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박주경,이선영,임석건,곽근탁,이승훈,김양수,황호인,차석용,Park, Ju-Kyeong,Lee, Sun-Young,Lim, Seok-Geon,Kwak, Geun-Tak,Lee, Seung-Hun,Kim, Yang-Su,Hwang, Ho-In,Cha, Seok-Yong 대한방사선치료학회 2009 대한방사선치료학회지 Vol.21 No.1
Purpose: Evaluate the mold we have made to improve the reproducibility of the patient position and make homogeneous dose distribution to the treatment volume effectively when treating the patient who has hypervascular ulcer on her tongue caused by paraneoplastic autoimmune multiorgan syndrome by mold brachytherapy. Materials and Methods: The mold is consisted of upper and lower parts. We inserted 2 mm of lead sheet on the gums toward the oral cavity to protect them from unnecessary irradiation during the treatment. We had planned on orthogonal images obtained the patient. 200 cGy was delivered in every fraction with a total dose of 3000 cGy. To evaluate the effect of the lead sheet, we made a measurement with a phantom that has gums and tongue made of tissue with an equivalent material (bolus). Five of TLDs were placed on the interesting points of gums to measure the dose during irradiation with lead sheet and without lead sheet for three times respectively. Results: The result of the measurement without lead sheet are A: 33.9 cGy, B: 30.1 cGy, C: 31.8 cGy, D: 23.3 cGy, E: 24.1 cGy. The results of measurement with lead sheet are A: 20.6 cGy, B: 18.8 cGy, C: 19.6 cGy, D: 14.7 cGy, E: 15.1 cGy. Conclusion: Since we are using the mold made in our department during the treatment of the patient with hypervascular ulcer on tongue, we could deliver a proper dose to the treatment volume. In addition, the mold provided highly accurate and reproducible treatment and reduced the dose to the gums and teeth. Therefore, the possibility of side effects could be decreased significantly.
음경암의 방사선치료 시 자체 제작한 Device의 산란선 차폐 효과에 대한 유용성 평가
김양수,이선영,임석건,곽근탁,박주경,이승훈,황호인,차석용,Gim, Yang-Soo,Lee, Sun-Young,Lim, Suk-Gun,Gwak, Geun-Tak,Pak, Ju-Gyeong,Lee, Seung-Hoon,Hwang, Ho-In,Cha, Seok-Yong 대한방사선치료학회 2009 대한방사선치료학회지 Vol.21 No.1
Purpose: We evaluated the device that was created for maintaining the patient's setup and protecting the testicles from scattered radiation during treatment of carcinoma of the penis. Materials and Methods: The phantom testicles were made of vaseline cotton gauze and the device consisted of 5 mm of acryl box and 4 mm of lead shielding. $3{\times}3\;cm^2$, $4{\times}4\;cm^2$, $5{\times}5\;cm^2$, $6{\times}6\;cm^2$, $7{\times}7\;cm^2$ field sizes were used for this study and measurement was made at 4, 5, 6, 7, 8, 10 cm from the lower edge of the field for 10 times with lead shielding and without the shielding respectively. 200 cGy was delivered using 6 MV photons. Results: The scatted radiation without lead shielding at 4, 5, 6, 7, 8, 10 cm from the lower edge of the field were 14.8-4.7 cGy with $3{\times}3\;cm^2$, 15.7-5.2 cGy with $4{\times}4\;cm^2$, 17.6-5.5 cGy with $5{\times}5\;cm^2$, 19.9-6.6 cGy with $6{\times}6\;cm^2$, 22.2-7.6 cGy with $7{\times}7\;cm^2$ and the measured dose without lead shielding were 7.1-2.6 cGy with $3{\times}3\;cm^2$, 8.9-3.6 cGy with $4{\times}4\;cm^2$, 12.3-4.8 cGy with $5{\times}5\;cm^2$, 14.6-5.0 cGy with $6{\times}6\;cm^2$ and 21.1~6.4 cGy with $7{\times}7\;cm^2$. As shown above, the scatted radiation decreased after using lead shielding. Depending of the range of field sizes, the resulting difference between without shielding values and with shielding values were: 7.8-1.1 cGy at 4 cm, 5.1-1.2 cGy at 5 cm, 3.8-1.1 cGy at 6 cm, 3.4-1.7 cGy at 7 cm, 2.8-1.7 cGy at 8 cm, 2.4-2.5 cGy at 9 cm and 2.1-1.8 cGy at 10 cm. In the situation as described above, the range in values depending on the distance was 7.8-1.1 cGy with $3{\times}3\;cm^2$, 6.9-1.6 cGy with $4{\times}4\;cm^2$, 5.3-0.8 cGy with $5{\times}5\;cm^2$, 5.3-1.5 cGy with $6{\times}6\;cm^2$ and 1.1-1.8 cGy with $7{\times}7\;cm^2$. Conclusion: Using the device we created to shield the testicles from scattered radiation during treatment of carcinoma of the penis, we have found that scattered radiation to the testicles is decreased by the phantom testicles, and by increasing the distance between the testicles and penis.