رادیوتراپی

Radiotherapy is a prevalent modality for treating cancer; however, certain cancers, such as melanoma, exhibit resistance to ionizing radiation. Cold plasma, an emerging technology in the field of medical science, is currently under scrutiny for its unique properties. The primary objective of this research was to compare the efficacy of radiotherapy and cold plasma as treatment modalities for melanoma and healthy fibroblast cell lines.

Melanoma cancer cells (DFW) and healthy fibroblasts (HFF) were exposed to radiotherapy doses of 1, 2, and 4 Gy, as well as cold plasma radiation for varying durations of 15, 30, 60, and 90 seconds. Subsequently, the outcomes of the MTT assay were compared. Furthermore, the level of apoptosis in each group was assessed utilizing flow cytometry.

While the survival percentage in melanoma cells treated with radiotherapy did not significantly change compared to the control group, even at high doses, it reached 36% in cells treated with cold plasma. The survival rate in healthy cells reached 70% in high radiation doses, while in the treatment with cold plasma, no significant difference was observed even in long plasma irradiation times.

The present study confirmed the anticancer and selectivity properties of cold plasma in treating melanoma cells. Compared with radiotherapy and cold plasma, cold plasma shows better performance than radiotherapy in melanoma cell treatment.

Oral complications during and after radiotherapy are common and affect the quality of life.This study was aimed to assess the relationship between underlying factors and oral health related quality of life in head and neck cancer patients undergoing radiotherapy.

This Descriptive-analytical and cross-sectional study was conducted on 85 patients with head and neck cancer referred to the Radiotherapy Center of the Cancer Institute of Imam Khomeini Hospital Complex in Tehran. Sampling was done by "available" sampling method from April to June 2023. Demographic information and information related to the disease were checked in a questionnaire. Also, for the oral health related quality of life, a questionnaire including 26 questions was designed based on the complications and symptoms caused by radiotherapy.

There was no significant relationship between age, gender, education, history of smoking or alcohol consumption, smoking or alcohol consumption at the time of completing the questionnaires, type of lesion, week of the radiotherapy course in which the questionnaire was completed, area of ​​malignant lesion and the quality of life questionnaire score.(P>0.05) There was a significant relationship between occupation, marital status, underlying diseases and the quality of life questionnaire score.(P<0.05)

The results of this article show a general decrease in the quality of life of head and neck cancer patients undergoing radiotherapy. People with a better job status and married people had a higher quality of life, which could be due to better financial and emotional conditions in these people. People with underlying diseases also reported a higher quality of life, which could be due to getting used to the conditions of the disease and starting radiotherapy with a lower quality of life. These results can help in better implementation of care and in providing necessary support for these people.

Choosing the right treatment design system plays a significant role in effective treatment. The limitation of dose distribution to the target organs is one of the main goals of radiation therapy. Therefore, the purpose of the present study was to determine and compare two treatment planning systems, TiGRT and CorePLAN, in 3D adaptive radiotherapy using the fEUD competency index to optimize the treatment.

The present retrospective study was conducted in 2023. In order to compare the merit of treatment in two treatment design systems, Core PLAN and TiGRT, 20 treatment plans were designed for the treatment of head and neck and prostate tumors. The values ​​of OAR and EUD of the studied target organs were calculated and compared.Dose-volume histogram and the results of each treatment plan were compared and analyzed using the fEUD index, the collected data were analyzed using Student's t-tests

The production plans of head and neck and prostate tumors had similar and comparable performance for the two treatment design systems (p=0.46), but in the Core PLAN system, due to the higher fEUD index compared to TiGRT, healthy tissues were less at risk of radiation. Using the fEUD index as well as biologically based models and parameters while using treatment design systems highlights treatment optimization in radiation therapy.

fEUD index could be used to compare the results of two treatment design systems. Based on this index, the CorePLAN treatment system is suitable for complex or challenging treatments, where optimization and quality of the treatment plan are very important, but TiGRT is suitable for routine treatments where efficiency and ease of use are important.

Spinal cord is one of the organs at risk in esophageal cancer radiation therapy. The difference between the dose distribution due to the Treatment Planning System (TPS) and the patient's body dose is dependent on the calculation of the TPS algorithm, which is more pronounced in heterogeneities such as the Spinal cord. In this study, the dose distribution of TPS algorithm was compared with monte Carlo calculations in both homogeneous and heterogeneous tissue.

