DEVIATION BETWEEN THE PLANNED DOSE AND THE IN VIVO DOSIMETRY RESULTS DURING POSTOPERATIVE IRRADIATION IN PATIENTS WITH UTERINE CANCER DEPENDING ON ANTHROPOMETRIC DATA.

O M Sukhina, A S Simbirova, V S Sukhin
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Abstract

Topometry is an integral part of irradiation whose task is to repeat the position of the patient set by the simulator to repeat the PTV and the spatial relationship between the radiation field and the risk organs that were identified during planning. The dose distribution formulated in the plan is only an ideal model. There is some gap between the actual and planned dose distribution, especially in overweight patients.

Objective: evaluate the effect of anthropometric data on the deviation between the planned dose and the results of dosimetry in vivo in patients with uterine cancer during postoperative irradiation.

Materials and methods: The authors analyzed the results of treatment of 110 patients with stage IB-II uterine can- cer who were treated at the Department of Radiation Therapy of the Institute of Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine from 2016 to 2019. The technique of classical fractionation was used with a single focal dose of 2.0 Gy 5 times a week, the total focal dose was 42.0-50.0 Gy. To assess the effect of the patient's anthropometric data on the difference between the actual and calculated dose, the authors per- formed in vivo dosimetry after the first session and in the middle of the postoperative course of external beam radi- ation therapy.

Results: Рatients with BSA < 1.92 m2, had the median relative deviation at the first session -4.12 %, after 20.0 Gy - 3.61 %, patients with BSA > 1.92 m2: -2.06 % and -1.55 % respectively. After 20 Gy 34.8 % of patients with BSA < 1.92 m2 there was an increase in deviation from the planned dose, 65.2 % a decrease, while in 56.1 % of patients with BSA > 1.92 m2 there was an increase, and in 43.9 % - its reduction. With increasing BMI, the actual dose received on the rectal mucosa in the tenth session of irradiation is approaching the calculated one.

Conclusions: When irradiated on the ROKUS-AM device, we did not find a probable dependence of the influence of the constitutional features of patients between the received and planned radiation dose. When treated with a Clinac 600 C, only body weight and body mass index at the tenth irradiation session have a likely effect on the dose differ- ence. Therefore, issues related to the individual approach to the treatment of uterine cancer, depending on anthro- pometric data is an urgent problem of modern radiotherapy.

子宫癌患者术后放疗时计划剂量与体内剂量测定结果的偏差取决于人体测量数据。
地形测量是辐照的一个重要组成部分,其任务是重复模拟器设置的患者位置,以重复PTV和辐射场与计划中确定的危险器官之间的空间关系。计划中制定的剂量分布只是一个理想模型。实际剂量分布与计划剂量分布之间存在一定差距,特别是在超重患者中。目的:评价人体测量数据对子宫癌患者术后放射治疗中计划剂量与体内剂量测定结果偏差的影响。材料与方法:作者分析2016 - 2019年在乌克兰国家医学科学院医学放射学与肿瘤学研究所放射治疗科治疗的110例IB-II期子宫癌患者的治疗结果。采用经典分步法,单灶剂量为2.0 Gy,每周5次,总剂量为42.0 ~ 50.0 Gy。为了评估患者的人体测量数据对实际剂量和计算剂量之间差异的影响,作者在第一次体外放射治疗后和术后中期进行了体内剂量测定。结果:Рatients BSA < 1.92 m2的患者,首次治疗时的中位相对偏差为- 4.12%,20.0 Gy后的中位相对偏差为- 3.61%,BSA > 1.92 m2的患者分别为- 2.06%和- 1.55%。20 Gy后,34.8%的BSA < 1.92 m2的患者偏离计划剂量增加,65.2%的患者偏离计划剂量减少,56.1%的BSA > 1.92 m2的患者偏离计划剂量增加,43.9%的患者偏离计划剂量减少。随着BMI的增加,第十次照射对直肠黏膜的实际剂量逐渐接近计算剂量。结论:当在ROKUS-AM装置上照射时,我们没有发现患者的体质特征在接受的和计划的辐射剂量之间可能存在依赖关系。当用Clinac 600c照射时,只有第十次照射时的体重和体重指数可能对剂量差异有影响。因此,如何根据人体测量数据对子宫癌进行个体化治疗是现代放射治疗亟待解决的问题。
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来源期刊
Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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