| 葛宁,韩栋梁,易峰涛,辜石勇,陈福慈,王志斌.体部伽玛刀非治疗部位敏感器官放射防护的意义[J].中华放射医学与防护杂志,2016,36(6):456-460 |
| 体部伽玛刀非治疗部位敏感器官放射防护的意义 |
| Significance of radiological protection of sensitive organs in non-treated region in body γ-knife treatment |
| 投稿时间：2016-01-21 |
| DOI：10.3760/cma.j.issn.0254-5098.2016.06.012 |
| 中文关键词: 体部伽玛刀 铅屏蔽 敏感器官 放射防护 |
| 英文关键词:Body γ-knife Lead shielding Sensitive organs Radiation protection |
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| 中文摘要: |
| 目的 研究体部伽玛刀非治疗区域屏蔽前后敏感器官辐射剂量及影响因素。方法 选取实体肿瘤最大径<5 cm的20例患者。将刻度之后的热释光片置于患者非治疗敏感部位(眼晶状体、甲状腺及性腺)。测量敏感器官屏蔽前接受的辐射剂量。针对肺部及肾上腺肿瘤患者使用不同大小准直器制定治疗计划,利用水模体测量辐射剂量大小。选取肺部肿瘤患者治疗计划,覆盖1、2及4 cm铅挡块后,测量水模体上相应敏感器官位置处受照剂量的变化值。结果 实际患者治疗完成后,眼晶状体最大剂量为1023.3 mGy,甲状腺最大剂量为1235.7 mGy,性腺最大剂量为1176.8 mGy;且左侧敏感器官辐射剂量比右侧敏感器官高。利用水模体测量同一病例靶点数越多,敏感器官所受辐射剂量越大。覆盖1、2及4 cm铅挡块后,敏感器官受照剂量减少55%~91%,屏蔽前后辐射剂量差异有统计学意义(t=14.4、12.9、13.3,P<0.05)。结论 体部伽玛刀治疗过程中由于附加效应影响会增加敏感器官辐射剂量,对处于成长发育的青少年及有生育需要的成年人患者应附加铅挡块进行屏蔽保护。临床试验注册号 中国临床试验注册中心,ChiCTR-OOC-16008259。 |
| 英文摘要: |
| Objective To explore the radiation dose from body γ-knife treatment to the non-targeted region's sensitive organs before and after shielding. Methods 20 patients suffering tumors less than 5 cm were selected. Calibrated thermoluminescence dosimeters (TLD) were placed above the sensitive organs, such as lens, thyroid gland and sexual gland, to measure the radiation dose received before shielding. Different plans were prepared for the patients with lung and renicapsule tumors using calibrators of different size. Radiation dose was measured by the aid of water phantom. For selected lung-tumor treatment plan, the radiation doses were measured at the same location on the water phantom shielded with and without 1, 2 and 4 cm lead, respectively. Results The maximum doses were 1 023.3 mGy for lens, 1 235.7 mGy for thyroid gland and 1 176.8 mGy for sexual glands after treatment, respectively, being higher on the left site than the right. The radiation doses to the sensitive organs were higher for the water phatom with more tartgted points, decreasing by 55%-91% after being covered with 1, 2 and 4 cm lead shieldings. There were significant differences in doses received before and after lead shielding (t=14.4, 12.9, 13.3, P<0.05). Conclusions In the course of body γ-knife treatment, the additional factors would increase the dose to the sensitive organs. Therefore, it is necessary to provide lead shielding protection to the teenagers and adults with fertility when they undergo body γ-knife treatment. Trial registration Chinese Clinical Trial Registry, ChiCTR-OOC-16008259. |
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