Progress in Medical Physics (한국의학물리학회지:의학물리)

Korean Society of Medical Physics (한국의학물리학회)
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Estimation of Secondary Scattered Dose from Intensity-modulated Radiotherapy for Liver Cancer Cases

간암환자에 대한 세기조절방사선치료에서의 2차 산란선량평가

  • Kim, Dong Wook (Department of Radiation Oncology, Kyung Hee University Hospital at Gandong) ;
  • Sung, Jiwon (Department of Bio-convergence Engineering, Korea University) ;
  • Lee, Hyunho (Department of Bio-convergence Engineering, Korea University) ;
  • Yoon, Myonggeun (Department of Bio-convergence Engineering, Korea University) ;
  • Chung, Weon Kuu (Department of Radiation Oncology, Kyung Hee University Hospital at Gandong) ;
  • Bae, Sun Hyun (Department of Radiation Oncology, Kyung Hee University Hospital at Gandong) ;
  • Shin, Dong Oh (Department of Radiation Oncology, Kyung Hee University Medical Center) ;
  • Chung, Kwangzoo (Department of Radiation Oncology, Samsung Medical Center) ;
  • Lim, Young Kyung (Proton Therapy Center, National Cancer Center) ;
  • Shin, Donho (Proton Therapy Center, National Cancer Center) ;
  • Lee, Se Byeong (Proton Therapy Center, National Cancer Center)
  • 김동욱 (강동경희대학교병원 방사선종양학과) ;
  • 성지원 (고려대학교 바이오융합공학과) ;
  • 이현호 (고려대학교 바이오융합공학과) ;
  • 윤명근 (고려대학교 바이오융합공학과) ;
  • 정원규 (강동경희대학교병원 방사선종양학과) ;
  • 배선현 (강동경희대학교병원 방사선종양학과) ;
  • 신동오 (경희대학교병원 방사선종양학과) ;
  • 정광주 (삼성의료원 방사선종양학과) ;
  • 임영경 (국립암센터 양성자치료센터) ;
  • 신동호 (국립암센터 양성자치료센터) ;
  • 이세병 (국립암센터 양성자치료센터)
  • Received : 2013.12.06
  • Accepted : 2013.12.16
  • Published : 2013.12.31
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Abstract

We estimated secondary scattered and leakage doses for intensity-modulated radiotherapy (IMRT), volumetric arc therapy (VMAT) and tomotherapy (TOMO) in patients with liver cancer. Five liver patients were planned by IMRT, VMAT and TOMO. Secondary scatter (and leakage) dose and organ equivalent doses (OEDs) are measured and estimated at various points 20 to 80 cm from the iso-center by using radiophotoluminescence glass dosimeter (RPLGD). The secondary dose per Gy from IMRT, VMAT and TOMO for liver cancer, measured 20 to 80 cm from the iso-center, are 0.01~3.13, 0.03~2.34 and 0.04~1.29 cGy, respectively. The mean values of relative OED of secondary dose of VMAT and TOMO for five patients, which is normalized by IMRT, measured as 75.24% and 50.92% for thyroid, 75.14% and 40.61% for bowel, 72.30% and 47.77% for rectum, 76.21% and 49.93% for prostate. The secondary dose and OED from TOMO is relatively low to those from IMRT and VMAT. OED based estimation suggests that the secondary cancer risk from TOMO is less than or comparable to the risks from conventional IMRT and VMAT.

간암 환자에 대한 세기조절방사선치료(IMRT, intensity modulated radiotherapy) 및 세기조절회전방사선치료(VMAT, volumetric arc therapy)와 나선식토모치료(TOMO, Helical Tomotherapy)에서 2차 암의 원인이 될 수 있는 산란 및 누출선량률을 평가하였다. 5명의 간암 환자에 대해 IMRT와 VMAT, TOMO 치료계획을 실시하여 등중심(iso-center)으로부터 20, 40, 60, 80 cm 위치에서 유리선량계(RPLGD, radiophotoluminescence glass dosimeter)를 이용하여 선량을 측정하였다. 계획표적체적(Planning Target Volume, PTV)에 조사된 단위 선량(Gy)당 측정된 산란 및 누출선량은 IMRT의 경우, 최소 0.01에서 최대 3.13 Gy로 측정 되었고 VMAT에 대해서는 최소 0.03에서 최대 2.35 Gy까지, TOMO에 대해서는 최소 0.04에서 최대 1.30 Gy 까지 측정 되었다. 각 치료법에 대한 평균장기등가선량은 세기조절방사선치료에 대해 세기조절회전방사선 치료와 나선식단층토모치료가 각각 갑상선에서 75%와 51%, 대장에서 75%와 41%, 직장에서 72%와 48%, 전립선에서 76%와 50%로 나왔다. 본 측정을 통하여 산란 및 누출선량은 치료 중심으로부터의 거리에 따라 감소함을 보았으며 TOMO 치료의 경우, 환자치료를 위해 사용하는 모니터단위(MU, monitor unit)가 타 치료법에 비해 상대적으로 큼에도 불구하고 산란 및 누출선량은 크지 않는 것으로 평가되었다.

Keywords

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