• Structural Engineering and Mechanics
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• v.66 no.5
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• pp.649-663
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• 2018

The scaled boundary finite element method is extended to evaluate the dynamic stress intensity factors and T-stress with a numerical procedure based on the improved continued-fraction. The improved continued-fraction approach for the dynamic stiffness matrix is introduced to represent the inertial effect at high frequencies, which leads to numerically better conditioned matrices. After separating the singular stress term from other high order terms, the internal displacements can be obtained by numerical integration and no mesh refinement is needed around the crack tip. The condition numbers of coefficient matrix of the improved method are much smaller than that of the original method, which shows that the improved algorithm can obtain well-conditioned coefficient matrices, and the efficiency of the solution process and its stability can be significantly improved. Several numerical examples are presented to demonstrate the increased robustness and efficiency of the proposed method in both homogeneous and bimaterial crack problems.

• Radiation Oncology Journal
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• v.37 no.4
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• pp.302-308
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• 2019

The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.