Aaron Dewey Wright

Research Methods in Medical Dosimetry I

March 24, 2015
Compare and Contrast Articles Trade Publications vs. Professional Journal
Part I: Trade Publication
Articles published in trade magazines contain information that appeal to a broader
audience usually catered to a certain field but informally written and in language understandable
to incorporate other possible non-professionals interested in a certain field. These articles are
well written by professional staff writers or clinicians gathering information on news, products,
or services in a given area. 1 The article selected for this comparison paper was featured in
Radiology Today Magazine, titled Treating Prostate Cancer by Dan Harvey. In this article new
information presented was gathered from ASTRO involving treatment and outcomes of various
cancers with the main focus on prostate cancer. I will discern the information presented in this
article as it pertains to the medical dosimetry field, its strengths and weaknesses as well as
accuracy of the information presented.
The article begins by discussing a debatable topic of routine screenings effectiveness in
preventing metastasis. The author cites a study conducted on high, intermediate, and low risk
showing the benefits of pre-screening as well as post-screening and its effectiveness in
preventing metastasis within 10 years of treatment. The effectiveness in terms of side effects
found in IMRT and 3D conformal treatment techniques. IMRT allows for a more conformal dose
plan to the designated tumor volume compared to conventional 3D conformal techniques, thus
resulting in sparring of more gastrointestinal tissue and less complication of side effects
including proctitis, rectal bleeding, and cystitis. The article also discusses the effectiveness of
combining hormone therapy concurrently with radiation therapy to increase survival chances.
The author cites findings from a large study conducted proving the androgen deprivation therapy
can slow prostate cancer growth. An interesting finding also noted a large study indicating the
use of anticoagulants such as aspirin used in surgery and radiation treatment of the prostate can
reduce the risk of death by 50% of patients in the high-risk category, however more studies
needed to be performed before prescribing a regimen concurrent with radiation therapy
treatments.2

The strong point of this article is that it gives light to clinical trials being performed and
their impact on how cancer treatments are being managed today and possibilities for the future.
With this being written for a broad range this article can appeal to different professionals within
this field. Oncologist can use these presented findings in opening new doors in treatment options
with chemo therapy and possibly anticoagulants. Medical dosimetrist will find information on
the benefits of IMRT techniques for improving dose to tumor volumes while sparing
gastrointestinal tissues appealing when choosing a route for treatment planning. The weak
disadvantage of the presented material is that these are only summations of various findings and
are correlated with limited data. For claims of progress there should be strong data presented to
back the proclaimed success. I do believe that even though there are limited data presented in
this article the author skillful presented the topics discussed which in turn do peak enough
interest for further research into newly developing and effective treatment options for prostate
cancer.

References
1. Lenards N, Weege M. Radiation Therapy and Medical Dosimetry Reading.
[Powerpoint]. La Crosse, WI: UW-L Medical Dosimetry Program.
2. Harvey D. Treating Prostate Cancer. Radiology Today. 2011; 12(1):26. Retrieved from
http://www.radiologytoday.net/archive/rt0111p26.shtml.

