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Volumetric-modulated arc therapy (RapidArc) vs. conventional fixed-field intensity-modulated radiotherapy for {sup 18}F-FDG-PET-guided dose escalation in oropharyngeal cancer: A planning study

Fluorine-18-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG-PET)–guided focal dose escalation in oropharyngeal cancer may potentially improve local control. We evaluated the feasibility of this approach using volumetric-modulated arc therapy (RapidArc) and compared these plans with fixed-field intensity-modulated radiotherapy (IMRT) focal dose escalation plans. Materials and methods: An initial study of 20 patients compared RapidArc with fixed-field IMRT using standard dose prescriptions. From this cohort, 10 were included in a dose escalation planning study. Dose escalation was applied to {sup 18}F-FDG-PET–positive regions in the primary tumor at dose levels of 5% (DL1), 10% (DL2), and 15% (DL3) above standard radical dose (65 Gy in 30 fractions). Fixed-field IMRT and double-arc RapidArc plans were generated for each dataset. Dose-volume histograms were used for plan evaluation and comparison. The Paddick conformity index (CI{sub Paddick}) and monitor units (MU) for each plan were recorded and compared. Both IMRT and RapidArc produced clinically acceptable plans and achieved planning objectives for target volumes. Dose conformity was significantly better in the RapidArc plans, with lower CI{sub Paddick} scores in both primary (PTV1) and elective (PTV2) planning target volumes (largest difference in PTV1 at DL3; 0.81 ± 0.03 [RapidArc] vs. 0.77 ± 0.07 [IMRT], p = 0.04). Maximum dose constraints for spinal cord and brainstem were not exceeded in both RapidArc and IMRT plans, but mean doses were higher with RapidArc (by 2.7 ± 1 Gy for spinal cord and 1.9 ± 1 Gy for brainstem). Contralateral parotid mean dose was lower with RapidArc, which was statistically significant at DL1 (29.0 vs. 29.9 Gy, p = 0.01) and DL2 (29.3 vs. 30.3 Gy, p = 0.03). MU were reduced by 39.8–49.2% with RapidArc (largest difference at DL3, 641 ± 94 vs. 1261 ± 118, p < 0.01). {sup 18}F-FDG-PET–guided focal dose escalation in oropharyngeal cancer is feasible with RapidArc. Compared with conventional fixed-field IMRT, RapidArc can achieve better dose conformity, improve contralateral parotid sparing, and uses fewer MU.

61 RADIATION PROTECTION AND DOSIMETRY↗

Probing Carbon Mineralization Mechanisms in Pore and Bulk Fluids by Harnessing Architected Calcium Silicates

The ability to synthesize materials with well-controlled pore structures gives us unprecedented control over probing fluid interactions with reactive interfaces and advancing calibrated insights into coupled chemo-morphological interactions. One of the primary challenges in developing crystalline silicate materials lies in achieving ordered pore structures. Existing approaches of producing amorphous mesoporous metal silicates via sol–gel methods and heat-treatment of these materials to produce crystalline phases cause the pore structures in the amorphous phases to collapse. To overcome this challenge, carbon coating of amorphous mesoporous calcium silicate particles is carried out to retain the pore structure, while the material is heated to produce crystalline calcium silicate with calcium sulfate inclusions. The pore diameter in these materials is about 3.9 nm, with a surface area and a pore volume of 28.75 m 2 /g and 0.092 cm 2 /g, respectively. The mechanisms of carbon mineralization are investigated by reacting architected calcium silicate with 1 M Na 2 CO 3 and monitoring the evolution in the structural phases using operando wide-angle X-ray scattering (WAXS) measurements. Formation of stable calcium carbonate polymorph or calcite and metastable calcium carbonate polymorph or vaterite in pore and bulk fluids, respectively, resulting from the reaction between Na 2 CO 3 and CaSiO 3 , are noted. The mechanisms associated with carbon mineralization are delineated using ReaxFF molecular dynamics (MD) simulations. The surface dissolution reaction is initiated by 2H + ions that replace a Ca 2+ ion in the Ca–silicate matrix. Ca 2+ ions in the solution initially react with water to form calcium hydroxide and eventually form calcium (bi)carbonate. A slow and gradual increase in the formation of sodium silicate in the solution resulting from the reactions of silicic acid or the silicon dioxide reaction with sodium hydroxide is noted. When carbon mineralization occurs in environments bearing interfacial fluids, calcite is the dominant calcium carbonate polymorph, as determined using experiments with pore fluids and molecular-scale simulations. In conclusion, these studies provide fundamental insights into the mechanisms underlying the carbon mineralization of calcium silicate informed by experiments and molecular-scale simulations.

