Review of Leakage from a Linear Accelerator and Its Side Effects on Cancer Patients

Radiation therapy using external beam radiation therapy (EBRT) is playing an important role for effective treatment of all kinds of tumors. Peripheral dose is the result of leakage and scatter from multileaf collimators devices (MLCs), counts for 2-10% of the maximum dose given to the patient, depending on the machine used and type of treatment.

The present review reveals that despite of the recent advancements in linear accelerators (LINAC) and MLC design and technology, the remaining small amount of leakage (peripheral dose) of these devices still has significant side effects on patient’s life span and quality of life after treatment.

Based on the findings in this review, it is suggested that introduction of additional effective and patient-specific shielding techniques would have great impact on reducing risk of radiating healthy cells and hence adversely side effects on cancer patients.

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Quality of Life and Sexual Activity after Stereotactic Hypofractionated Radiotherapy of Prostate Cancer Patients

Quality of life (QoL) is an important factor for the cancer patients after treatment. The study aimed to investigate QoL and sexual activity in patients who had undergone stereotactic hypofractionated radiotherapy (HRT). Methods: The analysis included 82 prostate cancer patients: 40 patients treated by HRT (33.5 Gy in 5 fractions) and 42 patients treated by standard three-dimensional conformal radiation treatment 3DCRT (70-82 Gy in 35-41 fractions); and 50 healthy men without any type of cancer.

The subjects filled out the questionnaires: EORTC QLQC30 (version 3.0.) and the prostate cancer-specific EORTC QLQ-PR25. The median follow-up was 21 months for HRT patients and 28 months for 3DCRT patients. Results: The tolerance for stereotactic HRT was shown to be good. The QoL and the general health status of HRT patients were higher than of 3DCRT patients and even of healthy men. Most patients treated by HRT felt that they had lost their masculinity.

However, they were still interested in having sex; one third of them were sexually active, most reported satisfaction with their sex life. Conclusions: HRT for prostate cancer patients was an attractive treatment in relation to patients' QoL assessment in the short term analysis.

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Life and Sexual Activity

Prostate cancer is the most prevalent solid tumor diagnosed in men in developed countries. The standard treatment for early stage prostate cancer is surgery (prostatectomy) or radiotherapy. To improve local control, the radiation dose should be escalated.

Three dimensional conformal radiation treatment (3DCRT) increases local control rates while decreasing toxicity rates. Recent data suggest that, to achieve high local control of prostate cancer with acceptable toxicity, hypofractionated radiotherapy (HRT) could be used. Short-duration HRT  is an attractive option compared with a 7-to-8-week course of standard radiotherapy in terms of logistics; the patient’s job, daily activities, and emotions; the availability of accelerators, and the cost of prolonged treatment.

Quality of life (QoL) has become one of the most significant issues in treatment decisions in prostate cancer. In the case of QoL measurement after radical prostatectomy, brachytherapy, or external beam radiotherapy, all types of prostate cancer treatment were shown to be associated with changes in the QoL domains related to urinary, bowel, and sexual functions.

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