[en] In order to investigate if and how the vegetation has changed in consequence of the raised temperature in the biotest lake (which is the discharge area for the cooling water from the power plant), investigations of the distribution and production of macroscopic algae and higher vegetation have been carried out since 1974. This report presents the results from the period 1984-1986. The investigations have shown that not only the temperature, but also the absence of ice cover, the water stream through the biotest lake and the reduced exposition caused by the embankment, are of importance for the vegetation in the lake. The vegetation has changed in the following aspects: The area of the shore vegetation has been continuously increasing. In 1982 it was c. 6200 m², 1984 it was c. 9850 m² and 1985 c. 11000 m², mainly consisting of Phragmites communis. Most of the shore line is now occupied by vegetation. The standing crop was found to have decreased since the power plants started. 1980 there was 74 g/m² dry weight and in 1986 28 g/m². Among the most important species of macroscopic underwater vegetation Chara spp and Potamogeton pectinatus show a decrease of standing crop while Cladophora glomerata and Vaucheria sp have increased since the investigation started. (authors)

[en] The aim of the present study is to compare the merits of different radiobiologically optimized treatment techniques using few-field planar and non-coplanar dose delivery on an advanced cancer of the cervix, with rectum and bladder as principal organs at risk. Classically, the rational for using non-coplanar beams is to minimize the overlap of beam entrance and exit regions and to find new beam directions avoiding organs at risk, in order to reduce damage to sensitive normal tissues. Two four-beam configurations have been extensively studied. The first consists of three evenly spaced coplanar beams and a fourth non-coplanar beam. A second tetrahedral-like configuration, with two symmetric non-coplanar beams at the same gantry angle and two coplanar beams, with optimized beam directions, was also tested. The present study shows that when radiobiologically optimized intensity modulated beams are applied to such a geometry, only a marginal increase in the treatment outcome can be achieved by non-coplanar beams compared to the optimal coplanar treatment. The main reason for this result is that the high dose in the beam-overlap regions is already optimally reduced by biologically optimized intensity modulation in the plane. The large number of degrees of freedom already incorporated in the treatment by the use of intensity modulation and radiobiological optimization, leads to the saturation of the benefit acquired by a further increase in the degrees of freedom with non-coplanar beams. In conclusion, the use coplanar of radiobiologically optimized intensity modulation simplifies the dose delivery, reducing the need for non-coplanar beam portals

[en] A new method for producing very narrow and intense 50 MV bremsstrahlung beams with a half-width as low as 35 mm at a distance of 1 m from the target is presented. Such a beam is well suited for intensity modulation using scanned photon beams. An algorithm has been developed to minimize the width of the bremsstrahlung beam generated in a multilayer target by varying the individual layer thicknesses and atomic numbers under given constraints on the total target thickness and the mean energy of the transmitted electrons. Under such constraints the narrowest possible bremsstrahlung beam is obtained with a target composed of layers of monotonically increasing atomic number starting with the lowest possible value at the entrance side where the electrons impinge. It is also shown that the narrowest photon beam profile is associated with the highest possible forward photon yield. To be able to use the optimized target clinically it is desirable to be able to collect and stop all the electrons that are transmitted through the target. The electrons are most efficiently collected if they are kept close together, i.e. by minimizing the multiple scatter of the electrons and consequently the half-width of the generated bremsstrahlung beam. This is achieved by a thin low-atomic-number target. A dedicated electron stopper has been developed and integrated with the purging magnet. When the electron stopper is combined with a purging magnet, a primary photon collimator and a multileaf collimator, almost all of the transmitted electrons and their associated bremsstrahlung contamination can effectively be collected. The narrow photon beams from thin low-atomic-number targets have the additional advantage of producing the hardest and most penetrative photon spectrum possible, which is ideal for treating large deep-seated tumours. (author)