Calcium↗

Evidence for the utility of quantum computing before fault tolerance

Quantum computing promises to offer substantial speed-ups over its classical counterpart for certain problems. However, the greatest impediment to realizing its full potential is noise that is inherent to these systems. The widely accepted solution to this challenge is the implementation of fault-tolerant quantum circuits, which is out of reach for current processors. Here we report experiments on a noisy 127-qubit processor and demonstrate the measurement of accurate expectation values for circuit volumes at a scale beyond brute-force classical computation. We argue that this represents evidence for the utility of quantum computing in a pre-fault-tolerant era. These experimental results are enabled by advances in the coherence and calibration of a superconducting processor at this scale and the ability to characterize and controllably manipulate noise across such a large device. We establish the accuracy of the measured expectation values by comparing them with the output of exactly verifiable circuits. In the regime of strong entanglement, the quantum computer provides correct results for which leading classical approximations such as pure-state-based 1D (matrix product states, MPS) and 2D (isometric tensor network states, isoTNS) tensor network methods break down. These experiments demonstrate a foundational tool for the realization of near-term quantum applications.

97 MATHEMATICS AND COMPUTING↗

Reactor physics phenomena in additively manufactured control elements for the High Flux Isotope Reactor

Additive manufacturing is under investigation as a novel method of fabricating the control elements (CEs) of the High Flux Isotope Reactor (HFIR) at Oak Ridge National Laboratory with greater simplicity, eliminating numerous highly complex fabrication steps and thereby offering potential for significant savings in cost, time, and effort. This process yields a unique CE design with lumped absorbers, a departure from traditionally manufactured CEs with uniformly distributed absorbing material. Here, this study undertakes a neutronics analysis of the impact of additively manufactured CEs on the HFIR core physics, seeking preliminary assessment of the feasibility of their practical use. The results of the MCNP transport simulations reveal changes in the HFIR reactor physics arising from geometric and nuclear effects. Absorber lumping in the discrete CEs yields a large volume of unpoisoned material that is not present in the homogeneous design, in turn yielding increases in free thermal flux in the CE absorbing regions and their immediate vicinity. The availability of additional free thermal neutrons in the core yields an increase in fission rate density in the fuel closest to the CEs and a corresponding increase in neutron multiplication on the order of 100 pcm. The absorption behavior exhibited by the discrete CEs is markedly different from the homogeneous CEs due to several competing effects. Self-shielding arising from absorber lumping acts to reduce the effective absorption cross section of the discrete CEs, but this effect is offset by geometric and spectral effects. The operational performance of the discrete CEs is found to be comparable to the homogeneous CEs, with only limited deficiencies in reactivity worth that are expected to be operationally recoverable via limited adjustment of the CE positions and withdrawal rate. On the whole, these results indicate that the discrete CEs perform reasonably similarly to the homogeneous CEs and appear feasible for application in HFIR. In conclusion, the physical phenomena identified in this study provide valuable background for follow-up design studies.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

Production flux of sea spray aerosol

Knowledge of the size- and composition-dependent production flux of primary sea spray aerosol (SSA) particles and its dependence on environmental variables is required for modeling cloud microphysical properties and aerosol radiative influences, interpreting measurements of particulate matter in coastal areas and its relation to air quality, and evaluating rates of uptake and reactions of gases in sea spray drops. This review examines recent research pertinent to SSA production flux, which deals mainly with production of particles with r{sub 80} (equilibrium radius at 80% relative humidity) less than 1 {micro}m and as small as 0.01 {micro}m. Production of sea spray particles and its dependence on controlling factors has been investigated in laboratory studies that have examined the dependences on water temperature, salinity, and the presence of organics and in field measurements with micrometeorological techniques that use newly developed fast optical particle sizers. Extensive measurements show that water-insoluble organic matter contributes substantially to the composition of SSA particles with r{sub 80} < 0.25 {micro}m and, in locations with high biological activity, can be the dominant constituent. Order-of-magnitude variation remains in estimates of the size-dependent production flux per white area, the quantity central to formulations of the production flux based on the whitecap method. This variation indicates that the production flux may depend on quantities such as the volume flux of air bubbles to the surface that are not accounted for in current models. Variation in estimates of the whitecap fraction as a function of wind speed contributes additional, comparable uncertainty to production flux estimates.

