Smart News, Issue 5, Spring 2001

Newsletter for Economic Development

Smart News, Issue 8, Spring 2002

Newsletter for Economic Development

IDED Tools and Trends, Spring 2003

Newsletter for Economic Development

Girl Connection, Spring 2002

Newsletter for the Commission on the Status of Women

Musée de l'histoire du costume, 18e siècle, Louis XVI (1785), appartenant à M. Schütz [32 rue Beaujon, Hôtel de Madrazo, Paris, 8e arrondissement, ouvert au public le 24 janvier 1920] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57819

Crossroads, Spring 2002

Newsletter for Iowa Deparment of Public Safety

Crossroads, Spring 2001

Newsletter for Iowa Department of Public Safety

Crossroads, Spring 2003

Newsletter for Iowa Deparment of Public Safety

Iowa Aviation Bulletin, Spring 2003

Quarterly newsletter published by the Iowa Department of Transportation's Office of Aviation that contains information of interest to aviation-related persons and organizations.

Research News, Spring 2003

Newsletter for Iowa Department of Transportation

Carotid Dose Spring in Definitive Irradiation of T1N0 Squamous Cell Laryngeal Carcinoma Using Helical Tomotherapy

Purpose/Objective(s): To implement a carotid dose sparing protocol using helical Tomotherapy in T1N0 squamous cell laryngeal carcinoma.Materials/Methods: Between July and August 2010, 7 men with stage T1N0 laryngeal carcinoma were included in this study. Age ranged from 47 - 74 years. Staging included endoscopic examination, CT-scan and MRI when indicated. Planned irradiation dose was 70 Gy in 35 fractions over 7 weeks. A simple treatment planning algorithm for carotid sparing was used: maximum point dose to the carotids 35 Gy, to the spinal cord 30 Gy, and 100% PTV volume to be covered with 95% of the prescribed dose. Carotid volume of interest extended to 1 cm above and below of the PTV. Doses to the carotid arteries, to the critical organs, and to the planned target volume (PTV) with our standard laryngeal irradiation protocol was compared. Daily megavoltage scans were obtained before each fraction. When necessary, the Planned Adaptive software (TomoTherapy Inc., Madison, WI) was used to evaluatethe need for a re-planning, which has never been indicated. Dose data were extracted using the VelocityAI software (Atlanta, GA), and data normalization and dose-volume histogram (DVH) interpolation were realized using the Igor Pro software (Portland, OR).Results:A significant (p\0.05) carotid dose sparing compared to our standard protocol with an average maximum point dose of 38.3 Gy (standard deviation [SD] 4.05 Gy), average mean dose of 18.59 Gy (SD 0.83 Gy) was achieved. In all patients, 95% of the carotid volume received less than 28.4 Gy (SD 0.98 Gy). The average maximum point dose to the spinal cord was 25.8 Gy (SD 3.24 Gy). PTV was fully covered with more than 95% of the prescribed dose for all patients with an average maximum point dose of 74.1 Gy and the absolute maximum dose in a single patient of 75.2 Gy. To date, the clinical outcomes have been excellent. Three patients (42%) developed stage 1 mucositis that was conservatively managed, and all the patients presented a mild to moderate dysphonia. All adverse effects resolved spontaneously in the month following the end of treatment. Early local control rate is 100% considering a 4 - 5 months post treatment follow-up.Conclusions: Helical Tomotherapy allows a clinically significant decrease of carotid irradiation dose compared to standard irradiation protocols with an acceptable spinal cord dose tradeoff. Moreover, this technique allows the PTV to be homogenously covered with a curative irradiation dose. Daily control imaging brings added security margins especially when working with high dose gradients. Further investigations and follow-up are underway to better evaluate the late clinical outcomes especially the local control rate, late laryngeal and vascular toxicity, and expected potential impact on cerebrovascular events.

Iowa Aviation Bulletin, Spring 2004

Quarterly newsletter published by the Iowa Department of Transportation's Office of Aviation that contains information of interest to aviation-related persons and organizations.

Crossroads, Spring 2003

Newsletter for the Governor's Traffic Safety Bureau, Iowa Department of Public Safety

Tools & Trends, Spring 2004

Development tool for Iowa Communities