350 rub
Journal Science Intensive Technologies №1 for 2020 г.
Article in number:
Radiation therapy efficiency: research of radiological and psychological risk factors
Type of article: scientific article
DOI: 10.18127/j19998465-202001-08
UDC: 615.47:616-085; 615.849; 159.9
Authors:

Yu.P. Zinchenko – Academic of RAE, Dr.Sc.(Psych.), Professor, Dean of Faculty of Psychology, 

Lomonosov Moscow State University

E-mail: zinchenko_y@mail.ru

E.I. Rasskazova – Ph.D.(Psych.), Associate Professor, 

Department of Neuro- and Pathopsychology, Faculty of Psychology, Lomonosov Moscow State University E-mail: e.i.rasskazova@gmail.com

R.S. Shilko – Ph.D.(Psych.), Associate Professor, 

Department of Psychology Methodology, Faculty of Psychology, Lomonosov Moscow State University

E-mail: shilko_rs@psy.msu.ru

M.S. Kovyazina – Corresponding Member of RAE, Dr.Sc.(Psych.), Associate Professor, Professor, 

Department of Neuro- and Pathopsychology, Faculty of Psychology, Lomonosov Moscow State University

E-mail: kms130766@mail.ru

A.P. Chernyaev – Dr.Sc.(Phys.-Math.), Head of Department of Physics of Accelerators and Radiation Medicine, 

Faculty of Physics, Lomonosov Moscow State University; 

Head of Laboratory of Beam Technologies and Medical Physics, 

Skobeltsyn Institute of Nuclear Physics of Lomonosov Moscow State University

E-mail: a.p.chernyaev@yandex.ru

S.M. Varzar – Ph.D.(Phys.-Math.), Associate Professor, 

Department of Physics of Accelerators and Radiation Medicine, Faculty of Physics, Lomonosov Moscow State University

E-mail: varzar@physics.msu.ru

M.V. Zheltonozhskaya – Ph.D.(Eng.), Senior Research Scientist, 

Department of Physics of Accelerators and Radiation Medicine, Faculty of Physics, Lomonosov Moscow State University; 

Leading Engineer, Laboratory of Beam Technology and Medical Physics, 

Skobeltsyn Institute of Nuclear Physics of Lomonosov Moscow State University

E-mail: zhelton@yandex.ru

E.N. Lykova – Senior Lecturer, 

Faculty of Physics, Lomonosov Moscow State University; 

Leading Engineer, Laboratory of Beam Technology and Medical Physics, 

Skobeltsyn Institute of Nuclear Physics of Lomonosov Moscow State University

E-mail: iv-kate@yandex.ru

V.V. Rozanov – Dr.Sc.(Biol.), Professor, 

Department of Physics of Accelerators and Radiation Medicine, Faculty of Physics, Lomonosov Moscow State University;  Main Research Scientist, All-Russian Scientific Research Institute of Medicinal and Aromatic Plants (Moscow)

E-mail: vrozanov@mail.ru

Abstract:

Evaluation of the effectiveness of radiation therapy cannot be complete without taking into account the situation of the patients themselves. How a person reacts to the appointment of radiation therapy, what condition is in front of her, what she knows about her, side effects, consequences, and what she fears can also affect both the effectiveness of therapy and the risks associated with it. Radiological risk factors in radiation therapy can be associated with an increase in dose loading, primarily from unaccounted dose loading caused by flows of secondary particles. Psychological factors are largely related to the subjective attitude towards radiation therapy, anxiety about the health and well-being of patients, which requires a diagnosis of this relationship and possible psychological correction.

The study was conducted in two stages.

