原名「台灣學術線上」
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1
題名:頭頸部腫瘤於左右兩側照野時,劑量分佈不均勻度的分析及簡易套裝組織補償器的運用     (12點)
Assessment of Dose Nonuniformity under Bilateral Opposed Fields for Head and Neck Tumor and Introduction of a Simple Application Model of Tissue Compensator
著者:陳尚文(Shang-Wen Chen) ;林芳仁(Fang-Jen Lin) ;涂振邦(Chen-Pang Tu) ;蕭安成(An-Cheng Shiau) ;吳學鼎(Hsieh-Ting Wu) ;梁基安(Ji-An Liang) ;楊世能(Shih-Neng Yang)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:放射治療 ; 劑量分佈不均勻 ; 組織補償器 ; Radiotherapy ; Dose nonuniformity ; Tissue compensator
刊名:放射治療與腫瘤學
頁碼:157-162
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

目的: 左右兩側照野的放射治療在頭頸部腫瘤的治療上相當普遍。因頭部與頸部前綠的治療深度有差異,所以評估計劃目標体積內劑量分佈不均勻的現象,並發展一種簡易的套裝組織補償器的運用方式,以改善治療時的不均勻度。 材料與方法: 首先分析1 2 例因頭頸部腫瘤而接受左右兩{間J ~ll野之病人, 其中舌瘖4 例,下咽癌4例﹒鼻咽癌4例。這些病人的頭部及頸部寬度以電腦斷層攝影分析, 其中頭部寬度的參考點定在照野的中心( field center) ,而頸部寬度的參考點定在頸椎C 3 及C 4 交界處之治療截面向前延伸離頸部前緣2 cm (參考點A )及3 cm ( 參考點s )。於模擬攝影時將~ll 野中頸部寬度明顯減少區域標示於片子上, 經由電腦斷層攝影分析標示區的頸部落差情況,以標示區各截面之脊椎骨椎体前緣當作三角型的底邊的參考線,可量出每個案例頸部三角型區域的角度。以0 之平均值製作了幾套叢一斜度的組織補償器。 結果:若以照野的中心為基準﹒ 前頸部劑量過高的情況如下,參考點A高出治療中心點之處方劑量( prescribed dose) 的平均值分別是舌癌1 3 . 7 % ( 10.0 - 16.6 %) ,下咽瘖7 .4 % ( 5.8 - 9.9%) , 鼻咽癒為1 3 . 6 % (12 .4 一1 4 .4 %) ; 而頸部參考點B 高出治療中心點之處方劑曼的平均值分別是舌癌11.7 % (9 .5 一1 4 .7 % ) , 下咽箔5 .4 % (4.0 - 6.7 %) , 鼻咽街為1 0 . 1 % (7.4 - 13.1% ) 。病人頸部標示區不同截茵的。角度數都落在3 5 至5 5 度之間, 若以5 度為間隔單位, 其中有9 例。角平均值為4 5 度, 2 例平均值為印度, 1 例平均值為40 度。而個別使用了單一斜度( 分別爵的, 4 5 及印度) 的套裝組織補償諸後, 發現頸部劑量過高的情況已有很大的改善。 結論: 頭頸部腫瘤當進行大範圓的左右兩側照野峙, 必須評估照野內前頸部治療劑量是否較中心點給予劑量為高。如果無法針對每一個案製作一個組織補償器, 本文所介紹之簡易的套裝組織補償器的運用方式, 作為改善前頸治療劑量不均勻的一種參考。
Purpose: For the radiotherap y of many head and neck tumors , bilateral parall el opposed fields have been used for initial treatment. Because the thickness of head and anterior portion of neck may be different, our study is to eva luate the dose nonuniformit y within target volume and to introdu ce a simple application model of tissue compensator to improve the dose nonuniformity for the bilateral treatm ent. Materials alld methods:We analyzed the data of twelve cases with head and neck tumors (4 tongue cancers, 4 hypoph aryngeal ca ncers, and the rest are nasopharyngeal cancer). They received bilateral parallel opposed fields for initial treatment. The thickness of head and neck was estimat ed from CT scan, the reference point of the thickness of head was defined at field center, and the reference points of the thickness of neck were defined at cross-section of C3-C4 interface, 2 ern from anterior margin of neck (reference point A), 3 ern from anterior margin (reference point B). During simulation, the area with significant deficit was delineated, and was analyzed on CT scan. If the line along the anterio r border of vertebra l body was defined as the base of a triangle, we can find the base angle eof anterior neck. Following measurement and analysis of angle eof differ ent sections on CT scan, several sets of compensator were made. Results: If the given dose was normalized at the center of radiation fie ld, the average percentage of overdose of anterior neck was as following: referenc e point A, 13.7% (10.0-16.6) for tongue cancer, 7.4% (5.8-9.9) for hypopharyngeal cancer, 13.6% ( 12.4- 14.4) for nasopharyngeal cancer; referen ce point B, 11.7% (9.5-14.7), 5.4% (4.0-6.7), and 10. I% (7.4- 13.1) respectively. The degree of angle e at different cross-sections of anterior neck were all within the range of 35° to 55°. With the interval of 5 degree as a unit, the mean degree of angle e is 45° for 9 cases, 50° for 2 cases, and 40° for one case . After the application of compensator with simple slope (40°, 45°, and 50°), the overdose of anterior neck has been substantially improved. Conclusion : When bilateral parallel opposed fields are used for the initial treatm ent of head neck tumors, the dose nonuniformit y of anterior portion of neck should be assesse d. If significant overdose was noted and it is impossible to make tissue com pensator case by case, the simple application model of tissue compensator for anterior neck can be considered.


