Decomposition of the dose conversion factor based on fluence spectra of secondary charged particles: Application to lateral dose profiles in photon fields

2018 ◽  
Vol 45 (9) ◽  
pp. 4246-4256 ◽  
Author(s):  
Günther H. Hartmann ◽  
Klemens Zink
2001 ◽  
Vol 36 (4) ◽  
pp. 329-338 ◽  
Author(s):  
Tetsuo ISHIKAWA ◽  
Shinji TOKONAMI ◽  
Hidenori YONEHARA ◽  
Kumiko FUKUTSU ◽  
Yuji YAMADA

2014 ◽  
Vol 161 (1-4) ◽  
pp. 134-138
Author(s):  
S. Yoon ◽  
W.-H. Ha ◽  
S. Park ◽  
S. Shin ◽  
J. Yoo ◽  
...  

2006 ◽  
Vol 7 (1) ◽  
pp. 45-62
Author(s):  
Mario Eandi ◽  
Nicola Giotta ◽  
Roberto Russo ◽  
Maria Michela Gianino

Darbepoetin (DARB), a human erythropoietin with improved pharmacological parameters (longer half life and a dose-response relationship independent from the route of administration) is a new treatment option for chronic nephropathy-induced anemia that in many Italian dialysis centers is substituting older erythropoietins, mainly due to greater ease of use. At current prices and at the theoretical and recommended 200:1 dose conversion factor, DARB pharmaceutical cost ranges from –9% to +17% of EPO cost. In this monocentric study, real drug consumption and related actual costs of a pre-switch semester with EPO were analysed and compared to the first two post-switch semesters with DARB therapy. Furthermore, erythropoetic response was recorded and related to drug exposition levels, in order to establish a real life EPO:DARB dose conversion factor. In this experience, the conversion factor was estimated in at least 250-280:1, depending on the method adopted for the estimation. The initial dose, chosen on the basis of the recommended conversion factor, induced an excessive erythropoietic response, which was generally followed by a dose reduction and successive titration to target desired Hb levels, generating the spiraliform dose-response curve associated with delayed feed-back mechanisms. The pharmacoeconomical analysis, conducted in the perspective of the public health service, indicated that the choice of substituting DARB for EPO in the treatment of chronic kidney failure-associated anemia is univocally convenient, the former being less costly and more effective.


2019 ◽  
Vol 48 (2) ◽  
pp. 106-114 ◽  
Author(s):  
Marc Xipell ◽  
Enrique Montagud-Marrahi ◽  
María Victoria Rubio ◽  
Raquel Ojeda ◽  
Marta Arias-Guillén ◽  
...  

Background: Etelcalcetide is a novel second-generation calcimimetic that, because of its intravenous administration, could improve treatment adherence in secondary hyperparathyroidism (SHPT). The aim of this study was to evaluate the effectiveness of etelcalcetide compared with that of cinacalcet in controlling SHPT in patients under hemodialysis. Methods: A prospective observational study was performed in 29 patients with SHPT under hemodialysis who switched from cinacalcet to etelcalcetide with a follow-up of 6 months. A survey was conducted of adherence to the oral calcimimetic. The primary end-point of the study was to assess whether etelcalcetide was more effective than cinacalcet in controlling SHPT. Results: After the switch of treatment, none of the patients developed clinical intolerance or new adverse effects. Etelcalcetide was more effective than cinacalcet in controlling intact parathyroid hormone (iPTH), with an overall decrease in iPTH levels that was significant from the second month. Average calcium levels remained within the normal range, with a higher percentage of hypocalcemia with etelcalcetide (6.9 vs. 13.8%), which was asymptomatic in all cases. Patients who were nonadherent to cinacalcet (38%) showed a significant reduction in calcium and iPTH during follow-up with etelcalcetide. The adherent group (62%) also showed a trend to lower iPTH levels reaching statistical significance after 5 months of follow-up. The dose conversion factor for the switch from cinacalcet to etelcalcetide was etelcalcetide/session = 0.111*mg cinacalcet/day + 0.96, R2 = 0.57. Conclusions: Etelcalcetide was more effective than cinacalcet in this patient population, especially in the nonadherent subgroup, leading to better SHPT control without adverse effects.


2011 ◽  
Vol 46 (5) ◽  
pp. 503-509 ◽  
Author(s):  
Young-Yong Ji ◽  
Dae-Seok Hong ◽  
Tae-Kuk Kim ◽  
Kyung-Kil Kwak ◽  
Woo-Seog Ryu

Sign in / Sign up

Export Citation Format

Share Document