In this descriptive-analytical study, three-dimensional planning composed of four fields were done on the CT using the CorPLAN TPS of a SIEMENS PRIMUS linac. EGSnrc monte Carlo simulation code was used for the same conditions. The dose distribution obtained from Monte Carlo simulation and TPS was compared using PDD curve and Dose Difference Percentage index that obtained from these two modes.

According to the results, the error rate from the TPS was less than 3% in the homogeneous tissue, whereas the error in the Spinal cord heterogeneity was significant (more than 5%).

Results shows that the accuracy of CorPLAN TPS at homogeneous tissue is more than in the Spinal cord heterogeneity and this should be considered in the clinic. The findings also indicate that the monte carlo code can be used to simulate and evaluate the dose distribution in radiotherapy, and in cases where the practical measurement of some dosimetric parameters is impossible or difficult, this code can be used for prediction and optimization of treatment plans.

Magnetic fields can be used in radiation therapy to reduce electron contamination and improve dose delivery accuracy. MRIgRT systems use magnetic fields to track the position of the tumor during treatment and precisely deliver the dose from electron beams to the tumor, which will lead to improved treatment outcomes and reduced side effects.

The MCNP 6.1 Monte Carlo code was used to simulate the Varian 2100 C/D LINAC in both photon and electron modes. Percentage depth dose curves, dose profiles, and the fluence of contaminating electrons and photons were calculated. Dose profile penumbra and dose differences were calculated for different modes. In the second phase of the study, a constant 1.5 Tesla longitudinal magnetic field was applied to a water phantom that was aligned with the direction of the radiation beam.

Results:

 The MD reduced the surface dose by 8.3% and the dose profile penumbra by 5.6% at the surface of the water phantom. The MD removes all contaminating electrons from the radiation field without affecting the number of photons. The application of a 1.5 Tesla longitudinal magnetic field increased the dose by 4% in the maximum dose depth region and reduced the penumbra by 20% and the off-axis dose by 57% at the same depth.

Conclusion:

 The MD reduces surface dose, off-axis dose, and dose profile penumbra. The longitudinal magnetic field reduces penumbra and off-axis dose in electron beams.

Radiotherapy is a major modality for cancer treatment. One of the most important complications of breast radiotherapy is esophagitis. Esophagitis can reduce patient’s quality of life. Because of increasing role of radiotherapy in cancer treatment and importance of attention to quality of life in cancer patients, evaluation of radiotherapy complications is essential.

This was a descriptive analytic study and included 34 breast cancer patients who had referred to the radiotherapy center of Tohid Hospital in Sanandaj and received radiation therapy. Based on a standard questionnaire of esophagus complications, patients were assessed for the symptoms of esophagitis for six consecutive weeks. In addition to demographic characteristics and assigning a code to every patient and weekly follow ups for searching esophagitis symptoms, amount of received radiation dose and other dosimetric indecies were calculated and the results were analyzed.

According to the results, mean prescription dose was 50 Gy and the average of mean dose and maximum dose received by esophagus were 2.60 and 29.78 Gy respectively. The most and least rates of complications were found in the third and first weeks respectively.

In the patients who had received breast radiation therapy in the radiotherapy center of Tohid Hospital in Sanandaj in 2020, incidence of esophagitis was significantly correlated with the mean dose of radiation.

Treatment of head and neck cancers, it can have adverse effects on patients' oral health status. The aim of this study was to assess the level of knowledge and practice of general dentists in Yazd City in the field of oral care in patients undergoing chemotherapy and radiotherapy.

In this descriptive cross-sectional study, 134 general dentists were selected by systematic random sampling and their awareness and practice level were assessed using by using a researcher-made questionnaire with valid and reliable questionnaire (r=0.81). Data were analyzed using SPSS software version 25, t-test and ANOVA tests.

The mean score of knowledge score was 11.44 ±2.03 out of18 and mean of practice score was11.9 ±3.41 out OF 20. The mean score of knowledge was not significantly associated with age, work experience and practice score were not significantly associated with gender, age and work experience, but the mean score of knowledge in women was significantly higher than men (P=0.01). Moreover, dentists worked in both clinic and Personal office showed significantly higher awareness (P=0.001). The average practice score of dentists in personal office was significantly higher than other options (P=0.03).

Dentists of Yazd had moderate knowledge and performance level in the field of oral and dental care in patients undergoing chemotherapy and radiotherapy. It seems that the need to hold programs with this theme in the sessions of continuing education and holding training and educational webinar to improve the level of awareness and clinical practice to provide desirable services to these patients should be considered.

