PubMed · 3742579
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C W Zhang. 1986. [Sterilization by radiation].. https://pubmed.ncbi.nlm.nih.gov/3742579/
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OBJECTIVE: The volume of literature on radiation-induced caries is still inconsistent as regards the state of the art. Our histotomographic studies have shown direct radiogenic effects on the dentoenamel junction (atrophy of the odontoblast processes). Whether there are direct effects of radiation on dental enamel is not yet known. MATERIAL AND METHOD: Sound teeth (group 1, n = 10) were compared either with enamel specimens after high dose in vitro radiation (500-2500 Gy; group 2; n = 10) and after experimental enoral in situ irradiation (60 Gy; group 3; n = 20), or with teeth from patients after cancer radiotherapy (36 Gy; group 4; n = 20) and with teeth which had obviously decayed due to cancer radiotherapy (60 Gy; group 5; n = 20). Vestibular enamel surfaces of the teeth were exposed to identical in vitro demineralizations (lactic acid gel; pH = 5.0). Each of the samples was prospectively studied histologically by confocal laser scanning microscopy (CLSM) after 90, 180 and 270 min of acid interaction. Data were interpreted micromorphometrically (width of the demineralized area) and micromorphologically. RESULTS: The width of the demineralized area varies between the two in vivo irradiated groups of specimens (group 4: P < 0.01; group 5: P < 0.001) and the high dose in vitro irradiated teeth (P < 0.01) and is significantly different from the sound controls. The histological image of the demineralization in subsurface areas in the teeth of radiotherapy patients is characterized by a total loss of the prismatic structure (homogeneously, amorphous substance). CONCLUSIONS: Direct radiogenic effects at the dentoenamel junction have been described earlier. The additional information offered by this study is that there are significant micromorphometric differences in the demineralizing behaviour of irradiated enamel. Obviously, enamel is less resistant to acid attack after irradiation.
PURPOSE: In vivo dosimetry has been shown in a number of evaluation studies, generally carried out in larger academic centres, to be a reliable method of checking the overall treatment accuracy. The object of this study was to investigate whether it was possible and useful to perform in vivo dosimetry in a small radiotherapy department and to detect if there were any systematic errors in the overall treatment set-up. MATERIALS AND METHODS: All patients were treated on a cobalt-60 unit equipped with a verification system. Six hundred fifty entrance dose measurements were performed with silicon diodes. RESULTS: The analysis showed a mean deviation of -1.3%. This negative deviation was mainly due to the mean deviation obtained in the treatment of head and neck (-1.6%) or breast (-2.5%) cancer patients. The results for pelvic or lung irradiation showed almost no deviation (-0.8 to 0.43%). Further investigation showed that the negative values for head and neck or breast irradiation were due to the irradiation technique; the lack of scattering material causes a reduction of the dose at the reference point, which is not taken into consideration by the treatment planning system. By performing in vivo dosimetry, we were also able to detect two large errors in 650 measurements and could prevent erroneous treatment. CONCLUSION: Even when the overall treatment set-up is very accurate, in vivo dosimetry is very useful in a small department since only a small effort can detect and prevent errors.
The basic features of the convergent Co-60 gamma-ray unit, known as Gamma Knife and the standard procedures of treatment planning for various cases in general have been described in details. The new generation of the rotating gamma system and the future clinical applications are briefly mentioned.