遠隔放射治療現況及技術發展之介紹

Current Development of Teleradiotherapy

蔡玉莉(Yu-Li Tsai) ； 李玉麟(Yuh-Lin Lee) ； 顔上惠(Sang-Hue Yen) ； 梁麗麗(Li-Li Liang) ； 陳一瑋(Yi-Wei Chen)

《腫瘤護理雜誌》 6卷2期 (2006/12) Pp. 1-9

https://doi.org/10.6880/TJON.200612_6(2).01

摘要

自西元1895年侖琴發現X射線以來，放射線實際運用於腫瘤醫學治療領域已有百年歷史，期間爲因應癌症治療之需求，同時達到保留器官及其功能完整與病患良好的生活品質，遠隔放射治療技術及設備不斷演進，治療機種已由可產生高能量及高劑量率X射線的直線加速器取代，治療技術也由傳統二維放射治療進步到三度空間立體順形放射治療(3-D conformal radiotherapy)、強度調控放射治療(intensity modulated radiation therapy)、以及立體定位放射手術治療，如加馬刀、光子刀等，治療方針也由早期的大範圍治療，逐浙演變爲精緻順形之治療方式，不但增加腫瘤定位的精確度，更減少正常組織的傷害。此外，爲克服放射治療過程中的呼吸運動、不隨意肌肉之蠕動和分次治療間的位移誤差，降低對放射治療計劃的精準度及治療效益的影響，更進一步研發呼吸調控放射治療(gated radiotherapy)、影像導引放射治療(image-guided radiotherapy, IGRT)等技術，使立體順形放射治療更趨成熟。

關鍵字

遠隔放射治療 ； 順形放射治療 ； 影像導引放射治療

並列摘要

Since Wilhelm C. Roentgen discovered x-rays in 1895, the radioactive rays have been utilized practically in treating tumors for a hundred years. To fulfill the need for cancer treatment, to preserve organs and their functioning, and to maintain patients' quality of life, radiotherapy treatment techniques and equipment have developed dramatically. The types of therapeutic equipment have improved from linear accelerators with high energy and high dosage x-rays, from conventional two-dimensional radiation treatment to three-dimensional conformal radiotherapy and intensity modulated radiation therapy, as well as stereotactic radiosurgery such as gamma knife and X knife. The therapeutic principles have also changed gradually from conventional wide-field irradiation to precise conformal radiation. This not only improves the accuracy of tumor targeting but also reduces the injury to normal tissues. In addition, in order to compensate for movements from breathing and from involuntary muscle movements or muscle creeping during radiotherapy, the concepts of respiration-adjusted gated radiotherapy and image-guided radiotherapy (IGRT) are now being developed. These improvements will make 3-D conformal radiotherapy techniques mature rapidly.

並列關鍵字

teleradiotherapy ； conformal irradiation ； image-guided radiotherapy