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PURPOSE The aim was to assess changes of tumour hypoxia during primary radiochemotherapy (RCT) for head and neck cancer (HNC) and to evaluate their relationship with treatment outcome. MATERIAL AND METHODS Hypoxia was assessed by FMISO-PET in weeks 0, 2 and 5 of RCT. The tumour volume (TV) was determined using FDG-PET/MRI/CT co-registered images. The level of hypoxia was quantified on FMISO-PET as TBRmax (SUVmaxTV/SUVmean background). The hypoxic subvolume (HSV) was defined as TV that showed FMISO uptake ⩾1.4 times blood pool activity. RESULTS Sixteen consecutive patients (T3-4, N+, M0) were included (mean follow-up 31, median 44months). Mean TBRmax decreased significantly (p

Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

Cancers of the head and neck are a malignancy causing a considerable health burden. In head and neck cancer patients, tumor hypoxia has been shown to be an important predictor of response to therapy and outcome. Several imaging modalities can be used to determine the amount and localization of tumor hypoxia. Especially PET has been used in a number of studies analyzing this phenomenon. However, only few studies have reported the characteristics and development during (chemoradio-) therapy. Yet, the characterization of tumor hypoxia in the course of treatment is of great clinical importance. Successful delineation of hypoxic subvolumes could make an inclusion into radiation treatment planning feasible, where dose painting is hypothesized to improve the tumor control probability. So far, hypoxic subvolumes have been shown to undergo changes during therapy; in most cases, a reduction in tumor hypoxia can be seen, but there are also differing observations. In addition, the hypoxic subvolumes have mostly been described as geographically rather stable. However, studies specifically addressing these issues are needed to provide more data regarding these initial findings and the hypotheses connected with them.

Aims and objectives: Heatwaves can pose a severe threat to health, especially to older people. However, warnings do not necessarily lead to preventive action. This study aims at exploring individual risk perception and adaptive measures of older people and their carers. Their views are explored, taking into account personal backgrounds. Methods: Questionnaire-based interviews were administered to 20 men and women (64–94 years, living in their own homes or nursing homes) and 13 carers. A qualitative analysis following a framework approach was performed. Results: The majority of respondents stated that older people might be compromised by heatwaves; however, a large proportion of respondents saw themselves as less affected than the average population. Most respondents adopted preventive measures during heatwaves and a majority received warnings or pieces of information. The role of general practitioners in direct warning situations was judged controversial. Survey respondents displayed resistance to the use of technical devices to monitor potentially dangerous situations. In addition, the results support many previous findings. In particular, the relative concepts of ageing, variety of information channels used, and control orientations could be confirmed. Conclusions: General practitioners hold a position of trust and play a central role in the promotion of preventive action, but there are also limitations to their outreach. Many respondents could be classified as socially active, which has implications for preventive information campaigns. Information campaigns using different channels and targeting a larger audience should be considered. The degree of information of carers can partly be improved., GMS Psycho-Social-Medicine; 9:Doc05; ISSN 1860-5214