[en] Intensity modulated radiation therapy is rapidly becoming the treatment of choice for most tumors with respect to minimizing damage to the normal tissues and maximizing tumor control. Today, intensity modulated beams are most commonly delivered using segmental multileaf collimation, although an increasing number of radiation therapy departments are employing dynamic multileaf collimation. The irradiation time using dynamic multileaf collimation depends strongly on the nature of the desired dose distribution, and it is difficult to reduce this time to less than the sum of the irradiation times for all individual peak heights using dynamic leaf collimation [Svensson et al., Phys. Med. Biol. 39, 37-61 (1994)]. Therefore, the intensity modulation will considerably increase the total treatment time. A more cost-effective procedure for rapid intensity modulation is using narrow scanned photon, electron, and light ion beams in combination with fast multileaf collimator penumbra trimming. With this approach, the irradiation time is largely independent of the complexity of the desired intensity distribution and, in the case of photon beams, may even be shorter than with uniform beams. The intensity modulation is achieved primarily by scanning of a narrow elementary photon pencil beam generated by directing a narrow well focused high energy electron beam onto a thin bremsstrahlung target. In the present study, the design of a fast low-weight multileaf collimator that is capable of further sharpening the penumbra at the edge of the elementary scanned beam has been simulated, in order to minimize the dose or radiation response of healthy tissues. In the case of photon beams, such a multileaf collimator can be placed relatively close to the bremsstrahlung target to minimize its size. It can also be flat and thin, i.e., only 15-25 mm thick in the direction of the beam with edges made of tungsten or preferably osmium to optimize the sharpening of the penumbra. The low height of the collimator will minimize edge scatter from glancing incidence. The major portions of the collimator leafs can then be made of steel or even aluminum, so that the total weight of the multileaf collimator will be as low as 10 kg, which may even allow high-speed collimation in real time in synchrony with organ movements. To demonstrate the efficiency of this collimator design in combination with pencil beam scanning, optimal radiobiological treatments of an advanced cervix cancer were simulated. Different geometrical collimator designs were tested for bremsstrahlung, electron, and light ion beams. With a 10 mm half-width elementary scanned photon beam and a steel collimator with tungsten edges, it was possible to make as effective treatments as obtained with intensity modulated beams of full resolution, i.e., here 5 mm resolution in the fluence map. In combination with narrow pencil beam scanning, such a collimator may provide ideal delivery of photons, electrons, or light ions for radiation therapy synchronized to breathing and other organ motions. These high-energy photon and light ion beams may allow three-dimensional in vivo verification of delivery and thereby clinical implementation of the BIOART approach using Biologically Optimized three-dimensional in vivo predictive Assay based adaptive Radiation Therapy [Brahme, Acta Oncol. 42, 123-126 (2003)]

[en] The full potential of biologically optimized radiation therapy can only be maximized with the prediction of individual patient radiosensitivity prior to treatment. Unfortunately, the available biological parameters, derived from clinical trials, reflect an average radiosensitivity of the examined populations. In the present study, a breast cancer patient of stage I-II with positive lymph nodes was chosen in order to analyse the effect of the variation of individual radiosensitivity on the optimal dose distribution. Thus, deviations from the average biological parameters, describing tumour, heart and lung response, were introduced covering the range of patient radiosensitivity reported in the literature. Two treatment configurations of three and seven biologically optimized intensity-modulated beams were employed. The different dose distributions were analysed using biological and physical parameters such as the complication-free tumour control probability (P₊), the biologically effective uniform dose, dose volume histograms, mean doses, standard deviations, maximum and minimum doses. In the three-beam plan, the difference in P₊ between the optimal dose distribution (when the individual patient radiosensitivity is known) and the reference dose distribution, which is optimal for the average patient biology, ranges up to 13.9% when varying the radiosensitivity of the target volume, up to 0.9% when varying the radiosensitivity of the heart and up to 1.3% when varying the radiosensitivity of the lung. Similarly, in the seven-beam plan, the differences in P₊ are up to 13.1% for the target, up to 1.6% for the heart and up to 0.9% for the left lung. When the radiosensitivity of the most important tissues in breast cancer radiation therapy was simultaneously changed, the maximum gain in outcome was as high as 7.7%. The impact of the dose-response uncertainties on the treatment outcome was clinically insignificant for the majority of the simulated patients. However, the jump from generalized to individualized radiation therapy may significantly increase the therapeutic window for patients with extreme radio sensitivity or radioresistance, provided that these are identified. Even for radiosensitive patients a simple treatment technique is sufficient to maximize the outcome, since no significant benefits were obtained with a more complex technique using seven intensity-modulated beams portals

