İnopere serviks kanserli hastalarda 2 boyutlu ve 3 boyutlu brakiterapi tedavi planlamalarının dozimetrik karşılaştırılması
Küçük Resim Yok
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnopere serviks kanserinin tedavisinde radyoterapi esas olup, eksternal ve intrakaviter radyoterapi(brakiterapi) sıklıkla birlikte uygulanır. Brakiterapi ile tümörlü dokulara yüksek doz verilirken, kritik organlar korunabilmektedir. Bu çalışmada, inopere serviks kanseri tanısı ile brakiterapi uygulanan olguların 2 boyutlu ve 3 boyutlu tedavi planlamalarının dozimetrik olarak karşılaştırılması amaçlanmıştır. İnopere serviks kanseri tanılı 20 hastanın 2 boyutlu ve 3 boyutlu planlamaları yapılmış, hedef hacim dozları ve kritik organ dozları karşılaştırılıp, istatistiksel olarak değerlendirilmiştir. İki boyutlu brakiterapi tedavi planlamaları, BT (Bilgisayarlı Tomografi) görüntüsü üzerinden; ICRU (International Commision of Radiation Units) 38 raporuna göre, referans bir nokta olan A noktasına dozu %100 normalize edilerek yapılmıştır. Üç boyutlu brakiterapi tedavi planlamaları ise; BT görüntüsü üzerinden CTV (Clinical Target Volume)'ye dozu %100 normalize edilerek yapılmıştır. Her iki brakiterapi tedavi planlamasında da hedef hacmin %90'lık izodozlarının kapsadığı hacimler belirlenmiştir. Ayrıca, kritik organ dozlarının her iki brakiterapi tedavi planlamasında 2cc'lik hacimlerinin aldığı dozlar elde edilmiştir. Her iki planda da hedef hacim ve kritik organ dozları karşılaştırılmıştır. Sonuç olarak, CTV'ye normalize edilerek yapılan planlamalarda hedef dozların yetersiz olduğu görülmüştür. A noktasına normalize edilerek yapılan planlamalarda ise hedef doz hacmi dağılımı daha iyi bulunmuştur (her iki teknik karşılaştırıldığında hedef hacimlerin aldığı dozlar, istatistiksel açıdan anlamlı bulunmuştur p<0,001). Her iki tekniği kritik organlar açısından değerlendirdiğimizde, CTV'ye normalize edilerek yapılan planlamalarda alınan dozlar anlamlı derecede daha düşük bulunmuş (p<0,001), A noktası referans alınarak yapılan planlamalarda ise kritik organ dozlarında artış görülmüştür
In the treatment of inoperable cervical cancer, radiotherapy is essential. External and intracavitary radiotherapy (brachytherapy) are often applied together. With brachytherapy, when appling higher doses to the tumoral tissues, surrounding critical tissues can be protected from high doses. The purpose of this study is dosimetric comparison at 2-d and 3-d treatment planning of patiences diagnosed with inoperable cervical cancer. Therefore 2-d and 3-d plans of 20 patiences, who diagnosed with inoperable cervical cancer, had been done. Ten the target volume dose and dose to critical organs had been compared and evaluated statistically. In this study, 2-d brachytherapy treatment plans had been made accorrding to ICRU (International Commision of Radiation Units) 38 report. A reference point called "A" taken, and %100 dose normalised at point A. On the other hand 3-d brachytherapy treatment plans had been made through BT image and %100 dose normalised to CTV (Clinical Target Volume). At both brachytherapy treatment plannings; Isodoses, which contains %90 of target volume, had been determined. Also at both brachytherapy treatment plannings, intake doses acquaired at 2 cc volumes of critical organs. Then at both plannings, target volume and critical organ doses had been compared. As a result; At the plans, that made with normalisation to CTV, had seen insufficient. At the plans, that made with normalisation to reference point "A", had occured with better target dose volume. (doses exposed by target volume found to be statistically significant. (p<0,001)) When we evaluate in terms of critical organs; At the plans, that made with normalisation to CTV, doses had seen significantly lower. (p<0,001) At the plans, that made with normalisation to reference point "A", dose intake of critical organs had a tendency to increase.
In the treatment of inoperable cervical cancer, radiotherapy is essential. External and intracavitary radiotherapy (brachytherapy) are often applied together. With brachytherapy, when appling higher doses to the tumoral tissues, surrounding critical tissues can be protected from high doses. The purpose of this study is dosimetric comparison at 2-d and 3-d treatment planning of patiences diagnosed with inoperable cervical cancer. Therefore 2-d and 3-d plans of 20 patiences, who diagnosed with inoperable cervical cancer, had been done. Ten the target volume dose and dose to critical organs had been compared and evaluated statistically. In this study, 2-d brachytherapy treatment plans had been made accorrding to ICRU (International Commision of Radiation Units) 38 report. A reference point called "A" taken, and %100 dose normalised at point A. On the other hand 3-d brachytherapy treatment plans had been made through BT image and %100 dose normalised to CTV (Clinical Target Volume). At both brachytherapy treatment plannings; Isodoses, which contains %90 of target volume, had been determined. Also at both brachytherapy treatment plannings, intake doses acquaired at 2 cc volumes of critical organs. Then at both plannings, target volume and critical organ doses had been compared. As a result; At the plans, that made with normalisation to CTV, had seen insufficient. At the plans, that made with normalisation to reference point "A", had occured with better target dose volume. (doses exposed by target volume found to be statistically significant. (p<0,001)) When we evaluate in terms of critical organs; At the plans, that made with normalisation to CTV, doses had seen significantly lower. (p<0,001) At the plans, that made with normalisation to reference point "A", dose intake of critical organs had a tendency to increase.
Açıklama
Anahtar Kelimeler
Fizik ve Fizik Mühendisliği, Physics and Physics Engineering
