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1.  Dosimetric and radiobiological comparison of helical tomotherapy, forward-planned intensity-modulated radiotherapy and two-phase conformal plans for radical radiotherapy treatment of head and neck squamous cell carcinomas 
The British Journal of Radiology  2011;84(1008):1083-1090.
Objectives
The usual radical radiotherapy treatment prescribed for head and neck squamous cell carcinoma (HNSCC) is 70 Gy (in 2 Gy per fraction equivalent) administered to the high-risk target volume (TV). This can be planned using either a forward-planned photon-electron junction technique (2P) or a single-phase (1P) forward-planned technique developed in-house. Alternatively, intensity-modulated radiotherapy (IMRT) techniques, including helical tomotherapy (HT), allow image-guided inversely planned treatments. This study was designed to compare these three planning techniques with regards to TV coverage and the dose received by organs at risk.
Methods
We compared the dose–volume histograms and conformity indices (CI) of the three planning processes in five patients with HNSCC. The tumour control probability (TCP), normal tissue complication probability (NTCP) and uncomplicated tumour control probability (UCP) were calculated for each of the 15 plans. In addition, we explored the radiobiological rationality of a dose-escalation strategy.
Results
The CI for the high-risk clinical TV (CTV1) in the 5 patients were 0.78, 0.76, 0.82, 0.72 and 0.81 when HT was used; 0.58, 0.56, 0.47, 0.35 and 0.60 for the single-phase forward-planned technique and 0.46, 0.36, 0.29, 0.22 and 0.49 for the two-phase technique. The TCP for CTV1 with HT were 79.2%, 85.2%, 81.1%, 83.0% and 53.0%; for single-phase forward-planned technique, 76.5%, 86.9%, 73.4%, 81.8% and 31.8% and for the two-phase technique, 38.2%, 86.2%, 42.7%, 0.0% and 3.4%. Dose escalation using HT confirmed the radiobiological advantage in terms of TCP.
Conclusion
TCP for the single-phase plans was comparable to that of HT plans, whereas that for the two-phase technique was lower. Centres that cannot provide IMRT for the radical treatment of all patients could implement the single-phase technique as standard to attain comparable TCP. However, IMRT produced better UCP, thereby enabling the exploration of dose escalation.
doi:10.1259/bjr/53812025
PMCID: PMC3473826  PMID: 22101580
2.  Squamous cell carcinoma of the cervix: report of an unusual case of bicornuate bicollis uterus treated with bilateral intracavity brachytherapy 
The British Journal of Radiology  2010;83(991):e143-e146.
We report a case of congenital abnormality of bicornuate bicollis uterus in a patient who developed FIGO (International Federation of Gynecology and Obstetrics) stage IIB invasive carcinoma of the cervix in 2006. She was managed with radical concurrent chemoradiotherapy using an external photon beam of 50 Gy in 25 fractions and a weekly infusion of cisplatin, followed by low dose rate intracavity brachytherapy of 18 Gy to Manchester point A over two fractions. Intra-uterine afterloading brachytherapy catheters were inserted into both uterine cavities. Treatment was well tolerated with manageable acute toxicities. Complete response was achieved with therapy. The patient remains well on follow up with no clinical evidence of disease recurrence two years after initial treatment.
doi:10.1259/bjr/98391292
PMCID: PMC3473682  PMID: 20603399
3.  Tuberculous and fungal pericarditis. 
Western Journal of Medicine  1975;122(4):300-305.
PMCID: PMC1129717  PMID: 1154760

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