Beruflich Dokumente
Kultur Dokumente
Patrick Sheil
Part I: Trade Journal
Trade journals are informal publications geared towards a broad audience. They
are written to appeal to the reader with colorful displays and brief length articles.1 These
articles are free to the public and written by freelance writers who are typically paid for
their services. I will analyze the article: Helical IMRT- New Treatments Taking Shape for
Today.2 Throughout my analysis, I will breakdown the relevance and accuracy of the
presented information, along with my personal opinions of its strengths and weaknesses.
This article discusses the benefits of treating patients with multiple myeloma
using TomoTherapy helical intensity modulated radiation therapy (IMRT) rather than
total body irradiation (TBI). The author discusses how multiple myeloma is the second
most prevalent blood cancer, affecting more 750,000 people worldwide. The author
advocates that helical IMRT is the superior treatment option due to its ability to reduce
radiation-related side effects and increase dosage while limiting exposure to healthy
tissue and organs.2 The author then goes on to include a personal statement from the first
multiple myeloma patient who was treated using the TomoTherapy treatment option in a
clinical trial, Carol Ramnarine. The article then discusses how her blood counts dropped
within a few days and that she has been in remission for nearly five years. The articles
concludes that early studies done at Far Eastern Memorial Hospital and the University of
I found this article to be very engaging from start to finish. It gave a broad
synopsis of multiple myeloma and the treatment options of TBI and TomoTherapy in
which the common person could generally understand. Although it did grab my attention,
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I did not find the information to have substantial support backing its claim that
TomoTherapy is superior. The author incorporated a broad five-year survival rate for TBI
but did not include a comparison one for TomoTherapy. It lacked long term studies and
had contained no professionally reviewed studies with figures supporting its claim.
The author of the article cofounded TomoTherapy Inc, which makes me question
whether or not the article is written from an unbiased perspective. I find it hard to trust
that all information comparing TomoTherapy to TBI is on a fair playing field. In addition
to the bias, its core foundation of support relied on the opinion/case of one patient, who
was also the first patient treated during a clinical trial using TomoTherapy. One patients
account of his/her treatment is not a sufficient sample size and is more opinion based than
factual.
The article had some strong points but it was full of weak spots as well. The
biggest strength of this article was its short length and ease of understanding. For
someone who is not familiar with multiple myeloma or TBI/TomoTherapy, this article did
a good job of briefing him or her. The biggest weakness of this article is the bias of the
writer. The writer has a serious link to the treatment option that he is advocating is
superior to another. Another weakness is the lack of data or sample numbers. One
patients experience cannot exemplify the 750,000 people worldwide. A much larger
sample size would need to be seen for this article to have some traction.
more detailed study of TomoTherapy versus TBI for multiple myeloma patients comes
out in the future because I can definitely see how it could potentially be beneficial. The
traditional 10-12 Gy, while limiting exposure to healthy tissue and organs. Another aspect
that I found intriguing is how TomoTherapy would aid in day to day reproducibility in
patient setup over TBI where you are essentially eye-balling the field. I would not
recommend this article to a colleague/classmate due to the clear bias the author has
towards TomoTherapy. The bias and heavy use of opinions/quotations makes this article
lose credibility.
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References:
2. Mackie T. Helical IMRT- New Treatments Taking Shape for Multiple Myeloma.
Radiology Today. April 2010; 11(4):8. Retrieved from
http://www.radiologytoday.net/archive/rt0410p8.shtml
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and individuals in the academic setting who work in a specialized field.1 These articles
are derived from detailed research, analysis, and data collection. They differ from trade
materials, results, discussion, and conclusion, which analyzes the sum result/findings of
the study. These articles undergo a vigorous process in which peers review them before
the research is accepted for publication.1 I chose an article from the peer-reviewed
Trodella L, Ippolito E, et al.2 I will analyze all parts of this research article as well as
This question analyzed by Ramella and her peers was whether the benefit of using
various breast volume sizes. Ramella et al stated that the background of this research
relied on the observations and reports of radio-dermatitis, chronic fibrosis, lung toxicity,
and poorer cosmetic outcomes associated with patients treated in the supine position.
Whereas in the prone position, the breast hangs down away from the chest wall, which in
return improves target volume homogeneity, reduces infra-mammary and axillary folds
and decreases dose delivered to lung and heart.2 Previous research states that prone
treatment should solely be used for larger/pendulous breast, but Ramella et al wanted to
make a dosimetric comparison amongst subgroups of women having small (<400 mL),
The study included 38 women with early stage breast cancer. A CT plan was
derived in the supine and prone position for each woman. Of the 38 women, twelve had
small (<400 mL), 16 with medium (400700 mL), and 10 presented with large breast
volume (>700 mL). The lesions were located on the right breast in 23 cases and on the
left breast in the other 15 cases.2 Contours were drawn by the same physician for
consistency purposes and the prescribed dose was 50Gy to the isocenter in 25 fractions
within a 5 week span, followed by a 10Gy boost in 4 fractions to the tumor bed.
Following the methods section, Ramella et al provided the results of their study.
The summary of the findings was displayed in detailed tables and plotted graphs
comparing supine versus prone. The subgroup analysis according to breast volume
showed that non-target irradiated tissue in the supine was larger than in prone. It also
showed that the larger the breast volume, the bigger the non-target irradiated tissue there
was as well. Although the findings showed that the prone position showed a benefit
amongst all breast volumes, it wasnt significant in the medium and large groups. In the
small group however, it was evident that there was a 20% reduction in the mean value of
non-target irradiated tissue. The MUs delivered were also significantly decreased in each
subgroup. The authors concluded that the prone position is advantageous regardless of the
Overall, I found this article to be very informative and could be useful for me
down the road as I enter the field as a dosimetrist. During my under-grad studies I did a
research paper on supine versus prone technique for breast patients so this article
especially intrigued me. I learned that prone is not only substantially beneficial for
large/pendulous breast but in this study, the small volume breast saw the most significant
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benefit. It is interesting to see as time goes on, how many institutions will choose prone
over supine as the primary position. Another factor not added to the discussion is whether
the patient can handle the prone position depending on their age, mobility, and comfort
level.
After reading both articles, it is clear to see the distinction in quality of the
information presented. Ramella et al break down why the study was done, the
background behind it, previous studies, materials and methods, and enhanced the results
section by implementing tables and figures so that the reader had a visual aid. Ramella et
al study showed figures and facts to support their claims whereas Mackie just provided
opinion. The professional journal is more useful for a medical professional who is
References: