目的:手術中放射治療主要是針對腹腔腫瘤,如胃癌、胰臟癌、子宮頸癌、直腸癌等部位施以直接放射線治療,採高劑量集中於需治療之部位,並避開鄰近正常組織被涉及而減少治療副作用,以得到遠隔治療所無法達到之效果。手術中放射治療之治療部位，需放置一錐體準直儀及錐體,林口長庚醫院放射腫瘤科針對此設備加以設計及製作。材料與方法:林口長庚醫院放射腫瘤科設計及製作之: [一]錐體準直儀儸: (1)光欄連接設備:置於直線加速器準直儀下,此儀器有對正錐體之設備。(2)形狀大小控制部份:此部份置於錐體準直儀下之控制板,可依錐體形狀大小製作不同控制板,其厚度為1.4公分的鉛合金,足以阻擋電子射線之主射線。[二]錐體部份:因治療照野與人體內部器官及腫瘤形狀不盡相同,本科目前設針出六種錐體:(1)圓錐體、(2)馬蹄錐體、(3)五角錐體、(4)斜15度圓錐體、(5)斜15度馬蹄錐體、(6)斜15度五角錐體。[三]防止錐體末端輻射漏射之設計:因錐體末端直接接觸膿瘤,而錐體外為正常組織,故在錐體末端加一鋼片,以減少散射到正常組織之劑量。結果:使用高密度之數位式水平儀,不管錐體水平與否或傾斜,皆可依據此設備讀出正確角度,並作適度調整,使錐體與錐體準直儀呈現水平一致。討論:病患的轉送、上下治療床、錐體固定、病患的設定及治療,所花費的時間約需30至40分鐘。此設備之設計目的為求快捷與方便,以期達到縮短治療時間之目標。

　　　　　Purpose: It is dangerous to deliver high dose from external irradiation tothe tumor or tumor bed in the abdominal cavity without the consideration of thetolerance limitation of adjacent normal tissues. Intraoperative radiotherapy (IORT)then was developed to deliver high dose to the target in the hope of increasing localcontrol and sparing the damage to adjacent critical organs. The adapter to linearaccelerator for IORT and the electron cone application were the key to the IORTprocedure and were developed in our department.Material and Methods: An IORT adapter and a set of applicator-electron cone weredesigned and made in Radiation Oncology Department of Chang Gung Memorial Hospital.The apparatus consists of several items:(1)IORT adapter: including [a] dockingadapter, [b] beam shaping apparatus: made by 1-4 cm thickness of lead that matchedthe electron cone shapes. (2) Applicators: different electron cones were designed,including circular, horseshoe and pentagonal shapes. The applicators had either flator 15-degree oblique at the end facing the patient. (3) A copper of 2 cm high and0.5 cm thick was mounted at the end of the applicator to reduce the scat-tering ofelectron beam.Results: By using the digital level to measure the inclination of the electron cone,and then to determine the set up angles of the applicator, the electron cone can bealigned to the adapter without any diffculty.Conclusion: This design can be applied for the IORT without any difficulty, and ittakes only 30 to 40 minutes to complete the whole procedures, including setting upof the intraoperative applicators and the treatment time.