Introduction: In radiotherapy, the bolus is often used while treating the tumor under the uneven surfaces of the patients for correcting the anatomical irregularities and increasing skin dose. Wet cotton and wet gauze are still used in developing countries, since the use of wet cotton and wet gauze has certain disadvantages, there is a need for transparent bolus which should be similar to a universally accepted bolus in terms of properties with a lower cost (50% less expensive). Material and Methods: The present study was conducted to investigate the characteristics of transparent bolus (Senflab) material, such as transmission factor, percentage depth dose (PDD), stability over time and high dose, homogeneity and transparency using 6 and 15 MV photons beam and 12, 15, and 18 MeV electrons beam. Moreover, the new bolus material was compared with those of the commercially available Superflab and RW3 slab. Results: The percentage difference in the transmission factor of Senflab was less than ± 1. 9%, compared with Superflab and RW3. For PDD, the percentage difference was ± 2. 88% and ± 1. 26% for photons and electron beams, respectively. The performance of bolus remained constant both physically and dosimetrically after higher dose exposure. The percentage standard deviation was 0. 0002% for a period of one month, and 0. 0003% for the homogeneity. The transparency of the bolus material was good enough to display the set radiation treatment field. Conclusion: This study shows the suitability of the new bolus for routine use in radiotherapy.

Background: Intraoperative radiotherapy (IORT) within breast conserving surgery (BCS) is progressively utilized to deliver the optimal dose of radiotherapy immediately after the excision of cancer during the same operation to the well-vascularized tissue and to the margin of resected cancer to damage the cancer cells, which might remain nearby the tumor just on time without no delay as radical irradiation for particular cases or as boost dose for others. Methods: This study reports 54-month single-center experiences after introduction to deliver IORT (50 kV x-ray) as a tumor bed boost in BCS for breast cancer and comparison with External beam radiation therapy (EBRT). In this retrospective study, 255 patients (stages 1-3) with breast cancer were treated with BCS and IORT in the Cancer Research Center, Shahid Beheshti University of Medical Sciences (April 2014-September 2018). They received 20 Gy IORT as a boost compared with 321 patients in the same stages with EBRT. Results: Within 54 months, there were 3 (1. 2%) occurrences of local recurrence in IORT patients compared with 8 (2. 5%) local recurrences in EBRT patients (P = 0. 361) and 12 (4. 7%) metastasis in the IORT group vs. 20 (6. 2%) in the EBRT group (P = 0. 724). The 5-year disease-free survival (DFS) was 85. 1% in the IORT group compared with 86% in the EBRT group. Conclusions: IORT tumor bed boost with 50 kV x-ray during breast conserving therapy had a better outcome, but it was not significant compared with EBRT.

Ophthalmomyiasis is pathology of eye due to presence of fly larva, which rarely occurs in the world, and most cases has been reported in developing countries. These days incidence of Ophthalmomyiasis has been decreased in Iran. Most cases of Ophthalmomyiasis caused by presence of fly Larvae Oestrus Ovis.In summer 2011, a fourty year old rural woman with a good hygine presented to Ophthalmology department of Rouhani Hospital. She had no background of any disease.After physical examination External Ophthalmomyiasis was diagnosed. all seven larva has been removed, Topical antibiotic and corticosteroid were prescribed for daily use. Two days later in follow up the eye was asymptomatic.

