Intrafrakcijski premiki pri stereotaktičnem obsevanju pljuč : diplomsko delo

Kopinšek, Luka (author), Perčič, Dejan (author), Turk, Žan (author), Žager Marciuš, Valerija (mentor), Marolt Bukovac, Jerneja (co-mentor)

Uvod: Ena izmed novejših in učinkovitejših tehnik obsevanja je stereotaktično obsevanje telesa. Tovrstno obsevanje je visoko natančna tehnika zunanjega obsevanja tarče izven lobanje, kjer uporabljamo 1 do 8 frakcij in visoke doze na posamezno frakcijo obsevanja. Namen: Namen diplomskega dela je ugotoviti, kakšni intrafrakcijski premiki nastanejo v anterio-posteriorni smeri, superio-inferiorni smeri in medio-lateralni smeri med planiranim tarčnim volumnom v primerjavi z dejanskim obsevanim volumnom pred obsevanjem in po končani dnevni frakciji obsevanja pri stereotaktičnem obsevanju pljučnega raka. Metode dela: Izvedli smo presečno retrospektivno raziskavo. Podatke smo zbirali na Onkološkem inštitutu v Ljubljani na oddelku za radioterapijo na obsevalnem aparatu (Varian - Novalis Tx). Podatki so zajeti od začetka maja 2016 do konca novembra 2017. V raziskavo je bilo vključenih 25 pacientov, od tega 16 moških in 9 žensk. Za statistično analizo smo uporabili Microsoft Office Excel 2013 in IBM SPSS Statistics 24. Rezultati: Povprečni premiki pred stereotaktičnim obsevanjem pljuč so v antero-posteriorni smeri bili 0,38 cm, v superio-inferiorni smeri 0,33 cm in v medio-lateralni smeri 0,24 cm. Skupno povprečje premikov je po obsevanju v AP smeri znašalo 0,12 cm, v SI smeri 0,14 cm in 0,11 cm v ML smeri. Razprava: Ob pregledu rezultatov smo ugotovili, da je največji povprečni premik pred obsevanjem v smeri AP, najmanjši povprečni premik pa v ML smeri. Po obsevanju je bil največji povprečni premik v SI smeri, najmanjši povprečni premik pa v ML smeri. Ugotovili smo, da so premiki pred obsevanjem višji od tistih po obsevanju. Zaključek: Z ustrezno geometrično verifikacijo lahko potrdimo, da so verifikacijski postopki za kvaliteto obsevanja nujno potrebni, saj nam omogočajo najmanjše možno odstopanje od načrtovanega volumna za obsevanje.

• Language: Slovenian
• Keywords: pljučni rak, stereotaktično obsevanje pljuč, intrafrakcijski premiki
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-106272
• COBISS.SI-ID: 5623147
• Publication date in RUL: 19.02.2019

Secondary language

• Language: English
• Title: Intra-fraction movement in lung stereotactic radiation therapy : diploma work

Abstract

Introduction: One of the more recent and effective irradiation techniques is stereotactic body radiotherapy. Such irradiation is a highly accurate technique of external target irradiation outside the skull, where 1 to 8 fractions and high doses per individual irradiation fraction are used. Purpose: The purpose of the diploma work is to determine which intra-fraction movements appear in the anterior-posterior direction, the super-inferior direction and the medio-lateral direction between the planned target volume compared to the actual irradiated volume before the irradiation and after the completed daily fraction of irradiation in the stereotactic irradiation of lung cancer. Methods: We performed a cross-sectional retrospective study. Data were collected at the Oncology Institute in Ljubljana at the radiotherapy department of the irradiation machine (Varian - Novalis Tx). The data were collected from the beginning of May 2016 to the end of November 2017. The study included 25 patients, of which 16 were men and 9 women. For statistical analysis, we used Microsoft Office Excel 2013 and IBM SPSS Statistics 24. Results: The average movement from stereotactic irradiation of the lungs was 0,38 cm in the antero-posterior direction, in the superio-inferior direction 0,33 cm and in the medial-lateral direction 0,24 cm. After the irradiation in the AP plane, the total movement average was 0,12 cm, in the SI plane 0,14 cm and 0,11 cm in the ML direction. Discussion: When examining the results, we found that the maximum average movement before the radiation was in the AP direction, and the smallest average movement was in the ML direction. After irradiation, the largest average movement was in the SI direction and the smallest average movement in the ML direction. We found that movements before irradiation are larger than those after irradiation. Conclusion: By appropriate geometric verification we can confirm that verification procedures for the quality of irradiation are indispensable, because they allow us to minimize the possible deviation from the planned irradiation volume.

• Keywords: lung cancer, stereotactic lung irradiation, intra-fraction movements