Jinekolojik endokaviter brakiterapi uygulamalarında bilgisayarlı planlama ve TLD dozimetrisi ölçümlerinin karşılaştırılması

Nezahat Olacak; Zeynep Özsaran

doi:10.19161/etd.1315183

EN TR

Comparison of computerized planning and TLD dosimetry measurements in gynecological endocavitary brachytherapy applications

Abstract

Aim: Dosimetric evaluation of rectum and bladder doses in endocavitary brachytherapy treatment of patients with operated/inoperable cervix and endometrium cancer. Materials and Methods: A rectal probe with thermoluminescence dosimetry (TLD) was inserted to measure doses in the rectum in endocavitary brachytherapy treatments of 10 inoperable, 12 operated patients with cervical and endometrial cancer. A foley catheter (balloon) in the neck of the bladder and a chain in its base was placed to determine the bladder doses. Applicator points, vagina, bladder, and rectum points were determined on the radiographs of the patients taken in the simulator, and dose distributions were calculated in the brachytherapy treatment planning system. Doses calculated at 4 points in the rectum and measured by TLD were compared as a percentage difference. The dose at the bladder neck was statistically compared with the highest dose at its base. Results: The differences between the two techniques in operated and inoperable patients for the rectum; respectively, maximum 17.68% and 17.96%, minimum 0.38% and 0.20%, mean R1:5.62%, R2:4.22%, R3:5.96%, R4:7,58% and R1:6.73%, R2:4.36%, R3:4.34%, R4: 7.53% were determined. While the difference between the bladder neck and the maximum dose point at its base was significant in operated patients (p=0.0037), it was insignificant in inoperable patients (p=0.3863). Conclusion: The difference between the calculated and measured doses in the rectum is not clinically significant. Doses for rectal complications should be determined at multiple points. The dose determined at the bladder neck is not sufficient for bladder complications, the doses should also be determined at the base of the bladder.

Keywords

Jinekolojik endokaviter brakiterapi uygulamalarında bilgisayarlı planlama ve TLD dozimetrisi ölçümlerinin karşılaştırılması

Öz

Amaç: Opere/inopere serviks ve endometrium kanserli hastaların endokaviter brakiterapi tedavisinde rektum ve mesane dozlarının dozimetrik değerlendirilmesidir. Gereç ve Yöntem:10 inopere, 12 opere serviks ve endometrium kanserli hastaların endokaviter brakiterapi tedavilerinde rektumdaki dozları ölçmek için, thermolüminisans dozimetre (TLD) içeren rektal prob yerleştirildi. Mesane dozlarını belirlemek için mesane boynuna foley sonda (balon) ve tabanına bir zincir yerleştirildi. Hastaların simülatörde çekilen radyografileri üzerinde aplikatör noktaları, vajen, mesane ve rektum noktaları belirlenip brakiterapi tedavi planlama sisteminde doz dağılımları hesaplatıldı. Rektumda 4 noktada hesaplanan ve TLD ile ölçülen dozlar yüzde fark olarak karşılaştırıldı. Mesane boynundaki doz, tabanındaki en yüksek doz ile istatistiksel olarak karşılaştırıldı. Bulgular: Rektum için, opere ve inopere hastalarda iki teknik arasındaki farklar; sırasıyla, maksimum %17,68 ve %17,96, minimum %0,38 ve %0,20, ortalama R1: %5,62, R2: %4,22, R3: %5,96, R4: %7,58 ve R1: %6,73, R2: %4,36, R3: %4,34, R4: %7,53 olarak belirlendi. Mesane boynu ile tabanındaki maksimum doz noktası arasındaki fark opere hastalarda anlamlı (p=0,0037) iken, inopere hastalarda anlamsız bulundu (p=0,3863). Sonuç: Rektumda hesaplanan ile ölçülen dozlar arasındaki fark klinik açıdan önemli değildir. Rektal komplikasyonlar için dozlar birçok noktada belirlenmelidir. Mesane boynunda belirlenen doz mesane komplikasyonları için yeterli değildir, mesane tabanında da dozlar belirlenmelidir.

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Details

Primary Language

Turkish

Subjects

Radiation Therapy , Health Physics

Journal Section

Research Article

Authors

Nezahat Olacak ^*
0000-0002-0700-0420
Türkiye

Zeynep Özsaran
0000-0003-4362-3542
Türkiye

Publication Date

June 10, 2024

Submission Date

June 15, 2023

Acceptance Date

December 12, 2023

Published in Issue

Year 2024 Volume: 63 Number: 2

DOI

https://doi.org/10.19161/etd.1315183

IZ

https://izlik.org/JA22JN87BL

Cite

RIS / Bibtex

Vancouver

1.Nezahat Olacak, Zeynep Özsaran. Jinekolojik endokaviter brakiterapi uygulamalarında bilgisayarlı planlama ve TLD dozimetrisi ölçümlerinin karşılaştırılması. EJM. 2024 Jun. 1;63(2):249-60. doi:10.19161/etd.1315183