[en] Since 1980, Forsmark Power Plants has discharged large amount of cooling water into the Biotest basin. In 1974, before the dam was constructed, and 1980 to 1986, the macrophytic algae and higher vegetation inside and around the basin has been investigated. The observed changes are mainly caused by the increased water temperature causing lack of ice cover during the winter, the embankment reducing the exposition, the heavy water stream through the basin and the reduced light transmission in the water. The macroscopic vegetation in the Biotest basin was originally distributed all over the lake, but is now mainly found in more shallow water. The deepest part, a passage from the input of the cooling water to the output, totally lack vegetation. The reason for this is a combination of the heavy stream, raised temperature and reduced light transmission. The total biomass of macroscopic vegetation in the basin has been reduced from c. 70 metric ton in 1980 to c. 27 ton in 1982 and 1986. Among the most important species, the production of Chara spp. and Potamogeton pectinatus have been strongly reduced, while Cladophora glomerata and Vaucheria sp. have increased. Especially for Vaucheria, the raised temperature has been of vital importance. Among other species, Tolypella nidifica first increased, but has now totally disappeared. Zannichellia palustris was the only phanerogam which increased all the time. It is Z. palustris var. major which stands for the increase, while Z. palustris var. repens has disappeared from the basin. The shore vegetation, mainly reeds, has expanded conspicuously. From 1974 to 1980, the shore vegetation was favoured by the reduced exposition caused by the embankment. Since then, the raised temperature and absence of ice cover have resulted in an accelerating expansion of mainly Phragmites communis. Scirpus tabernaemontani and S. maritimus were first increasing, but do not seem to be able to compete with Phragmites in the long run. (au)

[en] Due to the clinical advantages of Intensity Modulated Radiation Therapy (IMRT) high flexibility and accuracy in intensity modulated dose delivery is desirable to really maximize treatment outcome. Although it is possible to deliver IMRT by using broad beams in combination with dynamic multileaf collimation the process is rather time consuming and inefficient. By using narrow scanned high energy photon beams the treatment outcome can be improved, the treatment time reduced and accurate 3D in vivo dose delivery monitoring is possible by PET-CT based dose delivery imaging of photo nuclear reactions in human tissues. Narrow photon beams can be produced by directing a low emittance high energy electron beam on a thin target, and then cleaning the therapeutic photon beam from transmitted high energy electrons, and photon generated charged leptons, with a dedicated purging magnet placed directly downstream of the target. To have an effective scanning and purging magnet system the purging magnet should be placed immediately after the bremsstrahlung target to deflect the transmitted electrons to an efficient electron stopper. In the static electron stopper the electrons should be safely collected independent of the desired direction of the therapeutic scanned photon beam. The SID (Source to Isocenter Distance) should preferably be short while retaining the ability to scan over a large area on the patient and consequently there are severe requirements both on the strength and the geometry of the scanning and purging magnets. In the present study an efficient magnet configuration with a purging and scanning magnet assembly is developed for electron energies in the 50-75 MeV range and a SID of 75 cm. For a bremsstrahlung target of 3 mm Be these electron energies produce a photon beam of 25-17 mm FWHM (Full Width Half Maximum) at a SID of 75 cm. The magnet system was examined both in terms of the efficiency in scanning the narrow bremsstrahlung beam and the deflection of transmitted and photon generated electrons. The simulations show that its is possible to have a scan area on the patient of up to 43x40cm² for an incident electron energy of 50 MeV and 28x40cm² at 75 MeV, while at the same time adequately deflecting the transmitted electron beam.