Vloga konvencionalnega simulatorja pri korekciji položaja bolnika pred obsevanjem : diplomsko delo

Zarnik, Nejc (author), Jug, Tadej (author), Žager Marciuš, Valerija (mentor), Selak, Boštjan (co-mentor)

Uvod: Radioterapija je ena izmed metod zdravljenja otorinolaringološkega raka. Za tako vrsto zdravljenja, je značilna priprava na obsevanje na računalniško tomografskem simulatorju in konvencionalnem simulatorju. Zaradi potrebe po veliki natančnosti obsevanja se ob pripravi na simulatorju ter na obsevalnem aparatu izvajajo meritve odstopanja od izocentra in premiki le tega v X, Y in Z oseh. Namen: Z raziskavo smo želeli ugotoviti ali s korekcijo izocentra po končani drugi pripravi bolnika z rakom otorinolaringološkega področja na konvencionalnem simulatorju, zmanjšamo morebitno nedopustno in sistematično napako pri obsevanju pacienta na linearnem pospeševalniku. Metode dela: Raziskavo smo izvedli na Onkološkem Inštitutu v Ljubljani na oddelku za teleradioterapijo, na konvecionalnem simulatorju. V raziskavo smo zajeli dve skupini bolnikov: bolniki s korekcijo izocentra ter bolniki brez korekcije izocentra na simulatorju. V vsako skupino smo vključili 20 bolnikov. Pridobili smo podatke o portalnih slikanjih na obsevalnih aparatih, da smo lahko med seboj primerjali odstopanja od izocentra. Primerjali smo sistematične in nedopustne napake pri obeh skupinah bolnikov. Rezultati: Rezultati so pokazali, da se je pri bolnikih pri katerih nismo izvajali korekcije izocentra sistematična napaka pojavila pri sedmih bolnikih, pri enem se je pojavila nedopustna napaka. Pri bolnikih kjer smo izvajali korekcijo izocentra na konvencionalnem simulatorju, smo sistematično napako zaznali pri treh bolnikih, nedopustne napake pa ni bilo. Razprava in zaključek: Z raziskavo smo ugotovili, da pri skupini bolnikov, pri katerih smo opravili korekcijo planirnega izocentra zmanjšamo sistematično in nedopustno napako. Pri meritvah odstopanja planirnega izocentra si pomagamo z diaskopijo. S pomočjo diaskopije, bi lahko korekcijo planirnega izocentra na konvencionalnem simulatorju izvajali tudi za druge anatomske lokalizacije raka. Za potrditev tega bi bile potrebne še dodatne raziskave.

• Language: Slovenian
• Keywords: obsevanje, rak ORL področja, konvencionalni simulator, korekcija izocentra, diaskopija, verifikacija
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-95557
• COBISS.SI-ID: 5340267
• Publication date in RUL: 20.09.2017

Secondary language

• Language: English
• Title: Role of conventional simulator for correction of patient position before irradiation treatment

Abstract

Introduction: Radiotheraphy is one of the medical treatment of the otorhinolaryngologic cancer. For this kind of treatment the preparation for irradiation is based on computed tomography simulator and conventional simulator. Due to the need of high precision when irradiating there are carrying out measurements of variations from isocentre and its the movements in X, Y and Z axle. They are carrying out on simulator and on irradiation machine. Purpose: With this research we wanted to find out if it is possible to reduce intolerable and systematic mistake when irradiating the patient on a linear accelerator with correction of the isocentre after finished second preparation of the patient with otorhinolaryngologic cancer on conventional simulator. Methods: The research took place on the Institute of the Oncology in Ljubljana on department for teleradiotherapy, on conventional simulator. We included two types of patients in research: patients with corrections of isocentre and patients without correction of isocentre on simulator. In each group we included 20 patients. We managed to get the results of the scans of the observing machines so that we could compare the variations from isocentre. We compared the intolerable and systematic mistakes with both groups. Results: The results have shown that systematic mistake with patients which didn’t receive correction of isocentreappeared by 7 patients and by 1 there were intolerable mistake. With patients that received correction of isocentre there appeared 3 systematic mistakes and none intolerable. Discussion and conclusion: With this research we figured out that we can reduce systematic and intolerable mistake by correction of isocentre. When measuring variations of isocentre we can help with fluoroscopy. With fluoroscopy we could carry out the correction of planed isocentreon conventional simulator also with others anatomical localizations of a cancer. To verity that there would be necessary to make additional researches.

• Keywords: irradiation, cancer of ORL field, conventional simulator, correction of isocentre, fluoroscopy, verification