- 期刊
使用輻射變色膠片於卡波西氏肉瘤放射線治療的活體劑量驗證
In Vivo Skin Dose Measurement with Gafchromic EBT Film in the Treatment of Epidemic Kaposi's Sarcoma on the Feet with Radiation Therapy
摘要
目的：卡波西氏肉瘤的特性主要為侵犯皮膚組織，臨床上常使用組織補償物增加表面劑量。此次研究目的為評估個別侵犯單腳與雙腳皮膚的卡波西氏肉瘤病人，因不同適應症而搭配兩種不同組織補償物，使用Gafchromic EBT膠片做為活體劑量計，經由臨床實測，記錄每天劑量變化情形，藉以作為醫生客觀評估皮膚劑量的依據。 材料與方法：分成兩種不同的治療擺位方式，皆貼上2×2平方公分大小的EBT膠片，用以量測皮膚劑量。第一種為雙腳皆需要接受放射線治療的病人，雙腳併攏置於水箱中，使用能量10MV光子進行兩側對照，單次處方劑量為300 cGy，共治療12次；第二種為僅需單腳局部接受放射線治療的病人，使用發泡劑固定系統，添加厚度至少3mm以上的Polyflex Ⅱ當作組織補償物，照射方式為使用4個入射角度的三度空間順形放射治療，光子能量為4MV，單次處方劑量為200cGy，預計治療25次，治療計畫系統為Philips pinnacle^3v7.6c。 結果：雙腳照射中，12個量測點重複量測5天，雙腳皮膚平均劑量為313.3±15.7cGy；單腳照射中，2個量測點重複量測10天，A點處的皮膚平均劑量為219.5±4.1 cGy；B點處的皮膚平均劑量為219.0±5.5cGy，治療計畫計算結果A點為212.7 cGy，其測量結果比治療計畫多3.2%；而B點計算結果為216.7 cGy，其測量結果比治療計畫多1.1%。 結論與討論：文中使用的兩種設置方式，不論是使用水或Polyflex Ⅱ當作組織補償物，經過活體劑量量測，證實都可以使皮膚得到足夠的劑量，甚至接受到約高於處方劑量10%左右的值，提供給醫師作為日後客觀評估皮膚劑量的依據。
並列摘要
Purpose: Epidemic Kaposi's sarcoma mainly invades skin tissues. In the clinic, we often use bolus to increase the surface dose. To evaluate the patients of epidemic Kaposi's sarcoma who had lesions on either single foot or on both feet skins, Gafchromic EBT film was used as in-vivo dosimetry to compare two different radiotherapy methods and verified the skin doses. Materials and Methods: In these two different treatment methods, we used 2×2 cm^2 size EBT film to measure the skin dose. The first method treated both feet. Two feet were immersed in a water tank and irradiated with 10 MV bilateral photon beam. The total dose of 36 Gy was delivered in 12 fractions. The second method treated only partial single foot, and used the Alpha cradle fixation system. In this study, we used at least 3mm thick Polyflex II as the tissue-compensator. Base on CT images, the treatment site was irradiated with 4 MV photon beams at 4 different angles. The total dose of 50 Gy was delivered in 25 fractions. The treatment planning system used in this study was Philips pinnacle^3 v7.6c. Results: In both-feet irradiation case, we chose twelve points and repeated measurement for 5 days. The average skin dose of both feet was 313.3±15.7 cGy. In single foot irradiation case, two measure points were repeated for 10 days. The average skin dose at points A and B were 219.5±4.1 cGy and 219.0±5.5 cGy respectively. The calculation results of treatment planning at A and B points were 212.7 cGy and 216.7 cGy respectively. The measurement results were higher than the treatment planning system by 3.2% and 1.1%. Conclusions: As shown by the results of this study, either water tank or polyflex II may be used as tissue-compensators. They can provide sufficient doses to the skin tissue. Both methods are available for follow-up evaluation.
延伸閱讀
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