CAJ | 학술논문

目的使用MOSTET探测器观察分析乳腺癌术后5种常用放疗技术在模体中的剂量分布特点,同时验证TPS计划剂量准确性,为临床治疗方案及技术选择提供剂量学依据.方法使用高仿真模体模拟成年女子左侧乳腺癌术后患者.对患侧胸壁靶区的代表测量点及其不同深度测量点进行标记定位后,在TPS上分别设计正向IMRT、逆向IMRT、3DCRT、6 MeV电子线、9 MeV电子线照射方案.最后对模体进行模拟照射,并对各点进行实时测量.采用方差分析检验5种方法间总差异.结果正向IMRT、逆向IMRT、3DCRT、6 MeV电子线、9 MeV电子线实测平均剂量在表面的分别为74.32、69.21、73.97、75.86、81.41 cGy (F=3.36,P＜0.05),0.5cm深度的分别为95.59、93.37、96.78、99.63、94.97 cGy(F=2.40,P＞0.05),1.0cm深度的分别为103.42、102.53、103.48、88.89、101.36 cGy (F=7.19,P＜0.05),近胸壁肺的分别为82.74、68.24、85.34、21.49、75.02 cGy (F=46.43,P＜0.05).5种方法的平均剂量偏差在表面的为-8.04％(-6.57％～-11.93％),0.5 cm深度的为-1.95％(2.15％～-5.90％),1.0 cm深度的为0.65％(-2.87％～ 3.22％),近胸壁肺的为-3.53％(3.90％～-8.93％).结论 MOSFET探测器配以相应的仿真模体可以测量体内某部位的实际剂量,对放疗QA与QC提供了一种较好方法,亦可用于评价不同放疗技术的剂量学特点.MOSFET探测器适用于乳腺癌放疗的在体剂量监测,指导补偿膜的间隔使用以调整剂量,纠正误差,提高靶区吸收剂量的准确性.
목적 사용MOSTET탐측기관찰분석유선암술후5충상용방료기술재모체중적제량분포특점,동시험증TPS계화제량준학성,위림상치료방안급기술선택제공제량학의거.방법 사용고방진모체모의성년녀자좌측유선암술후환자.대환측흉벽파구적대표측량점급기불동심도측량점진행표기정위후,재TPS상분별설계정향IMRT、역향IMRT、3DCRT、6 MeV전자선、9 MeV전자선조사방안.최후대모체진행모의조사,병대각점진행실시측량.채용방차분석검험5충방법간총차이.결과 정향IMRT、역향IMRT、3DCRT、6 MeV전자선、9 MeV전자선실측평균제량재표면적분별위74.32、69.21、73.97、75.86、81.41 cGy (F=3.36,P＜0.05),0.5cm심도적분별위95.59、93.37、96.78、99.63、94.97 cGy(F=2.40,P＞0.05),1.0cm심도적분별위103.42、102.53、103.48、88.89、101.36 cGy (F=7.19,P＜0.05),근흉벽폐적분별위82.74、68.24、85.34、21.49、75.02 cGy (F=46.43,P＜0.05).5충방법적평균제량편차재표면적위-8.04％(-6.57％～-11.93％),0.5 cm심도적위-1.95％(2.15％～-5.90％),1.0 cm심도적위0.65％(-2.87％～ 3.22％),근흉벽폐적위-3.53％(3.90％～-8.93％).결론 MOSFET탐측기배이상응적방진모체가이측량체내모부위적실제제량,대방료QA여QC제공료일충교호방법,역가용우평개불동방료기술적제량학특점.MOSFET탐측기괄용우유선암방료적재체제량감측,지도보상막적간격사용이조정제량,규정오차,제고파구흡수제량적준학성.
Objective To study the dose distribution of five clinical technologies commonly used in simulation phantom of breast cancer after radical mastectomy are observed and analyzed by using MOSFET detector.The dose validation from TPS plan is tested for clinical treatment.Methods High simulation inhomogeneous equivalent phantom of human body is used to simulate the typical patient after the operation of left breast cancer.The kay points and other points on behalf of depth to the region of interest with side of the chest wall are marked.Five radiotherapy plans (FIF-IMRT、IMRT、3DCRT、6 MeV-electron beam,9 MeV-electron beam) were designed separately on TPS based on phantom image series.After confirmed,the plans are delivered to the phantom and the dosimetrical quantities are measured.Using analysis of variance test the difference in the five methods.Results FIF-IMRT,IMRT,3DCRT,6 MeV-electron beam,9 MeV-electron beam,Five method actual measured doses respectively:Surface 74.32 cGy,69.21 cGy,73.97 cGy,75.86 cGy,81.4 1 cGy (F =3.36,P ＜ 0.05);0.5 cm Depth 95.59 cGy,93.37 cGy,96.78 cGy,99.63 cGy,94.97 cGy (F =2.40,P ＞ 0.05);1.0 cm Depth 103.42 cGy,102.53 cGy,103.48 cGy,88.89 cGy,101.36 cGy (F =7.19,P ＜ 0.05);Nearly chest wall of lung 82.74 cGy,68.24 c Gy,85.34 cGy,21.49 cGy,75.02 cGy (F =46.43,P ＜ 0.05).Compared to the dose value in TPS,dose delivered to Surface is lower at 8.04％ (-6.57％ to-11.93％),points at 0.5 cm is lower at 1.95％ (2.15％ to-5.90％),points at 1 cm is higher at0.65％ (-2.87％ to3.22％),lungislowerat3.53％ (3.90％ to-8.93％).Conclusions MOSFET detector with the corresponding simulation phantom can be used to measure the actual dose in a portion of body,and to evaluate the dosimetrical characteristics of different radiotherapy techniques.MOSFET detector is suitable for real-time,in vivo measurement of radiation dose during radiotherapy in breast cancer patients,so that the physicians are able to change treatment plan in time to ensure the accuracy of target dose.