Part II: Professional Journal

Professional journals differ from trade publications in that they are formal writings
appealing to narrow interest groups usually professionals within the given subject matter. These
journal articles are reviewed by peer groups before publication for accuracy, and usually involve
a purpose to seek attainable answers to hypothesis or new and debatable concepts found in a
profession.1 The accuracy and presentation of subject material should be done so in concise
manner in which the reader should be able to follow and take with them a greater understanding
of the answers to the hypothesis found within the presented research. For my comparison to the
trade publication article I will critique a professional journal publication which I have selected
titled Surface Dose Effects of Linen Coverings for Breast and Chest Wall Patients by Jessica
Fagerstrom and Emily Harata featured in ASRTs Radiation Therapy journal. I will review and
summarize the element of the professional journal that differ from trade publications these will
include the introduction or purpose, hypothesis presented, methods, results, discussion and
conclusion. I will then discuss my overall impressions of the article as it my pertain to the
medical dosimetry field.
The main purpose of this article was to discuss the effects of linen coverings on skin
surface dose from breast and chest wall external radiation treatments. For many patients there
are increased comforts in being draped during breast and chest wall treatments either by gown or
other linens such as bed sheets. Prior research conducted on electron energy treatment fields
with varying results, while some research stated there were significant increases others stated
negligible findings. Various measuring devices were used including film, TLDs, optically
stimulated luminescence, and ion chambers all measuring the bolusing effect of various energy
electron doses on phantom surfaces with and without several types of linen coverings. The
purpose of this article expands on research performed by Johnson et al using TLD readings on a
slab phantom and a 6MV beam which provided substantial differences of surface dose with
various linens draped in the beam versus without linens. These findings are expounded upon
with a similar setup using TLDs however an anthropomorphic phantom has taken the place of the
slab phantom to increase the data accuracy of beam geometry in various regions.
Data measurements were conducted using (TLDs) were placed on the chest wall surface
of a RANDO anthropomorphic male phantom that was irradiated with photon tangent beams and
electron enface fields with a circular block. Performing separate measurements on the phantom
while it was covered with a hospital gown, a sheet, and a towel; all 3 items together; and without

any coverings with varying beam energies including 6MV, 16MV, and 6, 9, 12, 15, 18MeV
performed on a Varian 2100EX linac. The linens used were all standard material and standard
thickness linens found with in most hospital or clinic settings. The methods and materials used
were documented with photographs presented in the article to give the reader a visual
representation of the research.
Graph tables of the results were presented for all photon and electron energies used, in
reference to the linens used as well, uncertainty bars represent the overall uncertainty determined
by the standard uncertainty associated with the TLD readings for each energy and covering.
Data results show that there were increased surface dose with the use of a cotton hospital gown
varying from 4.6 +/- 2.1% to 6.9 +/- 2.7% for photon beams and 0 +/- 3.6% to 3.0 +/- 2.2% for
electron beams. Due to the handicap faced with TLD uncertainties found with electron beam
measurements an overall increase in dose was found with photon beams while electron beam
data failed to find a definitive relationship.
The TLD readings confirmed previously published findings and hypothesis that
increasing linen covering thickness increases surface dose for 6 MV photons. However, this
study used an anthropomorphic, clinically-relevant setup to measure both entrance and exit doses
and tested a 16 MV photon beam as well. Surface dose increased with 16 MV photons, although
results were not statistically significant for electrons. With the inconclusive results found in
electron beams and TLD uncertainties the findings can not suffice for the same results in using
electron beam treatments. TLDs have a larger uncertainty associated with readings than do
ionization chambers, although TLDs can be used to measure dose in an arrangement that more
closely resembles actual patient treatment geometry. With these shortcomings the authors went
further to state that further study could be done using an extrapolation ionization chamber to
better assess the effect of linen coverings on patient surface during electron treatments. The
success of each patients treatment involves adequate tumor volume coverage while minimizing
radiation toxicity effects including the skin. Treatments conducted on personal areas such as
breast or chest wall treatments of female patients linen coverings can prove to increase the
comfort of the patient however it should be noted that this has a detrimental effect on the patient
skin surface and can lead to unwelcome outcomes during treatment. This article was very
thoroughly written with many references for additional research in this subject, the graphs of
data findings were displayed in an understandable format as well as the flow and format of the

article itself. My overall impressions as a medical dosimetriy student and radiation therapist, one
aspect of this article that can be taken from this is having the radiation therapist use linens to
cover the patient as much as possible without involving the treatment field by covering the
ipsilateral breast and exposing only treatment field areas during treatments. By doing this a
successful treatment can be accomplished while sparring unwanted skin dose in the treatment
area and allowing some comfort for the patients going through a tough treatment.

References
1. Lenards N, Weege M. Radiation Therapy and Medical Dosimetry Reading.
[Powerpoint]. La Crosse, WI: UW-L Medical Dosimetry Program.
2. Fagerstrom J, Hirata E. Surface Dose Effects of Linen Coverings for Breast and Chest
Wall Patients. Radiation Therapist. 2014; 23(2):119-124.