透過您的圖書館登入
IP:18.223.106.232
  • 期刊

全身皮膚電子射線照射新治療技術的開發及研究

A New Technique to Improve Patient Skin Dosage in Total Skin Electron Therapy

摘要


目的:一般在病人做完全身電子射線治療後,病人的頭頂及腳底會有劑量不足的現象;此時能夠做的就是採事後補足劑量的措施;如何在治療過程中,同時讓病人的頭頂及腳底及全身都給到足夠且相同的輻射劑量是此篇研究的主題。 材料與方法:我們選擇Elekta廠脾的直線加速器及6MeV的電子射束做為給予輻射劑量的設備;治療室內直線加速器的等中心旋轉點到病人表面的距離是350cm,並且選擇0.6cm的壓克力板放在距離病人表面90cm處,做為電子的散射板;實驗過程是先找出如何讓直線加速器的機頭水平往上或水平往下的角度照射後合成一個可用劑量剖面照野,之後再以二個旋轉框,最外框是固定用,中間的框是可以前後傾斜旋轉,而最內框司以順時針、逆時針旋轉,讓病人司以得到足夠且均勻的電子劑量以便做全身性的電子射線的治療。 結論與討論:結果顯示以在等中心旋轉點處照野為40cm×40cm,當加速器的機頭水平往上及水平往下各155。的組合照射時,此組合照野在病人治療表面處會有一個平坦的劑量剖面,此剖面的劑量均勻度可控制在±10%的範圍內;因使用全身電子射線旋轉板的關係,所以6MeV於病人治療表面處的百分深度曲線會比傳統垂直照射的結果會更往表淺處偏移;R50變成125cm,E0變成2.913MeV,Rp是1.75Cm,輸出劑量率是0085cGy/min。 結論:雖然此治療方式看似複雜,但是病人在整個治療的一次循環中只需上下內框各一次;一次是俯臥在內框網上,另一次是正躺在內框網上;其餘的姿勢都司由傾斜中框及旋轉內框擺出各種治療角度。此種方法的最大優點是不需像史丹佛大學的治療方式需在治療後補足劑量不足之處,而司以同時讓頭頂及腳底在同一次的治療結束後得到和全身其餘的區域相同且均勻的劑量。

並列摘要


Purpose: The aim of this study is to present a novel technique in which uniform dose to the whole body as well as the soles and vertex of scalp can be achieved in one electron beam treatment fraction. An experiment was undertaken with a home-made aswirl board that enables the patient to lie in supine or prone position for treatment. Material and Methods: A 6 MeV nominal electron beam was delivered using Elekta Precise Sli throughout this experiment. The patient is treated at a isocenter to skin distance of 350 cm. The largest field size available at SSD 100 cm is 40x40cm^2 and a high dose rate of 3000 MU min^(-1) was used. A 0.6 cm thick acrylic beam spoiler was placed 90cm away from the surface of the patient to scatter the electron beam for a more homogeneous surface dose. Patients are treated with two groups in prone and supine position by leaning on inner rotational board in prone and supine position, each group can further be separated into two subgroup with tilting and rotation positions for treatment. By incorporating all these seeting on the aswirl board with the optimal gantry angle, the patient will final accumulate compensated dosages on whole body surface. Results: One of the gantry beam was directed 15.5° upward and the other 15.5° downward from the horizontal axis to provide a field size as large as 200 cm in height and 140cm in width. An incline angle of 31.50° anteriorly (forward) or posteriorly (backward) of the middle frame and an angle rotated 60° clockwise or counterclockwise of the inner frame is found to be most appropriate. The output dose rate for the AB-TSET was 0.085 cGy/mu at SSD 350 cm. The beam characteristics of the AB-TSET depth dose curves were R50=1.25cm, d(subscript max)=0.6 cm E0=2.913 MeV, R(subscript p)=1.75 cm. Conclusion: The AB-TSET technique presented in this study is able to deliver a uniform dose to the patient’s skin surface as well as to the vertex and the soles all in one time, eliminating the troubles of having to further boost fields for these two regions when using the Stanford Six Field Technique.

延伸閱讀