Abstract: This invention relates to adaptive resistance inhibiting 100 to 10,000 Gy, single fraction proton and carbon ion microbeam and nanobeam radiosurgery, proton spray chemotherapy and proton spray gadolinium and boron neutron capture therapy with least normal tissue toxicity. Secondary neutrons, protons, ions and radiation from the accelerator and the patient specific collimator are removed with tissue equivalent collimator that also generates proton and carbon ion microbeam and nanobeam. Laser interaction with micrometer and nanometer thick metallic and diamond like carbon targets are also used for proton and carbon ion beam generation. Polyenergetic proton beam is spatially separated. Ion beam and Laser ion beam is accelerated in a hybrid RF accelerator. It is split into microbeam and nanobeam. Secondary neutrons, protons and gamma radiation are removed with tissue equivalent collimators that also generate microbeams and nanobeams.

Abstract: Mutated genome silencing with endogenous RNAi-siRNA and miRNA with near total cellular apheresis with pulse flow apheresis system and EV-exosome-RNA molecular apheresis with sucrose density gradient continuous flow ultracentrifugation combined with array centrifuge for both 50S higher and 50S lower proteomics and genomics apheresis and their fractionated purification with immobilized Tim4-Fc protein Ca2+ magnetic beads affinity chromatography (ACG) and immobilized metal ACG is disclosed. It purifies normal cell derived and tumor cell derived EVs-exosomes, proteomics and subcellular particles. Tumor-specific endogenous siRNA is generated from mutated RNA containing pre-miRNA hairpin through RNA-induced silencing complex (RISC) composed of Dicer, dsRNA binding protein TRBP, and AGO2. Incubating purified RSIC with pre-let-7 hairpin generates siRNA. SiRNA is bonded with T-EVs and T-cells to silence its evasion from tumor immunity.

Abstract: Normal tissue complications limit curative broadbeam radiotherapy to tumors including lung cancer. Radiation retinitis causing blindness limits quality of life and long term survival for patients with ocular melanoma. This invention pertains to alternative, normal tissue sparing 100 to 1,000 Gy microbeam radiations with least normal tissue complications and concomitant radio-immunotherapy by innate immune response of epidermis and dermis to low dose radiation with 50 kV X-rays. Total body skin radiation with former airport passenger screening machines with 50 kV X-ray is disclosed. Microbeams are generated without contaminating scatter and neutron radiations from collinear gamma ray and electron beam produced by inverse Compton interaction with high energy laser and electron beam and from proton and carbon ion beams in tissue equivalent cylindrical collimators.

Abstract: Conventional single fraction 20-Gy broadbeam photonbeam or protonbeam chemo-radiosurgery does not sterilize EMT-MET cancer stem cell radiodurans but single fraction 100 to 10,000 Gy microbeam radiosurgery sterilizes them. Device and methods for microbeam chemo-radiosurgery including 250 MeV wakefield electronbeam is disclosed. Surgery, chemotherapy and broadbeam and microbeam radiosurgery releases billions of abscopal metastasis causing, tumor specific plasma soluble proteins, cell membranes, apoptotic bodies, DNA and RNAs, exosomes like telomere-telomerase, ATM-ATM kinase and others. They and adaptive resistance to chemo-radiosurgery, paraneoplastic and non-paraneoplastic diseases causing immune complexes are removed by pulse flow combined continuous flow ultracentrifugation apheresis and immune affinity chromatography.

Abstract: This invention pertains to a method of low-cost intraoperative all field simultaneous parallel microbeam single fraction few seconds duration 100 to 1,000 Gy and higher dose radiosurgery with micro-electro-mechanical systems (MEMS)-carbon nanotube based microaccelerators. It ablates cancer cells including the mesenchymal epithelial transformation associated cancer stem cells. Microbeam brachy-therapeutic radiosurgery is performed. Microaccelerators are configured for simultaneous parallel microbeam emission from varying angels to an isocentric tumor. Their additive dose rate at the isocentric tumor is in the range of 10,000 to 20,000 Gy/s. It eliminates most tumor recurrence and metastasis which enhances cancer cure rates. It also exposes cancer antigens which induces cancer immunity. Stereotactic breast core biopsy is combined with, positron emission tomography and computerized tomography and phase-contrast imaging. Parallel microbeam brachytherapy preserves normal breast appearance.

Abstract: This invention relates to MEMS X-ray sources based on carbon nanotube coated with metal oxides and metal oxide crystals and insulated with parylene for parallel microbeam intraoperative 100 to 1,000 Gy radiation therapies with minimal toxicity to normal tissue. It sterilizes cancer stem cells that cause tumor recurrence and metastasis. It generates high brightness, 10,000 to 20,000 Gy/s radiations that is closer to synchrotron radiation's dose rate. The parallel microbeam generating X-ray sources are microfabricated with CNT and its variant herringbone, stacked carbon nanotube. They are implantable or contact therapy X-ray sources. Each microfocus carbon nanotube based X-ray source is capable of switching a series of parallel microbeam simultaneously or in sequence. The 100-1,000 Gy single fraction radiosurgery exposes tumor antigens that induce local and systemic tumor immunity. It avoids adaptive resistance to radiation therapy as with 2 Gy daily fractionated radiation therapies that lasts several weeks.