54 ENVIRONMENTAL SCIENCES↗

PARETO: A novel evolutionary optimization approach to multiobjective IMRT planning

Purpose: In radiation therapy treatment planning, the clinical objectives of uniform high dose to the planning target volume (PTV) and low dose to the organs-at-risk (OARs) are invariably in conflict, often requiring compromises to be made between them when selecting the best treatment plan for a particular patient. In this work, the authors introduce Pareto-Aware Radiotherapy Evolutionary Treatment Optimization (pareto), a multiobjective optimization tool to solve for beam angles and fluence patterns in intensity-modulated radiation therapy (IMRT) treatment planning. Methods: pareto is built around a powerful multiobjective genetic algorithm (GA), which allows us to treat the problem of IMRT treatment plan optimization as a combined monolithic problem, where all beam fluence and angle parameters are treated equally during the optimization. We have employed a simple parameterized beam fluence representation with a realistic dose calculation approach, incorporating patient scatter effects, to demonstrate feasibility of the proposed approach on two phantoms. The first phantom is a simple cylindrical phantom containing a target surrounded by three OARs, while the second phantom is more complex and represents a paraspinal patient. Results: pareto results in a large database of Pareto nondominated solutions that represent the necessary trade-offs between objectives. The solution quality was examined for several PTV and OAR fitness functions. The combination of a conformity-based PTV fitness function and a dose-volume histogram (DVH) or equivalent uniform dose (EUD) -based fitness function for the OAR produced relatively uniform and conformal PTV doses, with well-spaced beams. A penalty function added to the fitness functions eliminates hotspots. Comparison of resulting DVHs to those from treatment plans developed with a single-objective fluence optimizer (from a commercial treatment planning system) showed good correlation. Results also indicated that pareto shows promise in optimizing the number of beams. Conclusions: This initial evaluation of the evolutionary optimization software tool pareto for IMRT treatment planning demonstrates feasibility and provides motivation for continued development. Advantages of this approach over current commercial methods for treatment planning are many, including: (1) fully automated optimization that avoids human controlled iterative optimization and potentially improves overall process efficiency, (2) formulation of the problem as a true multiobjective one, which provides an optimized set of Pareto nondominated solutions refined over hundreds of generations and compiled from thousands of parameter sets explored during the run, and (3) rapid exploration of the final nondominated set accomplished by a graphical interface used to select the best treatment option for the patient.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Room temperature stress relaxation in nanocrystalline Ni measured by micropillar compression and miniature tension

In this report, we report a micropillar stress relaxation technique employing a stable displacement-controlled, in-situ scanning electron microscope indenter, and unusually large micropillars to precisely measure stress relaxation in electroplated nanocrystalline Ni thin films. The observed stress relaxation is significant under constant displacement: even well below the 0.2% offset yield strength, the stresses relax by ~4% within a minute; in the work hardening regime, stress relaxes by ~9% in 1 min. A logarithmic fit of the relaxation curves is consistent with an Arrhenius thermal activation of plasticity and suggests an activation volume in the vicinity of ~10 b 3 . The apparent and effective activation volumes diverge at lower strains, particularly in the “elastic” regime. These measurements are compared to similar measurements performed on free-standing thin film tensile coupons. Both methods yield similar results, thereby validating the applicability of pillar compression to capture time-dependent plasticity. To our knowledge, these are the first micropillar stress relaxation experiments on metals ever reported.

