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Byline: Andrea. Girardi, Silvia. Anglesio, Gianluca. Amadore, Edoardo. Trevisiol, Maria Grazia. Redda In radiotherapy treatments the correct dose delivery to the target volume and the consequent conservation of healthy tissues [...]

Byline: Alessia. Reali, Gianluca. Mortellaro, Simona. Allis, Edoardo. Trevisiol, Silvia. Anglesio, Sara. Bartoncini, Maria. Redda Ewing's sarcomas and peripheral primitive neuroectodermal tumors (ES/PNETs) are high grade malignant neoplasms. These malignancies [...]

In radiotherapy treatments the correct dose delivery to the target volume and the consequent conservation of healthy tissues is affected by multileaf collimator (MLC) leaf positioning accuracy and reproducibility, mostly in intensity-modulated radiation therapy (IMRT): For this reason a quality assurance (QA) program is necessary to ensure the best treatment possible to each patient. The aim of this study is the implementation of a method using Gafchromic® RTQA 2 films to perform routine QA on the MLC, both for qualitative and quantitative analysis. A flatbed document scanner (Epson 10000XL) was used in conjunction with radiochromic detector; a scanning protocol was firstly defined to improve readout accuracy. RTQA2 films were irradiated with 6 MV X-rays at different dose levels to obtain calibration curve. To evaluate the leaf positioning accuracy in different conditions, a rhomboidal shape and a field consisting in three rectangular segments were selected. The images quantitative analysis was handled with a program developed in MATLAB to evaluate the differences between expected and measured leaves positions. The reproducibility and global uncertainty of the method were estimated to be equal to 0.5% and 0.6 mm, respectively. Moreover, a qualitative test was performed: A garden picket fence field, consisting in multiple segments 2 x 22 cm², was realized setting known leaves shifts to test the method sensitivity. The picket fence test shows that the method is able to detect displacements equal to 1 mm. The results suggest that Gafchromic® RTQA2 films represent a reliable tool to perform MLC routine QA. [ABSTRACT FROM AUTHOR]

Ewing's sarcomas and peripheral primitive neuroectodermal tumors (ES/PNETs) are high grade malignant neoplasms. These malignancies are characterized by a chromosome 22 rearrangement, arise from bone or soft tissue, predominantly affect children and young adults, and are grouped in the Ewing family of tumors. Multimodality treatment programs are the treatment of choice. Primary localization of ES/PNET in the mediastinum is extremely rare. We describe a case of ES/PNET presenting as a mediastinal mass with tracheal compression and initial signs of superior vena cava in a 66-year-old woman. [ABSTRACT FROM AUTHOR]