[en] The annual production of plutonium in the individual reactor types is shown and the annual and cumulative production in capitalist countries between 1975 and 2000 is estimated. The use is discussed of plutonium as FBR type reactor fuel and plutonium recycle in light-water reactors is economically justified. The basic hygiene characteristics of Pu are indicated and Pu health risks are compared with those of other toxic substances. The question is discussed of possible contamination with Pu in normal or emergency operation of nuclear facilities, of very high-active Pu-containing waste processing and of the misuse of plutonium by terrorists. It is shown that although plutonium cannot be considered to be harmless, thirty years of experiences have proved that it does not pose a major risk provided safety regulations are observed. (J.P.)

[en] Background and purpose: Single fraction radiation treatment (SFRT) is recommended for its equivalence to multiple-fraction (MF) RT in the palliation of uncomplicated bone metastases (BM). However, adoption of SFRT has been slow. Materials and methods: Literature searches for studies published following 2014 were conducted using online repositories of gray literature, Ovid MEDLINE, Embase and Embase Classic, and the Cochrane Central Register of Controlled Trials databases. Results: A total of 32 articles detailing patterns of practice and clinical practice guidelines were included for final synthesis. The majority of organizations have released high level recommendations for SFRT use in treatment of uncomplicated BM, based on evidence of non-inferiority to MFRT. There are key differences between guidelines, such as varying strengths of recommendation for SFRT use over MFRT; contraindication in vertebral sites for SFRT; and risk estimation of pathologic fractures after SFRT. Differences in guidelines may be influenced by committee composition and organization mandate. Differences in patterns of practice may be influenced by individual center policies, payment modalities and consideration of patient factors such as age, prognosis, and performance status. Conclusion: Although there is some variation between groups, the majority of guidelines recommend use of SFRT and others consider it to be a reasonable alternative to MFRT.

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[en] The reporting of adverse effects is an integral aspect of a hospital quality improvement (QI) program with the goal of improving care for current and future patients. We report the results of our experience tracking patient hospitalizations, treatment breaks, and weight loss in patients receiving radiotherapy as part of a departmental QI program. In 2014, the Center for Cancer Care at Exeter hospital developed a departmental quality initiative to track adverse outcomes in a population of patients receiving radiation therapy. Criteria for inclusion in this initiative included: treatment break ≥3 days, hospitalization either while on treatment of within 2 weeks of treatment, death within 2 weeks of treatment, or weight loss of ≥10%. Patients included on this registry were reviewed at regularly scheduled departmental QI meetings, where solutions for improvement were discussed. Ninety-one patients were identified as having an event that meet the above-mentioned criteria. Forty-three patients were receiving concurrent chemotherapy (47.2%) Fifty-four (54.9%) patients had toxicity directly attributable to their treatment. Sixty-five patients (71.4%) were treated with curative intent. Nineteen patients (21.1%) died either during the course of radiotherapy, or within two weeks of completion of treatment. Advanced age was significantly associated with inferior overall and disease free survival in this analysis, HR 1.030 (1.006–1.054) p = 0.0125, and HR 1.034 (1.008–1.061) p = 0.010 respectively. We believe that this protocol to track events has been helpful in making practice changes in our department. Our results suggest that elderly patients who experience qualifying event are at increased risk of death, and providers should be cognizant of this finding. Future QI projects can seek to better understand how such changes have resulted in improvements in patient care.

[en] Risk assessment has become a popular, controversial, and sometimes misunderstood subject in the nuclear field. Part of the difficulty is the use of different meanings by different investigators, as well as variations in the depth of analysis considered to be appropriate. This paper discusses the various meanings, suggests a specific meaning for decisions involving radiological hazards, considers the phases of such an analysis, and proposes an approach to be used where the methodology is incomplete

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[en] Abstract only

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[en] This volume contains the knowledge which is needed for safely working in a laboratory. With the help of the contents it is possible to come, after an evaluation of the risks, to practical measures (risk control). Not only exposure to chemicals but also to other burdening factors (radiation, sound, radioactive materials, micro-organisms) are discussed. A general strategy for risk control forms the central point in this book. 51 refs.; 67 figs.; 29 tabs

[en] To investigate the risk of second cancer and radiation induced second cancer following prostate cancer radiotherapy. We compared men with radiotherapy only with those treated with radical prostatectomy only and those with radiotherapy after radical prostatectomy. Cumulative incidences of second cancers were calculated. Cox analyses were performed to identify determinants influencing second cancer incidence. Nineteen thousand five hundred thirty eight patients were analyzed. Age and median follow-up differed significantly with radiotherapy only patients having the highest median age (70.3 years) and radical prostatectomy only patients the longest median follow-up (10.2 years). Ten-year cumulative incidence of second cancer was 15.9%, 13.2% and 10.5% for patients with radiotherapy only, radiotherapy after radical prostatectomy and radical prostatectomy only (p <0.0001). Increasing age and belonging to the radiotherapy only group were associated with a higher risk of second cancer—no significant increase was seen in radiotherapy after radical prostatectomy patients. A significantly higher rate of smoking related malignancies, like lung, bladder and non-melanoma skin cancer, was seen in radiotherapy only patients. No clear increase in radiation induced second cancer was found in patients after radiotherapy for prostate cancer. Whereas the rate of second cancer was increased in radiotherapy only patients, no such increase was seen in patients with radiotherapy after radical prostatectomy. The increase of second cancer following radiotherapy only is highly likely to reflect advanced age and lifestyle habits and comorbidities.