    

本卷期目次
放射治療與腫瘤學
Lymphoma with Intraspinal Extramedullary Involvement as Initial Presentation/ Szu-Jung ChenNa-Na ChungLouis Tak LuiWei-Chung HsuLai-Lei Ting
Radiotherapy in the Treatment of Paranasal Sinuses Cancer-The Experience of Tri-Service General Hospital/ Chang-Ming ChenWen-Lin HsuYee-Min JenJing-Min HwangPei-Wei ShuengChin-Jung WuLi-Ping ChangYaoh-Shiang Ling
鈷六十治療機除役處置及人員劑量評估/ 林招膨劉幕台林桂華黃勝賢林昇宏林松彥葉啓源莊庭禎
頭頸部腫瘤於左右兩側照野時,劑量分佈不均勻度的分析及簡易套裝組織補償器的運用/ 陳尚文林芳仁涂振邦蕭安成吳學鼎梁基安楊世能
A Left Lower Lung Mass in a Hodgkin's Disease Patient/ Chong-Jong WangHsuan-Chih Hsu
體外放射線對未經用術的視綱膜母細胞瘤之治療效果:一回溯性研究報告/ 白冰清曾雁明曾振淦高玲玉洪志宏
何杰金氏病的放射治療方法:探討與分析/ 劉幕台林招膨林松彥林昇宏
以Plexiglass假體校正Ir-192近接治療射源活度/ 黃英明李必忍賴耿光顏溫榕
電腦斷層模擬攝影機影像解析度及雜訊的量測/ 趙敏趙良曉劉雪君李玉麟顏上惠陳光耀
Prlmary Radiotherapy Treatment Results of Maxillary Sinus Squamous Cell Carcinoma/ Chih-Chiech HsuLouis Tak LuiNa-Na ChungLai-Lei TingWen-Yi Shau
輻射調節細胞內基因的表現/ 鄧文炳黃正仲林冠如吳國海
體外放射線對未經手術的視網膜母細胞瘤之治療效果:一回溯性研究報告/ 白冰清曾雁明曾振淦高玲玉洪志宏
頭頸部腫瘤於左右兩側照野時,劑量分佈不均勻度的分析及簡易套裝組織補償器的運用/ 陳尚文林芳仁涂振邦蕭安成吳學鼎梁基安楊世能
Primary Radiotherapy Treatment Results of Maxillary Sinus Squamous Cell Carcinoma/ Chih-Chiech HsuLouis Tak LuiNa-Na ChungLai-Lei TingWen-Yi Shau
Radiotherapy in the Treatment of Paranasal Sinuses Cancer-The Experience of Tri-Service General Hospital/ Chang-Ming ChenWen-Lin HsuYee-Min JenJing-Min HwangPei-Wei ShuengChin-Jung WuLi-Ping ChangYaoh-Shiang Ling
Lymphoma with Intraspinal Extramedullary Involvement as Initial Presentation/ Szu-Jung ChenNa-Na ChungLouis Tak LuiWei-Chung HsuLai-Lei Ting
電腦斷層模擬攝影機影像解析度及雜訊的量測/ 趙敏趙良曉劉雪君李玉麟顏上惠陳光耀
鈷六十治療機除役處置及人員劑量評估/ 林招膨劉幕台林桂華黃勝賢林昇宏林松彥葉啓源莊庭禎
以Plexiglass假體校正Ir--192近接治療射源活度/ 黃英明李必忍賴耿光顏溫榕
何杰金氏病的放射治療方法:探討與分析/ 劉幕台林招膨林松彥林昇宏
A Left Lower Lung Mass in a Hodgkin's Disease Patient/ Chong-Jong WangHsuan-Chih Hsu
輻射調節細胞內基因的表現/ 鄧文炳黃正仲林冠如吳國海
 
   
 
   

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