Retinoblastoma is the most common primary malignant ocular malignancy in children. The management and treatment of retinoblastoma is a very complex process and requires attention to different aspects, such as the stage of the disease based on the International classification of retinoblastoma (ICRB) or International intraocular retinoblastoma classification (IIRC), the genetic status of the tumor and mutations, psycho-social factors of the family and society, cultural beliefs, and available economic resources. From the identification of this malignancy until the beginning of the 20th century (before the introduction of radiation therapy as one of the treatment options), enucleation was the only treatment option for this disease. In addition to not controlling metastatic and extensive features of the disease and increasing the chance of death in these cases, enucleation causes many adverse psychological and aesthetic complications in patients, and especially children, who are the main population affected by this disease. Tremendous progress has been made since the 20th century to identify and invent new methods to preserve the eyes and less invasive treatments (globe salvage treatments), and the set of efforts led to the inventing of new treatment methods such as radiation therapy, systemic chemotherapy, local treatments such as cryotherapy and thermotherapy, intra-arterial chemotherapy and intraocular chemotherapy. In summary, the set of treatments from the beginning until now has gone towards increasing survival, reducing the rate of enucleation and providing more targeted and less invasive treatments. Despite these advances, early diagnosis is the most important prerequisite for better outcomes. However, early detection is influenced by socioeconomic factors and is a major challenge, especially in low- and middle-income countries. In fact, the provision of advanced medical care in high-income areas has provided excellent survival, globe, and vision-saving rates. Unfortunately, these results do not hold true for medical systems in low- and middle-income areas, leading to poor patient outcomes. In this article, we briefly introduce various retinoblastoma treatment methods from the beginning of detection until now, and we assess the evolution of the treatment of this disease from the beginning until now, which has reduced the need for enucleation as a treatment for this disease.

Several reports have shown that radiotherapy treatment increases the risk of sarcoma. In this report, a 67-year-old female patient complained of chest wall pain and swelling in the previous mastectomy area. Twelve years ago, She had a history of mastectomy, after which she underwent five sessions of chemotherapy and 25 sessions of radiotherapy. In the examination, the immobile hard mass arising from the rib was evident. In the CT scan, there was involvement of three ribs in the front. The patient was a candidate for radical excision and reconstruction with Prolene mesh and was discharged three days after surgery with a good general condition. The final pathology of undifferentiated liposarcoma was reported as grade III. Awareness of the possibility of sarcoma caused by ionizing radiation along with long-term follow-up of patients treated with radiotherapy can lead to early diagnosis of these patients.

Adjuvant or salvage radiotherapy can control biochemical relapse after radical prostatectomy and reduce the risk of distant metastases. Dose-escalated radiotherapy after radical prostatectomy can lead to improved biochemical relapse-free survival. Over the last decades, despite the technological advancements in prostate radiotherapy, radiation-induced rectal toxicity is still the main limiting factor for dose escalation owing to the anatomical proximity of the prostate gland to the rectum. To this end, several rectal sparing devices, including Endorectal balloons (ERBs), prostate-rectum spacers (e.g. SpaceOAR hydrogel), and rectal retractor have been explored to increase the distance between the prostate and the rectum to reduce rectal radiation doses and toxicities. Over the last decade, several studies applied these devices during post-prostatectomy radiotherapy setting. Therefore, the purpose of this review is to evaluate the impact of rectal sparing devices on dose-volume parameters of anorectal, radiation-induced rectal toxicity, and prostate bed motion during post-prostatectomy radiotherapy. The results showed that although using ERBs can lead to stability in the target volume position, it cannot reduce rectal radiation doses, in particular dose to the anterior rectal wall. The application of ERBs can reduce the received dose of the anal wall and increase the geometric reproducibility of the clinical target volume (CTV) position. However, the role of ERBs in reducing the received dose of the rectal wall is still controversial, which can be associated with the displacement of the anterior rectal wall towards the prostate bed (high radiation dose area). The use of SpaceOAR hydrogel can significantly increase the distance between the rectum and the prostate bed and ultimately reduce the dose received by the rectal wall. Also, the use of rectal retractor remarkably reduces rectal radiation doses. The dosimetric and clinical results of the use of SpaceOAR hydrogel and rectal retractor are very promising, and these devices can be used for patients after the necessary evaluations by radiation oncologist in post-prostatectomy radiotherapy. However, further studies will be required to elucidate the efficacy of SpaceOAR hydrogel and rectal retractor in reducing radiotherapy-induced rectal toxicity following post-prostatectomy radiotherapy.

