ExacTrac sistem kot faktor kontrole kvalitete v radioterapiji : diplomsko delo

Čagran, Marko (author), Gaube, David (author), Žager Marciuš, Valerija (mentor), Bradač, Primož (comentor)

Uvod: Radioterapija je veja medicine, ki se ukvarja z zdravljenjem malignih in ne malignih bolezni in je ena izmed glavnih metod za zdravljenje raka danke in želodca. Pomembno je, da tumor prejme željeno dozo sevanja ob čim manjši obremenitvi okoliških tkiv. Vzrok za nastanek želodčnega raka in raka danke, ki bo obravnavan v diplomskem delu, še ni povsem znan. ExacTrac sistem se v radioterapiji uporablja za vsakodnevno nameščanje pacientov v pravilen položaj pred obsevanjem in za preverjanje le-tega med obsevanjem. Pomembno vlogo ima tudi pri obsevanju raka želodca in danke, pri zagotavljanju kontrole kvalitete obsevanja. Namen: V diplomskem delu smo želeli ugotoviti, ali obstajajo razlike pri obsevanju raka danke in raka želodca. Zanimalo nas je, v kolikšni meri se razlikujejo povprečne vrednosti interfrakcijskih premikov, pridobljene s pomočjo sistema ExacTrac v prvih petih dnevih obsevanja, od povprečja interfrakcijskih premikov v zadnjih petih dnevih obsevanja pri teh dveh lokalizacijah. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela in sistematični pregled strokovne literature. V času izdelave smo se seznanili z vsemi postopki in načini, kako se pridobivajo podatki v sistemu ARIA na linearnem pospeševalniku Varian Clinac 2100C/D, Onkološkega inštituta v Ljubljani. Pridobili smo vrednosti interfrakcijskih premikov pri 20 pacientih, ki so imeli obsevanje zaradi raka želodca in pri 20 pacientih, ki so imeli obsevanje zaradi raka danke. Statistično analizo smo izvedli s pomočjo računalniškega programa Microsoft Office Excel 2016 in IBM SPSS Statistics 24. Rezultati: Iz dobljenih rezultatov in statistične analize povzamemo, da se interfrakcijski premiki pri obsevanju raka želodca in raka danke v primerjavi s številom obiskov obsevanj na obsevalnem aparatu pacientov v večini ne zmanjšujejo. Večina translacijskih in rotacijskih premikov je bila prvih 5 dni obsevanja manjša kot zadnjih 5 dni. Pri obeh področjih obsevanja, pri obsevanju želodca in pri obsevanju danke se večji ali manjši interfrakcijski premiki v zadnjih petih dnevih obsevanja v različnih oseh pojavljajo v približno enaki meri. Razprava in sklep: Sproščenost pacienta, znano okolje, dobra seznanjenost s postopkom obsevanja in vsakodnevni stik z radiološkimi inženirji zgolj v manjši meri vplivajo na zmanjševanje interfrakcijskih premikov. Sklepamo, da so večji premiki v zadnjih 5 obsevanjih posledica izgube telesne teže, spremembe anatomije ter naključnega odstopanja od izocentra.

• Language: Slovenian
• Keywords: ExacTrac sistem, interfrakcijski premiki, rak danke, rak želodca
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-102533
• COBISS.SI-ID: 5473387
• Publication date in RUL: 01.09.2018

Secondary language

• Language: English
• Title: ExacTrac system as factor of quality control in radiotherapy : diploma work

Abstract

Introduction: Radiotherapy is a branch of medicine, which treats malignant and non-malignant diseases. It is one of the main methods for treatment of gastric and rectal cancer. It is important that tumor receives the planned radiation dose while the surrounding tissue’s received radiation dose is as low as possible. The cause of the gastric and rectal cancer is still mostly unknown. ExacTrac system in radiation therapy is used for everyday patient setup before radiation and to check the position of the patient during the radiation. It also has an important role in the radiation of the gastric and rectal cancer, as well as in ensuring quality control. Purpose: In our research we want to figure out, if and to what extend the average values of interfraction shifts, acquired with the help of the ExacTrac system are different in the first five and in the last five days of radiation between gastric and rectal cancer patients. Methods: In our research we used descriptive method and systematic review of literature. In the time of the research we became more familiar with our procedures and ways of acquiring data in ARIA system on the linear accelerator Varian Clinac 2100C/D in the institute of oncology Ljubljana. We acquired values of interfraction shifts of 20 patients with gaster cancer and 20 patients with rectal cancer. We performed statistical analysis with the help of the Microsoft Office Excel 2016 and IBM SPSS Statistics 24. Results: From the obtained results and statistical analysis we conclude that the interfraction shifts in the radiation therapy of gastric cancer and rectal cancer are not decreasing in comparison with the number of radiation fractions. Most of the translational and rotational shifts were smaller in the first 5 days of the radiation therapy in comparison to the last 5 days. Larger or smaller interfraction shifts appeared in different axes when we compared interfraction shifts of the both irradiatied organs in the last 5 days of radiation therapy. Discussion and conclusion: We conclude that interfraction shifts are larger in the last 5 days of radiation therapy due to weight loss, changes in anatomy and random deviations from the isocentre. The patient`s relaxation, familiar environment, good knowledge, acquaintance of the radiation process and daily contact with radiographers are not as important as we thought in the relation to the interfraction shifts.

• Keywords: ExacTrac, interfraction shifts, cancer of rectum, gastric cancer