36 MATERIALS SCIENCE↗

Minimizing phase-space energies

A primary technical challenge for harnessing fusion energy is to control and extract energy from a nonthermal distribution of charged particles. The fact that phase space evolves by symplectomorphisms fundamentally limits how a distribution may be manipulated. While the constraint of phase-space volume preservation is well understood, other constraints remain to be fully appreciated. To better understand these constraints, we study the problem of extracting energy from a distribution of particles using area-preserving and symplectic linear maps. When a quadratic potential is imposed, we find that the maximal extractable energy can be computed as trace minimization problems. We solve these problems and show that the extractable energy under linear symplectomorphisms may be much smaller than the extractable energy under special linear maps. As a result, the method introduced in the present study enables an energy-based proof of the linear Gromov nonsqueezing theorem.

First-principles calculations in plasma physics↗

SU-F-T-503: Trajectory Modulated Arc Therapy of Intracranial Lesions: Development of a Standardized Path-Based Technique for Fully Dynamic Couch-Gantry Modulated Treatments

Purpose: The integration of couch motion during arc delivery is necessitated to enable irradiation trajectories such as coronal arcs, and to enhance the geometrical sampling for dynamic deliveries to the highest extent. To enable such capability, a platform of Trajectory Modulated Arc Therapy (TMAT) is developed in conjunction with standardized noncollisional dynamic path-set for irradiation of intracranial lesions. Methods: A generalized path-set was constructed through the combination of sagittal arcs (45 degrees from the CAX), axial arcs, and coronal arcs produced through modulation of the dynamic rotation of couch. The standardized path was implemented in a contiguous manner enabling the formation of fully automated sub-trajectories to provide maximal geometrical convergence with minimal number of arcs. Progressive sampling technique is used for direct aperture optimization of the MLCs and the selection of couch positions across the control points. Dosimetry of the resulting plans was assessed relative to clinically delivered plans. Using the TrueBeam Developer Mode, plan deliverability was tested. Results: Treatment planning of TMAT sub-trajectories for central, anterior and posterior tumor sites with volumes ranging from 4.75cc to 107cc demonstrated radically reduced doses to the critical OARs when compared to the clinically treated VMAT. Specifically, percentage reduction in mean dose for critical organs such as brainstem, cochlea, and optic nerve are found to be as low as 74±15%, 50±26% and 74±30% respectively as compared to VMAT. Conformity Index, defined as the ratio of tumor volume (VPTV) and 100% dose volume (V(D100%)), was reduced up to 12% while the Gradient Index, defined as V(D100%)/V(D50%), was concurrently improved by up to 14%. Conclusion: An automated standardized trajectory with dynamically modulated couch-gantry arcs has been developed for intracranial radiotherapy. Through the incorporation of coronal arcs, it is demonstrated that significantly reduced OAR doses can be achieved relative to clinically treated patient plans via VMAT. Research Grant Funding Support by Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

Generalized Fluid System Simulation Program (GFSSP) - Version 6

The Generalized Fluid System Simulation Program (GFSSP) is a finite-volume based general-purpose computer program for analyzing steady state and time-dependent flow rates, pressures, temperatures, and concentrations in a complex flow network. The program is capable of modeling real fluids with phase changes, compressibility, mixture thermodynamics, conjugate heat transfer between solid and fluid, fluid transients, pumps, compressors, flow control valves and external body forces such as gravity and centrifugal. The thermo-fluid system to be analyzed is discretized into nodes, branches, and conductors. The scalar properties such as pressure, temperature, and concentrations are calculated at nodes. Mass flow rates and heat transfer rates are computed in branches and conductors. The graphical user interface allows users to build their models using the 'point, drag, and click' method; the users can also run their models and post-process the results in the same environment. The integrated fluid library supplies thermodynamic and thermo-physical properties of 36 fluids, and 24 different resistance/source options are provided for modeling momentum sources or sinks in the branches. Users can introduce new physics, non-linear and time-dependent boundary conditions through user-subroutine.