Abstract: This invention relates to adaptive resistance inhibiting 100 to 1,000 Gy, single fraction radiosurgery with inverse Compton scattering gamma ray microbeam and nanobeam. The distance from two adjacent microbeams or the nanobeam generate peak and valley dose. Proliferation of normal tissue's clonogenic cells from low or no dose valley region to peak dose regions makes the normal tissue tolerance to to 100 to 1,000 Gy. The collilinear electron beam and gamma ray microbeam and nanobeam are generated in microfocus carbon tubes in a tissue equivalent primary collimator. Electron beam is absorbed by the tissue equivalent primary collimator. Focusing anode and magnets and multiwalled carbon nanotubes channels the microbeam and nanobeam as focused beams. Methods of spread out or spot scanned or raster scanned collilinear gamma ray microbeam and nanobeam radiosurgery are implemented. Adaptive resistance to cancer treatment is inhibited by inactivation of cancer cell's repair capabilities.

Abstract: A microbeam intraoperative, 10-50 kilovoltage radiation therapy system with multiple simultaneous microfocus X-ray sources and method for image guided, microsecond duration, 100 to 1,000 Gy microbeam radiation therapies with dose rate ranging from 1,000 to 20,000 Gy per second and RBE closer to high LET with minimal toxicity to normal tissue is provided. Dismountable coronal, sagital and transverse half-circle gantry sections are assembled on to a surgical table for mounting the microfocus X-ray sources for intraoperative radiosurgery. A stereotactic breast core biopsy system is adapted for combined breast biopsy, positron emission tomography and computerized tomography with phase-contrast imaging. Cosmetic whole breast preserving electronic brachytherapy is combined with stereotactic core biopsy. The low dose valley regions of the intersecting microbeams at the tumor site are filled with scattered and characteristic radiation from high Z-element that is bound or implanted into the tumor.

Abstract: This invention describes a system for generating multiple simultaneous tunable electron and photon beams and monochromatic x-rays for all field simultaneous radiation therapy (AFSRT), tumor specific AFSRT and screening for concealed elements worn on to the body or contained in a container. Inverse Compton scattering renders variable energy spent electron and tunable monochromatic x-rays. It's spent electron beam is reused for radiation with electron beam or to generate photon beam. Tumor specific radiation with Auger transformation radiation is facilitated by exposing high affinity tumor bound heavy elements with external monochromatic x-rays. Heavy elements like directly iodinated steroid molecule that has high affinity binding to estrogen receptor in breast cancer and to iodinated testosterone in prostate cancer or with directly implanted nanoparticles into the tumor are exposed with tuned external monochromatic x-rays for tumor specific radiation therapy.

Abstract: This invention relates to single session image guided all field simultaneous radiation therapy combined with hyperthermia. Hyperthermia renders the radiation resistant cells as more radiation sensitive cells. The high and super-high dose rate radiation greatly improves the RBE of the photon radiation. It also minimizes photon radiation therapy's OER and cell cycle dependent tumor cell kill by minimizing the repair capacity of cell after photon radiation. Single session hyperthermia and radiation therapy overcomes the thermotolerance-associated inefficiency of hyperthermia treatment as it is when hyperthermia is combined with fractionated, lower dose rate radiation. The synergetic effects of sublethal damage repair inhibiting single session hyperthermia-combined with high dose and dose rate single session radiation therapy, and combined chemotherapy brings the photon radiation therapy's tumor cure and control capabilities closer to high LET radiation therapy.

Abstract: S-band, C-band or X-band microwave powered linear accelerators capable of delivering therapeutic photon and electron beams are mounted to a gantry with extensions to hold multiple accelerators and are combined with a kV CT for 3-D conformal—IMRT and IGRT to treat a patient by SSD or SAD methods and in a full circle. The invention's tertiary collimator system consists of semi-automated reusable custom field shaping with tungsten powder or melted Cerrobend blocks. The beam's intensity modulation is by means of simultaneous but independently operating multiple accelerators. This system's multiple accelerators enable to avoid interrupted subfractionated radiation therapy to each treatment fields. Hence its effective dose rate at the tumor site is high. The improved radiobiology reduces the total radiation dose to treat a tumor, reducing the incidence of developing second primary tumors is also minimized.

Abstract: A medical accelerator system is provided for simultaneous radiation therapy to all treatment fields. It provides the single dose effect of radiation on cell survival. It eliminates the inter-field interrupted, subfractionated fractionated radiation therapy. Single or four beams S-band, C-band or X-band accelerators are connected to treatment heads through connecting beam lines. It is placed in a radiation shielding vault which minimizes the leakage and scattered radiation and the size and weight of the treatment head. In one version, treatment heads are arranged circularly and connected with the beam line. In another version, a pair of treatment heads is mounted to each ends of narrow gantries and multiple such treatment heads mounted gantries are assembled together. Electron beam is steered to all the treatment heads simultaneously to treat all the fields simultaneously.

