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| 題 名 | 使用錐狀射束電腦斷層量化肩部位移及對頸部劑量的影響=Using Cone Beam Computed-Tomography to Quantify Shoulder Displacement and Evaluate Influence of Dose |
|---|---|
| 作 者 | 吳卉蓁; 謝敏文; 林俊彥; 陳臣苑; 陳顯鑫; 范綱行; | 書刊名 | 中華放射線技術學雜誌 |
| 卷 期 | 40:4 2016.12[民105.12] |
| 頁 次 | 頁234-242 |
| 分類號 | 416.36 |
| 關鍵詞 | 頭頸固定模具; 肩部位移; 錐狀射束電腦斷層; 銳速刀治療; Head mask; Shoulder displacement; CBCT; RapidArc radiotherapy; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 本研究使用錐狀射束電腦斷層取像以量化分次放射線治療間與分次治療中的肩部位移，並使用侖道假體模擬肩部位移量對頭頸癌病患於銳速刀治療方式下的頸部劑量影響。共60位頭頸癌病患，使用頭頸固定模具與銳速刀治療方式。每周一次於放射治療前先經影像導引修正擺位誤差後，再分別於治療前與治療後使用錐狀射束電腦斷層擷取肩部影像，用以記錄治療前與後的肩部誤差修正值來量化肩部位移。最後以侖道假體模擬出不同的肩部位移量，並分析不同的肩部位移量相對於基準治療計畫中對頸部劑量的影響。結果顯示，右肩治療前和治療後位移平均值分別為0.33±0.17cm、0.14±0.08cm (RL)；0.80±0.36cm、 0.24±0.18cm (SI)；0.58±0.37cm、0.30±0.18cm (AP)。左肩治療前與治療後位移平均值為0.33±0.16cm、 0.12±0.08cm (RL)；0.65±0.31cm、0.20±0.15cm (SI)；0.45±0.28cm、0.25±0.13cm (AP)。假體劑量體積百分比V_(100) 及V_(95)在肩部模擬位移量0cm、0.5cm、1cm、1.5cm、2cm、2.5cm、3cm分別為97.33%、93.91%、87.45%、78.4%、51.95%、40.87%、31.23%及99.56%、99.46%、99.02%、97.67%、90.01%、87.54%、75.34%。使用頭頸固定模具下的肩部位移量在放射分次治療間的變動性以SI方向最大，在分次治療中的穩定性則以AP方向最差。另外由假體模擬肩部位移量對頭頸癌病患於銳速刀治療方式下的頸部劑量影響得知，隨著肩位移量增加會使得頸部的劑量包覆率降低且與基準治療計畫間的劑量差異而變大。 |
| 英文摘要 | This study used cone beam computed tomography (CBCT) to evaluate the displacement of shoulder during fractionated treatment of radiotherapy. A RANDO phantom was used to simulate and evaluate the dose difference caused by shoulder displacement in the RapidArc radiotherapy. Total 60 patients were selected for this study who underwent RapidArc treatments with customized immobilization device. Onboard images of the patients were acquired before and after treatment everyday and CBCTs were carried out once a week . After correction of setup errors, we performed CBCT scan in the shoulder region before and after irradiation for each patient. CBCTs were used to measure the shoulder displacement during daily treatment. The displacement of shoulder was simulated on Rando phantom then the dose of lower neck was calculated. The differences between original plans and simulation results were assessed to find out the effect of shoulder displacement on the dose distribution in lower neck. The displacements of right shoulder in different axes before and after treatment were 0.33±0.17cm, 0.14±0.08cm (right-left, RL); 0.80±0.36cm, 0.24±0.18cm (superior-inferior, SI); 0.58±0.37cm, and 0.30±0.18cm (anterior-posterior, AP), respectively. The displacements of left shoulder in different axes before and after treatment were 0.33±0.16cm, 0.12±0.08cm (RL); 0.65±0.31cm, 0.20±0.15cm (SI); and 0.45±0.28cm, 0.25±0.13cm (AP). Radiation doses delivered to target at V_(100) for shoulder displacements at 0cm, 0.5cm, 1cm, 1.5cm, 2cm, 2.5cm, and 3cm were 97.33%, 93.91%, 87.45%, 78.4%, 51.95%, 40.87%, 31.23% and 99.56%; whereas at V_(95) they were 99.46%, 99.02%, 97.67%, 90.01%, 87.54%, and 75.34%, respectively. The inter-fractional displacement of shoulders with head and neck immobilization device was the most significant at SI direction. The intra-fractional movement was the most significant at AP direction. By the simulation of the shoulder displacement on RANDO phantom, the shoulder displacement would decrease the dose coverage of lower neck and increase the dose difference between simulations and original plans. |
本系統中英文摘要資訊取自各篇刊載內容。