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臺灣應用輻射與同位素雜誌

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篇名 運用底片及熱發光劑量計量測乳癌病患接受放射治療輻射劑量分佈及肺部劑量之探討
卷期 5:4
並列篇名 Target Dose Verification and Critical Organ Dose Check of Breast Cancer by Using Thermoluminscence and Film Dosimetry
作者 吳嘉明葉世安蕭光吟陳宗哲趙敏
頁次 751-757
關鍵字 乳癌底片熱發光劑量計肺部劑量breast cancerTLDRondo phantomacrylic phantom
出刊日期 200912

中文摘要

一般乳癌的患者如果接受放射治療最常採用的方式是切線照野或等中心半照野的方式,一方面把胸壁、腋下淋巴結和內乳淋巴結含蓋在照野內,另一方面此兩種照射方式也可減少肺部組織因被輻射線照射後所造成的纖維化而降低肺部正常的功能;但如果病患不施行呼吸監控放射治療方法,則前述的切線照野或是等中心半照野的方式爲了要將輻射劑量完整的包覆病灶,則肺部將無法避免的會有較高劑量的區域出現,所以醫師往往需要知道乳癌患者接受放射治療時病灶及肺部的劑量,以便預估副作用的程度。本實驗的做法是以治療計劃系統上所選取病灶邊胸腔圓弧(病灶)的幾何中心點爲直線加速器的等旋轉中心點在結束治療計劃後,再將此治療計畫口所規劃的等旋轉中心點及照野和入射角度等參數全部移轉到假體上再執行一次計算,因爲要用底片量測等劑量分佈及用熱發光劑量計量測肺部的劑量,所以本實驗採用兩套假體;此兩套假體所量測的劑量再跟治療計劃系統所規劃的病人劑量做比較。結果顯示用底片量測劑量的結果在高劑量區蠻穩合(90%以上),80%到40%的區域實測比治療計劃系統所規劃的病人劑量略大;40%以下,治療計劃系統所規劃出來的劑量區域比實測的等劑量曲線大一些;而使用熱發光劑量計量到肺部的劑量和治療計劃系統所規劃病人肺部的劑量相當接近。

英文摘要

Radio therapy is one of the common way to treat breast cancer. There are a lot of method to deliver radiation dosage to breast cancer chest wall region. Tangential field and mono isocenter half block field play an essential role of breast cancer treatment. Once the chest wall、internal mammaly chain, axillary lymph node of breast cancer are to be treated, there will a lot of unavoidable lung tissue be irradiated, especially when the treatment procedure is not monitor by respiration gating, therefore, physician usually ask to check the target dose distribution and lung dose as an critical organ preservation. Rando phantom was used for lung dose monitor while home-desigh acrylic phantom was used for embedding film for dose verification of chest wall. TLD was used only in Rando phantom dose check because Rando provide TLD insertion hole and special design acrylic phantom to embed film to check the lung dose by enlisting the fixation function. A complicate calibration procedure both of TLD and film were done prior to do the dose verification and check. After film was irradiated by the same treatment planning design perform in both acrylic and Rando phantom. The films optical density signal was read and converted to dose distribuation by adopting the H-D calibration curve. TLD glowing curve was read from the TLD Raxion UL-320 TLD reader and converted the dose by using the well calibrated TLD signal-dose caibraton curve. The film results showed good coincidence with planning results in high dose region-say 90%, while in 80% to 40%, the measurement results was slightly larger than planning results, but in the region under 40%, the planning distribution was larger obvioulsy than experiment results.

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