Surgery, chemotherapy and radiotherapy are the main pillars of brain tumor treatment. Radiotherapy is usually done with photon, which with this method, photon radiates to healthy tissue and causes secondary cancers. Proton therapy is a new method in radiotherapy that addresses many of these concerns. Considering the newness of this treatment method, we decided to introduce this method and its applications to review the systematic review of proton therapy in the treatment of brain tumors.

In this systematic review, Scopus, Medline PubMed, Google Scholar, CINAHL, Trip and Magiran, SID databases were searched between 2017 and 2022. The search was done based on the keywords, Proton therapy, Brain Tumor, Proton radiotherapy and suitable Mesh words and using the PRISMA checklist, and 16 articles were included in the study out of 40 articles searched.

Proton therapy in adults is effective in treating low-grade glioma tumors and benign tumors such as meningioma. They are also used as an effective treatment in the control of chondrosarcoma and chordoma tumors that are resistant to other types of radiation therapy. The role of this therapeutic method in the treatment of brain tumors, craniopharyngiomas, ependymomas, germ cell tumors, low-grade gliomas, medulloblastomas and atypical teratoid/rhabdoid tumors in children is very important because it does not spread to the surrounding tissue and reduces the possibility of late toxicity of the central nervous system. Gives.

Considering the benefits of proton therapy, such as reducing the damage of healthy tissue around the tumor, its use in the treatment of tumors resistant to radiotherapy and its wide application in the treatment of all types of brain tumors in children, this treatment method is recommended in the country for patients with tumors. brain to plan and execute.

Radiation therapy is one of the major subsets of cancer treatments. Normal tissue toxicity and tumor cell resistance are two main obstacles during radiotherapy treatments. Toxicity to healthy tissue limits the applied dose, resulting in inadequate tumor control. On the other hand, the resistances of cancer cells lead to increased doses of radiotherapy. Therefore, agents that can simultaneously reduce the toxicity of normal tissues and increase the sensitivity of tumor cells to radiotherapy could be a potential solution to increase the efficiency of radiotherapy during cancer treatment. Many studies have found that atorvastatin, as an HMG coenzyme A reductase (HMG-CoA) inhibitor, and protects normal tissue while sensitizing cancer cells to radiotherapy via various molecular mechanisms and signaling pathways. This review summarizes the evidence for radioprotective and radiosensitivity effects of atorvastatin in vitro and in vivo studies.

Heart damage is one of the complications of radiotherapy. Due to the favorable effect of exercise training on the heart, this study aimed to investigate the impact of HIIT training on Troponin I and B-type natriuretic peptide in rats undergone radiotherapy.

In this experimental study, 24 male Wistar rats were randomly divided into four groups: control, HIIT, radiotherapy, and radiotherapy + HIIT. After anesthesia, radiotherapy was performed using an 11 Gy dose of the linear accelerator. The training program of HIIT and HIIT + radiotherapy groups included 10 weeks of HIIT. To assess the serum levels of troponin-I and B-type natriuretic peptide (BNP), five ml of blood was taken 24 hours after the last training session. One-way ANOVA was used to analyze the data at a significance level of P<0.05.

The results showed that the levels of troponin I in HIIT or radiotherapy + HIIT groups were not significantly different from the control group (P<0.05). But there was a significant difference between the radiotherapy group and the other three groups (P<0.05). Furthermore, no significant difference was observed between the BNP values ​​of any of the groups (P<0.05).

Radiotherapy seems to increase troponin I, but HIIT does not have this effect and even reduces its increased levels. Also, neither HIIT nor radiotherapy has an impact on BNP. Therefore, patients undergoing radiotherapy can use HIIT as an effective therapeutic intervention.

Decreased sleep quality is one of the most common complications of radiotherapy in cancer patients. Although soaking feet in warm water and foot reflexology are two easy, inexpensive, and accessible ways to improve sleep quality, which one is more effective, has not been evaluated in existing studies. The purpose of this study was to compare the effect of soaking feet in warm water and foot reflexology on sleep quality in patients undergoing radiotherapy.

