[1]邓大平,卢峰,孙洪强,等.颅脑肿瘤放射治疗时射野外器官吸收剂量体模法测量与分析[J].国际放射医学核医学杂志,2016,40(4):272-276.[doi:10.3760/cma.j.issn.1673-4114.2016.04.007]
　Deng Daping,Lu Feng,Sun Hongqiang,et al.Test and analysis of out-of-field organ dose in intracranial tumor radiotherapy using phantom[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(4):272-276.[doi:10.3760/cma.j.issn.1673-4114.2016.04.007]
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颅脑肿瘤放射治疗时射野外器官吸收剂量体模法测量与分析(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
40
期数:
2016年第4期
页码:
272-276
栏目:
出版日期:
2016-07-25

文章信息/Info

Title:
Test and analysis of out-of-field organ dose in intracranial tumor radiotherapy using phantom
作者:
邓大平1;  卢峰1;  孙洪强2;  魏玮2;  姜玉华2
1. 250062 济南, 山东省医学科学院放射医学研究所防护监测室;
2. 250033 济南, 山东大学第二医院放疗科
Author(s):
Deng Daping1;  Lu Feng1;  Sun Hongqiang2;  Wei Wei2;  Jiang Yuhua2
1. Department of Protection and Monitor, Institute of Radiation Medicine, Shandong Academy of Medicine Sciences, Jinan 250062, China;
2. Department of Radiation Oncology, the Second Hospital of Shandong University, Jinan 250033, China
关键词:
脑肿瘤; 放射疗法;  适形; 辐射剂量; 三维适形照射技术; 普通方野照射技术
Keywords:
Brain neoplasms; Radiotherapy;  conformal; Radiation dosage; Three dimensional conformal radiotherapy; Common square field techniques
DOI:
10.3760/cma.j.issn.1673-4114.2016.04.007
摘要:
目的 在是否使用楔形板和照射野面积不同的情况下，测量和分析颅脑肿瘤放射治疗时射野外器官的吸收剂量。方法 使用中国成人男性仿真人体模型，模拟颅脑肿瘤放射治疗，采用不使用楔形板的普通方野照射技术组和使用楔形板的三维适形照射技术（3D-CRT）组，普通方野照射技术组分别用2 cm×2 cm野和4 cm×4 cm野进行照射，3D-CRT组分别按等效方野面积分为2 cm×2 cm野和4 cm×4 cm野进行照射；使用热释光剂量计测量射野外器官的吸收剂量并进行分析。结果 颅脑肿瘤靶区处方剂量为100 cGy时，射野外各器官吸收剂量范围为0.13～2.83 mGy.头颈部器官4 cm×4 cm野照射时的吸收剂量与2 cm×2 cm野比较，差异有统计学意义（t=-5.023,P=0.004）;胸腹部器官4 cm×4 cm野照射时的吸收剂量与2 cm×2 cm野比较，差异无统计学意义（t=-1.438,P=0.171）.普通方野照射组头颈部器官、腹部器官的吸收剂量与3D-CRT组比较，差异均有统计学意义（t头=-2.805,P=0.038;t腹=-11.966,P=0.000）.结论 接受颅脑肿瘤放射治疗的患者，射野外器官吸收剂量的大小与照射野面积、是否采用楔形板照射技术有关。接受大野照射的患者，靶区邻近器官吸收剂量越大；照射野面积和处方剂量相同时，使用楔形板的照射技术相对于不使用楔形板的射野外器官的吸收剂量增大。
Abstract:
Objective To test and analyze out-of-field organ dose in intracranial tumor radiotherapy with or without wedges and in different radiation field areas. Methods The absorbed doses of out-of-field organs were measured using a thermoluminescent dosimeter by intracranial tumor radiotherapy simulation in the domestic phantom. The tests were grouped according to radiation field areas and techniques. Common square field techniques do not use wedges, whereas 3D conformal radiotherapy(3D-CRT) uses wedges. The radiation field area was divided into 2 cm × 2 cm and 4 cm × 4 cm fields. Results The absorbed doses of out-of-field organs ranged from 0.13 mGy to 2.83 mGy per 100 cGy prescription dose. The doses of organs adjacent to the target area are higher after irradiation using the 4 cm × 4 cm field than after irradiation using the 2 cm × 2 cm field(t=-5.023, P=0.004); however, no statistically significant(t= -1.438, P=0.171) difference can be found in organs non-adjacent to the target area. The doses of organs are higher after irradiation using 3D-CRT with a wedge than after irradiation using common square field techniques without a wedge regardless of whether the organs are adjacent to the target area or not(t头 = -2.805, P=0.038; t腹= -11.966, P=0.000). Conclusions The absorbed doses of out-of-field organs of the patients who received intracranial tumor radiotherapy are associated with radiation field areas and techniques. The doses of organs adjacent to the target area increase as the radiation field area increases in size. Given a uniform radiation field area and prescription dose, the absorbed doses of out-of-field organs irradiated by radiotherapy techniques with wedges are higher than those of organs irradiated by radiotherapy techniques without wedges.

