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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Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Radyoterapi , Sağlık Fiziği

Bölüm

Araştırma Makalesi

Yazarlar

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

Zeynep Özsaran
0000-0003-4362-3542
Türkiye

Yayımlanma Tarihi

10 Haziran 2024

Gönderilme Tarihi

15 Haziran 2023

Kabul Tarihi

12 Aralık 2023

Yayımlandığı Sayı

Yıl 2024 Cilt: 63 Sayı: 2

DOI

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

IZ

https://izlik.org/JA22JN87BL

Kaynak Göster

RIS / Bibtex

Vancouver

1.Nezahat Olacak, Zeynep Özsaran. Jinekolojik endokaviter brakiterapi uygulamalarında bilgisayarlı planlama ve TLD dozimetrisi ölçümlerinin karşılaştırılması. ETD. 01 Haziran 2024;63(2):249-60. doi:10.19161/etd.1315183