INTRODUCTION
This purpose of this paper is to critically appraise a research article titled “Technical Aspects of Daily Online Positioning of the Prostate for Three-Dimensional Conformal Radiotherapy Using an Electronic Portal Imaging Device.” The article provides an abstract which clearly stated the purpose of the study, the methods and materials, the results, and the conclusions. The purpose of this study is to develop a real-time electronic portal imaging device procedure to identify intraprostatic gold markers and correct daily variations in target position during external beam radiotherapy for prostate cancer.
Researches in medicine and science such as this improve the practice of the health care profession and raise the standards of the profession. But not all findings in researches are properly done and can be used as a basis for nursing practice. Therefore there is a need to consider the worth of the study and the evidence provided in the study, thus critically appraising the study.
CRITIQUE
Radiotherapy is the treatment of disease with radiation, especially by selective irradiation with x-rays or other ionizing radiation and by ingestion of radioisotopes. It is also called as radiation therapy. Long-term control of prostate cancer can be achieved in a relatively high-risk patient population using interstitial brachytherapy in combination with external beam radiation therapy (2003).
External beam radiation has proven successful in the treatment of localized prostate cancer and is associated with a success rate comparable to surgery for patients with localized prostate cancer. The survival rate for patients with localized prostate cancer, stages A and B, treated with external beam radiation is similar to that for age-adjusted cohorts without prostate cancer (1996).
The efficacy and tolerance, however, of external beam radiation therapy depends on the accurate localization of the target, maximal exclusion of critical normal structures, and the delivery of an appropriate dose to this volume. However, the accuracy and position of target is usually dependent on skin markings. Errors therefore occur in field alignment. Thus this study describes an efficient treatment protocol that uses an Electronic Portal Imaging Device with gold markers to measure and find the correct location which needs radiation.
All these are part of the introduction of the study which provides the background of the medical issue and the importance of doing such a research. The most important purpose of the introduction is to define the question that is to be answered and to provide the reason for finding the answer to the question raised. This section is usually divided into parts consisting of background, rationale, and conceptual framework among many others. But for this particular paper, that is not so the case.
The next should have been the review of literature which is an exhaustive summary of relevant information regarding the topic of the research. It provides information that justifies the need for the research to be conducted. However, this section is not found in this particular research paper. The study has no literature review included but the introduction in itself can be considered the literature review also since it was able to provide relevant literature related to the topic.
In the study, twenty patients with clinical stage II prostate cancer were recruited as participants. Informed consent was obtained in this feasibility study. The twenty patients undergo an intended treatment following acquisition of pretherapy electronic portal images and external beam radiation. There was no mention if ethical approval was obtained from the hospital or a higher ethics committee. In the study, a detailed discussion is provided on how the research is being carried out. However, some of the terms used in the research are very technical and can only be understood by a medical practitioner.
The results provided are also very detailed. The bottom line is that all markers are identified on 99.6% of the pretherapy. Fifty three percent of the treatment fractions are realigned. In the discussion section, results should have been compared with similar information from other reports and reasons for differences should be identified. The discussion stated that interfractional set up variation and organ motion is a well-described phenomenon in external beam radiation therapy for prostate cancer. Because of the variations in the position of the prostate, the researchers wanted to develop an easy to implement, reliable, and time-efficient localization method, which is the one used in the study. This discussion can be easily understood by non medical professionals and makes up for the confusion that the earlier part of the paper presents.
The article then provides a conclusion wherein it emphasized the need to use intraprostatic gold markers during radiation therapy, in order to pinpoint the exact location and save time. This study uses general principles which are focused on prostate cancer and the prostate gland can also be used on other disease sites. Future researchers can gather information from this study and use it on other researches that focus on diseases affecting other parts of the body.
CONCLUSION
The research on ‘“Technical Aspects of Daily Online Positioning of the Prostate for Three-Dimensional Conformal Radiotherapy Using an Electronic Portal Imaging Device” has its ups and downs. The authors of the research should provide a scholarly discussion of the research activity that they conducted in which the results indicate a mastery of the topic. Although the authors presented a mastery of the topic in this research and the results are useful and could benefit the entire medical organization, the study in its printed from was not properly presented. It lacks many things that a formal research paper should have. Its redeeming point is only that it is very relevant to the medical community. All in all, this particular research is not bad, yet it could benefit from some improvement.
Credit:ivythesis.typepad.com
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