Majumdar, Alok↗

Application of the Concepts of Load State, Load Space, and Output Space to Strain-Gage Balances

The concepts of load state, load space, and output space are used to describe elements of the development of a load prediction process for a six–component strain–gage balance. The use of these terms adds clarity during the selection of the independent and dependent variables for the development of the load prediction process. First, the control volume model of a strain–gage balance is reviewed as it helps better understand the role of loads, outputs, and state variables during the load prediction. Then, the description of the absolute load datum in both the load space and the output space is discussed. It is concluded that the use of the difference between a raw output and the natural zero of a balance gage has a key advantage for the definition of the output space. In that case, the origin of the output space will also describe the absolute load datum of the balance. Finally, details of the application of the concepts of load state, load space, and output space to two commonly used balance load prediction methods are discussed.

strain-gage balance↗

What's on the menu? Examining native apex‐ and invasive meso‐predator diets to understand impacts on ecosystems

Abstract Understanding how carnivores impact ecological communities is essential for guiding effective management actions and conserving biodiversity. Quantifying predators' diets, including prey selectivity, allows for the assessment of the relative effects native and invasive predators may have on prey populations. In Australia, populations of a native, terrestrial apex predator, the dingo Canis dingo/C. familiaris , and introduced and invasive subordinate mesopredators, the European red fox Vulpes vulpes and feral cat Felis catus , co‐occur, but there is limited understanding of their relative impacts on native and invasive prey in different ecosystems. To assess the possible effects of dingoes, foxes and cats on prey, we examined their diet and prey selectivity across a ~10,000 km 2 semi‐arid mallee ecosystem. Using macroscopic scat analysis, we identified strong dietary niche separation. Larger‐bodied dingoes primarily consumed large marsupial herbivores, whereas foxes and cats primarily consumed smaller prey, including introduced and native rodents and birds. Foxes had the broadest diet, and the greatest dietary overlap with cats ( = 0.81), compared with dingoes ( = 0.50) or between dingoes and cats ( = 0.36). Livestock were identified in 2% of dingo and 7% of fox scats. Cats and foxes consumed more than 15 times the volume of small native mammals compared with dingoes, including threatened species such as fat‐tailed dunnarts Sminthopsis crassicaudata . Cats and foxes also selectively consumed small mammals relative to their estimated availability and consumed fewer large mammals. In contrast, dingoes consumed fewer birds and more echidnas relative to their availability. Our results suggest limited intraguild competition within this semi‐arid ecosystem, as dingoes are primarily exerting top‐down pressure on large herbivores, whereas invasive mesopredators are disproportionately impacting smaller prey, including threatened native mammals. Practical implication . Our findings suggest that ongoing conservation management of dingoes, red foxes and feral cats must consider the variation in diets, impacts on prey and ecological roles of these different predator species, and avoid indiscriminate lethal control methods. Quantifying actual, rather than assumed, impacts of predators on threatened native species, large herbivores and livestock is essential to achieve effective and integrated ecosystem management.

Mason, Rachel T. [School of Life and Environmental↗

Patterning Si at the 1 nm Length Scale with Aberration-Corrected Electron-Beam Lithography: Tuning of Plasmonic Properties by Design

Patterning of materials at single nanometer resolution allows engineering of quantum confinement effects, as these effects are significant at these length scales, and yields direct control over electro-optical properties. Silicon is by far the most important material in electronics, and the ability to fabricate Si-based devices of the smallest dimensions for novel device engineering is highly desirable. Here, the work presented here uses aberration-corrected electron-beam lithography combined with dry reactive ion etching to achieve both: patterning of 1-nm features and surface and volume plasmon engineering in Si. The nanofabrication technique employed here produces nanowires with a line edge roughness (LER) of 1 nm (3σ). In addition, this work demonstrates tuning of the Si volume plasmon energy by 1.2 eV from the bulk value, which is one order of magnitude higher than previous attempts of volume plasmon engineering using lithographic methods.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

Stereotactic Irradiation of the Postoperative Resection Cavity for Brain Metastasis: A Frameless Linear Accelerator-Based Case Series and Review of the Technique

