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題名:以電腦斷層為模擬計畫基礎的乳癌病患放射治療成果報告     (24點)
Using Ct-Based Simulation as an Aid for Radiotherapy of Breast Cancer
著者:范景超(Ching-Chao Fan) ;葉啓源(Chi-Yuan Yeh) ;邱仲峰(Jeng-Fong Chiou) ;高仲瑜(Chung-Yu Kao) ;蔡若婷(Jo-Ting Tsai) ;羅濟慶(Chi-Ching Lo) ;鍾道生(Tao-Sang Chung) ;陳秋萍(Chiu-Ping Chen)
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 ; 電腦斷層模擬攝影 ; 乳癌 ; 肺部纖維化 ; Radiotherapy ; CT-based simulation ; Breast cancer ; Lung fibrosis
刊名:放射治療與腫瘤學
頁碼:261-272
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

且且: J:).電腦斷層掃描儀作為乳癌病患放射治療前之模擬攝影,可增進治療準確度期望能減少肺續維化。 拉起盟主法:自民國8 3 年7 月至民國88 年1 月止, 以在本科接受完婪放射治療治療並定期追靜、的乳宿病患為研究對象,共有的人,平均年齡為49 歲,平均追踩時間為2 6 . 7 4個月。所有的病人均先以A l p h a C ra d le 固定, 模擬定位後, 接受診斷用的電腦斷層掃眩, 並將影像傳至工作站之電腦,做模擬計量訂出切線照野部位。確定後﹒再於模擬定位室依電腦模擬的結果實際模擬一次,並訂出其他治療部位,完成後方開始治療。治療結束後,須定期回診並以胸部X光片檢靚肺部狀況,以觀察其肺級維化情形。此外,應用3-D電腦治療計畫系統檢視所有病患其切線照野之肺部接受放射治療的狀況,與肺續維化做比較。 益基經過治療前後胸部X 光片與放射部位之比對檢視, 肺纖維化共有5 例( 5 . 2 6 % ) ,而局部復發者有3 例( 3 . 1 6 % ) 。就肺織維化的5 例病患而言, 其電腦斷層圖上的最大垂直距離( greatest perpendicular distance, GPO ) 平均為1.7 5 cm 。接受切線照野照射的肺部體積平均為1 2 2 . 2 5 ml '而其接受照射的肺部體積佔同側肺體積之百外比平均為7 % 0 3 例局部復發病患其G P O 平均為1.5 cm ;接受切線照野照射的肺部體積平均為1 5 5 . 4 8 ml ; 而其照射的肺體積伯同側肺體積之百分比平均為6 .1 2 % 。 益益以電腦斷層為模擬計畫基礎的手l癌病愚放射治療可以增加治療計童的準確度。它比傳統治療更精確的原因在於能精確地掌握解創學上的位置, 如脊髓,心臟,淋巴結,及原發腫瘤位置,所以更能掌握要治療的部位及要保護的組織。我們希望藉此可以安全地給予較高劑量,以提昇局部控制率, 及減少肺部照射以降低肺纖維化的發生。
Purpose: Using CT-based simulation as an aid for breast cance r radiotherapy to increase the acc uracy of treatment and hope to decrease the rate of lung fibrosis. Material s and Methods: From Jul y 1994 to January 1999, we retrospectively ana lyzed 95 patie nts who received full co urse radioth erapy with regu lar follow-up at our departme nt. The average age of the patients was 49 years old, and the median follow-up interval was 26.7 months. A method was devised to simulate patient s with breast cancer in the act ual treatment position by using a diagnostic CT spiral sca nner and a workstation for virtual simulatio n. It was des ired to produ ce non-di vergent tangential beams thro ugh the lung at the match ing line for tangential and supraclav icular fields. Each patient was immobilized in an Alpha Cradle cast. Radio-opaque markers were placed on the margins of the fields decided by simulation and CT scan was performed. The data set was transferred to the worksta tion . After reconst ruction of all the images, we performed virtua l simulation from computer. When treatment para meters were deci ded , we would resimulate patie nt before treatment started. Patients received regular follow-up after completion of radiotherapy. Chest X-ray films were taken to detect lung metastasis and fibros is while physical examination and chest CT were performed to eva luate local rec urrence. Results: All the ches t X-ray films were rechecked and 5 pat ient s (5.26%) with lung fibro sis were noted. According to the chart records and CT images. loca l recurrence was noted in 3 patien ts (3. 16%). Among the 5 patients with lung fibro sis, the average grea test perpendicular dista nce ( GPO ) measured from the CT image was 1.75 cm, the ave rage irrad iated lung volume of the tangential fie lds was 122.25 mlthat occupied 7% of the ipsilateral lung volume. For the 3 patient s with local recur rence, the average GPO was 1.5 cm, the average irradiated lung volume within the tange ntia l fields was 155.48 rnl, and the average irradiated lung volume was 6.12% of the ipsilateral lung . Conclusion: Using CT-ba sed simulation as an aid for brea st cancer radiation treatment was more accu rate than traditional treatment planning. It prov ided us the accurate relationship betwee n the posi tion of the target and cr itica l orga ns. We decrease irrad iated lung volume and hope to reduce the chance of lung fibrosis.


