Technique of Total Body Irradiation Used in NCKUH

成大醫院所用的全身照射術

陳海雯(Helen H. W. Chen) ； 梁永昌(Henry W. C. Leung) ； 郭永芳(Yeong-Fang Kuo) ； 黃英明(Ing-Ming Hwang) ； 郭珍妮(Jenny Que) ； 王裕文(Yu-Wen Wang)

《放射治療與腫瘤學》 3卷2期 (1996/06) Pp. 93-99

https://doi.org/10.6316/TRO/199603(2)93

摘要

目的：為了縮短病患在接受全身照射治療時的位置擺設時間及增進臨床治療的再複製可能性，我們提出成大醫院所用的全身照射方法。
材料和方法：我們自己製做了一個可供病人站立的架子，上面有一個類似腳踏車座墊的椅子和固定頭及身體的裝置，如此病人治療時位置的擺設可以很輕易地擺好。為了避免肺部接受到超過正常忍受的劑量，每個病人都特別製做了肺部遮擋的鉛塊，這鉛塊是固定在一件為病人量身製做的鑄成品上，以加熱可塑造冷卻即定型的材料(Aquaplast(上標 TM) Thermoplastics)做成，病人穿在身上好像穿了一件貼身的背心。藉著比實際照射時的照野片子和模擬攝影片子有無一致來評估病患的肺部遮擋鉛塊是否在正確位置，以及他的姿勢是否正確，佐以半導體偵檢器來測量生物活體照射時的劑量測量，並以全程照射的確認片來對整個照射過程做監測。
結果：對身體正面的照野來說，肺部遮擋鉛塊的平均水平與垂直偏移為4.8±1.1mm和4.3±1.3mm; 對身體背面的照野來說，其平均水平與垂直偏移為3.1±1.1mm和3.4±0.9mm。肺部所受到的平均劑量為936±21 cGy，每次治療的時間若使用直線加速器約需30±5分鐘，若用鈷六十則需55±5分鐘。
結論：我們以這樣的方怯可以達到一個令人滿意的結果，不但病患臨床治療時不麻煩，而且可以提高病患在治療時的舒適度。

關鍵字

骨髓移植 ； 全身照射術 ； 病患位置的固定

並列摘要

Purpose: We developed a system for total body irradiation (TBI) in an attempt to shorten patient setup and increase the reproducibility.
Materials and Methods: A special homemade stand with a quasi-saddle shaped chair and an additional immobilization system for the head and body help to position patient in a reproducible manner. Customized lung shields are used to protect the lung from excess tolerance dose. The blocks are screwed in a customized Aquaplast(superscript TM) Thermoplasties cast which the patient wears like a vest. The reproducibility of the patient's positioning and lung shielding was evaluated by comparing the verification films with the simulation films. In vivo dosimetry was performed by placing diodes in the central axis and in several off-axis sites. Full-course verification of the lung shields was also performed.
Results: The mean horizontal and vertical deviations were 4.8±1.1mm and 4.3±1.3mm for the anterior fields, and 3.1±1.1mm and 3.4±0.9mm for the posterior fields. The average lung dose was 936±21 cGy. The mean duration per fraction was about 30±5min for linear accelerator and 55±5min for (superscript 60)Co.
Conclusions: Our technique can reach a satisfactory level of reproducibility. It can also increase patient comfort during the treatment.

並列關鍵字

Bone marrow transplant ； Total body irradiation ； Patient immobilization