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題名:?如何以旋轉準直儀的方式來改善頭頸部強度調控放射治療所?生照野相接劑量不均勻的情況     (22點)
TO REDUCE DOSE INHOMOGENEITY AT NECK JUNCTION BY USING A ROTATING COLLIMATOR ON IMRT-TREATED HEAD-AND-NECK CANCER PATIENTS
著者:吳東和(Tung-Ho Wu) ;邱仲峰(Jeng-Fong Chiou) ;朱曉榮(Ron Zhu) ;黃光偉(Kuang-Wei Huang) ;翁培峰(Pei-Fong Wong) ;董世民(Sam Tung) ;趙坤山(K.S. Clifford Chao) ;蔡若婷(Jo-Ting Tsai)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:強度調控放射線治療 ; 頭頸部 ; 照野相接 ; IMRT ; Head-and-neck ; Field match
刊名:放射治療與腫瘤學
頁碼:205-215
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

且且1: 針對頭頸部癌症的放射治療,嘗試採用準直儀旋轉式的強度調控放射線治療(CollimatorRotated IMRT, CR IMR T)來改善頸部照野按合處的劑量均勻度,並比較與傳統IMRT方式的差異性。 姐姐盟主法:本研究選擇10位頭頸部痞症患者的CT影像,分別以傳統的IMRT及新設計的CR IMRT電腦治療計劃進行分析,並比較真順形參數與劑量均勻度的差異。CR IMRT治療方式為旋轉準宣儀九+度,主靶區及上頸部以九個照野涵蓋;鎖骨及下頸部的淋巴結則以三個照野,照野上下緣相接處分別呈階梯狀互棺重壘,用以減少相接處局部劑量不均勻的情形。依據美國醫學物理師學會TG-40 報告的要求,準直f義的誤差應在2公釐以內,所以本研究分析照野接鄰處偏差的間隔(gap) ±1 公釐、±2公釐'重疊(overlap) 土1 公釐、士2公釐時對劑量的影響。X光片驗證也於本研究進行,用以分析這兩種強度調控治療方式在照野相接處的劑量不均勻度。 益星﹒傳統IMRT與CR IMRT在計劃品質分析上,幾乎達到相同的順形參數(conformity index) 和劑量鉤句程度(homogeneity index) ,重要正常器官的劑量評估上,包括腦幹、脊髓、兩側唾液臉的最大劑量或平均劑量均在器官容許劑量範圍內。以X光片實際照射頸部相接處發現傳統IMRT治療方式在上下緣1 公釐、2 公釐、4公釐誤差時相接處劑量為土12% 、±22% 、土41% '以CRIMRT的治療方式買Ij發現上下緣1 公釐、2公釐、4公釐誤差時相接處劑量大幅改善為士6% 、士8% 、±12% 。 益證: CR IMRT 在治療計量品質幾乎與傳統IMRT相「司,且上下頸接鄰區的劑量不均勻性可以大幅改善,為一值得用以治療頭頸部癌症之IMRT治療方式。
Purpose : To improve dose homogeneity at the neck junction in head-and-neck cancer radiotherapy, we employ a rotating collimator and compare the differences between it and conventional intensitymodulated radiation therapy (IMRT). Materials and Methods : CT images for 10 head-and-neck cancer patients previously treated with SIHB technique in our clinic were used for this planning study. We generated a new CR IMRT in each case and compared the differences between the conformity index and homogeneity index. The new planning technique also used 9 beams with equally-spaced gantry angles but only for the neck above the shoulder. We made 9 beams above the shoulder with a slightly lower field border (normally 3 to 5 mm), to have a built-in feathering. Three of the nine beams treated the entire neck, including the lower neck and supraclavicular lymph nodes. Only three beams are required to split and therefore the total number of fields is 12. The AAPM TG-40 recommended an accuracy of field size and jaw symmetry calibration to be within 2 mm. Hence, for an accelerator operating within these guidelines, two abutting fields can overlap or gap up to 2 mm. Field mismatches of ±1 mm and ±2 mm because of imperfect jaw/MLC calibration were simulated. We used film to measure junction inhomogenity. Results : The new technique could be used to successfully generate IMRT plans for head and neck cancers. Both conventional IMRT and CR IMRT had almost the same conformity index and homogeneity index. Upon evaluating the dose distribution of critical organs, we found all of them were within the tolerance ranges. Film measurements showed that dose inhomogeneities that resulted from 1 mm, 2 mm, 4 mm junction area as jaw/MLC calibration errors were reduced from as large as ±12%, ±22%, ±41% with the single-isocenter and half-beam (SIHB) technique to less than ±6%、±8%, ±12% with this newly developed technique. Conclusion : Compared with the conventional SIHB technique, the new technique provides superior dose homogeneity in the abutment region between the supraclavicular and head-and-neck IMRT fields. With a modulating lower border of 9 fields, the feathering mechanism substantially reduces dose inhomogeneities that result from imperfect jaw/MLC calibration.


    

本卷期目次
放射治療與腫瘤學
Radiation therapy with or without hormonal therapy for prostate carcinomafor prostate carcinoma/ Cheng-Hong LiouMu-Tai LiuTung-Hao ChangChu-Ping PiAi-Yih WangWen-Shan LiuChao-Yuan HuangAi-Yih WangWen-Shan LiuChao-Yuan Huang2
Treatment outcome and patterns of failure in breast cancer patients with locoregional recurrence after mastectomy
高能光子射束下直線加速器治療床及固定模具對淺層劑量的影響/ 趙曉玲鄭秀成吳簡坤許雅娟曾鑠鑠黃國明吳筱菁成佳憲
TREATMENT OUTCOME AND PATTERNS OF FAILURE IN BREAST CANCER PATIENTS WITH LOCOREGIONAL RECURRENCE AFTER MASTECTOMY/ Sung-Hsin KuoJason Chia-Hsien ChengChiun-Sheng HuangWun-Hon KuoChun-Ru ChienLai-Lei TingAnn-Lii ChengKing-Jeng ChangMing-Kuen Lai
RADIATION THERAPY WITH OR WITHOUT HORMONAL THERAPY FOR PROSTATE CARCINOMA/ Cheng-Hong LiouMu-Tai LiuTung-Hao ChangChu-Ping PiAi-Yih WangWen-Shan LiuChao-Yuan Huang
原發性中樞神經淋巴瘤治療的新進展/ 熊佩韋黃經民任益民吳樂榮
電腦刀系統驗收測試程序/ 陳秋萍邱仲峰黃英強黃光偉林家瑋傅曉梅鍾道生蔡若婷
?如何以旋轉準直儀的方式來改善頭頸部強度調控放射治療所?生照野相接劑量不均勻的情況/ 吳東和邱仲峰朱曉榮黃光偉翁培峰董世民趙坤山蔡若婷
高能光子射束下直線加速器治療床及固定模具對淺層劑量的影響/ 趙曉玲鄭秀成吳簡坤許雅娟曾鑠鑠黃國明吳筱菁成佳憲
MALIGNANT MELANOMA OF THE RECTUM: A CASE REPORT/ Chung-Chih HsiehMing-Hong TsaiChia-Ing JanChen-Hua TsaiNgot-Swan Chong
 
   
 
   

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