Abstract: A medical accelerator system consisting of coplanar and non-coplanar beams, on line magnetic resonance anatomic and functional imaging and cone beam computed tomographic imaging for single session image guided all field simultaneous radiation therapy and radiosurgery is provided. This system enables single session simulation, field-shaping block making, treatment planning, dose calculations and treatment of tumors. The radiation exposure time to the tumor and the normal tissue is reduced to a few seconds to less than a minute. In filed intensity modulated radiation is rendered by combined divergent and pencil beam, multiple smaller fields within a larger field, selectively varying beam's energy, dose rate and beam weight. Since all the treatment fields are treated simultaneously the dose rate at the tumor site is the sum of each of the converging beam's dose rate at depth. This super-high biological dose rate impairs the lethal and sublethal damage repair.

Abstract: An improved method and products for the primary hormonal treatment of early stage, low and intermediate risk prostate cancers by prostatic implants of androgen suppressive drugs formulated as fused with a lipoid carrier or encapsulated in microcapsules or in Silastic capsules is provided. Such prostatic implants renders a constant slow-release of their contents to the prostate for extended periods by biodegradation and diffusion. It facilitates higher prostatic and lower systemic concentrations of androgen suppressive hormones. Because of their high prostatic and lower systemic concentrations, tumor control is much improved and the their systemic toxicity is minimized. Tumor control after such primary hormonal implant treatment is followed by clinical examinations and the biochemical tumor control is followed by periodic estimations of serum levels of PSA and acid phosphatase.

Abstract: An improved method and products for the hormonal treatment of breast cancer by breast implants of anti-estrogens and steroid hormones in formulations as fused with a lipoid carrier or encapsulated in microcapsules or in Silastic capsules is provided. Such breast implants renders a constant slow-release of their contents to the breast tissue for extended periods by biodegradation and diffusion. It facilitates higher breast tissue concentrations of anti-estrogen and hormonal compositions. Because of their high concentration in the breast and lower systemic distribution, tumor control is much improved and the their systemic toxicity is minimized. An added beneficial effect of these breast implants on breast cancer is mediated by the inhibition of hypothalamic-pituitary LHRH, FSH and LH secretion by these composition's systemic contents. It is also an effective prophylaxis against breast cancer. Furthermore, it reduces the cost of hormonal treatment of breast cancer.

Abstract: A method and a system for high, super- and ultra-high resolution digitized image analysis of chest x-rays is provided for diagnosis of slowly evolving difficult to visualize early stage lung cancer and pulmonary diseases including very early stage diffuse pulmonary pneumoconiosis and silicosis. This method of digitized chest x-ray image analysis also facilitates the visualization of visceral, mediastinal and parietal pleura and the pericardium as separate distinct layers covering the lung and the heart. Such distinct imaging of those structures was not feasible by any other methods of imaging of the chest. Digital image enhancements allow presentation of important structures in the image in different colors and contrast. This method of high resolution digitized and software assisted chest x-ray analysis shows that it takes about 3-4 years before a lung cancer becomes distinctly visible in a chest x-ray. Chest x-ray is the most commonly used initial diagnostic imaging for the diagnosis of pulmonary diseases.

Abstract: A patient setup and treatment verification system for radiation therapy having diagnostic imaging devices connected to a room containing a megavoltage radiation therapy machine. The diagnostic rooms and the megavoltage therapy room are connected to each other by openings in the shared secondary wall of the accelerator or through an anteroom to the megavoltage therapy room. Daily patient setup for routine and three-dimensional conformal radiation therapy and on-line treatment port verification with superimposed isodose are done with the patient on a diagnostic-imaging table. The patients are transferred from the diagnostic table to the treatment table without changing the verified treatment position. Sliding or rotating shield or maze walled anteroom are used for radiation protection. A patient setup with multiple diagnostic devices in separate chambers allows rapid turnover of patients in the megavoltage treatment room with patients spending much less time in the treatment room.

Abstract: A preliminary simulated patient setup is done with a x-ray unit (14) or an ultrasound unit (16) with patient on a flat table top insert (68) on preliminary imaging tables (12) in preliminary imaging support rooms (10). Patient is transported from tables to table by sliding the flat table top insert (68) on these tables' cradle. If surgery is to be done, before or after surgery, patient is transferred to flat table top insert (68). Multiple preliminary imaging tables (12) are connected to patient transport room (26). It also connects to CT or MRI imaging room (32). A patient transport table (28), in patient transport room (26) makes connection with preliminary imaging tables (12), a mobile surgical table (22) and CT or MRI-table (36). After imaging, patient is unloaded to a patient unloading room (66).

Abstract: A process for the direct iodination of steroids and steroid hormones in the presence of hydrogen peroxide or chloramine-T is disclosed. The antigenicity and the specific receptor binding of directly iodinated estradiol 17-beta is identical to tritiated estradiol 17-beta.