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乳腺癌放射治疗中皮肤剂量的评估:体模测量与蒙特卡罗模拟

Assessment of skin dose in breast cancer radiotherapy: on-phantom measurement and Monte Carlo simulation.

作者信息

Bahreyni Toossi Mohammad Taghi, Mohamadian Nastaran, Mohammadi Mohammad, Ghorbani Mahdi, Hassani Mohsen, Khajetash Benyamin, Khorshidi Farideh, Knaup Courtney

机构信息

Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Medical Physics, Royal Adelaide Hospital, Adelaide, South Australia.

出版信息

Rep Pract Oncol Radiother. 2020 May-Jun;25(3):456-461. doi: 10.1016/j.rpor.2020.03.008. Epub 2020 Mar 18.

Abstract

AIM

The main purpose of the present study is assessment of skin dose in breast cancer radiotherapy.

BACKGROUND

Accurate assessment of skin dose in radiotherapy can provide useful information for clinical considerations.

MATERIALS AND METHODS

A RANDO phantom was irradiated using a 6 MV Siemens Primus linac with medial and tangential radiotherapy fields for simulating breast cancer treatment. Dosimetry was also performed on various positions across the fields using an EBT3 radiochromic film. Similar conditions of measurement on the RANDO phantom including field size, irradiation angle, number of fields, etc. were subsequently simulated via the Monte Carlo N-Particle Transport code (MCNP). Ultimately, dose values for corresponding points from both methods were compared.

RESULTS

Considering dosimetry using radiochromic films on the RANDO phantom, there were points having underdose and overdose based on the prescribed dose and skin tolerance levels. In this respect, 81.25% and 18.75% of the points had underdose and overdose, respectively. In some cases, several differences were observed between the measurement and the MCNP simulation results associated with skin dose.

CONCLUSION

Based on the results of the points which had underdose, it was suggested that a bolus should be used for the given points. With regard to overdose points, it was advocated to consider skin tolerance dose in treatment planning. Differences between the measurement and the MCNP simulation results might be due to voxel size of tally cells in simulations, effect of beam's angle of incidence, validation time of linac's head, lack of electronic equilibrium in the build-up region, as well as MCNP tally type.

摘要

目的

本研究的主要目的是评估乳腺癌放射治疗中的皮肤剂量。

背景

放射治疗中皮肤剂量的准确评估可为临床考量提供有用信息。

材料与方法

使用6兆伏西门子Primus直线加速器,采用内侧和切线放射治疗野对RANDO体模进行照射,以模拟乳腺癌治疗。还使用EBT3放射变色胶片在射野的不同位置进行剂量测定。随后通过蒙特卡罗N粒子输运代码(MCNP)模拟RANDO体模上包括射野大小、照射角度、射野数量等在内的类似测量条件。最终,比较两种方法对应点的剂量值。

结果

考虑在RANDO体模上使用放射变色胶片进行剂量测定,基于规定剂量和皮肤耐受水平,存在剂量不足和剂量过量的点。在这方面,分别有81.25%和18.75%的点存在剂量不足和剂量过量。在某些情况下,观察到测量结果与MCNP模拟结果在皮肤剂量方面存在一些差异。

结论

基于剂量不足点的结果,建议对给定的点使用填充物。对于剂量过量的点,主张在治疗计划中考虑皮肤耐受剂量。测量结果与MCNP模拟结果之间的差异可能归因于模拟中计分单元的体素大小、射束入射角的影响、直线加速器机头的验证时间、积累区域缺乏电子平衡以及MCNP计分类型。

相似文献

本文引用的文献

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In vivo skin dose measurement in breast conformal radiotherapy.乳腺适形放疗中的体内皮肤剂量测量
Contemp Oncol (Pozn). 2016;20(2):137-40. doi: 10.5114/wo.2015.54396. Epub 2016 Feb 10.

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