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題名 | 頭頸部病人調強放射治療皮膚劑量之初步研究=Preliminary Study of Skin Dose for Head and Neck Patients Treated with Intensity-Mudulated Radiation Therapy (IMRT) |
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作者 | 梁永昌; 傅筱如; 徐椿壽; 羅素花; 胡尹薰; 陳爲立; | 書刊名 | 放射治療與腫瘤學 |
卷期 | 17:1 2010.03[民99.03] |
頁次 | 頁19-28 |
分類號 | 416.36 |
關鍵詞 | 皮膚劑量; 熱發光劑量計; 輻射變色軟片; Skin dose; TLD; Gafchromic film; |
語文 | 中文(Chinese) |
中文摘要 | 目的:本實驗主要評估頭頸癌病人皮膚劑量量测工具的可信度,以及找出臨床上評估頭頸痞病人皮膚劑量的參考數據。 材料與方法:本實驗採用熱發光劑量計、平行板游離腔以及輻射變色軟片來作為測量工具,並分別作其特性研究以及增建區的量測;腫瘤輪廓國選方面,分別為標靶(target)輪廓內縮表面下5mm、標靶輪廓與表面相同邊緣和無經過修改之標靶輪廓突出表面。本研究用表面劑量(D0)與垂直於表面劑量點切線方向往下1公分的劑量(D1)之比值(D0/D1),期望可以用此比值求出實際劑量。 結果:本實驗之熱發光劑量計變異係數在3%以內,計值與給予劑量問呈現良好線性關係;輻射變色軟片校正區線上每個點之變異係數在5%以內,整體校正曲線呈現穩定的關係;輻射變色軟片的量測值與治療計畫系統的計算值,在距表面下1公分時的誤差小於5%,並以此點作為與表面劑量的比值,可以藉由D0/D1概略求出皮膚劑量。在假體模擬方面,當標靶輪廓突出表面或是標靶輪廓與表面相同邊緣時,其表面劑量有司能會達到D1之85%~95%之間,而在標靶輪廓內縮表面下4mm時,表面劑量則有可能會達到D1之67%~68%之間。 結論:由本實驗得知,不同的腫瘤輪廓以及輪廓到表面的距的確會影響病人皮膚照射的劑量;D0/D1可應用於臨床上評估頭頸癌病人皮膚劑量的參考數據。 |
英文摘要 | PURPOSE: This research was focused on the reliability of measured tool for the skin dose in vivo of the head-and-neck patients treated with radiation. To establish the relationship of the dose ratio of the surface and Dmax, and this data can be used as references for c1inical applications. MATERIALS AND METHOD: This experiment adopted Harshaw cylindrical TLD, Markus parallel ion chamber and ISP Gafchromic EBT film as the measured tool to establish the characteristics and buildup region. Target contoured were under the skin surface, equal to the skin surface and over the skin surface respectively. This research will establish the relationship of the dose ratio of the surface (D0) and 1 cm depth from skin (D1) when D1 of the measurement is similar to that calculated by the treatment planning system. D0/D1 is expected to predict the actual absolute received dose. RESULT: In this experiment the variance coefficient of TLD was within 3%. The reading values and delivered doses were in a good linear relationship. The points on calibration curve of Gafchromic film were within 5% and in a stable performance. In additiol1, D1 of Gafchromic film compared to that calculated by the treatment planning system was similar and the errors were all within 5%. Thus, the dose ratio (D0/D1) of the measured surface dose and calculated dose with 1 cm depth from skin could be used to calculate the approximate skin dose. The measured skin dose for most of the head-and-neck patients with the target contoured over or equal to the skin surface was around 85%~95% of D1; whereas with the target contoured 4 mm under the skin surface, the measured skin dose was around 67%-68% of D1. CONCLUSION AND DISCUSSION: From the experimental results, the proximity of the target contour to the skin indeed affects the skin dose received from radiation treatment. D0/D1, can be used as references for clinical applications. |
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