参考文献/References:

[1] King AD, Ahuja AT, Teo P, et al.Radiation induced sarcomas of the head and neck following radiotherapy for nasopharyngeal carcinoma[J].Clin Radiol, 2000, 55(9): 684-689.DOI:10.1053/crad.2000.0503.
[2] Wang CC, Chen ML, Hsu KH, et al.Second malignant tumors in patients with nasopharyngeal carcinoma and their association with Epstein-Barr virus[J].Int J Cancer, 2000, 87(2): 228-231.DOI:10.1002/1097-0215(20000715)87:2<228::AIDIJC12>3.0.CO;2-T.
[3] 陈运贤, 钟雪云.第二次原发性肿瘤的发生与预防[J].肿瘤研究与临床, 2001, 13(1): 5-7.DOI:10.3760/cma.j.issn.1006-9801.2001.01.002.Chen YX, Zhong XY.Occurrence and prevention for second primary cancer[J].Cancer Res Clin, 2001, 13(1): 5-7.
[4] Halg RA, Besserer J, Schneider U.Systematic measurements of whole-body dose distributions for various treatment machines and delivery techniques in radiation therapy[J].Med Phys, 2012, 39(12): 7662-7676.DOI:10.1118/1.4767773.
[5] 马缠过, 杨克强.放射治疗诱发恶性肿瘤32例分析[J].中华放射肿瘤学杂志, 2000, 9(2): 108.DOI:10.3760/j.issn:1004-4221.2000.02.010.Ma CG, Yang KQ.32 cases of radiation induced malignant tumor[J].Chin J Radiat Oncol, 2000, 9(2): 108.
[6] Chuang SC, Hashibe M, Yu GP, et al.Radiotherapy for primary thyroid cancer as a risk factor for second primary cancers[J].Cancer Lett, 2006, 238(1): 42-52.DOI:10.1016/j.canlet.2005.06.015.
[7] 中华人民共和国卫生部.GBZ 126—2011电子加速器放射治疗放射防护要求[S].北京: 中国标准出版社, 2011.Ministry of Health, People’s Republic of China.GBZ126-2011 Radiological protection standard of electron accelerator in radiotherapy[S].Peking: China Standard Press, 2011.
[8] 温晓玲, 邓开鸿.头颈部癌放疗后的并发症[J].华西医学, 2008, 23(6): 1497.Wen XL, Deng KH.Complications after head and neck cancer radiation therapy.[J].Huaxi Med J, 2008, 23(6): 1497.
[9] 杨云利, 刘颖新, 陆海杰, 等.鼻咽癌放射治疗后诱发肉瘤4例报告[J].实用癌症杂志, 2002, 17(1): 15, 转18.DOI:10.3969/j.issn.1001-5930.2002.01.049.Yang YL, Liu YX, Lu HJ, et al.Report of 4 cases about induced sarcoma after nasopharyngeal carcinoma radiation therapy[J].J Pract Cancer Med, 2002, 17(1): 15, 转18.
[10] Sharma DS, Animesh, Deshpande SS, et al.Peripheral dose from uniform dynamic multileaf collimation fields:implications for sliding window intensity-modulated radiotherapy[J].Br J Radiol, 2006, 79(940): 331-335.DOI:10.1259/bjr/16208090.
[11] Meeks SL, Paulino AC, Pennington EC, et al.In vivo determination of extra-target doses received from serial tomotherapy[J].Radiother Oncol, 2002, 63(2): 217-222.DOI:10.1016/S0167-8140(02)00074-9.李德平, 潘自强.辐射防护手册(第一分册)辐射源与屏蔽[M].北京: 原子能出版社, 1987.
[12] Li DP, Pan ZQ.Manual of Radiation Protection(Part 1).Source and shielding[M].Peking: Atomic Energy Press, 1987.
[13] 刘永超.Omni-wedge在脑瘤三维适形放射治疗计划中的应用[J].包头医学, 2011, 35(1): 12-14.DOI:10.3969/j.issn.1007-3507.2011.01.008.Liu YC.Application of Omin-wedge to brain tumor three dimensional conformal radiotherapy planning[J].J Baotou Med, 2011, 35(1): 12-14.
[14] 邹念东.医科达物理楔形板在治疗计划设计中的使用研究[J].中国医学物理学杂志, 2014, 31(2): 4756-4759.DOI:10.3969/j.issn.1005-202X.2014.02.009.Zhou ND.Study on The ELEKTA Wedge in The Treatment Planning[J].Chin J Med Phy, 2014, 31(2): 4756-4759.
[15] Milliken BD, Hamiton RJ, Rubin SJ.The omni wedge:a method to produce wedge fields at arbitrary orientations[J].Med Phys, 1996, 23(3): 337-342．

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备注/Memo

备注/Memo:
收稿日期:2016-3-11;改回日期:。
基金项目:山东省科技发展计划（2009GG10002051）
通讯作者:邓大平,Email:yanzhid@126.com
更新日期/Last Update: 1900-01-01