牙科修复体和假体对放射治疗剂量分布的影响：一项蒙特卡罗研究。
Effect of dental restorations and prostheses on radiotherapy dose distribution: a Monte Carlo study.
作者信息
Chin David W H, Treister Nathaniel, Friedland Bernard, Cormack Robert A, Tishler Roy B, Makrigiorgos G Mike, Court Laurence E
机构信息
Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center and Harvard Medical School, Boston, MA, U.S.A.
Dana-Farber/Brigham and Women's Cancer Center and Harvard School of Dental Medicine, Boston, MA, U.S.A.
出版信息
J Appl Clin Med Phys. 2009 Feb 3;10(1):80-89. doi: 10.1120/jacmp.v10i1.2853.
Dental restorations, fixed prosthodontics, and implants affect dose distribution in head and neck radiation therapy due to the high atomic number of the materials utilized. The backscatter of electrons from metallic materials due to the impinging treatment x-ray results in localized dose enhancements. These dose enhancements cause localized mucositis in patients who have dental work, a significant clinical complication. We investigated the backscatter effect of 23 configurations of dental work using the EGS4nrc Monte Carlo (MC) simulation system. We found that all-metal fixed partial dentures caused the highest amount of dose enhancement--up to 33%--while amalgam restorations did not cause a significant amount. Restorations with a ceramic veneer caused up to 8% enhancement. Between 3 mm and 5 mm of water-equivalent material almost completely absorbed the backscatter. MC simulations provide an accurate estimate of backscatter dose, and may provide patient-specific estimates in future.
由于所使用材料的高原子序数，牙科修复体、固定义齿和植入物会影响头颈部放射治疗中的剂量分布。由于入射治疗X射线，金属材料对电子的反向散射会导致局部剂量增强。这些剂量增强会在进行牙科治疗的患者中引起局部粘膜炎，这是一种严重的临床并发症。我们使用EGS4nrc蒙特卡罗（MC）模拟系统研究了23种牙科治疗配置的反向散射效应。我们发现，全金属固定局部义齿导致的剂量增强量最高——高达33%——而汞合金修复体则不会导致显著的剂量增强。带有陶瓷贴面的修复体导致的剂量增强高达8%。3毫米至5毫米的水等效材料几乎完全吸收了反向散射。MC模拟提供了对反向散射剂量的准确估计，并且未来可能会提供针对患者的估计。
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