切尔诺贝利核电站事故35年后:评估大规模不受控制的辐射照射后果的回顾性剂量学方法及其随后的发展和在放射学中的应用(A. Tsyb MRRC的经验)

V. Stepanenko, A. Kaprin, S. A. Ivanov, P. Shegay, T. Kolyzhenkov, V. Bogacheva, E. Iaskova, A. Petukhov, O. Karyakin, M. Kiseleva, L. Krikunova, N. Borysheva, V. Biryukov, G. A. Rukhadze, V. Kucherov, V. A. Korotkov, A. Ivannikov, A. Khailov, E. Zharova, K. Zhumadilov, S. Endo, M. Hoshi
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引用次数: 0

摘要

切尔诺贝利事故发生后,在A. Tsyb医学放射研究中心(A. Tsyb MRRC)开发了个人回顾性剂量测定法,以评估和分析卡卢加和布良斯克地区受放射性污染住区居民受到的辐射影响。该方法还用于国际试点项目框架内的辐射流行病学病例对照研究。获得的数据表明,在事故发生时是儿童和青少年并居住在布良斯克地区放射性污染地区的诊断为甲状腺癌的患者中,甲状腺癌的剂量-反应关系可靠。在2008年10月至2013年2月期间首次确诊癌症的妇女中发现了诊断为浸润性乳腺癌的剂量-反应关系,这些妇女自事故发生以来一直居住在受放射性污染的定居点。他们的确诊年龄在55岁以下。同时,在事故发生时5岁以下儿童中未发现白血病的剂量-反应关系。个人回顾性剂量测定法已得到更新,并用于试点研究,以核实因塞米巴拉金斯克核试验而受到辐射照射的人口的辐射剂量保守估计,以及核实受福岛第一核电站事故影响的人的外部辐射剂量估计。该方法还用于估计广岛和长崎原子弹爆炸幸存者的个体残留放射性剂量。根据国家医学研究放射中心与哈萨克斯坦共和国和日本的主要研究中心之间的双边国际合作协议,继续进行长期合作。自2016年以来,A. Tsyb MRRC的研究人员和医生改进了天然材料和合成材料的受激发光方法,并开发了创新的体内剂量学技术,用于前列腺癌、妇科和复发性盆腔肿瘤近距离放疗中评估危险内脏器官的空间辐射剂量分布,以及评估肿瘤乳腺皮肤的局部辐射剂量,并已投入临床实践。切尔诺贝利事故后,在个人回顾性剂量测定方法的开发和应用方面有35年的经验,这为确定受激发光技术新应用发展的未来趋势奠定了基础。辐射诱导受激发光剂量法适用于非受控辐射事件;适用于中子束放射治疗的回顾性剂量测定方法正在研究中。体内对称法在放射肿瘤学中是有用的。现在组装热释光微型剂量计用于动脉放射栓塞。目前,已经研究了在暴露于从几毫戈瑞到大于60戈瑞的高LET辐射后,使用衣物和特殊插入物(纽扣、扣件等)、可穿戴电子设备部件作为天然剂量计的可行性,以及使用由不同材料制成的发光微剂量计的可行性。考虑开发柔性平面微剂量计组件,以便获得有关放射治疗期间计划和实际放射剂量分布可能存在差异的更详细信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
35 years after the Chernobyl NPP accident: methods of retrospective dosimetry in assessing of the consequences of large-scale uncontrolled radiation exposures, their subsequent development and application in oncoradiology (experience of A. Tsyb MRRC)
Individual retrospective dosimetry was developed at A. Tsyb Medical Radiological Research Centre (A. Tsyb MRRC) after the Chernobyl accident for assessment and analysis of radiation effects on people lived in radioactively contaminated settlements in the Kaluga and Bryansk regions. The method was also used in radiation epidemiology case-control studies within frames of international pilot projects. The ob-tained data demonstrated reliable dose-response relationship for thyroid cancer in patients with diag-nosed thyroid cancer, who were children and adolescents at the time of the accident and resided in radi-oactively contaminated areas in the Bryansk region. The dose-response relationship for diagnosed inva-sive breast cancer was found in women, resided in radioactively contaminated settlements since the acci-dent till the first diagnosis of cancer that was established within the period from October 2008 to February 2013. Their age at diagnosis was under 55 years. At the same time, no dose-response relationship for leu-kaemia was found in children under 5 years old at the time of the accident. The individual retrospective dosimetry method has been updated and used in pilot studies for verifying conservative estimates of radi-ation doses to the population exposed to radiation as a result of nuclear tests at the Semipalatinsk nuclear test site, as well as for verifying estimates of external radiation doses to people affected by the accident at the Fukushima Daiichi NPP. The method was also used for estimating individual doses from residual radi-oactivity for the survivors of the Hiroshima and Nagasaki atomic bombings. The long-term collaboration continues under bilateral International Collaboration Agreements between the National Medical Research Radiological Centre and leading research centres in the Republic of Kazakhstan and Japan. Since 2016 researchers and physicians of A. Tsyb MRRC have modi-fied method of stimulated luminescence of natural and synthetic materials and developed innovative technology in vivo dosimetry that has been put into clinical practice for estimating spatial radiation doses distribution in internal organs at risk during the brachytherapy of prostate cancer, gynecologic and recur-rent pelvic tumors, as well as for estimating local radiation dose to the skin of the breast gland with the tumor. The 35-year experience in the development and application of methods for individual retrospective dosimetry after the Chernobyl accident formed the basis for identifying future-pointing trends for the de-velopment of novel applications of stimulated luminescence techniques. Radiation-induced stimulated luminescence dosimetry can be applicable in uncontrolled radiation events; retrospective dosimetry method applicable for neutron beam radiation therapy is under development. The method of in vivo do-simetry is useful in radiation oncology. Now assembled thermoluminiscent micro-sized dosimeters are used for arterial radioembolization. At present, feasibility of using items of clothing and special inserts (buttons, fastenings, etc.), parts of wearable electronic devices as natural dosimeters, as well as the feasi-bility of using luminescent microdosimeters, made of different materials, after exposure to high LET radiation ranged from a fraction of mGy to the dose greater than 60 Gy have been examined. Development of flexible planar microdosimeter assemblies in order to obtain more detailed information about possible discrepancy in distribution of planned and actual radia-tion doses to patients during radiotherapy is considered.
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