This two-group randomized clinical trial was conducted on 62 cancer patients undergoing radiotherapy at Reza (AS) Medical Center in Mashhad in 2020. Patients were randomly allocated into two groups of soaking feet in warm water and reflexology. In the group of soaking feet in warm water, patients soaked their feet in 41 °C water for 20 minutes every night from the seventh day after starting radiotherapy for two weeks. In the foot reflexology group, the intervention was performed from the seventh day after starting radiotherapy for two weeks every night for 10 minutes for each foot in three areas including solar plexus, pituitary gland and pineal gland. Sleep quality score was assessed using the Petersburg Sleep Quality Questionnaire on the seventh day of radiotherapy (pre-test) and then 7, 14 and 28 days later. Data were analyzed by the SPSS software version 20 using descriptive/inferential statistics.

The results showed the total score of sleep quality in the two groups decreased significantly over time (P<0.001), and this reduction was from 13.81±1.33 on the pre-test day to 4.86±1.73 on the day 28 for the reflexology group, and from 13.55±1.23 to 7.92±1.97 for the group of soaking feet in warm water. It should be noted that a decrease in the score of Petersburg questionnaire means an improvement in sleep quality.

Foot reflexology and soaking feet in warm water improve sleep quality in patients undergoing radiotherapy but foot reflexology is more effective in improving sleep quality. Therefore, using this method is recommended.
Clinical trial registry: IRCT20190625044009N1

Retroperitoneal liposarcoma (LS) is a rare neoplasm. Well-differentiated LS is a slow-growing subtype with a high rate of recurrence. Despite the high recurrence rate after complete surgical resection, tumor transformation to poorly-differentiated LS is very rare.

A 45-year-old man with a primary retroperitoneal tumor and the final pathology of well-differentiated LS underwent tumor resection surgery. Local recurrence was detected nine months after surgery. Second surgical resection revealed a poorly-differentiated subtype of LS which was treated with adjuvant radiation therapy. No local recurrence and distant metastasis were detected in a three years follow-up period.

Tumor transformation of well-differentiated retroperitoneal LS to poorly-differentiated subtype is extremely rare. Nevertheless, this rare case was successfully managed in a multi-disciplinary setting using surgical resection and adjuvant radiation therapy.

With 6,020 new cases and 1,150 deaths annually in the United States, vulvar cancer is uncommon, resulting in age-adjusted incidence rates of 2.8 and 1.7 per 100,000 in white and black women, respectively. Vulvar cancer represents about 4% to 6% of malignancies of the female genital tract and 0.6% of all cancers in women. Vulvar cancer predominantly affects postmenopausal women, and it is the most common anogenital cancer in women with more than 70 years of age. HPV infection is associated with a significant number of vulvar cancers. Bartholin Gland carcinoma is a rare form of vulvar malignancy that accounts for less than 5% of all vulvar cancers and 0.001% of all genital cancers. The aim of this study was to report a rare case of Bartholin's cancer in a young patient.

The patient was a 37-year-old woman p2l2 (history of two pregnancy and two delivery) who had complains of severe pain in perineal area and was referred to the gynecology emergency clinic, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, in June 2020. In past medical history she had no previous history of medical illnesses or surgical interventions. She had swelling and pain in perineal area since one year ago. Bartholin Gland abscess was diagnosed and she received some oral antibiotics, but did not improve. On the last examination under anesthesia, a firm mass of about 3 cm was palpated in the third distal part of posterior vagina which was at the site of Bartholin Gland and was necrotic. The pathologic report of the mass biopsy confirmed the diagnosis of squamous cell carcinoma. The patient was underwent chemo radiation therapy. At a follow up visit about 5 month later she was cured completely and there was not any symptom of recurrence or metastasis.

In dealing with any patient with diagnosis of Bartholin Gland abscess, in the case of resistance to medical treatment, further evaluation and biopsy of the mass should be considered to rule out Bartholin's gland cancer.

Radiotherapy (RT) is an effective treatment in the field of cancer. Since the potential effect of RT is heavily dependent on the patient's immune system, using the immunotherapy to enhance the radiotherapy effects seems to be a positive step in the treatment of cancer.

In order to write the present review article, keywords including radiotherapy, immunotherapy, combination therapy, and immune-checkpoint inhibitors antibodies were searched in reliable databases, including Google Scholar, PubMed, Scopus, and Elsevier. Among potential candidates, those which were the most relevant to the purpose of the study and evaluated the combination of radiotherapy and immunotherapy with immune-checkpoint inhibitors antibodies were selected.

