Pomen površinsko vodene radioterapije pri obsevanju bolnikov z rakom danke : magistrsko delo

Boshkovski, Petar (author), Danevska, Mila (author), Žager Marciuš, Valerija (mentor), Salmič, Klemen (comentor), Oblak, Irena (reviewer)

Uvod: Rak danke sodi med najpogostejše oblike raka, pri kateri je zaradi anatomskih značilnosti in bližine kritičnih organov ključno natančno pozicioniranje bolnika med obsevanjem. Uporaba naprednih tehnologij, kot je površinsko vodena radioterapija, omogoča zmanjšanje potrebe po ponovnem nastavljanju bolnika v ustrezen obsevalni položaj. Namen: Namen magistrskega dela je bil ovrednotiti vpliv uporabe sistemov za površinsko vodeno radioterapijo na natančnost translacijskih premikov bolnikov z rakom danke ter število dodatnih slikovnih verifikacij z računalniško tomografijo s konusnim snopom pri obsevanju bolnikov z linearnima pospeševalnikoma Varian TrueBeam in Varian Halcyon. Cilj je bil preveriti, ali uporaba teh sistemov prispeva k manjšim premikom in s tem k izboljšanju radioterapevtskega zdravljenja. Metode dela: Uporabili smo retrospektivno raziskavo z opisno metodo dela. Analizirali smo podatke 100 bolnikov z rakom danke, obsevanih na Onkološkem inštitutu Ljubljana med aprilom 2019 in aprilom 2025. Primerjali smo velikost translacijskih premikov v lateralni, longitudinalni in vertikalni smeri. Prav tako smo primerjali število dodatnih slikovnih verifikacij z računalniško tomografijo s konusnim snopom pri 50 bolnikih, obsevanih z uporabo površinsko vodene radioterapije na linearnem pospeševalniku Varian TrueBeam, ter pri 50 bolnikih, obsevanih na linearnem pospeševalniku Varian Halcyon brez uporabe tega sistema. Rezultati: Iz dobljenih rezultatov smo ugotovili, da so bili translacijski premiki pri bolnikih, obsevanih na linearnem pospeševalniku TrueBeam z uporabo površinsko vodene radioterapije, manjši v vseh smereh v primerjavi z bolniki obsevanimi na linearnem pospeševalniku Halcyon. Poleg tega je bilo pri skupini TrueBeam izvedenih manj dodatnih slikovnih verifikacij z računalniško tomografijo s konusnim snopom, kar kaže na večjo natančnost pri nastavitvi bolnika v ustrezen obsevalni položaj. Razprava in zaključek: Ugotovitve raziskave potrjujejo, da uporaba sistemov za površinsko vodeno radioterapijo pomembno prispeva k izboljšanju celotnega procesa nastavitve bolnika v položaj za obsevanje. Uporaba sistemov za površinsko vodeno radioterapijo je zato smiselna tudi pri linearnem pospeševalniku Varian Halcyon, saj bi dodatno izboljšala kakovost radioterapevtskih postopkov pri bolnikih z rakom danke.

• Language: Slovenian
• Keywords: magistrska dela, radiološka tehnologija, površinsko vodena radioterapija, rak danke, položaj bolnika, Varian TrueBeam, Varian Halcyon
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [P. Boshkovski : M. Danevska]
• Year: 2025
• Number of pages: 62 str., [3] str. pril.
• PID: 20.500.12556/RUL-177182
• UDC: 616-07
• COBISS.SI-ID: 261876483
• Publication date in RUL: 17.12.2025

Secondary language

• Language: English
• Title: The role of surface-guided radiotherapy in the radiation treatment of patients with rectal cancer : master thesis

Abstract

Introduction: Rectal cancer is among the most common forms of cancer. Due to anatomical characteristics and the proximity of critical organs, precise patient positioning during irradiation is essential. The use of advanced technologies, such as surface-guided radiotherapy, helps minimise the need for repeated patient repositioning into the correct treatment position. Purpose: The aim of this master’s thesis was to evaluate the impact of surface-guided radiotherapy systems on the accuracy of translational shifts in patients with rectal cancer and on the number of additional cone-beam computed tomography verifications during irradiation of patients with the Varian TrueBeam and Varian Halcyon linear accelerators. The objective was to determine whether the use of these systems reduces patient movement and consequently improves the overall quality of radiotherapy treatment. Methods: A retrospective study with a descriptive research method was conducted. Data from 100 patients with rectal cancer, irradiated at the Institute of Oncology Ljubljana between April 2019 and April 2025, were analysed. The magnitude of translational shifts in the lateral, longitudinal, and vertical directions was compared. Additionally, the number of additional cone-beam computed tomography verifications was compared between 50 patients treated with surface-guided radiotherapy on the Varian TrueBeam linear accelerator and 50 patients treated on the Varian Halcyon linear accelerator without these systems. Results: The results showed that translational shifts in patients treated on the TrueBeam linear accelerator with surface-guided radiotherapy were smaller in all directions compared with patients treated on the Halcyon linear accelerator. In addition, fewer additional cone beam computed tomography verifications were required in the TrueBeam group, indicating more accurate patient positioning during radiotherapy. Discussion and Conclusion: The findings confirm that surface-guided radiotherapy systems significantly improve the patient positioning process prior to irradiation. The use of surface-guided radiotherapy systems is therefore also recommended for Varian Halcyon linear accelerators, as this would further enhance the quality of radiotherapy procedures in patients with rectal cancer.

• Keywords: master's theses, radiologic technology, surface-guided radiotherapy, rectal cancer, patient positioning, Varian TrueBeam, Varian Halcyon