At the first stage, to identify the radiological risk factors during radiation therapy with high-energy photons, the fluxes of secondary neutrons were studied during the operation of the linear medical accelerator Varian Trilogy. Both direct measurements of the neutron spectrum in the room were carried out during operation of a medical accelerator using an SDMF-1608PRO.DB spectrometerdosimeter with an organic scintillator, and measurements directly under the beam using the Bonner spheres method based on neutron spectrometry using a set of moderator balls of various diameters, in the center of which is a compact detector. The obtained experimental data on the neutron energy and the activation of tantalum monitor targets were used to evaluate the fast neutron flux, which in turn made it possible to develop a number of specific recommendations for increasing the efficiency of radiation therapy while minimizing the radiological risks associated with the additional dose from secondary neutrons.

The second stage was a clinical and psychological examination of patients with cancer, first sent to radiation therapy. A structured clinical and psychological interview was conducted with all respondents, aimed at creating motivation for the examination, as well as identifying their current status, subjective complaints, attitude to the disease and treatment, followed by filling out modified ques-

tionnaires (Beliefs about Medication Questionnaire, Horne et al., 1996), self-regulation questionnaire regarding health and disease (Kovyazina et al., 2019)). The diagnosis of subjective well-being was based on the model of E. Diener (Diener et al., 2009). It has been shown that the risk groups for psychological work are primarily elderly people due to a higher level of anxiety about radiation therapy against the background of confidence in its necessity, as well as people with minimal functional impairment due to cancer due to their doubts about the need for such an appointment. Further research should be aimed at expanding the samples and assessing various sociodemographic factors in relation to radiation therapy, as well as studying the prognostic value of the attitude to radiation therapy in patients with cancer.

