전립선암 방사선치료 시 광자극발광선량계를 이용한 광중성자선량 평가
Evaluation of Photoneutron Dose for Prostate Cancer Radiation Therapy by Using Optically Stimulated Luminescence Dosimeter (OSLD)
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초록
본 연구는 전립선암의 방사선치료에 적용되는 치료기법별 세기조절방사선치료의 적절한 조사문수의 선택 및 광중성자 피폭을 고려한 방사선 치료계획 수립을 위한 기초자료를 제공하고자 하였다. 연구대상은 2013년 9월부터 2014년 1월까지 5개월 동안 전립선암으로 방사선치료를 받은 환자 10명을 대상으로 하였다. 그리고 3-dimensional conformal radiotherapy (3D-CRT), volumetric-modulated arc radiotherapy (VMAT), intensity modulated radiation therapy (IMRT) 5, 7, 9 조사문으로 각각 치료계획을 수립하였다. 기술통계와 분산분석으로 광중성자선량의 평균적 차이를 비교하였으며, 상관관계분석과 회귀분석으로 상관성 및 영향을 분석하였다. 연구 결과, 치료기법별로는 3D-CRT가 가장 낮았다. 또한 IMRT가 가장 높게 측정되었으며, 통계적으로 매우 유의하였다 (p<.01). 세기조절방사선치료 조사문수별 광중성자선량은 평균 4.37 ± 1.08 mSv였으며, 조사문수 간에 통계적으로 매우 유의한 차이를 보였다(p<.01). 그리고 조사문수와 광중성자선량은 상관계수가 0.570으로 나타나 통계적으로 매우 유의한 양의 상관관계를 보였다 (p<.01). 조사문수와 광중성자선량의 선형회귀분석 결과, 조사문수가 1단계 증가할 때마다 평균적으로 광중성자선량이 0.373배로 유의하게 증가하였다. 결론적으로 전립선암의 방사선치료에 빈번히 사용하고 있는 IMRT의 조사문수의 선택 및 광중성자 피폭선량 및 방사선 치료계획의 질적 수준 평가를 고려한 적절한 치료계획 선택에 있어 기초자료로 활용될 수 있으리라 기대된다.
Abstract
This study is to provide basic information regarding photoneutron doses in terms of radiation treatment techniques and the number of portals in intensity-modulated radiation therapy (IMRT) by measuring the photoneutron doses. Subjects of experiment were 10 patients who were diagnosed with prostate cancer and have received radiation treatment for 5 months from September 2013 to January 2014 in the department of radiation oncology in S hospital located in Seoul. Thus, radiation treatment plans were created for 3-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric-Modulated Arc Radiotherapy (VMAT), IMRT 5, 7, and 9 portals. The average difference of photoneutron dose was compared through descriptive statistics and variance analysis, and analyzed influence factors through correlation analysis and regression analysis. In summarized results, 3D-CRT showed the lowest average photoneutron dose, while IMRT caused the highest dose with statistically significance (p <.01). The photoneutron dose by number of portals of IMRT was 4.37 ± 1.08 mSv in average and statistically showed very significant difference among the number of portals (p <.01). Number of portals and photoneutron dose are shown that the correlation coefficient is 0.570, highly statistically significant positive correlation (p <.01). As a result of the linear regression analysis of number of portals and photoneutron dose, it showed that photoneutron dose significantly increased by 0.373 times in average as the number of portals increased by 1 stage. In conclusion, this study can be expected to be used as a quantitative basic data to select an appropriate IMRT plans regarding photoneutron dose in radiation treatment for prostate cancer.
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