Purpose: Whole-brain radiation therapy (WBRT) is the standard of care after resection of a brain metastasis. However, concern regarding possible neurocognitive effects and the lack of survival benefit with this approach has led to the use of stereotactic radiosurgery (SRS) to the resection cavity in place of WBRT. We report our initial experience using an image-guided linear accelerator-based frameless stereotactic system and review the technical issues in applying this technique. Methods and Materials: We retrospectively reviewed the setup accuracy, treatment outcome, and patterns of failure of the first 18 consecutive cases treated at Brigham and Women's Hospital. The target volume was the resection cavity without a margin excluding the surgical track. Results: The median number of brain metastases per patient was 1 (range, 1-3). The median planning target volume was 3.49 mL. The median prescribed dose was 18 Gy (range, 15-18 Gy) with normalization ranging from 68% to 85%. In all cases, 99% of the planning target volume was covered by the prescribed dose. The median conformity index was 1.6 (range, 1.41-1.92). The SRS was delivered with submillimeter accuracy. At a median follow-up of 12.7 months, local control was achieved in 16/18 cavities treated. True local recurrence occurred in 2 patients. No marginal failures occurred. Distant recurrence occurred in 6/17 patients. Median time to any failure was 7.4 months. No Grade 3 or higher toxicity was recorded. A long interval between initial cancer diagnosis and the development of brain metastasis was the only factor that trended toward a significant association with the absence of recurrence (local or distant) (log-rank p = 0.097). Conclusions: Frameless stereotactic irradiation of the resection cavity after surgery for a brain metastasis is a safe and accurate technique that offers durable local control and defers the use of WBRT in select patients. This technique should be tested in larger prospective studies.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A Simple, Revolutionary Approach to Waste Packaging Utilizing Proven Technology - 20201

Historically, removing hazardous waste from gloveboxes involves the use of bags as the primary containment method. This method can prove tedious, repetitive, and time consuming to ensure the process follows all safeguards required to contain the waste and mitigate any breach of containment. Layers of bags, yards of tape, and multiple filters are added to the waste stream in order to transfer the hazardous waste from the glovebox safely into the drum package. Then, finally, it can be shipped and disposed of. The process to cut, tie, and tape each bag for disposal involves manual effort by multiple operators. Following Administrative Safety Controls, good operators are able to safely perform those tasks; but, since the bag is the only confinement layer, incidents can occur. Operators, in some cases, are also at close proximity to this waste which may increase the risk of radiation exposure. Once the waste is transferred out through these bags, it is nearly impossible to remove packaged waste that may contain higher dosage levels, thus increasing drum disposal costs incurred by the facility. Exceeding the allowable radiation levels, and drums not fully filled, both contribute significantly to excess disposal costs. Central Research Laboratories (CRL), based in Red Wing Minnesota, has developed the Waste Drum Transfer System (WDTS) building upon the proven technology and containment of the Rapid Transfer Port (RTP) as an alternate, more efficient method of waste transfer. This solution consists of an RTP Alpha port mounted inside a glovebox and Beta assembly unit composed of a drum liner fitted inside a standard 55 gallon drum. The use of the Beta drum liner bypasses the typical use of bags, sleeves or tape to provide leak tight containment. The process to connect and disconnect a drum from the glovebox is achieved by the self-docking and rotating system controls of the RTP Alpha, all done with only one operator standing in an upright ergonomic position. This system also allows for greater flexibility in available Beta connection options, expanding the overall functionality of the system. This system can be disconnected and reconnected multiple times to maximize volume containment. This will minimize drum disposal costs and reduce the overall volume of waste output by more efficiently filling the drums. Radiation levels inside each drum can be monitored and adjusted more efficiently by operators utilizing the reconnect option. Minimal As Low As Reasonably Achievable (ALARA) levels are also achievable with this system. This paper will show how highly efficient packaging and disposal of hazardous waste can be accomplished in a cost-effective manner utilizing the proven RTP technology. Maximized operator productivity and safety, as well as minimized radiation dose exposure, are all attainable through the system's engineered controls. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Elective Nodal Irradiation and Patterns of Failure in Head and Neck Cancer After Primary Radiation Therapy

