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Ontida Apinorasethkul
DOS711
March 25, 2015
Article Comparison: Trade Publication Article vs. Peer Reviewed Article
Part I: Trade Publication
Trade publications are targeted to the general public audience. The articles are informally
written and may have included the writers experiences or any topics in the current situations or
current news to attract the readers attention.1 Writers of the trade publications can express
his/her own opinion into the article or may have an intention to sell the products within the
article. An article from Radiology Today Magazine appealed to me to stop and read further. The
article titled Radiation Dose - Properly Balance Risk, Reward for Dose Optimization written by
Dominic Siewko gives an overview to the general readers on benefits and risks of using radiation
dose for diagnostic procedures.
As a short summary to the article in this magazine, the author was making the public
aware that the use of radiation dose for diagnostic purposes had nearly tripled in 2010 when
comparing to 1996.2 With the technology to acquire more precise and clearer images, CT scans
could help patients avoid the need of surgery and/or clarify the diagnosis. Although we know the
benefits of using the CT scans, we should be mindful of the risks associated with exposing self to
more radiation dose. The article emphasized and concluded that balancing of benefits versus
risks of radiation exposure is the overall goal of clinicians to obtain the best possible diagnostic
information as well as limiting the radiation dose to the patients.
This article attracts my attention because it directly involves my job. It is what I do daily.
It is my responsibility to consider benefits versus risks on all my treatment plans. As medical
dosimetrists, we always weigh positives and negatives of beam arrangements, where the
radiation dose goes, which organs can exceed or cannot exceed the tolerance doses, etc. It is the
balancing exposure as the author had summed up in his article. This information was given to
me on the day 1 of my medical dosimetry school. Although the information is general and basic
to radiation oncology, I think this article is a great reminder to the radiation oncology
professionals. As to the authors ways to strike the balance between benefits and risks, I do not
think that there is one way or a fixed way to do it. Every patient is different. The ways to

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approach any treatment plan depends on the diagnosis and the need of each patient. The author
did get his points across to the professionals as well as the audience to be aware that there is no
benefit without risk, which I feel is the strength of this article. However, the author did not
mention what risk he was referring to and what are the consequences if one received too much
radiation dose. The audience may or may not have the knowledge of radiation exposure,
therefore, the author could include more risk information to strengthen his argument since he
mentioned what are the benefits.
As mentioned, this article is a great reminder for me as a medical dosimetrist to keep in
mind of the As Low As Reasonably Achievable (ALARA) acronym that was taught during the
radiation safety course. We should make every reasonable effort to keep the radiation exposure
as low as possible. This article provided useful information for the general audience to be aware
of what the diagnostic scans entail.

References
1. Lenards N., Weege M. Radiation Therapy and Medical Dosimetry Reading. [Powerpoint].
La Crosse, WI: UW-L Medical Dosimetry Program, 2015.
2. Siewko D. (2015 March). Radiation dose properly balance risk, reward for dose
optimization. Radiology Today,(16)3,25. Retrieved from
http://www.radiologytoday.net/archive/rt0315p25.shtml

Part II: Peer Reviewed Research Article


Peer reviewed research articles are scientific research journals with a more formal form
of writing when comparing to the trade publication articles. These articles target specific
professional and researcher groups that have similar interests. The articles are to be reviewed by
the professionals in the same field prior to publishing. These research journals seek answers to
the hypotheses or debates on professional issues.1 I chose to explore an article from the Medical
Dosimetry Journal titled Spot-Scanning Beam Proton Therapy vs. Intensity-Modulated Radiation
Therapy for Ipsilateral Head and Neck Malignancies: A Treatment Planning Comparison by
Kandula et al.2 A thorough review of this article will help me identify the methods and results of
this research comparison.
This research article was comparing treatment plans of different modalities; proton
therapy and intensity-modulated radiation therapy (IMRT) in head and neck malignancies. The
article clearly had separate sections labeled introduction, methods, results, discussions, and
references. The introduction section mentioned acute and chronic radiation treatment-related
side effects of head and neck malignancies, which includes insufficient salivary function or
xerostomia.2 Substantial irradiation to the brainstem, oral cavity, salivary glands, cochlea, larynx
and optic structures can also cause both acute and chronic morbidity.2 The hypothesis was that
proton therapy would be able to reduce dose to normal tissues and decrease toxicities and
treatment-related morbidity using its Bragg peak.
The method section included patient selection, dose prescription details, treatment
planning and optimization criteria, and the statistical evaluation criteria. The details were clearly
presented, except the planning method. The article did not specify if the treatment plans were
performed by the same planner or different planners. Different planning experiences may affect
the outcome of this study, especially when the patient pool was only 5 patients. The article did
state that the treatment volumes (TVs) were drawn by one radiation oncologist. All IMRT plans
were done in Pinnacle while all proton plans were done in Eclipse. Same CTs were used for
planning both IMRT and proton. The dosimetric values of each organ at risk (OR) were
evaluated and compared.
In the result section, the authors were able to confirm the hypothesis that there was more
normal tissue sparing using proton therapy. The results included in the tables and graph were
clearly demonstrated the superior dose-sparing capabilities of proton plans when comparing to

IMRT plans. Mean dose of contralateral parotid gland was reduced by a factor of 11 when
compared to IMRT.2 Larynx, oral cavity and contralateral submandibular were also better spared
with proton plans. The data was well organized and easy to interpret. It compared doses to the
ORs on the proton plan and IMRT plan. Overall, proton plan gives less integral dose and less
low- and intermediate-dose to the normal tissue.
The data supported the correct hypothesis of researchers. In the discussion, many articles
were referenced, however, the treatment modality was different. This research was using single
field uniform dose method of proton planning to plan and compare with IMRT plans, though,
Intensity Modulated Proton Therapy (IMPT) method was referenced which was unrelated to the
article. The data was appropriately supporting the conclusion and seem accurate. There was no
separate conclusion section, however, it was adequately summarized at the end of the discussion
section.
The article was well presented and definitely is a peer-reviewed research article. The
references were appropriate and majority was within the past 5-7 years. Contents of this article
contain all the components for a professional journal article. I would reference this publication
in the future.

References
1. Lenards N., Weege M. Radiation Therapy and Medical Dosimetry Reading. [Powerpoint]. La
Crosse, WI: UW-L Medical Dosimetry Program, 2015.
2. Kandula S, Zhu X, Garden AS, et al. Spot-scanning beam proton therapy vs. intensitymodulated radiation therapy for ipsilateral head and neck malignancies: A treatment planning
comparison. Med Dosim. 2013;38(4):390-394.
http://dx.doi.org/10.1016/j.meddos.2013.05.001