Background: Breast conserving surgery (BCS) and its following radiotherapy is an accepted therapeutic method for patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC). Objectives: The aim of this study was to investigate the effect of intraoperative electron radiotherapy on women with breast cancer (invasive lobular and ductal carcinoma). Methods: Between August 2013 and September 2017, 968 patients, who were referred to Cancer Research Center, Shahid Beheshti University of Medical Sciences with invasive breast cancer, were treated with breast-conserving surgery and radiotherapy. Of those, 426 patients received a tumor bed boost with intraoperative electron radiotherapy (IOERT) during lumpectomy (58 patients with pure invasive lobular carcinoma, 239 patients with pure invasive ductal carcinoma, and 129 patients with other diagnoses). 542 patients received a tumor bed boost with conventional External beam radiotherapy post lumpectomy (24 patients with pure invasive lobular carcinoma, 418 patients with pure invasive ductal carcinoma, and 100 patients with other diagnoses). The patients were followed up to 49 months. A comprehensive list of clinical and pathologic features was evaluated for all patients. We retrospectively analyzed outcomes of breast cancer treated with boost intraoperative electron radiotherapy (pure ILC and IDC groups) and in other group treated with boost conventional External beam radiotherapy (pure ILC group). Results: None of the ILC patients had recurrence in the two groups. The four-year survival rate for ILC patients was 100%, but in the IDC group the survival rate was 97%. Survival analyses showed patients with IDC had a higher risk of ipsilateral breast tumor recurrence (IBTR) and metastasis. Conclusions: Overall, the rates of IBTR and metastasis in the ILC boost IOERT group were significantly low. This finding suggests that IOERT technique deployment in ILC had no inferiority compared with the control group.

Introduction: Tumor motion is a challenging issue in radiotherapy, which complicates the process of tumor delineation, localization, and dose delivery. External surrogate radiotherapy is one of the available strategies that provides motion dataset for a consistent prediction model to track tumor motion using internal-External markers. Regarding this, the present study was conducted to investigate the effect of implanted fiducial on 3D uniform dose distribution. Material and Methods: For the purpose of the study, a Monte Carlo code was utilized to simulate clip with different dimensions and material structures against four therapeutic beams. Moreover, a combinational clip made of golden and covered by polymethyl methacrylate (PMMA) was proposed to be used with lower dose perturbation. Finally, it was proposed to implant a clip outside tumor volume at specific distances from tumor site to keep dose uniformity on tumor volume. To investigate this issue, the correlation coefficient parameter was calculated as the metric among the motion dataset of tumor and clip. Results: Based on the results, dose perturbation caused by implanted clip was remarkable at hadron therapy depending on its size and material, mainly at the downstream part of the clip. Conclusion: As the findings indicated, the golden marker covered with PMMA could remarkably reduce dose perturbation. The most important concern in this domain is the presence of a possible correlation between tumor motion and motion of the clip implanted outside the tumor volume. The results of the correlation coefficient revealed a close relationship between tumor motion and clip motion.

While surgical resection of the primary tumour and regional nodes is part of the standard algorithm for the treatment of early-stage invasive breast carcinomas, not all patients are surgical candidates or agree for surgery. This case report is about one such patient who refused surgery for a biopsy confirmed in the 7th edition of the tumour, nodes, metastases (TNM) Classification System (TNM7) T2N1M0 left breast infiltrative ductal carcinoma with estrogen receptor/ progesterone receptor positive and human epidermal growth factor receptor 2 negative for personal reasons.A 39-year-old lady presented with left breast mass at upper outer quadrant, which confirmed to be infiltrative ductal carcinoma with Luminal A sub-type from the biopsy report. Despite the early stage of breast cancer, she refused for surgery because of personal reasons. Therefore, she underwent 12 cycles of chemotherapy followed by radiotherapy to the left breast and regional nodes to a dose of 50 Gy in 25 fractions (fx) and further high dose rate (HDR) brachytherapy boost of 16 Gy in 1 fx to the 2.0 × 2.0 cm residual lesion. After the completion of the treatment, the patient was on 20 mg tablet Tamoxifen daily.During follow-up, there was a residual fibrotic lesion in the left breast from the computed tomography scan, and there was a doubt on the nature of the lesion. Thus, the patient was subjected to excision of the lesion and regional nodes, which showed a pathological complete response of three years after the completion of HDR brachytherapy. While surgery is the standard of care, this case report shows that definitive HDR brachytherapy has a role in patients not suitable for surgery.