Purpose: The delineation of elective clinical target volumes in head and neck cancer (HNC) is important; however, the extent of lymph node levels necessary to include is debated. A comprehensive analysis of recurrence patterns in a large cohort of patients with HNC was performed, with an emphasis on recurrence in the retropharyngeal region and level IB. Methods and Materials: From 2005 to 2012, 942 patients with oropharyngeal, hypopharyngeal, laryngeal or oral cavity carcinomas were curatively treated with primary radiation therapy. The median follow-up period was 34 months, and 77% of the patients underwent intensity modulated radiation therapy. The retropharyngeal region was only routinely included in cases of involvement of the posterior pharynx wall and level IB only in cases of involvement of the oral cavity. In patients with regional recurrence, the anatomic site of the recurrence was assessed from the surgical descriptions or computed tomography scans and compared with the original radiation treatment plan (available from 2007 onward). The p16 status was available for 282 oropharynx carcinoma cases, with 65% p16-positive. Results: Of the 942 patients, 376 (40%) developed recurrences: 228 (24.2%) local, 123 (13.1%) regional, and 109 (11.6%) distant. In 700 patients with available treatment plans, retropharyngeal and level IB recurrence was observed in 2 and 7 patients, respectively. Eight patients (1.1%) had recurrence in a lymph node level not included in their primary treatment plan. For oropharynx carcinoma, the locoregional control rate (90% vs 70%) but not distant control rate (92% vs 87%), was significantly better in the p16-positive than in the p16-negative patients. Although fewer recurrences developed in the p16-positive group, patients with recurrence of p16-positive tumors were more likely to develop recurrence in distant sites. Conclusions: Retropharyngeal or level IB recurrence after primary HNC radiation therapy is rare. Thus, inclusion of these regions in the elective treatment volumes should be limited to patients with involvement of the posterior pharyngeal wall or oral cavity.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Hypofractionated Dose-Painting Intensity Modulated Radiation Therapy With Chemotherapy for Nasopharyngeal Carcinoma: A Prospective Trial

Purpose: To evaluate the feasibility of dose-painting intensity-modulated radiation therapy (DP-IMRT) with a hypofractionated regimen to treat nasopharyngeal carcinoma (NPC) with concomitant toxicity reduction. Methods and Materials: From October 2002 through April 2007, 25 newly diagnosed NPC patients were enrolled in a prospective trial. DP-IMRT was prescribed to deliver 70.2 Gy using 2.34-Gy fractions to the gross tumor volume for the primary and nodal sites while simultaneously delivering 54 Gy in 1.8-Gy fractions to regions at risk of microscopic disease. Patients received concurrent and adjuvant platin-based chemotherapy similar to the Intergroup 0099 trial. Results: Patient and disease characteristics are as follows: median age, 46; 44% Asian; 68% male; 76% World Health Organization III; 20% T1, 52% T2, 16% T3, 12% T4; 20% N0, 36% N1, 36% N2, 8% N3. With median follow-up of 33 months, 3-year local control was 91%, regional control was 91%, freedom from distant metastases was 91%, and overall survival was 89%. The average mean dose to each cochlea was 43 Gy. With median audiogram follow-up of 14 months, only one patient had clinically significant (Grade 3) hearing loss. Twelve percent of patients developed temporal lobe necrosis; one patient required surgical resection. Conclusions: Preliminary findings using a hypofractionated DP-IMRT regimen demonstrated that local control, freedom from distant metastases, and overall survival compared favorably with other series of IMRT and chemotherapy. The highly conformal boost to the tumor bed resulted low rates of severe ototoxicity (Grade 3-4). However, the incidence of in-field brain radiation necrosis indicates that 2.34 Gy per fraction is not safe in this setting.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Deuteration Effects on the Physical and Optoelectronic Properties of Donor–Acceptor Conjugated Polymers

The significant differences in scattering cross sections between deuterium and protium are unique to neutron scattering techniques and have been a long-standing area of interest within the neutron scattering community. Researchers have explored selective deuteration to manipulate scattering contrast in soft matter systems, leading to the widespread use of deuterium labeling in materials development. As deuteration changes the atomic mass, it alters physical properties such as molecular volume, polarizability, and polarity, which in turn may affect noncovalent interactions and crystal ordering. Despite previous studies, there remains a limited understanding of how deuteration impacts donor–acceptor (DA) conjugated polymers. To address this, we synthesized deuterated DPP polymers and systematically investigated the effects of side-chain deuteration on their thermal stability, crystal packing, morphology, and optoelectronic properties. We found that deuteration increased the melting and crystallization temperatures of DPP polymers, although it did not significantly alter their morphology, molecular packing, or charge mobility. These properties were assessed by using atomic force microscopy (AFM), X-ray scattering, and thin-film transistor device measurements, respectively, for DPP polymers. Our work shows that deuterium labeling could be a powerful method for controlling scattering length density, enabling neutrons to study the structure and dynamics of conjugated polymers without impacting their electronic performance.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