    

本卷期目次
放射治療與腫瘤學
Radiotherapy in Graves Ophthalmopathy at National Taiwan University Hospital/ Wei-Chung HsuNa-Na ChungLouis Tak LuiSoso TsengSzu-Jong ChenLai-Lei Ting
3D-Conformal Radiotherapy of Unresectable and Unembolizable Advanced Hepatoma-A Pilot Study/ Yuk-Wah TsangShang-Lung DongSang-Hue YenYee ChaoKwan-Hwa Chi
以電腦斷層為模擬計畫基礎的乳癌病患放射治療成果報告/ 范景超葉啟源邱仲峰高仲瑜蔡若婷羅濟慶鍾道生陳秋萍
Preliminary Results of Fractionated Stereotactic Radiotherapy in Patients with Advanced Hepatocellular Carcinoma/ Po-Ming WangShin-Jeng ShiangNa-Na ChungLai-Lei TingLouis Tak LuiGau-De Lin
非侵入性腦立體放射治療定位架之技術與再現性研究/ 劉幕台林招膨張雅婷林昇宏張東浩許智捷黃昭源
放射治療之癌患接受另類療法的調查/ 陳玉萍曾雁明曾振淦林信吟洪志宏
實體與增強動態型楔形濾片對射束百分深度劑量調變之測量與研究/ 林賢岳郭珍妮黃英明黃旼儀湯人仰何耀輝江怡良
Evaluation of Tumor Markers in the Follow-Up of Breast Cancer Patients after Treatment/ Jen-Yang TangShi-Long LianShun-Jen ChangMing-Yii HuangYu-Hui Ho
骨骼轉移的單次與分次緩和性放射治療的比較:一個前瞻性隨機試驗/ 陳虹汶賴允亮張國華陳裕仁鍾昌宏吳孟浩王銘志邱世哲
西門子虛擬式楔型濾器與實體楔型濾器穿透因子之比較評估/ 張雅婷林招膨林昇宏林奎利劉幕台朱鐵吉洪裕正
骨骼轉移的單次與分次緩和性放射治療的比較:一個前瞻性隨機試驗/ 陳虹汶賴允亮張國華陳裕仁鍾昌宏吳孟浩王銘志邱世哲
Preliminary Results of Fractionated Stereotactic Radiotherapy in Patients with Advanced Hepatocellular Carcinoma/ Po-Ming WangShin-Jeng ShiangNa-Na ChungLai-Lei TingLouis Tak LuiGau-De Lin
3d-Conformal Radiotherapy y of Unresectable and Unembolizable Advanced Hepatoma-A Pilot Study/ Yuk-Wah TsangShang-Lung DongSang-Hue YenYee ChaoKwan-Hwa Chi
以電腦斷層為模擬計畫基礎的乳癌病患放射治療成果報告/ 范景超葉啓源邱仲峰高仲瑜蔡若婷羅濟慶鍾道生陳秋萍
Evaluation of Tumor Markers in the Follow-Up of Breast Cancer Patients after Treatment/ Jen-Yang TangShi-Long LianShun-Jen ChangMing-Yii HuangYu-Hui Ho
Radiotherapy in Graves' Ophthalmopathy at National Taiwan University Hospital/ Wei-Chung HsuNa-Na ChungLouis Tak LuiSoso TsengSzu-Jong ChenLai-Lei Ting
放射治療之癌患接受另類療法的調查/ 曾雁明曾振淦林信吟洪志宏
實體與增強動態型楔形濾片對射束百分深度劑量調變之測量與研究/ 林賢岳郭珍妮黃英明黃旼儀湯人仰何耀輝江怡良
西門子虛擬式楔型濾器與實體楔型濾器穿透因子之比較評估/ 張雅婷林招膨林昇宏林奎利劉幕台朱鐵吉洪裕正
非侵入性腦立體放射治療定位架之技術與再現性研究/ 劉幕台林招膨張雅婷林昇宏張東浩許智捷黃昭源
 
   
 
   

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