RT has distinct effects on the tumor microenvironment which can either inhibit or promote tumor growth. By inducing immunogenic cell death results in releasing danger signals, RT increases in cytokine/chemokine secretion, recruits immune cells, and alters the expression of CTLA-4, PD-1, and PD-L1 molecules on tumor and immune cells. Previous studies showed that the combination of immunotherapy and RT (radio-immunotherapy) induces the synergic effects on stimulation of anti-tumor immune response. Due to the change in the expression of immune-checkpoint molecules, including CTLA-4 and PD-1 on tumor and immune cells, and the impact on anti-tumor immune function in controlling tumor growth as a result of radiotherapy, it seems that a rational solution to overcome the inhibitory effects and to enhance the anti-tumor effects of RT is anti-checkpoint antibodies (anti-CTLA-4 and anti-PD-1). However, some factors including dose, type of radiation, and the timing of RT in relation to administration of checkpoint inhibitors are some of the challenges along this way.

Human resources play a highly important role in providing health services. The aim of this study was to determine the human resources required for the linear accelerator sector at Reza Radiotherapy-Oncology Center.

This applied analytical-descriptive study utilized human resources determination method based on workload indicator of staffing needs. Expert meetings were held to determine the components of workload and standard time. A survey was used to confirm the standard time of main activities, and interviews and personnel information system were used to determine the amount and factors related to available working time.  Furthermore, management system and registries were used to determine the annual workload. The data were analyzed using the Excel and SPSS software version 19.

Seven factors related to the annually available working time of employees were identified. Annually available working time for employees was set at 806 hours. Patient preparation, treatment, surgery, and case completion were identified as the main activities. The results of workload index calculations showed that the accelerator sector had a shortage of three people.

The results of this study showed that Reza Radiotherapy-Oncology Center is experiencing a shortage of professional staff in the linear accelerator sector. It seems that using the workload indicator of staffing needs method to determine and distribute the required human recourses is a necessary step for the optimal management of human recourses in specialized sectors.

The risk of heart ischemia after radiotherapy has not been determined precisely, and since myocardial ischemia jeopardizes the results of breast cancer treatment, we decided to increase the risk of heart ischemia after breast radiotherapy and the factors affecting in women candidates for general anesthesia for surgery.Materilas and

In this cross-sectional descriptive study, 209 patients referred to the operating room of Imam Reza Hospital in Tabriz with a history of radiotherapy by census method in the one year leading to September 2017 were included in the study. Demographic and Rose profile checklist (diagnosis of myocardial ischemia) was used for research purposes and the data were analyzed by logistic regression and Wilcoxon tests after entering SPSS21 software. P value less than 0.05 was considered significant.

Standard deviation; mean score of cardiac ischemia diagnostic index was 04.88 ± 0.93, of which 78 patients (37.33%) scored higher than 5 and 131 patients (62.67%) scored less than 5; seven potential ischemic related factors Patients at high risk for radiotherapy were identified as including age (OR=0.35, p=0.009), BMI (OR=0.38, p=0.007), and chemotherapy (OR=0.29, p = 0.005), tumor size (OR=0.45, p=0.005), tumor location (OR=0.09, p=0.02), tumor involvement side (OR=0.33, p=0.003)Number of radiotherapy sessions (OR=0.60, p=0.001).

Radiotherapy for the treatment of breast cancer as a risk factor for cardiac ischemia in women is a candidate for general anesthesia for surgery, which is exacerbated by factors such as age, body mass index, chemotherapy, tumor size and location, side involved and the number of radiotherapy sessions.

To date, there is no accurate information on whether the history of radiotherapy for breast cancer can lead to increased nausea and vomiting in upper limb orthopedic surgery, so we decided to compare the present study with the aim of comparing nausea. And vomiting after upper limb orthopedic surgery in two groups with and without a history of breast radiotherapy.   A total of 90 patients (45 with a history of radiotherapy - 45 healthy) during the years 1399-99 who were candidates for upper limb orthopedic surgery were included in the study by available sampling method and after surgery for nausea And vomiting were compared using the Rhodes Index tool. The collected data were compared using Shaprovillek test and t-test with the significance of P value less than 0.05. The prevalence of nausea and vomiting after upper limb orthopedic surgery in 100% of people with a history of breast radiotherapy and in people without a history of radiotherapy, the prevalence of nausea and vomiting was 40% (18 people) (P = 0.001). The standard deviation ± mean of the total score of nausea and vomiting after surgery in the group of patients with a history of 25.5 ± 5.29 radiotherapy was significantly higher than the group of healthy individuals (14.19 ± 3.45) (P = 0.003). ).   History of breast radiotherapy can lead to exacerbation and increase in the number of nausea and vomiting after upper limb orthopedic surgery.