified using opened off-axis factors (OAFs) and primary off-centre ratios (POCRs) which are obtained from in air measurements of the largest possible opened field. Beam hardening occurring within the flattening filter is taken into account using of attenuation coefficients for opened field and used to generate the opened POCR at different depths. A full investigation to compare measured and calculated profiles demonstrates favorable agreement

The filed shape must be frequently treated in terms of shielding block choices in man clinical applications of electron beam therapy. Because of the difficult of measuring the output factors for individual rectangular electron beam field for each patient, it is necessary to know the output factors for rectangular field size electron beam fields to accurately deliver the prescribed dose to the target. The output factors for rectangular fields have been found that the equivalent area technique generally used in X-ray treatment can be utilized reasonably well to predict the output factors for rectangular electron fiel

The filed shape must be frequently treated in terms of shielding block choices in man clinical applications of electron beam therapy. Because of the difficult of measuring the output factors for individual rectangular electron beam field for each patient, it is necessary to know the output factors for rectangular field size electron beam fields to accurately deliver the prescribed dose to the target. The output factors for rectangular fields have been found that the equivalent area technique generally used in X-ray treatment can be utilized reasonably well to predict the output factors for rectangular electron fiel

Background: Controversy exists over the extent of surgical treatment of papillary thyroid cancer.Reoperations may carry a significant risk of surgical complications. The aim of this study is to investigate the complications following surgical treatment of thyroid cancer and the association between the extent of surgery and complication rates. Methods: A total of 196 patients with papillary thyroid cancer were retrospectively reviewed to identify extent of surgery and associated complications, between 2009 and 2018 atSouth Egypt Cancer Institute Assiut University. Results: Primary procedures included less-than-total thyroidectomy (near total thyroidectomy in 5.1%, subtotal thyroidectomy in 4.1%, thyroid lobectomy in 3.1%) and total thyroidectomy in 87.8% (18.9% of them are completion thyroidectomy). No lymph nodes dissection was done in 10.7%, Berry picking in 6.1%, central compartment neck dissection in 41.8%, central compartment neck dissection with modified ipsilateral radical neck dissection in 12.2%, central compartment neck dissection with modified bilateral radical neck dissection in 26.0%, central compartment dissection with both modified bilateral radical neck dissection and superior mediastinal lymph node dissection 3.1%. The most common surgical complication were transient hypoparathyroidism (16.7% - 45.8%) and 2.0% permanent, transient vocal cord palsy (7.3% - 16.7%), and 3.9% permanent, hematoma 1.5%, seroma 7.1% and chyle fistula in 2.6% of patients. Conclusion: Thyroid cancer surgeries are safe. The transient complication rates of hypoparathyroidism increased significantly with increasing the extent of surgery.

Background: Controversy exists over the extent of surgical treatment of papillary thyroid cancer.Reoperations may carry a significant risk of surgical complications. The aim of this study is to investigate the complications following surgical treatment of thyroid cancer and the association between the extent of surgery and complication rates. Methods: A total of 196 patients with papillary thyroid cancer were retrospectively reviewed to identify extent of surgery and associated complications, between 2009 and 2018 atSouth Egypt Cancer Institute Assiut University. Results: Primary procedures included less-than-total thyroidectomy (near total thyroidectomy in 5.1%, subtotal thyroidectomy in 4.1%, thyroid lobectomy in 3.1%) and total thyroidectomy in 87.8% (18.9% of them are completion thyroidectomy). No lymph nodes dissection was done in 10.7%, Berry picking in 6.1%, central compartment neck dissection in 41.8%, central compartment neck dissection with modified ipsilateral radical neck dissection in 12.2%, central compartment neck dissection with modified bilateral radical neck dissection in 26.0%, central compartment dissection with both modified bilateral radical neck dissection and superior mediastinal lymph node dissection 3.1%. The most common surgical complication were transient hypoparathyroidism (16.7% - 45.8%) and 2.0% permanent, transient vocal cord palsy (7.3% - 16.7%), and 3.9% permanent, hematoma 1.5%, seroma 7.1% and chyle fistula in 2.6% of patients. Conclusion: Thyroid cancer surgeries are safe. The transient complication rates of hypoparathyroidism increased significantly with increasing the extent of surgery.

Background: Controversy exists over the extent of surgical treatment of papillary thyroid cancer.Reoperations may carry a significant risk of surgical complications. The aim of this study is to investigate the complications following surgical treatment of thyroid cancer and the association between the extent of surgery and complication rates. Methods: A total of 196 patients with papillary thyroid cancer were retrospectively reviewed to identify extent of surgery and associated complications, between 2009 and 2018 atSouth Egypt Cancer Institute Assiut University. Results: Primary procedures included less-than-total thyroidectomy (near total thyroidectomy in 5.1%, subtotal thyroidectomy in 4.1%, thyroid lobectomy in 3.1%) and total thyroidectomy in 87.8% (18.9% of them are completion thyroidectomy). No lymph nodes dissection was done in 10.7%, Berry picking in 6.1%, central compartment neck dissection in 41.8%, central compartment neck dissection with modified ipsilateral radical neck dissection in 12.2%, central compartment neck dissection with modified bilateral radical neck dissection in 26.0%, central compartment dissection with both modified bilateral radical neck dissection and superior mediastinal lymph node dissection 3.1%. The most common surgical complication were transient hypoparathyroidism (16.7% - 45.8%) and 2.0% permanent, transient vocal cord palsy (7.3% - 16.7%), and 3.9% permanent, hematoma 1.5%, seroma 7.1% and chyle fistula in 2.6% of patients. Conclusion: Thyroid cancer surgeries are safe. The transient complication rates of hypoparathyroidism increased significantly with increasing the extent of surgery.