Pages: 50-62
References
  1. Климанов В.А. Радиобиологическое и дозиметрическое планирование лучевой и радионуклидной терапии: Учеб. пособие. М.: НИЯУ МИФИ. 2011.
  2. Bednarz B., Xu X.G. Monte Carlo modeling of a 6 and 18 MV Varian Clinac medical accelerator for in-field and out-of-field dose calculations: development and validation // Phys. Med. Biol. 2009. V. 54. P. 43.
  3. Howell R.M., Kry S.F., Burgett E., Hertel N.E., Followill D.S. Secondary neutron spectra from modern Varian, Siemens, and Elekta linacs with multileaf collimators // Med. Phys. 2009. V. 36. P. 4027−4038.
  4. Vanhavere F., Huyskens D., Struelens L. Peripheral neutron and gamma doses in radiotherapy with an 18 MV linear accelerator // Radiat. Prot. Dosim. 2004. V. 110. P. 607−612.
  5. Kry S.F., Howell R.M., Salehpour M., Followill D.S. Neutron spectra and dose equivalents calculated in tissue for high-energy radiation therapy // Med. Phys. 2009. V. 36. P. 1244−1250.
  6. Martinez-Ovalle S., Barquero R., Gomez-Ros J., Lallena A. Ambient neutron dose equivalent outside concrete vault rooms for 15 and 18 MV radiotherapy accelerators // Radiat. Prot. Dosim. 2012. V. 148. P. 457−464.
  7. Ongaro C., Zanini A., Nastasi U., Rodenas J., Ottaviano G., Manfredotti C. Analysis of photoneutron spectra produced in medical accelerators // Phys. Med. Biol. 2000. V. 45. P. L55−L61.
  8. Nedaie H.A., Darestani H., Banaee N., Shagholi N., Mohammadi K., Shahvar A., Bayat E. Neutron dose measurements of Varian and Elekta linacs by TLD600 and TLD700 dosimeters and comparison with MCNP calculations // J. Med. Phys./Assoc. Med. Phys. India. 2014. V. 39. P. 10.
  9. Vega-Carrillo H.R., Hernandez-Almaraz B., Hernandez-Davila V.M., Ortiz-Hernandez A. Neutron spectrum and doses in a 18 MV LINAC // J. Radioanal. Nucl. Chem. 2010. V. 283. P. 261−265.
  10. Tosi G., Torresin A., Agosteo S., Para A.F., Sangiust V., Zeni L., Silari M. Neutron measurements around medical electron accelerators by active and passive detection technique // Med. Phys. 1991. V. 18. P. 54−60.
  11. Maspero M., Berra A., Conti V., Giannini G., Ostinelli A., Prest M., Vallazza E. A real time scintillating fiber Time of flight spectrometer for LINAC photoproduced neutrons // Nucl. Instrum. Methods Phys. Res. Sect. A: Accel., Spectrometers, Detect. Assoc. Equip. 2015. V. 777. P. 154−160.
  12. Ezzati A.O., Studenski M.T. Neutron dose in and out of 18 MV photon fields // App. Rad. and Isot. 2017. V. 122. P. 186−192.
  13. Bezak E., Takam R., Yeoh E., Marcu Loredana G. The risk of second primary cancers due to peripheral photon and neutron doses received during prostate cancer external beam radiation therapy // Europ. J. of Med. Phys.2017. V. 42. P. 253−258.
  14. Naseria A., Mesbahia A. // Rep. of Pract. Oncol. and Radioth. 2010. V. 15. P. 138.
  15. Желтоножская М.В., Лыкова Е.Н., Черняев А.П., Яценко В.Н. Исследование потока вторичных частиц медицинского ускорителя электронов // Известия РАН. Сер. физ. 2019. № 83(7). С. 915−919.
  16. Осин Е.Н., Леонтьев Д.А. Апробация русскоязычных версий двух шкал экспресс-оценки субъективного благополучия // Материалы III Всерос. социологического конгресса. М.: Ин-т социологии РАН, Российское общество социологов. 2008.
  17. Рассказова Е.И., Лебедева А.А. Скрининговая шкала позитивных и негативных переживаний Э. Динера: апробация русскоязычной версии // Психология. Журнал Высшей школы экономики. 2019. В печати.
  18. Colagiuri B., Dhillon H., Butow P.N., Jansen J., Cox K., Jacquet J. Does assessing patients' expectancies about chemotherapy side effects influence their occurrence? // J Pain Symptom Manage. 2013. V. 46(2). P. 275−81.
  19. Diener E., Emmons R.A., Larsen R.J., Griffin S. The Satisfaction With Life Scale // Journal of Personality Assessment. 1985. V. 49. P. 71−75.
  20. Diener E., Wirtz D., Tov W., Kim-Prieto C., Choi D., Oishi S., Bisqas-Diener R. New well-being measures: short scales to assess flourishing and positive and negative feelings // Social Indicators Research. 2010. V. 97. P. 143−156.
  21. Dong S., Butow P.N., Costa D.S., Dhillon H.M., Shields C.G. The influence of patient-centered communication during radiotherapy education sessions on post-consultation patient outcomes // Patient Educ Couns. 2014. V. 95(3). P. 305−12.
  22. Guidolin K., Lock M., Brackstone M. Patient-perceived barriers to radiation therapy for breast cancer // Can J Surg. 2018. V. 61(2). P. 141−143.
  23. Horne R., Weinman R., Henkins J.M. The beliefs about medication questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication // Psychology and health. 1996. V. 14. P. 1−24.
  24. Kovyazina M., Rasskazova E., Prigorneva E., Varako N. Self-determination theory in rehabilitation of patients with somatic and mental illnesses: validation of Illness and Treatment Self-Regulation Questionnaire in the Russian neurological sample // European Psychiatry. 2019. V. 56. P. S699.
  25. Leventhal H., Brissette I., Leventhal E. The common-sense model of self-regulation of health and illness // The self-regulation of health and illness behavior / Ed. by L.D. Cameron, H. Leventhal. Routledge: New York. 2003. P. 42−65.
  26. Shaverdian N., Wang X., Hegde J.V., Aledia C., Weidhaas J.B., Steinberg M.L., McCloskey S.A. The patient's perspective on breast radiotherapy: Initial fears and expectations versus reality // Cancer. 2018. V. 124(8). P. 1673−1681.
Date of receipt: 18 декабря 2019 г.