Treatment of facial cutaneous carcinoma with high-dose rate contact brachytherapy with customized molds.
ABSTRACT The main treatment given for initial stage facial epitheliomas is surgery, although there are alternatives. We present our results with Ir-192 high-dose rate (HDR) contact brachytherapy.
Fifty-one epitheliomas, with a mean size of 1.5 cm and a maximum thickness of 3mm, were treated with HDR contact brachytherapy by means of customized molds, with plastic tubes on bolus for flat surfaces and on wax molds for the nose. A total dose of 48-57 Gy, 3-4 Gy/fraction three times a week, was administered.
After a median followup of 45 months, five tumors relapsed (9.8%), four of them on the tip of the nose. The 5-year actuarial local control rate was 89%, 100% for flat surfaces, and 83% for the nose. All of them were salvaged with surgery. The treatment was well tolerated, 21.6% developed severe acute toxicity, with good or very good late cosmetic results.
HDR contact brachytherapy is a good alternative to treat facial epitheliomas with a maximum thickness of 3mm. Tip of the nose tumors are not well covered with this technique and a different procedure is required.
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ABSTRACT: In this paper, an exact solution for the diffraction of short-crested waves incident on a circular cylinder is presented. The pressure distribution and water run-up on the cylinder was found to be quite different from those of plane incident waves. The total force exerted on the cylinder in the direction of the wave propagation was found to be smaller compared to that induced by plane waves with the same wave number in the direction of the wave propagation. The total wave load increases as the wave number in the direction perpendicular to the direction of the wave propagation increases, or as the incident waves become shorter. These results show that if the wave loading is calculated, as a design criterion, according to plane incident waves, it will be over-estimated when the incident waves are short-crested. However, from the safety point of view, the wave loading formula derived from a plane incident wave may still serve as a good engineering design criterion.Ocean Engineering. 01/1993;
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ABSTRACT: A wave prediction system was implemented and tested in Madeira Archipelago. It is based on two state-of-the-art spectral phase averaging wave models, WAM and SWAN. Ocean-scale simulations, covering almost the entire North Atlantic basin with WAM, provide the boundary conditions for the archipelago. Three levels of SWAN simulations were successively connected to the generation area. For the first level spherical coordinates were still maintained whereas, in order to account better for some coastal processes, the simulations in the second and third levels were performed using the Cartesian coordinates. For the last two computational levels a detailed spatial analysis was carried out. This was focused on the effects of diffraction and triad nonlinear interactions emphasizing the influences induced in the model results when increasing the spatial resolution. The first targets of the analysis were the most energetic cases but, as a further step, wave patterns corresponding to average energetic conditions were also discussed. Two buoys located south of Madeira Island were considered to validate the model system for two winter periods (1997–1998 and 2000–2001) giving a total of about 8 months of simulations. In terms of significant wave heights the system is able to provide accurate results while for the mean periods and directions, the predictions still follow the main wave patterns although the agreement is of lower quality. Comparisons with the results provided by a similar scheme in the Portuguese continental nearshore have been also performed.Ocean Engineering 01/2008; 35(13):1357-1371. · 1.16 Impact Factor
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ABSTRACT: The paper describes results from experimental runs with a version of the WAM Cycle 4 computer model, run operationally at the Norwegian Meteorological Institute. The question to answer is how high waves may become in weather conditions that are extreme, but plausible in a meteorological sense. Results focus on 2 sites: the Northern North Sea under southerly wind conditions and Haltenbanken under southwesterly conditions. For the North Sea site, the selected approach was to reduce the low pressure over UK in a severe southerly condition and intensify the high pressure over Scandinavia/Northern Europe. For Haltenbanken, experiments were run with deepened low pressure and changing speed of propagation of the low. The study shows that the worst scenarios can produce significant wave heights of a severity being comparable to sea states being predicted as 10−4 probability events11A q-probability event is an event corresponding to an annual exceedance probability of q. by traditional methods based on observed sea states. Minimum and maximum pressures used in the worsening scenarios for the lows and highs were never deeper or stronger than observed during the 20th century, but the simultaneous occurrence utilized herein for the extreme highs and lows are not observed. An assessment of the annual probability of the simultaneous occurrence is presently ongoing.Marine Structures - MAR STRUCT. 01/2005; 18(5):428-450.