Abstract
The article is devoted to the quality control of the radiation therapy in uterine cancer patients. The treatment of such patients includes surgery and postoperative course of radiation therapy. The purpose of adjuvant course of radiation therapy is to damage the subclinical tumor foci. During the radiation therapy, it is impossible to avoid the radiation overload on the adjacent organs. The search and utilization of methods that quantify the dose overload on critical organs — rectal mucosa, during the adjuvant course of radiation therapy are highly relevant, especially in comparison to the estimated radiation therapy planning data. In our study the postoperative course of radiotherapy was performed in 110 uterine cancer patients stage I–II by the cobalt machine (60Co) ROCUS-AM or linear accelerator Clinac-600C. In vivo dosimetry was performed in order to evaluate the variation of the actual dose overload after the first irradiation session and in the middle of the adjuvant course (after achieving the dose level of 20 Gy). While performing radiation therapy by ROCUS-AM (60Co) during the first measurement, the single absorbed dose to the rectal mucosa in all 50 (100 %) patients was less than planned, and the range of the single absorbed dose was from 1.69 Gy (min) to 1.89 Gy (max), which was fixed as the deviation from the planned dose from ‒15.26 to ‒5.50 %, and the median of the relative deviation from the planned dose was ‒12.76 %. While conducting the radiation therapy by the Clinac-600C, the range of the single absorbed dose at the first session was 1.56‒2.19 Gy (min-max), which have made the deviation from the planned dose from ‒21.5 to 9.66 %, and the median relative deviation from the planned dose was ‒0.88 %. Thus, in vivo dosimetry data indicates on significant differences between the planned and measured absorbed doses to the rectal mucosa. The presence of intra- and interindividual variability of in vivo dosimetry results during the radiation treatment showed the necessity of development of new approaches to the topometric preparation of uterine cancer patients, who are scheduled for the postoperative course of radiation therapy
Highlights
The article is devoted to the quality control of the radiation therapy in uterine cancer patients
While performing radiation therapy by ROCUS-AM (60Co) during the first measurement, the single absorbed dose to the rectal mucosa in all 50 (100 %) patients was less than planned, and the range of the single absorbed dose was from 1.69 Gy to 1.89 Gy, which was fixed as the deviation from the planned dose from ‒15.26 to ‒5.50 %, and the median of the relative deviation from the planned dose was ‒12.76 %
Использование дозиметрии in vivo при проведении дистанционной лучевой терапии пациенткам с местнораспространенным раком шейки матки
Summary
Актуальним є пошук та застосування методів, які здійснюють кількісну реєстрацію дозового навантаження на критичні органи, а саме слизову прямої кишки при післяопераційному опроміненні хворих на рак тіла матки, у порівняльному аспекті із розрахунковими показниками планування променевої терапії. У дослідженні післяопераційний курс променевої терапії проведено 110 хворим на рак тіла матки I–II стадії із використанням лінійного прискорювача Clinac‐600C або апарата РОКУС-АМ (60Co). Наявність інтра- та міжіндивідуальної варіабельності результатів дозиметрії in vivo в ході променевого лікування показала необхідність розробки нових підходів до топометричної підготовки хворих на рак тіла матки, яким заплановано післяопераційний курс дистанційної променевої терапії. Мета дослідження ‒ порівняти індивідуальне дозове навантаження на слизову прямої кишки при опроміненні хворих на рак тіла матки за даними дозиметрії in vivo і розрахунковими показниками, які отримано при плануванні променевої терапії
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